# Got hired with an IFT company in Los Angeles County, have questions.



## strangerdude88 (Oct 8, 2010)

What is the best way to learn about meds and illnesses? There seems to be a lot of stuff i need to learn that was not taught in EMT school. 

Is it common for your company to be strict on the use of NRB's, In training taught me to only use NC's @ 2-4LPM. If my patient need 02 I want to give him full blast 15 lpm via NRB.

Honestly any tips would be appreciated, the only reason I am not doing 911 is because McCormick was not hiring, but I plan on applying at the end of the year. I feel pretty lost in this company, my FTO didn't teach me :censored::censored::censored::censored:. All the paperwork I had to pretty much learn on my own.

Oh and do you guy's usually us an Isolation Kit for MRSA Nares, because my FTO didn't, not even a mask?


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## Shishkabob (Oct 8, 2010)

What do you mean by "meds and illnesses"?  Meds that you can give, or meds that patients are on?  If it's about meds you give, you should already know.  If it's meds that patients are on, and illnesses they have, you'll learn that stuff through exposure.  What meds are used for what, like why a patient will be on Lisinopril or Labetaolol.  



If a patient doesn't need 15LPM NRB, than don't give them 15LPM NRB.  I can count on my left hand how many patients I've put on a NRB in the past 10 months.  There's a bunch of threads on this forum about NRB vs NC and when to give patients O2... you'd be good to search and read those.


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## TransportJockey (Oct 8, 2010)

MRSA is a contact precaution, not a droplet or airborne precaution, so mask is not required. And even then, when I worked IFT in NM, I can count on one hand the amount of times I wore a banana gown. Usually it was draped over the patient. Gloves always though.


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## JPINFV (Oct 8, 2010)

strangerdude88 said:


> What is the best way to learn about meds and illnesses? There seems to be a lot of stuff i need to learn that was not taught in EMT school.


Take an anatomy and physiology course would be a good start



> Is it common for your company to be strict on the use of NRB's, In training taught me to only use NC's @ 2-4LPM. If my patient need 02 I want to give him full blast 15 lpm via NRB.


Key phrase there is "if my patient need." The vast majority of patients do not need a NRB. The problem is that EMT class teaches "everyone needs a NRB."


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## strangerdude88 (Oct 8, 2010)

Linuss said:


> What do you mean by "meds and illnesses"?  Meds that you can give, or meds that patients are on?  If it's about meds you give, you should already know.  If it's meds that patients are on, and illnesses they have, you'll learn that stuff through exposure.  What meds are used for what, like why a patient will be on Lisinopril or Labetaolol.
> 
> 
> 
> If a patient doesn't need 15LPM NRB, than don't give them 15LPM NRB.  I can count on my left hand how many patients I've put on a NRB in the past 10 months.  There's a bunch of threads on this forum about NRB vs NC and when to give patients O2... you'd be good to search and read those.



Yes I was referring to meds that patients are currently taking.


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## strangerdude88 (Oct 8, 2010)

JPINFV said:


> Take an anatomy and physiology course would be a good start
> 
> 
> Key phrase there is "if my patient need." The vast majority of patients do not need a NRB. The problem is that EMT class teaches "everyone needs a NRB."




I will definitely do that, because I feel that I need to learn more in order to assess me patients better. Yeah, I was confused because when I took my ride along with McCormick they only use NRB's no matter what the situation, so I figured that's what I would do. I'm guessing they do that because they get to charge more on the bill?


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## LonghornMedic (Oct 8, 2010)

strangerdude88 said:


> I will definitely do that, because I feel that I need to learn more in order to assess me patients better. Yeah, I was confused because when I took my ride along with McCormick they only use NRB's no matter what the situation, so I figured that's what I would do. I'm guessing they do that because they get to charge more on the bill?



All they used were NRB's? There is no justification to that at all. Listen, if you are doing IFT and your patient legitimately needs a NRB, it would be in your best interest to upgrade the call and get Paramedics involved. You should be transporting nothing but stable patients. In my opinion anyway.


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## strangerdude88 (Oct 8, 2010)

LonghornMedic said:


> *All they used were NRB's?* There is no justification to that at all. Listen, if you are doing IFT and your patient legitimately needs a NRB, it would be in your best interest to upgrade the call and get Paramedics involved*. You should be transporting nothing but stable patients. In my opinion anyway.*



Yeah, the EMT's told me that the company protocols are to use NRB's on everyone. 

Yes we do, but occasionally one will deteriorate en route.  Our protocols allow us to upgrade to code 3 if we are within five minutes of the ER, If not we call Paramedics.


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## JPINFV (Oct 8, 2010)

strangerdude88 said:


> Our protocols allow us to upgrade to code 3 if we are within five minutes of the ER, If not we call Paramedics.



Err... they don't. Los Angeles LEMSA protocol is purely ETA based. If transport time is less than paramedic ETA then you transport code 3 to the closest emergency department. 

Point 7.
http://ems.dhs.lacounty.gov/Policies/Ref800/808.pdf


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## terrible one (Oct 8, 2010)

strangerdude88 said:


> Yeah, the EMT's told me that the company protocols are to use NRB's on everyone.



Ahhh LAco EMS at it's finest. It's not so much a company protocol as is a LAcoFD thing. They will literally put EVERY ALS pt on 15Lpm regardless of pt presentation/condition/evaluation, it is the most absurd thing in the world. And dont you dare question LAcoFD paragods about their tx methods as you are simply beneath them.
Ya I spent too many years at McCormick back in the day.


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## iftmedic (Oct 28, 2010)

LA county is a joke, You need to get out of there if you want to get any real experience, As far home meds that patients are taking through experience and exposure will you increase your knowledge base. As far as medications that would be in your scope you'd better know indications, contraindications, routes blah, blah, blah, Your working for a private company wich probably means that your management is gonna give you a twisted opinion on what County protocols are, or they are just Supervisors  or FTOs that have kissed enough butt to get their silly titles and have only worked in LA county so really don't know Jack, and probably will be out of work because they are making too much a (little above min wage ) for some petty reason. So don't really expect to learn very much from IFT company out of LA. Only thing you will learn is how cool the Fire dept is and how under appreciated and under paid you are, in LA county atleast.


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## JPINFV (Oct 28, 2010)

iftmedic said:


> Only thing you will learn is how cool the Fire dept is and how under appreciated and under paid you are, in LA county atleast.



Oh, I was supposed to learn working in So Cal how cool the fire department was? Opps.


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## iftmedic (Oct 28, 2010)

JPINFV said:


> Oh, I was supposed to learn working in So Cal how cool the fire department was? Opps.



I'm sorry that was an under statement, how heroic the fire dept is.


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## JPINFV (Oct 28, 2010)

iftmedic said:


> I'm sorry that was an under statement, how heroic the fire dept is.



Either or works for me...


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## SoCal (Oct 28, 2010)

strangerdude88 said:


> What is the best way to learn about meds and illnesses? There seems to be a lot of stuff i need to learn that was not taught in EMT school.
> *The internet is your friend here, take a tablet notebook with you to work and on the boring IFTs write down the meds and illness the pt. has and when you get home spend 30 min or so researching the meds and illnesses, it will make you a stronger EMT and furthermore, a stronger medic when you want to become one. Be a student of your profession. *
> 
> Is it common for your company to be strict on the use of NRB's, In training taught me to only use NC's @ 2-4LPM. If my patient need 02 I want to give him full blast 15 lpm via NRB.
> ...



My $.02


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