Ridryder 911

I believe the problem with the study was the intent not so much what it revealed. Also, what was the sugeestion at the end of the conclussion.. to place more BLS units within a 4 minute response time.. yeah, that will happen. I still would like to see a formal sudy of pre-hospital care of trauma trained physcians vs. paramedics. I believe it would be very interesting, on the diagnostic value. I agree, trauma is a surgical disease. Needless interventions should be decreased as much as possible, however; the risk of aspiration, venous acess to infuse blood, can be treated & obtained enroute. Let us not throw the baby out with the bathwater yet. Even with Level 1 trauma centers there still has not been a great reduction in trauma deaths. So could we argue these are futile also ? Of course not.. but let us learn also how studies are conducted, the perimeters around, the pre-cursor why the need of a study or sponsors of a study. the number & type of patients involved, length etc... Just because it is a "scientific study" .. not everything should be taken literally. There are skewed studies. Just wait a few months there will be one to dispute it...then hopefully, we can decide with a rationale mind on what is best for the patient. Be safe, Ridryder 911

Well it is called EMT City.. may I suggest : http://forums.philosophyforums.com/General-Philosophy or www.ephilosopher.com/phpBB_14.html I am sure they would love a philosohy debate... Ridryder 911

As you mentined Holistic Medicine. herbals treatments & their side effects.. Labarotory results & the Paramedic.. base levels & adnormal ones & what they mean.. key ones to know Sexual Assault treatment for both women & men Pychological Emergencies... intervention with pysch patients High Risk O.B. patients Neonatal Resuc. Provider Course Advanced Burn Life Support ( ABLS) there are several others Good luck, Ridryder 911

No beef ..actually find it quite amusing.. remember when I also thought "It really mattered".. & stayed up all night drinking coffee ...& having deep philosophical debates..then realized, nobody really cares... & it doesn't change a thing in life... Have fun debating.... Ridryder 911

Geez .. what is next . a coffee house with some junior yr. philosophy major debates..Aristotelian logic, fallacies, fundamentals of probability, decision theory, and game theory debates. Maybe we can throw in some Beatnik poetry as well and how we "should save the earth lectures ... From some famous philosophers... We're going to have the best-educated American people in the world." Dan Quayle. "I'm a philosophy major. That means I can think deep thoughts about being unemployed." Bruce Lee. "An intellectual is someone who has found something more interesting than sex." Edgar Wallace Be safe, Ridryder 911

I believe to have a real good debate, you should at least be educated & have knowledge in the subject to debate the topic. In which I have not seen one post to show or demonstrate to me this of yet. Again, I see rhetoric ataganizing prompts, and appearantly a fixation of this topic. Peace, Ridryder 911

Cause like others feel, it probably turn ugly.. & also it has been beaten to death.. We now know if you do or not.. as the question was asked. Now, we are getting into theoligical debates, as far as I know, no theologist or true scientist are here to debate, accurately, scientifically. The debate so far has been on qualatative findings. In my opinions are like anuses every has one (or should have at least). Some things like politics & religion, are usually never or ahould be discussed at the station house. Be safe, Ridryder 911

me too.. really who cares ? Do I really think a group of medics, that will bitch about requiring an associate degree requirement has the answer to "how the earth was involved"..? c'mon give me a break... Ridryder 911

I refer to recent article: www.emtcity.com/phpBB2/viewtopic.php?p=18211#18211 Be safe, Ridryder 911

OMG their trying to "revive " the old plunger again... Most of you do not the "rest of the story:.. a man had a cardiac arrest, his brother grabbed the toilet plunger & uses it to do chest compressions.. he was resuscitated & then he patented it..... tried to market it ...push it.. it was popular for about a year or so... in the early 80's.... This was about the time Amway had a answer to choking victims..a suction device to remove foreign bodies. A device that "suctioned or pulled the object out... unfortunately, whomever designed it forgot that the esophagus collapses under suction & actually squeezed the object tighter.. McDonald's had bought thousands for every restaurant...they got burned really bad after a law suit. So remember there are a lot of toys out there, be sure they are safe. Be safe, Ridryder 911

Good luck, I hope things turn out in your favor... Be safe, Ridryder 911

Dixie, seems your placing the blame on "your higher power".. just because you are christian, Jewish, Muslim, Buddha, etc.. bad things happen to all people. All faiths have "horrible events" that occur, within the circle of members.. it shouldn't but it does. Unfortunately, it happened to you.. those who really know the love of Christ, being a Christian would never condone such behavior, that occurred. Tragic events that occurred in your life, should not had happened. Learning how to deal with them appropriately is the hard thing.. many people do develop a faith & helps them through the tough times. Along with this many have found professional counseling is worthwhile as well. Behavior & addiction problems is a tragic problem that plagues many people today. Most cannot overcome by-themselves. I personally believe all medics should have a "mind wellness check" every few years with the things we see & deal with daily. The EMS system would benefit from it. Since we already have one of the highest, suicide, divorce, chemical dependency, burn-out profession there is. If we took care of ourselves emotionally, we would probably have less turn-around in EMS. I truly wish you the best of luck, & success. As a Christian, I am sorry for what occurred to you, & the hurt & pain that it has caused you. I wish you peace. Peace, Ridryder 911

Ditto, Peace, Ridryder 911

So let me see if I can get this straight .. college education or just certification...hmm, which would I hire.... Geez that's a no-brainer.. then of-course I did go to college... If you can afford it or have the chance I highly recommend it to everyone. You should not complain about pay in your profession if there is no minimal education requirements. Most say no pay difference... true for right now, the same happened in nursing .. there used to be diploma nurses.. that changed & so did the pay. Also, education can be applied later to either promoting yourself or another career. With the low pay of EMS most EMT's can apply for student aid.. check with counselor for assistance. vs-eh .. Associate Degree is basically a 2 yr degree with minimal general education requirements attached. Some states do not recognize it as a official degree; however sometimes can be applied to a undergraduate degree. Be safe, Ridryder 911

As one that has been through both RN & Paramedic (ADN/BSN) & AS in EMS.. I will tell you there is a great difference in programs. Actually my Paramedic was more difficult in medical care,& actually had more clinical hours (not clinical days) than both of my nursing programs. Nursing is very broad based & touches a large topic & various of diseases & disorders. Where as the Paramedic specializes & goes in great depth of narrow specific emergency disorder of emergency & critical care. What would I add to the EMT/Paramedic ..oh about 2 1/2 yrs of supplemental science, such cadaver anatomy, a 16 week pathophysiology course, microbiology, medical terminology, required reading level at least college sophomore level, technical writing & scientific studies. These would be co-requisites, for the program double the cardiology portion, hemodynamic, respiratory areas, as well psychology & high risks O.B. & Geriatric medicine to start with. There is no reason why a Paramedic should not be able to describe "shock pathophysiology" using terms i.e Fick principle, pre-& post capillary sphincters, Roleux effect , etc.. if you can't I highly you suggest you either refresh, or learn pathophysiology of shock. Can you really know how to fix something you don't is broken ? Even Mr. Goodwrench knows this much ! Getting tired of the pay in EMS , tired of no growth, benefits ? We HAVE to become more scientific, medical based. Without this, we will never receive adequate pay...or really should we ? You have to prove yourself in medicine.. & we have not yet ! Well I get off my Respectfully, Ridryder 911

First of all Zippy RN.. you don't have all the facts. Please don't make broad statements or generalized statements. Not all RN's require individual orders, please I have worked with European nurses ..give me a break ! Talk about non-autonomous! Second, please don't start that free enterprise vs. socialized stuff .. Won't trade you taxes or socialized medicine.. no thanks! Second it is based upon state by state, some states are larger than your whole country.. & individualized by the local community. Yes, some are licensed & yes some are Registered. Yes, we have problems ...just like you do ! Be safe, Ridryder 911

Actually this going to be in the end of Basic EMT & Paramedic classes, senior level...near graduation. A quick congrats on behalf of the service & if they looking to change or do not have an EMS home... I usually talk to the instructors prior & get their opinion on the "better students".. & try to recruit them. I know there are many students that are apprehensive on getting their first EMS job or changing EMS sites. I was hoping this would increase visibility & maybe a better place for them to increase their profession. Thanks, Ridryder 911

We need to keep the education to elementary level. Lets have our EMT textbook written at a 6'th grade level. Also, no entry requirements, hell anyone can be an ambulance driver. Why should we require psychology classes & anatomy & physiology& all that fancy stuff. Who needs all that reading, writing & math stuff...All EMT's do is drive an ambulance anyway. How much training do you need for that? Maybe if they want to advance themselves they could go to a trade school later & finish a 500 hr course, with one 11'th grade textbook, this is next door to the cosmetology program.. (although they go for a full year). But, unfortunately they will probably want to get paid if they do that & then they will quit volunteering....(geez there goes the swimming pool & golf course budget.) Oh yeah, who knows the next thing they will want to be medically licensed .. .huh ... don't they already have a license to drive an ambulance ? Its not like there educated anyway ? Yeah, lets just keep it the way it is .... it just fine!

Trauma is a BLS is job when it happens < 3 minutes from a Level 1 Trauma Center.. Believe me, it easier to find a vein for fluid & blood replacement in the stage 1 or 2 than stage 3 or 4 shock...also, I rather have the patient intubated to prevent aspiration than a lung full of vomit...ever seen a head bleed vomit ?... Again, use common sense.. most of these procedures can be done enroute.. (Which I challenge most physicians to attempt to intubate, start a peripheral line in a moving EMS unit) they have enough hard time in a lighted aseptic ER/Trauma center... you know that would be a neat study.. Paramedics vs. Physicians successful performance in procedures while enroute to trauma centers... think they would even take the bait.... naww I don't think so either... Be safe, Ridryder 911

O.K. as most of you are aware there is a Paramedic shortage.. (I have seen this in the early 90's, like the nursing shortage it comes in waves or cycles.) My point is I going to propose to my administrator of having a Paramedic recruiter.. I did this several years ago, & appeared somewhat effective, I just would like your input. This would be similar to the nurse recruiters that visit classes, & gives propaganda.. such as taking them out to dinner or feeding the class, with a little talk about the service, benefits, etc..& maybe some trinket gifts .. & nice door prize. .. What ya think ? Thanks, Ridryder 911

I too believe we sometimes assume most of our COPD patients are constrictive instead of true chronic lungers with poor compliance. Many medics miss pulmonary congestion vs. pulmonary obstruction. There are very few EMT's that are taught the difference in "pink puffer & blue bloaters" any more. I was wondering Steven, what medication(s) do you prefer for "air entrapment syndrome".. ? Be safe, Ridryder 911

This reminds of the Houston PASG study. All of EMS knee jerked after "hearing" about it, but never really read it. Still today, people quote it as "showing MAST/PASG... caused harm"... actually what it did say there was no change in outcome.. no increasing in mortality or survivability.. If you look at patient injuries that the study was performed on, there was no chance of survivability, no matter what you did. Even if there was a trauma surgeon standing over them. the outcome would had been poor. I always finding it amusing that "studies show EMS, lacking or need to do less".. etc...& the scientific community never address local ER, or tietary centers lack of stabilization & rapid packaging to send patients to appropriate facilities in timely manner. There also has been studies showing the difference in having a surgeon in house compared with one on call (<15 minute response) no change in outcome difference, but several of thousands of dollars in costs. Yet, we do not hear about that very often, or continuous studies on it... I believe it way to easy, for resident & fellowship students to look for a need to be published. When researching a topic, it easier to set your sites on "outside" the arena, there is way less political retaliation, & stepping on toes of fellow comrades. I worked in Trauma Research & development for over 3 yrs full time, I was thoroughly discouraged & disgusted in the play of numbers & stats, & inaccurate scientific methodologies needed to make the study interesting. Some of these studies was published & hailed upon. My opinion of scientific studies & data was forever changed, & now believe very little when the studies are first published, I now wait for a comparison study to verify or dispute previous study, before I make an official opinion. Be safe, Ridryder 911

I have read the OPALS study too, & I found it to be an interesting study. But I see political motivation in it & find it to be a flawed study. The study did not just state for trauma but basically all ALS .. no increase in outcome. Of course the study did not address, a solution other than increasing BLS units, to reduce time line. Be safe, Ridryder 911

Wow ! Summit that is the first time I have seen Hudson in 25 yrs... I just remembered they cost more, never seen or used Guegal, we order the Berman type by the case full.... Be safe, Ridryder 911

Just to clarify.. you can administer IV med's through saline lockes.. we carry pre-filled saline syringes so flushing behind a med is no problem. I can carry everything I need in my side pants pocket.. Be safe, Ridryder 911