stcommodore

T-14 hours

I work and volly at two seperate EMS squads as an EMT-B. I see the merit in the volly service, but no merit in the excuse it must be volly because the area can't fund it like I said. I honestly haven't taken this debate to far for personal reasons. In the end it probaby isn't one of the major 3 issues I would have EMS unite around anyway.

I guess your not really using my example the way I had ment it, but yes there is no reason a city/town/etc can't fund a service if there is really a need for it. Be it through a regional ems service, local municipal service, fire department based, hospital based, or whatever.

its my example if an urban area, the service is a hospital based ALS service.

I hardcore need to pass this time. Looking through the material nearly everyday I wonder if there is anything but doubt I could be missing anything. Looking at my past results I reallly hope I was close that I can get a few more (10-15) questions right and actually pass.

If anyone can remeber questions or topics that gave you trouble feel free to lend some help.

I'm sure its been said but a degree track be it 2 years (paramedic only) or expanded 4 years with BLS training/EMS Managment mixed in with the ALS training is the goal this profession should strive for.

For as many people as I read stories about and personal accounts I've heard I'm more apt to believe there is no way to compare the total questions you get to your chance to pass.

Ex.

I've seen people pass and fail in the 80's

I've heard people passing in the 110-120's and in turn others fail.

It simply comes down to scoring "above passing standard" for all your specific catagories. Be it for the B. I or P test you have to pass every area of the test and honestly who knows if the numbers matter at all. It just our only thing to go on after we leave the testing site and until we get our results.

Where in the hell do you work? Butcher Holler? Mogadishu? Falluja?

City of Chester, Pa avg per captia income $13,000 with a population under 40,000 and urban landscape to rival rough parts of philly

CBT Retest 1....Wednesday, January 23rd at 1330 HR

I'm sure "help", "mayday" or "holy sh*t I in trouble" would get the idea out there

Buy a couple of review books, work through then until you feel very comfortable and then prepare for one of the hardest tests ever.

I got the Baron review book yeasterday and just sent my payment for my next retest. I like telling people my hands have passed the test but not my brain yet. So close, but yet so far.

This is a debate about two TOTALLY different worlds and that basically has no end. Does the urban setting need medics, Yes. Does the rural setting need medics, yes. Sick people need paramedics regardless of location.

Practical Exam Date: 12/13/2007

Practical Exam Scored: 12/18/2007 2:00:00 PM Passed

Practical Results Mailed: 12/19/2007 2:00:00 PM

Now thats more like it! CBT you better be ready for my wrath!

Congrats, she said I passed to. Just waiting for the actual registry letter to come and then on to the CBT!

Alot of good advice, thanks.

I spent about an hour and a half this afternoon with my two lead instructors, and friend playing the patient reviewing LSB. It's not that I don't know the skill I just feel its better to practice it and get feedback prior to doing it again. My biggest issues are not time. First though what appear to be how tight the straps are. Second making sure the patient gets on the board from the log roll well and keep movement down.

How many of you that did the station or have experence giving it used 3, 4, or 5 straps on the patient? Any opinion on straping hands in, or another method of securing them?

Feel free to catch me on AIM at 'stcommodore' or email at cms82@drexel.edu if you want my insight (be it what it is) on the oral stations or if you just want to review both of our past practical experences.

Yes I will.

So far from my class:

5 pass

7 yet to pass

this sure isn't fun. I watched the 'pass paramedic' video for supine lsb, my single station retest comming thursday...I have to pass this or I'm back taking eveything all over again!

During medic school I precepted in a urban setting where the max transport time was probaby 10min. Outside of trauma, in the medical setting I found that stabilizing the patient on scene, making the move to the unit, setting up for transport and going worked the best.

When you have a sick CHF'er for example if you scoop and run and arrive in 10min but have little acomplished its not worth you being there. If you take 5-10min on scene to get your IV, put the patient on CPAP, give nitro and get going. En route giving Lasix, follow up Nitro and then making a good call to the hospital with time for them to set up you and the patient should be alot better off.

I could be totally off, but I don't think the bullets kinetic energy can really be classified at all in the blunt trauma catagory.

I asume the term written/CBT are being used as one and the same.

Our protocol (a guideline...well technically) for EMT-B is ONLY based on MOI . . . For paramedics it seems to be what PHTLS says. So, if EMT's aren't supposed to take into account pain, deformity, neuro deficit, then almost anything would require immobilization... http://ladhs.org/ems/Manuals/Medprotocols/...obilization.pdf

PHTLS is for EMT-B's to. If we don't trust what the studies tell us then how do we expect to be considerd anything but tech's? We have so very little EMS research as it is that when something like this presents itself do we consider it or brush it off in favor of 'what we have always done.'

Case and point, penetrating trauma with no neuro deficit on EMS arrival = no need for LSB

Two cases:

20 YOM, GSW to left shoulder with no exit would, cardiac arrest. Unsafe/Unstable scene, Do you LSB?

35 YOM GSW Chest, No Neuro Deficit, A0x4, CC: Resp Distress corrected via Needle D, Do you LSB?

Both patients I treated during medic school and neither got LSB, in fact in the many GSW cases I saw we never LBS'ed a single one. This was a hospital based system, with the hospital being a trauma center.