I did one of these about 6 months ago. I’m really bored at work and I thought maybe you guys could give me something to do 
I’ve been a paramedic for over 5 years now, and I’ve been a supervisor and field trainer at various points. I currently work for the Denver Health Paramedic Division, and I started there after I did the last thread. I got to go through a whole new field training process and worked during the Democratic National Convention.
I’m happy to answer any questions you’ve got!
My question: where are all the questions?
Bump.
How about a good war story about an awkward moment?
My favorite so far is the one about clinical training in the ER. I was sent to get a 12 lead EKG on a woman with chest pain, and she was very proud of and eager to show off her surgically reduced breasts. I’ll admit the doc did a nice job, but the situation was way too weird to enjoy the scenery.
One other time, my partner told a pregnant teenager in premature labor that I was gay so she’d let me check for crowning.
Being in Colorado, do you have any day-from-hell-weather-related stories?
The last place I worked covered from the suburbs all the way to the continental divide. During one of the big snow storms about a year ago, I was working an 2000-0800 shift. We got sent on a call up by the divide in the midst of the storm a little before 0700. We got done with work at 1145. That sucked! During the big blizzard in 2006, we spent about 4 days driving around with chains on the ambulance. That’s not fun- it’s like driving a tank. You have to stop to do anything, too. Typically, though, we’re not real busy when it snows hard. I think everybody just stays home.
What do you think is the most important quality in being a Paramedic? I often think my husband would be good at it, he’s big, strong, can tolerate blood and gore and has a very even disposition.
Come on, give us a horror story. You can change the names to protect the innocent. 
What goes through your head on some of the odder situations you find yourself in?
Was Erma Bombeck right? Do you judge people on their panties?
“Never do anything you don’t want to have to explain to the paramedics!” 
It doesn’t snow here (Seattle area) often, but it’s snowed quite a bit this winter. One of the fire department ambulances actually managed to get stuck on our street (with chains). It’s a cul-de-sac on a hill (the end is the low part), so getting out when it’s icy or snowy is a real challenge. There was probably about 8" of snow on the ground at the time. They brought in a 4x4 pickup and tried to tow it out with no success. Finally they got a plow to come out, flatten the snow a bit (they didn’t actually plow down to the pavement) and lay some sand. After that, they just barely got it out. Took about two hours total. I watched most of the time. I was kind of tempted to go get the video camera, but I figured they had enough stress 
(One of the guys did say to me, “we’re going to see this on YouTube tomorrow, right?”). I bet the driver will be getting some crap about that for a long time.
Hello St-Urho,
Thanks for doing this thread. Can you tell me a bit about your training/schooling? I’m a 40yrd old stay-at-home dad. I worked as an engineer & business manager until I decided to go full-time managing my son’s autism therapy 3 years ago. He’s now in regular 1st grade and doing very well, and I’m seriously considering becoming a paramedic when he’s a bit older, in about 5 or 6 years.
How much raw memorizing did you have to do? Was it easy to remember all the protocols and differential diagnoses if you had a good understanding of the underlying processes? Did you have to study a lot of anatomy like med students? What was hardest for you in medic school? Did you do a practicum in an ER?
Up here, from what I understand, it’s a 2 to 3 year course of study to get up to EMT-P. Apparently basic and intermediate EMTs are a dime a dozen, but many can’t hack the academics to become full-fledged paramedics. Is this true in your neck of the woods?
I’m not to worried about the academics (engineering school & the graduate business degree were OK) but all the memorization worries me a little bit. I might take a year to study another language before to get my memory back into shape. I think I could be a good, compassionate paramedic, and believe I would certainly find it more rewarding than driving a computer and arguing about business cases and project timelines.
Do you have any advice for someone contemplating a mid-life switch to your line of work?
Aren’t you just an ambulance driver with a stethoscope?
D&R
Actually I have 2 scope of practice questions.
Oh, c’mon!
Why bullshit around?
Let’s hear your Foreign Objects in Rectum stories! :eek:
Ex-EMT-1 checking in
Good list to start with general maturity is helpful as well as being able to think on your feet. You also have to be a problem solver. All the medical training in the world is worthless when you have to get a 400 pound patient down a tight spiral staircase. Also the ability to forge on even when things are ugly, messy, and unhappy. In 30 minutes it will only be a matter of finishing the paperwork for you, whatever is eating you or pissing you off today is trivial compared to what your patient is going through.
Things school never prepared me for:
The blood and gore you encounter in the biz is orders of magnitude more than any playground cuts and scrapes. Sometimes even I had to take a deep breath or two before diving in looking at the mangled mess of person the fire department was trying to pry the wreckage away from. You will be amazed how much blood one person can hold.
The screaming and hysterical crying, you learn to tune it out, but your first major multi car accident or death at a big family event you are going to want to crawl back into your ambulance and hide.
Realizing that everyone has different levels of coping skills, and you don’t get to change it. It may be just another day for you but to the patients and families, this is often the worst day of their lives.
Many people are long beyond hope before 911 was ever called, accept that you cannot save them all.
Hardest thing I ever did:
Asked an ER doc to let me inform the remaining family that mom and dad didn’t make it (serious car accident). I had gone to highschool with the girl (at the time age 20), she was sitting in an exam room awaiting a cast with her little brother. She had come in on a different ambulance, we had her dad in my ambulance.
Here I sit in my typical second-floor Montreal apartment, atop a flight of the typical narrow, contorted, slippery-when-snowy, sometimes rickety, but always picturesque outdoor stairs for which Montreal is famous.
And it occurred to me that second- and third-story walkups must account for, oh, about two thirds of the ambulance calls they must get in certain neighbourhoods. And for the life of me I can’t figure out how they do it. I can barely get my IKEA purchases in, to say nothing of the movers and my appliances, and that’s not such a big deal if it gets a little dinged.
How do you deal with obstacles like difficult staircases, odd home layouts, hoarders’ troves, and the like?
ETA: Huh, I see drachillix referred to this. So? Tell!
I’m surprised you were able to stop wiping butts long enough to type that…
The training in Canada is somewhat different than in the US. From what I understand, most (if not all) provinces recognize two levels of paramedics- Primary Care Paramedic (PCP) and Advanced Care Paramedic (ACP). The PCP roughly translates to an EMT-I in the US and an ACP to a US paramedic. Both have more education requirements than their average US counterparts. Seeing that you’re in Calgary, I’d start with the Alberta College of Paramedics. Most US programs require you to be an EMT before you go to paramedic school. I don’t know if this is the same in Canada.
Paramedic training in the US varies widely- anywhere from 6 month fast-as-you-can courses to 2 year associates degree programs. I went to a 2-year associates degree program. We did 2 semesters of all classroom work, including 2 5-credit anatomy classes. Then we did a semester with one day per-week in the classroom and our in-hospital clinicals. We also did all of our certifications this semester, including Advanced Cardiac Life Support, Pediatric Advanced Life Support, and Pre-hospital Trauma Life Support. Our last semester was almost all ride time with some test review at the end.
There’s a fair amount of memorization, primarily drug dosages. I didn’t find I had to spend a ton of time memorizing protocols- like you said, if you understand the disease process you’ll generally know what to do. The National Registry requires 1 year of college-level anatomy & physiology for paramedics.
Most paramedic programs that I’m familiar with do clinical time in the ER, ICU, and OR (primarily for intubations). In addition, most require a minimum of 500 hours of ride time.
Most of the paramedic programs here have pretty high fail rates, but I couldn’t say exactly why. Around here, there’s a lot of EMT-B programs that churn out lots of graduates. There’s comparatively fewer paramedics. In fact, there’s generally paramedic shortages.
I would encourage you to do it! I know a few people who have come to EMS as second, or even third, careers and enjoyed it. In fact, I’ve found them to be some of the more pleasant people to work with as well.
I’m having a hard time coming up with a single most important trait. There’s a lot of different ways to approach the job. I’d say the two most important things are being able to think on your feet and put up with a lot of crap.
I’m not big on horror stories, but I’ll come up with something for you when I’m less tired…
Usually, “Wait, what?” “Did you see that, too?” and “How come I always get these calls?”
I notice you are dodging the Erma Bombeck question…I KNEW she was right!
We still have it in our scope of practice/protocols. We are, however, discussing how we should handle these patients. According to our medical director, each of our medics averages a pediatric intubation once every 5 years - and this is a busy, urban system. Clearly this isn’t enough to stay proficient. In addition, there’s research on the subject that shows no measurable difference in ABGs between intubated and non-intubated pediatric patients. Also, the calls where pediatric patients were intubated had much longer scene times.
It sounds like we’re leaning towards option C- King Airways. More airway control than no tube and really fast and easy to use.
As far as agreeing, it’s hard to argue with the numbers, but it would be interesting to see if we could change some of that with something like the GlideScope, which makes intubation much easier.
We don’t do this anymore, it’s been out of the protocols for about 5 years, now. Our primary route is IM, since it provides significantly faster absorption than SQ and works better on patients who are shunting away from the skin. We also have protocols for IV epi, both bolus and drip, for patients who are truly in anaphylactic shock.
I cut that out by accident. I usually don’t even notice unless there’s something weird about it…
