Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 Where's your evidence, Jim? Put up or shut up. And- now! Bob Kellow wrote: > >That's called " anecdotal " and " ill-defined " . It has no basis in emergency > >medicine. > > > >Bob Kellow > > Then we might as well stop doing almost everything we do each day in > emergency medicine Mr. Kellpw because EMS is an extremely undefined > science and there remains little literature to support what we do or > don't do. > > Ok systems stop. > > Jim< > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 We (LifeNet, Texarkana) use 9 hour, 11 hour, 12 hour and a couple of 24 hour trucks. Mostly 12 hour trucks, it seems to work good for us. Re: SSM SSM with shorter shifts like 8 or 10 hours might be easier on the troops. Does anybody know of any systems that employ 8 or 10 hour shifts in their SSM trucks? Gene Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 That is the purpose of meta-analyses. To look at outcomes across different variables and systems. Some people don't wamt to investigate because they don't really want to know the answers. BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: SSM >BEB, > >I noticed that you have a thing for numbers and research... > >My question is --- > >#1 - Since San Diego ended its study of RSI, should we consider that RSI is >something NOT needed in pre-hospital care? > >#2 - Since Houston concluded their study on MAST, should we remove them from >ALL units nationally? > >#3 - Since LA/Orange Counties concluded their joint study, should we no >longer intubate pediatrics? Another major problem with implying the conclusions from any of that research is the vast differences in EMS systems. Paramedic's are not trained the same and the systems are vastly different. Because of this it makes it very hard to use the conclusions from one city and implement them in another area. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 Here at CareFlite in Dallas, we use 8 hour, 10 hour, 12 hour and 16 hour trucks. We also have a High impact Truck that is scheduled for 8 hours but goes home after 6 calls and gets paid for 8. The crews love this truck. Ruhnke, NR/CCEMT-P Field Training Officer jruhnke@... Re: SSM SSM with shorter shifts like 8 or 10 hours might be easier on the troops. Does anybody know of any systems that employ 8 or 10 hour shifts in their SSM trucks? Gene Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 In the overall scheme of things, paramedics are educated about the same. After all there is the National Standard Curriculum that all of the textbooks and EMS educational programs are based with its usage tied to the states receiving federal highway funds. All paramedic programs teach the same basic skills. The higher end programs teach less frequently used skills and more theorey. However, as these skills are infrequently used, the day to day performance of a graduate from a high end program is very akin to that from a low end program. In terms of systems, they involve at least two people, an ambulance, dispatch, travel to the scene, scene time and care, transport to the hospital, and return to service. There is little difference between the way Houston FD and Austin EMS accomplishes this. They have differences (civil service, staffing, first response, etc.). But, when you look at the meat of the matter, most services are similar and similar parameters are measured. The rest is fluff. Heck, the OPALS study may show that all ALS is a waste of time (except airway control). That will further equalize any differences. Saying well we are different is an example of pseudoscience. EMS is different that barbering, but FD and private EMS are much more alike than they are different (I have been on both sides of this coin). BB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: SSM >BEB, > >I noticed that you have a thing for numbers and research... > >My question is --- > >#1 - Since San Diego ended its study of RSI, should we consider that RSI is >something NOT needed in pre-hospital care? > >#2 - Since Houston concluded their study on MAST, should we remove them from >ALL units nationally? > >#3 - Since LA/Orange Counties concluded their joint study, should we no >longer intubate pediatrics? Another major problem with implying the conclusions from any of that research is the vast differences in EMS systems. Paramedic's are not trained the same and the systems are vastly different. Because of this it makes it very hard to use the conclusions from one city and implement them in another area. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 Let's not start a debate on the PEPP class, this is one of the most useless classes I have ever attended as an experienced medic. Bring back the PALS course. I know they developed PEPP up in Colorado, Wyoming area and it should be sent back there. Re: SSM > > > BEB, > > I noticed that you have a thing for numbers and research... > > My question is --- > > #1 - Since San Diego ended its study of RSI, should we consider that RSI is > something NOT needed in pre-hospital care? > > #2 - Since Houston concluded their study on MAST, should we remove them from > ALL units nationally? > > #3 - Since LA/Orange Counties concluded their joint study, should we no > longer intubate pediatrics? > > OR should we just consider that those agencies decided that it was NOT for > them? > > What was so bad about your SSM experience because I had no problem with mine. > I loved the fact that I had a chance to work with some of the best guys in > Southern California [Anaheim FD, Orange County Fire Authority, Orange FD, > Buena Park FD - back then, and LA County FD] and would not trade that > experience for anything. I am sorry that I had a chance to work for a company > that cared for employees and could make a dollar doing it. > > Yes, I will agree with you that there are some companies with less than > acceptable operational practices, using both SSM and station placement. In > Southern California, SSM is a GREAT concept due to the lack of real estate, > and uncertainty of getting the right location for a station. But you also > have to take care of your employees and they did that with us. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 Dr. B, Why are you dragging CentTexMedic1970 employer into this discussion? Nowhere has he brought up what WCEMS procedures are. He was discussing how things operate in California, who he works for right now was not part of this discussion. For his part, he purposely changed the way he post on here to not bring attention to who he is employed with currently. How about we discuss the issues without dragging unnecessary baggage into the arena. Most of us DO NOT represent our employers out here, we are here of our own free will with our very own opinions. ok I'm done, for the record and since we were pulled into the discussion WCEMS does more of a move-up more then a true SSM. We have stations and move crews after an area has been depleted. It is done 24 hours a day (our customers expect quick responses regardless of the time of day). We only post on corners whent he system is depleted of over 1/2 the trucks. Otherwise crews just relocate to another station in order to provide better coverage and quick response times. take care.. Re: SSM > > > Basic EMTs don't make base hospital contact *smile* > > That is the great thing about being BLS-unit [with MICU capabilities] in LA, > you can stop at ANY hospital ED without Paramedics on-board. Where P-EMTs can > ONLY transport to paramedic receiving EDs and generally the one that is > assigned by MICN [usually the closest & open if no specialty is needed]. > > C'mon, been there and done that. May not work for everyone, but it is the > system that is there. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 I think you have a great point!! The education departments of the various systems should be including this info and NEW info during CE classes. Re: SSM > > > > > > BEB, > > > > I noticed that you have a thing for numbers and research... > > > > My question is --- > > > > #1 - Since San Diego ended its study of RSI, should we consider that RSI > is > > something NOT needed in pre-hospital care? > > > > #2 - Since Houston concluded their study on MAST, should we remove them > from > > ALL units nationally? > > > > #3 - Since LA/Orange Counties concluded their joint study, should we no > > longer intubate pediatrics? > > > > OR should we just consider that those agencies decided that it was NOT > for > > them? > > > > What was so bad about your SSM experience because I had no problem with > mine. > > I loved the fact that I had a chance to work with some of the best guys > in > > Southern California [Anaheim FD, Orange County Fire Authority, Orange > FD, > > Buena Park FD - back then, and LA County FD] and would not trade that > > experience for anything. I am sorry that I had a chance to work for a > company > > that cared for employees and could make a dollar doing it. > > > > Yes, I will agree with you that there are some companies with less than > > acceptable operational practices, using both SSM and station placement. > In > > Southern California, SSM is a GREAT concept due to the lack of real > estate, > > and uncertainty of getting the right location for a station. But you > also > > have to take care of your employees and they did that with us. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 We should do away with the Merit Badge courses altogether. If you are a LP or REMT-P, why should you take a course where the material was already addressed in your initial education. Courses like SLAM, that bring new techniques, are a different matter. BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: SSM > > > BEB, > > I noticed that you have a thing for numbers and research... > > My question is --- > > #1 - Since San Diego ended its study of RSI, should we consider that RSI is > something NOT needed in pre-hospital care? > > #2 - Since Houston concluded their study on MAST, should we remove them from > ALL units nationally? > > #3 - Since LA/Orange Counties concluded their joint study, should we no > longer intubate pediatrics? > > OR should we just consider that those agencies decided that it was NOT for > them? > > What was so bad about your SSM experience because I had no problem with mine. > I loved the fact that I had a chance to work with some of the best guys in > Southern California [Anaheim FD, Orange County Fire Authority, Orange FD, > Buena Park FD - back then, and LA County FD] and would not trade that > experience for anything. I am sorry that I had a chance to work for a company > that cared for employees and could make a dollar doing it. > > Yes, I will agree with you that there are some companies with less than > acceptable operational practices, using both SSM and station placement. In > Southern California, SSM is a GREAT concept due to the lack of real estate, > and uncertainty of getting the right location for a station. But you also > have to take care of your employees and they did that with us. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 It was a joke. BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: SSM > > > Basic EMTs don't make base hospital contact *smile* > > That is the great thing about being BLS-unit [with MICU capabilities] in LA, > you can stop at ANY hospital ED without Paramedics on-board. Where P-EMTs can > ONLY transport to paramedic receiving EDs and generally the one that is > assigned by MICN [usually the closest & open if no specialty is needed]. > > C'mon, been there and done that. May not work for everyone, but it is the > system that is there. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 Got it.... Re: SSM > > > > > > Basic EMTs don't make base hospital contact *smile* > > > > That is the great thing about being BLS-unit [with MICU capabilities] in > LA, > > you can stop at ANY hospital ED without Paramedics on-board. Where > P-EMTs can > > ONLY transport to paramedic receiving EDs and generally the one that is > > assigned by MICN [usually the closest & open if no specialty is needed]. > > > > C'mon, been there and done that. May not work for everyone, but it is > the > > system that is there. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 Well said Bob. The one thing you might have added to your first paragraph is the reason (although it's obvious) for that minimum staff/unit outlay under the SSM " model " . Jack Stout is a bottom line economist whose EMS philosophy appeals to the bigwigs, board members and stockholders of large private providers. It's all about 15% profit margins and ridiculously low bids for service; it's damn sure not about giving EMS street personnel a sense of home, humanity and belonging. Jay Garner SSM > Welcome back Gene. > > SSM is used as a tool to optimize staffing and vehicle deployment as a means to > ensure the most efficient service possible. Unlike the fire service, most SSM > operated services attempt to deploy the fewest number of personnel and vehicles > as possible, while staying within the stipulated response time requirement(s). > Software is used to establish demand and location patterns, which theoretically > over time (sample size) increases the reliability of predicting same. That's my > rendition of the official version. > > In human terms, I believe SSM has no basis to exist. Status plans can be > constructed so " tight " that an enormous burden is placed on the workforce. This > is best determined by the frequency of post moves because theoretically an > entire fleet could be re-posted to new locations for a single call. It's bad > enough to have to sit like a trollop at a 7-11 while sprouting hemorrhoids, and > it's another thing all together to be re-posted many times in a single shift. > The worst example that I can think of was 12 post moves in 8 hours without > running a single call (Portland, OR). > > To my knowledge, no one has ever attempted to establish whether SSM has made a > difference in morbidity or mortality. It has never been " sold " as medical tool. > Neither has anyone ever investigated the toll it takes on the field personnel in > terms of worker fatigue, traffic risks, obesity, medication errors, psychiatric > disorders, domestic or marital issues, attrition, absenteeism, illness, etc. If > there was any evidence that SSM improved outcomes then everyone would do it, or > it would be required by statute or rule. > > Like many things in EMS, SSM has become institutionalized. It has its own legion > of card carrying SSM planners and managers, training programs and certification > - which makes some people a lot of money. It has also turned many into SSM > handmaidens, who serve to perpetuate its myths of indispensability and " high > performance " . > > The last thing that I want when I keel over is a crew that is worn out, hungry, > disillusioned and pissed off because they have been jerked through the SSM " key > hole " . I would prefer that they had to interrupt their nap, meal or TV program > when they come to my assistance, rather than from inhaling 12 hours worth of > diesel fumes and sitting on a doughnut, while eating micro waved burrito's and > drinking Mountain Dew. > > Bob Kellow > > wegandy1938@... wrote: > > > First of all, I'm BACK! Thanks to Jay Hoskins who, guru that he is, was > > finally able to thwart the idiots at Yahoo and figure out how to get me back > > on the list after being unceremoniously kicked off never, I thought, to > > return. So abandon all hope, ye Yahoo Dwellers: The Gandy Factor Returns. > > > > Now, on the subject of unit deployment, otherwise known as posting. Can > > ANYBODY tell me of any scientific study done anywhere, anytime, by anybody, > > which shows any advantage to so-called system status management deployment > > over fixed base deployment? Other than the musings of Jack Stout and the > > Stoutians? > > > > If moving trucks about were the definitive answer, why wouldn't fire > > departments have their apparatus rove the streets, parking in cafeteria > > parking lots, 7-11 lots and street corners? > > > > If roving units were the answer, why is it that fire departments almost > > always beat the cops to a scene? Why is it that we arm fire engines with > > AEDs in order to rapidly defibrillate patients and that they can arrive in 3 > > minutes when the system status managed trucks can barely meet their > > contracted time of 8:59 90% of the time? > > > > Why, oh why? > > > > Is there REALLY any substance to system status management? > > > > Gene Gandy > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 That is what courses such as PEPP are supposed to be, continuing education. I don't know what specific problems you had with the PEPP course you attended but my guess is that they were probably due to the instruction and not the course itself. As for PALS, the newest course material does include scenerios for EMS but interestingly enough most of the powerpoint lectures for PALS are the same as the ones for PEPP. This is because the AAP have a hand in both courses. People tend to forget that these courses might be beneficial for those providers who went to school prior to this information being put into the NSC. It is also a pretty painless way to get CE if you are in a part of the state that CE is hard to come by. Lee Re: SSM We should do away with the Merit Badge courses altogether. If you are a LP or REMT-P, why should you take a course where the material was already addressed in your initial education. Courses like SLAM, that bring new techniques, are a different matter. BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: SSM > > > BEB, > > I noticed that you have a thing for numbers and research... > > My question is --- > > #1 - Since San Diego ended its study of RSI, should we consider that RSI is > something NOT needed in pre-hospital care? > > #2 - Since Houston concluded their study on MAST, should we remove them from > ALL units nationally? > > #3 - Since LA/Orange Counties concluded their joint study, should we no > longer intubate pediatrics? > > OR should we just consider that those agencies decided that it was NOT for > them? > > What was so bad about your SSM experience because I had no problem with mine. > I loved the fact that I had a chance to work with some of the best guys in > Southern California [Anaheim FD, Orange County Fire Authority, Orange FD, > Buena Park FD - back then, and LA County FD] and would not trade that > experience for anything. I am sorry that I had a chance to work for a company > that cared for employees and could make a dollar doing it. > > Yes, I will agree with you that there are some companies with less than > acceptable operational practices, using both SSM and station placement. In > Southern California, SSM is a GREAT concept due to the lack of real estate, > and uncertainty of getting the right location for a station. But you also > have to take care of your employees and they did that with us. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 Lee, The PEPP classs was not new information. It was stuff that at least my department already knew and was doing. So for us it was very redundant. Our education department has the focus the CE should be a mix of some reminder stuff and lots of new educational, learning stuff. 2 days in class of basic Paramedic stuff was just not what we were use too. Trust me it was not our Instructors. With Continuing Education (mandatory) every month, they are quite experienced at Instructing Adults. This is probably just a class that was not at the level that we have come to expect. Being that it was a National program they had to teach a specific way and it just didn't work for us. For other departments it might be a great program. Our take was that this is a good class for brand new Paramedics. take care, Re: SSM > > > > > > BEB, > > > > I noticed that you have a thing for numbers and research... > > > > My question is --- > > > > #1 - Since San Diego ended its study of RSI, should we > consider that RSI > is > > something NOT needed in pre-hospital care? > > > > #2 - Since Houston concluded their study on MAST, should we > remove them > from > > ALL units nationally? > > > > #3 - Since LA/Orange Counties concluded their joint study, > should we no > > longer intubate pediatrics? > > > > OR should we just consider that those agencies decided that it > was NOT > for > > them? > > > > What was so bad about your SSM experience because I had no > problem with > mine. > > I loved the fact that I had a chance to work with some of the > best guys > in > > Southern California [Anaheim FD, Orange County Fire Authority, > Orange > FD, > > Buena Park FD - back then, and LA County FD] and would not > trade that > > experience for anything. I am sorry that I had a chance to > work for a > company > > that cared for employees and could make a dollar doing it. > > > > Yes, I will agree with you that there are some companies with > less than > > acceptable operational practices, using both SSM and station > placement. > In > > Southern California, SSM is a GREAT concept due to the lack of > real > estate, > > and uncertainty of getting the right location for a station. > But you > also > > have to take care of your employees and they did that with us. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 I agree. The only stuff I felt was of good value to the masses was the stuff on kids with special healthcare needs. The new flexibility of the PALS modules probably will make it more appealing than PEPP to a lot of people. Take care, Lee Re: SSM Lee, The PEPP classs was not new information. It was stuff that at least my department already knew and was doing. So for us it was very redundant. Our education department has the focus the CE should be a mix of some reminder stuff and lots of new educational, learning stuff. 2 days in class of basic Paramedic stuff was just not what we were use too. Trust me it was not our Instructors. With Continuing Education (mandatory) every month, they are quite experienced at Instructing Adults. This is probably just a class that was not at the level that we have come to expect. Being that it was a National program they had to teach a specific way and it just didn't work for us. For other departments it might be a great program. Our take was that this is a good class for brand new Paramedics. take care, Re: SSM > > > > > > BEB, > > > > I noticed that you have a thing for numbers and research... > > > > My question is --- > > > > #1 - Since San Diego ended its study of RSI, should we > consider that RSI > is > > something NOT needed in pre-hospital care? > > > > #2 - Since Houston concluded their study on MAST, should we > remove them > from > > ALL units nationally? > > > > #3 - Since LA/Orange Counties concluded their joint study, > should we no > > longer intubate pediatrics? > > > > OR should we just consider that those agencies decided that it > was NOT > for > > them? > > > > What was so bad about your SSM experience because I had no > problem with > mine. > > I loved the fact that I had a chance to work with some of the > best guys > in > > Southern California [Anaheim FD, Orange County Fire Authority, > Orange > FD, > > Buena Park FD - back then, and LA County FD] and would not > trade that > > experience for anything. I am sorry that I had a chance to > work for a > company > > that cared for employees and could make a dollar doing it. > > > > Yes, I will agree with you that there are some companies with > less than > > acceptable operational practices, using both SSM and station > placement. > In > > Southern California, SSM is a GREAT concept due to the lack of > real > estate, > > and uncertainty of getting the right location for a station. > But you > also > > have to take care of your employees and they did that with us. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 (BTW, our master text is written by some dude named Bledsoe, any relation?) You're just now putting that piece together. Somebody as full of crap as me has to find a way to write and the books just got out of hand. Usually I get, " Are you related to Drew Bledsoe? " or " Are you related to Bledsoe Dodge? " I am sure Drew gets, " Are you related to Bledsoe? " all the time. I can, though, get you a good deal on a Dodge. BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: SSM > > > BEB, > > I noticed that you have a thing for numbers and research... > > My question is --- > > #1 - Since San Diego ended its study of RSI, should we consider that RSI is > something NOT needed in pre-hospital care? > > #2 - Since Houston concluded their study on MAST, should we remove them from > ALL units nationally? > > #3 - Since LA/Orange Counties concluded their joint study, should we no > longer intubate pediatrics? > > OR should we just consider that those agencies decided that it was NOT for > them? > > What was so bad about your SSM experience because I had no problem with mine. > I loved the fact that I had a chance to work with some of the best guys in > Southern California [Anaheim FD, Orange County Fire Authority, Orange FD, > Buena Park FD - back then, and LA County FD] and would not trade that > experience for anything. I am sorry that I had a chance to work for a company > that cared for employees and could make a dollar doing it. > > Yes, I will agree with you that there are some companies with less than > acceptable operational practices, using both SSM and station placement. In > Southern California, SSM is a GREAT concept due to the lack of real estate, > and uncertainty of getting the right location for a station. But you also > have to take care of your employees and they did that with us. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 This comes full circle back to an EMS organization. The organization should determine what the EMS folks want as CE (RSI, SLAM, CCT, suturing, triage, bioterrorism) that is above and beyond the curriculum. I have done a suturing course for medics once or twice and they love it. While it is important to review less frequently used core material, it is important to challenge people with new skills and concepts and encourage critical thinking. That is what I try to do--unfortunately a few people get pisssd off along the way. BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: SSM > > > > > > BEB, > > > > I noticed that you have a thing for numbers and research... > > > > My question is --- > > > > #1 - Since San Diego ended its study of RSI, should we > consider that RSI > is > > something NOT needed in pre-hospital care? > > > > #2 - Since Houston concluded their study on MAST, should we > remove them > from > > ALL units nationally? > > > > #3 - Since LA/Orange Counties concluded their joint study, > should we no > > longer intubate pediatrics? > > > > OR should we just consider that those agencies decided that it > was NOT > for > > them? > > > > What was so bad about your SSM experience because I had no > problem with > mine. > > I loved the fact that I had a chance to work with some of the > best guys > in > > Southern California [Anaheim FD, Orange County Fire Authority, > Orange > FD, > > Buena Park FD - back then, and LA County FD] and would not > trade that > > experience for anything. I am sorry that I had a chance to > work for a > company > > that cared for employees and could make a dollar doing it. > > > > Yes, I will agree with you that there are some companies with > less than > > acceptable operational practices, using both SSM and station > placement. > In > > Southern California, SSM is a GREAT concept due to the lack of > real > estate, > > and uncertainty of getting the right location for a station. > But you > also > > have to take care of your employees and they did that with us. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 ly. I have attended and then taught PEPP, and it was a great course. I think it depends (like ANY class) on WHO is teaching it. The material is terrific. I thought the textbook was very well done and geared more specifically to the prehospital environment. I am also a PALS instructor and find most of it useful for Paramedics only (where as PEPP provides pediatric training for all EMS levels). But most of the PALS course is geared toward the hospital environment. I can see where it can be a useful course for medics who work in hospitals, flight programs, or critical care transfer environments. I think comparing PALS to PEPP is comparing apples to oranges. Both have up and down sides, but they each have a different mission. Jane Hill Re: SSM > > > BEB, > > I noticed that you have a thing for numbers and research... > > My question is --- > > #1 - Since San Diego ended its study of RSI, should we consider that RSI is > something NOT needed in pre-hospital care? > > #2 - Since Houston concluded their study on MAST, should we remove them from > ALL units nationally? > > #3 - Since LA/Orange Counties concluded their joint study, should we no > longer intubate pediatrics? > > OR should we just consider that those agencies decided that it was NOT for > them? > > What was so bad about your SSM experience because I had no problem with mine. > I loved the fact that I had a chance to work with some of the best guys in > Southern California [Anaheim FD, Orange County Fire Authority, Orange FD, > Buena Park FD - back then, and LA County FD] and would not trade that > experience for anything. I am sorry that I had a chance to work for a company > that cared for employees and could make a dollar doing it. > > Yes, I will agree with you that there are some companies with less than > acceptable operational practices, using both SSM and station placement. In > Southern California, SSM is a GREAT concept due to the lack of real estate, > and uncertainty of getting the right location for a station. But you also > have to take care of your employees and they did that with us. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 WOW! I've taken a few crummy classes too, but you've obviously been OFFENDED by this one! What are the major deficiencies you've found with PEPP? I've had both, I can see them each having a few real nuggets that have affected my ability to care for Pedi's, our local Pediatricians like PEPP more than PALS, our local Pedi specialty hospitals like them both our Medical Director wants them Paramagics to have one or the other at THEIR choosing. In all seriousness, even though I am an Instructor for PEPP, I did not have my card graven in stone and can handle a little passionate debate, now and then. Your experience and opinion matter a lot to me, so give me a holler off-list if you like at mailto:dinerman@... I don't WANT to go to Wyoming!!!!!!!!! Regards- TerryD EMTPEMSIPEPPIPGDMEIEIO Re: SSM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 Thanks Doc- I would love to see the whole Merit-Badge system relegated to the ash-heap of EMS history. But where would all of us Merit-Badge Instructors get another captive audience and that little dab of butter-and-egg money, every now and then! ;-) The system could be so much better served by purveying this stuff as Continuing Education, and I, for one, would be happy to burn my PEPP Instructor card with all the rest of my merit badges...........but till further notice, I have to give my EMTP students a Pediatric specialty class, as well as BTLS, and ACLS, outside of the materials presented in our master text in order to graduate a marketable entry level Paramedic. (BTW, our master text is written by some dude named Bledsoe, any relation?) Regards- TerryD EMTPBTLSACLSPEPPEMSIPEPPIPGDMEIEIO Re: SSM > > > BEB, > > I noticed that you have a thing for numbers and research... > > My question is --- > > #1 - Since San Diego ended its study of RSI, should we consider that RSI is > something NOT needed in pre-hospital care? > > #2 - Since Houston concluded their study on MAST, should we remove them from > ALL units nationally? > > #3 - Since LA/Orange Counties concluded their joint study, should we no > longer intubate pediatrics? > > OR should we just consider that those agencies decided that it was NOT for > them? > > What was so bad about your SSM experience because I had no problem with mine. > I loved the fact that I had a chance to work with some of the best guys in > Southern California [Anaheim FD, Orange County Fire Authority, Orange FD, > Buena Park FD - back then, and LA County FD] and would not trade that > experience for anything. I am sorry that I had a chance to work for a company > that cared for employees and could make a dollar doing it. > > Yes, I will agree with you that there are some companies with less than > acceptable operational practices, using both SSM and station placement. In > Southern California, SSM is a GREAT concept due to the lack of real estate, > and uncertainty of getting the right location for a station. But you also > have to take care of your employees and they did that with us. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 In a message dated 10/28/2002 7:40:22 PM Central Standard Time, texaslp@... writes: > Let me make sure I am reading and interpreting this > right. There are hospitals (receiving EDs) that are > designated to receive patients from ambulances that > are BLS, while others are designated to receive > patients from ALS units? Not all Paramedic Providers can transport to ANY hospital. Paramedics are ASSIGNED a hospital to go to, and if the patient request another, it is based upon the POLICY of that department/agency... UNOFFICIALLY [and something I have NEVER been apart of **EVIL GRIN**] if the Paramedics on-scene think that Basics are capable of handling the task at hand. > > Given, Hospital A is for ALS and Hospital B is BLS; > What does an ALS unit do when the patient requests to > go to hospital B, or vice versa? > BLS units can deliver patient to ANY ED in LA County. ALS units are ASSIGNED a hospital to transport to [and not all EDs are on that list to accept]. Well, I am not gonna answer any question RE: what may happen IF you encounter a Kaiser Permanente [when I left, NONE were paramedic receiving centers] patient in Compton because King Drew, St. Francis and cannot recall the name of hospital in Paramount are closer, but Kaiser has the facility and staff [Level IV Trauma equivalent] to handle any patient that comes to there door. Why would paramedics transport patients to a non-Kaiser facility when Kaiser is not gonna PAY and set up a transfer to their facility [delaying definitive care]. If patient care is what its about... why are you gonna argue? But to keep it short, California law is DIFFERENT than Texas law. LACO hell look at the run form, it is SCREAMING lawsuit in Texas. **shrug** But it works for them!!!! > Sounds very 'fishy' to me, but many, no most things in > California do. Oh, by the way, my mother in law was > born and reared in Sacramento, so we have it out all > the time. Sacramento... know nothing about it, and not worth my time to change that opinion. *smile* I was asked why Texans could not play well together and why there was only 1 USAR Team? They think it is FISHY that we have 2 of 5 top cities in the nation and only 1 USAR Team. Quote Link to comment Share on other sites More sharing options...
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