Do you know about - First Responders, EMTs, and Paramedics Are Not Just "Ambulance Drivers"
Vagal Afib! Again, for I know. Ready to share new things that are useful. You and your friends.A number of years back I decided to become a Firefighter. First off, I thought that it would be a good idea to consult with my friends that were already in the field. A good friend of mine told me that in order to make yourself a better candidate for hire, I needed to become a Paramedic, but even before that, I must first become an EMT. I thought it was going to be a breeze, but after my first day of class, I realized that maybe I bit off more than I can chew, and that Firefighters knew a lot more than I originally thought. You see, I was just like you, a member of the general public that thought that the people inside the ambulance were in fact just the "drivers," it turns out that this could not be further than the truth.
What I said. It is not outcome that the real about Vagal Afib. You see this article for facts about an individual need to know is Vagal Afib.How is First Responders, EMTs, and Paramedics Are Not Just "Ambulance Drivers"
We had a good read. For the benefit of yourself. Be sure to read to the end. I want you to get good knowledge from Vagal Afib.First Responders, EMTs, Paramedics and other EMS personel are highly trained professionals that take great pride in being the first line of defense in the treatment of your loved ones. This specialized group of people can be found anywhere in the field or the hospital. One thing for sure, is that if you have ever had chest pain, shortness of breath, or have found yourself trapped in a burning car you will quickly see that these people are not just licensed to drive, but are quick on their feet, highly trained, specialized personal.
So, what do EMS personal know? There are many levels to the knowledge base of the workers that represent those in EMS and each have their own personal expertise. It is often difficult to determine who is who when 911 is called, but "typically" the Paramedic is the highest level of "pre-hospital" medical care you can receive in the field. Paramedics have the ability to administer a multitude of drugs that can help even the most desperate of victims. Paramedics have specialized skills and treatments that they are authorized to administer to patients that include, but are not limited to the following:
Various Advanced life support medications that vary per region
PROCEDURES AND SKILLS
RSI (RAPID SEQUENCE INTUBATION)
External Jugular Vein Access
Transcutaneous Cardiac Pacing
Oral Endotracheal Intubation
Oral Endotracheal Intubation
Synchronized Cardioversion
Insertion of Nasogastric/Orogastric Tube
Needle Thoracostomy
Intraosseous Infusion
Nasotracheal Intubation
Needle Cricothyrotomy
Vagal Maneuvers
Axial Spinal Stabilization
Pulse Oximetry
Esophageal Tracheal Airway Device (ETAD)
MEDICAL EMERGENCIES
Adult Respiratory Emergencies
Shock (Non-Traumatic)
Altered Level of Consciousness/Seizures
Poisonings (ALS)
Adult Airway Obstruction
Heat Related Emergencies
Cold Related Emergencies
Poisonings (BLS)
CARDIAC EMERGENCIES - ADULT
Suspected Acute
Adult Tachycardias
Non-Traumatic Hypertensive Crisis
Adult Bradycardia
Adult Cardiac Arrest
12 Lead Electrocardiography
Automatic External Defibrillation AED
PEDIATRIC EMERGENCIES
Pediatric Cardiac Arrest (1 Day to 14 years of Age)
Pediatric Altered Level of Consciousness
Pediatric Respiratory Emergencies
Pediatric Seizure
Pediatric Allergic Reaction
Pediatric Airway Obstruction
TRAUMA
Trauma Triage Criteria & Destination
Adult Trauma
Pediatric Trauma
Glasgow Coma Scale Operational Definition
Fractures and Dislocations
BURN
Burn Criteria & Destination
Adult Burns
Pediatric Burns
OBSTETRICAL/NEONATAL EMERGENCIES
Newborn Care
Obstetrical Emergencies
MCI/HAZMAT
Medical Response to a Multi-Casualty Incident
Medical Response to a Haz-Mat Incident
TRANSFER OF PATIENTS
EMT-P Inter-facility Transport Guidelines
Inter-facility Transport - Nurse Staffed Units
Transport of Patients
Cardiovascular "Stemi" Receiving Centers
POLICIES AND PROCEDURES
Physician on Scene
Suspected Sudden Infant Death Syndrome Incident
Responsibility for Patient Management
Reporting Incidents of Suspected Abuse/Neglect
Patient Refusal of Care or Other Patient Request
Guidelines for Adult Refusal of Care
Determination of Death on Scene
Withholding Resuscitative Measures
POLST Form
EMSA DNR Form
Do Not Resuscitate (DNR)
A Paramedic operates under the license of the Medical Director. The Medical Director is a licensed doctor in that Paramedic state, city, or county. Paramedics have a limited scope of practice that is referenced in their Protocols. Protocols are basically the foundation to the treatment the Paramedic operates within. Paramedics operate under the strict guidelines of these rules set forth by medical direction. Protocols can vary across the United States. Some Paramedics have more protocols than others, and have the ability to operate autonomously within these protocols. Typically Paramedics that are in rural areas have more ability to perform more skills and give more medications than their counterparts in the "big city", because medical care is so far away and time in a true medical emergency is of the essence.
So do you still think that EMS personal are just drivers? Let's review just ONE drug that almost all Paramedics are familiar with and use in the field. Keep in mind that this is just one of about 30 drugs Paramedics are able to use in an area located in San Bernardino California's (ICEMA Region). Paramedics are required to recognize when this drug is indicated and not indicated. The drug used below has the capability to save or kill someone under it's use, and is measured by micro grams, per kilogram, per minute, coupled with the desired effects on the a given patient.
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Advanced Life Support Medication
DOPAMINE - Sympathetic agonist - A naturally occurring catecholamine and a chemical precursor of
norepinephrine. It acts on alpha-receptors, is dose dependent, and causes peripheral vasoconstriction. The effect on beta 1 receptors causes a positive inotropic effect on the heart, without increasing myocardial oxygen demand as much as Epinephrine. Dopamine maintains renal and mesenteric blood flow, when used in lower therapeutic doses. Used in patients with significant hypertension, when fluid replacement is unsuccessful.
Side Effects: Increased heart rate. Can worsen or induce both narrow complex and wide complex arrhythmias.
Deactivated by alkaline solutions such as Sodium Bicarbonate. May cause hypotension in patients taking Dilantin.
Infiltration of IV will cause localized tissue necrosis. Notify receiving facility if IV infiltrates. Do not give via IO.
Typical Preparations: 200mg/5ml: Ampule or Vial and premixed IV solution.
Dose:
Adult: 5-20mcg/kg/min. For the average adult 400mg of Dopamine in 250ml D5W at a rate of 30-
60 microdrops/minute provides this dose range. Titrate to blood pressure and other signs of
perfusion.
Pediatric: Contraindicated in children under 8 years of age within the ICEMA region.
This concludes our review of the ALS (Advanced Life Support) medication Dopamine.
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Sounds easy enough right? Most cab drivers, truck drivers, and airport shuttle drivers know about these things, so why not just call them the "ambulance driver" too? So as you can see, there is just a tad bit more to the ambulance driver than you originally thought. Am I right?
Most people respect and are somewhat familiar with the vast knowledge and extraordinary services nurses provide, but on the other hand have limited knowledge of what the capabilities of EMS are. Many times, I have been asked by nurses in the field if Paramedics are allowed to perform even the simplest of skills such as start an IV. Sometimes, these remarks are said with "tongue in cheek" because of the sometimes "ugly" workplace rivalry between Paramedics and Nurses. Did you know that most Paramedics have the ability to perform more advanced skills than that of their counterparts the nurses? In many states, counties, and cities Paramedics do not require the doctors advanced orders before performing life saving measures or to administer advanced life support medications. Paramedics are allowed to make split second decisions based on their patient's signs and symptoms. The ability to work within their protocols allows the medics to change procedures and medications as the patient's condition improves or worsens. Nurses are required to follow the orders of their doctor before most medications are administered. Another distinctive difference between Paramedics and Nurses is that there are certain skills that may only be performed by Paramedics and Doctors trained to do so. So, Are Paramedics better than Nurses? No, of course not! They are two completely different medical service providers. Paramedics and Nurses both have their limitations. Paramedics, EMTs, and EMS personal are again, specialized personal that are trained to perform specialized work.
So how does one become a Paramedic you ask? The requirements to become a Paramedic vary between states. In most states you must first become an EMT and acquire at least one year of field experience prior to applying to Paramedic school. The next step into getting into Paramedic school is to pass a college proficiency exam, a Paramedic academy entrance exam, oral exam, background check, medical examination, and have the necessary prerequisites to enter the Paramedic academy that can include anatomy, physiology, or medical terminology. The entire academic process can take approximately two years or more. (Depending on the program, prerequisites ETC) Many Paramedic Academy's take one year to complete. Paramedic training is some of the toughest academic training around. Students must maintain a score of at least 80 percent to pass throughout their entire class time or are subjected to dismissal from the academy. Many will have to attempted to pass the Paramedic Academy several times before graduating. Once the academy is completed, students will have to pass a national registry examination, state examination, and finally a local examination. The fees, regulations, and form filling are endless (Especially in "anti-business friendly" California). EMS personal are required to keep their certifications, licenses updated and current by attending skills and continuous education classes. After the completion of mandated training hours, EMS personal must submit completed training certificates noting the minimum skills training hours, academic review have been met, and of course..pay the necessary fees in order to maintain their accreditation or license requirements.
I hope that this article has given you a greater understanding of capabilities of the "ambulance driver" and to know that this term is considered to be little insulting by some in the EMS field. So, the next time your loved one finds themselves at the mercy of the 911 system, you can feel a sense of relief knowing that a "cab driver" is not on the way, but an "ambulance driver" is.
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