Posts Tagged ‘EMS’

Opportunities, opportunities

October 23, 2012 Leave a comment

By: Michael Stanley

Right now, I’m in a job drawdown, from coordinating EMS classes, being an EMR/First Responder, and Intermediate to being a Paramedic.

U.S. Air Force

Stanley worked at an Air Force base in Abilene, TX.

For quite some time I have setup instructors, materials and texts to create military medics from all branches, but unfortunately there are smaller numbers due to budget cuts. Military training will be open to registration through NREMT and NAEMTS upon return to civilian EMS. This is more successful with military contractors and subcontractors and even federal law enforcements.

Specialized federal organizations and secretive groups use former military and new hires rather than regular military medics. I believe if you follow politics right now, there are some congressional reps. that are holding hearings on how we are retaining some excellently trained medics. Due to specialized military training, some medics cannot go out on a civilian ambulance.

When I was first assigned as a new medic in the Air Force to a west Texas base, I was assigned to the emergency room. We ran all on base and off base EMS calls. We even offered mutual aid for the city of Abilene. I selected this base as my first choice, because I had been a member of a volunteer junior rescue squad since age fifteen. This put me in line to go to the best unit in the hospital. We had two groups, and offered State of Texas EMS training starting at EMT, through the ranks to Paramedic. One group finished then the second group went through, at the Air Force’s expense. When not in class, we worked in the base hospital emergency department.

What better set up could we have had? It was awesome.


Translating EMT Concepts Between Cultures

August 16, 2012 5 comments

By: Grant Campbell


Inaugural ambulance at hospital in Punjab, India.

Situated in the Himalayas of North India, we at Lady Willingdon Hospital are uniquely positioned at the forefront of emergency medical education in the region.  Due to this fact, we have found ourselves struggling to balance the dual needs of tackling the lack of adequate first responder services in the area while meeting our own requirements for highly skilled critical care Paramedics. 

So, do the tried and true methods of emergency medical education work in the Indian context?  Can we simply translate curriculum developed in the States into the local language?  Well, yes and no.

The typical use of oral boards and skills stations as a means of assessing skills competency, breadth and depth of knowledge is a much-needed enhancement to the way training is done.  But, on the other hand most of the people here have a great ability to make things work with whatever resources they have.  This is a key attribute of a good EMT anywhere and is not an easy thing to teach.


Campbell’s students learn about ventilation.

Teaching in India, I have found that I don’t have to teach my students to work together.  It is a natural part of the culture.  But I do have to figure out ways to teach them to make the most efficient use of team members. 

I don’t have to tell them to think about remembering to document the medications used because they want to make sure the patient is billed.  But, I do have to encourage them to communicate more openly with the patients about what is happening to them and to get informed consent.

These are just a few examples of differences between teaching in the States and India.  We have certainly had to find new ways to ensure that critical concepts are learned but the information and skills necessary to assess and treat patients remains constant. 

The human body works the same in the United States as it does anywhere else. No matter where you find yourself, at the end of the day, no matter where you go, patients are patients and they all require and deserve the best care that can be afforded to them.

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Not Lost in Translation

March 28, 2012 Leave a comment

“Patients are patients. No matter where you go, don’t forget that.” Those were my Lieutenant’s words just before I left the states.

Ambulance in North India

Campbell uses ambulances like these to transport ill or injured North India citizens.

Now, her words rang in my ears as I stepped into the ER at a mission hospital in the majestic Himalayas of north India. The early days here were challenging.  All of the patient interviewing skills that had been drilled into my head in Paramedic school were thrown out the door because I couldn’t speak the language. I had to rely on my physical exam techniques: Inspection, Palpation, Auscultation… All of you can probably recite the mantras you memorized during your training.

But you know what? She was right. Yes, communication barriers can be a huge hindrance in treating patients, but if you stick to the fundamentals you will be OK and what’s more, your patients will fare better too.

How well you grasp the fundamentals is what defines you as a caregiver, so that is what we teach. Fortunately, Brady materials make that possible. When I first started in India, I was spending countless hours making slides, quizzes, tests, and handouts from scratch. Now, we use the Instructor Resources for Brady’s Paramedic Care: Principles and Practice. For some classes, I have a translator at my side. However, English is an official language in India and therefore a principle medium for medical education.

EMS in India is a relatively new but emerging field. Many states provide primary response emergency transport free of charge. In other places, private hospitals and companies are providing critical care transports for exorbitant rates that are unaffordable to the average citizen. At the mission hospital we are focusing solely on providing critical care transport at an affordable cost while the state government has contracted with a private company to provide free BLS level primary response.

The laws governing EMS in India are under development and we—as the only provider of critical care services in our region—have a unique opportunity to play a central role in setting a high standard for training and service in the swiftly developing field of EMS. Essentially, I have the chance to be a pioneer of life-saving techniques with the help of Brady’s comprehensive resources.

Greg Campbell volunteers at Lady Willingdon Hospital in Manali, India as a Consultant in Ambulance and Emergency Medical Technician Training: By U.S. standards, Campbell offers Level III Trauma Center services.  Prior to his involvement in India, patients had to wait as long as nine hours for a critical care level ambulance to arrive from Level I hospitals in the bordering state. Campbell’s responsibilities include working to develop an EMT-Paramedic program that will be accredited by an Indian agency and funded by foreign donors as well as student fees.

Unaffiliated Un-uniformity

February 24, 2012 Leave a comment

Photo credit:

There are plenty of informative sites, blogs, and other variants of social media out there for the already-employed-EMT, but what about those of us that have gone to school, have a license, but have not been hired yet…for two years?

OK, the two years part may not be the norm, but the rest of it might be, to more folks than you may think. I went to a small community college in North Carolina, enrolled in a six-month course, took the state exam, failed the first time, then retested. This was all shortly before moving to New Hampshire.


But did you know North Carolina does not require NREMT? I didn’t think it was a big deal. I heard of ‘reciprocity’ and thought that it might help. It seems that it does not extend very far. I looked into what was going to be needed for employment in NH, even though I knew I was not to be staying in NH for more than a year, but I desperately wanted to get my career started. I looked up websites, made phone calls, and knocked on office doors. Finally, I had to take a one-day ‘transition class’ for the state of NH. I was actually misinformed about this; the class had no bearing on my NH license.

Everyone tells me to get NREMT. Great, sure, have you read HOW to do this if you are “unaffiliated?” Excessively frustrating, not to mention, living paycheck to paycheck does not allow for it.

Now, I am facing the same thing in my new home state of Maine. There seems to be no ‘reciprocity’ between NC, NH, or ME. It has even been suggested that I may need to take the EMT-B course all over again!

Lack of uniformity

Now more to the point. Where is the uniformity? Hypothetically, if many states use the same detailed textbooks, specifically Brady Books, why is it so difficult for someone without NREMT to transfer to another state? Is what has been learned any different? Is the human body really any different from one state to the next?

I understand differences in protocol, which is why I took the $150 one day ‘transition class’ in NH. Should it really be this difficult (and costly) to transfer credentials from one state to another?

A possible solution

Here is an idea that has worked for me in EVERY other career field I have been in: hire me conditionally, with the stipulation that I get fully-licensed in said state within a specified number of months. This would solve MANY issues.

The issue of not being able to afford the process (as it would be a second income) and also would put me in direct daily contact with people who can steer me in the right direction. I have asked three different people about how to do this. Simply put, I have received three different answers.

So, have I done what is required educationally? Yes. Do I have a valid EMT-B license? Yes. Can I get employment? No.

There must be some sense of uniformity in the education process that could eliminate some of this hassle. How about a simple solution of offering to sit for NREMT along with state exams after completing a class in every state? Why not, if a majority of the schools use the SAME textbooks, right?  

Uniformity, in a career where we wear uniforms, where is it?


Eric Carlson is a dad, husband, (unemployed) EMT, volunteer firefighter, writer, and fire protection systems specialist. Visit his blog:


How All of My Students Passed Board Exams on the First Try

January 26, 2012 Leave a comment

For the last several years I have been learning right along with my students. I’ve never been satisfied with just being an average instructor. As Albert Einstein once said, “Insanity: Doing the same thing over and over again and expecting different results.”

I choose not to be an insane instructor of EMT students.

A personal goal of mine has always been to have all my students pass their practical and written board examinations on the first try. Last semester, I was fortunate enough to reach that goal.

I would like to share some of the things I have learned along the way about student success in the classroom:

  • I have found that students learn best and retain more when they teach themselves. My classes are all required to participate in my online discussion board. I use the critical thinking scenarios and follow up questions from our text (Mistovich; Pre-hospital Emergency Care 9th edition). After the student’s initial response, all of their classmates are encouraged to give constructive feedback. I monitor the discussions and occasionally give my own input. These discussions take place online and outside of class. In class, I encourage small group collaboration to stimulate critical thinking skills.


  • Chapter open book quizzes are to be completed prior to attending lecture. This form of self-study helps prepare the student for the information they will receive during lecture. It stimulates discussion and often times the student will come to class with questions about the material. Once again, this puts the student in a situation where they are teaching themselves.


  • Finally, I am a rigorous not ruthless instructor. My students know from the first day that they can expect frankness and honesty from me. To let students languish for weeks on end, stealing precious time in their lives that they could use to move on to something else, when in the end they aren’t going to make it anyway—that would be ruthless. To deal with it right up front and let students get on with their lives—that is rigorous.

Kent Sallee is Logistics Coordinator and EMT-B /I.C/AA at Hutchinson Community College in Hutchinson, KS.  Sallee found that a combination of rigorous instruction and use of a Brady title helped his students succeed on the first try.

Critical Thinking: The Only Skill We Always Use

October 11, 2011 2 comments

By: Nick Montelauro, NREMT-P, FP-C, NCE

Because of the variety of hats I get to wear, I get to talk to students at many different points in their EMS careers – many who haven’t even started yet.   The question I get asked the most about our profession and the training and education we give is, “When I’m done with class, what do I get to do?”

My standard response is that the successful student will “get to” be trusted with other people’s emergencies. With the upcoming changes to the National Scope of Practice and new National Educational Standards, everyone seems concerned with who “gets to” poke holes in people or expose them to other potentially harmful procedures and medications.

The question I enjoy is another common one, “What’s the hardest part about becoming an EMT (or paramedic)?”

This question, in many forms, is what students and educators always want a simple answer to.   I’ll submit that there are many things required and different students will have different things that come easily and that will require more of their attention.  But when people ask me to name the one skill required to be a proficient EMS provider, there’s only one answer that stands out – you have to be able to make decisions.  Educators call this critical thinking and it’s a skill that touches literally everything you do from the time you report for your shift to the time you go home.

“But, wait, isn’t airway more important?  If the patient doesn’t have an airway, they die!”

What makes airway so important and why do we spend so much time harping on it?  Because you need to be able to make decisions about how best to manage it.  Is the patient maintaining an adequate airway on his own?  Do I need to intervene?  Which airway is most appropriate?  How invasive do I need to be?  How often do I need to reevaluate?  Each of these decisions could be the most important one you make today.

My students love the fact that skills are currently tested from a published, step-by-step rubric that can simply be memorized to ensure a passing score.  What they don’t love is when I tell them to put the skill sheets down so we can talk about “real life.”  They know I’m going to what-if them to death.  They know I’m going to ask them what to do when the equipment doesn’t work right, when the airway won’t fit, when the transport is prolonged, when the patient’s complaints don’t fit squarely in any one protocol, or when the patient won’t cooperate with what the skill sheet says will always happen.

They know we’re in for some heated discussions, a lot of push and pull, and a lot of agreeing that there’s more than one way to skin a cat and that some bridges can only be crossed when you come to them.  What they may not know is, I’m forcing them to sharpen the axe in a way that some don’t think about – the anguish I’m putting my students through is going to pay off on their first non-traditional call.

The ability to make a decision is a skill that can be studied at great length.  Professionals in many fields -pilots, physicians, quarterbacks, and executives – study decision making and the ones who are the best at their jobs are often the ones who make the best decisions.

And next time you’re in class, or between calls, or doing some self-evaluation to look for ways you can be a better provider, don’t forget the one skill you use on every call: critical thinking.