spenac

Just quoted your statement, but really fiqured you did not mean it the way it came out. Sorry to nit pic. Have a great national Put Words In Dustdevil's Mouth Day. O yea is this a paid holiday?

Dust what makes everyone with a different opinion than you "unprofessional and uneducated idiots in EMS management"? I appreciate your opinions but calling those of us with different opinions names really makes you seem unprofessional. My opinion is based on my time in management and even as a business owner. I also base my answer on the professional acting and extremely well educated volunteers I was associated with. Again I do feel volunteers need to stop giving away services. It is time that all areas find ways to fund EMS. Now that PRO-EMT has some ideas he should visit with people already with companys he's interested in working for to see what the person in charge looks for. All of us can really only give an opinion of what we look for.

I agree list your volunteer service. Yes you may have some people look down on it but others will appreciate that you have the desire and fulfilled it in the only way possible initially. I started volunteer and still look consider it my home service even if only get to help 1 or 2 days a year. I have seen volunteer service listed in employment section, but it seems to carry more weight when placed in special heading such as Community Involvement. As a side point I do feel that for us to be more recognized as professionals that as with other health professions the number of people giving their skills away for free will need to drop. Just my $.02.

Definitly tuffer than just taking time to start IV, but even new acls standards are having IO's come in to play after fewer IV attempts.

If possible IV first I agree but mentioned IO as a reminder that we can still get access.

Our protocols allow all levels to not start cpr if obvious death ( what state has the rule that for decapitation the head has to be at least 6" from the body? I was told there is one don't know if true. ). Then we have to wait for a Justice of the peace with no medical training to show up and declare them dead. Always makes me feel like laughing when they finally show up more than an hour after we call and they check for a pulse.

Wish all the name calling and attacks would stop, no wonder so many look at us as a group as being non-professional. It's beneficial to have discussion so we all learn but the recent posts benefit no one. We all work in different conditions, with different protocols. We can all be helped to improve patient care by getting input from others. If we don't agree we don't have to adopt that persons method, but at least we have insight into how others think or what they are required to deal with. Let's learn from each other not kill each other.

IO?

Psych patient why bother with legal. Drunks got mentioned - persue them, their actions were started by a choice and they need to face justice. Maybe this will keep them from killing someone next time. Seen to much death and destruction caused by drunks that almost always seem to walk away uninjured.

I better shut my mouth before someone threatens to intubate.

Probably just modified it to ask for damages caused by the lifesaving attempts since she didn't request treatment.

Honesty. Do not try and make yourself look more experienced than you are. But do emphasize the training and types of experience you have had. Ask your EMS director and medical director if they will be willing to write reference letters. Just a couple of things from small town USA. Sorry can't give insite to big city EMS.

We work off line protocols that allow EMT-B's to carry and administer, Albuterol via neb, Atrovent ( in duoneb ) via neb, Epi 1:1000 vials draw up our own syringes don't carry epi-pens because of costs ( epi and syringe about $3, epi-pen $50+ last I priced, patient breathing freely priceless ).

What really suprises me is when we bring in a restrained patient and nurses w/o backup start freeing them. Some say they have to see the actions themselves are they cannot legally restrain, don't know if that is true or not but it seems that they should still us caution while releasing restrained patients. We were transporting a violent Psych patient restrained. My partner was in the back. In the mirror I would look back and check when safe as I drove. About 30 minutes into the transport I looked back and the patient had my partner and was hitting him. Patient was still partially restrained and together we restrained him with even more restraints, law enforcement about 30 miles away so no help. Partner was more embarrassed than hurt. Got to hospital notified them what had happened. They left him restrained while we were their. Shortly after we left someone ordered him released from restraints. So a lone nurse went in and began releasing him and he kicked her breaking her ribs. Same patient later injured another nurse when they again started to unrestrain him. Never prosecuted because of mental status.

beam me up scotty

First responder kit including 2 o2 tanks. Some used to joke that I am better equiped than the ambulance. Also have some wildland ff gear. But not big in buying collectables, Though some of the t-shirts might be nice even if couldn't wear them because to funny.

You may want to have a change of clothes in vehichle as some may even want you to demonstrate a skill or 2.

Thanks for explaining how your service deny's transport. It is interesting to hear how it's done in the big city. It is funny how many people in custody decide they're sick or hurt. We get some that are caught smuggling dope into the country. We get called out and while we are checking them we explain to them that they will still be under arrest, they will be cuffed, they will be accompianed by an officer, and this will delay how soon they can see their lawyer or get bailed out. If vitals are good we then ask if they want to go to hospital, most decide they would rather have the officers take them to the jail so they can work on getting out. I guess some of them think that if the ambulance takes them they're free. If anything is questionable or obviuosly wrong we recommend that they be taken by ambulance. We can as previously stated at times refuse transport w/o calling Dr. But we also if we can reach a Dr on the phone can call give them the info and let the Dr decide whether we transport or refuse. But again as previously posted like all services we still transport the majority that ask to go. I like the idea of providing a voucher, I'll have to look into it,discuss with medical director and discuss it with the city as it would keep us in service and plus cost less than us transporting a patient that is just looking for ride to Dr appointments. I hope more that have the right to deny transport will post the procedures they use.

I see the red on the budget , I get the complaints from the officials. I see all the stacks of bills that are returned no one by that name at this address. I work the 7 24's straight, In fact starting next week I have to work 13 24's straight so I can get some days off that I need. Yes I have the facts. I don't ask any patient for there paperwork to prove they're legal. If you call for ambulance we come we treat and yes we transport almost all that ask to go to hospital. I will never bully a patient, that statement pisses me off and shows your lack of professionalism. You may not agree with frontier medicine and the things we have to do but those of us that survive it do so because we care about those we serve. Its not just a paycheck. We have worked fund raisers, we have asked people to even send $5 month towards the bill, we've offered free first aid,cpr,eca,emt education. Again I am always proffesional with my patients hell a lot of them are my friends by the end of our trip to the hospital even the illegals. I have people come to my house that know me from the ambulance and don't have money to go see doctor to get blood pressure checked or have me explain what the medicine is that the DR sent them home with, yes I said my house not the station. Do you allow people to stop by your house or call it day or night with questions. I don't ask them to call me or come by but I don't refuse them. If they need more than that I help them contact their Doctor or call 911 for them. We have extreme poverty here and you know the best pay I get are the hugs and handshakes of people that appreciate my efforts taking care of them or a family member. If it seems I have skirted any ? sorry did not do it on purpose unless it required me giving to much personal or patient info. As previous we survive on city and county funds and occasional grants. Even the state had to bail us out so we could get an ambulance recently as we were all but walking. I have not attacked practices on any posts that I disagree with or don't understand because I realize everyone has different circumstances and I haven't walked in their shoes. I ask that you do the same.

We still transport 95% or more of the patients that want to go and more than 90% of them never pay a dime. Our discretion is limited but thankful that we have it. We use a billing service that applys for medicaid, medicare, insurance, illegal alien fund (forget correct name), and bills patients, but when given false names and addresses doesn't do much good, and even many that give you ID give a false ID, so no way to collect. We have the number of runs to justify more ambulances and the state even verbally recomended it but will not order it as then they would have to help support it.

Something that really bothered me about your grandfather was a bals crew turning around als when they had signs/symptoms that really needed at least an ECG exam. I definitely would have rather traveled to the hospital than risk a life. As far as illegals I've even asked the checkpoints to stop us but they won't as they don't want to assume reponsibility for the illegals. We have a rule that no one but the patient rides with us and no luggage. Years ago had people claiming to be family would ride to get past checkpoints or even smuggle drugs in luggage.

Sorry for your loss. With your grandfathers history and signs/symptoms we would have erred on the side of caution and transported. When I say we refuse we refuse the obvious such as the 911 call that I feel hot. We get there and the patients a/c is broken. No medical problems. Patient wants us to take them in ambulance to the hospital so they can be more comfortable. Had we transported and someone died in the 4 hours we were gone I would have felt horrible. No need for the ambulance your not going. We are strictly a 911 emergency service. Texas also licenses transport or combo services. We are not the taxi though we would make more money if we were. We still get abused because people learn what to say so we have to err on side of caution. Many of them end up being illegals using us to get passed the border patrol checkpoints. Get to the hospital and we see many miracles as people's pain goes away and they walk out the hospital doors w/o even seeing the doctors. Again let me clarify to refuse has to be obvious bs. We transport lots of taxi rides just like the rest of you but we can use common sense and recommend a repair company or a hotel or for them to visit a friend for the person who's A/C broke. Just like the person who called that said they had heard one of their friends had some illness and they wanted to go get checked to make sure they did not have it. Not an emergency could safely travel pov. Guess I should use term limited common sense allowed.

If we actually got paid for a third of our calls we'ld be in the money. Most have no money and they do not qualify under their medicare / medicaid for the ambulance transport, and we will not lie in order to make it sound worse to try get paid. So most everyone when they they receive the bill just file it in the round file and we see nothing.