scratrat

Some days its just not worth chewing through the leather restraints...

The answer is alcohol. I don't remember the question.

Happiness is like peeing your pants. Everyone can see it, but only you can feel

how warm it is.

Give a man enough rope, he'll hang himself. Teach a man to make rope, he'll

hang other people.

It takes 47 muscles to frown, but only 4 to pull the trigger of a finely

tuned sniper rifle.

For every complex question there is an answer that is simple, clear, and wrong.

Moo.

Give a man a fire and you keep him warm for a night. Set him on fire and

you keep him warm for the rest of his life.

Arguing on the Internet is like competing in the Special Olympics. Even if

you win, you're still retarded.

Never underestimate the power of very stupid people in very large groups.

1 out of every 5 people thinks the other 4 are idiots.

Reality is a crutch for people who can't handle drugs.

The day your life sucks and you put a gun in your mouth, 2 minutes

later they'll have your lotto numbers on the TV, some hot chick will

call you and ask you out, your boss will call in with a promotion

and your parents will call and apologize for making childhood suck.

Intolerant people should be shot.

The total accumulated knowledge of all the men that ever walked the Earth on the

topic of women can fit in the period at the end of this sentence.

Black holes are where God divided by zero.

LSD melts in your mind, not in your hand.

Lately, the only thing keeping me from becoming a serial killer is my distaste

for manual labor.

Love is a cruel and bitter way of paying you back for all the faith you

ever had in your brain.

Death by suffocation is a piece of apple strudel next to a night with you.

I haven't been the same since that house fell on my sister.

Every time I start feeling blue, I start breathing again.

Scatrat, your report format is very very similar to mine. I also agree that a set format that you use every single run from minor injuries to major injuries to codes is a very very good idea. If you are consistent in documenting you will become very proficient in it and it will likely keep you out of court.

There is a book out there called I believe the "Fourth Protocol" that tells how to write a legally defensible report. This book assumes that you already have a format of a report you use consistently, it goes further and it will have you examining how you write the report. Is it legally defensible in court??? Great book.

Oooops the books name is "The Missing Protocol" it also comes highly recommended by Kate Dernocour.

Any idea where to find it? I mean other than Amazon? They don't always have those weird little medical books. I might be interested in reading it.

All of my run reports have a standard to them. When I did transports, I had to use the charts from the hospitals to determine medical history and such. In doing so, I learned the physicians dictation format. It helps me remember what to document. On traumas, I add another line. But here is my generic format that I use. Keep in mind, I'm doing this as ALS, so you can delete or add whatever is pertinent to your job.

CC : CP

HPI (Stands for history of present illness): Arrived to find male pt sitting on sofa. Pt reports sudden onset of SSCP while at rest at approximately 1700 this date. Pt describes mid-sternal CP radiating to (L) arm. Pt rates pain 7/10. Pt is constant. Pt describes pain as 'an elephant sitting on my chest'. Neg aggravating or alleviating factors. Pt denies any previous episodes of CP. Neg SOB. Neg N/V. Neg dizziness. Neg lightheadedness. Neg syncope. Neg H/A. Neg blurred vision. Neg facial droop. Neg slurred speech. Neg arm drift. Neg recent fever or illness. Neg recent air travel.

PE: (Stands for physical exam)

LOC : CAO x 4.

Skin : N/W/Moderately diaphoretic.

HEENT : (Stands for head, eyes, ears, nose, throat) Pearl. (Includes pain/trauma if needed)

Neck : Neg JVD. Trachea midline. (Includes c/o pain, trauma, if needed)

Chest : Equal expansion. (Includes injuries if a trauma, or lack thereof.)

Lungs : CTA c/ adequate air exchange. SaO2 98% on room air.

Rhythm : NSR s/ ectopy. 12 lead shows definitive ST segment elevation in leads V1, V2, V3, and V4.

Abd : Soft ; non-tender.

Pelvis (I include for trauma only) : Intact. Neg crepitus.

Ext : Neg edema. Full equal pulses. Neg deficits.

Back : (For trauma or pain complaints) Neg deformity noted. Neg c/o pain.

Tx : O2 via nasal @ 6 lpm. 12 lead ECG. NTG 1/150 SL c/ slight relief of CP to 6/10. ASA 324 mg PO. IV NSS lock (L) ACF 18g. Labs drawn x 3. Blood sugar 112 mg/dL. NTG SL 1/150 SL c/ slight relief of CP to 5/10. NTG 1/150 SL c/ slight relief to 4/10. MSO4 4 mg IVP c/ decreased CP to 2/10. NTG Paste 1' transdermally to (L) anterior chest wall. MSO4 2 mg IVP c/ complete releif of CP. Transferred pt care to ED RN in bed 3.

Granted, this is probably more in depth than you need, but the standard is always the same for me. I have been in depositions several times, and the way I document usually precludes me from court. If you didn't write it, it didn't happen. Not to bore you but here is a perfect example why I document the way I do.

Dispatched for a fall. Little old lady tripped over one of those concrete car stopper things in a parking because she didn't see it. Unfortunately, she really did get hurt bad. Fractured her hip, ankle, wrist, and I think something else. In my report I wrote EXACTLY what she said. "I tripped over that parking bump thingy." Long story short, the major food chain store paid for ALL of her medical expenses. She then attempted to sue for millions because she said she tripped in a pothole. After reading my chart, without me going to court, they threw out her lawsuit. I think that food chain owes me a gift certificate, but hey.....

I can't repeat this 100% but my partner told me a story about Jewish beliefs that he did, but he's not Jewish. After someone passed away, he did the pronouncement. He covered the body, and then covered the mirrors in the room, because something in their beliefs says this is basically bad. I won't act like I know it completely. Something to do with them not wanting the deceased to see themselves in the mirror or something like that. Kind of like needing to be buried before sunset. Anyway, even though he didn't pray, the family was grateful for his utmost respect that he took the time to show.

Anyway, if someone asks me, I might. I not much on prayer, but I'll do whatever it takes to makes someone's life easier when they're in a crisis.

Bob, elighten me.

True.

The hospitals will fire you, but still, they never report anyone to the State, or at least it's very infrequent. That's another problem I guess.

3. Keep the ALS Hospital-Based, with dual-medics. With how corrupt county governments in NJ are, I really don't wanna work for them.

3.a Keep the two-tiered system. Frees up ALS for ALS patients.

4. Hold the crappy EMTs and Paramedics accountable for their actions.

4a. Hold the EMS organizations accountable for not keeping the ambulances staffed 24-7. NJ is the most densely populated state in the nation; there is no reason that this can't be done. If it means regionalization of BLS units and providing paid staff, oh well. There are other hobbies out there.

5. Teach the EMTs not to be ALS-dependent for everything. This requires education. If anyone pulls the "well, I'm a volunteer card," take their EMT card away.

Now I wanna see how many people I pissed off.

You didn't piss me off, but I have a couple comments. I feel slightly entitiled since I worked there and had first hand knowledge. I'll reply to your numbers above.

3./ Partly agree. I like having a medic partner instead of an EMT. But the county thing has it's benefits too. I get to retire in 25 years with 75% of my best 5 year average. Can beat that. Jersey was, well, you're on your own.

3a./ Can't agree at all. I came to an all ALS system, but we treat everything including BLS, which can suck. BUT I cannot tell you the number of times I had to hold BLS's hand because of some stupid crap, that because of some stupid reason (age, history, etc), I couldn't leave, but the pt would have been fine to go BLS. Then the MI or cardiac arrest goes out down the street and the closest medic unit is 25 minutes away, if they are even available. So I can't see your logic there. Here, every ambulance is ALS, with one medic and an EMT. Every call is guarenteed a medic unit. A little over effective, but effective. At least if something goes wrong, you don't have to call a medic unit. Can't see your logic on that one. Sorry bud.

4./ THANK YOU!!!!!!!!!!!!! That state could literally care less if you kill someone. You MIGHT lose your job, but the state never investigates. This partly lies in the problem that ER's and squads never report them. Like medics who can't operate equipment and effectively watch a pt die. Someone got fired, but why was this never brought to the States attention by the employers or the ER? Why was this person still allowed to practice as a medic? No intervention at all by the state. That's insane.

4a./ Again, 100%. If they can finance police and a mayor who make more money then we do most of the time, they can finance EMS. Everything down here in Florida is either county or city based. Barely any volunteers. And, I think (but don't quote me), every county has paud 24 hour EMS. Maybe remote in some places, but it's there.

5./ Again, 100%. You worked in Jersey once too right? So you performed a SNR (services not rendered) or triage to BLS or whatever you called it when you evaluate and release the pt back to BLS? I think that when they say, "WE were going to recall you but since you're here...", their squad should get a bill for $250.00 for an ALS exam. Not the pt. When I left, I believe they were toying with the idea of billing pt's for these calls. They didn't request us, BLS did. If BLS can't figure it out, charge them a fee. That'll curb it. Probably create another firestorm where they'll be afraid to call, but at least they will only do it when they know it's warranted.

I'm done now. I just had to comment. Sorry dude.

I was still there when the casinos closed. What a slow day that was!!

Scrat,

UMDNJ stayed open during the shut down as it was considered an Essential Service (as the State Police didn't shut down). Parts of OEMS remained in service during the shut down. The entire department was not shut down. However, as much of what OEMS does is reviewing complaints and regulations, would EMS as we know it grind to a halt if they closed up shop for a few days? No, which is why they many of the staff were off during that period.

Medic2891,

As for the First Aid council, it wields power only in few places in New Jersey. Bergen County is one, some south Jersey areas as well. However, the vast majority of NJ squads have signed out of the FAC or stay only as a means of getting an invitation to their annual party. They do have some influence only because they know how to whine. However, with the right pressure you can get them to acquiesse (any Garden Staters remember the turmoil with the creation of the EMS Task Force?). And trust me, working loosely with the DHSS I can say you'll NEVER see OEMS become separate in your lifetime. The way to solve that problem is to get quality people in there and have the state actually fund it properly. You have some really good people working there now, but why would you work hard or stay if you're getting paid S**T?

For all the bashing NJ gets, I honestly think it works ok. Could it be better? Sure, but I'm positive every state has their particular problems. My advice to help you avoid an early ulcer is to not expect much from anyone. Don't expect to have quality BLS and you won't be disappointed, only pleasantly surprised when they turn out to be competent. And don't expect quality ALS partners either, that educational process seems to be tanking in several programs (many non-Jersey programs).

Devin

I'm a jackass. I forgot all about the fact that NJSP stayed open. Ok, I'm retarded. I saved a copy of the Press of AC to carry on my fond memories of NJ!!

I raise the stretcher about half way, and since I'm a bean pole, I ride the rail baby!!

I have a radar detector that is at least 4-5 years old. Occasionally, depending on where I travel, it will beep and flash about road construction and display something. It also very rarely picks up on something in emergency vehicles, but I'm not sure what. It occasionally flashes "Emergency" and goes nuts but I don't know if it's the strobes maybe, or the siren, I'm not sure.

This technology is 4-5 years old AT LEAST. There is no reason they can install something like that. How many people now-a-days have a radar? Or GPS? Or Garmin? It's easy, they're just lazy!

Nice job dude.

Another question out of morbid curiosity.....was UMDNJ still allowed to function? They are state government employees. Were they allowed to continue working EMS? I can't remember.

All I remember is the casinos being REALLY REALLY pissed off about the millions they lost. I'm guessing he won't be reelected. LOL.

Another solution, get out while the gettin's good.....not that I advocate going to warmer climate or anything. Oh, and by the way, it's been in the 80's. You should follow your parents' footsteps Jeff. County ALS is the way to go!! 25 years and I'm out with the same pension the cops get!!!!

I used cards of my own design, tried using Scrat's template when we were partners but went back to my own. Now I just use the template the department uses, it's just easier. I generally give one to a family member asking them to drop me a line to let me know how their loved one made out, or if I'm taking the big bag o' meds to the hospital. Those letters are worth their weight in gold since it takes two "attaboys" to wipe out one "ahshit"

I miss you sarcasms

I'd put a bullet in my mouth.

And why is it they never live on the bottom floor with no steps??????

I bought some from Staples or wherever and printed them myself.

They still look professional. I used our patch graphic and put our company name on it with my name. I hand them to anyone who asks, or at least the ones who aren't going to complain. I've handed a bunch out.

I can't think of two many times I'd need to, especially with the corrosive nature of drugs these days. If you can get the needle in on a seizure pt to give valium, then why not just pop a line in in case you need to give it again? And I definately would never do it with narcan like someone else said they've seen done. That's a good way to ensure vomiting. Plus they are probably disease infested anyway. I used a device in Jersey for intranasal narcan and versed. Great little device. Wake up an OD and never get contaminated with blood. Love it!!

being and ex 51-56 medic i can say the guys i worked with the greatest, it was fun and loved going in every day, but management made some piss poor decisions, think we just need to remove the mangement and start over.

Have you been tracking the Asbury Park newspaper? Vince is screwing up again and even the reporter realized. He's fighting to take traumas IF they are the closest unit, but says it has to do with pt care, not fighting with South/Northstar. Yeah, I'd buy that.....

EMT -- Double heroin overdose. Got to watch the medics do two EJ's. Kind of weird your first time seeing that, doesn't seem right somehow...

Medic -- Two twin 3 y/o dead from house fire. Worked one of them.

Or at least, those are the two I remember from early in my career.

Easier solution : Don't live in New Jersey. Guaranteed to extend your life !

Words to live by

I had coverage with that company for 4 years. I let it lapse, only because I forgot. I've been meaning to do it again.

Here's the catch though :

I agree you should purchase it.

HOWEVER,

Sorry for cyber shouting : DON'T ADVERTISE IT!

You don't have to disclose it unless you are SUCCESSFULLY sued.

And if you think you employer's got your back, you're sadly mistaken. If you get sued and it's over whatever your employer coverage is, guess who foots the bill? Most likely, they will go after your employer since they usually have more to pay out. But if you get stuck with a sum, now you've got a cushion. Not that I ever plan on needing it, but it's cheap enough to help ensure your house doesn't get taken away!!

I would treat the child as normal.

Then I'd do everything in my power to ensure she makes it to jail, not a pyschiatrict hospital, which is where I guarentee you she'll end up. Someone like her deserves to suffer the same fate as her child. Then after she suffers from repeated blows to head daily for a year, shoot her. Slowly.

Sorry. I just have no tolerance for child abusers.

This isn't exactly true. This definiation sounds like a watch with strong possibilities (something which catches a strorm chasers eye and starts them breathing heavy).

I don't intend to be picky (well, yes, I do), but as a storm chaser, I know the critical importance of the correct terminology.

Now, back to our regularly scheduled government bashing.

Sorry, I had it backwards, I knew what I meant though. Does that count?

Here in Florida, at least where I am, you cannot refuse to transport someone no matter what. We also have to call in every refusal to a supervisor for clearance of that refusal. They acually go a little overboard trying to get everyone to go to the ED. HOWEVER, lets say someone calls mt at 3am for a toothache. I will try to explain to them that they will probably sit in triage, and 99% on the time, doctors will not give out pain meds and will just tell you to seek a dentist. If it's blantanly obvious that they have no medical emergency, I will try to convince them that they are wasting their time and money without coming out and saying it.

That happened about 75 miles west of me. That's exactly why I would never trust a school to handle my child's life. We got tornado warnings shortly thereafter. For those who don't know, a warning is worse than a watch. It means conditions are favorable and likely to produce tornados. Our daughter was immediately pulled from school. At least if something happened, we could be with her. Maybe it's stupid logic, but I'd rather she be with us then alone.

I don't care what the school says. If I tell them I'm picking up my kid, then that's what I am going to do. They don't get a say in the matter.

It is also the day the welfare and social security checks arrive. Coincidentally, it also seems to be the day in which a higher number of heroine overdoses occur. Hmmmmmmm......

Guess what I found out?

If a registered sex offender has a child attending school, he or she is allowed to attend school functions with said child? Even if they are a registered predator......scares me to death.

That's why I moved to Florida, so the minute they step foot on my lawn I can shoot them

God help the person that looks at my daughters funny...