EMS-Cat

Sorry - liver and onions lover here. :wink: Let's see ... 'The person below me reads science fiction'.

Sorry 'bout that. squint. :oops: I got a smell I want to dodge, I'll use either Mentholatum or tincture of benzoin. Neither smells like a food stuff and both are fairly easy to get/keep in the box or rig. A dab of Mentholatum on my upper lip or a dab or spray of benzoin on the inside of a mask [a trick taught to me by an old time anesthesiologist]. I've had some *really* bad memories of the one time I tried to use peppermint extract and had to dodge mints for a year or so. Rowan

Yes, once. My very first cardiac arrest as a student RT in a small hospital [1970]. The gentleman had just come back from an upper GI series and I was setting him up to start IPPB [back in the early 70's here folks - we still used it]. He asked for a glass of water [he wasn't NPO], I gave it to him and he got about one swallow down before his eyes rolled back and he went totally out on me [pulseless and apnic]. I yanked the 'Oh Shit!' cord in the room, stuck my head out the door and yelled 'Code Blue' and started into mouth-to-mouth on him [remember 1970, folks, we did mouth-to-mouth back then. No individual masks in the rooms, usually no suction units unless specifically ordered, etc]. I was doing fine: good airway and chest movement, but no one had warned me about that characteristic gurgle that tells you to get out of the way. He threw up second hand barium, I got a mouth full [strawberry, I believe], I rolled him over so he could puke off the bed, I leaned over and puked on the floor, rolled him back, cleared his airway and started in with the mouth-to-mouth again. After a 2+ hour code where we kept getting him back and then losing him, he was pronounced. Later labs showed a pretty high K+ [don't remember exact numbers - it was too long ago, but I do remember that I was impressed it was that high]. I decided later if I survived that, I could probably survive just about anything the field could throw at me.

I agree, AngelKiss - you never really know until you're faced with the situation. I didn't know if I could aim and fire a weapon at another living being until Desert Storm. I can. And it's something that I'll carry with me the rest of my life. But the rest of my unit came back alive and my patients were protected - I could see no other option. And if the same thing were to happen today [threat to self, family or patient], I'd draw and fire in a New York Minute. Not quite the same thing, I know. Could I push the button? Don't know. It might have actually been easier for me when I was younger - I looked at life's checks and balances a bit differently then. Now? That's between me and my Higher Power.

I'm guessing from the dates of the posts on this thread that things aren't going to be happening. In a way that's too bad - I actually like pitting my knowledge, etc against someone else's tests. I like learning. :wink:

Blue 2004 Chevy Aveo 4 door w/ hatchback. The 2nd generation of the Geo Metro. Small, but good milage, and handles pretty well. Maybe, someday, we'll get a second car - having one set a wheels is a pain.

Hot button here, so be warned. Bit of a generality there, don't'cha think? That a woman's priorities should be directed to the home while the man's is directed outside of it? What if the woman can command a higher salary then the guy? A married relationship should be a partnership, not an assumption. I worked up to the Wednesday before I delivered, has three months off post C-Section and went right back to work. Out of all the years since I left high school and got into the medical fields, the only reason I stopped working full time was health and that was courtesy of a 20+ year career in the US Army [active and reserve]. There are a lot of reasons nursing is messed up. Family may be one of them, but there are a lot of others. I'll be if you took a real close look, a good percentage of the women who've had to choose between their careers and their family are single moms because dad took a hike. Or women who had to stay at home because their husbands didn't feel that child care should be one of their duties [you can help make them, you should have to help take care of them]. FWIW: Both my parents were registered pharmacists from the 50's through the mid 80's, back in a time when women didn't go into medical professions. They owned a retail store in a small country town with one clerk to help part time and they did all their own buying, stocking, inventory [i remember spending nights sleeping on the floor down at the store while they did a count], clerking, patient and billing records, etc. Store was open from 0900 to 1700 Mon say through Sat and the rest of the time on call. They raised myself and my sister. Mom was a pharmacist in the Navy in WWII and dad was a Navy corpsman with the Marines in the Pacific [iwo Jima and parts around]. I grew up with the understand that the family raised the children, the family ran the business, etc. It was about as non-gender specific as one could be in those days. I applied to the U of W med school in 1969 aiming at starting in 1970. Made it thorough all the paperwork with flying colors. And then came the final face to face interview [that's how they did it in those days]. And guess what - I was refused. Know why? Because they didn't realize I was female [my name is very masculine and they never really bothered to look things over] - and I only had a 3.7 GPA. You see, back then, a guy only needed a 3.6 GPA to get into Med School, a woman was required to have a 3.8 GPA to prove she could 'make the grade'. I was refused the chance to even try because of someone's antiquated belief that gender made a difference. So, please take a good hard look at what you just said, stating that you would use gender as a criteria for hiring. Or do you want the world to turn backward 40+ years? Bigotry is bigotry, no matter what it's using for it's criteria.

Just be glad we use the big, high-box rigs these days. I know a guy who used to work in the late 60's- early 70's who concussed himself. Hit the back of his head on the overhead dome light when his partner driving hit a speed bump. :oops: No, I wasn't a 'ride along' on that one, but I did hear about it in the ER when he came in to get the back of his head stitched up.

Hang in there you two. You both are in my thoughts.

Most please to make your acquaintance, Good Knight! From where do you hail? {I am of the Barony of Blatha an Oir, in the Lands of the Sable Lion of An Tir http://www.blathaanoir.org }

Thanks for getting back with us on this. Please keep us apprised and the very best on this.

I agree about vinyl: it's really hard to get a good 'feel' with them. Good fitting nitrile, on the other hand, can give you the same 'touch' that latex does. I spent a period of time in the OR as a scrub [in the Army reserve] and worked with a couple of docs with latex problems. The entire team would wear nitrile and we had no problems. There's a bit of a learning curve involved, but it can work.

Vinyl and nitrile are becoming more and more the standard where I am for just this reason. Since some of our patients can't speak for themselves when they need our care, it only makes sense. JMHO - YMMV.

"The Lieutenant" was a series created by Gene Roddenberry. JMS of Bab-5 fame wrote some of the pisodes as I remember it [looking back, that is, I didn't have a clue who he was back then]. http://www.tv.com/the-lieutenant/show/4532/summary.html Ah, let's see, what else was around that time... "Space:1999": kinda sad, but I liked Martin Landau "Mission Imporrible": The original! "I Spy": with Culp and Cosby "Man from U.N.C.L.E": the year I fell in love with turtlenecks "Lost in Space": Dnager, Will Robinson!

First runs of: 'Emergency': gotta love Station 51 'Adam 12': the good old black and white 'Ripcord': parachuting is us! 'Whirlybirds': helicopters for fun and profit 'Time Tunnel': funky but fun 'Voyage to the Bottom of the Sea': again hokey, but fun 'Combat': I know that sergeant 'The Lieutenant': Short lived but interesting 'Star Trek': the original - accept no substitutes I remember Challenger. I was teaching a home ventilator class to a bunch of home care RN's [i'm also an RT and was working for Baxter Travenol as a home care therapist at the time]. I stepped into the room next door to the classroom to make a couple of copies of a hand out just in time to see the lift off and the explosion on the TV there. I walked back to class and told everyone we're were having a 15 minute break and told them why. Most folks didn't really grasp what had happened for a bit. But then, I also remember being home from school sick and watching the TV when Kennedy was shot. I saw the motorcade and the whole thing happen. My formative years were... interesting. And yes, I am that old.

Courtesy of my second major full time employer [ret], I can carry/shoot just about anything from an M-16 automatic rifle through an M-9 9mm Beretta sidearm, an MP-5 and P-90 bull-pup style automatic pistol, you name it: pretty much anything the US Army wanted to put in my hands. Not counting a few things our allies let me learn/train with [uzi, etc]. Also any variety of explosive ordinance [claymores, grenades, LAWs, DRAGON shoulder fired missile] etc. And yes, for most of those 21+ years I was a 91 series MOS enlisted woman. [91 series was medical career fields]. I believe in 'preventive medicine' and if throwing lead downrange at someone shooting at me or my patient 'prevents' any of mine from getting hurt, well... that's the way it goes. I don't do anyone any good as a 'dead medic'. Mundanely? I have my CCP where I live and if I carry, it's my personal 9mm Beretta. If I'm working security, it's OC spray, a short ASP and cuffs. But most folks honestly don't try to give a 50+ yo grey haired lady a lot of trouble amazingly enough.

Okay, maybe I'm missing something here, but pulse rate is pulse rate is pulse rate. Now, if he'd asked what the palpable B.P would be since that varies with location, I could see this, but not H/R. In my professional opinion, you got jerked around. Push this to the limit and then some. If this is an example of this guys teaching method, others deff. need to know and be made aware of it. FWIW: I was taught to do my detailed head/neck assessment before collaring as part of my initial rapid trauma assessment because once that collar goes on, that's it - you can't access the neck from then on. But someone else made a good point: you folks don't use c-collars with openings in the front?

Pretty much everyone here has agreed with the creation of strong educational standards. But, as I have mentioned before, why don't we present these 'improved standards' on the forum for folks to look over and comment on rather than simply making the blanket statement 'We need increased educational standards!' and not providing a baseline to work from. Maybe some folk's programs already cover all you think needs to be covered and actually can do it in less than two full years. Let's look over the pros and cons first of what topics and standards should be considered for the program first, rather then assume that anyone who isn't on your 'Two Years or Else' bandwagon has less than the patient's utmost welfare at heart. & FWIW: I, for one, prefer to be talked with and to, not talked down to. And my 'manner of sense' is just fine, thank you kindly for asking.

Thank you, Lady. I most certainly agree. * Available and affordable class time, not necessarily mandatory time. * Mandatory required field time before being allowed to apply for the EMT-P program. * And for heaven's sake, make it worth the person's while. We all know the hours suck and the stresses are incredible and yeah, we do this because we want to and feel good about doing it. But wanting to and feeling good doesn't put beans and bread on the table. Help offset the cons of the EMS field by making the pay and benefits realistic and reasonable. If folks can afford to stay in the field, you'll see more qualified, experience folks remain in the field. JMHO-YMMV.

************************************************* Okay - be prepared - this will be long winded. I think part of what we've got here is no one is really sure what everyone is referring to as a '2 year program' - that is, what's the makeup of classes involved. I'll cite what I've got locally for my example. In my area, the local community college gives you two options: a 1 year certification program or a two year AS program. Please understand that both programs require you to have already received your EMT-B and worked at least one year as one before you can even apply. And nothing says you can't get some of the non-EMT-P stuff out of the way before the program starts. You have to interview before you can even be considered for the program. You have to have people who've actually worked with you recommend you. These are just some of the ways and means to help cull the 'Johnny Gage Syndrome' folks from the incoming class. Here's the local program's info verbatim from it's site [Note: there are other EMT-P programs in the local area, but they are run internally by either the Fire Dept. or one of the local ambulance companies and I have no information them. This is from the local community college]. And I realize what this doesn't show are the actualy hours spent each quarter in class and hands on. I can dig that out if anyone wants. I think that fact it meets accreditation should suffice as a baseline. ====================================== The Paramedic Education Program at Tacoma Community College educates individuals who provide advanced pre-hospital emergency care to patients. The program is offered as a one-year Certificate course or optional two-year Associate of Applied Science Degree. The core curriculum begins in September of each year with the prerequisite classes being offered in summer quarter. The graduate will have developed competencies in recognition and management of medical and trauma emergencies. Paramedics are typically employed by fire services, hospitals, or ambulance companies. TCC's Paramedic Education Program is designed to prepare graduates to meet State certification requirements, as well as to take the National Registry EMT-Paramedic examination. The program is fully accredited by the Committee on Accreditation of Educational Programs for The Emergency Medical Services Professions (CoAEMSP) Upon successful completion of the certificate program, students have the option to pursue an Associate in Applied Sciences Degree by completing 42 additional credits of general education courses as outlined in the curriculum. Those classes may also be taken prior to beginning the Paramedic Education Program ========================================= Admission/Application Requirements The following checklist of items is to be completed and included in your application: (Application deadline is March 1st of each year): 1. Completed Allied Health application form 2. Copy of High school diploma or GED certificate 3. Official college transcripts showing successful completion (grade of C or above) of Math 90 (Elementary Algebra) and English 101 (Composition) OR College Assessment scores of Math 90 and English 101 (College Level Reading). Assessment tests can be scheduled through the TCC Assessment Office at (253) 566-5093. 4. Letters of recommendation (2-3) from supervisors or other professionals, who are directly involved and familiar with your work as an EMT (i.e. chief, physician, advisor, etc.). Up to two personal recommendations will also be considered. 5. Photocopy of current EMT-B card (State or National Registry) 6. Photocopy of current (Health Care Provider) CPR card 7. Documentation of active EMT experience on letterhead stationery from the agency(s) where applicant works (or has worked) as an EMT. This should include total years as an EMT, as well as estimated total patient contacts. You must have at least one year of EMT experience prior to the March 1st application deadline in order to apply. Optional (recommended) documents: * A recent photograph of the applicant (signed on the back) to assist the selection committee to more readily recall each applicant. * Photocopies of additional certifications (i.e. ACLS, PALS, PHTLS, etc.) ================================================== Course Curriculum: Paramedic Certificate Program Course Title Credits Summer Quarter (Prerequisites) Anatomy & Physiology BIOL 118 5 Medical Terminology I HT 130 3 First Quarter (Fall) Well Being of the Paramedic EMC 118* 4 Paramedic I (Didactic) EMC 120 12 Paramedic I (Clinical) EMC 130 3 Total Fitness PE 100 2 Second Quarter (Winter) Paramedic II (Didactic) EMC 121 12 Paramedic II (Clinical) EMC 131 7 Total Fitness PE 200 2 Third Quarter (Spring) Paramedic III (Didactic) EMC 122 5 Paramedic III (Clinical) EMC 132 9 Total Certificate Credits 64 ** Associate Degree Option : Additional Required Courses (37- 40 Credits) Contemporary Issues in Prehospital Care EMC 200 2 General Psychology PSYCH 100 5 College Freshman Composition ENGL 101 5 Business Math BUS 110 5 Principles of Management BUS 163 5 or Leadership and Human Relations BUS 164 5 Introduction to Critical Thinking COMSK 100 5 Fundamentals of Speech Communication SPCH 100 5 or Public Speech Communication SPCH 101 5 Introduction to Information Technology IT 235 5 Select one: Survey of Sociology SOC 110 5 Marriage and the Family SOC 152 5 Social Psychology SOC 240 5 Total Associate Degree Credits 106 * Taught between summer and fall quarters during 2-week pre-instructional days. ======================================== Based on this, I have to take the cert program to earn my EMT-P [i'll suck it up and take med term again - it's only 3 credits...]. I have *no* problem with any of that. It could even be a bit more, in my book. There's always room to learn new stuff. In regards to the two year AS diploma, however, taking into account the classes I already have on record at other facilities, I would only need 2 or 3 classes to make up the necessary required credits for the degree. So... do this mean I don't need two years to get a two year degree? Yes. Does this mean I can come out of the one year cert program a good baseline EMT-P? Yes, because you got out of something what you put into it with time after class reading, pushing to get more experience, just one more hour, one more shift. So ... let's start comparing actual class loads, etc. when we're talking 'one vs two year programs'. It might make things clearer for every here in the discussion.

Most right! Some folks around where I live tend to think of EMT-P's as 'ER Doc Extenders'. Perhaps well and good. But we EMT-B's are 'Paramedic Extenders'. It's our job and it's where we not only hone and keep our own skills sharp, but where we get the exposure that let's us figure out is we want to 'move up the ladder'. No where in all my years in medicine have I ever run across a book that said on the front page' This book is to be read by an MD only.' There's nothing keeping EMT-B's and FR/ER from reading and broadening our personal/professional information level.

All I'm advocating is that training programs are geared to the end product: people who are clinically competent to work in the field *not* the number of hours/years you have to put in to meet someone else's requirements. if a program can do that in "X" number of quarters/semesters, that's good. Great, in fact. But [and here's the 'but' I keep making] I don't see where the extra credits/hours that get tacked on in some programs [speech, PE, etc] need to be requirements. Or that someone should have to retake classes they already have on record with another program/school if they can pass the 'final' where they are taking their EMT-P. And that's all I ever said. Not once did I say 'lower the standard' on what's coming out of programs. Never that. I've only advocated not setting a mandatory number of 'years' if the program requirements can be met in less. And let's face it - the only true adjudicators in the end are the written and practical finals. There's no way to say 'Make they take 2 years or 3 years because they'll come out a better paramedic'. Each and every person will come out differently. Some may benefit from additional class room hours. Some may already have those. Some may need to augment what they've already got in skills, etc. That's all I'm saying. Just make sure there's something in place so we folks who already have a list of 'expanded skills' and education behind us can find our way into the system. In my case, being a broke-down retired vet on a pension, two years+ of school/classroom is pretty pricey. But I've got 30-some odd years of emergency/critical care skills I can bring to the field, the system and to the patient. You bet I'm going to try and find ways that I can put my background to use while saving as much time and funds in the process as I can. 'Significant life experience'. Gotta love it. :wink:

Just FWIW: Johns Hopkins turns out a very adequate Master MD in 6 years [at least they used to a few years ago when I was looking at that]. They tend to cut the 'extra stuff' - like the extra credits most programs require in fine arts. If I want to be an MD, I want to spend my time/money being an MD. If I want to be an EMT-P, that's where I want my money to go. not having to retake a med term class because the program says I have to [and mine is less than five years old] or spend hard earned $$ on two PE classes [personal health and a random 5 credit PE] because someone somewhere thinks I need them and "X" number of credits over all. Take the credits and classes I've already got and apply them. Make me take a competency test for A&P and med term and if I can pass them, don't make me take them again. What folks aren't picking up from my posts is I don't want to spend my time and money taking 'class room' classes just to make a two year degree. I want to take classes that build on what I already know [RN/LPN, EMT-B, OR Tech, RT, combat medic, etc] to give me the specific skills to use in the EMS field. Make the degree equal ="X" number of specific credits in the skill field of choice and let me be a big girl and learn the side bar stuff outside of the program where I won't be wasting valuable time on it. Yeah, a bit of background in things like speech, etc. is good for those fresh out of High School and who may not have a clue about that sort of stuff, but I've taken Speech 101 twice already, just for example. I'm 53 years old and I think I can probably talk to just about anyone I need to, give any in-service I need to, etc. Make the program skill and education driven, not just credit and number of years driven. I've never begrudged necessary training in the field: both manual skills and the education background needed to understand why you're doing it that way. What I do argue against is requiring 'years' just for the sake of years. Give me a projected class schedule and curriculum - than I can discuss things more intelligently.

Just don't penalize those of us who can learn the job and develop the skills in less that two years. Those hours spent taking the EMT-B [in the case of my program over 130 hours of specific skills classroom and hands on training], running rigs and going to OTEPs should count from something.

SWAG - Stupid Wild Ass Guess [come on, we all know this one] : the answer/diagnosis/etc. you came up with before you took your EMS class. EWAG [E-WAG] - Educated Wild Ass Guess: the answer/diagnosis/etc. you came up with *after* you took your EMS class.