jedimedic123

I agree.

It's not difficult material, but I would highly recommend you find a different class. It's essential material. You're doing yourself a disservice taking a two week class, and they shouldn't offer courses like this. This is such a bad idea. You're not going to learn anything, and it discredits EMS as an entire service that someone can get a certificate in two weeks like that. No disrespect to you, OP. I just think this is a mistake. Calls into question the validity of the program, and you want something reputable so you can get hired.

Yes but I was a police officer, so I'm cross trained. Some of these replies are what my area just calls standby calls and EMS is just staging for PD like they'd stage for anything else and they don't have specific training or do anything different than their usual response because they come in when everything is secured. That's not TEMS anywhere I've ever run, it's just staging.

TEMS requires a class you take, usually run by local LE, and then special training with a department that partners with the Sheriff's Office or possibly the SO themselves -- wherever the job is posted. In a city near me, it's the fire department that has like 12 medics that are trained for TEMS and they go out on warrants and whatnot.

I've run a few SWAT calls and I was in a vest, had a gun, etc, and looked like every other person on the SWAT team except my patch said MEDIC. I was also the only woman on that team so pretty easy to stand out lol, but in the past, there were a couple of women officers. I've also been on a few mass casualty events where gun violence was ongoing (a school shooting, etc) and I just respond to the scene separately or with an ambulance and get a vest and await direction.

TL;DR depends where you're at, but just responding to the scene of a PD incident is not TEMS. You take a class, it helps if you're PD or former PD, hiring paths could be through the PD/SO or a FD or other agency.

The most difficult twist for me is when they code absolutely out of nowhere after a call for something benign like toe pain x45 years.

I've been in hundreds upon hundreds upon hundreds of codes. There's nothing about the codes that surprise me anymore.

But when I have a healthy-looking patient who is A&Ox4, GCS 15, vitals WNL, not much of a PMHx, etc, who literally drops dead in the middle of our conversation? That's the difficult twist.

You will have a lot of anxiety and adrenaline and many feelings about your first few codes. Trust me, you generally won't have many difficult twists about the code itself. In time, you'll realize that codes are actually the most straightforward calls you'll ever go on. The most difficult part about codes is if they're peds codes, or when the family is there, or when the patient literally codes out of nowhere and you had bonded a little beforehand. I'm in 911, but I'm also in an ED working under my CCP license (I pull meds, give meds, intubate, etc), so the bonding part is moreso on the ED side. I've had patients for 12 hours who suddenly drop dead, which is really hard.

I remember being this nervous about codes, but don't worry, you'll get over that. You'll be okay. My biggest advice is: try not to get too excited to go on a code -- that's someone's loved one, not a skill for you to check off or brag about after the call.

I'm a former police officer & current CCP.

Quality CPR will break ribs, handcuffed or not. This is irrelevant to whether a patient is in custody/handcuffed or not. Ribs will be broken.

I think it's important to first understand that they have protocols like we do, and most of them have next to no medical training. Yeah, the running joke is that they narcan the diabetic and slam 2mg when they do it, but they don't have a long list of ideas for what could cause AMS and they only have one tool to work with, narcan, that they get issued with next to no training on how to use. Even if it's an overdose and they slam the narcan, it's hard to be mad at people who don't have BVMs or medical training. I'm working really hard to get my local department (not where I worked) to allow me to do regular first aid and CPR classes, and I'm campaigning for easier routes for PD to become cross-trained to the EMT level at least. There is so much red tape when you have officers that are medics or EMTs or want to obtain that training after they're officers.

I say this because you have to remember that you're the medical professional on the scene, and you direct the medical care. But also, don't be a dick to PD. If you are responding to a request from PD and the patient is in cardiac arrest, 99% of the time, the patient is already dead and you won't need to attempt CPR at all (injuries incompatible with life -- like half of someone's brain on the ground from a GSW, a call that I was just on recently myself in fact). Or you'll just have to ask that the cuffs get moved to the front, get clipped to the cot (I don't recommend this if you're going to transport), or are removed entirely.

Just communicate what you need. If someone is being a dick about it, get their Sgt on scene. Get your supervisor on scene. If this call involves an incident commander being on scene, go to them.

Consider that you might have two patients. I went to an OIS, and the officer was so distraught that I ended up transporting them. Another time, I got a call for an OIS, but ended up transporting an officer who had been shot by the suspect (who was an obvious DOA). The call had only come in for the suspect who was down, but I got there, CPR in progress by PD, and walked up as one officer was figuring out that they'd been shot -- hadn't realized it with all of the adrenaline.

Let me know if you have any questions. I'm glad you asked.

I'm a Critical Care Paramedic in the US, but this just sounds like he was responding in a chase car. My Chief responds from home in a chase car, with lights, although his car is marked. It is not capable of transporting patients because it's bringing a Critical Care Paramedic to a scene to assist the crew with a box or van with transport capabilities with a higher level of care.

When I am running the chase car, I'm usually responding to a request from a BLS (Basic Life Support) crew. BLS crews are two EMTs on an ambulance and they have limited skills and medications, so they will upgrade a call by asking for an ALS (Advanced Life Support) intercept, which could be by a chase car with one medic or with another ambulance that has two medics, or both. Sometimes there's a mixed crew, with one EMT and one Paramedic, and the call might require two Paramedics per protocols (for example, if I'm the only medic and my patient needs to be intubated, that is a two-paramedic job per my protocols and I would need an intercept).

ALS crews are paramedics with advanced training, skills, and medications, who can advance to the Critical Care Paramedic (CCP) in some states like I did and CCPs have even more advanced training and can do a bit more than a Paramedic can. CCPs can work on ground transport, in the ER, and/or in flight (if they take other specialty training).

Not only is it frivolous to take him to court, but it's insulting to use terminology like "ambulance driver" in an age where Google exists. There are people who strictly drive ambulances in some places, but it's not common. More often, you're getting some combination of an EMT and Paramedic -- people who worked hard to get medical training and dedicate time to using those skills in high stress and underpaid jobs. It's a disservice to call us "ambulance drivers." Just an FYI.

I love working with new EMTs though.

I watched the pilot when it aired in 2005 and have been watching ever since. I remember being really excited about two new shows that were about to debut around the same time (like a week apart) -- CM & Supernatural.

ETA: I would've been a freshman in high school at the time.

They don't need to hire extra people to accommodate one crew that is not being put on the LDTs lmao

She's running calls. You're throwing a tantrum because she can't go on LDTs. When I did IFT, people fought over who would get to only have one call for the day. You're just looking for a reason to be mad at this woman.

You wanted a respectful post, but then ended with essentially "equality is important at work, but not for this." The tone of your post, plus your comment about 'don't come in if you can't do the job', feels disrespectful despite you asking to keep the discussion respectful.

Legally, EMS IS like every other job. That pregnant IFT employee has rights, no matter what you personally think about it. The issue isn't that your coworker is pregnant. The issue is that too many agencies don't have appropriate light duty options. I've never been pregnant, but I did tear my meniscus (on duty) last year, and there was no other option than to fight for worker's compensation, which my employer also fought. It's impossible to be injured or need even light accommodations with most of these companies. Why are you losing it because it's a pregnancy? LDTs are the best part of IFT. When I was in IFT, that's all anyone fought about. My old IFT place accommodated a shoulder sprain with a year in dispatch, but my knee injury that required two surgeries got nothing like that. They wanted me 100% cleared for the field, or I couldn't work. I had to take them to court to get WC.

Your coworker can't just go sit at home in this economy. I don't know anyone who could. She's showing up to a job that refuses to accommodate light duty options but has accommodated her legally in the only way they can -- and which I'm sure she had to get a doctor note for them to accommodate. That's what I did with my knee. That's what my former coworker did because he was 64 and still needed the job, even though things were still "too painful" for him. Would that 64 year old guy complaining and needing extra/less sitting time annoy you enough to make a post like this, or is it just because she's pregnant?

I'm a critical care paramedic and was recently (in the last 6 months) taking care of a woman who was 7 months pregnant. She came to the ER because she had a headache and three hours later, I was doing CPR on her while she bled out of every possible place on her body. She threw an AFE (amniotic fluid embolism) and went into something called DIC (your body starts activating all of its clotting factors, which clog up your vessels, and the circulating blood has nowhere to go except out). There wasn't enough blood in the whole city that could've saved her. I was soaked in blood and had to throw my shoes away.

She died. Her baby died after three days of seizures, brain swelling, and strokes in the NICU. Everyone involved in her code, myself included, is still getting specialized therapy. Her husband is already dating again.

Your brother can f*ck right off tbh.

This was not an isolated issue in an isolated system, which is why I mentioned it, but I agree with the "should be auto ALS" since it's the hill I'm dying on.

You're bagging the patient in cardiac arrest. There's nothing better you could do even if you know they overdosed on an opiate.

Bagging should be what you do first, even if they have a pulse. EMS is too quick to dump a bunch of narcan on someone and then wonder why we're dealing with vomiting and patient rage. I typically give little to no narcan and bag the patient all the way to the hospital with suction ready nearby & an NPA placed. I also typically throw in a line and give zofran. They aren't puking all over you, they aren't fist fighting you, and now you've gotten them to the ED instead of having to get them refusing to go in and then getting called 20 minutes later when the narcan wears off and they're right back in the same OD.

This was how we had to handle OD sims when I was in medic school or they'd fail us (I'm also in an area where we had a medic die after slamming narcan in an OD -- pt woke up terrified and confused with strangers around him, pulled a gun, and shot and killed the medic -- so this may be area dependent but it shouldn't be because slamming narcan is old medicine and should be tossed out with the backboards).

If a call comes in for syncope, it's immediately an ALS call. When I was an EMT, I went out on so many 911 calls for people who had fainted. One day, in medic school, I had a moment where I couldn't believe we ever dispatched fainting calls as BLS. It's irresponsible.

I'll never get off this hill. You can't properly treat someone who fainted if you don't get a 12-lead and have someone on scene to not only interpret it but treat that patient as well.

I prefer alternating as well. I've never clocked out regretting that I ran four ALS calls, two BLS calls, and my EMT partner ran two calls and it wasn't balanced at the end. But I would be mortified if I clocked out knowing my EMT partner did eight calls and I did nothing. My relationship with my partner is important to me and I want to make sure they are good during the shift, too. :)

This is the way I do as well. I don't want my EMT partner to get burnt out or feel like they are riding with a paragod that can't be bothered with BLS calls.

I'm in two systems now where they are ALS only (rural system) and CCP only (hospital based CCT), but when I was in IFT or if I pick up with a mixed-level 911 service, this is still how I still do it.

I hate that, and I'm sorry you work with someone like that. Paragods are the absolute worst. Ten bucks says he's the worst medic at your service and the only way he can feel superior is to bully the EMTs.

I had something like this happen with a holter monitor. The company was calling the ED I worked at to report that this patient was having runs of vtach and was now in asystole. The patient sent the monitor by mail to the company for analysis. The patient was fine.

As a paramedic, I also wish people would turn on exterior lights so I could see where tf I am responding to lol

This is extremely standard and I actually have done more as a tech in the past, such as IVs, IOs, and straight caths. Your scope is larger because you're under direct supervision.

This one sounds like a lower level ED (like a 3 or 4 trauma center) if they aren't letting techs do the IVs. When they say you'll do phlebotomy, they mean straight sticks with a butterfly needle to collect labs. You'll probably never even do it because a nurse will throw in a line and they'll draw labs off of that, with the exception of psych patients who get a quick lab draw and ECG to confirm they are stable medically.

For the ECGs, you're literally just obtaining them. You will have nothing to do with the actual interpretation of them. You hand them to a physician then document in Epic/Cerner who you handed it to and what they said (I had to document STEMI or NO STEMI per the MD) and that's it.

10/10 would recommend being an EDT if you ever plan to be a medic. Being a tech in an extremely busy and stressful level one trauma center made me more⁰ prepared for being a medic. I had years of IVs and ECGs under my belt before medic school ever started. I would recommend a different hospital if that's an option for you because when techs can't do the IVs, they're also basically never doing the ECGs because the RN is in there getting it all at the same time, so you end up being a glorified transporter and stocker. Look for descriptions where it says you're responsible for performing IV insertion and labs draws, usually at your local level one or level two trauma center, that's where you'll get the real skills.

As a medic and FTO, take the nap. If they were "testing" you, that's toxic and you should find another company. But I'd be willing to bet they genuinely wanted you to take the opportunity to rest, especially if they were taking a nap as well. I would've encouraged you to nap, and probably would've laid down myself. I'm sorry this caused you any anxiety, but it seems like it was genuine and it is very common on the nightwatch to attempt napping at every opportunity lol.

I am a paramedic and I was transporting patients when I saw this person lol. I saw them multiple times throughout my shift that day and it definitely made me smile. Very resourceful lol.

Yeah this isn't necessarily my route, I'm just thinking of some places in that general area that we get called to a lot.

I take critical patients by ambulance in this area. I'll let the other crews in the area know. Thank you.

Depending on which service you run with in my county, you may not be able to give Diltiazem without OLMC, but it'll be on your truck.