Ridryder 911
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Posts posted by Ridryder 911
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I was taught in NP 2-4 hours for facial and up to 8 hours for other. The reaon is for infection but the proximate edges become dry and non pliable. Yes, one can incise and attempt to use better tissue that is if it is possible. Usually it is loosely placed together to prevent dehiscence.
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I don't work for them but I do know several that do.
R/r 911
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True, there is a lot of "suck" in the field, but getting an absolute vacuum is going to be hard.
R/r911
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If what he was attempting to make a point about was real, then one would had never seen this video or him ever again. Compare that to other countries that one would dare qustion the authorities. Too bad one cannot make a slide and post into the video of : "Idiot... One that pisses off a person, that is wearing a weapon"....
Seriously, some people need to get a real life.
R/r 911
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About a month ago, I was in a meeting with Bill Brown CEO of NREMT and the discussion was made that the NREMT better not find any institutions giving the okay before the student has "graduated" from that program (this includes total completion of everything including clinicals).
Although, I know the Registry has many problems; it does appear they recognize them and as well attempting to correct them.
R/r 911
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Here is a another news story, as we attempt to address the upcoming shortage of Paramedics, yet want quality over quantity.
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As soon as you know how to spell the title correctly and yes if it is NREMT, one has to officially finish and successfully complete the program.
R/r 911
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I was under the impression that an EMT/ Paramedic, working for a municipality or private service is covered under the same law as striking a Police Officer or FF since they are State and / or Nationally Certified.
But I could be wrong.
Apparently not. They charged him with striking a city worker (EMS) misdemeanor and an officer (of course felony). Something that we in EMS should demand is the very least a felony charge!
R/r 911
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We used to go through many of processions because one of the larger cemetery was next door to the hospital (no joking). In my region, people also drive with their headlights on as well and usually an officer is assigned as an escort if possible.
We always turned the siren off but kept the lights on and most always pulled to the side as well. I am glad to say, that it is usually customary to still respect someones life here. You will still see men remove their hats, and people pull over when the procession drives by.
R/r 911
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Yep, several times. One was the spouse of the deceased (even heard in the background if they could make a double ceremony).. and one was at a Native American Indian inside a tepee (yes, a real one) with the deceased (yep, you guessed it .. one I had worked) on the burial platform. I have to admit this was strange to be shocking someone in a tepee and seeing the vast cultural and technology changes...
R/r 911
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I would have SO much fun setting up that mock apartment scenario. I'd have the floor piled high with stinking trash, with just enough room to walk to the couch, and animal feces all over the rotting furniture, with a naked and malnourished toddler playing in the middle of it. Little remote control rats would run around the room as the students walk through. Crack pipe on the table. Empty disposable lighters, syringes, and malt liquor bottles everywhere. And, of course, a brand new giant big screen plasma TV in the middle of it all, with ESPN on the satellite dish. Alternate having either a Pit Bull or a guy with a gun jump out of the next room.
You would make many feel at home!....lol I can assure you as you are aware of, if they go on at least one clinical they can see at least one double wide with all of the above!
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Is there any prerequisites for this course? How many people do they knock back?
It is a a quote open door type program however; there is a process..
For entry level, you must have had completed at the least A & P I, some other general education such as math, science and be a current NREMT basic level. Personally, many of us feel experience is nice but alike the discussion here a clean slate is many times easier to mold and teach the right way without any prior prejudices. One can obtain a "certificate" without attending all of the usual general education, but it is highly encouraged to obtain at least the associate degree level. As well, there are multiple bridge programs for nursing that are used to this program also the college itself has one, if the person so desires to choose that path.
I cannot say exactly what the "wash out" rate is, but it is not unusual to have several either quit or fail. Which I am proud to say not everyone can nor should be able to finish such a program. Something the Coordinator and I have discussed and agree upon.I believe currently there are three Paramedic classes going. Two traditional and we just started a pilot on-line Paramedic, which I am the clinical instructor (the only classroom instructor they will have). It is too early to determine the effectiveness but I believe it will be an alternative way of instructing if performed properly. All of the students can admit that it is definitively not any easier. I discussed with them last week, as most say they study at least 3-4 hours a day (minimum) as they are expected to know all objectives and perform thesis type research and projects as well. The lead instructor is a very well known, experienced and knowledgeable professor that demands excellence.
R/r 911
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Very nice as a former EMSA employee, I hope they send as many of thier recruits through the program and facility.
I wished but EMSA is now having an employment + school sign on agreement. They are sending some to OKCC, but many to EOC, Metro Tech and Gordon Cooper Vo-Tech.
R/r 911
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FYI: He was charged as having possession of PCP, and abandonment of children. He was also charged with assaulting an office, and striking city employees (EMSA is a trust of the city).
A note that EMSA is reviewing to assure that the medics action was correct as well.
R/r911
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Well, this just happened up the road...
Let you know more as details is let out....
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We just opened a new state of the art facilities where I teach at. The mock code was for tv (yes they knew they were bouncing)..
http://www.kwtv.com/global/video/flash/pop...mp;rnd=73547672
R/r 911
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Nearly every ER I have experienced had a supraglottic device in their airway cart or difficult airway set up. I even worked in a five bed ER out in the middle of nowhere that had LMA's in their failed airway cart.
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You were lucky then. I still do not know of any ER's in my area that has LMA's (except in OR) or King/ Combitubes, etc. Nor does most of the ER physicians (yes they are board cert ER docs) know anything about them. I wished I could say it is a regional thing, but they come from all over from different states.
I have seen more my fair share of botched up airways. One attempted to perform a crich after a failed intubation using a Melker crich kit. He inserted it with the curvature upwards and refused to listen to Paramedics on the proper placement. Another attempted intubated with an NG tube then attempted slide the ETT over it alike a bougie device.. except the NG tube was too big so he then placed KY and attempted with no avail... Again, different ER's and no these were not small ones either. My opinion is let's start at the top and clean it up..
Personally, would like to see the performance level of Dr. Wang on airways from hell.
R/ r911
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our medical control doctors are listening. Maybe you should, too.
I do hope that they really read whole the study. Read the type and acuity of what the patients are compared to. Again, skewed and misunderstood studies is of no value. Alike the Houston PASG study that first accused the knee jerk of removing the garments. Many assumed it said that they did not work; when in fact it did NOT say that, it described it did not an increase in survivability. Yet again, the acuity of the type of patients it would be doubtful if a trauma surgeon would had made a difference.
Look at the whole picture.... and then be sure to read in between the lines as well. Again the procedure(s) is not the problem rather the lack of education of the personal.
R/r 911
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I agree, another propaganda to assure FD has security. Just because they have a patch does not mean the will be able to or want to perform. Alike the old saying.. "just shoving feathers up your arse does not make you a chicken"....
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Wang has always had a hard on against EMS. Unfortunately, his studies has always been known to be biased even before publication one can predict which way it will be skewed.
Ironically Wang is getting up in age.. would it not be ironic.. you can guess the rest.
R/r 911
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If we were to base our procedures upon the number of times or if needed, then ER physicians would only have to go through a year of school. How many times do you see pericardiocentesis, crich'ss, trach.'s performed in ER by the ER Doc? Yet, we still allow and want them to be able to perform if needed. See the correlation? How proficient do you think that ER Doc is in performing some of those procedures they have not used in 15 years? Not being able goes back to poor education and follow up of proficiency. Yanking the procedures because there was poor rates is foolish. It is not the procedures that is wrong, rather the individuals performing them that is poor.
Sorry, I have worked in rural areas where the nearest trauma center was 2 hours flying time. Does one not think that maybe RSI might be nice in the head injury patients with clenched jaws? Stop at the ER and have a P.A. attempt RSI?... Yeah, they intubated a whopping five times in their life.
Yes, we definitely need to police ourselves. Enforce true education in and on every procedure we perform, ensure safety and the person is qualified and is able to perform correctly. Just wished they made others as responsible too (including physicians).
R/r 911
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I have to disagree that this is the physicians' problem to address. We are the ones that FAIL. It is our problem to address. The physicians are addressing it in the only way they can, which is to "just say no" until we get our act together. And getting our act together is our responsibility, and ours alone. We have to self-regulate. We have to be the ones to decide it is time to stand up and elevate our game educationally. We don't get no respect from doctors? Boo f'ing hoo! I don't respect paramedics either, and I'm no doctor. Yet any attempt to even elevate our basic entry level is opposed fiercely by three-quarters of our ranks. Attempts to elevate our advanced level is opposed by two-thirds or more.
The physicians are not the enemy. I have seen the enemy, and it is us.
I don't think their the enemy, yet they have not taken the proper actions as well. I definitely agree we are lacking on our part, yet this does not exempt them either just because they are physicians. If you want to assume the role tof medical control then be active and assume the responsibilities seriously. Make sure that your standards are carried out. Again, just you are a Doc does not exempt you not becoming qualified as a medical director and actively participating within the service (controlling whom can function or not). Again, instead of worrying about removing one procedure, I would worry about the total care that may or may not be provided.
I do agree, we should get our act together as well. We should never recommend to physicians idiots that cannot pass tests, perform quality care. Again, alike you described it is as much as of our responsibility. We have became so relaxed in whom, what is produced and still can operate as a Paramedic it is a wonder more procedures are not removed.
Time we start cleaning up our own profession.. anyone got a big broom?
R/r 911
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I have a lot of opinions but would like to see more. My ex-brother in law help assist in developing some of those systems in the 80's. As well when I see the name Jack Stout and PUM; the hair on my neck stand up.
In regards to PUM; I don't believe they are a considered a dinosaur yet. There are still many that are still attempting to operate such as those in my home state... how successful is still debatable. Hence, the reason the Fire Services are circling alike a buzzard just awaiting their time.
R/r 911
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let's take this example
you are a medical director. Your medics under you have a intubation success rate of 45-55 percent and a 30 % success rate on RSI.
How do you justify allowing them to intubate patients with success rates like that.
I know of a medic out there who has a success rate of 25% for intubations. Do you honestly as amedical director want him tubing someone?
No, neither would I bless or allow them to work under my license. Period. Again, Medical Directors can and should pull a lot of weight. I honor those that are truly involved and do participate as they should.
What many of the Medical Directors do not recognize is, that they can be the screening process. Who is to say whom becomes a functional Paramedic?.. You do! Will it be the EMS service or the one that has the license they will operating under? Many may say ... "the service is too large to control"; is it really? NO!
All one has to do is look at the statistics in the QI program. If there is not one then as a physician demand one! Again, it is your license! Demand better education and more in-depth training and reviewing at the service. Guess what you also control the purse strings! You will get what you want or reduce their provider level.. you will get their attention!
Be pro for better and quality care, but NEVER compromise patient care! This also means removing proven procedures that increases survivability!
If you do not like the care then DEMAND a change! You are the one that really is in charge. Do some house cleaning. They may have the license/certificate/patch but that DOES NOT mean they will get to operate in that capacity.. only you can really determine that!
Most EMS medical directors are poorly educated and trained as such. Majority have never attended a formal EMS Medical Directors Course. Again, whose fault is this?
Fix the problem or be part of the problem, the choice is yours!
R/r 911
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