I know that the title of this article might be a bit alarmist but I have to speak up about some alarming trends I am seeing in EMS across the country. As other healthcare workers in the private sector make more and more money, we seem to have to get by on less and less. With most of us working multiple jobs in EMS just to survive, it doesn’t make much sense for us to continue.

I’m almost finished nursing school. Why? Because I couldn’t find a flexible schedule EMS job in my area that would just let me work nights and weekends on a PRN basis. Everything was shift work or didn’t offer any kind of regular shift. I looked at my skills and then looked at what I was getting paid for them and I couldn’t justify staying in that field, at least as a primary job.

1. Nurses work inside, out of the weather.
2. They get paid twice as much (or more) than a paramedic.
3. Nurses also seem to get a whole lot more respect in the medical community than EMS providers.
4. (I could keep going but you get the picture)

It was a no-brainer. I can still operate as a volunteer provider in my community and do what I love but I have to go where I’ll be most appreciated, right? But that’s just me. The rest of the providers will stick around. Then I got this email from a good friend and contributor to the show, Chris Black:

Hey man,

I don’t know how things will go in the next few weeks/months, but I’m seriously concidering leaving EMS. I’ve been with the same hospital for 10 years now and earn only $13.74/hr. We just found out that even though the hospital is WAY in the black we will only get a 3% raise this year and that our prescription drug benefits are to be cut dramatically.

I’ve seen and done things in the past 17 years that noone should ever have to see or do. A couple of years ago I had to actually use a pickaxe to remove a man’s lower extremities from a railroad crossing(body part recovery). I have scraped up multiple brains and put them into ziploc bags. I have done this all for pennies and all the while had to work a second or even third job and loose spending time with my wife and kids.

I may have the oppurtunity to work for the local phone company either installing phones or network systems at a starting pay of $23/hr. It is shameful that as a paramedic I can’t come close to what I can as a telephone man. What’s more is that with the phone company my insurance will be paid in full by the company and I will work 8-4 weekdays only. EMS is going to have to change in America or is is going to DIE!

Get ready for a rant!

If people like Chris and other experienced providers leave the EMS field for greener pastures simply because the system won’t pay us a living wage, then we are headed back to the days of the scoop and run hearse ambulance.

The American health care system is broken and there is a lot of talk about how to fix it. Nowhere in any proposal I’ve seen or heard about, has there been any mention of the abysmal wages paid to our professional rescuers on the street. We need to keep this issue on the table in any public health discussion. Our government has no problem spending hundreds of billions of dollars each year protecting the interests of oil companies — why can’t they take that money and spend it on the health care and services needed here at home!

What do you think? Post a comment below — or better yet

Head over to forums.mediccast.com and sign up for the new MedicCast forums!

Jamie, the Podmedic

blubrry.com

Are you ready to spy for the Department of Homeland Security?  Well they think you are.  A recent news item I found talks about a new program for training firefighters and EMS providers to look for specific danger items in an effort to head off terrorists in their homes.  Isn’t this a betrayal of the trust the public puts in us when they call us to their homes (as well as being a warrantless search).
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I report on this and other EMS news in the most recent episode of the MedicCast News at the Podcaster News Network.

Jamie

the Podmedic

I talked about the handling of patients who have attempted suicide on this week’s show. Here’s an article that adds a risk group to the list. The study cited in this article states that reports on increased mental illness rates for returning Iraq War veterans around 3 to 6 months after their return home.

Add this to your history taking when transporting a suicide attempt patient.

Are you a veteran?

When did you return home?

Review signs and symptoms of Post Traumatic Stress Disorder (PTSD). I covered this as a Tip of the Week in Episode 83 of the MedicCast. Check out the show and the links in the shownotes for more information.

According to this recent study of 88,200 soldiers, these patients may also be at increased risk for alcohol or substance abuse problems and interpersonal conflicts with the people around them. Keep this in mind when dealing with this difficult issue in the field.

I have been asked by many listeners to add a forum page to the MedicCast site. The work involved has been prohibitive up to this point — finding the right software, creating a MedicCast template for the site, managing forum spam, and just the work of overseeing the posts themselves in order to provide the quality that I know this community demands — all have kept me from setting up forums to date.

Now I have found an option — a social community site that will allow me to manage the forums — look, content, and access — without taking too much time away from those things with which I already am already over-extended. Visit forums.mediccast.com and sign up as a member of the Ning community with the MedicCast network there.

You can even add a badge to your own site, MySpace, or Facebook page like the one below.

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These forums are yours to use and support. Forums won’t work unless you post to them and reply to other’s questions and comments when you have something to say. You can use them to suggest story and topic ideas for the MedicCast podcast or the MedicCast Live show. You can also share tips and tricks with each other there. Try it out and see for yourself!

Welcome to Episode 94

The MedicCast is a proud member of the Blubrry Podcast Network.

Right Click here to download (Macs Ctrl Click)

Subscribe with iTunes here!

A podcast for EMT’s, Paramedics, and other medical providers of all kinds.

Fill out the New Survey!

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Code BLU27 gets you 10% off your order at checkout
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Try them out and get your piece of the internet at GoDaddy.com!

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Link of the Week: Pediacast interview with vaccine book author

Buy The Vaccine Book at Amazon

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News:

Preemie Brought Back to Life

Paramedic Shortage Addressed

Maryland EMS Doctor Recognized

Japanese EMS Triage System Troubles

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Tip/Trick of the Week — Dealing with Suicidal Patients

NIMH on Suicide and Prevention

Is Suicide Contagious?

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Med of the Week — Insulin

FDA on Insulin and Diabetes

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Visit the MedicCast Forums

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Thanks for Supporting the MedicCast!

Rate the podcast at iTunes or at EMS Village or Vote at Podcast Alley

Visit the MedicCast Store!

Get the New MedicCast Newsletter — Sign up now — it’s free!

Other Podcasts: MedicCast News, MedicCast Live, and Headliner News Roundup

Contact Me!
Call the Voice Mail Line — (941) 306-3342

send me a note at podmedic@mac.com

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Podsafe Holiday Music by Jill Parr from the Podsafe Music Network

Do You Hear What I Hear?

Click here to get Songs from the MedicCast at the iTunes Store.

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Until next time, Scene safety, BSI!




This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.

Trauma Patients, Trauma Patients!  Some we end up taking to local hospitals when they should have gone to the trauma center.  Some we take to the trauma center and they walk out in a few hours with no problems.

How do we make a decisions about that “suspected GI bleed” when we can’t see inside the abdomen?  Seimens Medical Solutions has come up with a solution that we may see in the field sometime in the near future.  It is a cell phone sized ultrasound device with a flip up screen.  You can use it to look for fluid in the abdominal space and help make a decision about transport.

The best part is that the pictures are digital so they can be transmitted to the hospital remotely during consult, or uploaded to the hospital upon arrival for comparison with subsequent imaging. This is just one of the devices I see showing up in our units to assist with remote diagnosis with medical control.

When will this happen?  Well, I see it being forced into play when the emergency room overcrowding problem reaches a critical mass and field triage becomes more about weeding out the real emergencies from the walking wounded.

Either way, this may assist us in saving time and money for us, the emergency room and trauma centers, and for the patients.

An inspirometer is a device that can be used to measure the inspiratory lung capacity in respiratory patients when charted over time.

You’ve all seen one before in hospitals. It’s that plastic device that has a flexible tube with a piston in a vertical cylinder with marked measurements on the side. The patient exhales first and then SLOWLY inhales, trying to maintain a constant draw on the tube, raising the piston in the cylinder.

COPD and Asthma patients know their normal values on this device. When those values start to decrease as they will during an acute episode, then further treatment is indicated.

An article over at MedicineNet looks at new guidelines for treating patients with stable COPD how have an acute onset of respiratory distress. One of the guidelines looks at changes in baseline inspirometer values.

Familiarize yourself with this test and you may be able to predict in the field what kind of episode you are looking at.

Sometimes we get called to patients who have experienced a trans-ichemic attack (TIA) or mini-stroke that resolves on its own prior to our arrival. Do you let this patient refuse so you can get back to your favorite episode of COPS or do you convince them to take a ride to the hospital just to get checked out?

A recent study I found at reported on at MedicineNet should convince you that this patient needs to be seen right away. This study was a review of previous study findings to look at commonalities in their findings on TIA and subsequent stroke risks. What these British researchers found was that 1 in 20 people who have suffered TIAs will go on to have a full stroke within the next week!

Don’t let these at risk patients slip through the cracks. If you can’t convince them to go with you to the ER at the time of the call, at least get a promise from them that they will call their primary care physician and report the incident right away.

The study also shows that people who do seek immediate treatment have an 80% chance of avoiding the follow-up stroke that might ordinarily occur.

Jamie Davis, the Podmedic

It’s the cold and flu season right now in the U.S.  But what exactly does that mean?  If you have questions about the common cold, you are not alone.

I found an article over at WebMD which offers 10 facts you may not have known about the common cold.  They are all pretty interesting and informative and I think might make a good link for you to send out to friends and co-workers to combat common misconceptions that are out there.

Here’s a sample fact from the list:

1. What is the difference between a cold and the flu?

Although the flu and the common cold are both respiratory illnesses, they are caused by different viruses. Because they have similar symptoms, it can be difficult to tell them apart. But generally cold symptoms are much milder than flu.

Common cold symptoms include:

• Sore throat
• Stuffy nose
• Runny nose
• Cough
• Mild fever

The flu, on the other hand, often causes higher fever, chills, body ache, and fatigue.

Check out the other facts in this article.  Remember people, knowledge is power!

Jamie, the Podmedic

The next time someone tells you that vaccines are part of a government plot — agree with them! Tell them it is a plot — to keep everyone healthy.

The CDC has released figures on contagious diseases for which we have vaccines and the changes in the number of occurrences speak for themselves. This is according to a press release I found over at WebMD.

Check out the numbers:

• A 92% drop in cases and 99% or greater drop in deaths for diphtheria, mumps, pertussis (whooping cough), and tetanus, compared to pre-vaccination days.
• Smallpox has been eliminated worldwide.
• Polio has been eliminated in the U.S.
• Invasive Haemophius influenzae type b (Hib): cases down nearly 100%
• Hepatitis A: cases down 87%
• Hepatitis B: cases down 80%
• Invasive pneumococcal disease: cases down 34%
• Varicella (chickenpox): cases down 85%

These numbers represent the cases in 2006 versus times prior to the use of the respective vaccines for those diseases.  It is an impressive report no matter what you think about vaccines and there are a great many of us here today who might have died as children from one of these diseases.  Think about it and educate yourselves.

If you want more info on vaccines, check out a book recently published called The Vaccine Book.

Buy The Vaccine Book at Amazon

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