Ridryder 911

Like to see the inflatable one ... never ever heard oe seen one of those either? Be safe, R/R 911

Richard, I think the reason why most are not posting is because many "never even heard " of bio-telemetry's. I know we no longer even teach it. I was discussing it the other day with some medics, they had never even heard of such a thing. The ones > 30 y.o. only remembers it from the t.v. show Emergency. Be safe, R/R 911

It would be unfair for me to post what it was like for me (since you were only 3-4 years old when I first became a medic) but I will tell you what ti have seen & hear from newbies. How much do EMT-I make in your area? It is all geographical, don't base income with salary amounts. For instance a EMT/I at my service is considered a basic. Actually our basic are required to become an EMT/I within 6 months to maintain their position. It ranges from $17 to 25k all dependent upon experience. Now, for some that is piss poor money & for some that is great money .. all depends on the region you live. Remember costs of living varies VERY much in parts of the U.S. so that $25 hr is not that much in some areas and whopping in others. What do you love most about your job? I returned full time to field from being an ER RN full time for the past 10 years even ER Director.. so you can see I like the field a lot better (for me). The autonomy of giving my client or patient the best care I know that they can receive at that time... I guess proud of my job done right and thorough. The other the bortherhood of EMS, yes, those pain in the butt EMT's can be fun to work with as well, as getting some down time (not much) but it beats standing on your feet for 12 hrs straight. You also have a brief patient contact time (<2hrs). Baby sitting patients awaiting on lab, physician orders, etc. and the family, patient is mad at you because they had to wait... and there was nothing you could do. The last is the outdoors, I like spring & fall weather. Being trapped inside on a nice day ..ewww... The hours, I work 24 on 24 off for 3 shifts then 4 days off straight (10) days a month. What do you dislike about your job? The hours ... sometimes we are busy for 24 hrs straight... but, I still like it better than 8 or 12 hr shifts. People abusing the system, yet again, we do not educate many on proper use. The abuse of EMS in hospital to hospital transfers in my area. What was your schooling like? I had several schooling in my early years as EMS developed. I was actually a Paramedic before I attended my Basic EMT class... (long story) Then I went on and received my degree. What were you 1st days as an EMT like? Scary, like everyone else. Apparently, nothing has changed in the past 29 years. From what I still see and read here. Of course there is more defined care now, the equipment is a hell of a lot better, and so are the working conditions in comparison. Most EMS still has a long way to go, but some do have very nice equipment and living quarters and decent (not great) benefits. Main points, I recommend; is to really investigate EMS companies. See what the turnover rate is & why ? Look at protocols . are they too defined or so vague that you are risking your career ?.. Remember this is what you are working under. Compare benefits in lieu of salary ... if you have to spend $4000 a year on family insurance is the additional $2000 yr salary worth it ?... many factors come into to play such as advancement, education bonuses, do you want to be stuck as a Paramedic only at age 50 ? ... Good luck, R/R 911

The point I believe we are trying to make is, that the NREMT is the set standard for many states and actually by wearing the patch in some states, displays that you have passed their license or certification. It may not be required in your area, but that would be minority to most of the nation. Why we were concern is as a NREMT you get literature on how to obtain NREMT patches and paraphernalia. I ask e-bay not to sell NREMT patches all the time and NREMT is trying to get legal with them to ban them from being sold. The same if it was a police officers badge or shield. It is an identification emblem, as well as a trade mark for such. Impersonations occur in all areas, cities, rural etc. even those whom let their license lapse. I inform them by wearing they are held accountable and can be considered impersonating an EMT, which in my state is a felony. (yes, I will contact the D.A.) I hope you understand in some areas their plenty of whackers with emblems, lights, enough patches to make any NASCAR driver embarrassed. Definitely to infer or to pick on you, but inform future whackers, we (professional EMT's) do not endorse this. Be safe, R/R 911

I don't know about Canada's A & P requirement, but I sure suggest an anatomy class that offers a cadaver dissection, This really makes it come together and have a better understanding. I wish you good luck ! Be safe, R/R 911

Although it is a tragic event, I have not seen any special changes for those that have committed suicide while in school. Most are under the opinion that it occurred for mental health reasons, not associated with the profession or school. Life continues as normal. Far as those that have attempted, there are many that have deep problems. Unfortunately, this profession requires "stable" mental health as much as possible. Many medics, IMHO feel that this is not the place for those that have a history or have unstable periods. The patient life depends upon it, the medics life depend on it as well as yours might as well. Clear thinking without any disturbances as much as possible. Many will refuse to work with or be partnered with those until cleared. Yes, there is privacy, when it involves ALL lives, it a matter for all. Be safe, R/R 911

We have used in ER for initially tx but, I only it seen it drop the K+ a very points. The usual tx. of curse is Kayexalate, or (Sodium polystyrene sulfonate ) per mouth if possible (NG tube or per rectal per enema (which I hate administering this way it is very thick and actually has consistency of syrup) . and the usual D50W with Insulin (usual dose is one unit of Insulin Regular IV per each 2 grams of Dextrose) .. some do administer Sodium Bicarbonate to reduce the pH and due to the low sodium as well. I have read once that it the benefit that it worked fast, however not very effective. Of course just lowering a few points in hyperkalemia is beneficial. Since most of the time we do not have current labs, unless they are dialysis or hospitalized/clinic patients. Be safe, R/R 911

I agree with you Squint. The point I am trying to make is that Peak Flow (which many ER and EMS still attempts to get ) is really foolish to try to get in a asthmatic crisis. Sorry about the # of ventilation's, the reason is Medtronics has had so many reports of false reading or no readings only later to find out that a "wash out" was never performed. So a standard of at least 6 breaths is being attempted to be made. The same as research is showing a very low to no Co2 level that no rescitation measures should be made ( M & M has never shown any success) The uniqueness in this tool, is we are actually bringing into the ER setting more than the opposite. It went from O.R. to ICU to field. Yes, it definitely has it's limitations. Far as DKA, sure hx. and assessment, but those difficult cases with a glucose of 350mg/dl and they are just starting a Kussmaul respiratory drive, you can assess the Co2 level which will become significant less in time. The same is true when using Beta [sub:521ff2d6ce]1[/sub:521ff2d6ce] respiratory medications, to assess effectiveness or should combination neb.'s be administered. Respectfully, R/R 911

The National Registry is an non-profit organization that administers testing for the multiple levels of EMT. There are approximately 40 states that recognize the NREMT as a training or certification. If you ever decide to move or change locations, or positions, I recommend taking this test. Be safe, R/R 911

I think you will make a huge mistake by not going straight through to medic school. I used to have the opposite opinion, but for job security, finding a job, making a decent living within a reasonable time, it be foolish to postpone medic school. Remember by the time you get through school, you will have had 1-2 years experience. Spend your time on education... experience will come. Besides basics are a dime a dozen to free in Oklahoma, get your medic so you can a job. There are too many "I'll get some experience first, well meaning EMT's that NEVER return.... look at the posts. It is too easy to get hooked into being a basic and never progressing. The longer you wait the more competition for that spot and less money you will make... Good luck, R/R 911

I hope that this is either for a patch collection or you are NREMT certified... in which, you of course have to give your NREMT #. I am definitley against anyone pr persons selling EMT patches on E-bay. To many impersoantions have occured already. Be safe, R/R 911

Actually, if you read any literature you will find the standard protocol or operation is to give the patient 7 breaths to perform "a wash-out", before evaluating the wave form. The same is true to allow pre-oxygenation (3 minutes) or 7 breaths. I totally disagree with you on "peak- Flow " meter. In my opinion it is a WORTHLESS tool and SHOULD NOT be used in the Emergency or pre-hospital setting. First, the patient has to perform deep inspiratory breathing and exhale fully...hence Peak Flow. Then this should be performed at least 3 times over a period of 5 minutes to get an accurate record. Is your patient that stable to perform that tasks ? That is why most ER's have totally abandoned the use of the device. With EtC02 you get an immediate reading without stress to the patient. There are MANY literature out there in praises of the EtC02, capnography with wave form. Dr. Krauss, describes this tool as important or equal to ECG monitoring. Although Sp02 is essential to monitor the saturation, EtC02 which monitors the ventilation, in which we deal with continuous. This tool has more applications than just to verify tube placement, monitoring perfusion level in capture of pacing, return of spontaneous pulse (in which Co2 level will improve before perfusion of pulse is felt) as well as effective CPR and PEA syndromes. Many are not aware of ability to use for aid in diagnosing questionable DKA. No it is not a cure all or should not be thought as nothing more than another tool to aid in our diagnostic skills. The same as ECG, etc.. Again, PROPER education, and applying to clinical skills enhances the uses. Yes, it does have its limitation , like other medical equipment, most with improper use or poor maintenance. If one does a web search you will find MANY research articles out there other than Bledsoe opinion. It is a shame most EMS is not utilizing this device, rather placing money into other equipment which will not be used or provide information. Good luck, R/R 911

I agree with above posts, although I question her "self integrity". She brags about her feminism and she is labeled as a "bitch" or "hard instructor". Although admirably, that might be, I also had professors whom pride themselves as failing students as much as passing them. If you compare her grading, she really did not change them. a to A- etc. is not really going to change grade level, maybe a GPA. Yes, it is a shame she felt obligated to change her grades, it is also a shame she could not come up additional ways of improving course work or even maybe evaluate herself as a professor and wonder why her students do poorly. At the same comparison, I have seen many students lately, that definitely that did not deserve to pass. Interesting article. Be safe, R/R 911

The problem with that is who can afford $400 to $ 900 per credit hr ?.. Although I am sure it is an outstanding program, will the pay off be worth $ 25,000 to nearly $75,000 student loans for a Paramedic position or even management. I even recommend nurses that are truly serious of management and education to get those degrees, so lateral move can be made and one specialty is according to the degree. As most are aware I definitely for upper education of EMS, but let's make the pay off worth it and make it reasonable for those to attend or at least increase grants. Be safe, R/R 911

One of my Paramedic professors became an attorney... (can't beat join em :wink: ) He initially is the one that informed not to purchase insurance, because the chances would be slim. However; as I described there is a sharp rise of litigation's against the medics individuals. I am aware most states have different laws, but most generic describes you can be held liable, for any damage occurred to employer. Remember that one can be sued for accidents involving equipment such as stretchers ( #1 law suit) if a patient is dropped. If the stretcher did not malfunction, whom are they going to blame ?.. I don't think most would pursue.. but never say never. They can attach a claim on potential earnings or damage suit that may damage your future credit and assets. The main point I suggest insurance ( I recently purchased 1'st time in 29 yrs of EMS experience) is litigation charges. Again, I have seen how fast loyalty reascends in time of trouble. One can become attorney poor very fast.. Again, it is a individual choice.. and it does not protect from being stupid. Just with the numbers of litigation's increasing, I personally want to have some legal coverage. .... Be safe, R/R 911

My personal uniform is pretty resistant to most body fluids, needle sticks, and accidental defibrillation discharges. The "scotchlite" reflective material is handy as well as the tool belt, with all life saving tools. The pocket size MRI & CT scan with U/S capability, has been handy since my X-ray vision has been limited lately. The only problem is the cape... :wink: R/R 911

I agree Akand I used to have the opinion of not wanting insurance because I would not be a target. The protocols, guidelines etc. or even your state license or certification merit will be brought in on the suit. Again, I used to have the apathetic attitude, of not worrying about until I worked with some attorneys, & asked them about it. They describe, they would sue the individuals, (EMT's) even if they had no money, because the principle of the matter as well as being addressed as the individual. Of course you can not get blood from a turnip. but to ruin your career and go bankrupt on attorneys fee as well as ruin my family's life even if was found innocent, is shameful. Funny in comparison with nursing, most nurses carry malpractice insurance. Ironic, that they have a lower fee. I discussed with the insurance company, and they informed me that it was because Paramedics has more autonomy and the suits has increased in the past 5 years. As well, as now some suits are suing the individual medics without suing the physician or even the company. Be safe, R/R 911

You raise the "whole" board by placing blankets underneath the board raising the board slightly.Although, they you cannot technically "raise" the head up, remember to continue with administration of oxygen, and reassessment of why the patient is having s.o.b. ? good luck in your studies. R/R 911

I too agree, I used to believe they would go for the "big money" i.e medical control, company. But, now the trend is to sue the medics personally, if they did not follow the protocol exactly. As well, if you believe your employers attorneys will represent you or be on your side.. you are a fool. even if you were in the right, they are only representing the firm or company. If their is any chance of plea or settlement, you will have to take the blunt force as well. Ever hire an attorney ?... hmm usual costs is about $ `0,000 starting out for malpractice. Think you can afford it..? Again, don;t bank the company being for you.. every time I have seen the company drop the medic like a "hot potato".. even if they were in the right. I bought million dollar coverage for just over $130 yr... even though Paramedics is one of the higher end risks, I believe it is worth it. If not for just the attorney coverage, I least I will be able to afford one, if it ever occurs ( God forbid) .. it is a scary thing to think about. Good luck, R/R 911

Capnography vs. Pulse Oximetry as EMS Tool http://www.merginet.com/index.cfm?pg=airway&fn=capnog By Bryan E. Bledsoe, DO, FACEP February 2006, MERGINET—I am now of the opinion that continuous waveform capnography is a much better EMS tool than pulse oximetry. It took some convincing. After discussing capnography at length with my good friends Sal Silvistri, MD, FACEP in Orlando, Fla. and Ed Racht, MD, in Austin, Texas, it became clear how important this tool is. A study in the October issue of Annals of Emergency Medicine further reinforced this belief. These researchers confirmed what many of us felt to be correct— that end-tidal carbon dioxide (PetCO2) readings correlated with the partial pressure of carbon dioxide (PCO2) in arterial blood gas measurements. In a prospective cohort of 39 acutely ill asthmatics, researchers compared arterial blood gas readings to capnography. Because of the severity of their asthma, these patients underwent arterial blood gas analysis (not for the purpose of the study). The a priori limits of agreement were ± 5 mm Hg between the PetCO2 and the PCO2. The PetCO2 was recorded during exhalation at the exact same time arterial blood pulsated into the blood gas syringe. The mean difference between the PetCO2 from capnography and the PCO2 from arterial blood gas measurement was 1 mm HG (95% CI: -0.1 to 2.0 mm Hg). The median was 0 mm Hg. Of the 39 patients in the study group, 37 (95 percent) fell within the a priori limits of agreement. They concluded that in acute asthmatic exacerbations in adults, the PetCO2 correlated with PCO2 levels. While additional validation of these findings is needed, the overall findings look very promising. Reference Corbo J, Bijur P, Lahn M, Gallagher EJ. “Concordance Between Capnography and Arterial Blood Gas Measurements of Carbon Dioxide in Acute Asthma.” Annals of Emergency Medicine. 2005; 46:323-327. /////////////////// //////////////////// ////////////////////// //////////////// ///////////////// //////////////// //////////// We personally started using EtC02 monitoring more than the usual assessment. We now include for aid in diagnoses of DKA, treatment modalities of using beta[sub:38f0f1ef8b]1[/sub:38f0f1ef8b] etc.. With PROPER education this device is very informative as an ADJUNCT tool in diagnostics. I personally believe it as well to know the ventilation as well as oxygenation perfusion (v/Q) . There are several web sites (www.capnography.com) etc.. I highly recommend Dr. Krauss material. He is a professor emergency medicine at Harvard and has done intense research in capnography in EMS. Be safe, R/ R 911

I believe we ought to donate all funds to local EMS. Now that would solve our budget problems...now, sign me up ! Be safe, R/R 911

Actually, Dust I am sure there are plenty out there, but I have yet personally seen any head injuries to medics.. yes, thrown around, bruised and battered.. Far as exposure, I have seen plenty of medics, nurses, even physicians (whom are the worst of not wearing protective BSI). I had to administer chemo tx to a fellow medic because she did get exposed to Hep C due to not wearing gloves.. ( although it was a rapid situation) and fortunate for her it was followed out as the source. The chemo treatments alone was over a $800 an injection and with 1 to 2 a month would had bankrupted most in a few months. the same as for an emergency physician .. he was able to go overseas to obtain advance treatment. He definitely has a new outlook in BSI... Both of these were exposures not needle sticks. The same is true of an ER nurse that was splashed with blood into her eyes..(she was wearing eye glasses but not safety wear. Unfortunately she has tested + for HIV, but as yet, not have AIDS. Still scary. Other areas we need to really explore as well where deaths are high is in staging and personal safety at night time. Each month we read were more and more medics are getting struck, ran over etc.. due to the scene being unsafe. I myself has seen more & more unsafe, staging of vehicles and attitudes of LEO changing into apathy. I agree, we need to evaluate all safety... if we don't no one else will. Be safe, R/ R 911

APA format is what scientific research should be written at. American Psychological Association (APA) is somewhat confusing and changes frequently. The use of citation of references from web sites, verbal discussion, even t.v. is documented specific in different formats. Although, I doubt he will take off if not strictly adhered to, I highly suggest you look into it for future reference for medical or scientific thesis papers. This is much different than NLA national literary association (most common usage). Again, good luck! R/R 911

True about, the K but dialysis patients are also hyonatremic as well. Calcium chloride and Ca has been used for several years in PEA ( or before that EMD) syndromes. Although, it worked, the side effects was tremendous and no real success was seen over all (patients leaving the hospital). Again, one needs to really assess the history, the patient in all circumstances. be safe, R/R 911

Awww... you beat me to posting it...Lol Be safe, R/R 911