FormerEMSLT297

Yeah that was kind of my point. I'm not going to work for years on a BLS unit if I'm already a medic just so I can get a spot in that "GREAT" system.,,, I just wonder how they keep people long term if all the new hire medics work BLS for years until a spot opens up. Sounds a little elitist.

I think Seastrat hit the nail on the head. The idea of using tactical medics is simply this. Do you want an EMT (or P) running into a hot or warm zone without any type of training?... No you don't, so you train a team member or civilian medic to provide BLS or ALS care while in a potentially hostile environment. The Tactical medic is also a PMT (Preventive Medicine Tech), like the navy corpsman who wraps or moleskins a marine company before a forced march, or provides basic NSAIDS or minor pain meds after the march. The other thing that he mentioned is the LEGAL aspect. If a suspect gets shot, or injured seriously, the agency standard that most lawyers want to see is an immediate ability to provide care. If you dont have that and the suspect dies, the ambulance chasers will claim you faild to provide aid in a timely manner. So that an additional reason that the tactical medic is there.... As for any research papers I know of several instances where a tactical medic made a diference, so I would call for further research on the topic before we TRASH the tactical EMS concept. Former

I will say this, unless I'm overwhelmed by patients , I don't need untrained or semi trained bystanders stopping to help. Now if I'm first on scene I'll stop. But almost NEVER if I see an ambulance stopped on the side of the road. My car doesn't have light and emerg. equipment. I don't want to have to leave it on the side of the road and jump in with the crew/patient. I don't want to get all bloody and then contaminate my car, civvies clothes, etc. But having said that I did witness a Motorcycle go down several years ago on the New york Thruway. I pulled past the accident and well off the shoulder in my personal car with my 6 y/o son sleeping in the back seat, and left my brother to watch him. I called 9-1-1 and approached to patients (2 on the same M/C). Even though watched the accident happen, by the time I got to the patients I had 2 EMT's and 2 nurses tending to the patient. I told the 9-1-1 Op, that I was an off duty medic and that I didn't know where the nearest trauma center was, but that if there wasn't one near by I could start a helo. I gave the patients conditions to the Op, one had massive head trauma, was unc, decorticate and posturing, the other had an open TI-fib on 1 leg and closed femur on the other. When the first trooper arrived, I told him what i did. We waited like (well lets just say it seemed like forever) for the first ambulance and FD to arrive. When they arrived I told the Fire Chief that I had called, he confirmed the helo was en route, and told me I made a good call. Now for the best part. Because I had pulled well ahead of the accident, I was able to leave the scene before the helo even landed, and the other good sams at the scene were STUCK in the back up. The road was closed for several hours, and I had open sailing ahead with almost no traffic on the road.

AHHHHHHHHHHHH, not this again.... do a search we've beat this topic to death for gods sake. I have one question for my senior posters: If someone is not smart enough, or too lazy to google "flight paramedic", should they even bother to apply?????? Will they have the stamina to complete the years of training necessary and obtain the alphabet soup certifications to get the job? will they be smart enough, commited enough, or motivated enough to get through ?????????? if they can't even do a basic computer search ? Hmmm...... FOOD for thought... not knocking you just want you to think. ) PS good luck My thoughts are my own and do not represent my agency or dept.

The latest genius from the FDNY is to consider 7 man paramedic engine companies staffed by 4 FF CFR-D 1 FF/Paramedic 1 FF/EMT-D and 1 officer. The other is to have Lieutenants ride as Paramedic units with EMT partners. It is all detailed in the "FDNY Strategic Plan" so check out this link: http://www.nyc.gov/html/fdny/insider/strat...007/index.shtml All FDNY EMT's should see this for what it truly is. An attempt to eliminate all non Medics from the system and privatize or contract out the BLS transport units. Read further into it and you will see the plan to have FF keep their EMT or medic, and for a requirement that EMS officers be Medics. This is step one to have an all Paramedic FDNY with NO BLS personnel or units. Stay safe. My thoughts are my own and do not represent my agency or Dept.

Maryland does not, Wash, DC does not Virginia does not. New York Does not. However NY, MD and VA all have colleges that offer a EMT-P and an A.S. in EMS/Health Science, in the same class that is 2 yrs long. Former

O.K. I stand corrected... Is that all of NYS ??? because I think I remember NYC having a traffic regulation against them. But that was like 10 years ago. Sorry for the error.... been out of NY for a while now, just go back to visit.

If Police Dept's. will hire someone with a DUI, the world isn't over for your "friend"... Some jobs go back 5 years, some 7 years, some 10 for DUI. It all depends. I do know of some Police officers and EMS personnel that have DUI/DWI's in the past. He would have to check with the State EMS licensing agency. The only thing that I know of that is automatically disqualifying is a FELONY conviction. Many Private ambulance companies may preclude your friend from driving because of insurance regs. But you would have to check and find out. Former

I agree with getting an ALS version,, also carrying a pocket guide to your protocols is a good idea. It will have: local poison control numbers, ER numbers, Med Control numbers, What hospital is a trauma, peds burns etc. as far as the run of the mill book go to: www.informedguides.com I have the 14th edition and it is 170 pages and has a lot of good stuff in it.

Be careful with "Studded tires" there are some states, like NY, where they are not legal, others have restrictions on when you can have them on a public highway because they cause damage to the road surface if there is no snow covering on them. Having said that, if they are legal, they work GREAT in ice and snow. Check with the DMV or State police before going that direction. one question: Isn't it a little late in the season to be getting snow tires? If I was going to switch, I would do it in late nov. early december. But other than that,, make sure you get tires that are properly rated for the size and weight of the vehicle you are putting them on. whatever you decide good luck Former

Thats GREAT. congrats.... Is it going to be on a Medic unit, BLS unit or in the ER/OR..? No matter.... What the other folks said is true. Another one is DEEP DEEP breaths. Think before you act.. Ohh and don't worry too much. Everyone was new once... Even Dust. LOL You will be expected to make mistakes, and when you do,, just try to learn from them and don't repeat them. I would hope that they give you some type of training manual or guide book.... and parameters that you are expected to meet. Thats all. Good luck Former

The highest I have ever seen it in the field I think was the high .3x or I think low .4x.... but like I said in a previous post, these people were all driving... But .53 is a very high number..... Thats amazing. We did lock up a girl who was like 23-24 and she was a .38 at 5 PM on a weekday afternoon. Think she had a drinking problem???

Most if not all EMT classes have a patient transport, patient packaging, patient movement part of the class. How will your husband be able to package, lift and move a patient with an injured back?... I think the best idea is for him to take an office job, as a dispatcher, maybe ambulance cleaner, restocking, etc. something that doesn't require heavy lifting. With so many people in the industry suffering career ending back injuries, WHY would your husband want to volunteer on an ambulance if his back was anything less than 100%...and potentially risking another aggravating injury. ??? the best thing I can suggest is for him to rest up, heal up and reenroll in the next class. If I were the instructor, I would not allow him to participate in the class without a complete bill of health from a physician. I've been in the industry for over 22 years and EMS personnel who are unable to lift do not last very long in volunteer or paid services. IMHO. My thoughts are my own and do not represent my agency or dept. Former

Just went thru a PEPP refresher,, they said birth to up to and including 28 days old. After that it's an infant.

No training you receive is ever a waste. I never understand companies like that,, they are short so they rush you through, then they b@#$%h about you not completing training. I would say if they are as bad as you said, you are probably better off wthout them. Try to find EMS employment elsewhere,, the other suggestion is File for unemployment,, everybody else does. best of luck

Without starting the ALS/BLS debate, that is very true. AMS diabetics who are hypoglycemic is one area where rapid ALS intervention can help correct the situation. An experienced medic or EMT can make a judgement call and if questioned speak quite educatedly about why they did or did not do a procedure. When I precept EMT and Medic students, I always debrief the call and ask them before they do something, if time permits, why what their rationale is. And we talk constructively about what if's and how to justify a particular procedure. I hate cook book medics. When I was a new Medic my "senior" partner and I went on a call for an Unconscious Diabetic in an office building. Upon arrival we got a Dex stick of like 40. We gave her 25 Grams of Dextrose I.V. B. and as she began to come around, he whipped out 2 mg of Narcan and and started to give it to the patient. I stopped him and he said "we have to give it, it's in protocol", and he proceeded to give it over my objections. After the call we had a QA and the Medical Director said to him what was your rationale for the narcan. Well when he couldn't answer except that it was in protocol, the Doc was not pleased. And before anyone asks, she had no signs of Narcotic O.D. Pupils midline, known diabetic, took insulin, and didn't eat breakfast, etc. Thanks Former

I didn't catch that she (the original poster was a girl),, you expect me to catch that the teacher was a nutritionist and not an EMT? LOL I do not advocate blindly following protocol, however, if something is in protocol and you feel it should not be, isn't it better to have an educated discussion with you Protocol committee or Med Director and fix the problem.???????? The other question/comment I will proffer is this. If oral glucose in in protocol for an Unc. patient between the cheek and gum, and you don't do it, I think you open yourself up to litigation especially if the patient has a bad outcome. After all you're not a Doctor, you operate under a Medical Directors license and he/she, the person with the highest medical training (your MD), advocates the use of oral glucose and placed it into your protocols. We can argue all day about what treatments in our collective protocols are effective, and which ones are not, but until you get an MD behind your name, or until you get a particular protocol removed, or added to a list of "may" try instead of "must" administer, you are somewhat bound by your systems protocols. In MD our protocols for BLS Altered Mental Status/Unresponsive Person state in part: "...Administer glucose paste (10-15 grams) Between the gum and cheek.." I don't see anywhere where is says, "If you feel like it" or maybe give glucose that would give you any room for deviation. Now do I agree with all the stuff posted about Glucose lack of rapid absorption, possibility of aspiration, etc. Yes they are all possible. If I had my druthers, I would start O2, Start a line, check glucose level and if appropriate give a D50.... BLS personnel do not have that option. So to reiterate, I'm not a Protocol Monkey, or Cookbook medic or anything like that, I just was/am concerned with giving a NEW EMT direction that MAY be in direct contradiction to her protocols, and what the ramifications of that MAY be. As to whether you, the original poster, in Minnesota can and should give oral glucose to an Unc. patient, diabetic or otherwise, check your Minnesota AMS Protocols, and follow them, I think we have beat the pro's and cons to death. That is all; I AM done. My thoughts are my own and do not represent my agency or dept. Former

opps,,, sorry, her teacher

REALLY.??? be careful with the "always and never" statements,, Oral Glucose for "unconscious or Altered Mental Status patients" with known diabetic history, is in a lot of protocols. Even if the patient is unconscious. I know for a fact that it is in the MD Protocol for 10-15 Grams paste between gum and cheek. So, don't tell him "your teacher should know better." That may be directly out of the protocol book from the state or county they they are in. Now you may not agree with it, and being an ALS provider you may have a better way of doing it, and it can be a airway problem if you are not careful, but Glucose paste is protocol for Unc. Pt's. Thank you

That's quite O.K. Truckie1245, We have a couple of choice names for the FDNY: They are in no particular order: 1. Bucket Fairies 2. E.D.U. (police term Evidence Destruction Unit's) 3. F@#$in' Dummies of New York 4. (I like Dusts) Fire Monkeys 5. U. B.R.T.'s (pronounced EUBERT; Useless Big Red Trucks (on EMS calls only) 6. Monkeys with Axes etc. As you said usually out of earshot, but I had one partner bless his soul who used to announce at the top of his lungs. "Ohh thanks God, the Bucket Fairies are here, we are saved". As you can expect, that went over well.... And just to reiterate and explain, I think the FDNY does a Great job fighting fires, I just don't think they run a quality EMS system, or want to run a quality EMS system. IMHO Thats all. As always my thoughts are my own and do not represent my agency or Dept.

We are looking to replace our current Propaq 106's with the Encore monitors, If any flight medic/nurses can PM me with any problems they might have had or whether they like them, are happy, etc. I would appreciate it. We have seen the unit and done some limited testing, but we also heard that there were some problems with the units. Any info would be appreciated. Thanks My thoughts are my own and do not represent my agency or dept.

If NJ EMT-B follows what is known as the National Satndard, which i believe it does, then if you can't take the registry, you can get what is known as legal recognition or reciprocity,,, years ago,, NJ to NY was almost automatically granted if you filled out the proper paperwork.. You need to check the state that you want to go to, and then see if NJ is listed under legal rec/reciprocity. You can also check the NJ DOH or EMS website to see if they know what states, or NREMT will recognize NJ EMT's ...

This is what I was told: "great place to work innovative and progressive." I don't know I've been to Boston once. so I dunno, I was just told by some friends who have visited the system and have other friends that work there .... I thought maybe someone from Boston could shed some light.

No I agree that is very true,, the accident stats are an important factor... another one that some people don't know about is that SOME life Insurance policies will not cover you if you are employed as a flight medic and die in a work related air crash. That can be a BIG factor in deciding whether or not to work in the aviation field. My thouhgts are my own and do not represent my agency or dept.

I think the impression given to my friend, and I just went thru refresher and a Doc said this to. Was that he would land, and be wisked into the cath lab right away, bypassing the ER and directly into the cath lab. That didn't happen in my friends case. They waited in the ER. And her point was she thought that her husband would be bypassing the ER and directly into the lab.. thats all. As far as what on in the refresher class, the Doc from a particular hospital assured us that if a patient had ST elevation in 2 continuous leads, and we did a pre-hospital 12 lead the ambulance could by pass the ER and go straight to the cath lab and use the medics EKG as documentation. My friend felt that the price of the helo in dont remember the numbers was very high for a few minute flight, and that the time saved by the flight was eaten up waiting in the ER. My thoughts are my own and don't represent my agency or dept.