Niftymedi911

I like, scoobykate, I was taught at a very young age, that do you everything to the best of your ability, you go above and beyond what your told or asked to do. And I still strongly believe in that. When it comes to work related issues, it's also not just a sense in pride or professionalism. But another thing that goes hand in hand with the idea, is a work ethic. You might have pride or professionalism in your job, but without a work ethic, how can you truly define professionalism? I think that some of the posters started to touch the surface with the Gen X / Y people. The younger generations of today really aren't taught in their homes work ethics, sound thought processes, or a self pride in what they do. It's all about what they can do to get by, live off mom and dad for as long as they can (lack of work ethic), and then wonder why the world has left them by. Now for the older generations who work with the younger generations, they might have been taught a work ethic, might have been taught what was needed to be taught. But because of the influence of the younger generation with our profession, the older generation might decide that having too much of a work ethic, pride, or professionalism is out dated and overrated. (Now, I know most on here aren't but tell me this doesn't describe a lot of attitudes anymore). As for myself, I don't get too easily influenced on my habits or morals. My truck is washed inside and out, disinfected, waxed, detailed checkouts, stations duties are performed as described. Everything is done as it is inteded to be, plus a little extra. Sometimes, I end up doing these things myself, because my partners don't feel the same way I do. But, my truck is my office, I take pride in what I do and I come to work TO WORK... (I know... I know.... that makes too much sense). I beleiev it truly starts by instilling these morals and values while your young. Just because you switch jobs or professions at age 30 doesn't mean, you'll also just have an immediate sudden change of morals or values.

I recently had a training bus that is federally funded come through our county and got to experience some new equipment that had recently been placed out on the market. The one I was most intrigued by was the S.A.L.T. (Supraglottic Airway Laryngopharyngeal Tube) Apparently, the U.S. Government uses them in the military with the combat medics. I've done some (not a whole lot but enough to be familiar with its uses and the like) research on the device and am quite impressed with it. I got to use one during the training simulator and intubated 4/4 times. They even changed out the airways in the dummy to the a Mal # 4 and I still had ease of use. Now, given the fact that this device has been used in the military and is slowly working its way in the urban EMS market. What are your thoughts? Do you think that this device will change what we use for airway control? Does anyone around you or even your service utilize this device? If so have you had any luck with the device, does it improve overall patient care? Some might seem hesitant and I'm also looking for your opinion. Obviously, the old fashined way most people will not want to let go of. But, I'm for anything that will improve my patient's outcome safely and quickly. This device promises to do both. The device itself is made of semi-maliable plastic with an elongated tube with a large base to "block" off the esophagus to prevent aspiration. It is a dual use BLS/ALS airway, in which using it BLS wise would be an advanced type of OPA. The device would also in turn eliminate the use of the laryngeal scope and properly intubate every time. Here is the web address: http://www.mdimicrotek.com/prod_salt.htm

Spenac, I never said STOP, I said gain experience as an EMT before putting yourself and everyone your involved in through hell. Because too many people go right on through the schooling (EMT/Paramedic for A.S.) just to come out and find out its not what they expected and they dont like it. Less then a year later they either fired or quit. If he's starting a new career and taking an abrupt 90* dgeree angle, feel the water out, get the expereince and street knowledge prior to going through PM school. Because everyone knows they can make it through the school. It's putting your book knowledge to your hands and reacting to the ever changing environment around you that's the difference.

You aren't the only one who was getting sick of being in the weeds trying to grill a poterhouse on the fly............... I too also came from the culinary industry as a Sou Chef. I started EMS 5 yrs ago and am never looking back. I would have to agree with Orlando, been there quite a few times, nice place to visit, horrible place to live. I prefer where I'm at now. Not too crowded, awsome fishing, beaches are top notch, and COL isn't too terrible (well, with the ecnomy the way it is it isn't). Apprently we were called "ground zero" for the entire nation in the home foreclosure market. The only bad thing are the snowbirds. Within the past week they've come from the walls, and everywhere else. But good luck with school, I strongly suggest getting about 2 yrs as an EMT and being proficient at it before going through medic school.

Welcome to the city!!!! It's always nice to have another Floridian around......... All those Texans get a lil overhwelming......

Once a new hire has been given the green light they must attend a three week refresher academy which covers all topics Medical/Legal/Guidelines/Locations of VIA's (very important areas). You'll also get re-certed in ACLS,PALS,ITLS,ALMS,BLS, IV Cert (for EMT's to start IV's in the field) and also attend a 2 day EVOC course. From then you are then assigned based upon compatibility (you fill out a questionnaire and a computer matches you with your FTO based upon your answers) to a field training officer (FTO). You are then riding 3rd, working closely with your FTO for approx 2-3 months. During those months, you complete "modules" which are set up to take you from a civilian to EMT/Medic working within our medical guidelines and being operationally proficient. At the end of each module there is a test and you must complete the test prior to moving on. By the end of your 2-3 months you'll have completed every module and test. By this point your are then able to "Credential" or sit in front of the credentialing board (MD, Capts, Lt's, Training Chief). There your asked a series of scenario based questions and using your knowledge and guidelines you answer each one. If you successfully treat each patient (not only medically but also show competence and confidence in your medicine) you are then released into the wild to ride as a released medic or EMT. Typical Time frame is about 3 months. But you have up to 6 months to credential.

When people are willing to let things go and COMPROMISE for the betterment of the profession........ Oh wow, wait a minute that word exists? NO.. it can't........ You'll see a unity that will be able to bring down any wall or deterrent. Until then all we are left to do is bicker, back stab, lie, cheat, steal, and bicker some more. You hear all of us whinning about trauma, because we are in unity and will COMPROMISE our views to get something that we all view is negative out of the public's eye to save our profession. On another note firefly...... A quote from my best friend who is also a medic...... "It takes less enegry and faith to whine, bitch, and moan about something. Then to change if for the better and expect someone else to do it for them." At the end of the day, this world doesn't change.

Paramedics from TLC had to be cancelled due to HIPPA act. Because of HIPPA, the reality of it is simple, in order to keep it as much of a reality show vs. a drauma or etc. the people in it are real paramedics,the procedures are real and done in real time. They're running realistic calls (becuase every show has a glorious MCI, and in my 5 yrs with EMS there has only been two from my county, which is close to a million people). Now, an idea, that can incorprate both portaying EMS in real terms and keeping people happy would be a first person reality. Every week you follow three "recruits" or probies from different agecnies. The probies have been recently hired and have to complete a "FTO" phases and while doing so they run real calls and function as a 3rd persons to "credential" up. The probie after 10 or 12 episodes "credentials" and becomes a released paramedic and deals with the ascpets of life after FTOing. They're not competeing for anything,but can and will be able to show the various different lifestyles, morals, and feeings that make every paramedic unique. Thus, giving Hoollywood its ratings for being "reality", giving the professional EMS community something to be proud of, and protrays the REAL side of EMS to the nations.

Well technically for the paramedic career itself... its future is bright. As for a non-fire based paramedic working in the state of FL, its 50/50.....

Vent, To be the best of my knowledge there is no "talk" of EMS/Fire Consolidation even within the next 5 yrs. There is only "talk" of fire consolidation. But I am watching the situation carefully. Hey Flastudent.....if you send me a message please send it through forums PM. I don't have yahoo messenger anymore. Or email it to me.... thanks!!!! Vent answered the rest of the questions better then I could..... she's got more info in that arena then I do......... For the FD taking over EMS thing...... It's becoming the norm for the United States. Unless there is a strong EMS service with loads of public support, a private agency that can generate numerous profits, or a FD that cannot feasibly take over EMS..... those are the norm.

Well, sometimes one can only speak from experience and I will try to help you out as much as possible. Right now you need to focus on schooling. Find a community college with an aggressive program. Sometimes it might be looking at their pass/fail rate. If you've got a 97% pass rate its more then likely a medic mill. In all honesty it might be a lil easier for you if you go through the EMT/RN/Paramedic route. They incorporate all the fields of practice and study you will need for EMT/Paramedic field work, but it will also incorporate a higher education that most college EMS programs cannot offer. You'll learn better patient care tactics, a much more in depth pathopysiology study with diseases, medications, interactions, and medical/legal. Most standard EMS programs offer the basics, touch on the most important things you'll need to know and then move on. Something that almost everyone in EMS currently wishes would stop. You'll find the general consensus around here is to try and get higher educational levels for Paramedic/EMT certs. Some people I've also been told find it a little harder for paramedics going through RN school. They develop habits, tactics, and the like while in the field, and when its time to convert that into an RN lifestyle its completely different. Most RN's cannot act on their own authority, they have to follow doctor's orders. Paramedics also do have to follow protocols, but can operate within those established protocols without the doctor standing directly over them. Some find it hard, that once they've been given that freedom that paramedics have over RN's, to go back to being, "mother may I?" After obtaining your EMT/RN you can then challenge the Paramedic boards for FL. If you pass, now you will have the street knowledge to work in the field and rely on yor basics, the higher knowledge to understand the different situations to encouter, and now the freedom to practice those knowledges. Not to mention that fact that you will have an RN license on a resume or job application will make you stand out above the rest. Something that this day in age you will desperately need. The job opportunities will aslo allow to you to cover almost every aspect of EMS. HEMS, Special Events, Special Appointments (Oil rig, Factory etc), GEMS (Ground), or the potential to work for Homeland Security. After you complete EMT school, you'll need to find a good RN school.... Edison State College down here has one of the best RN programs in the nation. Here are some services in FL that do not require fire certs that do hire EMT's AMR (Palm Beach, Broward, Miami-Dade, Monroe) Sunstar (St. Petersburg/Clearwater) Lake-Sumter EMS Polk County EMS Lee County EMS Collier County EMS Hendry County EMS Medics Ambulance Service (Palm Beach / Broward) Good Luck and Happy Hunting!!

Ben, I surprised you didn't say anything about my neck of the woods..... Or is it because you secretly want to work here too?

I've been in EMS and with the same service for 5 years now.

+9 I love my job, love the people I work with (some of the best in the country), and love the service I work for (also one of the best, in my opinion). VERY progressive, evidence based medicine with sound finanical practices. I gave it a 9 because the only thing I would change would be that our department needs to be a little more focused on promoting a proacvtive and positive image in our community. Our PR department at a time where budgets and everything is accountable should be doing PSA's to let the people know that we are here for THEM, that we are THEIR service. But, I guess that will follow soon enough. I love my job simply put is the fact I get to help people, and truly make a difference. Rreguardless if it is a cold or "flu lke symptoms" for 2 weeks or a person suffering from CHF and without immediate intervention they will decomp. I take every opportunnity to treat, relieve stress, and educate my patients. I have an inability to sit still for very long periods of time....... ah crap my ADD is kickin in....... this job is a perfect match for me. I've always loved medicine and always loved helping people. This is a perfect combo for me.

JoshK, We're using Image Trend v4.0 in our system. The program is both road crew and billing department freindly. It's a very easy to read, work, and understand the program. There are numerous "power tools" (Big button type select screen, where you touch the button and it time stamps the time you did your procedure) which come in handy when your doing your procedures. The program in itself is designed to effectively eliminate double documentation. Signatures are accurate, it interfaces with your CAD, (if ya got one), your able to "upload" your CAD data right into your PCR (milage, address, call type, response, times, etc), It can also interface to your monitor downloading your call data via bluetooth right into your PCR. Insurance info is a breeze. It can also interface with a barcode reader for Driver's licenses and etc for direct "upload" to your PCR. Billing wise, Image Trend provides the ability, to not only bill for medciations and the like, but now the ability to charge to do the procedure. For example if I do a Neb Tx on someone, I select the correct meds, add "Assessment--Nebulizer Treatment" under procedures.... meaning not only are they getting billed for administering the meds, now they're getting billed to "do" the procedure. This was something that our previous program couldn't do. This is resulting in a net gain of over 2 million more dollars this year over last year since we implemented Image Trend. I don't know the techincal aspects of the software, servers, or cost..... But, I personally love the software. I'm able to from start to finish do a PCR in 10 min.

There is nothing wrong with the title.... We did lose one of our own helo's. There is no report out yet by the FAA or the NTSB.

Medstar Helicopter Crashes Near Captiva By WINK News Story Created: Aug 17, 2009 at 3:56 AM EDT Story Updated: Aug 17, 2009 at 6:18 PM EDT The FAA and NTSB will continue their investigations to determine what caused the MEDSTAR helicopter to go down without warning. The EC-145 helicopter crash-landed while attempting to pickup a patient on Upper Captiva Island. "I definitely heard cha.cha.cha.cha... Crash and I though maybe someone ran aground," say Max Lillie What Max Lilie heard off the shore of upper Captiva wasn't a boat. It was the MEDSTAR helicopter crashing into the water, a few hundred yards offshore. The helicopter was on a midnight run to pick up a patient when suddenly the crew was in need of rescue too. "After a while I'd seen a couple of lights pop up. I didn't hear much commotion. I jumped in the golf cart and went down to the runway. I seen the fire department down there." The chopper sat upside down in the water, but pilot Diana Tackett and medics Jason Ausman and Dave Duncan made it out safely. They put their own emergency training to use. Ironically, all MEDSTAR personnel had recieved crash/water survival training in May, a first for the program. "They climbed onto the aircraft, and you might have heard about lights. That was actually their flashlights. They were signaling to people on shore," says Rick O'Neal, of Lee County EMS. The three were picked up and transported to pineland marina, and despite a few scratches and bruises, all three made it to land in good condition. I just wanted to remind everyone to please be safe!!! Sometimes, no matter how big or small an agency you are..... things are going to happen. We're just lucky and blessed enough to have all three crew members alive with us today.

Now if only NBC or CBS could capture what this guy catpured..... would be the perfect, solid, deep, and intense view of EMS that this public needs to see. Not some hollywodd BS that's coming. A docudrama about EMS providers by EMS proivders.....

Alright Adam I waited enough..... I'm calling it V-tach. The right ward axis, wide complex (its completely ventricular in nature) lack of P waves, and rate in itself all show the rhythm. Tom, wouldn't that suck major if no 12 lead was done on this patient? Lead II totally sucks in this one. Every cardiac monitor defaults to Lead II, this just goes to show you, that you must not always think "inside the box". I'm a strong believer of not using lead II as a simple strip on the monitor, for this reason! Lead III and V1 are much much better.

See what I mean............

Welcome to the forums. I'd like to offer you some friendly advice....... Before other people around here start posting, I'd just like to direct your attention to the search function in the yellow menu bar at the top of your screen. That button will be able to answer a majority of all your questions and for your benefit, would HIGHLY reccomend you use it prior to posting or asking questions that have been asked numerous times. Also, if you do post on the forums, be PREPARED to defend your postion. A lot of people post thinking their the best thing since sliced bread, get their toes stepped on and have a sour attitude the rest of the time. Use this site as a education yet informative position. There are a ton of highly epxerienced and educated personnel here. They will help you, just don't ask which LED's to put in your POV or what sticker to put on your POV bc you'll not like the answer...... Happy posting!!! Nifty

And for the record Adam, I did not read your blog prior to posting. Cardiogoly is my niche, I love it. I'm not saying I'm the best either, but I could see the delta waves in numerous leads. It was plain obvious with the irregularity that was there.............

Adam, Its a complete heart block with artifact. It actually threw me off thinking it might be A-fib with the complete heart block, but if you look closely there are numerous P waves found in the pericordial leads. They don't map out, giving way to complete AV dissocation, meaning complete heart block. Atropine is not the treatment of choice here. If it's asymptomatic, you watch and monitor close. If he's symptomatic: postion of comfort, NC @ 2-4 lpm O2, IV access, have someone ready the pacer and apply it, begin pacing and start a dopamine drip 5-20 mcg/kg/min for perfusion. Repeat 12 leads while enroute with ETCO2, SPO2, BGL, and Temp monitoring.

Counting Spatula with cotton pick

Well done and well put chbare +100 for you!