rescue25

Barely relevant, but... I recently saw a TV advertisement for a sleep clinic, wherein the spokesperson on screen in lab coat had the following title displayed at the bottom of the screen.

"Jane Smith, EMT"

I had to laugh - what in the world does an EMT certification have to do with working in a sleep clinic?

I think it's perfectly normal to get a bit of an adrenaline rush - and to want to "help" people - particularly when you're relatively new. That said...

I have, so far, never come upon an accident where I felt that stopping would be of any real value. If PD/EMS/FD isn't already on scene, I'll call it in. If they are, I can almost guarantee they don't need any help 9.9 times out of 10.

Anyway, what am I going to do with the pair of gloves, pocket mask, and basic first aid kit in my trunk? Hold c-spine? No thanks. Unless someone is exsanguinating or in cardiac arrest, there isn't a whole lot I'm going to be able to offer.

Not getting run over is also high on my list of priorities. I don't have whacker lights on my vehicle, so I don't even have a way to warn traffic - not that lights really help that much, anyway.

I have to agree. Whenever I come up on an intersection with all lanes blocked, I shut down the siren and just hang back until the light turns green. If I'm running hot and a car pulls out into the intersection through a red light, and causes an accident, I'm automatically at fault by Virginia law. So I really don't want anyone poking through the intersection for me.

If the Opticom would ever work properly, it should be turning the light for me shortly, anyway.

Web developer/programmer. Looking fairly seriously at going back to school to become an RN.

... minimal level of an associate degree in EMS to perform...

I've heard a rumor that the local major teaching hospital & university (our nearby level 1 trauma center) is going to offer a four year baccalaureate degree in paramedicine soon. I'm still trying to confirm this, because it would wonderful and something I'd like to pursue. Currently the best you can get around here is an AAS and that's for paramedic. Are you suggesting an associate's degree for the EMT-B curriculum? And do you know of other universities offering bachelor's degrees in pre-hospital medicine (one that would allow you to write the NREMT-P exam at the end of the program)?

Well, we do have "adopt-a-road" litter pickup volunteers.

(Edit: JonathanGennick beat me to it!)

R1, I don't want to derail this thread any further and I certainly didn't mean my response to come off as picking on you, because it wasn't intended that way!

... but what self-respecting individual who is already a Paramedic, WANTS to be a firefighter? I'm sure there ARE some out there, albeit probably very few. No slight against FireMedics, btw. I just can't imagine doing it myself.

I can't either. In fact, one of the reasons I'm doing EMS as a volunteer right now is because there aren't any career opportunities nearby where I wouldn't have to pretend to be a firefighter on the side. Richmond City is an exception, but I have no desire to burn out in a year and get paid sh!t for the pleasure. I can assure you I'd rather be making money doing EMS, but vollying is the only way to get solid experience without the hassles of Fire or the inner city.

I'd imagine the call volume is high enough to support volunteer and fire medics at the same time? Educate me on this point, if you're familiar with it, please.

Henrico's call volume is pretty good. I can't find the fire department's call stats page off-hand, but my volunteer station alone ran just over 6,000 calls last year, and we only cover a small portion of the county as our first due area. That area is getting smaller all the time due to the increasing number of fire medics -- which, while that may not be great for our volunteer recruitment and retention, is certainly the prudent thing for the county to be doing in order to maintain an adequate system. Our situation is certainly different from a rural area where one (or a few) volunteer agencies are the only real game in town.

I agree with this 100%, and fully support it. I'm not going to hold my breath, however.

I hope not, unless you enjoy syncopal episodes! :shock:

I'm inclined to agree with this statement, because of the edu properties of it...but even if it was accomplished for Paramedics, you know how Virginia is. I feel the OEMS would still maintain the other certs, which would continue to enable the half-assed providers out there (in Va anyway) to continue to practice half-assed EMS.

Yeah, I love how Virginia phased out the Shock-Trauma and Cardiac Tech levels only to replace them with essentially the same thing: Enhanced and Intermediate. I won't pretend to understand the supposed advantages of having the Enhanced level, since I don't ride in a rural area. I've been told the value of an IV and a handful of drugs is beneficial in these areas (never mind the frighteningly lack of accompanying education/training), although I really think we need to shift our collective mindset toward making sure that "real" ALS providers are available, even in rural areas, instead of making up new "in-between" levels to accommodate volunteers who either don't have the time or willingness to go farther. Which, let's face it, is why they exist in the first place.

Take the Richmond, Virginia Metropolitan Area, for example. Richmond Ambulance Authority is a joke. Staffed & managed by AMR. There's so many volunteer agencies in that area, there's no real need for the surrounding 4 or 5 counties, or the city for that matter, to pay Medics a living wage. Chesterfield County Fire Dept. Medics staff some of the volunteer squads, due to manpower issues. Henrico County has FireMedics as well. There's no REAL EMS. By REAL, I mean a free-standing municipal agency dedicated to Emergency Medical Services. Why should there be? Volunteer Rescue & the Paid Fire Dept's make it unnecessary. Sure, it may work out well for the city and county...but then why would someone then want to be a paramedic in that area? They'll have to travel a much longer distance to earn a living wage.

Although the existence of volunteer agencies in nearby areas probably plays some role in this (fewer overall available jobs), I think you've probably overstated its impact.

In Henrico, volunteer agencies exist, but are far outnumbered by career Fire Medics. There really is no lack of career opportunities in Henrico, but the caveat is you have to be a firefighter. Who wants to become a paramedic only to ride on the engine half the time? In my opinion, this probably has a greater effect than anything volunteers might contribute as it creates a big disincentive for many to seek employment as a medic in Henrico. The upshot is that you get paid a respectable salary with excellent benefits - a direct result of working for a well-funded municipal agency.

It's about supply and demand. If there's no demand, then I can't supply it. I WANT to supply it, but I can't, because volunteers are "in the way".

If volunteers are truly "in the way," then why can Henrico County Fire Medics earn a decent salary even though the volunteer component in Henrico is stronger than that in the city?

I would contend that RAA can get away with paying such low wages primarily because it offers two things that the surrounding counties cannot (or will not):

1. More experience: more trauma, more varied medical calls, (slightly) fewer nursing home runs, higher overall call volume

2. It's EMS - plain and simple: no firefighting requirement, just EMS.

The impact of volunteers on wages is, I think, quite negligible in this particular instance simply because volunteers play an increasingly diminished role in the provision of EMS in this particular area. I do see your overall point, but feel it would probably be more applicable to more rural areas that are heavily or totally dependent on volunteers.

I believe you would see a much greater equalization of pay if the surrounding counties were to move from fire-based EMS to a separate, municipal Emergency Medical Service. It would certainly level the playing field a bit with respect to #2. Elimination of volunteer agencies in these areas would increase the overall number of jobs available - particularly in areas that are still more rural and, thus, more dependent on the volunteer component - but would probably do little to change wages in the City of Richmond. Or even within career fire agencies in those counties (again, maybe some more than others).

I fully agree with Rid, Dust, and others on here when they point out (rather emphatically) that a higher bar for education of pre-hospital medical providers is needed and will take care of weeding out many of today's volunteer agencies - especially those that are poor performers.

I also wear Bates, but with the zipper. This model also has a little flap that velcros over the top of the zipper when its all the way up so it doesnt catch on anything. They are quick on and quick off...and ultra-light. I recommend them highly.

These? I've got 'em too and couldn't be happier. I bought mine locally for ~$20 less than they are at Galls.

Elderly female at a nursing home. Toned out as a cardiac arrest, but she was actually brady (~30 bpm) w/irregular shallow respirations. She ended up getting a tube and external pacing. I don't remember what the outcome was.

I got me 1 o dem cryosuperprecipitators startek 5000 polypharmacy modulators, a roll cage, brushbars, 2 roatating light bars 10 LED strobes, 6 flashers, a pack of gum, 4 M tanks, a trauma or, all the koolaid i can drink, and 250-6gpm pumpms and tanks to cover all the bases....no bambulance is got dem dings.. oh and i forget me YAHOO MODEL 300 TYPE2 SIREEN...

SOUNDS LIK YAHOOOOOOO.......YYYYYYAAAAHHHHHOOOOOOO.....WHACKER....WHACKER...WOOP...WHOOP...

YAHOOO..............

Last night, while driving through a rather rural county that shall remain nameless, I witnessed a vehicle that can only be described as the ultimate whackermobile. Rusty old pickup truck with what appeared to be busted springs, a red "bubble" light on the roof with cigarette cord dangling into the cabin through the driver's side window, a "star of life" license plate jammed inside the windshield, at least 5 antennae on the roof (magnetic mount, too!), and papers all over the dashboard. YEAH...

Hell, y'all, who needs sirens and lightbars? I just holler out the window 'n wave my penlight.

But really... I have a Jetta turbo with some bandaids and Tylenol in the trunk, I think.

Did I miss a meeting? Are basics dispensing ASA now? Did they change the dose to 235 mg and not send me an email at work about it?

My BLS protocol for non-traumatic chest pain includes 160-325 mg ASA PO if no sensitivity nor active GI bleed.

Patient assessment has been the hardest thing for me to learn and get good at. Fortunately I've always been paired with good ALS providers to guide me and help me learn. Have you had any experience as a Basic or are you starting fresh as a paramedic? I'd be a deer in headlights too, if that's the case! Not a good feeling, for you or your patients.

Be proactive in seeking out the help you need and hang in there!

I've got a Littman II SE... was on sale when I got it for about $55. I like it quite a bit more than the cheap $10 stethoscope I had prior to that.

What's the reasoning behind having police respond to (most) every call?

Under ideal circumstances, an ALS transport unit would be all that's needed for the majority of calls, but of course geography and underfunded/poorly organized EMS systems mean that's not necessarily the reality in many areas.

Engine + BLS transport + ALS chaser + PD seems excessive for ordinary medical calls, though.

The city EMS system near me is entirely ALS and only sends BLS engines (simply due to proximity; although most of the time, the ambulance is less than 8 minutes - often 4 minutes - away from any given calls) to chest pain, diff. breathing, codes, and MVAs. There might be a few other instances, but those are the major ones.

I guess I should feel lucky that, for the most part, the first-response FF's I've worked with are a great bunch of men and women. Sure there are exceptions, but that's true of any service.

The EMS side of the show was absurd, but I probably could have forgiven that part if it weren't for what's either bad acting or terrible writing. I can't tell which; maybe both. The show was just plain boring in my opinion, aside from any issues I have with the image it presents/procedural inaccuracies.

Oh well!

66% Dixie. Just under the Mason-Dixon Line.

Having lived in an urban area of Virginia my entire life (well, except one year spent in Toronto), this probably makes sense.

I'm about 200 miles south of the Mason-Dixon, though.

While Opticom can be very helpful -- when it works properly, and always in conjunction with caution and regard for safety -- I agree that we should be running L/S much less often than we currently do. The worst: having medics run hot to a call where we have to stage for PD, who are going code 2 (no L/S), is absurd.

All of our ambulances and fire apparatus are equipped with Opticom. I don't have exact figures on how many intersections are Opticom-equipped, but I would guess somewhere around 75% based on my observations. Certainly all of the larger intersections are equipped.

It's nice to have, but often the Opticom won't trigger until we're practically on top of the intersection.

we have First Respondoers, EMT B, EMT I, AND EMT P ......they are kicking around the ideal EMT Enhanced for the all EMT B's

to upgrade....yes i do read those updates I get in the mail......

Yeah, I was just listing the ones that were missing from the original list.

Hell, we've still got Cardiac Techs and Shock-Trauma (OK, I actually don't know anyone personally who still has that cert) hanging around, even though they're being phased out at the end of 2008.

We have a few EMT-Enhanced at our squad, although I don't think we actually have a protocol for them to use yet, so it's basically useless at the moment. And as I've said before, I'm not a huge fan of the level anyway.

Virginia has a First Responder level as well as EMT-Basic.

Just as a sidenote, New Jersey does not allow volunteers to be ALS providers, correct? I thought I read that when looking into reciprocity with NJ.

My squad operates on the following schedule:

Main station:

Days (0600-1500 or 0900-1800 or 0600-1200 option on weekdays): work the same day every week

Nights (1800-0600): Rotating nights (i.e., if you work Wednesday night one week, the next week you'll work Thursday night)

Sub-station:

Days (0600-1800): work the same day every week

Nights (1800-0600): work the same day every week

It works out fairly well, although I'm not a big fan of rotating night shifts, which is why I mostly work dayside.

With regard to EMT-J, I've never heard of it, although Virginia has been known to have some very odd, non-standard levels, unfortunately. We currently have an "EMT-Enhanced" level which is more or less the old "Shock-Trauma" - I see very little point to it; from the course material I've reviewed, it really does seem like ALS without the education, and too little training. Think of being able to start IVs and intubations with a very limited list of medications.

I can't find any way to vote, so I suppose the poll's closed since it's an old thread.

But anyway, I would stay. I think that we respond to far too many calls with L&S, anyway. Hot responses should be the exception, not the rule.

EMS providers wearing public safety style uniforms doesn't give me heartburn, although I'm not a huge fan of badges, and what our uniforms are doesn't really matter to me as long as they're comfortable, professional looking, and not ugly.