BEorP

Again mother said "no concern" that required ambulance other than her illegal status. Do you need medical complaint to transport or are you just transporting illegals?

As far as need more ambulances and staff I agree but thats another gripe for another day. But even if we had one ambulance for every house in our 2000 square mile plus primary coverage area is there any way to justify this transport.

And please note I have not brought money into picture, we assume we will not be paid. But as another point to ponder do you feel medicaid would pay for this? But again we are not concerned with payment at this time, just more to ponder.

If someone wants to go to the hospital I would take them. There may not be any immediate medical concern, but still the mother wants the child taken to the hospital.

The fact that she is an "illegal" should make absolutely no difference in the treatment that she receives.

As a Canadian, I have no idea if medicaid would pay for that or whatever but does that really matter? Are you paid on commission?

When driving lights and sirens to a call and you come up to someone in the left turning lane in the middle of the road, watch the wheels to see if they start to turn left (as this will obviously happen before the person is able to pull out in front of you if you are passing on the left).

I voted yes. If someone wants to go to the hospital, take them. It doesn't matter who they are or what their complaint is. If there are not arrangements to cover your area when you go on a call then that is something that your service should be looking into and fixing.

jw-c152,

The KED fit perfectly behind the pt. and the built it handles gives you something to hang on to and makes it easy to lift on to the cot. Sounds funny but it worked, sometimes you have to think out of the box to get things done.

I can't remember for sure, but I thought I remember reading that the KED should technically not be used for lifting but rather just to facilitate the turning and sliding for an extrication.

With this patient you do not want to tilt their head back, trauma patients require the jaw thrust instead of the head tilt. I'm guessing you were taught this at some point. Anyways have someone take c-spine and then extricate the patient out of the car and on to the ground. Have the person at the head control c-spine and open the airway, if the patient is pulseless then start cpr, if you don't have a face mask or anything similiar and EMS is that close then just do compressions @ 100/minute until EMS arrives.

Lay rescuers should no longer be taught the jaw thrust.

And to the OP regarding C-spine. By "taking C-spine" we just basically mean holding the head in line until the pt can be fully secured to a backboard. You basically instructed the bystander to take C-spine when you told them to hold the head still. And if you just meant what is C-spine... it means cervical spine.

she was lying there completly limp and unconscious, about 70 years old. there was a large pool of blood at the base of the seat, drool coming out of her mouth and no pulse. one person already at the scene said she just had a seizure.

by the time i assesed the situation the paramedics had arrived as the fire station was 3 blocks away.

im wondering what i did right, wrong and what i should do if the paramedics had not arrived for a while. even though i knew my basics i really eflt that i was not prepared. what woudl you have done in the situation.

Since you asked what if the paramedics had not gotten there so fast I will provide some input. It is a nice thought to get the old lady out and start CPR but remember that you come first. That means that if you don't have a face shield (you don't sound like the type to have a BVM on your belt) then you might want to consider compression only CPR. The unfortunate truth is that if this lady is dead from the trauma there is almost zero chance of getting her back. You did the best you could, but even more importantly than than, you were critical of your performance and looked for ways to improve. Good work.

Im glad you all are giving this person full support by telling this person that emt-e is not the way to go. As far as I'm concerned THE LEVEL IS OUT THERE for us to take it and I do not see any reason not to. I was doing this level while I am in school full time for nursing. But thankx I have learned that I no longer want to be a part of EMT City because its sounds like yall do not want to support but think because you are at the top level you know everything. Well I am sorry I know some paramedics that I do not know how in the world they passed. Anyways yall have a good time hashing each other. And to the person getting ready to take the enhanced test GOOD LUCK! You will do fine if you just go in there knowing your stuff. P.S. know a lot about asthma and airway. I hope you learned a lot and GOOD LUCK!!!!

EMT-EN

There's nothing wrong with a good debate... unless of course you don't have anything left to say. If you decide to grace us with your presence again, please respond to my post above regarding education and advancing a profession.

Just think! In today's society many people do not feel the need to go to school as long as others but want to help the community.

Many people might not think school is important, but look at any health profession and you will see that it is. Look at the history of medical dominance, look at how nursing is starting to eat away at some of that dominance, and look at how well BLS Paramedics in Ontario are paid even though there are many many applicants for very few jobs. What do these all have in common? Education.

Example being Ontario; Full cost (I believe is around $240) for misuse of emergency system. Rather then the $45 surcharge for regular usage. In the past Paramedics were able to determine this, recently revoked to only be approved by receiving MDs

Just to add to this... in Ontario if you charged full cost for every unnecessary use (which does not usually happen now) then maybe the cost for actual emergency use could be dropped so OHIP would cover it entirely (thus making it free in an emergency).

Better battery life would be nice so you don't get stuck changing it on a call or plugging it in on an arrest... I know it's not that big a deal but it would be nice. I like a lot of stuff about the Zoll E series like the colour screen, NIBP, easier to carry design but I'm not a big fan of the slightly increased weight over the M.

I'll be honest, I only read about half of it and then decided that I really didn't care to hear the guidelines bashed.

Show me lay rescuers who can check a pulse and be right on whether or not it is there in a true emergency situation after taking a six hour course that they take once a year and then we'll talk.

How much education is required to be a paramedic?Not a nurse,or doctor.A ambo grunt, i have to laugh at you supermedics who are impressed with your titles! Hey we're talking being a paramedic, next thing i'll here is lets do chest tubes in the field!

Go back to school.

I find this new breed of supposedly educated paramedics don't do well when you have large scale triaging or large crowds in the ghetto threatening to kill you.

It must be in the third year of a B.Sc. program where they teach you that if the scene isn't safe you don't go in.

There's a company here in Toronto that employs paramedic students to cover movie shoots and other events but basically sends them out on their own with equipment and no one to help them out. After finding out how this goes, do you think I work for them?

Does the 2 year degree have to be in "emergency medical services" or Paramedic sciences?

Nope, I'm just curious about education in general.

This was brought up by CBEMT in the other thread, but it really interests me and I think it deserves a thread of its own. The majority of people who have voted support a mandatory two year degree. My question to the people who support it is: what is your level of education and in what subject area?

I am interested to see if the people who support a minimum two years of school are generally only those who are already educated.

Four years.

(Now the bitching starts about it not taking four years to learn how to do the job. That's a fair argument, but education doesn't just mean knowing what you need to to do the job.)

Well maybe I will get in on this... Remember first year chem and the importance of sig figs?

http://phoenix.phys.clemson.edu/tutorials/measure/index.html

"A measurement reading usually has one more significant figure than the least count reading of the scale. The least count of our laboratory meter sticks is 0.1cm and therefore a reading can be made to 0.01cm."

I know that our pressure gauges are only marked in 2 Torr intervals which is very different from a metre stick, but it still adds something to think about.

There was a bit of a disagreement on this topic, so I'd love to hear your opinions on it.

Q. When a car accident occurs, and someone who has some medical knowledge and training (Like an EMR, MFR) stops to help, to assist with what is needed, provided the actions are in his/her training/authorized ability to do so. EX. Keep a clear airway, hold manual C-Spine, CPR, protect from elements with blanket, update EMS, etc.

If you were responding to this emergency. How do you feel, has this person done the right thing by stopping to help, or should s/he, who has the ability to help, just drive by, and only call 911?

Even an EFR first on scene is not going to be much use. Holding C-spine, updating EMS, and putting a blanket on someone will not save their life (and chances are your CPR won't either...). I'm not saying don't stop to see if they want 911 called, but I'm just saying it's no different if it's an EFR or a random person.

Many wanna bes get their EFR certs and suddenly think that they are the greatest thing to happen to people in need since paramedics. The way I see it with stopping as an EFR is that either it is going to be pointless because the accident will be minor and you will be able to do nothing or the accident will be serious and all the pt really needs is a quick trip to a trauma centre. Also keep in mind the safety issues with stopping at an accident.

Thank you for all the replies. Now I have a follow up question just to be sure I'm not wrong on this... So really when we talked about neonatal resus with a compression to ventilation reatio of 3:1 we really mean "newborn" resus since the 3:1 only applies for the first 24 hours of life?

Thank you for the reply, but I am specifically looking for someone who can quote someone like ILCOR, the AHA, the HSF or some other organization like that.

I have heard both first four weeks and also just the immediate time after birth, usually the initial hospitalization and that's it.

I don't mean to be harsh or insult the OP, but here is how I see it. EMS is a profession. We don't have any volunteer services in Ontario that I know of which makes sense since the education requirement is still the same.... If you want to volunteer to provide EMS then that is fine but, and this is a big but, you should still be held to the same standards as a paid service.

Would a paid service hire your husband? I think that's all that needs to be said.

It's good that he is doing well and I hope he stays healthy.

We're learning neonatal resus right now, but there it some debate as to what exactly a "neonate" is (as in when it becomes an "infant"). Can you please tell me what you consider a neonate v. infant and provide a source for this?

any reason why with an hour transport time... your service doesnt have 12-leads? Maybe im out of line.. but that seems the same as saying.. my service doesnt carry oxygen or EPI.

And that would be a fair compairson how? Oxygen and epi are treatments. A 12 lead monitor is not.

What is the "Paramedic Specialist program"? Is this some type of degree program?