becksdad

I've been watching this thread, and so far I haven't seen the questions I would want to ask. Patient hasn't been feeling well for 2 weeks? What is the Hx of that? Had URI? Cough? Fever? SOB different in nature from her typical asthma? Re decreased breath sounds uni-or bilateral? Did you have a good stethoscope? Reason I ask, our agency provides cheap sprague stethoscopes that suck for all but the most pronounced changes. Could there have been friction rubs?

Is there anything else that provokes or palliates pain besides rest? Such as deep inspiration? The elevated resp. rate could be in response to pain on inspiration.....Relief with her Albuterol?

Some lab results referrable to liver elevated. Any Hx of cholecystitis? Recent worsening of GI complaints? (she takes Protonix). I know a few of these questions may be a bit of a stretch, but I find that thorough history taking can often focus the search. The answers to questions usually lead to more specific questions that you wouldn't have considered before you get a more complete picture.

I am not discounting the possibility of cardiac causes of the patients discomfort. Lord knows plenty of people present atypically (especially women). But I also think we often get tunnel vision, and focus solely on cardiac when someone complains of "chest discomfort". That is actually a pretty generic complaint that I think needs to be more specifically defined. It is even more tempting to focus on cardiology when a patient has a Hx of cardiac problems.

So while remaining alert to anything specifically cardiac, I would be searching for answers to R/O or confirm suspicions of differential diagnoses. Did you follow-up and get any further info on this patient, 1EMT-P? I would be curious to find out what went on.

That made me laugh!

A spork? That means you must be in EMS because you've eaten at too many fast food joints!

nyuck, nyuck, nyuck!

OK, AK - I say I am a spoon because of the 3 utensils, a spoon causes the least damage, while still accomplishing the objective. The knife cuts, the fork impales, but the spoon transports whole. Your turn....

Chevy - Then I would do exactly what I said. Remove us from service, have LE respond, attend patient, recruit assistance. My "partner" would be done. Partner is in quotation marks because no partner of mine would do that.

AK - So which one are you? I say I'm a spoon.

AK- Ah, Zen interviewing....

First off, the only acceptable reason to attempt harm to a patient is in self-defense. My safety comes first, then my partner, then my patient. Barring that scenario, I would have immediately put the truck out of service, summoned LE, had another truck respond to take over patient care. Obviously, a supervisor, too. There are usually others available on scene. If necessary, I would have recruited an FD medic to take over patient care.

As far as interview questions, I think very good ones are "tell me about your strengths and weaknesses?". This implies the ability to self-evaluate, which I think is a necessary quality for any practitioner.

At first glance, it may appear that the thread has meandered away from topic, but upon closer scrutiny, I think it has everything to do with the topic. The original question concerned a new EMT asking what not to do. One of my mantras in EMS has always been that everyone can be a teacher. Some demonstrate what to do and how to conduct oneself. Others demomstrate what not to do and how not to be.

Probably the worst thing anyone in EMS can do is to not care. I think it is worse than whackerism. At least whackers care about something. So, to any new EMT's out there, if you truly care about what we do, if you really want to be the best you can, you will quickly realize what to do and what not to do. You will learn more than you ever thought possible, and will continue to do so throughout your entire career. If you really do care about this field, and have even a modicum of maturity, you will choose wisely who to follow, and who to take valuable lessons from, but leave behind.

If you wish to work in a corner office and make buttloads of money, I wish you success in your endeavor, but please do it.

Looks like it can be really useful for those idiots who like to follow too close!

Dust - all of that advice sounds like a very good recipe for success. Thank you for sharing it with me!

Hey, vivibonita - from what I know so far (and that is very little), a minimum requirement would be CNA for entry level. The job description I have states that cert. as EMT-B or EMT-I is strongly desired for positions above entry level. Which is amusing, because Florida doesn't recognize EMT-I! Maybe they haven't updated their job descriptions in a while....

I can tell you that any certifications you do have - EMT, BTLS, PALS, ACLS, etc. plus any years of experience can be used as negotiating points for the level you are hired at and the rate of pay.

Dustdevil wrote: "Me EMT. Me no need know that".

Hahaha! No, Man! What I'm really excited about is that I have an opportunity to go in any direction I want in medicine! I can look 360 degrees around me, and everywhere I look, there's a door. That's pretty darn cool! So I'm sure you all will hear me talking about stuff I learn, and asking a million questions....

Well, it's official: I begin the new adventure on Monday as a Tech in the ER. I'm hoping to learn a lot, go back to school and have it paid for, etc. It will be interesting to learn the difference in the ER as opposed to the street. But, God I miss the street!! You know, its a lot of fun, really! But, hey, I expect I'll have fun inside the hospital, too. Anyway, wish me luck!!

Yourself.

TUBERS!!!!!

ooops. My bad....

Well, it's just good to know that your kleip just woomba deek.

Admittedly, it is not difficult to do, but the last 3 posts here just confused the hell out of me!

How can you not laugh along with that baby?!

Just to enter this debate over whether we practice medicine or not:

One of the people I have considered a mentor since the day I met him has entered a management/leadership role with our agency. Of course, I have always considered him a leader, and he is quite accomplished both in the field and within continuing care settings. This person refers to all of us field providers as "clinicians".

Of course, this proves absolutely nothing. But what it does do, is that the simple attitude shift implied by using the word "clinician" raises the bar, the expectation level, and the respect of our profession.

In turn, we raise the bar for ourselves, raise our own expectation levels, and increases our desire to become better. If we view ourselves as "technicians", that is what we are. If we view ourselves as "professionals", that is what we become.

Qoute from another mentor - "Please do not impose your limitations upon me".

Firefighter, Congratulations! You made some good friends today! You happened to attempt an insult to 2 of the most respected members of this board. And respect doesn't come easy here. One must prove oneself first, and both Ridryder and Scaramedic have done so. Both of these Medics have demonstrated the knowledge and skill that comes from combined education and experience.

Also, if a patient presented to me with a nail in the foot, I would not remove it, just like any other impaled object.

HEHEHEHEHEHE!

Puts a whole new meaning to that commercial: "What's in your wallet?"

CASH! i HAVE CASH!!

Probably all or most of us have been presented with similar situations. I have never encountered the quantities of cash talked about here, but I've gotta go with chaser and Rid. (of course, who's going to say they would take the money and run??!!).

But, I have always felt this way about money and possessions: "It wasn't mine to begin with". This is also what kind of upsets me about people fighting over inheritances, possessions, etc. Also, like Rid, it is good to sleep at night with a clear conscience. I don't think I would be able to look my partners, patients, or supervisor in the eyes if I did something like that. I think it would destroy my career. Not from the fact of maybe getting caught, but destroy from the inside out.

Also, I have always tried to teach my kids that their lives are determined by their decisions - one will reap either the consequences or the rewards for every action one takes. How could I possibly teach them to choose well if I did something like that?

ON a less ethical note - how much cash is your career worth? Because if someone was discovered stealing from patients - any patients, they would be finished in EMS. And rightly so.