Dominion300

Looks pericarditis, as ruff said until it's ruled out. Establish IV access, O2, continuous monitoring, do all your normal assessments and call for a transport to ER. I'd also try to get the doc on the line to let them know what you got, maybe they can get in or will have further orders for you.

oh so we do need the fire department

Of course we need the fire department. Who else will carry the stairchair and patient for me up and down stairs. Who else would I call to carry the heavy ones. I'm just saying, they have a purpose.

I miss living in Germany so much. =/

I'm gonna have to plan to come back for several months again. Wanted to come back this fall but that's not happening.

While I cannot say for sure it doesn't happen, the only 2 incidents I know of are both in "Mother, Jugs and Speed".

1) Murdoch rapes an unconcious female OD patient.

2) Jugs and Speed have sex in the back of a Caddylance, as "Peaches", the service owner's wife, radios them to at least change the sheets before bringing the vehicle back to base.

hehe I've heard stories here about the days before GPS in the ambulance where people would be MILES outside of their stationed area to go to someones house and get it on. Or partners who were married getting it on in the back. One of which story was my old partner and his ex-wife getting it on in the back on a regular basis. Pretty sure one of their children was conceived in the back of an ambulance. Most of the stories i heard, I heard being retold in front of a command staff. Now whether or not the people above the EMS director knew (executives) I don't know. I've never heard of someone raping someone around here. I have heard of it in the news.

I am with most on here about the firing of the officers. Was it a dumb decision? Yes. Do people make dumb decisions? Of course, and these guys got caught. If this picture did not have the fire arm in it? I probably would have voted no to firing them. Maybe disciplinary action but not firing. I'm not going to lie and say I've never seen or done something unprofessional, we've all made a dumb decision. Maybe not as dumb as letting someone sit on your squad car with an assault rifle. It would be the same as if a medic let a waitress hold defib paddles to her chest or if he was pretending to give her an injection.

On a similar note of dumb decisions. Sex in an ambulance? I've heard of it happening but it was always a 'teehee did you hear' kind of thing. Despite command also knowing, no one cared. It wasn't reported. Should someone be fired for that if it was not caught or suspended or what? This is of course unprofessional behavior but what would you do if you were command and heard someone had sex in an ambulance, the person wasn't denying it (to the people they told the story to) and you had no proof. Just wondering while we're on the topic of unprofessional behavior (Oh in any scenario the sex was on duty, whether it was between partners or between one person and a wife/girlfriend not in EMS, or one person and a waitress (or hooker, someone they met, etc)

Honestly we just call for the good ole FD and they usually handle the moving of the patient while the medic sees to the care of the patient

We also only have one bariatric truck for the entire county. Reinforced suspension, bariatric (manual) striker, ramps, and winch. It's just a shame that it's broken down 70% of the time

This is an actual scenario for me. 620lbs woman in respiratory distress, non-ambulatory. Broken elevator and on the 3rd floor. Call placed to fire department after a few phone calls to supervisors etc she was brought out on a tarp with handles essentially (forget the actual name of the item) The fire department placed her on the device and dragged her down the stairs. The type of material and the floor made the drag really easy. The stairs they lifted her as best as possible but it was still a bit of a drag.

When she was released from hospital I was working IFT and was called to transfer her home with our bariatric unit (which was JUST repaired). Thankfully the elevator was working and we had no issues getting her home.

Sounds like a great class. My only concern is the fact they haven't already pushed for accreditation as I know most are already clear with it that though I'm fairly certain being affiliated with U of L and they will end up with it and especially if they can manage to work it into a degree program. At a minimum maybe get it to where they could do a degree completion with the accreditation? I imagine these ideas have been hashed out to some degree already - are they looking at a 2 or 4 year degree option or all the above like EKU? UK used to have a great program, shame they closed it down. Would love to see LCC pick it back up or do a degree completion for those already with it.

Honestly I don't know too much on the accreditation. I know it's been talked about that they are gathering the materials currently to apply. I don't think the class will have any issue with it either. As far as the degree program I don't know 100%. I was told a few ideas were tossed around and considered. 2 year AS degree where you just have to get your gen eds and then take the program so you can either get your AS degree or enroll without having to get an AS (without doing gen eds). There is a department who said they were interested in giving students a BS in that program with a minor in paramedicine. You'd have to talk to the course leads about that specifically. It's a pretty good program and despite not being accredited I've been happy with it, I looked into other programs and if I'm not mistaken the only two currently accredited programs nearby are EKU and Ivy Tech in IN. I had considered once I get my license heading to Lexington or even nearer to EKU and getting a degree from there. That is if UofL or other college doesn't get one set up.

There HAS been talk of making the AS at UofL (if they give it) retroactive for his class, so you just go do gen eds, basic science courses and you're done. Which would be awesome cause I'd only have to do about one semester MAYBE one year to finish up. Part time at that, I have 62 hours into a biology degree that I decided to not finish right now.

If you have to pick a day, thursday is definitely the star day. If you only pick one, that's it.

Just looked and yea if I go one day it'll be Thursday for sure.

Edit: Thinking Thursday for sure and maybe Wednesday, some good panels going on Wednesday too.

Dominion - how is that being run? Is it an offshoot of U of L with the consideration of eventually being degree seeking or are they staying with the accreditation through KBEMS? How long is their program aimed from start to finish? I'm kinda interested as I don't know much about that program and would like to hear a bit more as I try to keep up with the programs in the area. Thanks and yes, there's alot of good programs 'round here !

The program was originally to run from August 2008 to August 2010. Brandon Heming is the main instructor and he's been doing a good job I think for his first medic class. It's an offshoot right now, officially it's sponsored by UofL and they are working on a degree program. If they can't get the details hammered out for that they want to shoot for accreditation.

The program itself spreads the topics over a long period of time, so for example when we started cardiology we did an A&P class on the heart, blood, and vessels. Then we did cardiology. We also lumped in 'cardiology' drugs. So instead of giving us a stack of drugs to learn in a month or so we've learned some shortly over a period of time. Also we had planned on doing our clinicals near the end of class and running them concurrently with class. So instead of trying to fit in classes, study time, and clinicals we would replace a class day with a clinicals day.

The books we're using is the Mosby Paramedic Super Book and A&P for Emergency Care. We're also doing the standard ACLS, PALS modules and PHTLS, ABLS, AMLS, and a couple other alphabet courses.

However we since scrapped that idea so we could finish the classroom portion in october and we'll start our clinicals then.

We are doing our Peds clinicals at Kosair (ER and OR), UofL ER and OR), Nortons for OR, Doctor shadow time at Kosair and UofL (or nortons), L&D, CCU/ICU, etc. I forget how long it's been since Kosair has let a paramedic class in.

I don't think I'm missing anything, if you have any other questions let me know.

Great ! I'll be out on Thurs/Fri but that's it. Hope you have a good time, lots of good topics. The stroke care on Thursday by William Brooks is guaranteed to be good ! Also bernard's got the resucitation thing on there as well.

Yea I'm looking forward to some of the topics. I've made plans to go but I gotta get the money together and see if I can go each day. Or pick a couple that look good. Not entirely sure which ones I want to go to yet. This will be the first year I've gone so I'm looking forward to it.

I'll be going from Louisville. That's the week of my birthday and I have friends out that way.

thanks you and be glade you never worked for yellow well never go back to that place

There are many quality programs in Louisville right now you can look into. The one I'm in (Associated with UofL and Dr. Price who is our director) has been very good despite being a pilot program. I don't know much about Know How, etc but I'm happy with where I ended up. I'd still recommend some kind of college A&P, biology and chemistry, math, etc. The class I'm in whenever we start a new A&P section we are given that particular organ system to learn with. Not quite a body a lab but still nice.

I worked for Yellow for awhile, just your standard IFT company.

The interesting part is this particular neighborhood isn't terrible. It's pretty much a long drag of shops and such surrounded by suburbia.

My county dispatch is similar. It is also the EMA office and probably a few other things. You have to show ID, get buzzed in, then walk up stairs... THEN you have to check in your firearm if you are carrying one. FAIL. The dispatch center reminds me of a news station. Each dispatching console has 5 monitors, 1 for cable tv.

Local Ambulance stations, most of which the stations are locked at all times. In nice weather they are propped open and bay doors open. When out on a call, of course they are shut and locked if they remember. Some places you can just walk right in and take a jump kit, defib, heck the whole ambulance.

But, this isn't a discussion on security, it is about safety. A lot of places around my parts are requiring staff to wear bulletproof vests. It's a great idea, but most of them don't protect much against a stab, or offer any protection in your sides (most brands/models).

I wonder what this guy was after. He just walked up and stabbed him, then walked away? Seems kind of fishy to me for a person to do something like that unless there was something premeditated towards this person, or theft was in question and was foiled by another person being around and had to flee. There isn't much to be stolen from a med kit in regards to drugs that will get a person high though. Narcs are supposed to be locked up times 2. Although, they are not where I work and that really concerns me. Druggies I guess, just want the needles, or more likely, the narcan.

According to the news reports, the guy asked the medic for money and when he said he didn't have any the guy stabbed him and ran. Dunno if theres more to it or not there were no witnesses.

Very brief article, actually they've removed about 3/4 of the original post. All I know still at this point was the medic in question was stocking the truck getting ready for shift, a guy came up and stabbed him in the abdomen and ran. I don't know the location he was stocking very well (aside from where it is) so I don't know if there are gates or cameras or what not. I know that in the other locations around town there are no gates leading into the bays (aside from most places bay door which is normally wide open during the day when trucks are coming and going every 15 minutes)

(WHAS11)

WHAS11 News has learned of a paramedic that was stabbed in Middletown. We have been told that the streets are being shut down from the location of the stabbing, to Market Street and University Hospital in an effort to transport the victim quickly.

We will bring you more information as soon as it becomes available.

Here is a better article from a different news source. I haven't read this one till I posted the above.

LOUISVILLE, KY (WAVE) - A Louisville Metro EMS employee is recovering after being stabbed on the job Thursday night.

According to Louisville Metro Police, around 8:40 p.m., the EMS paramedic was in the rear of the St. Mary's Center in Middletown preparing to start his shift when he was approached by a man asking for Money. When he told the man that he had no money, the suspect stabbed the paramedic in the stomach.

The injured employee was able to call for help on his radio. Police and additional EMS crews arrived on the scene shortly after. The EMS employee, whose name has not been released, but is said to be in his mid 20's, was taken to University Hospital. He was listed as stable with a stab wound to the lower abdomen. Dr. Neal Richmond, CEO of Louisville Metro EMS, said he did not believe any organs were damaged. The injury is not thought to be life-threatening and Richmond said that if everything goes well, he should recover quickly.

"You know, he's a little upset, but he's completely lucid," Richmond said. "[He's] talking to us, his family is around [and] he's doing really well."

Police have not released information about a suspect in the case, but ask anyone with information to call the LMPD Crime Tip Line at 574-LMPD.

There aren't many details know, I just was told a paramedic for the local city service was stabbed while getting his truck ready for duty. Here is a link to the story, but not much information. The assailant is still uncaptured at this time. The medic is in stable condition at University.

Just thought I'd post and share that the job we do is still dangerous and to keep this medic and family in your prayers, or thoughts, or whatever religious denomination you affiliate yourself with.

http://www.whas11.com/news/local/stories/0...s.27c6b32c.html (You might have to sign up, not sure)

I forget who I bought my train tickets through when I was living there, I'd get it online versus going to the Hbf. Aside from stopping 900000 times between Regensburg and Frankfurt it wasn't terrible. It might not be cheap anymore or something, I know after the strike my ticket prices went up for long hauls. Train system is still 900 times better than the US

Annnnd off to paramedic class I go.

Damn, might have to convince my wife to change careers. Will just have to see what I can find, if I can find a flight for less than 700-800 to anywherei n Europe I can catch another ryan air flight to Frankfurt and ride the ICE down to Munich (did that a few times). Probably be cheaper in the long run than flying straight into Germany.

Quick Edit: Flights into dublin for 600 US, ICE ticket is like 100 US (or atleast it was in 2007), and a ryan air flight for probably less than that...hrm I think my wife would be pissed if I went to Europe without her though

Well, might be as long as you can handle my terrible english;)

And BTW: I think "drunkish" is a language spoken worldwide;)

So you might just undertand our patients (at least most of them) very good;)

Well if I can ride drunk I can speak pretty good German

Now if just wasn't so damn expensive to fly to Europe. Staying there is cheap, it's flying there that's the problem.

It is up to each and every individual to further their education and to improve themselves as a healthcare provider. Think of it this way, how many nurses and doctors for that matter don't know their ass from a hole in the ground....who went from HS to College to med school (or nursing school, or trade program, whatever). Now how many doctors and nurses do you know who are competent and overall amazing. They took the same track as the other nurses and doctors (generalizing for a moment). How is that different than being a medic with no experience prior.

@Dominion:

I'm very sorry to hear that you expirienced those problems. If you ever come back to Bavaria, feel free to mail me. It should be no problem visit a Station. Maybe we even get the chance to invite you to an few shifts on my rig. (I can't guarantee that, but it seems "possible").

Hah deal, just so long as you can deal with my more than terrible german when needed

My experience has been that the difference between a good paramedic and a bad paramedic boils down to one thing: respect for the job. I have found that respect for this work tends to motivate people to pursue additional study, encourages people to be constructively critical (and honest!) about their mistakes, and instills a sense of humility that so many in this field seem to lack. I believe experience and education are the foundation for good medicine, but in the end it seems those that WANT to do well, do. Those that don't care, or are (as a result?) unwilling to put in the effort, don't.

That said, I believe paramedic candidates need at least a year on the job as an EMT before they move on. My reason for this is because this job isn't simply about the medicine. In addition to caring for patients, we need to know how to handle a scene, to be aware of our surroundings, to elicit histories from uncooperative patients under stress, to properly handle equipment, interact with other medical providers, and coherently write a report. There are logistics to this work that students ought to have mastered before they attempt to build on them. Paramedics are tasked not only with managing the medicine, but also to function as a leader on scene. For that reason, I think we need people who know their way around a scene and an ambulance -- so that they can focus on the rest.

Honestly I feel that anyoen who is competent enough to become a medic is competent enough to build that foundation of scene management, working with patients etc. You also forget that the medic isn't the only one on the truck and I don't know very many services (at least none in this area) that will put a green medic with a green EMT and if they do in my opinion that service has shitty management. Whats that old retarded line; Paramedics save lives, EMT's save medics"? It is of my opinion that anything you need to learn about patient contact will be done in your clinicals, and anything you need to learn about the field is done while you have a medic precept AND an EMT, Intermediate, or even another paramedic partner on that truck. In my case we have 450 hours of hospital clinicals which is the equivelent of 11 1/2 or so weeks of an actual job. Then you have another 500 hours on an ambulance so that's about 25 weeks total (rough estimate, don't feel like basic math right now) of practicum. During each you have experienced people watching and educating you (or at least I hope you do), in which you can learn by doing, ask questions, and screw up semi safely. When I first started as an EMT I can tell you that in 6 months I was able to have a firm grasp on basic patient management for a variety of situations, scene management, ambulance protocols, etc.

Late reply but thanks for the pictures. I lived in Germany during 2007 (in Regensburg) and tried all year to hunt down some people to show me around their rigs and explain the system. My wife was going to University there and doing an Anthropology study. I couldn't find anyone unfortunately and wish I knew someone then. I miss Germany and would love to live and work there but the systems are so different and very difficult for a foreigner to do anything.

I whole heartedly disagree with absolutely no experience. Giving yourself some time as an EMT-B will give you a better idea if EMT-P is really what you want. I've met many people, who after acquiring their EMT-B, decided this field was not for them. Granted, most people entering this line of work are pretty sure they're in it for good; however, getting that preliminary experience as a basic is smart. Give yourself the time, I say, and move on gradually -no need to rush. This may not be the case for everyone, but I'm sure there are good reasons as to why most places require you to do it in steps (EMT-B, EMT-I [some places] and EMT-P). If at all possible, give yourself the time to learn, and saturate your neurons with as much as you can. Take it slow, I'm sure you'll be glad you did in the long run. Good luck.

This is why I believe in a bit more strict and longer basic program (or bypassing the basic completely). In my basic program I was required to complete 100 hours on an ambulance with a MIN 10 contacts. Get your 10 in the first 5 hours, cool, but you still have 95 hours to do. This gives you a bit more time as the basic to get a feel for things. Does it fully prepare you for the real world in EMS, no of course not. BUT it gave us all a good idea of whether or not we'd like the field.

Further to that, my paramedic class required another 125 hours at the beginning riding as a BASIC in which we had more time to determine if we wanted to go further, working only with other medics in fly cars (to ensure that we'd have the most exposure possible). The basic time was for us to evaluate and watch the medic, assist the medic and get a bit of experience into the how things work. It was a useful metric in my opinion, not to evaluate how good you are at basics, but to give you a better glimpse into being a medic, especially if you are inexperienced or have not ever worked with medics before.

Personally I am happy with my decision to go straight into medic classed with minimal experience. I've learned WAY more than I ever did in 6 months in a VERY busy (100k+ runs a year) system. The class takes a very good approach to ddx, and we are required to go through them every day. It's never using the checklist, it's just a think and do type scenario.