akroeze

Agreed.

What procedure's are people talking about that they "can" or "feel they can" do (on whatever level, but apparently were are educated in said procedure), but are somehow restricted based on their current "protocols"? Please give me your grossly hypothetical and reasonably hypothetical situations...

I have standing orders to do a surgical cric and needle thoracostomy. Can I do them? Yup. Do I feel comfortable with them? Absolutely not. Will I do it? If all other airway solutions have failed or the patient is hemodynamically unstable secondary to the pneumo then yes.

Is it like having a patient in a pseudo unstable rapid afib or something and thinking that giving amiodarone would be of benefit, but you can't? I know that amio can be given to said patient, and I think it would work so I'll just do it?

I don't get.

Added to the fact that a proportion of US medics with potentially substantially less education have a higher scope to begin with is a little unnerving.

I'll give you an example that happens in Ontario. A medic who is an ACP at one service and a PCP at another (BLS only) service. They get into a situation where they have a tension pneumothorax and are pretty sure the person won't make it to the hospital.... do they perform the decompression even though today they are wearing the uniform of a PCP?

Yup, it is.

And then if your protocols state that you can proceed with best judgement if unable to contact a Doc....

Then there is always the "What's that Doc? The cell phone is breaking up, I can't hear you!" And then disconnect

Seems to ben a military academy type situation. Not sure that is the way EMS should be but having not experienced it I dunno

*DISCLAIMER* I am NOT trying to 'flame' anyone

it's to finally put an end to the paragod syndrome that seems to afflict so many Paramedics!

Unfortunately the evidence seems to contradict your opening statement.

To save my life definitely

In my service, which is private, we can release (we use SOR) just about anyone. I had a buddy of mine SOR a full arrest. The patient was in his 90's and just got his steak at a local restaurant when he went into v-tach. He was successfully defibrillated and on the way the the squad he didn't want to go to hospital, he wanted to finish his steak.

:shock:

*opens mouth*

*shuts it*

*opens mouth*

*shuts it*

:shock:

Ok, I'm moving there!

Having never needed any ALS drugs in a year of operation they have to be the safest place on earth.

I would pick a service Hospital based service, associated with medivac and have an option to work part time in the ER doing some Primary Care under an proactive MDs direction that had access to practice intubations in an OR

(within walking distance commute to work) snowshoes in the winter and bike in the summer and near a big water (Lake or Ocean)

And work in Dusts Clinic, 3 months out of the year ... but just in the Iraq Winter.

When you find this service, let me know

Also, their website states The average EMSA Paramedic makes $43,000 per year.... sounds like they are maybe referring to with OT

That is definitely a concern.... from what I have read would Tulsa be an option for avoiding the whole FD thing?

Two of our guys got on with the OKC FD recruitment round and took a major cut in pay. It will be nearly five years before they make up the difference in Paramedic pay. Yes, rice benefits and longevity pan but other than that don' t see the benefits. I guess if you want to be public servant.

R/r911

Hi there,

Is it safe to assume from your location that you work for EMSA?

I'm looking at going to the states to work for a while to get some varied experiences and was wondering if I could get an inside person's perspective. I would be working at the Paramedic level and honestly at this point EMSA is pretty much at the top of my list.

I hear that it is busy, but do you feel over worked at the same time? Are you basically in the truck your entire shift non-stop? What is the pay like (starting wage and how does it scale up)? Is there a copy of your protocols somewhere that I could look at? Is management responsive to employees and their needs/problems/issues?

Anything you can say would be appreciated.

Thanks,

Alex

Can I have your stereo?

I am so tempted to send this Councilman a letter, giving him some honest and intelligent insight into what the problem is. Even after all these years of beating my head against the wall, I still occasionally get these idealistic notions that someone who can do something about it might actually listen and "get it". But nah... knowing Floridia today, Gary Price is probably a recent frostback immigrant from New York, who still thinks that the Long Island volly system is wonderful.

I suggest you make a form letter so that in the future you can easily send them out.

Although, relocating for a BRIEF period COULD be an option potentially.

Is Acadian a good employer? Decent (comparatively speaking) wages and treatment of employees?

One that has always caught my eye is EMSA

Well to be honest I'm more looking at working in Michigan because I'm right by the border. Easy hop across to get to work.

My understanding was to get certified in Michigan you have to have NREMT first.... I'm confused

Why can't you all just stop the kindergarten name calling, and act like the professionals that you claim to be. Learn to accept the fact that other people have opinions that may be different from yours and move on!

[extreme analogy]Learn to accept the fact that other people feel murder is acceptable which is different than your opinion and move on[/extreme analogy]

Hi all,

I'm pretty sure this question has been asked here before but I'll ask it again. I have checked the NREMT web site and can not find any information for out of country applicants getting equivalency to write the NREMT exams. Does anyone know about this? Anyone been through it? Is it easier just to take the courses all over again in the states?

Since I already have the extensive educational foundation I wouldn't feel guilty taking a 556 hour (plus 350 clinical) Paramedic program I found just across the border if I have to.

I dunno. Everytime I think I may be attracted to someone in EMS, I realise it's time to take a hiatus and go remember what real women look like.

Harsh

ACLS

Epi (1:10000)

Atropine

Lidocaine

Narcotics

MSO4

Fentanyl

Benzos

Diazepam

Midazolam

Symptom Relief

Nitro Spray

ASA

Epi (1:1000)

Glucagon

Dextrose 50%

Ventolin (MDI and Nebs)

Glucose paste

Diphenhydramine

Dimenhydrinate

Not a whole lot really...

Here is another question....

Does the response time stop on the first arriving unit? What if it is a BLS unit on a VSA? What if it is a first response truck (eg Supervisor) does that count?

LOL! Have you seen their pay? And their uniforms? Ugh! The city is a great place to work, with great hospitals and an excellent call volume and lots of variety. Good medicine practised there too. Not load and go firemonkey-style like Dallas, next door. But they simply don't pay enough to make it worth your while. And with 12 hour mobile shifts, and transfers being half or more of your call volume, you burn out quick.

Cooking the books is the only thing they are doing right. Their cardiac arrest save rate is no better than anyone else. They just only count witnessed arrests in shockable rhythms. If everyone did their statistics that way, Seattle would look like just any other system. And it's tiered, which means automatic suckage.

I was SO tempted to move there back in the late 80s. The companies have changed since then, but it's still all privates, with the usual low (lower than most) pay. And the cost of living has gone way up in Vegas in the last twenty years, so I don't know how those guys get by. Sure is a cool place though! If I were independently rich, and just working for fun, I'd go there.

I'm very interested to see where you would pick Dust

Hi folks, out of curiosity if you could work for ANY US service which would it be and why?

In other wods, which service in the US is your 'dream job'?

1) Getting a job as a Nurse instead

2) Going back to school for some kind of Network Administrator role

3) Going back to school for med school (this one I would really like but I'm quite annoyed that despite having 5 years of post-secondary schooling I essentially have to start at square one on an undergrad)

Finishing my preceptorship now, starting to rethink things already...