scubanurse

I would keep an eye out at Montgomery College's website over the next few years as they are doing a lot in the way of a paramedic program and since they have a pretty good nursing program they might offer a bridge. The nursing school is located in Takoma Park, Maryland, which can be a little bit of a hike from Fairfax (not sure where you live). I'll shoot an e-mail to the program directors over there and see what they are thinking in ways of a bridge course. Montgomery College does however have a great Fire Science degree with one of the classes taught (last I heard) by our Chief Richard Bowers. The fire science course I took through there, equivalent to Officer I, met about once a month and almost all of the work was online. We had a career MCFRS member go through the course. Something to look into. I can not speak much to RN vs RT but I am a full time nursing student and just school alone (20 credits) is really kicking my butt some days. I just pulled an all nighter and I wish I could say it was my first of the semester. We have one woman in our class who works full time as an ED tech and she is barely scraping by with passing grades. It may just be the program I am in, but something to consider. A full time schedule anywhere is the equivalent to a full time job in my opinion and depending on your social life, may be hard to keep up and still do well. Best of luck to you and don't hesitate to PM me if you have any questions about MC's programs. I know both of their department heads and they are fantastic people and paramedic volunteers in Montgomery County.

Vent raised a point about the use of non-rebreathers that I think makes sense to me. If we attach the neb to a non-rebreather than the exhaled droplets should be relatively contained right? Also a technique I do for asthma patients is double back the blue part of the neb and tape it down so the patient will breath some of the excess neb through the nose. Not sure if it actually does help but I would like to think that it can't hurt? Correct me if I am wrong.. and I second Dwaynes comment... never assume anything here cause you make an ass outta you and me!

Welcome to the crazy city!! Like Dwayne said...stick yer neck out there and see what happens. We usually don't bite...hard. Welcome again and good luck with everything!!

Chemistry should most definitely be a requirement to be a paramedic. I don't understand how you could understand most of what we do without a basic understanding of chemistry and biology. I had both in high school and now again in college and I am just now getting to really understanding chemistry. College level chemistry and biology should be required for paramedic school.

So I was looking up the symptoms of the H1N1 and I'm confused. It seems there are such a varying range of symptoms that it would be hard to truly pinpoint. I read somewhere that cough, sore throat, fever were symptoms but to me that sounds more like an upper respiratory/strep throat than flu? Can anyone clear up what the actual symptoms are? Does a fever have to be present for it to be H1N1? Thanks!

I saw a chiropractor in DC who was amazing and worked well for me. Here in Denver, a friend of mine's parents are chiropractors to the extreme. They do not believe in vaccines or seeking medical care when they are sick. They want me to come in so bad because they believe herbal supplements and changing my diet will cure my Ehlers-Danlos which is just BS. Chiropractic care can be helpful in some situations and with a well trained provider. But the extremists I would stay away from. Anyone who believes that taking a vitamin can cure appendicitis instead of taking their kid to the hospital is nutso in my book. Sciatica pain can be horrible... I get it occasionally. Sometimes sitting or laying on a tennis ball and rocking around with the tennis ball over where it hurts really helps me out. Also an anti-inflammatory like diclofenac or motrin can really calm it down since most times the pain is caused by an irritation and swelling of that nerve. Good luck!

Both my grandmothers had breast cancer, and a few really dear friends have died of it. This month means a lot to me as well. I urge everyone to get checked and to check themselves regularly. I found the picture and thought it would be appropriate (although it is the IAFF logo) Maybe someone can make one with a star of life?? Sorry, here's the picture

Welcome!!! I was in Montgomery County, MD across the river This site is great and I hope you get a lot out of it.

I think in a lot of states, but as we all know I could be wrong, you can't ride alone as charge on the ambulance until you are 18. This was the case with me. I would have to ride as third on the ambulance until I turned 18 and took some pretty hard tests my department set. I agree a 16 year old should not be in charge of someones life, but where is the harm of them being on the unit and learning?

As someone who joined the fire department in high school and got certified by Maryland at 17, I really do think more should be done to restrict who gets certified. That isn't to say high school students can not do it, I did it and turned out more or less okay (I think?), but I have seen junior members (16-18) come and go and some be negative impacted by the experience. For me it really gave me the structure I needed in high school and helped me shape what I wanted to do with my life and was a very positive experience. I do not know how we could restrict or limit who is allowed to be certified, but I think that something must be done. Some 16 and 17 year-olds are mature and responsible and can handle the types of calls we see, while some others are not. Maybe recommendations from high school teachers and guidance counselors would be a good step in screening younger members. To simply say that you should not be certified until 18 is a little harsh as I know plenty of 18-21+ members who are still not mature enough to handle the calls. Something should be done to support the younger members too, a mentor of sorts so if they are having a problem, they can have someone to talk to about it. Report cards should be collected (my county is was required) and the students should maintain an adequate GPA, Should not be allowed to ride during class times, and various other restrictions should be in place. My chief went to my school and introduced himself and told them to not hesitate to call him if there were any problems. Various steps can be placed to help support the high school student in their path to becoming an EMT. My county also offered it as part of the curriculum, but as a previous poster said, you had to have all of your other required courses taken in order to sign up. A bus would take you from the high school to the fire academy and you would be a high school cadet for the afternoon. I never did this route as I loaded up on A&P in HS and sciences to help me in my college career. All in all, I think that high school students should be allowed to participate in EMS and fire as long as certain requirements are met prior to and during training.

I can get you Washington Hospital Center EMT-I curriculum and syllabus but it will take a little time for me to re-type it since I don't have a scanner. I'll try to get it to you by Friday.

You really need to just grow up and mature a lot of you want to be in this field. Having lost people I love dearly because of alcohol related car accidents and being in one myself when I was your age.... you will die or get hurt. It's not an if it's a when if you're participating in this risky behavior. It's something I take very personally as it has affected my family and I deeply. If you get in a car with someone who is under the influence...you might as well play Russian roulette because you will get hurt eventually. And really if you're in a crash like that... you'd be very lucky to even know what happened let alone refuse care.

I agree with you there doc. If I place myself in the shoes of the chief, I probably would not have done the surgery for all the reasons you stated. I think the outcome of problems like these rely solely on how the hospital and staff handle the situation after it occurs. I've found honestly to be the best policy from the patients side. I would much rather have a doctor come to me and look me in the eye and tell me what went wrong and what his/her plan was to fix it...instead of the blame game and avoiding the patient.

I used to be afraid of them operating on the wrong joint but now I figure that even if they did the wrong side or joint...the one they do open up will probably need work too so I don't worry about it so much!

Having your own insurance cards makes no difference... You're a minor---you go to the ER unless your parent or guardian says no. But really I'm with Ruff on this... you've come on here for medical advice for a cold and now you're questioning about this...what's really going on???

Holy cow.... I was 10lbs 9oz and nearly killed my mom in the dc heat... I was also 3 weeks late but still... wow. How did that baby not kill the mama?

tisk tisk

Generally if they are of sound mental state and are not a danger to themselves or others they are allowed to refuse. You can't force someone to go unless they have an altered mental status or are a danger to themselves or others. If they are deemed to have an altered mental status (head trauma, low/high blood sugar, alcohol/drugs, and numerous other causes) and Harm to self (suicidal/depressed) and others (homicidal/violent) then we usually have to involve the police department, medical control, or other resources depending on the local protocol. The other exception to this is minors with no parent or guardian present. If the patient is a minor and there is no guardian present to refuse for the patient, usually we must transport. If they are emancipated or otherwise legally independent then that is treated the same as an adult patient. No parents though means the kids gotta go to the ER under implied consent. That is assuming the parents are there they would want them to be evaluated by a doctor in the emergency department. As always though, local protocol and operating procedures take precedence.

Grey's had a case with a woman with two uteruses (uteri?) and had two babies conceived by different fathers... IT's crazyness! How would those kids feel knowing they had a sibling 2 1/2 weeks apart in age but not twins? On a different note... if someone is pregnant with twins or more and one baby needed to come out early because of complications, couldn't they take one twin but not the other? If they weren't identical and there were separate placentas.... just a thought process in which it is possible I am totally wrong.

Canine flu...or swine flu...or some other strange strain of the flu.

I second that Mobey... Anywaysss moving on from that delightful review session and the assumption we don't know anything about anatomy and physiology...

I like!

Everywhere I have run a code has used EKG waveform during CPR and the presence of a femoral pulse... I know I'm new and blond, but how does ETCO2 tell you CPR is being performed adequately? I thought that was used to determine if ventilation were adequate? And yes, ventilation is one part of CPR... is there another use for it? I am curious to see these studies about the femoral pulse checks in CPR... I would think that if a femoral pulse is present, adequate perfusion to the brain was occurring?

Being another product of the almighty MIEMMS organization... I think you are misinterpreting the Trauma decision tree. From what I gathered, the patient was just bleeding from the back of the head and had no obvious sings of a skull fracture. The hip injury is not a reason to fly out or even begin to call this a category A trauma. The protocol states 2 or more proximal long bone fractures. a Hip fracture you could argue is a long bone fracture but personally I would say that's stretching it, and since it was only affecting one side it doesn't meet the protocol regardless. Like others have said, you need to bring this up with the crew chief and your ems duty officer/chief. I don't know what county you are in, but you should have an officer (Lt and above) who is in charge of EMS operations. Talk with them, you need to hear the crew chiefs side of the story and understand the reasoning behind her decision to not follow the protocol. In my book there is no excuse for not doing at least a rapid trauma. Even when I had a priority PIC in front of a Level 2 trauma center, I still did a rapid trauma. She could have missed a life threatening injury by not doing one. Another question...not meant to intrude or anything, but why did you listen to her? If I were in that situation, and I can tend to be bullheaded and stubborn, I would have said, nope, I'm going to do an assessment and we can discuss this later. If I had been a supervisor on that call and witnessed you laying down in front of her and disregarding protocol yourself, I would have had issues with your behavior as well.

Hahahaha...how long are the kanye jokes going to go on though? It could be applied to everything and it seems everyone is. Congrats again!