Another EMS show.

Already posted in another thread in the EMS Lounge.


But if you consider a single medic + a pilot is "true"...
 
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Second said:
but this one might be more true. more so than the whisperer anyway.
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Only if you don't know SF.

There are no helipads at the hospitals in the city.

Paramedics are rarely used on flight team due to their limited scope. It is usually 2 RNs.

The helicopters have 2 RNs, and not one Paramedic, so the mother of the child doesn't have to participate in cutting her kid's throat open.

Anyone speeding through SF and yelling " I can't die" as the Flight Medic was doing in his POV with a young lady also in the vehicle would have a 5150 or a jail sentence waiting for him at the end of the ride. I haven't even begun to critique the hideous acting or patient care.
 
The air ambulance chopper here carries a single paramedic. The navigator has some training, like CPR and some familiarity with the drug box as I understand it. But that's it.

How does an RN have a wider scope to practice than a medic? Off topic I know but the OP topic is moot given it's a repost.
 
Melclin said:
How does an RN have a wider scope to practice than a medic? Off topic I know but the OP topic is moot given it's a repost.
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Around here from what flight crews have told me, if it's an IFT (transfer) the nurse is in charge, because it is generally they who have the medication and chronic care knowledge.

When it comes to an emergency call, the medic is in charge because that is 'their' territory.

Each works off the other.
 
Yeah I realise that's true in America (about the education). Not quite my point though. Nurses here are not actually allowed to do much, if anything, without the express permission of Dr.s. They don't have the training to be making medical decisions. They enact medical decisions and manage care, but they don't have the training regarding procedures, drugs, and decision making based on clinical evidence that paramedics do.

Clearly our countries are different, our medics are far more highly trained, what I'm getting at is the nurse thing - I don't see how it makes sense that "when a paramedic isn't good enough, you need a nurse". They are just different roles. Do nurses over their make decisions about patient care? Change the courses of treatments .. medications.. etc?
 
Melclin said:
Yeah I realise that's true in America (about the education). Not quite my point though. Nurses here are not actually allowed to do much, if anything, without the express permission of Dr.s. They don't have the training to be making medical decisions. They enact medical decisions and manage care, but they don't have the training regarding procedures, drugs, and decision making based on clinical evidence that paramedics do.

Clearly our countries are different, our medics are far more highly trained, what I'm getting at is the nurse thing - I don't see how it makes sense that "when a paramedic isn't good enough, you need a nurse". They are just different roles. Do nurses over their make decisions about patient care? Change the courses of treatments .. medications.. etc?
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Your right, there is much difference in training and education. Those that are in EMS here is more of a first aid level and entry point of providing medical care. All those that give care either have orders or work under protocols.

Registered Nurses here are required to have either an associate degree (2 yr) or equivalent as there are still some diploma nurses (very rare). It is within reason that the Paramedic has speciality training in emergency medicine where as nurses are educated diversely in many subjects. Alike medical models, one usually choose their speciality and obtain clinical experience and additional training in that area. Most acute care areas usually require nurses to have additional education and go through a internship type program.

Nurses here do have a role in help making decision in patient care. Yes, the physician writes the orders and has the ultimate authority but in realistic terms it is usually a team approach. Most physicians usually learn very early to listen to members of the health team and especially nurses; since they spend and assess the patient the most. Nurses in acute care areas usually work under standing orders and guidelines, as well nurses have what we call nursing diagnosis so interventions such as daily care and procedures can be performed without direct medical orders.

In regards to the higher, unfortunately Paramedics here go through about the same length of training similar to the vocational nurse. In some areas, actually go through less time than those that are beauticians. So yes, educationally in the majority of the areas the RN is regarded as more educated.

We started the ball rolling but dropped it in the mid 80's. Unfortunately, we much rather develop half arse levels and make excuses than resolve the problem.

R/r 911
 
Ridryder911 said:
Registered Nurses here are required to have either an associate degree (2 yr) or equivalent as there are still some diploma nurses (very rare). It is within reason that the Paramedic has speciality training in emergency medicine where as nurses are educated diversely in many subjects. Most acute care areas usually require nurses to have additional education and go through a internship type program.
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Here both are a 3 year bachelors degrees, although its a new approach and a lot of kinks still need to be worked out. As you mentioned, the philosophy we are taught is that we are trying to develop medics as pre-hospital emergency experts, the idea being that no body else including MDs will know more or be better at pre-hospital care. We're not all the way there yet, but certainly our Mobile Intensive Care Ambulance paramedics are emergency specialists in their own right. I've heard in rural areas that have trouble staffing hospitals, MICA paramedics have run the ED over the weekend or over night (might be apocryphal, but u get the point).

Ridryder911 said:
in realistic terms it is usually a team approach.
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Yeah, that was what I was getting at, they are trained to be a part of a team, so take away their team members (MDs, RRT, ) = problem. Where as paramedics are intellectually and clinically autonomous, and very experiences at being both. That's what I comprehensively failed at saying before :blush:

Ridryder911 said:
as well nurses have what we call nursing diagnosis so interventions such as daily care and procedures can be performed without direct medical orders.
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That's exactly the kind of thing I was inquiring about. As always, very illuminating. Cheers Rid.
 
I'll watch it, as I have been waiting for a show about the EMS side of medicine and NBC can put together a compelling, if not unrealistic, drama. "ER" was consistently entertaining, even though they were constantly blowing up the emergency room, infecting it with small pox, or having a swarm of locusts invading it.

So while I'm not expecting this show to display the boring aspects of our job, like the nine calls a day where you go to a older person's home where their chronic health is ushering their way out anyway, I'm sure the scenes where cars are exploding in huge fireballs as they run away in slow motion carrying a small child will be fun to watch.

I've often said what is missing in our work is copious amounts and liberal use of pyrotechnics.
 
PapaBear434 said:
I've often said what is missing in our work is copious amounts and liberal use of pyrotechnics.
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Amen

I've totally been out on like 30 calls, and I haven't once dove into the air to save a baby, from a fireball in front of a bunch of sexy women, and in doing so burn't my top off to reveal my ramboesque physique. I don't know whats going on, I must be doing wrong. :ph34r:
 
Melclin said:
Amen

I've totally been out on like 30 calls, and I haven't once dove into the air to save a baby, from a fireball in front of a bunch of sexy women, and in doing so burn't my top off to reveal my ramboesque physique. I don't know whats going on, I must be doing wrong. :ph34r:
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I also always said that life would be that much more awesome if it were directed by Micheal Bay. Wake up, dodge a guy wielding double broad swords, use the rest room, jump over a pit of snakes, run down the hallway being chased by a fireball in slow motion, and then kiss some random beautiful woman with no acting chops but looks good in a bikini top.

Of course, the world would cut away before any of the really sexy parts. You'd have to keep the PG-13 rating, after all. Got to draw in those kids! So yeah, there would be a few drawbacks to my Bay-esque version of life.
 
Linuss said:
Around here from what flight crews have told me, if it's an IFT (transfer) the nurse is in charge, because it is generally they who have the medication and chronic care knowledge.

When it comes to an emergency call, the medic is in charge because that is 'their' territory.

Each works off the other.
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The correct term is Critical Care knowledge. RNs on Flight will have at least 5 years of experience in the CC units and may also have been part of a hospital specialty transport team or CCT as well. That doesn't compare with an 80 hour overview class of critical care medicine Paramedics get if they even choose to take that. RNs are well versed in the meds and equipment of stabilization where this in not a strong area for prehospital providers especially in CA. RNs also have the opportunity to participate in many more advanced procedures than the paramedics as well. Since prehospital medicine is a Specialty, RNs will treat it as such and build un their fairly solid educational foundation gain what their need to out of hospital work. The foundation is often what is missing in the U.S. Paramedics cert. Thus, nurses will treat the Paramedic as they do other specialty certs and it may take less time to achieve if they need that cert. Several states will allow RNs to challenge the Paramedic exam.

Specialty teams have already been highly successful using RNs (and RRTs) for over 5 decades and they travel several hours away from their base hospital to pick up critical patients. It would be very difficult for the U.S. Paramedic to do such intense transports because they have acquired no ICU experience nor much training in specialty areas such as neo, peds or advanced cardiac methodologies. However, Canada does provide this education and training for their Paramedics.
 
I think Ive stated this before. True portrayal of what we do would not attract any viewers.

Anyway I like when shiit blows up, helicopters crashing into buildings and twenty car MVAs like we used to see on CHIPs, thats good mindless entertainment.
 
CAOX3 said:
I think Ive stated this before. True portrayal of what we do would not attract any viewers.

Anyway I like when shiit blows up, helicopters crashing into buildings and twenty car MVAs like we used to see on CHIPs, thats good mindless entertainment.
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Not to mention, I get a bit of a thrill out of picking apart shows with my friends, Mystery Science Theater 3000 like. Show like this will be a weekly mainstay for night crew at the station, I guarantee it.
 
I've often said what is missing in our work is copious amounts and liberal use of pyrotechnics.
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I like to keep the amount of crap exploding in my general vicinity to a minimum.


That said, two friends and I are kicking around an idea for a Mythbusters style show only with more focus on actual science. We think an injury epidemiology expert with a penchant for plane crashes, a theater major with a taste for bad B horror movies and an engineering student (also an EMT) who enjoys math just a little too much would be a great mix.

phd040609s.gif
 
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I kind of hate shows like this new Trauma one. They always try to hero-ize everything they do (HOLY SHNIKEYS! He started an IV!!!) or they end up making medics look like preening idiots. I'll stick to my Discovery Channel shows like Trauma: Life in the ER and Code Blue thank you very much.
 
MendoEMT said:
I kind of hate shows like this new Trauma one. They always try to hero-ize everything they do (HOLY SHNIKEYS! He started an IV!!!) or they end up making medics look like preening idiots. I'll stick to my Discovery Channel shows like Trauma: Life in the ER and Code Blue thank you very much.
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Or even the short lived Discovery show, Paramedics. I wish I could find out when it was on. But yea, I like thsoe shows, too bad they won't make new episodes.
 
MendoEMT said:
I kind of hate shows like this new Trauma one. They always try to hero-ize everything they do (HOLY SHNIKEYS! He started an IV!!!) or they end up making medics look like preening idiots. I'll stick to my Discovery Channel shows like Trauma: Life in the ER and Code Blue thank you very much.
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I too love "Life in the ER" and "Code Blue," but those focus on the ER. All you see of the EMS side is them hauling them in. I get why, though. In the ER, you have plenty of room for a guy with a camera. He stands in the corner with a stool, and you can catch most of the action. Not so much on an ambulance. And any really interesting calls we get that they'd actually WANT to film is usually so crowded that you'd never be able to fit a guy with a camera between the guy bagging, guy doing CPR, and three medics starting IV/IO and administering drugs.

The only way I can see that kind of a format working is having fixed cameras on the upper corners of the box, and copious amounts of editing to catch the good calls and cut the crap BS stuff.

But, there is something else to look at. When "ER" came on the air, a huge influx of people went into medicine seeking to be an emergency specialty. Yeah, they made them look like cape-less heroes, but people responded to that. I remember on the special they put on when "ER" was going off the air, and they said that the AMA reported a 200% increase in ED specialty nurses and doctors even ten years after the show debuted. It went from being a job that a lot of folks in the medical community viewed as one that only hacks and adrenaline junkies got into to being viewed as one of the most important functions at a hospital, by both the public and medical communities.

Maybe this show, if it works, would have the same effect for us. Yeah, you'd have a ton more people to compete with to get a job, but that also means we could be a little more selective about who gets in. Raising standards and education is something I think most of us here agree on here.

In addition, we have a problem of a lot of people viewing us as a sub-service of Fire, PD, or just transport. A show like this could inform the public, albeit in a very dramatic and explosive fashion, that we are our own service with our own function. Get a little more public respect for what we do, even if it IS based on a highly sensationalized show, and this will of course turn the opinion of politicians who are pushing to combine and slash our budgets with other services because they want to look good for their constituency.

I wouldn't dismiss this show outright, is all I'm saying. It could be good for us. I'm not expecting them to catch lightning in a bottle like they did with "ER," but if you think about it, EMS really hasn't had a show about them since that cheese-fest that was "EMERGENCY!" in the 70's. People are used to cop shows. People are used to hospital-based medical dramas. The closest we've had to a decent EMS show in recent memory was "Third Watch," which was people from all sorts of services from PD, hospital, and fire/rescue, and "Rescue Me," which is mostly about firefighting and comedy, not drama. This might actually catch on just because it's an emergency profession, which is always interesting to the public that aren't in it, but one they haven't seen that much of.

This could be VERY good for us. Or it could be a flop. Either way.
 
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PapaBear434 said:
But, there is something else to look at. When "ER" came on the air, a huge influx of people went into medicine seeking to be an emergency specialty. Yeah, they made them look like cape-less heroes, but people responded to that. I remember on the special they put on when "ER" was going off the air, and they said that the AMA reported a 200% increase in ED specialty nurses and doctors even ten years after the show debuted. It went from being a job that a lot of folks in the medical community viewed as one that only hacks and adrenaline junkies got into to being viewed as one of the most important functions at a hospital, by both the public and medical communities.
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"ER" had strong characters and strong story lines to where the helicopter crashes were not just there to carry an otherwise weak story. It also sometimes sent a little message about safety. BSI precautions were usually used and even the incident with the tail rotor blades and Dr. Romano's arm served a purpose. It showed how easily a life can be changed by one non-thinking moment and that you don't get distracted around a helicopter.

http://www.youtube.com/watch?v=vh-kw3DOIgk

This is actually a good training video for how not to transport patients by helicopter as well warning people the focus should be on the helicopter when any part of it is still moving.
 
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