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How to Become a Paramedic or EMT | EMT Paramedic Careers

While working in the EMT and Paramedic industry and other Allied Health professions, it can not escape your notice how important your own physical and psychological health is in serving others.   In fact, if you are studying to become a paramedic or getting a political science major, your own personal health should always be your first priority.  The various states of good and ill physical health can be viewed as points on a continuum.  At one end is early and needless death; at the other is optimal wellness, in which you feel and perform at your very best.  In the middle, individuals are neither sick enough to need medical attention nor well enough to live each day with zest and vigor.  For the sake of optimal physical health, we must make positive steps away from illness, and toward well-being.  We must feed our bodies nutritiously, exercise them regularly, avoid harmful behaviors, and substances, watch for early signs of sickness and protect ourselves from accidents.

Our psychological health is just as important as physical health.  Like physical well-being, psychological health is more than the absence of problems or illness.  Psychological health refers to both our emotional and mental states such as; our feelings, and our thoughts.  It involves awareness, and acceptance of a wide range of feelings in oneself and others, the ability to express emotions, to function independently, and to cope with the challenges of daily stressors.

While working in a line of work that cares for others, it is often easy to overlook our own health needs.  Please take the time to care for yourself and your body.

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Energy Systems

There are three sources from which you receive energy.  Whether you are studying how to become an accountant or interested in how to become a paramedic you receive energy into your body, your mind, and your soul.  You then channel this energy out through your body, mind and being converting it into nine forms of other forms energy before returning it to the environment around you.  Your body can be thought of as a pipeline or conduit of energy.  Wellness results from the balanced flow of these energies through you.  The presence of disease is a message that some form of energy is not flowing smoothly in your life.  It means that you are in some way blocking, overusing, or ignoring one or another form of energy.

Energy Input – The three major ways by which you receive energy from the environment are by breathing oxygen, sensing the stimuli in the environment around you, and eating food which is oxidized by cells and is also used to build and repair body tissues.

Energy Output – The outflow of energy to the environment begins with self responsibility, and love.  This is a form of energy which manifests as the attitude you choose toward your life.  Wellness is enhanced by living your life with self-responsibility and love.  Not only do you move your body through your external environment through exercise and fitness, but you move internal muscles to provide blood circulation, digestion, reproduction, etc.  Energy is used for feeling and expressing emotions.  The brain’s activity of thinking also includes intuition and dreaming.  Playing and working are how yo spend most of your waking hours.  Communicating is a complex form of energy encompassing many forms of energy.  Finding meaning gives purpose and direction to the above forms of energy.  Transcending goes beyond the rational and connects us with all that is.

The world can be changed by your transformation of energy.  People can be changed by your communicating and touching, your work and play, your laughter and your tears.  And your loving will change us all.

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Euthanasia: Two Case Studies

Most observers trace the modern euthanasia debate back to the court case of Karen Ann Quinlan, and her story is a poignant example of medical technology’s ability to prolong life.  In 1975, after consuming alcohol and tranquilizers at a party, Quinlan collapsed into an irreversible coma.  This coma left her unable to breathe without a respirator.  She also needed a feeding tube to be able to eat.  Her parents asked that she be removed from the respirator, but her doctors objected.  The New Jersey Supreme court case that followed was the first to bring the issue of euthanasia into the public eye.  In 1976 the court allowed Quinlan’s parents to have the respirator removed.  Although Quinlan lived for another nine years with the help of the feeding tube, the case set a precedent for a patient’s right to refuse unwanted medical treatment.

In 1990, that right was further expanded in the case of Nancy Cruzan.  Cruzan had gone into a irreversible coma in 1983 after a sever car crash, and her parents wanted the machine that was keeping her alive removed.  However, in this case the machine consisted of intravenous feeding tubes that provided Cruzan with hydration and nutrition.  Her parents viewed the removal of the machine as the termination of unwanted treatment.  However, the state of Missouri argued that to remove the tubes would be intentionally killing Cruzan through starvation.  In a controversial vote, the U.S. Supreme court ruled that the provision of artificially delivered food and water is a treatment which patients may legally refuse, even if doing so would result in death.

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As noted, profits are not the sole reason that health care organizations exist.  Sometimes profits are just a means to an end, and not an end in itself at all.  Health care organizations should always make decisions that keep their underlying mission in mind.  I hope to provide many techniques throughout my blogs to help you make the best decisions, other things being equal.  While studying how to become an accountant in the health industry, it became apparent that even allied health individuals as well as organizations, need accounting as well.

How can you make the best decisions financially, other things being equal?  If two projects yield the same health benefit, the one with the greater profits at a lower risk is the logical best choice.  However, what if the health care benefits are not the same?  In this case, managers need to factor that into the decision.  Sometimes you may decide that you are willing to take a lesser profit or take a higher risk in hopes of achieving a better health outcome.

Healthcare organizations have no desire to go bankrupt, so it is no surprise that one of the crucial goals of financial management is ensuring financial viability.  The goal is often measured in liquidity and solvency.

Liquidity – liquidity is the measure of the amount of resources an organization has that are cash or easily converted to cash in the near term to meet the obligations of the organization.  Accountants use near term and short term and current interchangeably.  Generally the near term means within 1 year or less.  Thus, an organization is liquid if it has enough near term resources to meet its near-term obligations.

Solvency – solvency is the same concept but from a long term perspective where long term means more then one year.  Will the organization have enough cash generation potential over the next 3,5, and 10 years to meet the major cash needs that will occur over those periods?  An organization must plan for adequate solvency well in advance because the potentially large amounts of cash involved may take a longer period to generate.

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Natural Death Guidelines

For many years people were not allowed to make decisions about death with dignity.  Today new laws allow individuals to have a say in how they want to live their last day.  Each state has adopted natural death guidelines and declarations that give direction to people about how to legally tell others their desire concerning end of life issues.  These documents ensure the individual the right to accept or refuse medical care.  In the United States every person is encouraged to prepare this document called an advanced directive.  Advanced directives help ensure the right to accept or refuse medical care.  Each state has a slightly different laws that govern the interpretation of these documents.  The advance directive is a written form providing a way for people to to express how they want medical decisions made if they are unable to make decisions for themselves.  Three common forms of advance directives are a living will, a health care power of attorney, and a durable power of attorney for health care.

Living Will - The living will provides a way for a person to express her or his desire for or against extraordinary measures that could prolong life.  A living will takes effect while a person is still alive.  Legal assistance may be necessary to ensure that it is interpreted in the way it was intended.

Health Care Power of Attorney - A health care power of attorney allows an authorized person to make health care decisions for an individual if he or she is unable to do so.  The HCPOA is more flexible than a living will and can cover any health care decisions.  A HCPOA can apply in cases of temporary unconsciousness or in case of diseases like Alzheimer’s that affect decision making.

Durable Power of Attorney for Health Care – In many states, a durable power of attorney for health care is a signed, dated, and witnessed paper naming an authorized person to made medical decisions for the individual if he or she is unable to make them.  This document also includes instructions about treatments to avoid.

It is important to remember that even with a written charge, a patient’s wishes stated directly to to the doctor generally carry more weight than a living will, health care power of attorney, or durable power of attorney, as long as the patient can decide and communicate his or her wishes.

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Medical assistants are responsible for the efficient operation of a physician’s office.  They also work in clinics, health maintenance organizations, and ambulatory care units.  Medical assistants must provide a clear record for someone who may be interested in learning how to be an accountant for the office you are a medical assistant at.  Medical assistants have varied duties besides keeping the accounting records straight.  Some medical assistants have specialized in back office procedures while others choose to work in the front office.  They work in doors in a clean environment, 40 hours a week, and some weekends.  They have varied job opportunities, and their work requires standing on their feet most of the day (back office), lifting, reaching and helping patients and clients.  They may be exposed to body fluids.  The front office worker sits at a desk for longer periods.

The current trend toward large medical groups has relocated administrative front office responsibilities.  Billing, insurance verification, medical records, appointment scheduling, and payroll have been relocated to departments that specialize in handling work for the increased number of patients/client.  Medical assistants often are responsible for:  Greet patients/clients, answer phones, handle mail, make appointments, arrange hospital admissions, arrange for laboratory services, prepare insurance forms, type medical reports, maintain patient files, may handle billing receipts, and prepare payroll for office staff.

While referring to the list of responsibilities above it is clear why a medical assistant should try to understand the role of accounting and the job of an accountant while preparing and documenting financial reports for a physician’s office.

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Your First Interview

Whenever you are making face-to-face contact with a potential employer, your appearance is critical.  First impressions are made in as little as three seconds, and once they are in place, they are lasting.  The first impression you make, good or bad will influence the decision of whether or not to hire you as an EMT or paramedic.

For job fairs, interviews, professional organization meetings, and anything else career related, always dress sharp.  A business suit is your best bet for an interview or for making a good impression no matter what.  It is recommended to wear a business suit even when trying to make contacts at events such as job fairs or conventions.  Stick to conservative or traditional styles and colors, and minimize accessories such as bulky watches or flashy cuff links.  In addition to professional appearance, allied health recruiters are looking for someone who makes good eye contact, smiles, has a firm handshake, and is engaging in conversation.  They are impressed by someone who can listen, interpret information, and acts in a professional manner.  Be courteous and polite, and be sure you interact with patience and confidence.  Being an EMT or paramedic is a people oriented job.  Recruiters and prospective employers are looking just as much for a personality that can work within a team, in addition to credentials.  Never act complacent or cocky about your credentials.  You must still prove yourself.  If you have a specialty, unit, or shift preference, let the recruiter know, but always express a willingness to get started in any area.  Flexibility can be a very valuable asset.  Ideally your professional appearance and approach will pay off, and you will get the job you are looking for.

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Contingencies can be divided into two categories: Gain contingencies and loss contingencies.  A gain contingency is a contingency where the possible future outcome is an increase in assets or a decrease in liabilities.  Gain contingencies are are rarely disclosed on financial statements. Gain contingencies are rarely accrued and only disclosed in the footnotes when they are highly probable.  The probability of a loss of contingency should be classified as either remote, reasonably possible, or highly probable.  A loss contingency is a contingency where the possible future outcome which leads to a reduction in assets or an increase in liabilities.  If the probability is remote, the loss need not be disclosed.  If the event is reasonably possible, the potential loss and all relevant information about it should be disclosed in the footnotes.  If the event is viewed as highly probable and the amount of the loss can be estimated, the potential loss and all relevant information about it should be disclosed in the footnotes.  If the event is viewed as highly probable the amount and the amount of the loss can be estimated, the potential loss and associated liabilities should be accrued on the financial statements and described in the footnotes.  When a sale is made that includes a warranty, the sale is recorded.  Because the warranty liability highly probable and can be estimated with reasonable accuracy, warranty expense and contingent warranty liability should be recognized in the amount of the estimated future warranty costs at the same time.  As the warranty costs are paid the contingent liability is reduced.  If you are learning how to become a CPA, one very vast field to practice accounting is in the medical industry.  Health care needs and costs will only increase in the future.

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Case Study: SAMPLE History

All patients must receive an initial assessment.  The focused history and and physical examination that follows the initial assessment may differ somewhat depending on whether the patient has a medical or trauma condition.  Most patients clearly fit into one of the two categories.

EMT’ Matt and Mary responded to a vehicle crash.  The patient was sitting on the ground outside the vehicle talking to bystanders.  Their scene size-up revealed no dangers to the EMT’s.  The mechanism of injury was obvious as they looked around the scene:  The patient’s car had struck a utility pole, causing moderate damage to the car.  Bystanders had helped the patient from the car, and no other patients were involved.  The initial assessment revealed that the patient was alert, had a patent airway, was breathing at a normal depth and rate, and ha a strong and regular pulse.  Matt then moved on to the next step – the focused history and physical examination for trauma patients.  The mechanism of injury was a front-end collision of a car into a utility pole.  The insider of the vehicle seemed intact, but because of the amount of damage to the exterior.  Mary realized that they must quickly evaluate the patient from head to toe to look for any unseen life threats not detected in the initial assessment.  The mechanism of injury suggested that there might be serious hidden life-threatening injuries even though the patient seemed to be stable.  Matt quickly evaluated the patient from head to toe to look for any unseen life threats not detected in the initial assessment.  The mechanism of injury suggested that there might be serious hidden life-threatening injuries even though the patient seemed to be stable. Matt quickly evaluated the patient from head to toe, inspecting, palpating, and auscultating to assess for injuries.  This rapid assessment was competed in 90 seconds.  Matt and Mary determined that no life threats were present.  The patient remained stable.  They applied a cervical collar and moved him onto a long backboard and into the ambulance and began to transport to the appropriate facility.  While en route to the hospital, Matt obtained the baseline vital signs and SAMPLE history.

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EMT’s chuck and Tyra were dispatched to a home of a 65-year old woman who was responsive, breathing and experiencing chest pain.  En route to the scene an EMT or Paramedic should consider what information they need to obtain immediately when they arrive.  Had anything caused chest pain?  What kind of pain was it?  Did anything help relieve the pain?  When did the pain start? Did the patient have any history of heart disease or heart problems?

On arrival Tyra immediately noticed the patient was sweating profusely and her breathing was labored.  The patient said she felt a crushing sensation in her chest, and the tightness was making it difficult for her to catch her breath.  Tyra questioned the patient and discovered that she had a history of heart disease and that the pain had started approximately 4 hours ago and did not subside after resting.  She had taken one of her own nitroglycerin tablet but experienced no relief.

As Chuck took the patient’s vital signs and administered high-flow oxygen with a nonrbreather mask.  Tyra decided that the patient would benefit by taking an additional nitroglycerin tablet.  She contacted the medical direction physician and received an order to assist with the nitroglycerin.  The patient felt some relief.  They continued monitoring her vital signs and began transport immediately.

Note: Cardiac emergencies are the most prominent type of medical emergency in the United States today.  Cardiovascular disease leads to more then 600,000 deaths each year, with half of those deaths attributed to coronary artery disease.  Up to 50% of heart attack victims suffer cardiac arrest, and up to 50% of these arrests occur outside the hospital.  Many of these victims can be saved if there is early recognition and the EMS systems can provide the CPR and early defibrillation.

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