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You call their supervisors and follow it up with. Written complaint. A few of those and they will be gone. This is a service industry. A lot of people forget that, that cause their is only one emergency number, 911, that who else are they gonna call.
I was always of the thinking that adenosine is kind of a diagnostic drug. Yes it can chemically cardiovert, but more importantly allow you to see the underlying rhythm of what is causing the extreme rate by slowing the rate long enough and take steps from there.
Years ago I got a call for someone who had been bouncing on a trampolene, while intoxicated, had smacked his face on the outer metal rim. Normal this would have been an uneventful call except that the man had braces, and some kind of retainer or palate expander.
So when he hit, the metal and plastic broke off partially and was rammed half down his throat.
The patient remained calm, I don't think he realized his peril at that moment, and allowed me to use magill forceps and manipulate the plastic and metal back up his throat and used tin snips to cut the mangled mess away.
He said thanks, I will go to my orthodontist tomorrow. I advised him against this. , but it was his party and there was no way to get him to leave. Called command had them talk to him, signed him off and was offered beer and cake to take back to the station.
If the call was on the way to the hospital you could have stopped, started to render care, have your partner stay with the woman in the back and just nicely explain that it will only be a short delay.
That way you can possibly get an airway and stabilization til the next crew shows up. Hand care off to them or transfer your patient to them.
I remember my first paid 911 job was a volunteer based squad. The one thing they told me when I started was that just like paid employees, volunteers can be fired.
I know that is drastic and last option, but if those who are there refuse to give the quality service your customers deserve, get rid of EM.
Philly just put a medic class through the fire academy, started April 18th. I actually had gone through the process, got fitted for bunker gear, had physical at 19th and fairmount. Decided to stay in the counties. Fire academy for medics is 6 weeks long.
There is a reason why they are hurting for medics, they have a high turnover rate. The management could care less about the staff and the union is at big odds with the mayor.
If you are doing 911 somewhere else, I wouldn't go to the city. Once I found out everything I did you couldn't pay me enough.
I am just glad I didn't quit my other gigs when I got my letter for the city.
The narcs are in a locked cabinet that only the medic can access(emts don't carry keys) and they are zip tagged.
But in the back of the truck when it is only the medic and the pt. who is to say the medic gives 5cc of saline instead of 100 mcgs of fentanyl.
Patients don't know. Medics have a great deal of autonomy, atleast in the area of PA. I am in and could very easily get themselves in trouble.
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From a rare, and I mean extremely rare, tour I may not get any rest in that 24. In Philly they can't do 24s as they don't usually see the station after the shift begins. But in the surrounding counties, where I practice, 24s are still allowed because there is almost guaranteed downtime.
As far as being awake at hour 20 compared to hour 3 , absolutely not. Even if I slept half the shift, I still wouldn't be as sharp, but 24s still have their place, simply due to shortage of ALS providers.