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The big thing is making sure your science prereqs are in-person. Having online courses as part of your degree is fine, or at least was fine for some of my classmates. I would be cautious about having your bachelors from a community college too--not that community college courses would be bad...

I did it. 5 years in EMS as a basic, 3rd year medical student now. I started in the same boat, by googling "how to become a doctor" after some fire instructor gave us our 400th "backboard all trauma patients and give them 100% oxygen" lecture. I understand the desire to get your paramedic, and...

The only times I ever used the folding knife that every new EMT feels the urge to buy was to open boxes in the supply closet. If I needed to use pliers or a screwdriver, I was either at the station with a real toolkit, or I was calling for the fire department. If you absolutely must spend...

There are several states where NPs do not require a physician's authority/license to practice.

We had a lecture from one of the interventional cardiologists at my hospital the other day and he was of the mind that nitro was appropriate in a right sided MI as long as it was given judiciously and you were aware of the potential for hypotension. I don't actually think its a terribly well...

You're in Lancaster, right? Are you using medic chase cars or medic ambulances?

I think a big problem is the relatively limited (in my opinion, given the minimal education--very justified) scope of BLS providers compared with the expansive scope of medics who can treat anything from nausea or mild dehydration all the way to tachydysrhythmias and refractory asthma. This...

I'm pretty sure the vast majority of crisis center-appropriate patients don't require handcuffs

Oh that's pretty neat, I'll check it out. Yeah I know it's not your fault, just like others have said it seems like a strange use of resources. But what do I know.

Thoracotomy can be indicated in abdominal trauma, though it's not the best indication, purely for clamping the aorta in what would be REBOA zone 1 and knocking out all abdominal blood flow. You can't really control those bleeds with REBOA either because the celiac and SMA are superior to the...

Thoracotomy with cross clamping of the aorta is taught as part of an emergency medicine residency, and the emerg docs (not surgeons) do it prehospitally with London Air Ambulance and all the other sexy flight doc programs that people like to talk about. You are correct though, that unless step...

While I agree with RocketMedic that "diversity initiatives" that just mean "straight white men need a higher score to get in" can be misguided and a pretty lazy way to deal with racial inequality or poverty, I think there is a problem with assuming that the only way to attract minorities to a...

Everyone is talking about "taking the best" and "not sacrificing quality for diversity", but every place I've worked as been so desperate for people that they'd hire a purple alien with three heads that all told offensive jokes if it had an EMT card and could get through a few days of FTO. I'm...

PA or MD/DO? Respiratory therapist? Emergency department medics can make more money and it's definitely easier on the back than being on the road. Why not RN? It's a solid gig and you can always go back and get your NP or CRNA. Plus you're pretty attractive for helicopter/critical care stuff...

Just wait till you see the studies on how nurses and doctors in the hospital do with hand washing

I know epi is no longer thought to be the lifesaving ACLS drug that it once was, but I can't imagine why a patient in a depressed cardiac output "PEA" arrest wouldn't respond to 3 doses of IV epi, but would then respond to a relatively low dose dopamine drip. I like the esmolol idea, I've heard...

As far as stuff that probably improves outcomes, vs making us feel good about what cool toys we have--probably widespread CPAP and EtCO2. More widespread use of I-gels/SGAs instead of intubating is probably also good. Even with video scopes the evidence base for (non-HEMS) prehospital...

What do the other medics/EMTs do in your system? I've worked in places that wanted basically the whole transfer of care report over the radio, and places that wanted age, sex, chief complaint, and ETA only. Usually the busier the hospital the less they care about radio reports for non-critical...

I agree that this is certainly a major blunder on the EMS side, I just also think there is a significant responsibility that falls on the hospital. Just because EMS says that a patient is fine doesn't mean you can leave a patient unassessed for 4 hours. If anyone here has worked in an ED...

Probably an unpopular (and cynical) opinion on this site, but while I'd like to live in a world where paramedic assessment is something valued and important, there are too many poorly educated medics for me to say that providers in the ED should have lots of faith in a paramedic assessment...