climbermedic

Upon rereading your original post, I realized that I misunderstood a bit. I have no firsthand experience with Philly but I work with a few former Philly medics. The overriding factor in Philly seems to be call volume. I've heard that 20+ calls a shift is not uncommon. I think that type of volume is, no doubt, a recipe for burnout and I can see how it might influence patient care. I recently heard about a study that showed Philly's call volume far exceeds burnout levels. I guess until I've been exposed to that type of environment (as you obviously already have) you can't possibly make a judgement. I like being able to stabilize a patient on scene or enroute. I have had several patients that have presented stable and changed condition enroute. I guess that has much to do with being a new medic with a still developing sense of clinical judgement. Good luck to you in your new endevor.

I work in a suburb of Philly as well (who knows, possibly the same system as you) and I find that pt treatment on scene vs. enroute vs. transport only tends to depend on a lot of factors. Pt condition, scene factors, partner, etc. I will say that this particular system can be pretty high volume at times and covering your own local is a high priority. It's your patient, your treatment/interventions and your chart, treat your patients as you see fit, and if that's a problem for your partner/mentor then it's their patient.

I guess most employers provide the training. Some do require that you have it though. Guess that'll help narrow the selection a bit...

Hi Folks! I'm curious how many of you took, are taking, or are teaching courses at the EMTB-P level that include EVOC. I recently completed a Paramedic Degree program that did not include EVOC. However, I am finding that some (very few, actually) employers require it as a prerequisite for employment. Seems like a relatively short and easy component to squeeze into courses that last a year or longer like most degree level Paramedic training. Weigh in!!!

Can anyone tell me the process or why increased PaCO2 causes pulmonary vasoconstriction? This would be in the instance of COPD causing cor pulmonale and right sided heart failure... Thanks :? In brain injuries increased PaCO2 causes vasodilation correct?

Hi Folks! I'm in my 2nd semester of Medic school up here on the beautiful Kenai Peninsula in Alaska. This is actually my 2nd semester of core Paramedicine, I have been knocking out GER's for a couple of semesters on a part-time status. We are currently in the middle of studying Medical Emergencies and I recently got my butt kicked by Cardiology. There are a couple of unique challenges facing the P-med student in rural AK: 1) The local hospital does their best to help with clinical time, but doesn't have super high volume so we travel 3 hours to Anchorage 2-3 times per month for clinicals 2) To complete an internship, we travel to the "lower 48" and spend around 6 weeks riding full time with a service that agrees to precept us in exchange for free labor 3) It's gorgeous here, and I have to try extra hard to buckle down and study instead of going hiking, climbing, fishing, hunting, mtn biking, snowboarding, etc. I am definitely enjoying P-med school and Alaska. While there are always things a student might change about their program, instructors, classmates, etc., I feel that this has been an overall positive experience so far and I have actually come to enjoy the challenges and uniqueness of this program. If there are any folks out there that have opinions, or advice regarding making it through school I always welcome them. I am especially interested in hearing from other medics in rural areas that have had to travel for their internships.