--------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DAR00004 Date: 06/21/96 From: RAYMOND PESEK Time: 06:21pm \/To: TOM BAKER (Read 1 times) Subj: Help -> An orderly in a good Emergency Department. TB ->Thanks for the advise I'm sorry I was so brief on this answer. Several people I know (non-EMT's or EMTs in training) work in our medical control hospitals ED as orderlys. Not only do they get to see a lot of varied cases, but they get to see a unique side of the EMS story, that of the ED workers. It's amazing how things we do that we don't think twice about cause someone some grief, and how once we know about it, we can easily change our procedures to make things work better for all concerned. Raymond Pesek * 1st 2.00 #2448 * Daddy, what does "Formatting Drive C" mean? --- InterEcho 1.18 * Origin: PC-Ohio PCBoard * Cleveland, OH * 216-381-3320 (1:157/200) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DAR00005 Date: 06/20/96 From: JAMES TARPLEY Time: 10:11am \/To: TOM WALL (Read 1 times) Subj: Re: Mail TW> I'm having a problem with mail could someone please reply to this TW> message. Reading you loud and clear here in Salt Lake City!! TW> Thanks for the help ! No problem, anytime!! James --- Blue Wave/RA v2.12 [NR] * Origin: Vital Signs - W. Jordan UT Med and More! 801-255-8909 (1:311/20) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DAR00006 Date: 06/20/96 From: THOM RILEY Time: 10:53pm \/To: TOM WALL (Read 1 times) Subj: Mail -> I'm having a problem with mail could someone please reply to this -> message. -> -> Thanks for the help ! -> Tom ...you might be a redneck if.... Just a bit of humor. Did you get it? (pun intended) Thom --- Platinum Xpress/Wildcat! v1.2j * Origin: Sports Section : (616)532-7448 Wyoming MI (1:228/152) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DAS00000 Date: 06/22/96 From: PHILIP PITMAN Time: 12:54am \/To: TOM WALL (Read 1 times) Subj: Mail On (19 Jun 96) Tom Wall wrote to Anyone... TW> I'm having a problem with mail could someone please reply to this TW> message. TW> Thanks for the help ! TW> Tom TW> --- Via Silver Xpress V4.3 SW12215 TW> * Origin: The Law & Order BBS Dickson TN 615-441-3302 -=>28.8k<=- TW> (1:116/209) Hi Tom, It arrived in Oshawa, Ontario, Canada.... Oshawa is about 30 miles east of Toronto. Hope this helps you. Sincerely, Philip Pitman --- PPoint 2.00 * Origin: Space Lodge Point 4 (1:229/618.4) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DAT00000 Date: 06/23/96 From: JOHN SIMMONS Time: 02:04am \/To: GEORGE VAISEY (Read 1 times) Subj: Emt Done -=> Quoting George Vaisey to All <=- GV> I passed my EMT w/flying colors. I'm now state certified! NYS EMT GV> #223855. GV> George Vaisey Gee, you got high registration numbers over there! Congrats, George. Your certification to EMT is a START in the profession. Certainly a milestone, but read on. You'll see Down here in Arizona, you are required to be EMT certified through the junior college system BEFORE ever hiring on to a fire department now. Too many wannabes out there. The course in 1986 used to cost $95 including malpractice insurance. Today, the same course is $245 plus another $225 for malpractice, AND you have to present PROOF of MMR vaccinations/DPT shots/Tetanus boosters/polio vaccine, and NOW the HEP B vaccinations at OUR own cost. When something can't be proved, then you have to have bloodwork to show that you have antigen positives to measles, mumps, rubela, rubeola, polio, diptheria, tetanus, chicken pox, and hepatitis B. All that can amount to a few hundred dollars more. The Hep B series is $195 alone. Back then, no health insurance paid for Hep B unless you are in a profession that requires it. My HMO gave me mine because they operate on a different premise - an ounce of prevention is worth a pound of cure and of course, *state law* mandated it. Today, Hep B vaccine is to be included in the standard course for babies because of diapers, etc. When I passed my first EMT certification in '86 with a score of 97% and was the first one out the door in 20 minutes after a 150 question exam, I was elated. As time goes by, standards get tougher and more strict. Then the NR (National Registry) version was implemented as the "gold standard" 2 years ago. Before that, we had to RECERTIFY every 2 years. I never scored below 91 all those years. Then they went to state EMT recertify every 4 years and NR every 2 years. This stupid state made the NR the "gold standard" for BOTH the state certification and NR. The only difference is the time lapse between recertifications! If we wanted NREMT, we test every 2 years with a 2 weekend NR refresher class of 2 credits. If we want EMT, then it's every 4 years with a 2 weekend NR refresher class of 2 credits, and the NREMT exam. We have to get a new CPR card at the new AHA Health Care Provider certification every 2 years along with a newly issued EMT card. In essence we have to get a new EMT card every 2 years, but recertify every 4 years. They only issue AHA CPR cards for 2 years only. That's why it's so wierd. On the back of the EMT license ID card, it says INVALID WITHOUT PROOF OF CURRENT BCLS/ACLS CERTIFICATION. On the front it has a space for photo insertion and then it's laminated into a plastic card. I just have to get ACLS/Health Care Provider renewal by 1/27/97 and send the paperwork and check in. Then I get a new card in the mail. Looks like my holiday season for 1998 will be spent doing NR studying. My first NREMT was tough - all case based scenarios. I scored an 88 on the NR, was the third to last person out of the room and took the whole alotted time span. The state exam was more gentle because it just focuses on the A, B, C's and you get an odd question here or there. Just remember - don't ever let your certification lapse. In Arizona, you have 30 days to recertify after the expiration date and if you don't, you have to go back to EMT101 and take the whole 7 credit hour course all over again!!!! AAAAGGGGHHHH! When they started enforcing the EMT requirement as being a condition of employment for the fire depts in 1990, we found out who was illiterate!! We had a hispanic fellow firefighter who put in 23 years into the FD. He never did make any attempts at promotions. Firefighter for 23 years (Now it's 30)! Now we knew that he had hid his shame from us for so long. We all helped him to pass the state certification exam by Q/A. He made an request to the DHS to have it administered orally in English. They granted the orals. He scored well. The state granted him his first EMT certification. We are very proud of him. Nothing else defines the bonds of the "closed clique" of friendship of firefighters better than this. People have always sensed a special "bond" of a firehouse crew. This event also made local news in the newspaper when it happened. One of my buddies, a NREMT-P (Bob) was on a trip to Ohio with the dept chairperson (R.N. and doctorate in nursing - Kay) to work on the NR council this spring. A gentleman on the DC-10 had a heart attack in flight. Bob and Kay were the only medical personnel on board. The passenger passed out, vomited, aspirated it, etc. They were flying INTERSTATE from AZ to OH. It happened over Missouri. Kay did the ALS/CPR with the man on his back spanning the 5 seats in the center, and Bob asked the pilot to patch into the nearest hospital in St. Louis. This is where the NR came into play - VERY IMPORTANT CONCEPT HERE. When the pilot asked for any medical providers, Kay's R.N./Instructor Level CPR id was provided, and Bob's NREMT-P/CPR id were provided to the pilots. Legally speaking, Kay's credentials were only valid in/over Arizona only. Bob's credentials were valid NATIONWIDE. If a doctor had been on board and he was not licensed in Missouri, the NREMT-P (Bob) has precedence over the doctor. These are airline SOPs. The doctor can ASSIST, but the NREMT-P has legal control of the scene. Most states acknowledge the NR credentials now. Therefore, Bob had legal jurisdiction in Missouri since he was NR certified and was in the cockpit following protocol on the radio patch. He always keeps a small, but necessary kit with him at all times so he can help cardiac patients with IV's, drugs, etc. He patched to a St. Louis hospital, where the base E/R issued orders (standing orders differ from hospital to hospital to EMS providers) and the plane landed in St. Louis where an ambulance was waiting on the runway. The passenger was unloaded, control passed from Bob to the local paramedics and they took off again for Ohio. The hospital replenished the consumables from Bob's kit and the airline's kit. I also keep a small kit handy at all times as well, but with no drugs or IV's. I'm not certified to provide ALS service, being an EMT, just BLS. EMT-P or NREMT-P are certified to provide ALS service. The whole plane gave the both of them a standing ovation when the pilot explained what happened (without disclosing names). Not only that, the both of them got their tickets refunded for this entire round trip flight, and each got 5 round trip first class tickets to anywhere in the USA. Passengers tried to get more information from Kay and Bob, only to be told, "I cannot disclose any information, it violates patient/health care provider confidentiality". TRUE. Now you will see that an NR certification will allow you to practice in almost all of the 50 states. Therefore, recertification and retraining are a must to keep up with the changes in healthcare. Each time I have done a CPR recert, it has been updated with new information provided. Now the NR is about to issue changes to the NREMT level. NREMT's will now be allowed to do IV's, the more simple computerized cardiac monitoring/shock machines, where available, and intubation. They also will be able to do very limited pharmacology - insulin, epinepherine, nitroglycerin, syrup of ipecac, narcan, D5W, Ringers, etc. This frees up the paramedic to take on more complex tasks of street medicine. I welcome all the changes of pushing down the most easiest tasks of paramedic's training. I've illustrated why I said that your first EMT cert was a "start" in the field of street medicine. Eventually you will use all your skills in patient stabilization and getting a patient to an E/R no matter where you are and what you're doing. Next time, go for the gold standard. I am. John FF/EMT #31098/Arizona ___ Blue Wave/386 v2.30 --- PCBoard (R) v15.22/10 * Origin: IOTP * Fido/Relaynet/Intelec/Usenet (1:114/237) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DAT00001 Date: 06/22/96 From: DELORES E ROWE Time: 01:03am \/To: GEORGE VAISEY (Read 1 times) Subj: Emt Done GV>I passed my EMT w/flying colors. I'm now state certified! NYS EMT #223855 Congratulations!! Enjoy your new career! *** SLMR 2.1a I may not always be perfect, but I'm always me. --- TriToss (tm) Professional 10.0 - #189 * Origin: TMK BBS - 509.886.7607 - mystique@nwinternet.com (1:344/115.0) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DAT00002 Date: 06/21/96 From: TIM TAMBURRINO Time: 09:10am \/To: GEORGE VAISEY (Read 1 times) Subj: Any Tips? GV>I actually did it quite well. Have the written on the 20th. Good Job and good luck with the written, As usual I feel that I may have screwed it up again (never have but sure feels like it this time) Cya TT --- * QMPro 1.53 * "Energize!" said Picard and the pink bunny appeared... * Origin: LD50 Wildcat! PX OS/2 (314)-364-9511 Rolla, MO (1:14/611) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DAT00003 Date: 06/21/96 From: BLAKE BOWERS Time: 11:08am \/To: JOHN SIMMONS (Read 1 times) Subj: Emt Done 11:08:1706/21/96 JS> you are and what you're doing. Next time, go for the gold standard. I JS> am. Please don't insult the many EMT's in states such as TN, where the state standards are much tougher than NREMT. Just because some states have standards lower than NR, does not mean that NR is the gold standard. Maybe the overall baseline, but by no means the gold standard. Many states do not recognize NREMT, or require additional training and testing before they do. ... --- PPoint 1.98 * Origin: KD4RME, The POINT of it all.... (1:284/99.10) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DAU00000 Date: 06/21/96 From: JANIS WETHERBEE Time: 08:26pm \/To: TOM WALL (Read 1 times) Subj: Mail Consider yourself answered! Enjoy and keep cool.... From SUNNY and HOT Lake Havasu City Arizona Janis Wetherbee --- WM v3.10/94-0099 * Origin: EZ Boarding BBS! (602) 680-3429 (1:3001/1) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DAU00001 Date: 06/23/96 From: GEORGE VAISEY Time: 04:03pm \/To: JOHN SIMMONS (Read 1 times) Subj: Emt Done > Down here in Arizona, you are required to be EMT certified through the > junior college system BEFORE ever hiring on to a fire department now. > Too many wannabes out there. The course in 1986 used to cost $95 > including malpractice insurance. Today, the same course is $245 plus > another $225 for malpractice, AND you have to present PROOF of MMR > vaccinations/DPT shots/Tetanus boosters/polio vaccine, and NOW the HEP B > vaccinations at OUR own cost. When something can't be proved, then you > have to have bloodwork to show that you have antigen positives to > measles, mumps, rubela, rubeola, polio, diptheria, tetanus, chicken pox, > and hepatitis B. All that can amount to a few hundred dollars more. The > Hep B series is $195 alone. Back then, no health insurance paid > for Hep B unless you are in a profession that requires it. My HMO gave > me mine because they operate on a different premise - an ounce of > prevention is worth a pound of cure and of course, *state law* mandated > it. Today, Hep B vaccine is to be included in the standard course for > babies because of diapers, etc. It is the same way here. It used to be a 1% bonus if you had CFR and 2% if you were an EMT-D. Now that we have gone to one person around the clock EMT-D is REQUIRED for paid staff. The vollunteers get everything paid for (EMT-D, physicals, shots, etc.). As to everything else I think that is cool & I do plan on going on for my Critica Care Technician. Thanks for the feed back and info. George Vaisey Firefighter / EMT Lake Shore Fire Department --- GEcho v1.2 / FD 2.12 * Origin: The Fire House (Rochester, New York * USA) (1:2613/353)