Quote from: manfredvonrichthofen on May 07, 2012, 03:41:36 AM
The endotrach is ok, but I'm not as confident in it as it only has one bubble to inflate. It seems like it could get dislodged easier than a combi or king. Plus, if you insert it just the right way you are inflating the epigastrium, and don't have a second hose to try for the lungs. Just an opinion, I haven't gotten to use one though.

ETI has it's place, as do the combi/king/PTL/LMA. When you're placing an ET tube, you HAVE to know where it's going, which is why it's an advanced level (AEMT/PM) skill. And, while they teach you to listen for epigastric sounds and lung sounds with the combi (and you always have to switch to the 2nd lumen during testing), for ETI they have us do a whole lot more. Colormetric and waveform EtCO2, equal/bilateral breath sounds, absence of epigastric sounds, using an EDD/EID, condensation in the tube, etc. However, ETI is more of a definitive airway, whereas the combi/king/PTL/LMA are only really meant as rescue airways, and if the patient requires continued ventilatory support, they're getting an ET tube eventually anyway. Not to mention, your king/combi/PTL/LMA have limitations on use (contraindications, size of pt, etc) whereas you can find an ET for essentially every patient population from your 5min old neonate to your 104y/o cardiac/respiratory arrest, and there's really no contraindications to an ET tube when the patient needs it.

Any tube can get dislodged with carelessness, combi, ET, king, or otherwise. I would encourage you to get in the habit of ALWAYS keeping 1 hand on the tube, against the pt's face, even with it secured. If I have an EMT/EMR/FR/insert other abbreviation here/ doing the ventilations after ETI or placement of a rescue airway, I still have them hold onto it. And always get in the habit of disconnecting your BVM before you ever move the pt (including in/out of truck), and re-verify your placement of your advanced airway after EVERY move. Doesn't matter if the tube was good for the 30min before you get to the ED, you show up there w/ a bad tube, they'll think it was bad the whole time, and you're in for a chewing/counseling.

And remember, the cuff(s) on any of these devices are NOT meant to hold them in place, they're there to either provide a seal to keep air from escaping, or moreso, to keep nasty things (GI contents) from migrating into the airway. Your tube securing methods, and moreso your attentiveness, keep the tube in place.

Congrats on passing, and welcome to the world of EMS.

Quote from: manfredvonrichthofen on May 08, 2012, 12:02:01 PM

Quote from: SARDOC on May 08, 2012, 02:07:13 AM

Quote from: manfredvonrichthofen on May 07, 2012, 05:05:22 PM
Ok, I am finished with all of my tests. I am done. I should get my card and what not in the next few weeks. What do I need to do to NREMT certification?

Congratulations.  Make a Copy of it and send it to your state to get reciprocity.  Then Go Forth and Do No Harm.

I got lucky with a wicked cool instructor, he takes everybody's paperwork and drives it up himself. I have faith in him that he will do it properly, it's no where near his first class. Plus just in case I have copies of all of it. But after I receive reciprocity what is my next step to get onto the NREMT registry? I am sure it's more testing, but who do I need to talk to to get it? Homeland Security or DOT?

I'm assuming youre in Indiana, correct? You'll need to create an account with NREMT, and the specifics of it I can't remember (its been a while) but I believe you select your school and whatnot. Your Program director should have access to go in there and see you, be able to throw the switch that you've completed the program of study and your practical examination, which should generate your authorization to test. You'll have to do the NREMT written examination at a secure facility, and once they have everything, they generate your certification. Your school's program director should be able to help you out with this process. You can also go to www.nremt.org, there's lots of helpful things on there to get you going.

Edit: here's what you need to do: http://www.nremt.org/nremt/downloads/NREMT%20EMSStudent%209.23.pdf

Thanks for the info secret squirrel, I will be getting onto that tomorrow so it's setup when I get my certification papers.

Quote from: SJFedor on May 09, 2012, 03:13:12 AM

Quote from: manfredvonrichthofen on May 08, 2012, 12:02:01 PM

Quote from: SARDOC on May 08, 2012, 02:07:13 AM

Quote from: manfredvonrichthofen on May 07, 2012, 05:05:22 PM
Ok, I am finished with all of my tests. I am done. I should get my card and what not in the next few weeks. What do I need to do to NREMT certification?

Congratulations.  Make a Copy of it and send it to your state to get reciprocity.  Then Go Forth and Do No Harm.

I got lucky with a wicked cool instructor, he takes everybody's paperwork and drives it up himself. I have faith in him that he will do it properly, it's no where near his first class. Plus just in case I have copies of all of it. But after I receive reciprocity what is my next step to get onto the NREMT registry? I am sure it's more testing, but who do I need to talk to to get it? Homeland Security or DOT?

I'm assuming youre in Indiana, correct? You'll need to create an account with NREMT, and the specifics of it I can't remember (its been a while) but I believe you select your school and whatnot. Your Program director should have access to go in there and see you, be able to throw the switch that you've completed the program of study and your practical examination, which should generate your authorization to test. You'll have to do the NREMT written examination at a secure facility, and once they have everything, they generate your certification. Your school's program director should be able to help you out with this process. You can also go to www.nremt.org, there's lots of helpful things on there to get you going.

Edit: here's what you need to do: http://www.nremt.org/nremt/downloads/NREMT%20EMSStudent%209.23.pdf

100 percent spot-on.

How long about did it take yu guys to get your certification?

The reason I ask is because I am going out of state soon for a bit over a month and wanted to make sure I got it before I leave because INDHS sends it so that you have to sign for it. And if you don't get it at the house you have to go the PO to sign for it, and if you don't get there in time they send it back. I was thinking I would follow the guidance of a friend who said he went to the office in Indianapolis and picked it up himself. If I have to I will do that, but I would like to get it before I leave so that I can start sending my info to hospitals while I am gone.

I know it likely varies state to state, but I was just hoping for a roundabout guesstimation as to the timeframe it actually takes.

Quote from: manfredvonrichthofen on May 10, 2012, 12:19:47 AM
How long about did it take yu guys to get your certification?

The reason I ask is because I am going out of state soon for a bit over a month and wanted to make sure I got it before I leave because INDHS sends it so that you have to sign for it. And if you don't get it at the house you have to go the PO to sign for it, and if you don't get there in time they send it back. I was thinking I would follow the guidance of a friend who said he went to the office in Indianapolis and picked it up himself. If I have to I will do that, but I would like to get it before I leave so that I can start sending my info to hospitals while I am gone.

I know it likely varies state to state, but I was just hoping for a roundabout guesstimation as to the timeframe it actually takes.

I believe I got mine from Indiana about 3-4 weeks after I passed my practical. I took the state written the day before the practical. It all really varies on how quickly your program director/state rep gets it to IDHS, and how quickly they turn it around. I didn't have to sign for my cert from them, though.

Tennessee was very nice, because if it shows on their licensure verification system, it's legal to work by, and usually the cert follows within a few days of it posting online.

Thank you Major Lord, I got the ET tray in the mail just now. Thank you, you rock!

Finished my final written exam on Tuesday and did the practical today. I was really nervous, but did better than I thought I would. Now I just have to pass the NREMT!

Quote from: CAP4117 on May 11, 2012, 11:36:07 PM
Finished my final written exam on Tuesday and did the practical today. I was really nervous, but did better than I thought I would. Now I just have to pass the NREMT!

I suggest you take your state test first. It is supposedly harder, but if you can pass it you can pass your NREMT. But Indiana requires you to take your state test before your NREMt exam.

Just study how to use the hazmat guide book, there were about 25 questions that you have to use it for.

In IL, if you take the National Registry you automatically get a state license. That's not how it is in all states, though.

Quote from: CAP4117 on May 11, 2012, 11:58:52 PM
In IL, if you take the National Registry you automatically get a state license. That's not how it is in all states, though.

You're lucky. I wish I only had to take one test. But I also found out that you can take another test and that is all you have to take to be an EMT instructor.

That's cool! Something to think about for the future. Honestly, I don't mind taking the tests because, as I understand it, there are tests to get hired with any company, on any department, to get into paramedic school, or virtually anything else we might want to do. I feel like I should try to get used to it! I just need to learn not to get so stressed out about the practicals... 

I don't know about taking tests to get on any job, here it is mostly who you know sadly. I wish it were all tests. But I am going to take my instructor exam after I get my cert papers.

Entrance exams are pretty standard in the Chicago area, even for private companies. It may be because the EMT market here is over-saturated and they need additional ways of weeding people out! (One reason why I am moving elsewhere after I graduate from college - the other being that I really want to run 911 calls and that opportunity just doesn't exist for EMT-Bs around here.) The instructor thing sounds like a good way to stay up on your knowledge and earn extra money - definitely worth checking out someday.

Quote from: CAP4117 on May 12, 2012, 12:17:00 AM
Entrance exams are pretty standard in the Chicago area, even for private companies. It may be because the EMT market here is over-saturated and they need additional ways of weeding people out! (One reason why I am moving elsewhere after I graduate from college - the other being that I really want to run 911 calls and that opportunity just doesn't exist for EMT-Bs around here.) The instructor thing sounds like a good way to stay up on your knowledge and earn extra money - definitely worth checking out someday.

Here EMTs are not dime a dozen. IU hospital is constantly understaffed. EMTs get calls constantly. Generally they are paired with paramedics, but sometimes they get paired together. But no, we don't have enough EMTs to meet the need. Plus IU hospital is moving to a new idea for the ED, half nursing staff and half EMT. So there too they need EMTs.

Wow! I'll put that on my list of possible places to move then! 

How's it coming along 4117? I am still waiting on my final cert to come in from DHS.

They say they are waiting for my written exam score to come in and they will get it loaded and into the system ASAP, they are really nice here. Hopefully it will be done in the next day or so.

I'm taking the National Registry tomorrow, and feeling apprehensive about it. I hope your scores come in soon! What kind of job do you plan on applying for?

Quote from: CAP4117 on May 22, 2012, 08:02:01 PM
I'm taking the National Registry tomorrow, and feeling apprehensive about it. I hope your scores come in soon! What kind of job do you plan on applying for?

I have my scores... And an 85 on my written and I got perfect scores on my practicals except I strapped the torso then the hips on the backboard, and got a bit gigged on that. But I also found out we don't have a set testing center for NREMT here in In, and I just might have to go to IL to get it.

But I am going to try to start off at the local hospital on an ambulance. What about you?

Congrats! That's great. Here in Chicago EMT-Bs don't run 911 calls, so I guess I'm stuck with a private company for the time being.