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VentMedic

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Everything posted by VentMedic

  1. I do not find humor in what happened to this baby or what the transport crew had to go through. Their company did fail. I get defensive because I do posts links to support my arguments and give examples. I repeat myself over and over as well as post more links but yet some keep coming back with the same blastings over and over just as what JP did. That is frustrating as I waste time arguing a point already made to someone who can not support their own statements. I realize, again, I only wsste my time on this forum and seriously could be using this time to teach those
  2. It seems you and I were typing at the same time. It is actually not a term of endearment but rather used by residents who hate NICU rotation or at least not in all parts of the country. It is sorta like the term GOMER but in neo land. If the neo attendings hear a resident using that term, the rest of their rotation will not be pleasant. In the past families have over heard less than thrilled residents talking about the babies and any disrespect to the babies or their families in the NICU will not be tolerated. What they do or say off campus is of course their own business. So
  3. Was I also supposed to write thank you for your compliment? I honestly did not believe it was necessary. However, when you agreed with ERdoc who again called me out to show proof to data that had already been mentioned in the JEMS article which is what I took apart, I did feel there was a need to provide a response and question your motive. You did not place a bunch of "smiley things" or provide any other indication that is was intended to be a joke. This point system gives no indication of who gave what. If one had to actually give a reason for the point, either negative or positive,
  4. Let me tell you how the conversation would have gone: ED physician to OB at higher level facility: Can you accept a maternal transfer with 25/26 week premature labor? OB: "Sure, can you arrange for transfer or do you need us to send out our team?" ED physician: "We have a Paramedic ambulance that states they are qualified for this transfer." Or, the OB assumed the sending doctor was utilizing one of the more advanced teams to transport the patient such as those that may have RN/RN crews with a variety of experience. ED physican to ALS ambulance: "Can you take a woman in labor
  5. My assumption came very easily when you agreed at a statement bashing me for a statistic that was initially posted in the JEMS article which was linked by Dust and also a newsfeed article. Did either you or ERdoc bother to email the author of that article to post his source for that statistic? This is a serious conversation and I don't appreicate you bashing me for something that has directly affected the way IFT transport is provided here in Florida. And, again, if you had bothered to read a couple of my links, you would see what exactly I have referred to.
  6. The sending doctor and hospital realized their errors and did not want a jury trial. Even critical care and flight teams that are considered advanced level care can abort a transport if they feel the patient can not be moved safely by their resources. A Paramedic ambulance definitely can in an area where there are other resources. Yes, the fault falls to the doctor but the Paramedic failed to inform they were not the best option for transport or realize they were in over their heads. Maybe the eager cowboy attitude also gave the doctor a false sense of security that the Paramedic was a sup
  7. By your "wheezer and seizer" remark this will probably be a waste of my time. It seems you already have your opinion about any efforts to save these babies. Doctor, in the past 3 years I have posted link after link about scientific studies and statistics. Do you know what I found? I wasted my time because very few people who reply to my posts never read the links and really don't give a rat's ass about stats or ANY of the information in those links unless it has been verified by JEMS. Doctor, this is probably one of the easiest piece of information to research. You can borrow an NR
  8. Here's an idea for both you an ERdoc...talk to a neonatalogist. See if a 25 week baby is viable. Did you not read what I stated about the NRP which is also stated in the course? The hospital knew they could not keep a 25 week baby. However, they could have kept the mother if she delivered. If this was an area where there were no transport options for hundreds of miles...maybe. But if that is the case you damned well better have some way of keeping a neonate alive. Just, "oh well, if they live, they live" is not acceptable. Please tell me which hospital in
  9. Do you not think that is a valid question since JP may be in that position some day? I have worked several areas in healthcare. I have moonlighted in those little EDs when a mother comes in ready to bring out a preemie into the world. I have been in a major medical center where ambulance crews have ran in with L&S where they are limited to even fixing an occluded IV line. The pumps were also set up by an RN who is trusting the patient will arrive safely or he/she may be drug into a bad mess. Truly not a good situation for all involved. I have seen an ICU attendings and ED doctors
  10. For goodness sakes JP! Do you not know how to search for neonatal statistics? The stats quotes at 50% came from JEMS. It just took a few quick checks to see where he pulled that number from on the internet. I never made any direct statement as to where he got that information because JEMS was not part of the trial. Just look at the reputable neonatal websites and you can read all about neonatal stats. I also take NRP which is full of fascinating stats in the reference section that makes taking the course over and over again worthwhile as they are being updated as medicine evolves.
  11. JP and ERDoc, I already provided links to Volusia County and the court documents. Sorry but I am not going to spoon feed either one of you and you will have to click on the links yourselves. ERDoc, Are you comparing your education and training to a Paramedic with 6 months of training and very little baby or peds education? Even without NRP, as an ED physician, did you not do a rotation in the NICU or L&D? Did none of your training and education address this? If you wanted a cardiac patient transferred out of your ED to a center of higher care and the Paramedic showed up wi
  12. So you think the back of an ambulance is better for almost 70 or even 17 miles with virtually no specialty equipment or even something to keep the baby warm? Or how about NRP and intubation skills? Almost every ED in this country, even the smallest, have a Braslow code cart, an infant warmer, infant ventilator and at least one person somewhere inhouse who has taken NRP. The Children's Hospitals sponsor NRP at these local little hospitals and invite their RRTs to their NICU to get some airway and ventilator management skills. It generally does not take long for one of these neo teams
  13. I have not seen this show yet although I know it is supposed to be modeled after the Ryder Trauma Center (Jackson Memorial Hospital). Here's a decent article about the inspiration for the show. http://www.tvguide.com/news/miami-medical-rock-1016874.aspx I also believe most of the filming will be in Southern CA so just like Miami Vice, watch for the sun to set over the Atlantic Ocean on Miami Beach. The only show I like that is supposed to be Miami based is Dexter. I guess you might say it involves some major surgery or at least the cutting part. Other than the original 1960s Flippe
  14. What exactly are the requirements for nurses to work on an ambulance in most areas of your country? Can you post some links?
  15. Right now the jobs are competitive and the better positions have always managed to attracted over 1000 applicants and now with this economy, that number is very high. San Francisco FD were just hiring for FF. It was rumored they got close to 10,000 applications. Of those, and this is from their HR website, 6,196 took the test, 5,200 passed. They also had a few vacancies on the EMS side and I don't know how many applied and tested for that but I would imagine quite a few since there is no shortage of EMTs and Paramedics in most of California. A couple years ago Oakland FD had open hi
  16. Undecided? California? Something even more silly than FF/Paramedic? How about this job: http://www.sunnyvaledps.com/recruiting.htm The Money: http://sunnyvale.ca.gov/Departments/Public+Safety/Recruiting/ Public Safety Officers have had their place in history and there are still several communities throughout the U.S. that utilize them.
  17. Here is a good example about California I borrowed from the "other forum". http://www.emtlife.com/showthread.php?t=17693
  18. Is it any more difficult than a Paramedic who has very little A&P and only has the minimum required hours to complete a Paramedic course? (speaking of the U.S.) Many of these new grads come out of the programs with very little live patient experience for even their skills such as IVs and intubation which is the meat and potatoes of theri profession. Working as an EMT-B only gives them very limited patient care experience. As it stands now, many Paramedic programs have too few clinical hours. After certification they are then given a couple of shifts with a preceptor and made "lead" medi
  19. Leaving each county to do its own thing can be a little fragmenting of state control List of Paramedic scope of practice by county. http://www.emsa.ca.gov/paramedic/files/scopechart.pdf Local optional scope of practice: http://www.emsa.ca.gov/paramedic/files/EMTSOP3.pdf Example of "CCT" expanded (?) scope: http://www.emsa.ca.gov/paramedic/files/contracosta_scope.pdf And this is their additional training requirment: I also believe they are only allowed to use ATVs as ventilators which is not appropriate for "critical care transport". Thus, the RNs are on the CCTs with their
  20. Freedom House http://www.freedomhousedoc.com/ MAKING A DIFFERENCE The History of Modern EMS (DVD) By:Jim Page,
  21. That article gave in detail examples of points I was trying to make in my earlier post although I don't believe the author sees it the same as I do. Highlights: Known high risk at 25 weeks gestation. Contractions at 4 minutes apart. Ground transport of over 60 miles. 1 Paramedic. (article only mentions one Paramedic being honored by EVAC for a good job) Must consider both the mother and the baby to be patients and SICK. No fetal monitor mentioned for a 60+ mile transport. Only a silver swaddler with a known possibility of a 25 week preemie being born. 8 minutes of CPR
  22. No. Not totally true. You can be summoned to court to recall and answer any questions about the care you did or did not provide. That piece of paper is not magic. There is a reason why surgeons make patients write what they believe the doctor just told them before surgery and while they are signing the consent. Several factors will be involved. Who placed the 911 call? The nature of the call? Is there alcohol or drugs (legal or illegal) involved? Does the call concern a safety issue for the patient or others? Are you the one who talked the patient out of transport for whatever reason
  23. For those of you who may not be familiar with what goes into one of these lawsuit cases, here is the court case number: Case Number: 2004 30861 CICI Court: Circuit Court, Volusia County, Florida http://www.clerk.org/menu/index.jsp Go to: Public Records > Case Inquiry
  24. The baby was at a hospital which offered a more stable environment for the birth than the back of an ambulance even if the hospital staff were not comfortable with it. As a hospital, they are still required to have a code cart with the necessary equipment and staff with at least the basic NRP cert as well as some expertise in their professions. The mother was in labor with a preterm infant. You have two patients with the potential need to resuscitate both of them depending on the cause of the preterm labor. The Paramedic knew this was a 25 week preterm infant about to be born and even in
  25. It is outside the scope of practice for Paramedics in the state of California. This is why RNs are usually found staffing flight teams in that state and not Paramedics.
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