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.
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.
-- 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.
-- 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.
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.
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.
-- 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.
-- 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.