stcommodore

You don't seem to agree with anything! SSM by having more units on during noted busier times is taking things 'into consideration' and the benefit is covering your local, getting units to patients and sometimes like in all business you don't make money. For the love of god the restaurant world uses SSM because it works.

Somebody said something here about a "negitive" skin test and chest xray, but from what I'm told once you have a positive test be it from an exposure (common in health care) or from active TB your not to have a skin test again because you'll always be positive.

System Status Mgt and Dynamic Deployment are not one and the same. SSM is the ideal way to handle peak time call volume, and a dynamic deployment a way to place units best for the call volume. I think if we are going to take any aspect of EMS and use it in fire it would be tired deployment. Why do we need 4-5 staffed pumpers going to calls when 80% of calls are false? Two FF's on minipumpers can take care of resetting alarm systems and assisting EMS units.

Without reading the entire thread this is my view of it all...Suicide and mental illness is a very real issue in Emergency Services. It isn't a chapter in our text books and education for no reason, we need to watch ourselves and our co-workers for issues and look out for each other in the early phases of a problem. I would wonder the legality of termination in this type of situation because in many cases when a health provider is found to have a drug problem there are requirments that you seek help for the provider before termination. On a more basic level I would hope that a "brotherhood" willing to look out for each other on the street would look out of each other back at the station.

I have my state and registry medic card in my wallet, all the other certs are at home.

I think alot of the dynamic in this topic has alot to do with the type of system (FD, Responder, MICU only) you work in and the setting (urban, suburban, rural).

Add to the equipment the phrase "everybody goes in together" if its just 2 on a crew, 3, 4 or whatever for simply safety does anybody else follow this?

You arrive on scene for a dispatch, what equipment do you bring in? Do you have calls (ex toe injury) where you or you have seen providers walk in without equipment? Do you go by the "long and deep" rule where the patient is in a nursing home or high rise for example and you take everything with you (Moniter, 1st in bag/drugs, 02)? Does your specific squad/department have a rule for this type of situation? A paramedic I consider a mentor of mine has a phrase that goes something like "without your equipment your nothing but a trained observer" which you can figure obviously means he and I are for bringing anything and everything the dispatch/location calls for.

props for being busy galeic but what does that have to do with the thread?

I drove through central/southern Illinois in November and while it didn't look like there was alot out there, it sounds like there isn't alot of intelligence there either with that kind of comment.

Congrats, its a step in the direction of being done! I remeber what it was like to pass that to and there is nothing wrong with being proud of yourself.

So you have completed your paramedic testing and have the brand new patch/uniform to go with your experence level. You begin to ride calls "precept" with a skilled provider and after a few weeks see a few BLS and a few acute patients. At what point in your Paramedic time did you feel you were ready to be the sole ALS provider on a call? Did you get the chance to "precept" or were you thrown the keys and a partner and told "don't kill anyone" regardless...

I guess the important question is do you as a staff provider/manager/etc feel that a dynamic deployment covers the calls better then a static deployment? Do you find it works better during peak hours, etc

The squad I work at serves a suburban area with first due on the Pa turnpike. It has three stations and a call volume around 5,000 a year. It recently created to "phantom" posts in an effort to create a dynamic deployment when necessary. Typical staffing is three transporting medic units, and five day shifts a week a "floating" BLS units is staffed as a fourth unit. The "float" unit responds to all calls and when possible will take a BLS patient to allow the medic unit to remain availible. If a patient is being transported ALS then the "float" unit covers that units area, or may elect to assist the medic unit on a critical patient(s). The phantom posts are set at the midpoint between two set stations and are relocated to when the two set station units are in service on calls. If for example all three units are comitted then the last unit is to relocate to the northern phantom post that sits in the most central location for the entire local. The system is rather new to our county, but for the most part has been very effective. Units aren't required to relocate unless the county dispatch or officer orders them to from 2300-0500 hours.

studys or documents to back your comments? One of the first lectures of EMS Managment I, says that the peak peroid of EMS follows the demand of electricity. (8a-5p) So having more resources ready to respond during that time is the most basic aspect of SSM. Fluid Deployment being the most advanced way to use SSM.

The possiblity exsists that in a large urban/county wide system that a "fluid deployment" using system status managment and "hybrid" use of 911 and transport services may be the ideal system.

I have no issue with there being a BLS and ALS level. My only issue is when they try and play around with some level(s) in the middle. There is always some laundry list of reasons why BLS can't do it, needs to do it, they can't get medics, there aren't enough medics, etc. Simply on the topic I'll say over and over BLS does not equal BGL.

So the national (draft or whatever status) considers treatment with Dextrose/assessment of a BGL to be an ALS skill and we are still debating the point? The problem here is that people at the BLS level have had the definition of BASIC care blurred with medication, intubation, IV, etc and forgot the purpose of there care. Stabilization of immediate life threats, and rapid transport to hospital or with advanced care if circustances allow.

No need for BLS to take a BGL or treat Hypoglycemia. We create a serious issue when you begin to mix the basic level of care with mini-als interventions in there treatments.

congrats, dont stop your education here.

see also: the search function

I hope your just trying to be breif but thats a really poor view of what EMS jobs are when you call 911 for a transport from an LTC. I would expect the same professional treatment you would give anybody else in the field and this has been talked about plenty here.

In my ideal world the paramedic education would be a 2-4 year college based education. You would be taught your A&P, your physology, your disease process right along with medical students and be taught more then what a basic paramedic education requires. After and or along with the standard program of lecture/clinical you would have further education in college english, college math (nursing pharm/math). In addition to that you would have EMS/Fire Managment, grant writing, etc classes that would prepare you for a future when you didn't want to, couldn't work or were needed in an aspect different then working the bus. Does everyone want a degree? No, in fact most just want a quick education so that they can do more. But the progression of the provider we produce and the progression of the field comes with a more indepth education.

As much as I argue against specific rules in the path between basic and paramedic. I'm totally against this rushed style of education, we will never progress as a profession if we continue to allow this type of education to be the norm or to even exsist.