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AZParamedic

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  1. Our friends the Air and Surface Transport Nurses Association (ASTNA, formerly the NFNA) put out this book which I think is a very good resource without all the hyperbole of the CCN textbook. I used this to go thru the TNATC course they put on and me likes it. LINK at Amazon.com I also have a copy of Bledsoe's new book and have throughly enjoied reading it. It is good at visually charting and tabling key concepts. It is probably better that the Holleran book above in its clarity and use of copy/graphics. Compared to the jumbled three ring binder of stuff UMBC gives out for the CCEMT-P course, any commercially-produced text is an improvement.
  2. I think the A (assessment) is to include the physical exam? I don't like it since it to take up too much space on preprinted PCRs that have a small narritive. The D, C, and T are often duplicious on a preprinted PCR too. Anyone still have checkboxes for the physical exam that indicate "WNL" or "no clinical findings" next to each area of the body?
  3. What's this D-CHARTE style of report writing all about? I've used SOAP notes in the military and tend to write my PCRs now in a narrative with SOAP-like attributes. Here in New Mex all the locals like to write using this technique. Does anyone else? D-Dispatch C-Chief Complaint H-prior History A-Assessment R- (Rx) tReatment plan T-Transport disposition E-Exceptional Information
  4. As I write this from the station, our newly hired 19 year old PARAMEDIC is working a code on the south end of Roswell. How ironic. (yes that's her real age) I became an EMT as soon as I turned 18. Did the Army medic thing by 19 and real life paramedic (from an exceptional university program ) by 20...then off to the Army's flight medic course, FNATC and all those other alphabet courses by 21. I don't have a good reason for all the rush, not sure it was all worth it. My friends from high school who went the traditional college route are all graduated by now and a few of them are even in law or med school. I sometimes think I should have done it that way too. I wish I knew about the BS-EMS degree programs when I was 18. With a degree like a BSN or MPAS I'd sure be making more $$$ and be in a more respected profession. College is the way to go for our profession to achieve the same respect (just ask the nurses.) There is no reason for paramedics to be retarded until you are in your late 20s and were an EMT for 10 years, but it should also not be accelerated for 18 year olds either. The latter is merely a matter of public trust and generallized maturity. I've been a paramedic on the streets for over two years and have been met with some limited skeptisism based on age. I never had any issues in Arizona working in the two high-volume systems with hospitals and fire departments, or teaching EMS for the military. But when I moved to NM, I found Albuquerque Ambulance Service was full of old burnouts that ran off the younger medics. During the brief time I worked for AAS, I had a supervisior tell my 29 year old EMT partner (who was considering medic school) that he was right to wait until he was 30....since "you don't have enough life experience until then." :roll: Please.... tell that to the 26 year old ER resident or 23 year old CEN RN you are giving report to. This was nothing more than this man compenstaing for a lackluster career where he wasn't able to be a medic until he was 30. This mentality hurts our whole profession because it robs the system of people who at 30 can be experienced and motivated supervisors set to steer EMS in a better direction, not novice medics. On the other hand, I'm all for EMT-B at 18 and EMT-P no sooner than 21. Our 19 year old medic had virtually NO street time at all. It shows up in the nuiances on calls and in authority in scene managment or delegation of tasks. She is preciously smart but there is more to the job than that. I'll be the first to tell you that I hit ALS a year too soon. If you can demonstrate EMT experience (not just the cert) since 18, then 21 isn't a bad time to be an entry-level medic, preferably with at least an AAS degree behind your name too. --Brian
  5. Hi all, I recently had a patient that reported an allergy to bennadryl. She said it made her "giddy or sometime itchy" but did not suggest any PMH of circulatory collapse. We were called to a very rural location and with the extended transport time (down a particularly bumpy and winding country road) I decided to administer phenergan as an anti-emetic and sedative to allay nausea enroute. Our protocols list a relative contraindication to phenergan as a known allergy to antihistamines. Is this a risk with those who have a bennadryl allergy? Are these folks allergic to the medication in IV/IM form or rather the dyes, suspensions, preservatives in the PO form? I administered the phenergan at 25mg IM without any adverse reactions. Transport was uneventful and the patient benefited from the sedation effects that reduced her anxiety and pain level. A quick consult with the medical control doc agreed with the TX via radio patch. Comments?? Thanks, Brian
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