island emt Posted January 29, 2013 Share Posted January 29, 2013 TIMEOUT called in the sandbox. Link to comment Share on other sites More sharing options...
J306 Posted January 29, 2013 Share Posted January 29, 2013 This conversation reminds me of why it is difficult for our profession to advance. It does not matter whether your protocol says it's okay; it's all about what your intentions are, and I think you've realized that your intentions may be misdirected since you are getting defensive. This also reminds me of the medics I've heard about who try and find a reason to practice a skill, not for the benefit of the patient, but to try and boost their ego. I witnessed a paramedic use the new MFI protocol on a patient in the hospital who turned out to have decreased resps/ LOC because of ETOH. This kind of behaviour scares me. Even more so that you don't see a problem with the culture you and your co-workers have created. 1 Link to comment Share on other sites More sharing options...
Arctickat Posted January 29, 2013 Share Posted January 29, 2013 Emily, we all agree that you're are doing right by your patient in turning them on their side to ensure the airway is clear, what we call into question is the lack of professionalism involved in your admission that your entire organisation intentionally attempts to contaminate their partner. Rolling the patient so he pukes on the floor is inconsequential and occupational hazard. We can step over the puddle, or throw a soaker over it so we don't track it around the back of the ambulance. However, you describe it as though you grab the spineboard and flip the patient haphazardly onto his side without warning your partner that he's about to hurl into his lap when what you should be doing is getting your partner to assist with C-spine control while the patient is rolled onto his side until the airway is clear. Clearing the airway of a vomitting patient with a suspected spinal injury is not a game and I sincerely hope that you have absolutely no patients with a long term spinal deficit, because if his lawyer were to stumble across this conversation....well.... Link to comment Share on other sites More sharing options...
Guest ~~~ Posted January 30, 2013 Share Posted January 30, 2013 (edited) Protocols says nothing about warning one and another. Its sort of obvious when a couple people do the roll. You clean the puke off the ground, and clean it off of you. Occupational hazards is apart of the job. Anyone that has worked on a rig long enough knows that. No patients have gotten hurt, none will. I'm no lawyer but I am sure my agency will have the upper hand in a suit. Finished with the thread. Edited January 30, 2013 by PattonEMT Link to comment Share on other sites More sharing options...
Arctickat Posted January 30, 2013 Share Posted January 30, 2013 Protocols says nothing about warning one and another. No, but common courtesy and respect do. Not to mention the statement, "He's gonna puke, help me roll him." No patients have gotten hurt, none will. I'm no lawyer but I am sure my agency will have the upper hand in a suit. It might have, until now. Finished with the thread. You might be, but I'm sure others will have more to add. Link to comment Share on other sites More sharing options...
scubanurse Posted January 30, 2013 Author Share Posted January 30, 2013 Went to an MVA and a man was obviously drunk. We took him to the hospital. On the way I noticed how he was about to shower himself in his own puke, so I did a patient roll towards to the emt-b's and they got the privilege to get some on their clothes. You know, don't want his airway being restricted. No offense to the emt-b's out there! It's actually a game the emt's and us paramedics play down here. If the patient looks like he or she is about to vomit who ever gets to them first can do the pt roll towards the other. It's also not your textbook perfect roll, but we're not aggressive with them. They are usually out of it and boarded/collared. Luckily the county gives paramedics jumpsuits and bunker gear, so it's a smaller mess to clean up off of us if we're wearing one of the two; needless to say emt's aren't as lucky. Personally the best stories I have is from schooling. Nothing too exciting down here.. Just your average hemorrhaging calls that by the time you get there the bleeding has already stopped, and cardiac arrest calls. This whole post just shows arrogance and ignorance when it comes to the risks of exposure. If the patient had force behind their vomit, would your partner be protected with adequate eye protection? To openly admit it is a game shows a lot of immaturity and lack of leadership. It's justifiable. In my agency's protocols if a patient shows signs of emesis we have to do a patient roll, ideally to the right side. Unless if you can prove it was for entertainment reasons then the report isn't going to get far. If one gets caught causing harm to a patient or another during transport for entertainment (yet to happen) or for other reasons depending on other factors the least case scenario is a two or three week administrative leave; worst case is being let go. That has yet to happen either. Also doing a patient roll isn't harming the patient if needed. On your side the liquids/solids tend to fall out on the gurney and floor, which is the point when one is vomiting. Worst thing is it gets on your shows and lower/mid parts of your pants. It's also not like we're laughing when we do it; but one may whisper to the other after releasing the patient to the hospital while doing paperwork "I got a point" or something along those lines. Hopefully clears it all up. I have also been a medic for 6 1/2 years, I promise I know what I am doing. You openly admitted it was for entertainment purposes on a public forum where you have your name, location and photo shown. Your time as a medic and the statement "I promise I know what I am doing" just goes to show maybe you don't. I would have thought after 6 1/2 years in the field, you would show leadership qualities to put an end to this game and perform BSI/Scene safety first above any entertainment factor. I really don't need to explain myself but here we go again. I'm going to re-edit so its shorter. Please understand #1 and #3 as clear as possible. 1.Once again as I said it gets on their shoes or lower/midnight part of pants. Its not the biggest decon ever; easy clean and change. 2. If you wish call my agency and report it, feel free. If you would like I will give you my directors and supervisors personal numbers and you can call them. 3. Before attempting to do #2 understand it's protocol to put the patient on his or hers side. Either way it will get on the rigs floor and either the emt or medics lower pants and boots. Once again I will say it again: Either way the medic or emt may get some on them. 4. Also understanding before attempting #2 there's no official score, we don't treat any patient as a game. 5. I will follow protocol, regardless. If it changes then I will stop and if I see someone do it I will report it. Thanks. And if it gets in their eyes or mouth and the insurance representative from workers comp asks you if there was anything you could have done to prevent the exposure? Protocols says nothing about warning one and another. Its sort of obvious when a couple people do the roll. You clean the puke off the ground, and clean it off of you. Occupational hazards is apart of the job. Anyone that has worked on a rig long enough knows that. No patients have gotten hurt, none will. I'm no lawyer but I am sure my agency will have the upper hand in a suit. Finished with the thread. A lot of falling back on protocols just makes me miss Dustdevil. Just because protocol doesn't state specifically not to log roll the patient towards a partner doesn't mean you shouldn't avoid doing it. 2 Link to comment Share on other sites More sharing options...
island emt Posted January 30, 2013 Share Posted January 30, 2013 as a supervisor you should know better. As you get older and move up the food chain , you will understand why. Link to comment Share on other sites More sharing options...
medicgirl05 Posted January 30, 2013 Share Posted January 30, 2013 I can't believe that you would try to defend intentionally getting vomit on your partner by stating that protocols don't say not to. The protocols don't say not to strangle your patient with oxygen tubing, yet I have never done that either. Some of us are trying to make a good name for our profession and others are making us look like idiots in practice and on a public forum. I'm embarrassed for you. Link to comment Share on other sites More sharing options...
paramedicmike Posted January 30, 2013 Share Posted January 30, 2013 It is a pretty ridiculous argument to say that protocols don't require notifying the person about to get puked on. I'm willing to bet your protocols don't address many issues that may be encountered over the course of a shift. Does that mean those issues aren't addressed simply because a protocol doesn't exist? Furthermore, demonstrating such a reliance on protocol in deference to common sense and basic exposure knowledge does not speak well for you as a provider, your employer or your system as a whole. You said that your supervisors are in on the joke and play along as well? What a horrible reflection on EMS in southern Delaware. Link to comment Share on other sites More sharing options...
Guest ~~~ Posted January 30, 2013 Share Posted January 30, 2013 as a supervisor you should know better. As you get older and move up the food chain , you will understand why. I am a field paramedic, also I wasn't a supervisor; it was called division manager. I stepped down, underlining that just to make it clear. I am thinking about continuing education elsewhere or changing agencies. It's harder to get out of it higher you get up. I can't believe that you would try to defend intentionally getting vomit on your partner by stating that protocols don't say not to. The protocols don't say not to strangle your patient with oxygen tubing, yet I have never done that either. Some of us are trying to make a good name for our profession and others are making us look like idiots in practice and on a public forum. I'm embarrassed for you. Intentionally? no. But since you have a problem with a patient roll because it can possibly contaminate a co-worker and you are ever my patient I'll make sure I will keep you in your current position collared and boarded and let the ED take care of you. Because why harm you anymore? your already going to the hospital. That goes for everyone. Now before everyone goes apeshit for that statement I would never do that, it was called sarcasm. I am going to put this in red and underline it and maybe someone will pick it up. When a patient roll is done the vomit WILL go on the floor; in result vomit may end up on an EMT's or medics pants and/or boots. If the EMT or medic moves vomit will STILL end up on the floor of the rig. In result vomit may still end up on a medic's or EMT's boots. When a patient roll is finished we do not laugh and make fun of each other during transport of the patient. If there is a possible neck injury c-spine will be held. I never said it wouldn't be. If I do a patient roll it's not my responsibility to clean up the vomit during the roll. If there is a suspected neck injury c-spine will be held, someone will be holding the board to it's side, and another if needed will be doing suctioning. In that time there is NO room to clean up the vomit on the ground. I don't think that's being quite put through people's heads. As I sad before there's no official score, sometimes a little comment will be stated in the ems lounge while filling out the paperwork or if a medic or EMT is walking out the door. It is a pretty ridiculous argument to say that protocols don't require notifying the person about to get puked on. I'm willing to bet your protocols don't address many issues that may be encountered over the course of a shift. Does that mean those issues aren't addressed simply because a protocol doesn't exist? Furthermore, demonstrating such a reliance on protocol in deference to common sense and basic exposure knowledge does not speak well for you as a provider, your employer or your system as a whole. You said that your supervisors are in on the joke and play along as well? What a horrible reflection on EMS in southern Delaware. Common sense, common sense, common sense. This will also go for medicgirl05. No one would strangle a patient with oxygen tube, especially if they are having a breathing issue. That's common sense. IT IS also common sense to move from danger. But good job at red herring. Supervisors will make little comments post call. -- There has yet to be a death caused by EMS in southern Delaware. Last injury to a patient in southern Delaware is countless of years ago. But there was an ambulance crash back in 08' in Sussex County (southern del) but there was no patients aboard. It was a couple EMT's and a county medic and a SUV hit them. Last injury to a patient in the whole state of Delaware was I'd say around five years ago. A junior firefighter was helping carry up a patient in a litter with a couple paramedics and other firefighters up a dirt slope. This patient worked at a state road services place where they dug up sand to place at certain parts of the state where ever needed. The sand pit filled with water and the patient felt like jumping in, when he did he didn't know he was jumping into shallow water and broke his neck. The junior firefighter slipped and dropped the basket less than a foot off the ground and his side hit a rock sticking out of the ground. Patient came around and found out he was paralyzed from the neck down. He sued the junior firefighter's company for paralyzing him. But in reality more than likely it was his jump. Link to comment Share on other sites More sharing options...
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