Ridryder 911

Well if we are taling about visionary we might as well want at the same time all medics have an upper middle income, all have at least a undergrad level, and recieve full benefits and no one is called an ambulance driver as well...... :wink: R/R 911

Basically it comes with education, knowledge and experience. I never play at a scene, I might not worry about scene time sometimes this may involve more psychological care than physical treatment. There are cases, in which the extra time may actually resolve or prevent further harm and then there are cases in which there will be no stabilization and only more detail intervention will do. Of course true trauma cases need rapid intervention, as well as surgical cases. Unless you are able to provide thombolytic therapy for an AMI then expediate transfer should occur. Be safe, R/ R 911

True, but this is considering that there is no clinical site... i.e intubations, etc.. not clinicals in general. I know that if you do not have clinical time, you may not be able to get reprecocity to any other state. Be safe, R/R 911

:?: ...The patient fell while standing.. you measure from that height. It does not matter the height of the person. 7 foot tall to 5 foot tall a 12 foot fall is a 12 foot fall. Be safe, R/R 911

As stated above, like any other treatment given "off duty" one is no more than a first responder. Good Samaritan should be applicable. What worries me is that should had been addressed in EMT class .. even in CPR class this is taught and well discussed. R/R 911

I too know many "kids that are professional students" and no one takes their research and them seriously. I believe we are getting out of track. and discussion is "putting the cart before the horse." Yes, money is not everything, but again,again you cannot have a professional doctorate degree in something that is still not considered a profession as of yet. The masters and even baccalaureate, I still question intent and creditability. After reviewing their core curriculum the appear to be generic science degree with an emphasis in EMS more than a true EMS degree. Although, they are from respectable institutions applications and use of these degrees has yet to be seen. I am by far not against furthering the education level, but as with ANY profession you must start at the base and then work your way up. It would be hard to present a Doctoral level degree, knowing that the entry level textbook is written at a 6'th grade level. We still have not determine that we are even in the medical field yet... many still consider us in the public service, rescue, etc.... That is why I still one of the reasons I question the baccalaureate degree at this time, let us mandate above the high school credentials, then get out of trade school (which is majority of programs is sponsored by). A while back a post regarding a university president mentioning that this was not a profession but more a trade. So academia still has not yet even considered us above "blue collar" profession. I know several years ago, I attended a JEMS conference and few of us educators met in a small board room to discuss the future of EMS. (some of those involved were James Page, Mike Smith, Mike Taigman, Bryan Bledsoe..etc) Brain storming of the future of EMS was made including the discussion of a Doctoral program were discussed. Again, the consensus was that we need to emphasize repairing the foundation before proceeding upwards. You cannot build an upper level profession without securing the base first. Actually, all this talk and discussion is just that ...talk. Even in my state it is difficult to have the Paramedic program in a junior college setting, due to funding. If there is a duplicate program offered through a technical program (Vo-tech) the state may not receive Federal funding, due to duplication of education and services. As well, competition of straight programs in comparison of those that require adjunct education makes non-degree more attractive to future students. Until NHTSA and states require degree programs this will never change. I am aware that the Doctorate Nursing (DNsc) programs have been well established for several years and it has been very difficult for Universities to obtain and fund these. In comparison of the Master programs of nursing science, there is still very few DNsc programs, and there is a market and funding for both programs. Most opt for Doctorates in allied degrees. Like I said before, I would like to see such, but better yet I prefer to see EMT's receive an above 6'th grade level programs and the Paramedic to have text written above the 10'th grade level as well. Be safe, R/R 911

I would be very cautious of taking any EMT courses then in that state. I doubt any other state will or should recognize their certification or license. If no clinicals area required they have deviated from the national curriculum, and have decided to to have substandard programs. R/R 911

Sounds like typical seizure activity. The brain has to "restart" the sensory again. Probably the patient might had actually some respiratory drive although very hypoventillatory in nature. It is common to see this in post-ictal phase of seizures and as well in diabetics. Since the seizures was probably glucose related, it might be related to it as well. Usually, in the early phase of post seizures patients may have very deep ..slow respiratory drive, possibly secondary from the anoxia during the seizures. Sounds like the patient has a very outstanding medical history and complications. Be safe, R/R 911

First is the subpoena against the EMS or against private citizens etc?.... then, I would review a copy of my medical records to see if you can recall any specifics. Make notes of the run, (don't tell anyone..they can also subpoena them as well). If the legal action is against private citizens, you will be contacted by one the attorneys. You may not even have to go to court but give a disposition. Usually, you will be used for expert witness for one side and the other side will try to discredit you. Brush upon specifics of the related medical case... Usually, you should not sweat it... the attorney will brief you and review with you prior if are to be used... Good luck, R/R 911

Yeah, lets get our education level above 6 to 10'th grade level first. Then associate, then upper level.. .then post level... . I will probably be dead by then..... :shock: R/R 911

Depedent on the call... sometimes "Allstate" cases are simply boarded up and immoblized. .........Like above posts, check out BTLS or PHTLS... there are many suggestions. Be safe, R/R 911

It all depends on the LOC of the patient, if I will consider administering analgesics. Although Nubain is a synthetic opioid type of analgesic, I have not seen it as effective as Morphine for certain type of pains. We use it like candy for headaches.... Most of the time if I will not administer analgesics, if there has been any questionable alcohol abuse. R/R 911

Here you go.. had to roll up the sleeves...LOL Okay here's your sign ...LOL Be safe, R/R 911

First EMS cannot have a Doctoral program for one simple reason, the studies must be recognized as a profession. At this time we are still considered a trade. As well there has to be scientific or social standards, to demonstrate academia as a profession. Usually, with a doctorate level means you have reached the highest level to be achieved and ranks into the professional category (i,e attorney, engineer, physician). We have a LONG WAY to go ...Our profession is still based at a technical phase. I believe that any University that would even consider would have their program challenged seriously. Even, levels above associate is in question due to the intent of the programs are still geared at a technical level. Although, I believe an undergrad level is acceptable above baccalaureate level should be specialized from EMS at this time. Unfortunately at this time there has not been enough education, research or associated academic levels to sustain it. What position would you place an individual to justify 10 years of college and a student loan $75,000 to $100,000 for a doctorate level ?Administration, education, research already has respectfully specific degrees that would be more adventitious. R/R 911

Saline Locks or formerly called Heparin Locks, are basically an IV route, that is easy accessible route for later use. After initiating an IV a lock type device is attached with a flush of 3-10 ml of NSS. The tubing is clamped of to prevent back flow of blood thus clotting the IV site. We have almost totally eliminated IV fluids in the field. The only occurrence for fluids is of course hypovalemia, (any fluid loss) and maybe continuous medications such as cardiac arrest etc... Most patients do not require additional fluids and the extra costs, accidental "over loading", and of course carrying of additional supply etc. As well the patient has less tangling and moving of extremity is easier on the patient. Meds are simple to administer with flushing the site and administer med's through the port, and re-flush with closure of tubing. R/R 911

After the 3 posts, of simplistic questions.. maybe we should add how to use SEARCH in the basic EMT class ? R/R 911

Hmm ..I wonder if you are to lazy to search for check off sheets how you will be on the exam or performance?.... R/R 911

Yes, I too believe NHTSA requires a minimum clinical hours. I would contact your state EMS and double check, you school maybe trying to something not authorized. You paid good money, you deserve to get a good education. Good luck, R/R 911

Did you even read the above posts ?... I would probably not say anything, might review my textbooks and demad my money back from the school. Your instructor appearantly did not instruct.... it is a shame that this still continues. This is why EMT's have such a bad reputation. R/R 911

How ironic, they only provide ALS part time. Grrrr.. don't even want to get started, a large University town without full time ALS.... R/R 911

Wow.. heck of a birthday party. when blows out the candles ..he really means it !.. Burns sucks... I used to be a burn nurse, it tis a horrible situation, and wil scar forever (if they don't die due to complications).. R/R 911

There are several ranging from possibly aspirin to several types of antihistamine blockers, antihypertension medications etc..... it all depends upon the chemical of the medication, the severity of asthma and possible allergens. Some may be more sensitive than others. Remember asthmatic attacks can be produced or sparked by an allergen. That is why it is so important to have an understanding of pharmacology.... If there is a specific medication try using e-med, any medical pharmacology web site for interactions, contraindications. R/R 911

It is all dependent on the company. I have seen anywhere from immidiately to several months before you are off orientation. I have not seen any difference from private to municipal. Be safe, R/R 911

This is interesting or ironic.. I just met with a Paramedic instructor and he was informing me of some of the difficulties that EMS students are having difficulties in clinical sites. He asked me if I would design or meet with his students on how to successfully succeed in hospital clinical areas. So here are some suggestions off the top of my head: 1) Come prepared..okay sounds like a no brainer but seriously... Do you really know what your clinical objectives are ? 2) Be there on time ... better yet, be there early. Yes, consider this like work or an employer... you really are representing 3 things. Yourself, the school, and yes the clinical site you are at. 3) Show up clean, groomed, rested, and yes in full clinical uniform that is clean, ironed, and shoes shined etc.. I had to send 6 students home last semester. 1 had body odor so foul, 3 other looked liked they slept in their uniform, 1 without name badges or credential I.D.'s, the other worked all night, so all he could do was try to stay awake and sleep in a chair.. you are wasting my time and yours.. go home. 4) Introduce your self... ever seen a shy medic ?............ Ask to speak to whom is in charge. They will direct you to the proper person. Ask, if they will assign you or will you float among the staff. Introduce yourself to clinical staff when possible. When introducing yourself, state your name and the level you are there for ..... sorry, I see too many students to know what level you are. 5) Ask them if they will keep you informed if they have an interesting case. I suggest to introduce yourself to the clerk or data enter... since they will be placing orders in, they will know where the interesting cases are as well. 6) As others have described... seem interested. It is your duty to learn.. this means listening, observing, touching and assisting. Ask to assist with some routine duties. No you are not there to be an cleaner or do all the dirty tasks, but do assist when possible. I have seen two types of students .... those that would not help at all and those that will not do nothing but routine tasks, and are not interested in interesting cases. 7) Don't charge in and take over... ask if they would like you to __________?. After, working with a preceptor a while, they will let you know when you don't have to ask. 8) Ask about the medical case in private.. if you don't understand, ask appropriate questions. Ask if they have reading material or information if more is needed. 9) Be nice to patients.. and family as well as other staff members. Housekeeping, x-ray, etc... 10) You can talk about yourself... please a little will go a long way. When talking about your class, please don't go overboard about how bad or good it is ... they probably already know. Again, don't be a wall flower but don't be an ear full. 11) When it is about time to leave... have you papers ready to be signed. Try to have an exit interview prior to time to leave, to talk to your preceptor. Ask them your weak points as well as positive. 12) Allow the preceptor some time to sign their comments in private.. 13) If there is an interesting case, that comes at the same time you are to leave... I highly suggest asking to stay to help or observe. When a student leaves & it is a good case... it demonstrates to me that they really don't give a damn. Again, ask nicely, they may have plenty of help.. etc.. but asking sure presents a good image. 14) Lastly, thank them... and smile. The old thank-you card is nice... after you have completed your rotations. Lasting impressions. You never know whom might be on that hiring committee... :wink: Have fun, keep your eyes & ears open.. watch and observe, talk to patients. Learn as much as you can... there is plenty of that to do daily. Be safe, R/R 911 Okay, that is some basics..

In my area there are a few volunteer EMS, EMS is usually professional and the Fire Departments are volunteer. Dependent of course on the population of the community. R/R 911