MTNMANMEDIC

I have a couple of problems with this post. The writer says he went to check on the pt. but the EMS crew was already on the scene. Why didn't the writer notice the pt.s' condition and treatment when he was on the scene, It seems to me that the writers curiosity would have allowed a second look.The writer had the knowledge that the call was called in as an unconscious person and we all know that aint good. The writer says he does not care what other providers do but he notices that the cot is empty and what equipment was on the cot. Why was the writer in position to see the cot come back downstairs ? He went from the 7th floor to the lobby in the time the EMS crew was treating the pt ? The writer says he ran into the spouse of the pt later on. I would take that to say he knew the pt and the spouse, again I don't understand the relationship, if he was able to determine the spouse of the pt. from the scene, he should have noticed what kind of treatment the pt. was getting. Why would the spouse ask his opinion ? The writer has stated no one would know he was in EMS by his dress. I belive that there is more to this story than just what we were told. I can not draw a conection between the call and the pt. going to the hospital, the pt. was not unconscious when the EMS crew arrived or they would have loaded the pt. on the stretcher and been headed to the ER. The pt.'s condition obviously went south sometime after the call, how many hours after the call is the question. The writer says the call took place in the afternoon but the pt. did not go to the ER until 2 am ? A lot can take place in 8 hours, did the pt. suffer for 8 hours ? I say 8 hours because if the call took place before 6pm then I would call it afternoon, after 6 pm would be evening hours, we could be looking at a 10 hour window here, the EMS crew could have transported the pt. to the ER and if the symptoms did not worsen in the ER, he would have been back at the hotel in the same time window. I do not defend the EMS crew going in under equipped. How many times have you responded to an unconscious and found a DOA ?

I agree with Dust on volunteer services bringing down the value of EMS. Why pay a full time medic and offer him insurance if you have 10 guys willing to do it for free. If your working as a volunteer and you get hurt, would insurance, workman's comp pay? Why? The volunteers didn't bid on the contract, there are no volunteer EMS agencies in the City of Richmond. How can you blame someone who wasn't even involved ? In Va. volunteers are covered by worker's comp. but many agencies carry their own insurance because the workers comp. policies are very lacking in the coverage provided, the last I heard the volunteer only recieves 300 dollars a month through the workers comp. policy. The ones to blame in the Richmond situation is AMR, RAA, they bid low and pay low.

If hell on earth could ever be defined it would have to include that day at VT. My heart also goes out to the fine young men and woman of the VT Rescue Squad, volunteer providers made up from the student body of the University, to have to respond to such a horrible incident and with the realization that the victims are fellow students. It horrifies me. I encourage all the agencies that play here to drop a line to the VT Rescue Squad and let them know that we are thinking about them. Friday is sort of an unofficial VT day and everyone is being asked to wear the VT colors of Maroon and Orange in support of the University and all those who lost their lives and for the survivors. God Bless them Hokies.

I have been to a few, those few were well known to the community and not going would have been out of the norm. We lost a squad member a few years ago in a MVA, we were quite surprised to see several "frequent fliers" and the staff of the local nursing home show up to pay thier respects.

Yes, my medic is showing because we are talking about a MEDIC job, not a firemonkey job. They are one in the same around Richmond. In the counties surronding Richmond you can work on the Medic Unit and the Engine in the same week. I was mainly pointing toward your statement regarding it being the Volunteers fault that wages are so low in Richmond. i am not sure where you can make 80,000 a year on no overtime anywhere within a 100 miles of richmond. The county I retired from, new hires with the benefits, paid time off, paid training and education can easily pull down 80K a year. The best part is you can live 100 miles away and travel, you stay at the station for your 24 hour shift, room and board provided and then drive home and not be due back for 48-72 hours ? I did it for the last 12 years of my time. The new hires are just about making on day one, what I made when I retired after 25 years.

Dust your medic is showing again. Similarly, when you look at the average pay for medics in Virginia, you have to factor in all those vollies who are giving it away for nothing. Consequently, $12 bucks an hour is what the math tells us they are worth. Kinda sucks for somebody who spent two years in college, doesn't it? The Vollies had nothing to do with it. The contract was awarded to AMR and Richmond Ambulance Authority as the lowest bidder. They are the reason the pay is so low, any medic worth the 2 year degree can go 10 miles out in either direction and pull in 40K a year without OT. They can go 100 miles to the north and pull down 80K a year and only work 8 days a month. The difference with RAA is no fire duty, no engine work, no passing FF school. Paid providers in Henrico, Hanover, Richmond City, Chesterfeild and just about any other county around the Richmond Metro will pull a year or so on the Engine at some point. The big draw for RAA is experiance, you will see more in the City of Richmond in a month than most providers will see in a year with a Gov't. agency anywhere in the state. By comparison, paid transport and a few contract EMS companies pay only 10 bucks an hour or less, in close by couinties to Richmond, again they are EMS only and nursing home cot jockies. Volunteers giving it away has nothing to do with it, it's the low bid,low pay mental state of the contract companies. The state of Virginia is even seeing this mental state take hold in the area of Medevac air services, hospital based air services are feeling the heat from the big corporate air services, the big air services are placing helios all over the state and telling dispatch centers we can be there quicker and still take the pt. to the regional trauma centers. The big boys are bringing "birds" that can fly 2 pts. and are even offering fly along programs to providers, doing all sorts of PR work and offering weekend long seminars.

DUSTDEVIL VS MTNMANMEDIC THE FREE FOR ALL FROM GERITOL!!! I want a clean fight, no hitting with your walkers and no pulling out each other foley's! OK back to your corners, take a hit off your inhaler and.... LET'S GET READY TO RUMBLE!!!!! Thanks, now that there be funny !!

I've been impressed with the quality of your posts until you laid this rotten egg. Okay, now that I have quit laughing I can answer this. Dust your Medic is showing. Once again here is a Medic who thinks the world is out to do things that impress him. Dust, you have yet to do anything that impresses me and I don't want you to, I'm impressed enough because you have chosen this proffesion and I give you all the respect you are deserved, not through words but deeds and actions. I was trying to be lighthearted in my response,what I should have said is. Here is the EMS community once again canabilizing it's young. No one here knows this kids situation, he could have been followed by a cop with a "woddy" for him, to proclaim him as Jesse James over a few speeding tickets is just plain wrong.

I hung up my fire gear at the ripe old age of 35. It is a young man's game. THe fire service needs yearly physicals and stringent on scene rehab and recovery protocols. THe amazing thing is the fire service is big enough to have a stair step system of responders, let the young guys handle the entry, hose and ladder work and leave the extrication and support activities to the old farts.

I have a department issued badge, it's gold and shiny and pretty and I wear it for parades and funerals, banquets and ceremonies, open houses...............etc. It says something like life member, I think. Why I want to subject it to being puked on is beyond me. I have nothing shiny on my duty clothes, I leave all that stuff for the dress clothes.

VC, don't listen to the "I aint ever made a mistake in my life and therefor I am greater than anyone crowd". I bet you have stood your punishment and now you would like to make a difference in another person's life ? Let's see why do the states have driver education and driver remediation courses ? Could it be that the states realize that people do make mistakes and need a second chance ? 3 speeding tickets showing total disrespect for the law ? I bet that came from someone with a pocket protector with at least 3 pens, 2 penlights and a belt full of useless crap. Heya VC, if I ever need a driver are ya available ?

There should never be a formal national scope of practice or protocols. Practicing medicine is an art with a knowledge of science. Individuality of the local medical community should be considered. Each community needs are different and treatment regime should reflect that. Each state should develop a Board composed of members of the EMS Community to govern those in EMS. This board should be composed of EMT's and Medics with advice from other medical professionals. However only as advisement capabilities. This board should develop individual state scope of practice which could be uniquely developed for that area, these could be added upon and give restrictions and guidelines for violators. That is what we have now and according to you and a lot of other folks, it does not work. We have to have National Standards to set the bar, after that bring in the State Officials and the OMD's who are willing to accept the Standards and then improve upon them, have the Board of Review on the National level with strict guidelines set, that say the Standards will be evaluated every 3-5 years. Let's look at a common occurance call. Chest Pains : In my region the EMT-B protocol calls for ASA 81mg X 2. Assisted Nitro tabs (no spray) if prescribed. High Flow O2. The next county over calls for: ASA 162mg X2 Assist with Nitro (spray allowed) High Flow O2 12 lead recorded on scene if time allows, no interuping, transmit to hospital if equipped, med consult if 12 lead software indicates ACS. 2 counties over allows EMT-B's to admin. Nitro unprescribed. They also have EMT-IV status. These protocoals are set by the regions and approved by the state but if I obtain my EMT-B in this county, I can go 2 counties over and sit through a 8 hour class and be able to start IV's, join an agency, go through the preceptor program and bingo I'm allowed to operate under that regions protocols and I still have the same basic education I started with 2 regions over. Are you willing to tell me that is the right way to do it ? Rid, I think you are on the right path with the changes you want to see and remember the Law Enforcement Community faced this problem, one man began the Nationally Accredidated Program they have now, it has progressed to the point where if you are a certified police officer but your agency is not Nationally Accredidated and you apply and get hired at a NA Dept., your butt goes back to school to bring you up to the Standard. The Police Academies recognized this fact and became NA and started turning out NA officers. The indivual states have their own laws but the foundation is still the US Constitution and until you teach a cop how it applies to every arrest, every arrest can be thrown out of court on one level or another.

In 30 plus years I have tried many scopes, I used a Littmann for about 10 years and recently switched to an Ultrascope. Littmann's and DRG are good scopes but a little too sensetive for the back of a truck or a caotic scene. THe Ultrascope is great but not as durable as it needs to be for EMS. Ultrascope has an amplified scope that I am not familar with but with the durability issues (retaining ring coming off, head coming off, earpieces coming off) that I have experianced with the regular Ultrascope I would be hesitant.

Where do we start ? Would we be better served by coming up with National Standards, National Protocols and then build the education programs based on them ? Fragmentation is a big problem in EMS, State A says do it this way, States B-Z say do this way, then you throw in Regional Councils and OEMDs that say do it this way. We have Hospital based EMS, Municipal based EMS, Private, Contract EMS and Volunteer Agencies. All have their own hiring standards and operating guidelines. What about a National Accreditation Standard like you see in Law Enforcement Depts ?

Great Lord. The question was taken directly from the ITLS final exam for basic providers. The question should read how do you transport such a patient ? What treatment should you provide such a patient ? Is the agency you are applying to a 911 transport agency or a cot jockey nursing home go and get'em type of agency ?