Ep 31 Listener Questions

[audio:31_ListenerQuestions.mp3] (57:24) Since Ron isn’t in school we took listener questions and there were a lot of them.

Listener Questions
I passed my NREMT-B exam – yay!!- but am curious to know why the CAT will ask one question a couple of times? It seemed a little odd, as if it was testing to see if I was guessing. Love the podcast! Kim

Something Ive wondered about was when we pinch off the IV tubing to administer a slow IVP, then unclamp the tubing… What’s the difference in giving that Fast IVP then? Just a random question.
Another is any advice for a student who’s about to start medic school in 3 weeks or so? It’s not my first time through but I want to do better this time than I did a couple years ago. suggestions on how to handle people at a service that decide to give me hell because I’m not satisfied with just obtaining the minimum. I plan on getting my LP here in TX which requires an AAS in EMS at a minimum and I’m catching hell for that idea here at my service in BFE.
-Transport Jocky

I feel like you failed to address what I think was Ron’s main point of frustration, or at least mine: WHY is it that the game somehow changes just because you’re a bystander versus when you’re on duty? I mean, taking Ron’s car accident example, really the only difference in the situation is that Ron happened to have been off-duty and witnessed the accident instead of being dispatched to it in an ambulance. One might think that this person is lucky to have had Ron, an EMT, witness his accident rather than a lay person because Ron is trained to deal with these situations. But you’re saying that because Ron is off-duty, even though he has special training and equipment handy, that he is just as powerless as any other “John Q Citizen” who may have witness this accident instead. WHY is it that Ron couldn’t pull out his OPA in order to open this person’s airway and potentially help them? It’s exactly what the EMTs who pull up in the ambulance are gonna do when they get there–why can’t Ron just do it sooner since it could potentially help? I understand what you were saying about how it MIGHT not help, and it fact might be harmful, but again, it’s exactly the same thing that the EMTs who show up are gonna do and exactly the same thing that Ron would do were he on duty, so I guess I just don’t get what the difference is.WHY does scope of practice suddenly change just because you’re off-duty? Are you only an EMT when you’re in uniform and on-duty then?……I’m sorry, I’m not trying to be difficult….but I’ve listened to that section of the podcast twice and I’m still confused. Any chance you can explain it even more and maybe give more examples?
…also heard you say somewhere in this episode that Ron, as an off-duty EMT, does NOT have a duty to act. (Please correct me if you didn’t say that.) Again, this completely flips my world upside down because it is completely opposite of what I understood from First Responder training. I thought we DO have a legal duty to act.

#2 what’s the value of a college degree in EMS. She’s a liberal arts psych major and wants to be an EMT, which people think is a step down.
-Katie B

I wanted to say thank you for all the great podcast and advice. I really just started listening a few days ago and have all ready gone though most of the them. It is really easy for me to relate to Ron since we both live in Texas, we are both entering the EMT/Paramedic field, and we both are model photographers. Lol.. Are you the future me? hmmmm..
My very first day of EMT-Basic will be on the 18th and I’m pretty much having panic attacks. My school, although is a community college (Weatherford College), is militarized in it’s teachings and rules and will be REQUIRED to maintain an A average throughout the course. We cannot even wear a jacket to class unless it is pre-approved by the EMT program coordinator. If we show up even a minute late to class we have to sit the class out until the next brake and will have to work out, jog, or push-ups as punishment for this. lol. We even have to have our hair short with no facial hair that is trimmed all the way to the top of the ears. Is this what you had to go through in your school Ron and Kelly? I am studying and obsessing about EMT and reading the book trying to get ahead of the curve and not get so over whelmed after school starts up. I will keep you posted again on how things go after school starts.
Anyway, Can an EMT or Paramedic be colorblind? Do you think it can affect with your ability in providing emergency medical care or cause problems? I have a red/green color deficiency and I would really like to know if this can affect me.
Another fun question and ultimately pointless is; If you could have one super power while being an EMT, besides healing powers, what would you choose to have that is most useful? – Listeners answer this one in the comments.
Thanks again guys and look forward to new podcasts!
Wish me luck,
-Aaron H.

What’s the best way to study for an EMT-B class? Notecards? Cramming? Just reading the book for hours on end?
What’s the Glascow Coma Scale? I’ve heard of it, but have yet to fully understand it.
How much anatomy am I going to be expected to know? Am I going to be asked bone – muscle attachment points, what muscle is where and performs what, etc.
I’ve got a bunch more in the back of my head, but I can’t really seem to word them right (not gonna lie, I’m a little tired, it’s 11:50 PM local time.) I’ll post them when they come to me.

Any tips for trying to save a (likely) blown vein when cannulating? Some people aspirate while pushing in/pulling out with varying results, any more tips?
– Simon

I am a 55 year old Intermediate. Got into EMS late in life. Was a Cop. Started as First Responder. Basic in 08. Intermediate in 09. Taking A&P this spring online. Thinking Paramedic in the Fall. Am I crazy?
I still suck at Iv’s. Any tips? I look forward to your stuff. Thanks!

I know you’re in a 2 year paramedic program, I’m in a 1yr compressed course. What are your opinions on the 2year v. the 1yr crash course?
-Nick Shaw

Any tips for taking a pulse easier?
Is the bouncing on the BP Cuff’s needle accurate for a Blood Pressure? I personally doubt it but friends who are EMTs & Paramedics tell me otherwise.

What’s the benefit of field experience for EMS number crunchers?
People who on QA projects like coordinating the cardiac arrest registry.
-Timothy Clemens

Is it better to take an EMT course durning HS or wait until you graduate? I’m dertimed and plan to succede at this however it may be. I would just like a proffesional opinon.

I’m a student paramedic in the UK, in year two of three, and I was wondering what your situation in the US/ your particular area is with regard to elderly patients and futile resuscitations?
This is mainly prompted by a cardiac arrest call I went to a while ago to a 90-year old lady in a care home; a carer had been doing ‘compressions’ mainly over her stomach and so as it was presented as case of CPR in progress we were obligated to continue, although if this hadn’t been started it would have been more than 15 minutes from arrest to onset of CPR so we could have just carried out our ROLE (recognition of life extinct) procedures. On the first proper compression carried out by my crewmate the whole side of her chest caved in; we’d felt it was futile anyway and this only served to make us feel more like all we were doing was inflicting indignity on her corpse for 20 minutes of required ALS.
Do you have an option to refuse to start? On this particular occasion I’d have given a lot to be able to turn around to the carer and say, ‘look you might think you’ve been doing CPR but you haven’t , she’s been down 15 minutes, she’s gone and probably was the second she collapsed, I’m sorry.’

Has anything totally freaked you out on your shift? How did you handle it and were you surprised by your reaction?
-Linda G


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10 thoughts on “Ep 31 Listener Questions”

  1. Great podcast!
    So Kelly, when you guys were answering Mike’s question you said that everything in the EMT textbooks that you need to know is either in bold, in italics, or in a box on the side. Does that mean that everything else in the textbook isn’t necessary? Or, is it more like my advanced biology course (I’m a sophomore in high school) where everything is important but they put in bold everything I have to know for the test?

  2. Totally agree with the red/green color deficiency… the hubby is also red/green deficient but a hell of a paramedic. He has developed coping mechanisms that work well except for matching socks and ties.

    On the superpowers, I think I am torn between being able to read a patient’s mind and being able to see inside the patient. On the unconscious unknowns, it would be nice to be able to figure out exactly what they were doing before they became unresponsive or what they had taken so we’d at least know what to do to help them. Especially when they don’t want to tell us.

    To EMT32, I am getting back in at 42 and find that life experiences make me a much better medic than I was as a 22 year old. I KNOW what peritonitis feels like and why. I’m familiar with various surgeries and their effects. I know that a 10 on the pain scale is very different for a 50 year old with various medical issues, versus an 18 year old with no medical history. One really good thing that has evolved in the past 20 years is the view on protecting your back. Used to be, you were not competent if you could not “man up” and lift the 400 lb. patient. Now, lift assists are encouraged. That’s an awesome thing.

  3. An invitation for Ron, Kelly, or anyone in the EMS community (or not) to answer a question related to the ones I asked before:


    I was going to ask on here, but I decided to turn it into a blog post instead, in an attempt to get a variety of thoughts/opinions–though I am particularly interested in what Kelly thinks, since he probably has the “right” answer. But everyone should feel free to check it out and leave your thoughts!

    Katie B.

  4. That was actually the first thing I thought of, but then I realized that we’d be getting to the patients so fast that 1. they’d call for more goofy stuff so they could get into the ED faster, 2. some wouldn’t even have time to have injuries show up for us to treat, 3. everything would become load-and-go since why waste even a split second out of the ED, 4. We’d do nothing but toss the pt in the truck and POOF… we’d never get to actually treat anybody, and 5. We’d be dispatched to EVERY call since we could handle the whole call in the time it would take a normal crew just to get to their truck.

    On the otherhand, it might be really good for our patients as far as getting them to surgery or balloon, etc. faster. Kind of a rip for someone who likes being a medic though. OK, if I take that superpower, can I have another one to balance out what I will be missing out on? I want to be able to talk to animals, too.

  5. Ron & Kelly,

    Sounds like this subject is one that several people have questions about. I have a suggestion… why don’t you have Dr. Gene Gandy on the show to answer EMS Legal Questions? That way, we don’t have to beat a dead horse, we can just get the answers straight from an EMS Legal Expert. What do you think?


  6. I sent him an e-mail and copied both you and Kelly on it so you would have his e-mail address. Knowing Gene, I am betting he will be happy to help!

    By the way, I don’t think your “send me e-mail follow up on the comments” think works… 🙁

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