HBIO Lecture 3

Background and Career Path

  • Interned in Washington D.C. during junior summer.

    • Worked long hours (7am to 7pm) but found paperwork overwhelming.

    • Needed a change of pace; continued education at UCI (University of California, Irvine).

  • Joined a sports team; one of the female coaches was a paramedic.

    • Offered an opportunity to ride along at an Orange County fire station.

    • Developed a passion for the career of emergency medical services (EMS).

  • Completed EMT (Emergency Medical Technician) program:

    • Six-week course.

    • Started working in the private sector after certification.

  • Worked at a different fire department for one year.

  • Current position at Los Angeles City Fire Department:

    • Over ten years of service; recently promoted to captain at USC station (30th and Hoover).

    • Invites students to visit the station.

Importance of the Medical Field

  • Important for students to figure out their interests in the medical field.

    • Particularly relevant for premed, PA (Physician Assistant) school aspirants.

    • Building rapport with patients is emphasized:

      • Importance of being able to communicate and understand patients' issues.

      • Challenges when patients are unable to communicate due to medical conditions or language barriers.

Personal Reflections and Journey

  • Emphasizes the significance of student choice to pursue premed.

    • Acknowledges the need for more individuals heading into emergency medicine.

    • Recalls the COVID-19 pandemic highlighting the crucial role of the medical field.

  • Hopes to inspire students to consider careers in EMS.

911 Call Process

  • Explanation of what happens when you call 911:

    • For cell phone calls:

      • Typically answered by California Highway Patrol (CHP), which may not be the right agency.

      • Calls can get lost during the transfer, especially during high-demand situations like riots or wildfires.

    • For landline calls:

      • Calls are linked to a physical address, providing clear locations to first responders.

      • Can respond directly to the caller's location without confusion.

    • Challenges in finding locations at night or in emergencies without visible cues (e.g., using phone flashlights).

Overview of EMT Role

  • The role of an EMT involves providing prehospital care:

    • Ranges from simple first aid to advanced support like CPR and medication administration.

    • Each region has specific scope limitations regarding what EMTs can do, guided by federal, state, and local regulations.

    • LA County EMTs are limited in their procedures given the proximity of hospitals.

Levels of EMS Training

  • The hierarchy of emergency medical training includes:

    1. Emergency Medical Responder (EMR):

      • Entry-level position involving basic first aid and CPR training (40-60 hour course).

    2. Emergency Medical Technician (EMT):

      • More advanced care with a limited set of medications and procedures (typically the interventional level).

    3. Advanced EMT (AEMT):

      • Additional training allowing for IV access and basic cardiac monitoring.

    4. Paramedic:

      • Highest level of prehospital care and requires more extensive training (1200 to 1800 hours) and patient interactions.

      • Capable of advanced procedures like intubation and medication administration with a clear scope of care.

Skills and Equipment Used in EMS

  • Commonly used equipment includes:

    • Glucometer: for checking blood sugar levels (recently classified as a basic skill).

    • Lucas device: automated CPR device that performs high-quality compressions.

    • Bag-valve mask: used for resuscitation during cardiac arrest.

    • Saline bag: for IV access and hydration treatment.

    • Cardiac monitor: vital for assessing heart rhythms and guiding treatment.

    • Cervical collar: used for spinal protection during transport.

  • Treatment of traumatic injuries and the evolution of protocols in response to past practices emphasized.

    • Example: Prior standardization of cervical collars for all trauma victims was reevaluated leading to selective use.

Career Opportunities and Paths in EMS

  • Options beyond EMT roles include:

    • Firefighter EMT/Paramedic: With a focus on emergency response in a fire department.

    • ER Technician: Offers a perspective within a hospital on emergency procedures and medical treatment.

    • Registered Nurse/Surgical Tech: Further options within healthcare.

    • Flight Paramedic: For cases needing air evacuation.

    • Private sector EMT: Different pay and work environments.

Salary and Work Schedule

  • Salaries in EMS vary based on position and location:

    • Public sector (e.g., firefighting, municipal EMS): generally higher salaries.

    • Private sector: usually lower pay and less favorable working conditions.

  • Typical work schedules:

    • Firefighters may work 24-hour shifts.

    • ER techs often have 3-12 hour shifts, likely on busier holiday weekends.

Conclusions and Advice

  • Emphasizes the importance of calling 911 directly for emergency situations.

    • Avoid calling other agencies (e.g., campus DPS) to prevent delays in care.

  • Encourages students to ask questions and stay engaged in their learning.

  • Reminds students to recognize the critical role first responders play, especially evident during crises like COVID-19.

Final Thoughts

  • Recalls many varied experiences in EMS, highlighting the unpredictable nature of the job.

    • Stories of dealing with challenges from everyday emergencies to large-scale events like riots or disasters.

  • Offers students insights into what a career in EMS entails, the challenges faced, and the fulfillment it can bring.

  • Encourages taking advantage of opportunities such as tech positions to inform future roles in medicine.

  • Stresses understanding the realities of the medical field, such as patient interactions and emotional investments.

  • Overall, a call to action for those interested in a medical career to appreciate the experiences they can gain and the importance of their future roles.

Background and Career Path

  • Speaker: Scott Cleveland, Captain at Los Angeles City Fire Department (USC Station, 30th30^{th} and Hoover).

  • Career Journey:

    • Interned in Washington D.C. during junior summer (77 am to 77 pm); found the paperwork overwhelming.

    • Continued education at UCI (University of California, Irvine).

    • Joined a sports team; one of the female coaches was a paramedic who offered a ride-along at an Orange County fire station.

    • Developed a passion for the "consistencies" and engagement provided by emergency medical services (EMS).

    • Completed a six-week EMT program and began working in the private sector.

    • Gained experience at a different fire department for one year before joining the LAFD, where he has served for over 1010 years (over 1313 years total in EMS).

911 Call Process

  • Mechanism of Calling:

    • Cell Phone Calls: Often answered by California Highway Patrol (CHP) or California Control. Calls may be rerouted, and there is a risk of being dropped during high-demand events like riots or wildfires. Cell phones only "ping" the nearest tower and do not provide a fixed physical address.

    • Landline Calls: Linked to a physical address; dispatchers immediately see the caller's terminal location and name.

  • Emergency Communication: Use a cell phone flashlight to signal first responders at night. It is critical to call 911911 directly rather than campus agencies (like DPS) to avoid delays in care.

Overview of the EMT Role

  • Definition: An Emergency Medical Technician (EMT) provides prehospital care, ranging from basic first aid and applying bandages to life-saving measures like CPR and medication administration.

  • Scope of Practice: Regulated by federal, state, and local laws. In LA County, the scope is relatively limited due to proximity to trauma centers; the focus is on stabilization and rapid transport.

  • The Investigative Nature of EMS: Professionals must quickly determine patient issues through communication and rapport, especially when faced with language barriers or unconscious patients.

Process of Becoming an EMT

  1. Education: Enrollment in an EMT program, which can range from a full semester to shortened, expedited courses (170170 hours).

  2. Certification: After completing the course, candidates must pass the National Registry (NREMT) exam.

  3. Employment: Apply and interview for positions in private or public sectors.

  4. Prerequisites for Advancement: One must be certified as an EMT-Basic prior to enrolling in paramedic school.

Levels of EMS Training

  1. Emergency Medical Responder (EMR): Entry-level (40−6040-60 hour course) focusing on basic first aid, CPR, and AED usage.

  2. Emergency Medical Technician (EMT): More advanced training (170170 hours) including childbirth assistance and a limited set of drug administrations.

  3. Advanced EMT (AEMT): Adds skills for IV access, specific drug therapies, and basic cardiac monitoring.

  4. Paramedic: Highest level of pre-hospital care (1,2001,200-1,8001,800 hours). Provides Advanced Life Support (ALS), advanced airway management (intubation), and extensive medication administration.

Skills and Equipment Used

  • Glucometer: Used for checking blood sugar levels (classified as a basic EMT skill).

  • Lucas Device: Automated device that performs consistent, high-quality CPR compressions to improve survival chances.

  • Bag-Valve Mask (BVM): Used for ventilation and maintaining oxygenation during cardiac arrest.

  • Saline Bag: Used for IV fluid administration to manage hydration and assist in blood level balance.

  • Cardiac Monitor: Essential for assessing heart rhythms and guiding treatment during cardiac events.

  • Cervical Collar (C-Collar): Used for spinal stabilization and transport of traumatic injuries; protocols have evolved to emphasize selective use for severe risk cases.

Career Opportunities and Paths

  • Public Sector EMS: Firefighter EMT/Paramedic (2424-hour shifts usually), Emergency Dispatcher.

  • Hospital Environment: ER Technician (excellent entry point for hospital exposure), Registered Nurse, Surgical Tech, Physician Assistant, Radiologic Technologist.

  • Specialized Fields: Flight Medic (air evacuation), Set Medic (entertainment industry), Vet Technician, Forensic/Senior Science Tech, Private Sector EMT.

Salary and Work Schedule

  • Salary Variations:

    • Private Sector EMT: $48,000\$48,000 to $73,300\$73,300.

    • Firefighter/EMT: $67,040\$67,040 to $90,460\$90,460.

    • Firefighter/Paramedic: $142,000\$142,000 to $201,500\$201,500.

  • Work Schedules:

    • LAFD: 2424-hour shifts in an "on/off/on/off" pattern.

    • Orange County Fire Authority (OCFA): 48/9648/96 schedule (4848 hours on, 9696 hours off).

    • ER Technicians: Typically three 1212-hour shifts per week.

    • Physician Assistants: 4040-hour work week or three 1212-hour shifts per week.

    • Flight Medic: Typically two 2424-hour shifts per week.

Ethics and Professionalism

  • Patient Interaction: EMS professionals must maintain a non-judgmental attitude and demonstrate emotional resilience.

  • Decision-Making: The job requires quick thinking and effective stress management in unpredictable environments.

  • Advice for Premed Students: Exposure to emergency medicine is described as critical for future healthcare roles, as it emphasizes the human side of medicine and patient rapport.

EMS (C) - Emergency Medical Services at USC

  • Main Contacts: Shivanee Kooner and Ryan Buckner.

  • Membership: Open to all California-certified EMTs.

  • Organization: Operates under the umbrella of USC Fire Safety.

  • Community Education and Outreach:

    • Offers Basic Life Support (BLS) classes and BLS CPR Certification.

    • "Stop the Bleed" workshops.

    • Vital EMS workshops designed to allow students to see if EMS is the right career path for them.

  • Certification Paths:

    • Students can obtain certification through the USC/UCLA EMT course.

    • Format: Accelerated hybrid format consisting of online coursework and in-person skills training (Pearson skills).

    • Duration: Typically lasts around 11 semester.

  • Contact Email: emsc@usc.edu.

Student Perspectives and Profiles

  • Ryan:

    • Joined EMS(C) as a first-semester freshman.

    • Premed track; currently preparing to take the MCAT in August.

  • Shivanee:

    • Joined as a sophomore; previously worked in 911911 services in San Diego.

    • Premed track; has already completed the MCAT and a gap year.

    • Holds a Master's degree in Anatomy; applying to medical school in May.

Background and Career Path - Scott Cleveland

  • Speaker: Scott Cleveland, Captain at Los Angeles City Fire Department (USC Station, 30th30^{th} and Hoover).

  • Education:

    • Completed undergraduate studies at UCR (University of California, Riverside) with a degree in International Relations.

    • Continued education at UCI (University of California, Irvine).

  • Career Journey:

    • Interned in Washington D.C. during junior summer (77 am to 77 pm); found the paperwork overwhelming and knew he wanted a different pace.

    • While at UCI, joined a sports team where a female coach—a paramedic—offered a ride-along at an Orange County fire station.

    • Developed a passion for the consistency and engagement provided by emergency medical services (EMS).

    • Completed a shortened, 66-week EMT program and began working in the private sector.

    • Gained experience at a different fire department for one year before joining the LAFD, where he has served for over 1010 years (over 1313 years total in EMS).

911 Call Process

  • Mechanism of Calling:

    • Cell Phone Calls: Often answered by California Highway Patrol (CHP) or California Control. Calls may be rerouted, and there is a risk of being dropped during high-demand events like riots or wildfires. Cell phones only "ping" the nearest tower and do not provide a fixed physical address.

    • Landline Calls: Linked to a physical address; dispatchers immediately see the caller's terminal location and name.

  • Emergency Communication: Use a cell phone flashlight to signal first responders at night. It is critical to call 911911 directly rather than campus agencies (like DPS) to avoid delays in care.

Overview of the EMT Role

  • Definition: An Emergency Medical Technician (EMT) provides prehospital care, ranging from basic first aid and applying bandages to life-saving measures like CPR and medication administration.

  • Scope of Practice: Regulated by federal, state, and local laws. In LA County, the scope is relatively limited due to proximity to trauma centers; the focus is on stabilization and rapid transport.

  • The "Medical Detective" Role: EMS professionals act as investigators on scene to determine patient issues through communication and rapport. This helps decide whether to treat the patient on-scene or transport them to the hospital, especially when faced with language barriers or unconscious patients.

Process of Becoming an EMT

  1. Education: Enrollment in an EMT program, which can range from a full semester to shortened, expedited courses (170170 hours).

  2. Certification: After completing the course, candidates must pass the National Registry (NREMT) exam.

  3. Employment: Apply and interview for positions in private or public sectors.

  4. Prerequisites for Advancement: One must be certified as an EMT-Basic prior to enrolling in paramedic school.

Levels of EMS Training

  1. Emergency Medical Responder (EMR): Entry-level (40−6040-60 hour course) focusing on basic first aid, CPR, and AED usage.

  2. Emergency Medical Technician (EMT): More advanced training (170170 hours) including childbirth assistance and a limited set of drug administrations.

  3. Advanced EMT (AEMT): Adds skills for IV access, specific drug therapies, and basic cardiac monitoring.

  4. Paramedic: Highest level of pre-hospital care (1,2001,200-1,8001,800 hours). Provides Advanced Life Support (ALS), advanced airway management (intubation), and extensive medication administration.

Skills and Equipment Used

  • Glucometer: Used for checking blood sugar levels (classified as a basic EMT skill).

  • Lucas Device: Automated device that performs consistent, high-quality CPR compressions to improve survival chances.

  • Bag-Valve Mask (BVM): Used for ventilation and maintaining oxygenation during cardiac arrest.

  • Saline Bag: Used for IV fluid administration to manage hydration and assist in blood level balance.

  • Cardiac Monitor: Essential for assessing heart rhythms (heart rate) and guiding treatment during cardiac events.

  • Cervical Collar (C-Collar): Used for spinal stabilization and transport of traumatic injuries; protocols have evolved to emphasize selective use for severe risk cases.

Career Opportunities and Paths

  • Public Sector EMS: Firefighter EMT/Paramedic (2424-hour shifts usually), Emergency Dispatcher.

  • Hospital Environment: ER Technician (excellent entry point for hospital exposure), Registered Nurse, Surgical Tech, Physician Assistant, Radiologic Technologist.

  • Specialized Fields: Flight Medic (air evacuation), Set Medic (entertainment industry), Vet Technician, Forensic/Senior Science Tech, Private Sector EMT.

Salary and Work Schedule

  • Salary Variations:

    • Private Sector EMT: $48,000\$48,000 to $73,300\$73,300.

    • Firefighter/EMT: $67,040\$67,040 to $90,460\$90,460.

    • Firefighter/Paramedic: $142,000\$142,000 to $201,500\$201,500.

  • Work Schedules:

    • LAFD: 2424-hour shifts in an "on/off/on/off" pattern.

    • Orange County Fire Authority (OCFA): 48/9648/96 schedule (4848 hours on, 9696 hours off).

    • ER Technicians: Typically three 1212-hour shifts per week.

    • Physician Assistants: 4040-hour work week or three 1212-hour shifts per week.

    • Flight Medic: Typically two 2424-hour shifts per week.

Ethics and Professionalism

  • Patient Interaction: EMS professionals must maintain a non-judgmental attitude and demonstrate emotional resilience.

  • Decision-Making: The job requires quick thinking and effective stress management in unpredictable environments.

  • Advice for Premed Students: Exposure to emergency medicine is described as critical for the future of healthcare. Scott Cleveland emphasizes that the recent COVID-19 pandemic highlighted how vital medicine is to the world, validating the decision to pursue a medical career.