EMS Solutions
-
Posts
124 -
Joined
-
Last visited
Content Type
Profiles
Articles
Forums
Gallery
Downloads
Store
Posts posted by EMS Solutions
-
-
Is there a way I could get a copy of the NJ Paramedic protocols?
http://www.state.nj.us/health/ems/regs.shtml
The standing orders are put out by the state as guidelines. Each "Project" medical control then decides what to allow the medics to do and OLMC options will vary.
How are medics usually deployed? Are you 911 only? Transfers only? a mix (scheduled 911 & transfer days, you start 911 but if a transfer comes in they pull you from rotation, etc)?
This will depend on where you work. Some are posted on street assignments usually in the urbam areas and others have quarters to station at. From what I know, you are either 911 or critical care transport. NJ runs dual medics for 911 and 1 medic/1 emt or 1 emt and 1 RN for CC.
Do you know what starting average pay is NJ?
Pay ranges I have seen are between $18.00 and $28.00
Is there a union?
This will also depend on where you work. From what I know there are 2 that have unions (IAFF). One being MONOC, who covers Jackson/egg harbor. But to date still no working contract, since the union decided to file job actions instead of solidifying a contract.
How are the benefits?
Still will depend on your employer.
My wife seems interested in the Jackson, Egg Harbor and surrounding areas for us to live...any suggestions on companies to approach?
MONOC.org is that areas coverage. But other NJ medic projects pay better and supposedly have a better work environment. I just cant speak for other agencies.
how busy is it? Is there a lot of violence? More trauma? More medical? or about equal?
Like other posters mentioned, this will vary and depend on your area. I found most of the time to be pretty busy.
I have worked in an urban setting for quite some time. I apologize for the ton of questions, but trying to as much info as I can before I plunge head first.
To get a medic card in NJ you must be sponsored by one of the providers. Then they send your info, training and experience to the state who then decides if you meet NJ requirements for reciprocity. If you dont, then most likely the sponsor will arrange for you to get the needed or missing training. Depending on the sponsor, this can be paid or at your expense.
If coming from another ems system, I think you may find NJ a shock to how they do things.
Hope this helps.
Jim
PS - Sorry I couldnt figure out how to get the "quote" thing working.
-
-
It isn't as bad as you may be thinking. Take a listen to this interview with the Assoc. Director of the NREMT. He talks about the exam and how it really isn't designed to have people fail.
http://ems-safety.com/greggm.htm
Good luck
-
Any recent landscaping, chemicals to treat grass, shrubs?
-
-
I think there needs to be better incentive.
Get rid of the volunteers - well no incentive. Why would a county pay for EMS when they can get it for free.
Get EMS out of Fire - no incentive there. Why remove a portion of your budget and response numbers.
Get better education - 2 years great! Wait, no incentive there either. Why go to school for 2 years to get paid 12 bucks an hour with no growth or career path. When you can do the same and be a nurse for 2x the pay or more with plenty of career options.
As long as you have commercials showing nurses in the back of ambulances ventilating a patient with a BVM and running to the aid of a downed motorcyclist. Theres no incentive to have the public care about us and OUR profession.
Getting real public and political support is the first step to getting support for the changes we need. Until they can truly undertsand what we do, no amount of education requirements, national guidelines and upteen levels of certification will help us.
No amount of fancy stickers given away or free public tours of the ambualnce during a fair at EMS week is going to make anyone turn their head to support us.
We need real PR. Not PR that tries not to step on anyones toes or hurt anyones feelings. Do you think that nursing commercial cares? Or that every Fire rescue operation rarely mentions a medic or emt that saved a life? It's always "firefighters help victims from car wreck" when you can plainly see the "paramedic" label on the jacket.
As far as the public knows we are the ones who drive the thing to the hospital, the ones who are wearing the flip flops or the big bat belt that jingled so nicely.
Get that public outcry about how they may or may no get an ambulance response from that volunteer agency, or let them in on how some providers are barely trained to use the oxygen cynlinder never mind poke them with a needle. Show them the training we should have nationwide, the calls we do and are expected to handle for $12 an hour. Just maybe then they will support us in our goals.
OK - now I went on much longer than I wanted and it's all just my 2 cents. There are people with much bigger brains than me.
But everyone has their own 2 cents. Isn't that the real underlying problem?
-
I have a basic PP file. PM with your email and I can send it to you.
-
NYC has a ten minute rule. Meaning that you can bring a patient to their hospital of choice as long as that hospital is not longer than 10 minutes away from the closest hospital.
With that said, special patient types psych, trauma, burns etc. are transportated to the appropriate facility unless certain criteria are met such as unmanageable airway or cardiac arrest- then they go to the closest.
When a hospital Er is on diversion and a patient requests transport to that hospital, patients are advised to choose a another hospital. But if the patient insists on that hospital anyway, and it meets the 10 minute rule, then you take them where they want to go.
Two other points - If a patient is a psych patient and the ER is on diversion, you would take them to the next available appropriate facility. If both are on a diversion status, then they go to the closest.
lastly - if a patient requests transport to a hospital longer than the 10 minute rule or you feel that even the 10 minute rule may compromise the patient. Then contact with medical control for approval is required. Mostly they will approve transport to the patients requested ER.
Now I dont think I covered all the bases, but this is the basics of it.
-
11 Ambulances Cut
28 shifts
Now where will the 45,000 patients each year go?
Come discuss it tonight at 8:30PM EST
Authorized Transmissions Radio Show
Just visit and listen in or call in and give your opinion.
-
Come join me as I hold an open discussion regarding EMS and the current financial climate. Is the EMS industry recession proof? What challenges does the industry face and what can providers at all levels do to help secure their jobs and future?
Have you seen any changes in your organization due to the current financial climate?
This Thursday March 12, 2009at 2030 (8:30 PM) EST
I am having another open forum call in radio show to discuss just this.
Come join me and have your voice heard, share your ideas or opinions.
You don't need to be some finance wizard. I certainly am not.
Just click the link below and bookmark the page. Then on Thursday come visit and
join in or even just listen to the discussion.
I hope to see you there.
While you're there take a listen to some past episodes or download them to your
computer or Ipod.
Jim
PS - If you want to be a featured contributor, drop me a PM.
-
A great way to get the word out is Facebook.
You can create a business/organization page thru your main FB page and then people can become fans of the page. Then your freinds freinds will see it and become fans and their freinds and so on and so on.
If you do this, let me know and I will be a fan.
I like the site BTW. Did you know that the dark background is saving 20% energy from a lighter or white background? So you're being "green" as well.
Good luck
Jim
-
Don't laugh, Video resumes are increasing in popularity. Sites like careerbuilder.com and even one soley targeting video resumes resumetube.com
are finding that it is a great way to give potential employers a peek of what you are all about before you get that interview.
With the job market the way it is, I would put a resume video of my own on youtube or viddler and send that link along with my one page resume and short 1-2 paragraph cover letter to the potential employer. That may be the thing that gets your foot in the door.
- Check out a free Job preparation guide. It is for designed for any job market, not just EMS.
http://ems-safety.com/emsfiles.htm
Maybe it will help you a little more.
Good luck
Jim
-
including interviews with Dr. Bledsoe and I.
Wow Dust, you may have to start going on a junket soon with all these interviews.
-
A small learning curve is Frontpage or CoffeeCup.
In addition many web hosting accounts also usually have a simple web design feature that would include a template with a WYSIWYG editor.
-
Most of the commercial field guides are way too big to fit in a pocket and are really just mini textbooks. They can be a good tool to use if kept in a bag or fornt of the truck to refer to. Especially for newer providers and those returning after a leave. I do agree that they should not a be a crutch or replacement for good retention of drugs, dosages, treatments etc. But there are calls like pediatrics that it can be better to look up some things to "refresh" your memory on the way to a call, rather than give an incorrect dosage or med. A quick refresher on certain drugs is all that should be needed. You should not be reading from the little 3x5 book on each call.
I get a lot of agencies to create custom guides for that start off wanting to have a 300 page guide with all the nuts and bolts included. I try and suggest that they keep it as a short reference guide and not as a replacement for being a well educated and knowledgable paramedic.
These guides can be useful in a regional setting since dosages and medical control options and treatment modalities can change from region to region and some of us work in several regions. So having a specific guide for a region that focuses on that areas protocols can be a very useful tool for not only "refreshing' on a particular protocol but also during chart writing.
So while I agree that any guide should not be a go to resource on each call you do. They can be another tool that we use in the field to ensure the best care is given. I would rather someone peek at a drug dosage real quick than give the wrong med. While at the same time, if that same someone is looking up the same med or dosage every time, then there is an issue. Whether it be laziness or just lack of interest in their career.
Field guides are a tool in our arsenal and it depends on how you use them.
-
Sent you a PM - Jim
-
I've been eating that many calories ever since I saw the Olympics and found out that Phelps was eating that many. I figured if he had a body like a super hero eating like that why not me.
so far... it's not working out like I planned.
-
Just as an FYI -
From Uncovering Difficult Airways ems-safety.com
-
I have worked for several agencies that tracked advanced skills the employee did. IV, cardioversion, IO, Needle Cric, Pacing, ETI etc.
We would have to either fill out a short form or record book and document the skill along with noting dates, chart # and any issues we had in peforming the task - 2 attempts at ETI , 2 IV attempts, unsucessful IV attempts. Then sign the form or book.
In addition two agencies spent a lot of cash to get the equipment to cover skills not done all that much such as IO or Needle Decompression.
The medical director would have a requirement of maintaining skills by perfroming "X" amount of skills each year during patient contact.
If you did not fulfill those requirements then you would have to do them in a skill station type of scenario with the Medical Director or his appointed designee - usually a paramedic preceptor or training officer.
For those who worked only PT, they would either have to provide documentation from a FT job that they maintained the required # of ETI etc for the year or do a bunch of the skill station scenarios mentioned.
They also required that all employees do a clinical assessment annually, which includes a patient assess, mega code, trauma and medical scenarios as well as go over any recent changes in local protocols and new treatments. This was done annually along with a short exam.
I am not sure if they did it for JCHAO. It may have been for CAAS requirements though. I know that one reason it was done was also to try and protect the agency from legal questions. Such as if a patient or family complained you didnt do something right, management could always provide some type of documentation that you did the skill "x" amount of times succesfully.
As far as JCHAO, I believe that most of what they did was a rush every three years to cover things like RACE, right to know, PASS, hospital operations, HIPPA and employee documenation and not so much the skills and ops of the EMS department.
-
-
Take a look at the Job Interview and Preparation guide I just posted. It can be applied to any market but hey it's free and maybe you can get something out of it.
http://ems-safety.com/free.htm
Jim
-
A note that EMSA is reviewing to assure that the medics action was correct as well.
I am surprised that no one has made it the medics fault yet. I mean how dare he fight back, he should just stand there and take it.
-
I wonder where the 15+ minute video is for paid EMS?
-
I agree that if you are confident in your knowledge going in cold should not be an issue. The issue may be the exam style since so many people are not used to or have never taken the NREMT CBT/CAT exam type format.
I actually did an audio interview Dr Margolis, Associate Director of the NREMT and he gave a bunch of great insight into the exam as well as the upcoming accreditation plans for medic courses.
http://ems-safety.com/greggm.htm
One of my members took the time and gave a short summary of the interview for me - I have posted the exam section below.
Good luck - I took the exam years ago and then again in the CBT format just so I know what it was all about first hand and passed with little to no study.
====
Gregg S. Margolis, PhD, NREMT-P, is Associate Director of the National Registry of Emergency Medical Technicians.
Re: CBT Exam Process (Computer adaptive Exam) – started in 2007
1. Not the old exam just placed on the computer
2. New Algorithm for presenting and grading the test – more accurate and fair
3. Adaptive – there is no fixed length to the exam. There is a minimum & maximum number of questions but the number will of questions presented to each candidate will be unique.
4. Test starts with medium difficulty items.
a. If answered correctly, questions get a little harder
b. If answers are incorrect, questions back up to a little easier
5. More failures since the change? – No
6. Most feedback is “pretty challenging”
a. every one gets ½ right and ½ wrong –
the score depends on WHAT questions are correct.
b. Since the questions adapt to the person, most find it quite difficult for THEM
c. Anyone who thinks it’s easy – probably missing a nuance and getting things wrong.
7. How does program choose questions?
a. NO desire or intent to make the exam SEEM hard
b. Test designed to make an attempt to determine the candidates ability.
(1) Old method in linear exam environment - score was a straight % of the questions
(2 ) New methodology – Item Response Theory
(a) Item difficulty adjusts DURING the exam
(
Now measuring WHICH items are correct © Therefore, hardest items correct = High performer and
mostly easy items correct – low perform
8. Have there been any major “glitches” since the 2007 rollout?
a. No major bugs
b. Some minor issues
(1) CANNOT EMPHASIZE ENOUGH THE NEED TO PRESENT PROPER ID DURING SIGN-IN
(2) Two forms of ID Required
i. One must be photo
ii. One must be government issued
9. Summary – designed to be a more accurate and more fair assessment of the candidates’ ability
a. It is a timed test, but
b. Less than 1% run out of time
c. Important to read each item carefully and make sure you understand what is needed before answering.
i. Read the entire question and all of the distracters before choosing the BEST response.
ii. There may be more than one right answer but only one is BETTER ie. more correct the majority of the time
d. Every exam has 10-15 pilot items.
i. These are not testing the candidate and won’t count for or against the candidate in the score.
ii. These are being included now, prior to inclusion.
iii. If you run into something that seems extremely difficult, just assume it is a pilot item and don’t worry about it.
==============
Please keep in mind that the above is short summary of the Q&A.
Jim
Passive VS Active Cooling in heat exhaustion
in Patient Care
Posted
Depending on the heat emergency some protocols say to give cool fluids by mouth if the patient has a patent airway. Others say nothing by mouth. I have put cold packs to arm pits, groin, neck to cool patient off. IV fluids are also an option. I would check with your local treatment guidelines and follow those established by your medical director.
I actually just did a hyperthermia overview podcast with Greg Friese from EMS1 and Everyday EMS Tips. There's some good points to listen to:
http://ems-safety.com/blog/?p=67
Plus a free online CE on Hyperthermia.