mobey

hahaha...I love the part where the doc says "we may need an intubator".

resonance

Just wondering what if any procedures your service has thier to-be employees go through, such as, scenarios, tests, interview (1 on1 or interview commitee) etc...

We have none but I would like to recommend starting to our management.

Perhaps you should explain what makes this "something good".

How is adding to a provider's procedure list good when the base understanding of when and why to use the procedures they already have is so poor? Adding an advanced skill to and under-educated group is going to cause all kinds of problems when it comes to application.

I have no idea how in depth the anatomy portion of the US EMT-B course is....But if it is anywhere near Canada's I too agree this could easily be an EMT skill. But I believe it should be used only in cardiac arrest transport times > than 5 min.

I'm pretty rocky on this though, feel free to change my point of view!!

Hx of traumatic injury, or recent surgery?

When did it start? What was he doing?

Has it gotten progressively worse?

Epiglottitis?

Sorry if I have repeated but I just joined and didn't feel like reading all 20 pages.

Laceration

yohimbine

myocarditis

arrythmia

"OK, you're done with the class, now throw the books away and learn the other stuff."

Be careful with statements like this. There is a balance....NEVER throw the books out, you will just get sloppy.

It's more like, "OK your done with class, now go apply the books to the street!"

A neighboring ambulance sandwiched a hockey player with spinal trauma face down between 2 longboards, to transport to the hospital so they woulden't have to roll him!! :shock:

That's a good example of throwing the books away!!!

Don't send your students out to the field thinking there is a street way and a book way. There is only one way....Thats the RIGHT WAY!!

Is she unable to talk?

Is she able to nod yes or no?

Ask the husband what preceded this presentation?

I had a great basic instructor, I will share his traits with you and you can filter them as you like.

On our first day of school after the introductions he started by saying, "This course will only teach you how to safely transport the public to the hospital without causing them any further injury." This convinced me that I was only taking an introductory course to EMS, which of course kept me in school to take the ICP (EMT-I) course as soon as I could.

Other charicteristics:

He was very preticular about everything. Such as wrapping the leads on the SPO2 monitor as to not stress the connections. When we left a scene in a scenario there could not be any garbage left on scene at all. Always wear 2 pairs of gloves to a trauma and if you touch blood then touch the cot or bags without removing the outer pair you failed the safety portion of the scenario.

He was very critical of the little things such as counting before you lift, Eye contact with your patient, communication with your partner, tone and volume of your voice, and lots more.

We never got away with doing anything half-assed, alot of people did not like him for that reason, but by the end of the course we all appreciated it.

Oh ya... He never gave us a pat on the back unless we truly deserved it. If we did something wrong, it was wrong no sugar coating. But if we did something right we knew it and he made sure of it.

mmm geee wouldn't that be a great debate topic?.... maybe I just posted that to get in to the chat room...... I seem to remember some thing about this topic... in my text book...lets see if I can remember... unconscious incompetent, conscious incompetent, conscious competent,unconscious competent..am I right on this? I'll have to go back to the books....I hope some day to be unconscious competent. Which medic would you trust your little johnny to? Some one who has 1 call per week and drives every other call.... or some one who gets 20 calls per shift? ahh well they all graduated with the same test right? well mabe not in saskatoon....(jokes) I get to chat now...got enough posts....he he

WOW I have a hard time following you here, Did you answer the question??

I can answer yours... You bring up Saskatoon, I know a Paramedic there I would not let give care to my cat!.. and I hate my cat!

I also know a Paramedic 2 hours south of there working in a system that does 80-100 calls a year, he never attends unless it is an ALS call. I would choose him over many many urban paramedics to treat my 5 year old daughter anyday. Call volume has nothing to do with whether your "Good" or not!

...we qualify our titles by the diploma or degree that we own.... what about work load titles? you can not tell me that an ontario city PCP has the same workload/ title as the alberta country medic with one call per week....

How do you explain call-volume affecting your title? Are you suggesting those with a higher call volume be labeled with a superior title?

Thanx for the replies.

I am hoping to start soon. I want to upgrade my A&P first but having some ALS experience and education already I think this should work out.

I have been tossing around the idea of writing a newspaper article. I would like to focus on the progression of EMS. Kind of a community awareness not only of our local ambulance but the entire EMS profession.

Have any of you wrote one before? I am looking for any input.

It seems like we sit and bitch about the way we are viewed by the public yet unless the general public subscribes to an EMS magazine they have no idea what is going on in the EMS world.

The key points I want to hit are:

Education (past & present)

Equipment (Past & present)

Scope of practice (Local)

As well as what is in the future for our community and EMS.

Please feel free to add any other key points you think should be included.

Ya I always get a baseline manually then if Pt is stable I will use the Lifepak.

Ya what they said and...

Have your Pt. straighten thier arm. Even palpate your own brachial right now with your arm slightle bent. Now straighten your arm right out and palpate it again....much easier hey!!

I always tell my patients the straighter they have thier arm the better I can hear. I find this proves true with the NIBP on our Lifepak, we get less false readings with a straight arm.

You started CPR on a known DNR for the benefit of the daughter? I don't know if local protocol in your area says so, but using mine, if CPR is started, it continues until physically unable to continue, relieved by equal or higher trained personnel, or until told to stop by an MD.

I am going to hope I misread that CPR was started, and then discontinued while enroute to an ED, without On Line Medical Control's authority.

Difference in protocol for sure.

We did not START CPR, the daughter had started before our arrival. Our protocol on DNR is we start CPR till a DNR paper is in our hands then we are authorized to stop.

The DNR was given to us when we arrived so we had 3 choices.

1. Tell the daughter to stop, and deal with the consequences.

2. Continue beating on this guy till we hit the hospital 10 mins down the road.

3. Continue CPR till we got to the rig to satisfy the daughter, then follow the wishes of the patient and cease all efforts.

We chose #3

What would you have chosen if you had the same protocols as us?

"Trauma Junkies" and Street Work

Occupational Behavior of Paramedics and Emergency Medical Technicians

C. EDDIE PALMER

Paramedics and emergency medical technicians develop a need for role validation associated with ambulance runs that call forth advanced lifesaving, rescue, and medical skills. Metaphorically, this need turns paramedics into "trauma junkies," because answering calls involving multiple casualties, physical trauma, and fast-paced action becomes the "real" work of emergency medical services personnel. Calls evoking less sophistication of response behavior are devalued. What does this mean to you and how does it apply, or not?

I think this is a problem that people fail to consider when they choose this proffesion. I believe some people choose this career because they are self proclaimed "Adrenaline junkies". The problem starts when they realize the adrenaline surges soon wear off and if you have no interest in patient care you get bored. The media portrays EMS as a fast paced, heart pounding career that is recognized as heroic. That just is not the case!

I don't really need an MVA every few days to validate me as an EMT, i am in the business of patient care, I do not need heart pounding action to remind me why I do what i do.

Personally I enjoy solving the riddle of why grandma feels "off" today, just as much as running a code, or transporting a multiple system trauma patient.

It is important for people new to this business to realize adrenaline rushes end, and you are not a hero. That medal is left to the firefighter who pulls 1 person from a fire once in his 35 year career.

People put themselves in this place. it is not the "Old peoples" fault for calling us when they aren't in dire need of us. It is the EMT(P)s fault for not expecting to do non-emerg runs for the majority of his/her career.

If you are an "Adrenaline Junkie" (which is the same as a "Trauma Junkie" as far as I am concerned), you are better off being a parachute testing technician than an Emergency Medical technician.

That's my thoughts!!

I am A Evoc Instructor . I would like to see a new driver drive atleast 5 eme calls befrore he get his or her evoc . What do you guys think

Hey Toes. Welcome to the site!!

Because everyone here is not from your state you will get a better variety of replies if you do not use acronyms such as Evoc.

What is Evoc?

BTW before you post hit the spellcheck button in the bottom right hand corner of the window. Mispelling on this site can be suicide lol.

Dispatch: Roger that Medic 2, Caller states she is the daughter of the Pt, she helped him complete the DNR yesterday, but she feels he didn't mean today!!

Did you guys end up running the code?

Well it probably wasn't the best choice I have ever made... But we basically put on the monitor and continued CPR till we got to the rig, then stopped. No tube, no defib, no IV, just CPR and BVM till we got out of eyesight.

The daughter was VERY insistant on us working him. I dunno if it was the right call to make or not, but I believe if the patient would have wanted us to make it as easy on his daughter as possible even if that meant we bang on his courpse for a few mins.

and give up Heroes, 24, ER and other favorite TV shows, you can do it too :!:

Alright but I'm not giving up House

A call of mine a few weeks ago...

Dispatch: Medic 2 respond echo for 76 y/o male in cardiac arrest

Me: Roger dispatch, Medic 2 responding

Dispatch: Medic 2 you are responding to #### **th ave. Caller states Pt. has Hx of ALS and cancer and has a DNR. She has started CPR.

Me: Does the caller realize DNR means no CPR

Dispatch: Roger that Medic 2, Caller states she is the daughter of the Pt, she helped him complete the DNR yesterday, but she feels he didn't mean today!!