Neb.EMT

This class has 21 students. There are 3 females in the class. All of us that are teaching this class agree the student in question knows her stuff and then some. She has problems with overall self-confidence however, which in turn finds it's way to class and EMS too. She has terrible test anxiety and struggles in this area as well. She can answer any question you throw her way. She doesn't just know the answer either; she can tell you the reasoning behind it too. Overall, we are just trying to find a way to get her to feel more confident so that she succeeds.

This is a pretty straightforward question. What are some tips to help students gain some self-confidence. I have one student in particular who definitely knows the material and knows the skills. This student however lacks ANY amount of self-confidence. Positive reinforcement, compliments, encouragement, etc... just don't seem to help with this student. I'm looking for things I can do as an instructor to help this student gain confidence in herself. Any and all suggestions will be greatly appreciated. Thanks in advance, Neb.EMT

I'm going to make this short. I don't really want to get into a big discussion on this on the open forum. If anybody needs further clarification or would like to discuss this issue further with me, just PM me please. Earlier this year we were called to an accident with a possible head injury. I was not required to respond to this call but could have. I didn't (2-3 years ago I probably would have). It turns out that the victim was a member of our department and a friend of mine. There were mistakes made on this call that reduced whatever chance the victim had in the first place. Meanwhile, I listened to this cluster on the radio rather than responding. My friend died about 4-5 hrs later at the trauma center. There's a lot more to this story but, this pretty much sums up the events. I have been a career EMS provider for about 6 years and have dealt with crappy calls (including family members that have died) in the past. This incident though just won't leave me alone. I just don't know what to do. It's the call I didn't respond to that is giving me more trouble than any I have responded to. If anybody has any suggestions please PM me. If you need more details, I can get into that too via PM. I just don't feel like getting into all the specifics on the open forum. Thanks in advance to anybody who responds to this.

We sent two units out late last week. The first 1 1/2 days they were there, they played a lot of hurry up and wait. Since then though, they've been really busy. It sounds like it hasn't necessarily been a really high call volume but fairly long distance transfers at this point.

We've got a couple of units down that direction. They say it is pretty interesting. I'm sure it will get a lot more interesting AFTER the storm hits. For all you guys down there, I wish you the best of luck. Hopefully the lessons learned from last time will make things a little easier this time.

I will try to make this as short as possible. A buddy and I are going to be doing some special event/on site EMS stand by. My first question is how can we justify dedicated EMS, not security/EMS as they currently utilize? I can think of a bunch of reasons but, what I'm looking for is how do I justify this to someone without an EMS backround? Secondly, we will be responsible for coming up with a structured approach to providing coverage for this area. We're talking approx. 75 acres. I'm not talking about "what equipment do we need?" or "what kind of pts can we expect?" We know the answers to those types of questions already. I don't want our people to just wander around aimlessly. I'm thinking more along the lines of personnel/resource management. Any advice would be appreciated. Due to service licensure level we will be working as a BLS non-transport service at this point (although the majority of those involved are ALS providers). We have an ALS service approx. 10-15 min. away. Advice on either or both issues would be greatly appreciated. I've got experience with special events but, not so much with events that last a month or with the planning of the EMS coverage of them. Thanks in advance for your help.

I get paid to sleep. Honestly, I've got a better chance getting a nap at work then at home. Where else do you get that? My current call volume is about perfect. Enough to keep you from getting bored. Not enough to burn you out.

Okay, let's throw a twist in. Let's say your basic IS a medic student. Your partners school doesn't have a contract with your service. Therefore, TECHNICALLY you can't precept him. You are a preceptor for other schools though. How would you feel in that situation? Personally, I've got a couple of good basic partners that I allow to do advanced skills. I generally don't have a problem with them doing thinqs they've been trained for as long as I am supervising. What does everyone think about that?

When I'm off duty from my paid job I'm still "on duty" with my volly dept. I respond direct to scenes so I have a fairly basic BLS bag set up. I usually don't need much because the ambulance is usually not more than about 5 minutes out. Basically gloves, BVM, 4x4s, and some other random junk. If it's not in my district though, I try not to have anything to do with anybody else's emergencies.

Sorry no = know. My mistake.

I can top that. Dispatched to a Sz. pt. Upon arrival we find first responders (EMTs) had placed an OPA, NRB, and AED on pt. Pt is lying supine with that greyish "I'm coding," color. They are just standing there looking at him. We asked (just to verify they didn't know something we didn't) "does the pt. have spontaneous respirations or circulation?" What do you suppose the answer was? Of course not. You would think if they no the pt is DEAD they MIGHT consider CPR. Nope, not these TRAINED PERSONELL. They opted to just LOOK at the very recently dead guy. Can we say DUMBASSES!

Pt. had a lock in place. Pt. appeared dehydrated. Attempted to flush the lock prior to adm. fluid bolus. It wouldn't run so I figured we'll just start another line. While moving pt to bed I see the lock is clamped. Makes sense why it wouldn't flush huh?

Well, she turned out awesome. I did as you guys said and made every BLS call hers. She became an above average EMT. She's actually starting medic school in about a week. Unfortunately I'm at a different service and don't work with her anymore. Kind of disapointing, we had excellent chemistry. Anyhow, I'd like to give a belated thanks to everybody who gave me advice.

Nebraska has 1st Responder. EMT-B, EMT-I (Both 99 and 85), and Paramedic. The weird thing is, is the state license for Intermediate doesn't differentiate between 85 and 99. It just says Intermediate. There are different protocols though. The state doesn't really seem to know what they want the scope for the I/99 to entail.

We have the option of soft or chemical restraints. Personally, if I have any choice in the matter I'll go chemical.

This question is for members of paid services. Does your service rely on "on call" personnel? Secondly, if so how does your "on call" program work? And lastly, what are your opinions on your system/or using "on call" personnel in general? I've seen a few different models and I'm just curious what else is out there and how common it is. Virtually every service in my area has some type of "on call" program in effect. And each has a different way of handling it.

I know that some of them can be field reprogrammed with instructions given by the manufacturers.

My paid service is small. We have one station manager and one field supervisor (me). As e manager goes, he doesn't really do much. Basically he deals with our corporate office and fills in on the squad as needed. As field supervisor I take care of da to day operations and handle most PR situations. On my volly dept. (fire and EMS combined) we have an EMS captain (me). As far as the EMS side of things I am in charge of everything. I am also fourth in charge for the whole dept. I have no second in command so to say. I take care of everything from scene command to training to budgeting and requesting money for EMS. And just like my paid job, my volly dept. is fairly small as well.

VS for starters, as has been discussed before, Canadian education requires more from you as a whole than the US system. As far as the Romazicon. I knew what was coming to me when I posted in the first place. If I can learn the pharmodynamics and pharmokinetics of other potentially dangerous drugs what makes it so impossible I learn this one as well? In all reality that concerned whether or not I can adm. it. It would just be nice to have avail. to me should the need arise.

CONTINUED FROM MY PREVIOUS POST I never said an "I" was a paramedic. Nor do I feel this way. l can tell you however, my knowledge base is closer to (not at) paramedic level than it is basic level. When it comes to interventions, yes, there are things paramedics can do that I can't. I also understand why that is. All I'm trying to say is things aren't black and white. Where I'm at and with my education, I practice very effectively as an ALS provider.

Minus the mag and procainamide yes. I guess if my pt. goes into torsades we're both SOL. Shane, my I class was the first year of medic class so maybe things were done a little differently than normal. I don't know. Class time was 499 hrs. Clinical/Field time was another 325 hrs. I didn't get along with the administration and it was a long drive so l switched schools. Why continue? There are several reasons. First, I want to learn as much as I can. Second, I want to make more money. And lastly, I understand an I/99 isn't a paramedic.

Not trying to pick a fight but, did you take the I/99 prior to your medic class? I'm not finished with medic class yet, which I stated. I'm just speaking from my experiences so far. And as I also previously stated, I haven't seen much differerce. Why do I compare the I/99 to paramedic level medicine? Because @ least around here, I AM an ALS provider. I work a code the same, I handle a Sz. the same, I handle resp. distress the same. It's not just "cookbook" medicine either. I consider the pathophysiology of what's going on with my pt., as I'm sure you do. I understand how/why my drugs are affecting my pts. I also understand why my pts. may or may not need my interventions. Like I said I'm not trying to fight. But from my own personal experiences the 2 levels are closer together than everybody on here makes them out to be.

I know there's a lot of controversy over Romazicon. Our protocols only allow for adm. if we caused the problem. Which honestly, is the only time I could think of wanting to use it. I understand that situation shouldn't happen in the first place but, adverse reactions do happen. I've never seen it used and, I'm not complaining. Personally, I just feel more comfortable with an extra tool in the box if I need it.

As an I/99 I can give Narcan. The question is why can't I give Romazicon? On a sidenote, most of the older medics I've talked with have said my I/99 is about the same as their paramedic classes (within 10 yrs.). I'm in medic class now and the only real differece l've seen is how A&P is presented. My medic class had a seperate A&P class. Don't get me wrong, obviously there are differences. It frustrates me that the I/99 level is not given the credit it deserves.

I was dropped from my old program b/c I was 12 hrs. short on clinical time. My daughter had to have surgery so I missed a day. I contacted the facility prior to my scheduled date and attempted to contact my clinical/field coordinator. She didn't respond to my messages or e-mails until after the deadline. I think I pretty much got screwed. But what can you do? I'm now in a different program (starting over) which I honestly feel is of a higher quality anyways. Just remember, everything happens for a reason. At least I got my I-99 out of it. (And by the way, my average was never below 96 percent.)