GAmedic1506

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disregard, we figured out his password, and will disable the link

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Oh I forgot, I think we are going to add CPAP, but we haven't tested it yet -- ordered one for demo, not here yet.

Ok, remember you asked me for this, and I am going out on a limb, so dont start sawing it just yet. This is the short list of major accomplishments, at my current employer, in no particular order: 1. Established cutting-edge protocols (cutting edge for our region, maybe not yours) in 1999, that were copied by most regional services. We are about to roll out a whole new set that are cutting edge for this generation, but I did not do those. 2. Created Homecare Instructions for those who refused EMS transport. Featured in JEMS, adopted by many services. 3. Upgraded equipment from LP10 to LP12s with 12 lead, new pulse oximetry, new glucometers, and stretchers. About to add end-tidal CO2, but not accomplished as of this date. Put baxter IV pumps on our trucks. Put fluid warming shelves on the trucks ($700.00), but initially used footwarming pads that secretaries use ($30.00). 4. Used Special Option Sales Tax to purchase new communications system (laptops 800mhz radios), will be implemented this fall. 5. Facilitated the revamping of our training/orientation process because it sucked. I can not take full-credit as many of the ideas came from employees and supervisors. 6. Bought over $200k in disaster supplies using HRSA and FEMA grants. In 2001, our disaster supplies consisted of one triage kit (with tags and vests), now we have decon showers, generators, suits, scbas, the full-meal-deal. 7. Increased overall pay by 30% since 2000, wished it couldve been more, but we have had tough financial constraints since 2002. 8. Facilitated 2 full-scale, multi-agency disaster drills before 9/11, which had never been done in this region. 9. Was one of three people that were in charge of our Hurricane Katrina shelter for evacuees. We took care of about 300 people for two weeks, and distributed 8 tractor trailor loads of supplies to other shelters. Thats a good topic to post here, as I learned alot from running that shelter. 10. Improved design of our boxes for medic safety -- not enough, but we tried -- safety net at end of bench, no overhead cabinet above squadbench -- no rough corners -- additional padding. Moved to a bigger chassis, Chevy 4500 -- seems to be a good move so far, but too early to say. 11. After 9/11 myself and a medic from a neighboring county wrote/compiled/created a WMD training guide for the whole region that educated everyone about those issues. It was distributed to every ambulance service -- emergent or non-emergent. 12. I have tried to fight for change within our region, asking all services to set benchmarks and compare data, but i have been unsuccessful in that cause. Thats all I could think of in 20 minutes -- feel free to ask about any of the issues.

You are right, we just revamped the whole orientation/ departmental training process.

Ok, give me a minute to compose a short-list, and no it will not be impressive, but I will attempt to list.

I didnt list my accomplishments for exactly the reason you stated, because I feared that it would come across as preaching, or that i was somehow superior to others. At the minimum, it would seem as though I was blowing my own horn. I have had an impact in a number of areas locally - regionally, but I do not think that I have had any impact beyond my own borders or the industry as a whole, nor do I have a legacy to pass on other than what you have stated: patient care, teaching and mentoring. In other words, there will never be an EMS building somewhere that is named after me. But I do believe that a forum such as this, with some of the best and brightest minds in EMS, we can make real differences, if we roll up our sleeves and go to work.

Ace, please go back to page 3 and read my last comment. I love you no matter what, and look forward to more civil, yet spirited debates in the future.

Thank you azep, I do apologize, as I had misread your comment. And thank you for sharing those two sites, as I had not heard of either one. I will check them out.

Thank you ace. I do not want us to get another post locked down, as that benefits no one. Lets just agree to disagree. I respect you because you like the facts and you are not afraid to challenge people. Your not one of those who just say anything to get attention. I think this site will benefit from our disagreements, if we can keep it civil.

I think it depends on what level of emt they are, and how your service uses them. I do not believe EMT-Bs should be on an ambulance, but I think EMT-Is should be. At our service, we do not dumb-down or have separate training for EMT-Is, everyone gets the same education. Most of our EMT-Is have attended ACLS, and are very knowledgeable. We have had EMTs who kept rooky medics from making a mistake several times (like giving atrovent to a CHF patient). I do not believe that children should be on the ambulance for all of the reasons already cited.

To Ace and Azep --- Do not poo-poo Tech's idea of improving his service. It is apparant that both of you work at the perfect EMS System where there is no room for improvement, or questioning of the status-quo. As far as the benefit of canned training, I agree that classroom instruction by a qualified instructor with some hands-on practicals is superior, but many of us do not work for the perfect EMS Service that you do. Many systems do not have a paid instructor, or a budget that allows people to attend training classes. Some medics actually struggle to meet National Registry Recert Hours. Some medics have to travel over 100 miles just to find a PHTLS/BTLS course. Then there are medics who arent happy with the status quo and have attended all of the standard classes, and may just want to read something new. Ace, I am sorry that i pissed in your cherios, it is obvious that my posts are generating more commentary than yours, and that has upset you (although your ego will not allow you to admit that). My intention was not to unseat you from whatever throne you sat on prior to my arrival, I just wanted to discuss EMS issues. I am sorry that I have upset your world so. As far as you being INSULTED, I have not accused any member of this forum, or the forum itself of being lazy. I asked the question "Are WE (EMS) (not emtcity, ruff, ace,or anyone else) lazy, scared, or indifferent ?" That thing at the end of the sentence is called a question mark, which means the statement is a question. Also, please note that I used the word "WE", not "you", which implies that I include myself in the problem. But there is a simple solution to the problem, when you see anything posted by me, just ignore it and go to a different thread. My thoughts, threads, and posts will live or die based on whether or not people enjoy the content. If people find my posts to be boring or stupid they will stop reading and responding. But my guess is that people want to discuss all EMS issues, even the ones that make them a little uncomfortable.

Good idea city medic -- and i will do you one better --- when you get it completed, share it on this site, so that all of us can use each others. THink how nice it would be if we had 1000 good-canned CEU courses on this site that anyone could use. Even if it doesnt help our companies, which i think it will, maybe we can help that guy in the wilderness who works for a service that doesnt offer any training.

The profit sharing plan can work anywhere, its just harder if you are a government system. But if you asked for it now, for your 2007 Budget, you would have time to make it work. There isnt a politician or owner who wouldnt jump at a no-lose situation, remember if you dont make the goals, you dont get the raise. Now I imagine you wouldnt necessarily have to set it up as an all or nothing plan --- you could have a staggered scale of lower raises compared to the percentage of success you had. It is easy to track monthly, every organization already pulls those numbers -- and of you are a government agency, you can get those numbers through an open records request if you have to -- but most governments have to publish their budget somewhere. I am not wild about unions, but that maybe what is needed to tie us all together with a common voice. I prefer this solution, as it is management and employees working together for a common goal -- it isnt adverserial, like my other suggestion, or the use of unions. See, its not as hard as we think -- by tomorrow i bet there will be atleast 5 more good suggestions that are doable. Pick another topic, lets see where this takes us.

City Sponsor, I would like to hear what you think are big topics. As far as college degrees, I think that will happen with time. We have to remember that our profession is not nearly as old as Fire, Police, or Nursing. I imagine degrees will become mandatory for management jobs in the future. I do not think it is necessary to raise pay-rates now. There are not enough of us to go around, so we could demand a higher wage if we chose to. Again, you have to have some solidarity though -- you cant do it alone. Education is my pet-peeve, but in reverse of techmedic, I think we need a bigger focus on real training programs that improve our skills on the streets. You can track the decline of EMS to when ACLS decided no one could fail. The thought of having to take ACLS use to make people so nervous that they would vomit, now no one even opens a book before they take the class (but in the old days you can bet your ass that most medics (not all) knew their acls backwards and forewards). I think that once we make "education" important, then degrees will become important.

In the south, an ALS call is usually around $400 for county ems, and 500-800 for private ems.

Love you techmedic -- good response. Well i think part of the problem is that the task is overwhelming, and people see it as undoable (new word). I think we need to eat this elephant one bite at a time. I have found on more than one occassion that it is not that difficult to have success, but you have to take the first step. You may not wind up where you thought you would, or on the time-table that you thought, but if you try -- more times than not, you will succeed. Lets take one of the problems that was listed --- pay. I can fix pay in one week, and do so without paying union dues: 1. How many of you work two jobs ? What would happen if every medic in your area, on a date-specific, decided they would no longer work that second job. I didnt say quit, I didnt say call in sick, but lets just say we chose not to sign up in Spetember because we had plans. If you could get all the medics to do it, pay would change overnight. If because of new EPA standards the cost of an ambulance went up by 50%, you better believe your company would still find a way to buy an ambulance. Just as I am sure they are having to deal with fuel prices now. But someone has to take some action, instead of just sitting back and whining, and we have to stand together, as well as sacrifice if we need to. 2. If thats too mean for you, why not ask for an incentive plan based on performance. If I were your boss, and you came to me and said boss, if we could increase revenues by 10% this year, and decrease expenditures by 10% would you reward us with a 5% raise ? There isnt a boss in the world who wouldnt take that deal. So how do you raise 10% in 911: You transport a few more than you would've, you fill out the bill with acccurate information, you hustle so you dont have to roll a call to another provider. How do you decrease expenditures -- dont call out sick when you arent sick, you swap out of the truck when the brakes first start squealing instead of when they are metal-to-metal. You dont waste fuel or supplies. Now thats my 2 suggestions, that are both possible, but not easy. I bet someone else has a better idea. Fire away Now I bet someone has a better suggestion

Now the conversation is coming around. Good points by RidRyder. Please, I have never been offended, please feel free to say whatever you like, I have thick skin -- cause lord knows I have been called everything in the book in the past few weeks. And my intention is not to make any one feel bad -- its just to raise awareness of issues. I am sorry, but I see too many people waving the EMS IS A VICTIM FLAG. We are right where we are because of our (EMS COMMUNITY) our actions and our inactions. Sure governments and other people give us hearburn and roadblocks, but it is we that have to figure out how to get around that.

Everything you'all say is true, but that doesnt mean we cant or shouldnt try to change it. Forty years ago, an ambulance was little more than two guys and a hearse. I imagine if you told those "ambulance attendants" that one day we would intubate and administer medications, would have computers on trucks, have cardiac monitors, 12-lead, and pulse-oximetry, they would have laughed in your face. If we wanted to, we could make big changes in the EMS Industry, but it is easier to gripe about problems than it is to fix the problems.

First of all, I have to ask if you are the person who has the power to confront these issues ? Your employer should be following a progessive disciplinary process that ends in termination when the employee fails to improve. Your supervisors are setting themselves up for a huge problem, in that if they fail to terminate her, they will have trouble terminating anyone in the future. The other employee can say look at Miss soandso, you didnt fire her. It sounds as though they will not terminate her, so any efforts on your part are probably futile. I would look for a better employer, as employers who will turn a blind eye to poor performance, just so they can keep the schedule filled, are usually failing in several other areas. And it is difficult to change personality, which is why your employer needs a better screening process before they hire someone. But it sounds as though they are happy just to get warm-bodies in the door.

On AEDs, who said anything about tax dollars ? Why cant the local EMS just educate the community to the issue. Let those businesses figure out a way to buy their own. If you only saved one life this year with a community AED, woudn't it be worth the 30 minutes you spent convincing that business to buy one. You cant convince me that if your department facilitated the purchase of 20 more AEDs in your community, that a life would never be saved. The value of lab work doesnt change alot right now, other than it may change your destination choice. If you knew for a fact taht someone was having an MI, you might take them to a facility that can do open heart versus your local hospital. A low H&H on a patient that looks uninjured might direct you to a trauma center. Again, I see it more as opening up future doors. I see computers in the same way. They open up alot of future doors. I disagree with your comparison of fire and arrests. Fires happen less because the fire department educated the public, used technology to minimize risk (sprinklers, alarms, and building code -- along with inspections), and forced changes in standards. If EMS did the same for cardiac arrest, the numbers would improve (more CPR taught -- taught the warning signs of MI, pass ordinance that any new business that is over 2000 sq ft or employee more than 50 persons must have an AED installed) And no, Paramedics cant open a trauma center, but they can be activist to the media and legislature to get more opened. We cant do it alone, but our voice can be used. The few things I listed are just sample suggestions. You bring up many "bigger issues" that need to be addressed, and you are right, they should be. My question is why arent they ? We all know what the problems are in EMS, but ask who is doing anything about it, and the answer is usually no one. But one thing that I have discovered is, that half of the battle is just deciding to tackle the problem, instead of ignoring it. We tend to say, it cant be done, and then we move on. But I am glad you brought it up, instead of just talking about it, why dont we see if we can actually solve one of those "bigger issues" that you mentioned. JPINV (or anyone else that is up for a challenge), If you could fix one of those big issues, which one would you choose ? Please post it, and lets put all of our brains together to solve it.

Here is where you and I differ. Regardless of whether or not I agree with you, regardless of whether or not I win, I think it is important to raise issues, have discussion, and then let people take from it what they will. I am not going to demand that you filter or arrange your ideas to meet my parameters, if i disagree with you, i will put it in the discussion notes, and let others decide who makes the better argument. You like to frame everything with a scientific study, which is not a bad thing, its just that i do not need scientific studies to back things that I know to be true. Obviously, if you have scientific data to refute anything that I claim, I would hope that you would use that as part of the discussion. So lets try to be better adults as we move forward, and not attack each other personally. There are some things that we will just have to agree to disagree on. As far as this thread, it is a great topic, that everyone needs to get more education on. When I attended our Pandemic Summitt, I saw a fear in the PH official's eyes that I have never seen before. They are gravely concerned about this flu.