# What happened to paramedic students?



## Medic348 (Jan 22, 2014)

I have been in EMS for 12 years and have seen a lot. Lately,  I have noticed new paramedics with this para-god mentality. What is up with this? I had such a open book mentality when I got out of school. I wanted to learn everything and I felt like I had just began.


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## Ridryder911 (Jan 22, 2014)

Nothing... it's been going on at least the past 34+ years. Unfortunately, it is one of our major pitfalls in this so called profession. 

Ironically, it is this type of demeanor that displays immaturity, and a lack of professional behavior but also basically reflects *ignorance*. I used to call them Parapuppies or Greenhorn but; I have determined that could be as unprofessional and really did'nt get any point across to them. 

Just ask a Paramedic about the importance of anion gap ratio; or some basic general medical questions (other than trauma & or cardiac) and they immediately throw up the old .. "_It's not my job_ (also another demonstration of ignorance of emergency medicine). All medicine is *our* job; we just specialize and should be better in certain areas.

I try not to LOL... seriously, and yes it is sometimes hard not to, but I have learned deal with them by patting  them on the back and whisper to them .. Come see me in a year or two; that is; if your still in this profession and will discuss things then and see if you still have this attitude. 

R/r 911


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## Medic Tim (Jan 22, 2014)

The term paragod means a lot of different things to different people. I am often called a paragod after I call out an EMT or medic for saying or doing something stupid (that they cant back up). Sometimes it takes less than that.


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## fma08 (Jan 22, 2014)

After I graduated, I was under the impression I had learned what I needed to in school, and thus, was as qualified as someone working for 10 years because we had the same certs, passed the same tests, etc.

I was wrong and I try to keep that in mind as I continue my education. Hopefully they'll realize it too eventually.


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## dixie_flatline (Jan 22, 2014)

Ridryder911 said:


> Just ask a Paramedic about the importance of anion gap ratio; or some basic general medical questions (other than trauma & or cardiac) and they immediately throw up the old .. "_It's not my job_ (also another demonstration of ignorance of emergency medicine). All medicine is *our* job; we just specialize and should be better in certain areas.



I have kind of the opposite problem.  Anion gaps specifically came up recently and I was ridiculed for wanting to know things that don't need to be known. Those of us discussing this stuff are definitely in the minority, and are looked at as the paragods.


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## medicsb (Jan 23, 2014)

Ridryder911 said:


> Just ask a Paramedic about the importance of anion gap ratio; or some basic general medical questions (other than trauma & or cardiac) and they immediately throw up the old .. "_It's not my job_ (also another demonstration of ignorance of emergency medicine). All medicine is *our* job; we just specialize and should be better in certain areas.



Anion gap ratio?  What the hell is that?  Are you talking about the delta ratio?  I can tell you that not even medical students learn about that (anion gap, sure; delta ratio, no).  I haven't even heard it brought up in EM lectures that I've attended.  Jesus Christ, of all the things to cite as proof of ignorance... the delta ratio?  *mind blown*


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## Brevi (Jan 23, 2014)

medicsb said:


> Anion gap ratio?  What the hell is that?  Are you talking about the delta ratio?  I can tell you that not even medical students learn about that (anion gap, sure; delta ratio, no).  I haven't even heard it brought up in EM lectures that I've attended.  Jesus Christ, of all the things to cite as proof of ignorance... the delta ratio?  *mind blown*



I thought the same thing. If I hadn't read more of RidRyder's posts, I would of guessed that he randomly picked out a medical sounding word just to make himself sound cool.


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## gotbeerz001 (Jan 23, 2014)

dixie_flatline said:


> Those of us discussing this stuff are definitely in the minority, and are looked at as the paragods.



We called those the Superfriends.


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## Brevi (Jan 23, 2014)

dixie_flatline said:


> I have kind of the opposite problem.  Anion gaps specifically came up recently and I was ridiculed for wanting to know things that don't need to be known. Those of us discussing this stuff are definitely in the minority, and are looked at as the paragods.



Knowing things above and beyond what you are expected to know is certainly commendable, but I've seen people go about it in a way that rubs me as very fake and non sincere. Like they are asking  the questions just to sound smart.


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## TheLocalMedic (Jan 23, 2014)

We hired a whole gaggle of newly minted medics and EMTs recently, and I have to keep reminding myself to play nice.  Depending on the culture at their training academy they can sometimes come out with the misconception that they really have been taught everything they need to know.  But don't worry, the real world is a nice cold wake up call.


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## neoclassicaljazz (Jan 23, 2014)

I look forward to meeting some of these "paragods" when I start school and hopefully not becoming one. I'm so young and inexperienced compared to most (all) of EMTs and medics I run with, all I do is ask questions


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## Medic496 (Jan 23, 2014)

*A good Paramedic needs shaping*

I have found that the young newly minted Paramedics need leadership and guidance. Making up names such as paragon, newbie, or anything else does nothing to build up the new person.  We are not the fire service, we do not need to create a culture of laughing and pointing the finger at those who have a deficiency.  If that new person was with our organization, I would go over and help them learn and become competent by showing them personally. 

EMS leaders need to lead.  The FTO's, Supervisors and Management need to believe in the idea of a quality organization, with quality operations and competent field personnel.   Upon initial hire set the expectation early.  This is at will employment and those who do not perform to standards may not be invited back to play after about 30 to 60 days.  We need to invest the effort to help a new grad develop, but the choice is theirs to succeed.


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## Burritomedic1127 (Jan 23, 2014)

Just ask a Paramedic about the importance of anion gap ratio; or some basic general medical questions (other than trauma & or cardiac) and they immediately throw up the old .. "_It's not my job_ (also another demonstration of ignorance of emergency medicine). All medicine is *our* job; we just specialize and should be better in certain areas.



R/r 911[/QUOTE]

Well said

Its funny that people complain of lack of respect for EMS and being called ambulance drivers when people don't want to go above and beyond "their job" and just drive pt's to the hospital. Maybe just maybe if EMS workers went above and beyond "their job" and tried to advance their knowledge on subjects higher than the NR standards, then we might just get that respect and, hold your breath, increased salary.

The power is in our hands...or minds... However you read it


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## Medic348 (Jan 24, 2014)

I agree with you on this 100% burritomedic!


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## medicsb (Jan 24, 2014)

More pay will not come with more respect, unfortunately.  Two routes to that: decrease supply of medics (e.g. increased training/education requirements) or unionizing.


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## WTEngel (Jan 24, 2014)

This is not new, and it happens in many career fields, particularly in healthcare.

If I could introduce you to some of the people I am fixing to start medical school with, who feel like they have some extraordinary amount of clinical experience because they have been a scribe for 2 years part time in a busy ER, you would understand that this phenomenon is not limited solely to EMS.

We will all be humbled at some point. Some people will actually gain humility from the experience, and others will simply continue to live life, utterly oblivious to the fact that they in fact do not know everything.


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## gotbeerz001 (Jan 24, 2014)

OCEMThopeful said:


> I have found that the young newly minted Paramedics need leadership and guidance. Making up names such as paragon, newbie, or anything else does nothing to build up the new person.  We are not the fire service, we do not need to create a culture of laughing and pointing the finger at those who have a deficiency.  If that new person was with our organization, I would go over and help them learn and become competent by showing them personally.



This is true to an extent. The bottom line is that there are roles to play. When you are new, you need to be the sponge. You need to listen to those that have been doing the job that you are just now starting. That doesn't mean that we are intentionally going to squash the good that the individual brings to the table. Someone who is unteachable is a problem.

Also, the quip about the fire service is unfounded. A seasoned fireman wants to pass on the tools of the trade to the next generation. That being said, thick skin is cultural reality and not a bad thing. The fact is, if you are being f#$@ed with*, people like you. The people that are liked get every possible chance to succeed. If you are "not liked", you probably did not display the adaptability required to thrive in the firehouse setting. You probably respond to advice with "I know" or some excuse. This attitude is detrimental to self and team. Frankly it is easier to spend 48 hours with this person in a house than it is to spend 12 hours in the bus. New guys should be given the opportunity to thrive, but the responsibility falls on them to remain teachable.

* It is true that some people just screw with the new guy out of malice. Everyone knows who they are and no one listens to them. They were usually the ones who didn't "get it" when they were hired.


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## 46Young (Jan 24, 2014)

Instead of talking about the anion gap ratio, which the majority of medics will not know, try testing them with simpler questions:

Why will the patient's ETCO2 be normal to low if they are in DKA? If they get that, ask them how to (reasonably) rule in a STEMI in the presence of LBBB or a paced rhythm.

As far as paragods, maybe these new providers are working in an all-ALS system, where they are the only medic on the bus, and are the highest medical authority. In my experience though, new medics are typically scared of their own shadow, and very hesitant to make a provisional Dx/run a protocol. The rookie paragods that I run into were typically EMT-I's before becoming medics, or EMT-E's riding with a medic, so they have the attitude that they've already seen everything.


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## 46Young (Jan 24, 2014)

Burritomedic1127 said:


> Its funny that people complain of lack of respect for EMS and being called ambulance drivers when people don't want to go above and beyond "their job" and just drive pt's to the hospital. Maybe just maybe if EMS workers went above and beyond "their job" and tried to advance their knowledge on subjects higher than the NR standards, then we might just get that respect and, hold your breath, increased salary.
> 
> The power is in our hands...or minds... However you read it



The problem that I'm finding is that many systems are all-ALS, where the medics run all of the BLS as well as the ALS. In this type of system, the good calls are few and far between, and most calls are just diagnostics and txp. In these systems, your critical thinking skills and medical knowledge are rarely tested. After a number of years (or sooner), you become indifferent to EMS, and begin to lose interest in improving your clinical knowledge. 

In my case, I went from a busy, tiered system (NYC), where I was using my protocols 3-5 times a day, to an all-ALS system, where I might see two or three patients in a month, who need more than vitals, 12-lead and maybe O2. I have some college level A&P/pharm courses, I go to whatever symposiums and conferences my employer will cover, but I rarely get to use what I've learned. Really, I could just do vitals, a BGL, 12-lead/15 lead, ETCO2, a stroke assessment, and maybe a line, and be fully covered for 90%+ of the patients I typically run in an all-ALS system. 

I've been finding myself becoming increasingly indifferent towards EMS. It's really easy work, it pays really well (I'm fire based), but there's no challenge. We could educate up to a point where we rival PA's, but I'm still going to run 90% non-acute patients when I get back to the field. I'm sure that Attending MD's have similar frustrations, dealing with all of the nonsense that come into the ED. This is one of the reasons why I sold out and went to fire based EMS. Txp becomes increasingly boring and non-fufilling, but there are many other job functions to slide into. I've been in EMS for over 11 years now, and I don't see how I could do 25+ years in 911 txp. I have a genuine interest in medicine, but in EMS, most of that knowledge is not used, or not even necessary. For example, I can't think of even one time in my career (on the 911 side) that it was important to understand what the anion gap ratio/Delta Ratio is, much less use that understanding to change a patient outcome. We don't do labs in the back of the ambulance.


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## Burritomedic1127 (Jan 24, 2014)

Higher education standards will decrease the amount of medics which will raise salaries and respect for those who went the extra mile. 

Take for example a pt who has a syncopal episode on exertion, you can have a medic that will scoop them into their office aka the back of the bus and get vitals  and look for signs of ischemia or infarct on the 12, and if the vitals were fine and no elevations/depressions are noted just monitor and transport the pt. Or you could have a medic that picks up the same pt and recognizes hypertrophic cardiomyopathy on the EKG that suggest you tell your PCP and schedule an appt. with a cardiologist because they recognize theyre more susceptible to sudden cardiac death. Yeah this is a pretty specific case and there's no protocol for hypertrophic cardiomyopathy but this is an example of going above and beyond for THE PT. 

Doing more for the pt's after and outside of the ambulance adventure is what EMS should strive for

Just my two cents


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## mycrofft (Jan 24, 2014)

New trainees are supposed to be exuberant weenies, then get that energy bent into constructive avenues by good instructors and better mentors/OJT trainers.

Ultimately there is no substitute for a good character. Unfortunately youngun's are hard to gauge for that since society now values superficiality more than  heart.

PS: welcome back Ryder.


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## unleashedfury (Jan 24, 2014)

Most of the the paragod attitude comes from within. 

Part of it can come from a "inferiority complex" they developed throughout their lives and want to prove that they "are better" 

Part of it is some EMS academies, where they make students believe that they are the best since day 1. 

Paragod goes 2 ways. One they get rolled and humbled, and then they realize that they are not the best or know all. Or they become flushed out of the field 

when I started the Paramedic program my coordinator made it very clear. what you get here is the entry level requirements to become a paramedic. This is far from the end of your education. If you want to become a good paramedic theres plenty of courses and additional college courses that will supplement that. If you want to stop educating yourself find another career.


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## gotbeerz001 (Jan 25, 2014)

unleashedfury said:


> when I started the Paramedic program



Haha... Not saying you're wrong in any way, but just how long ago was this?  Your profile still says "Paramedic Student".


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## gotbeerz001 (Jan 25, 2014)

Burritomedic1127 said:


> Higher education standards will decrease the amount of medics which will raise salaries and respect for those who went the extra mile.
> 
> Take for example a pt who has a syncopal episode on exertion, you can have a medic that will scoop them into their office aka the back of the bus and get vitals  and look for signs of ischemia or infarct on the 12, and if the vitals were fine and no elevations/depressions are noted just monitor and transport the pt. Or you could have a medic that picks up the same pt and recognizes hypertrophic cardiomyopathy on the EKG that suggest you tell your PCP and schedule an appt. with a cardiologist because they recognize theyre more susceptible to sudden cardiac death. Yeah this is a pretty specific case and there's no protocol for hypertrophic cardiomyopathy but this is an example of going above and beyond for THE PT.
> 
> ...


I guess this depends on the area that you work. Busy metro area with short transport times are not going to increase the requirements nor pay. Working in an area that does not support many of the optional skills due to potential liability for infrequently used skills, the trend is likely to go the other way. The fact of the matter is, even in a busy system you maybe have 3-5% of your calls that are truly emergent. Maybe 20% actually need to go to the hospital. A medic can study and train all they want, but there is no substitute for calls.
As for recommending that a pt see their cardiologist for the less obvious ekg reads, I'll leave that to the ER cardiologist. Either way, that pt is going for a ride.

If you want PA's on the rigs, have a blast getting that through.


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## Kevinf (Jan 26, 2014)

My partner and I called for an ALS intercept the other day and we got two medics on board (one precepting the other). You could tell which one was the new medic because he was shaking in his boots the entire time. Poor guy tried to get an IV going but just couldn't manage it, and was about to cut the patient's shirt off before my partner just lifted it out of the way. They don't all come out of the academy cock-sure :lol:


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## DrParasite (Jan 26, 2014)

Ridryder911 said:


> Just ask a Paramedic about the importance of anion gap ratio; or some basic general medical questions (other than trauma & or cardiac) and they immediately throw up the old .. "_It's not my job_ (also another demonstration of ignorance of emergency medicine). All medicine is *our* job; we just specialize and should be better in certain areas.


Why would you ask that?  Other than to prove how smart you are over a new paramedic?

Don't get me wrong, I understand what your intent is: to show that a paramedic doesn't know what he thinks he does.  But much of the medic's education is in trauma (ok, maybe not so much), cardiac and respiratory emergencies.  Why quiz them on something that has no impact on their job, and will have no impact on the patients that they treat?

Do you think psychiatrists quiz rookie psychiatrists on the best way to deal with a GI bleed that is coming out both ends?  Or would he ask about something that is directly related to their field, like a medication reaction with the brain or what the S/S are of a mental disorder?

I'm all for education, but 46Young had a better question: how to (reasonably) rule in a STEMI in the presence of LBBB or a paced rhythm.  That is directly related to their job, and if they don't know that, they are doing their patient's a disservice, because they could potentially misdiagnose the patient.  

now about the Anion gap ratio?  I have no clue what it is, and I'm pretty sure if I did, I couldn't deduce it in the field, and if it was off, I couldn't do anything to correct it.


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## Medic348 (Jan 27, 2014)

*Wondering*



DrParasite said:


> Why would you ask that?  Other than to prove how smart you are over a new paramedic?
> 
> Don't get me wrong, I understand what your intent is: to show that a paramedic doesn't know what he thinks he does.  But much of the medic's education is in trauma (ok, maybe not so much), cardiac and respiratory emergencies.  Why quiz them on something that has no impact on their job, and will have no impact on the patients that they treat?
> 
> ...



Was this directed at me? Ok I see where this was directed.. I get it and I wouldn't ask that question either.. lol


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## Burritomedic1127 (Jan 27, 2014)

gotshirtz001 said:


> I guess this depends on the area that you work. Busy metro area with short transport times are not going to increase the requirements nor pay. Working in an area that does not support many of the optional skills due to potential liability for infrequently used skills, the trend is likely to go the other way. The fact of the matter is, even in a busy system you maybe have 3-5% of your calls that are truly emergent. Maybe 20% actually need to go to the hospital. A medic can study and train all they want, but there is no substitute for calls.
> As for recommending that a pt see their cardiologist for the less obvious ekg reads, I'll leave that to the ER cardiologist. Either way, that pt is going for a ride.
> 
> If you want PA's on the rigs, have a blast getting that through.



There's always a chance, hopefully small, that the resident/PA/MD does not catch the less obvious EKG and it goes unnoticed. Then its a good thing for everyone that EMS brought it to attention. Why do we start IVs on pt's that don't need fluid or medications? Should we just leave that to the ER? 

Yeah anion gaps may be a little intense and wont be useful in most cases, but it can't hurt to know. We, EMS, dont need PA's just strong provider. The main point is having higher levels of education to provide better care for pt's.


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## Carlos Danger (Jan 27, 2014)

Burritomedic1127 said:


> Why do we start IVs on pt's that don't need fluid or medications? Should we just leave that to the ER?



I always do :unsure:


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## TheLocalMedic (Jan 27, 2014)

Halothane said:


> I always do :unsure:



Unless they need fluids, meds or something else that dictates the need for IV access (CVA, ACS/STEMI etc) I generally won't stick people.  Why are drunks and minor traumas always coming into the ED with IVs?  It's a waste of supplies and time.


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## Carlos Danger (Jan 27, 2014)

TheLocalMedic said:


> Unless they need fluids, meds or something else that dictates the need for IV access (CVA, ACS/STEMI etc) I generally won't stick people.  Why are drunks and minor traumas always coming into the ED with IVs?  It's a waste of supplies and time.



There was a thread on this very topic a while back where I questioned the need for "just because" or "courtesy" IV's on several bases, and lets just say those who see things the way you and I do seemed to be a pretty small minority.....


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## TheLocalMedic (Jan 27, 2014)

Halothane said:


> There was a thread on this very topic a while back where I questioned the need for "just because" or "courtesy" IV's on several bases, and lets just say those who see things the way you and I do seemed to be a pretty small minority.....



Then let us be the shining beacon of rationality amidst a sea of ignorance and guide those poor sailors to the safe harbor of intelligent prehospital emergency medicine.  

Felt like using some flowery metaphor.


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## unleashedfury (Jan 27, 2014)

gotshirtz001 said:


> Haha... Not saying you're wrong in any way, but just how long ago was this?  Your profile still says "Paramedic Student".



I started paramedic school last july,, I'll be finishing this year, barring no complications. 

(I was in a program and had to drop near the end due to becoming a single parent at the last minute)


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## Jester316 (Jan 28, 2014)

I got my EMT-P on 12/31/13. I start my Field Training with my company on 2/3. I'm nervous as hell, and I've been working as a basic on an ambulance for nearly 3 years. I've actively tried to avoid falling into the know-it-all mentality, and am excited to start working as a medic. We had a few people in my class who already developed the "paragod" mentality, but they were squashed hard with our 10hr cardiac midterm and 11hr class finals before getting to move on to clinicals...


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## SandpitMedic (Jan 28, 2014)

Lets get back to anion gap ratios and Scarbosa's criteria. This is how we become better providers and evolve EMS. 
I'm loving this discussion.

There are plenty of other threads on when and whether or not to get an I/V.


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## Carlos Danger (Jan 28, 2014)

SandpitMedic said:


> Lets get back to anion gap ratios and Scarbosa's criteria. This is how we become better providers and evolve EMS.
> I'm loving this discussion.



I don't remember specifically learning about anion gaps during paramedic school (though we may have; it was quite a while ago), but we did cover basic acid/base balance and basic blood gas interpretation pretty thoroughly. As a concept, the AG is a very simple and uncomplicated, though somewhat peripheral component of acid-base assessment. Not being aware of it probably means you simply weren't taught it - I don't see how it's a reflection of an overall lack of knowledge. It certainly doesn't take a medical degree or an in-depth background in physiology to understand. 

Lots of paramedics are very knowledgeable about EKG's, and I think understanding and remembering all the rules and criteria you have to know in order to interpret 12-leads is a lot more complicated than a basic understanding of ABG's.

Drawing ABG's and assessing acid base status may not be something we actually do on the ambulance, but it is very important physiology and terminology to understand.


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## gotbeerz001 (Jan 28, 2014)

Burritomedic1127 said:


> Why do we start IVs on pt's that don't need fluid or medications? Should we just leave that to the ER?



Depends on the hospital. If the nurses want to park a guy in the waiting room and I bring them in with an IV started, I get the stink eye.


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## gotbeerz001 (Jan 28, 2014)

unleashedfury said:


> I started paramedic school last july,, I'll be finishing this year, barring no complications.
> 
> (I was in a program and had to drop near the end due to becoming a single parent at the last minute)



Strong work. You seem to have a pretty good head on your shoulders.


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## medicsb (Jan 28, 2014)

SandpitMedic said:


> Lets get back to anion gap ratios and Scarbosa's criteria. This is how we become better providers and evolve EMS.
> I'm loving this discussion.
> 
> There are plenty of other threads on when and whether or not to get an I/V.



Sgarbossa = actually pretty relevant to prehospital paramedic practice
Anion Gap = a little relevant for critical care/interfacility paramedic practice (minimal to no relevance for prehospital)
Delta ratio = not relevant


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## medicsb (Jan 28, 2014)

Burritomedic1127 said:


> Why do we start IVs on pt's that don't need fluid or medications? Should we just leave that to the ER?



1. To feel good about ourselves and/or to increase billing.

2. In most cases, yes.


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## Ridryder911 (Jan 28, 2014)

Unfortunately, my remark about anion gap was taken out proportion, I could had have stated BUN or Creatnine and the majority of EMS providers have that puzzled look.  Please, let's not get into the .._I don't need to know it, if I don't use it in the prehospital phase_... 

I have been associated with EMS education for over 28+ years, and still overwhelmed with the old well there is the "field medicine and I don't need to know" statements. Which is part of our problem within the profession of EMS. We encourage and push autonomy which is definitely needed however; many of the personalities that enter this field have little or poor understanding of professional demeanor. Their not realizing that *the real education starts after you graduate and obtain your license and you being in your clinical practice.*. I always describe, that many that many that leave programs are dangerously dumb with a license. Knowing the difference between being what is technically correct and what is providing the best and most appropriate treatment comes with education and experience. 

There is a fine line between _cockiness_ and _confidence_. Unlike many other health care provider programs, that require shadowing or  residency many EMS push new Paramedics in the field only after a few months of being with an FTO or passing a protocol test. 

As I predicted a decade ago, we will see more and more EMS leave the emergency arena and provide out of hospital care. Sure, we will always have and need first responder type medics but for the long run (for financial expansion of EMS) we will have to continue to expand our way  of thinking and increase our knowledge. 

R/r 911


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## unleashedfury (Jan 28, 2014)

Ridryder911 said:


> Unfortunately, my remark about anion gap was taken out proportion, I could had have stated BUN or Creatnine and the majority of EMS providers have that puzzled look.  Please, let's not get into the .._I don't need to know it, if I don't use it in the prehospital phase_...
> 
> I have been associated with EMS education for over 28+ years, and still overwhelmed with the old well there is the "field medicine and I don't need to know" statements. Which is part of our problem within the profession of EMS. We encourage and push autonomy which is definitely needed however; many of the personalities that enter this field have little or poor understanding of professional demeanor. Their not realizing that *the real education starts after you graduate and obtain your license and you being in your clinical practice.*. I always describe, that many that many that leave programs are dangerously dumb with a license. Knowing the difference between being what is technically correct and what is providing the best and most appropriate treatment comes with education and experience.
> 
> ...



Your bolded statement is very true, Paramedic school provides you with the education you need to meet the minimum standards to pass the liscensure exam. You get your feet wet in the field during FTO and learn about appropriately applying your skills in the "gray area" as I call it. The book and protocol answers work great in the black and white education world. But we live in a world that offers shades of grey. Requires Out of the box thinking, strong physiology knowledge and experience to see visually what works what doesn't work and vise versa. All my scenarios that were for testing stations where clear. Medical patient presents with chest pain radiating to the arm and the suspected illness is a MI. The 56 yr old STEMI I had a few weeks back complained of nausea vomiting and respiratory distress. She also had pain in the back.. No way did she present as a textbook MI. 

We live in a world of greys to become a well rounded practictioner you need to become educated, experienced and listen to the veterans those guys who have seen the odd cases often provide great knowledge if you willing to listen.


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## hogwiley (Feb 2, 2014)

I think its more of a societal thing than anything else. You see the same thing with new EMTs as well, and its even more annoying with them because they truly don't know anything. Humility is increasingly seen as a sign of weakness, and the days of keeping your eyes and ears open and your mouth shut are long gone with this generation. They are cocky and arrogant right out of the gate. 

My Paramedic class is full of ultra cocky kids who can screw up repeatedly without so much as a dent to their egos. I recently watched one of them totally screw up an airway station he should be able to do in his sleep by now, then on break talk to his buddies about how he did everything right but the instructor probably just didn't get laid last night.


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