HotelCo
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Sounds like you did a great job. Excellent assesment skills. It's a good thing that you went and re-checked the pupils. Not enough people do that. That definetly saved some brain matter.
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Ask about facial pain if there is a recurrent or recent droop (Bell's Palsy), and be cautious with all that fluid if you think cardiac insufficiency. Well-played down the middle of the course, and good on you for not giving ASA as a knee jerk, since it might worsen a bleed.
Yes, I was riding being observed by a senior paramedic for our service. So basically a senior paramedic watches and doesnt get involved to see if Im ready to be cut loose to ride by myself.
The hospital is a level 1 in downtown Houston
"Well-played down the middle of the course".
If you had a great basic, you wouldn't have to delegate, it would have been done. When you are on a truck with a regular partner you will learn what to expect from your basic. Right now you are riding third, when you are by yourself you will be better off. Plus you can mold your basic to the way you want him/her. My partner and I review each call after. It works, because I learned over a few calls what she wanted done while in the back of the truck, also we review while driving to the call. I don't know if this will help. I always drive, so my partner has time to read our protocols before we get there too.She said I did awesome, but that I should delegate to my basic a little more. I was trying to do everything myself, and that I was doing things a little disorganized due to that. But overall, a good job.
If you had a great basic, you wouldn't have to delegate, it would have been done. When you are on a truck with a regular partner you will learn what to expect from your basic. Right now you are riding third, when you are by yourself you will be better off. Plus you can mold your basic to the way you want him/her. My partner and I review each call after. It works, because I learned over a few calls what she wanted done while in the back of the truck, also we review while driving to the call. I don't know if this will help. I always drive, so my partner has time to read our protocols before we get there too.
could you give me an example of things that your preceptor was thinking you should have delegated? Other than c-spine and BG? I'm just curious what you were doing that excluded your partner?
i understand the scope of the basic, but are you talking about things like vitals, while you performed your assessment?
Hate to see this bean counter application to our form of medicine.Thanks. I take it a level 1 facility is top notch and can well manage a stroke pt.
But do you have mixed crewing? ie one EMT-B and one EMT-P and is that standard for your county/region/state? The reason I ask is because crewing is the latest target of many services looking to cut corners and at the same time sell reduced services (in overall quality) but expanded (because they can claim they have "more").
Here in Melbourne our elite staff were so badly managed that they left in droves over recent years to the point where our management (and government) are now going to sell a (mostly -about 65% of the total) ALS single responder system as the equivalent or better of the system we had.
By splitting the crews they now have twice as many staff for the same number of rostered shifts. A very neat trick and one many services are now pawning onto an unsuspecting public.
I see there have been many threads on this and other forums about the subject.
(Sorry for the political distraction) and once again well done and enjoy.
PS Wait till you do a pediatric arrest as the top gun and watch that old sphincter tighten up!!!!
MM
How far is your transport time to a stroke facility?
I'm in the same position as you, we fly anything critical to Hermann or Taub.
I'm down in League City.
Thanks. I take it a level 1 facility is top notch and can well manage a stroke pt.
But do you have mixed crewing? ie one EMT-B and one EMT-P and is that standard for your county/region/state? The reason I ask is because crewing is the latest target of many services looking to cut corners and at the same time sell reduced services (in overall quality) but expanded (because they can claim they have "more").
Here in Melbourne our elite staff were so badly managed that they left in droves over recent years to the point where our management (and government) are now going to sell a (mostly -about 65% of the total) ALS single responder system as the equivalent or better of the system we had.
By splitting the crews they now have twice as many staff for the same number of rostered shifts. A very neat trick and one many services are now pawning onto an unsuspecting public.
I see there have been many threads on this and other forums about the subject.
(Sorry for the political distraction) and once again well done and enjoy.
PS Wait till you do a pediatric arrest as the top gun and watch that old sphincter tighten up!!!!
MM
Melb, when you say ALS single responder, are you talking about the MICA singles or is there some new hair-brained scheme I haven't heard about, to have ALS singles as well?
Also, out of interest (I live in Melb), which MICA van are you on? If you don't mind sharing in a public forum.
Hate to see this bean counter application to our form of medicine.
WE were a targeted paired system, however with MPDS, target's are hard to see. ( used to be they used basic's trained to dispatch and multitask, now they follow the cards and use the stunned closed ended questions that wouldn't be tolerated on car, consequently dispatched as rarely meets diagnosed as)
Pairing in my neck of the woods is fairly consistent, however, part of my province has gone to a nurse/medic trial.
Sorry for the hijack Ms.M. Sounds like you did a good call. Learning to delegate is an intregal part of the job, which will make life easier, once perfected. (knowing the partner is paramount so you know when and what to delegate)
I'm on Z2 at the Alfred
As regards you're query, the problem is in the non - transferable job descriptions.
"Paramedic" in Australia now refers to any ambo as you know. In the US a "Paramedic" is an EMT-P - one of their highest levels roughly equivalent to our MICA types.
"ALS" in Australia is the skill set our "Paramedics" now have - (remember not all our Paras (normal ambos) are signed off as "ALS" - its a skillset.
In the US their highest skill-sets are roughly described as "ALS". It is also the skill level applied to certain types of clinical situations - but may not reflect the skill-set of those attending the patient. (At this point, corrections by some of my US EMT-Life friends are welcome if I have my definitions wrong)
Confused? I am and I wrote it - thanks to the ambos in Australia who pushed for our name changes!!!).
Therefore I am referring to "ALS" single responders in the context of US EMS services in the same way as our MICA single responders.
Hope that clears it up.
PS There are many regional and state/private sector service variations but from what I gather there is roughly three general classifications of skill-set in the US.
EMT-B (Basic)
EMT-I (Intermediate)
EMT-P (Paramedic)
Once again I'm sure our local people here will tidy up my suppositions.
Cheers
PPS Do you like the forum? The boys and girls can get fired up at times but they're all pretty good types from my experience.
MM