Ridryder 911

The nice thing about EMS forums is to find about diversity. What a lot of people find out is that ALS is not always available and the difference in operations. To blame the dispatch and physician is not a likely story at some places. Chances if you blame or criticized a physician on how an ambulance was dispatched the EMT might be finding another job. Believe it or not, most places this would not be be an ALS call (diffused abd pain, treated with analgesics). Especially for a 2 mile transport, stable patient. Personally, I don't even see the necessity of an EMS unit, unless it was because she had been given medication and IV's. From just the picture that was painted, a 33 year old with umbilicus pain, no rebound pain, and had hx of shivering, and sinking feeling after receiving Demerol and Phenergran.... is really pretty normal with about >90 % of gastroenteritis. Although, it could be a ton of problems from appy to ovarian cyst... Sounds like the Doc wanted to get a more in-depth study he was not able to provide and have the ER physician rule things out. The patient appeared to be stable .. a pulse of 150 is really not that big a deal when you are in pain. (By the way a rate of 154 should not be labeled S.T.) The pressure was maintained... oxygen, shock position ( trenlenburg ? I am supposing ?) hmm that sounds like increasing pain on abdominal wall as well as it proven it really does no good either. I am asking why the suspicion of shock?... other than a slightly elevated pulse. What was indicating to you this patient was going to crash.. or was there such? From the picture you painted, it sounds like a simple transport made into a big event. EMT's should be able to handle medical calls, and transport appropitately. Yes, error on the side of the patient when you are clueless..... R/R 911

We hope !...LOL R/R 911

this is the typical response from most Paramedic students. As my professor describes.. " We are not doing our job, if you don't feel like we are force feeding you through a NG tube to your brain".. basically, it a lot of information to absorb in a short amount of time. If I don't see this 2 things has occurred... the person has already been medically trained or the class is lacking in giving enough information to their students. I suggest, you talk to your instructor on the problem again... maybe a tutor (upper level Paramedic students love to teach what they have just learned) or "study groups" can really increase your study time and help describe things you might have missed. Pre-studying and outlining with some good quality study time... Working in the field is nice and yes helps with clinical objectives, but is NOT essential, so don't beat yourself up on that. I wish you the best of luck, R/R 911

I agree that I don't see the need for emergency traffic. The pulse rate is not that high (pain will elevate) and 33 of high risk of ?.. 2 miles with no traffic a whopping 3 or 4 minutes transport time if you drove nice and smooth (in which abdominal pain patients need), and like Dust describes you saved a 30 to 40 seconds.. that long to open the doors. As far as ALS .. why ? Your 2 miles out.. what are they going to do in 3 minutes.. pain meds.. hmm ...nope, she already had analgesics and anti emetic. So why call for ALS? Again, I believe we are seeing more and more people not knowing how to treat patients. ALS is great and should be used appropriately, but this was a simple hospital transfer from point A to point B. R/R 911

C'mon Asysin2leads really tell us how you feel ?.. R/R 911

WTF ?... How upsetting and to allow even 10 seconds of idiot behavior.. this is why I am so against non-professional services! What is worst is they would had all charged in the set... without initial knock down. As well as as having a hot set for demonstration ?.. geez... Thanks for the video .. I will share with other Fire Service Instructors.. nothing like seeing idiots in action, hopefully someone else can learn off others mistakes. R/R 911

PEA syndrome is more a short circuit. Formerly known as electrical mechanical disassociation, it more where the electrical firing does not cause conduction in the muscle myocardial fibers. It can be caused by many factors, such as describes as well as hypovolemia, pericardial tamponade, electrolyte imbalances, etc... Be safe, R/R 911

As Dust describes, most colleges are usually cheaper than techinical schools. Until we actually start having EMT's educated, there is nothing they should complain of. Be safe. R/R 911

Sorry about your experience... but please remember you are just one of the few hundred they may see this semester. Although, I personally do like students many do not.. & with good reason(s). You have the right attitude, and keep being positive, you will make more an impression that way. Students come & go... I work in a rural ER & we still see about 150 EMT type students a semester, so don't get discouraged from the attitudes. In medicine you have to have initiative, you will find that most staff is too busy, and really is you & your institutions responsibility to be aggressive in obtaining your clinical objectives. Time to grow thick skin and determination. Be safe, R/R 911

There are several posts in regards to this topic, you might do a search. Yes, there are several assaults in this field and it is pretty routine. I suggest to check DT4EMS web site, he is a Paramedic that teaches protective defense. Using self defense against a patient (especially known psychiatric) can be a felony. Use protective measures as well and caution. this is a very dangerous job and career, and one needs to be aware of that. R/R 911

Awww. old man Johnson died.?..... maybe that is why I haven't seen him in a while ...lol R/R 911

So how do you leave your completed chart to the transfering facility, after arriving? I will not sign accepted patient form until I have FULL completed documentation form or narrative. I also question that most institutions have a time limit of charting as well as security (HIPPA) on charting as well. Just wondering....? R/R 911

I come from a moderate metro/rural area. We are usually busy, we work 24 hr. Mainly check your unit, wash & clean the truck, base, then sleep as much as you can... you will need it. We have separate sleep rooms at all of stations (3'rd party EMS) with a day room and t.v in each sleep room and bay room.. mainly relax as much as possible, read, video games, movies etc...Our crew goes to the health club, and covers areas so everyone can go "work-out'.. It relieves the stress. Murphy's law- sleep time =1/4 of call volume. There may be days in some areas you never stop... and then there may be days it's a long shift with nothing. I have learned to take advantage of that. If you do go very rural, because you are slow in call volume, has been studied to have a just high stress level as busy large metro areas. Down time .."waiting for the big one".. knowing you have to be prepared for anything... and usually your resources are limited as well. Good luck, R/R 911

You need to ask yourself how much commitment and also do some investigation. Of course I endorse accredited programs, but there are also very good programs that are not as well, but you need to ask some questions. It takes a program about 3 years to become accredited, mainly paper work, staffing, budget etc.. So there may be a several in this mode. I would ask: What is my long term goals? Is the programs worth the pay off ? In other words, spending less now, but pay me later. If you are going to a trade school, then come out with only a certificate how much money did you save and what did you save ? Look at the educational level it is taught? Are the instructors seasoned instructors ? Do they have upper level education and experience ?... I would not suggest Paramedic instructors < than 12 years field experience. As well, what type of clinical background do they possess? Clinical sites, are there plenty of true clinical sites ? Does the school have clinical professors to help you obtain your objectives and work with the staff?.. (these are not preceptors, but instructors from the school itself) What specialty areas will you be able to go through and what skill levels will you be able to obtain ? For instance, intubation.. I would not attend any program that does NOT have live intubation clinicals.... any program that does provide students with intubation rotations is substandard. Intubation should not be performed the 1'st time in the field setting. The same with IV's, thoracic and cardiac care and pediatric rotations. More exposure, more working knowledge. How much additional education is required? Doe the class have a separate anatomy and separate physiology ?.. If you don't know the parts and how they work ... you can't fix them! What is their employment success.. does local companies hire them & if so are they promoted rapidly and stay in the field > 2years? What is their pass rate on state & Nat'l exam ?...If you can't pass the cert or license, you can't practice .. simple enough What is their pass rate on the class.. I would be suspicious on a high pass rate... Again, the decision is not easy.... I am quite aware, that financial decision come into play, but really check into the programs and compare with time, end results in comparison of goal and outcome. Good luck, R/R 911

I agree with others as ParamedicMike stated confront one on one. I would be careful on how I would confront this person and use words appropriately and widely. If you do not receive adequate answers I would go through the official chain. Make notations of specific incidences with date and times. Attitudes can be worked upon, and hopefully they will change. If not then action should be taken. good luck, R/R 911

You made a good salary at what price... how much did that come out to an hour ? It is a shame that an EMS would even allow one to work so many hours. This profession needs to educate itself out of poverty! Be safe, R.R 911

My point there should not be an opinion that you are to good to perform care to a patient.... If you are there only for the heroic treatments, you should choose another line of work. Patient care is patient care... funny the profession considered with the least education actually thinks they are better than others... how ironic. Be safe. R/R 911

Wow... How many cases have we seen that people have actually "awakened" after periods of coma. What is the hurry ?. Is it financial reason for the hospital, is it they think what is best ? Scary, that we are going to allow "so called experts" to decide when it is time to let go. It has been just a month.... kinda fast to make such decisions. True, it will probably have a tragic outcome medically, yet what an arrogant anus attitude of a physician statement ""We don't treat dead patients, so there is no further care. If he is dead, I don't continue caring for him." Hopefully, he will never find himself in a tragic situation. Sounds like the vultures are circling, what the residents have had enough of practicing skills, or running test or did his HMO run out ? It does appear the physician needs a dose of compassion and humanity, and maybe start addressing the families needs of grieving and maybe turn to counseling planning of termination of care should be their emphasis. Be safe, R/R 911

I do understand, and nor I do not like it .. but, that is part of the job. Just like handling brain matter sometimes in ours profession I always find it interesting that medics makes the determination of what is "cool" and "not "... It is okay to clean up or pick up body parts, bandage together parts of brains, intestines, place tubes into snotty ..mucus .. puke areas, but have horrible thoughts to place a catheter in a patient that requires a long distance transfer or strict I & O. The same is true for B.M.... I too know medics that have allowed patients to lay in their own waste. This kinda look picky on what WE consider what is good for the patient or is it good for us to take care of ? I find it very poor that medics think of themselves so highly, that they would not perform cleansing of a patient on a long distance transfer.What makes "us" so special not to provide basic humanity needs ?.. If it is not dramatic or life threatening it is not important ? Maybe, we should evaluate ourselves... nurses are ranked number one on whom the public trust & consider the most ethical. This is over even clergy, Fire, Police etc.... http://www.prnewswire.com/cgi-bin/stories....28059&EDATE Be safe, R/R 911

I am wondering what the difference would be from this type of company and one like Paramedic Plus that employs the EMS personnel at EMSA in OKC & Tulsa. I believe they are owned from a hospital in Texas and provides the employment to several large EMS in the nation ?... Something to explore..... Be safe, R/R 911

Here in the U.S. it is considered a drug/medication. You have to have a Rx to obtain supplemental or technically administer it. R/R 911

Nurses = $$ Paramedics= [s:59f2c48ef2]$$[/s:59f2c48ef2] R/R 911

You can tell, we would never make it working at the Hallmark factory!.... R/R 911

I have always wondered why we did'nt have "agency type" services. However; the problem is for the service to pay the additional money to you for an employee. I think it could work for certain areas... Be nice to see it implemented. R/R 911

So basically your acting similar to an "agency?"..The people would work for you then you contract out to the services ?.. R/R 911