katbemeEMT-B

Dust, I do have some psychiatric education, but that is totally irrelevant here. What you're forgetting is regardless of whether it is a psych patient, medical, or frequent flyer, as EMS personnel, we ALWAYS have to question our safety. At some point, you learn to read people and pick up on those behaviors that cue you in to what is going to happen next. You have to stay a minimum of two steps ahead of your patient. After almost getting smacked in the face by the dumbass who decided he needed to take a bottle of pills chased with ETOH, I have learned this lesson well. I can say the same for a medical patient suffering from a diabetic reaction, except she actually hit me. I can tell you with certainty that when faced with a psych patient, LEO always accompanies us to the hospital. If by chance we have to transfer the patient from the hospital to another care facility, we must be guaranteed the patient is subdued or we will not transfer. Safety is number one for all involved. While it sounds like a great idea to just let the cops haul some one's ass in, it doesn't work that way. Let's also not forget, a psychiatric event can also be an emergency, hence why we have that little box on the PCR that we check for psych/behavioral.

Our service transports psych patients often. If it happens to be a violent patient, we will use whatever restraints necessary, (physical, chemical sedation, or both). If there are any questions as to our safety, we bring LEO with us.

The first thing I want to ask, why the hell is EMS governed by the NHTSA? Would it not make sense for EMS to be governed by the medical community, (ie, AMA)? Maybe this is the first change that needs to take place. I would imagine that if the AMA governed EMS, our education standards would increase dramatically, which is a positive. I could also see TRUE national standards and protocols being set forth with little variance. Maybe this would also give EMS the ability to assess a patient on scene and determine if the need to transport is really there. It would also put us in the professional category versus "taxi driver". Increasing the education at each level of EMS is also a necessity. I used to think that I knew it all after my training to be an EMT-B. After doing the job for awhile, I have realized how much I don't know. This has pushed me to further my education and become a medic. My objective is to give my patients the best possible care I can, I can't do that as a Basic. Even if the scope of practice isn't increased for a basic, the extra education could concentrate on those things that are already done (ie, assessment). Proper assessment is the key to proper care and 120hrs of training in which maybe 5hrs were spent on assessment is not enough to make you a competent provider. Stronger continuing ed. would also come with this. No more of this stupid monkey training that seems to be the norm, especially in BLS services. I work for both a career ALS service and paid volunteer BLS service. When comparing the CE offered, there is no comparison. The BLS service offers the same 10 CE every year and pays for one conference per year. The ALS service, which is hospital based, offers several CE every month, many of which are tied into the hospital employees, (ie, ED nurses, RT, and even Ed docs). Hospital care providers are encouraged to attend CE aimed specifically for EMS also. This is how it should be done. If we want to be viewed as medical professionals, than we have to be associated with a professional medical organization, not a highway organization. Maybe instead of trying to rejuvenate the standards and protocols, the NHTSA should relinquish their control of EMS and turn it over to the medical community.

:sign5: I sent this to my boss. He'll love it.

I have to agree with Dust and Spenac, EMS is probably not the right choice for you. I understand that maybe you are inspired by your father who is a medic, but there are so many other things to consider here. As Dust has already stated, your chances of making it through school beyond medic are minimal. You stated that you wanted to work your way through school. I could think of many other ways to do that other than EMS. I am currently am EMT and trying to complete my paramedic degree. It is very difficult. The wages you make as an emt or medic are not worth what you would be putting into it. You appear to be very intelligent and level headed, rethink your plan. The other thing is that even with the best physical therapy in world, your knee will never be 100%. What you have to remember is that as an EMT or Medic, you will spend a fair amount of time on your knees or squatting. The stress would be too much for your injured knee to handle. You may not feel the effects right away, but when you do, it will be miserable. I would suggest finding something that would allow your knee to continue healing and be less stressful on it. Good luck in whatever you decide.

I agree with Brent. Our PD takes care of welfare checks and with then call us if we're needed. I do not believe you can legally gain entry unless the individual themselves called, but don't take my word on that. I would remind you dispatch that EMS stands for emergency medical services and should be used only if there is an emergency. Checking on the status of a little old lady does not qualify as an emergency unless said little old lady is known to be having some sort of medical dilemma.

We also have the Emergent on our trucks for pretty much the same reasons as have already been stated. We are an ALS service with medic and emt staffed trucks. We had to attend a training session and prove we could effectively use the unit before they were introduced as part of patient treatment. Our numbers of intubations and RSI have decreased dramatically. The only problem we have is that the hospital doesn't have the same oxygen connection as our trucks so we have to change out the connecting hose once the patient hits the ED. The other problem is the ED nurses haven't been trained competently on CPAP so we have to babysit the patient until RT arrives.

I work for two services and in both it is about a 50/50 split. I think it is becoming more accepted for women to join the EMS field these days. I also believe that more women are finding the courage to take that step outside of the hospital and clinic settings and choosing to be prehospital providers. The school that I am attending currently has more female in their paramedic program then males.

I realize the original post was a lot to read, but an important fact was missed. Two more medics are now on scene and can assist in preparing patients for transport. Would it not make more sense to have them prepare the children for transport while you concentrate on the mother. With the help of the firemonkeys, this could all be done very quickly and all could be taken, for the most part simultaneously. This would appease the mother, who is not stupid, just loves her children.

girls

The reason I brought this up was because we had a call involving an 80 y/o mother and her 55 y/o daughter. The daughter was refusing transport unless her mother was taken first. The mother needed to be extricated where as the daughter was packaged and ready to go when the second truck arrived. The daughter was informed that her injuries were she would be transported immediately and her mother would be coming shortly. After some convincing, she accepted that decision. This brought up the conversation involving the children in the above scenario. I was just curious what you guys thought and how you would handle the same situation. It was the general consensus that we would transport the mother first and children after. One medics answer was to sedate mom. Not gonna happen. He's kind of a smart ass though. I will say that I have had parents tell me to take the kids first. I explained to the parents that their injuries were far more serious than the childrens and that seemed to work. Never had to get ugly though.

Yes she is.

This is purely a hypothetical situation that came up the other day at work. I am just looking for input from other people as to what you would do should you be in this situation... You arrive on scene of a two vehicle mvc. Vehicle #2 t-boned vehicle #1. In vehicle #1 you find a middle aged male with minor injuries. Inside vehicle #2 you find a woman in her early 30's unbelted with airbag deployment, driver side. She has facial trauma and is complaining of difficulty breathing. You note that there is obvious deformation to the steering wheel. In the back seat are two children unrestrained. The male, appearing to be about 7 y/o, is lying on the floor behind the driver. He is complaining of neck and back pain and has an obvious shoulder injury. The female, appearing to be about 10 y/o is sitting in the center of the back seat with minor facial trauma, complaining of neck and head pain. You have already requested additional transport. You tend to the female driver and prepare her for transport as the second truck pulls up. You explain to her that the medics are going to take her to the hospital. She tells you she won't go until her children have been taken care of. You and your partner reassure her that they are fine and you are taking care of them also. You also tell her that they will be in the ambulance right behind her. She is still refusing to go until her children have been loaded into an ambulance and are on their way. You note that her breathing is becoming more shallow with each breath and she is complaining of more head, neck, and back pain. She has pronounced deformity to her face, including the jaw area. A lung check is positive for gurgling telling you that she has aspirated blood. You explain once again the urgency for getting her to the hospital, but she is still refusing. The children's injuries do not appear to be as life threatening. What would you do? Do you honor the mother's wishes and delay her transport to prepare the children or do you take her against her wishes? Let me know if you need anymore info.

Citizen: So why were you called out? Me: Cuz' some one called 911 and said it was an emergency Citizen: So who called? Me: The person we took to the hospital Citizen: You're not going to tell me anything, are you? Me: By George, I think he's got it! Give this man a blue ribbon.

I have to agree with Dwayne. I was told once that "Good writing and communication skills will get you a good job". I believe that to be true. How you fill out an application, perform during an interview, and answer questions on a pre-employment test, will determine whether you are hired over another person; black, white, male, or female. Most services are looking for a specific type of individual and once they find that person, they really don't care what their race or gender are as long as they can perform the required duties with little effort and independently. I know that it seems as though you may have been treated unfairly, but the reality is this, most services are required to hire personnel over the age of 21 for insurance reasons. This may seem unfair, but it is a reality that I think we all can understand. Just look at what your insurance rates are versus a some one at the age of 21. My advice is to keep looking and find a place to get some experience even if it means volunteering. If you are moving to a larger city, some of these services have an explorer program, maybe they would allow you to ride along and gain experience that way.

The best one I have used on credit card solicitors who call for my ex: No, Mr Jackass is not here. He took off with our 15 year old babysitter and left me with our 12 children. If you track him down, would you let the bastard know I want my $80,000 in back child support. They usually don't call back.

I just got back from a call, 82 y/o female, heart hx, dialysis pt, feeling faint, found laying at the bottom of steps. More information can be provided. Address was given, but no fax was sent. Upon going en-route, we radioed dispatch to get direction as this is a at the farthest end of our PSA (not many calls out there). The dispatcher says, "follow highway A south, when you hit the intersections of highway A and B you will go about 3 miles and then take a left or right. This will take you to Old Lady Lane and the house is two block down." I looked at the driver and responded, "Did her just say take a left OR right?" Driver says, "Yep." I radio back, "Dispatch, can you please clarify whether that was a left turn or a right turn off of highway A?" Dispatch, "Yep, it was." Sensing we are getting no where, "Dispatch, can you have Little Town Rescue meet us on highway A where we are suppose to turn?" Dispatch, "10-4. Little Town Rescue did you copy?" Little Town Rescue, "10-4, our grass rig is already there." Once on scene, one of the guys asked the driver who the idiot was dispatching that he didn't know whether we were suppose to turn left or right. We have no idea. When we called in for our times, we asked the dispatcher what that was all about. The guy couldn't tell from the map if we were suppose to go east or west. Hey bonehead, the road only goes one way! This is what frustrates crews. Incompetence! Brent, I can tell you without a doubt, we also have some dispatchers that are wickedly awesome and I would put my life in their hands. I think maybe, because we are such cynics, we just complain about the bad ones and don't give credit to the good ones. So, to those dispatchers that know what they are doing, and can navigate a crew efficiently, =D> thank you.

:laughing5: :sign5: mao That's hilarious! Good one Michael!

We had a police officer like that. Instead of responding to calls, he would bang some chick in the cemetary. Needless to say, he got fired.

Welcome! This is a great place to learn and an even better place for stimulating debate. Hope you enjoy it.

I don't know that I have all the answers to these questions, but I can try to explain how I feel in regards to them. I'm not sure what the best punishment would be, although the purpose would be to correct an obvious behavior flaw. In the case of my example, it was for pure selfishness and disregard for life. In the original post, because of a lack of information, it is unclear as to the reasons for what she did so I can not be sure. I can say that in watching these stories time and time again on the news, it always seems to some down to the same thing, lack of compassion and total disregard for life. What would be the best punishment? It really depends on the person. Every person responds to things differently. That is why our justice system doesn't work. I think being plunged into doing service hours with an organization like the one I volunteer with would maybe have an affect on them. There is a judge in the neighboring county, that when faced with a juvenile offender, throws the penalty book out the window. He spends approx. half an hour with each first time offender as to get to know them a little bit. He then decides what he feels is the best sentence for them. It may be hard time if he feels they are a hard egg to break, or it may be service hours with the many organizations in the area. What he is trying to do, is reach inside these kids and get them to realize that having respect for others and one's self is an imperative part of life. He is also trying to teach them to have compassion towards others. I'm not saying that this works 100% of the time, but he does have I high success rate for non-repeaters. He is tough, but does it with compassion. You have to be able to get to the core of the individual and basically reprogram. You take away what they are used to, the finer things in life. You give them only the basics needed to live and teach them to appreciate those things first. Once they have learned to appreciate the few things they have, you allow them to work towards the privilege of gaining access to the finer things that they once had. You don't make it a cake walk either. You make them truly work for these things. Again, it comes down to a reprogramming of who these adolescents/adults are, although it is much harder to accomplish in an adult. The younger the person is the easier this task can be accomplished. When a child is involved I think the punishment should be twofold. It should involve not only the child, but also the parents of that child. In many cases, when a child/adolescent is unable to show love and respect, it's because the adults in his/her life have never shown him/her love and respect. The adults should have to take parenting classes and together, with the child, some type of family togetherness class. They should also have to do community service together. It brings back the family unit as it should be. I also believe that parenting skills should be taught before ANYONE has a child. I think my 14 y/o daughter put it best when she asked, "Mom, why is it you need a license to drive a car, shoot a gun, drive a snowmobile, shoot dumb animals, and even babysit; but any jerk can be a parent? Wouldn't it make more sense if parents had to have a license to raise kids?" I couldn't have agreed with her more (the jerk is her father or sperm donor as she calls him). I know many schools are implementing programs where students have to care for these electronic babies to deter them from having babies themselves, but maybe the real answer is to teach these kids how to truly love these babies instead. I also know that it is possible to teach a child that has never had love in their lives to love. It is not easy, but it can be done. These babies should be taken away from the mothers permanently and placed with families that truly want them and will love them. Let them have a chance in life. That it will take time, lots of money, and many people to rectify this problem. Even more so than any of those, it will take a willingness to want to change, not only how the child thinks, but how we, as adults think.

I don't think that everyone hates ALL dispatchers. I do think that there are plenty of incompetent ones though. I work for two different services with two separate dispatch systems. I will agree with Dust when he says a system that concentrates on EMS only is somewhat better than a general dispatch system. The general system in my area has a lower standard for new hires. They have a few great dispatcher and then we have MR and MRS RICKY RETREAD. If they had to dispatch a true emergency....OH SHIT! The system that concentrates soly on EMS requires all dispatchers to be EMT-B certified at a minimum, they must have two years experience on an ambulance. I don't know if it is required, but I do know that we get along really well with everyone of them. When we call in for shift change, they take that extra minute to acknowledge us as people and let us know they appreciate what we do (this also goes both ways). We carry great respect for these dispatchers. This is not to say they are perfect, but they're pretty close.

Dwayne, first off, I did get a giggle out of your post about your son. It is sad that he is autistic, but it also sounds like you have a grip on it. That is wonderful. I myself, am living with a son who is extremely ADHD and recently diagnosed with mild Tourette Syndrome. I do feel that these things often times make us stronger as parents. It also allows us to see things differently from other people. I also understand how others don't see these children for the loving people they are and instead find it easier to hate them and tease them. I am not a hater. I NEVER say I hate anyone. It is a very strong word that I believe is asking for Damnation. I have taught my kids not to use it when talking about people. I can not like some one, and I can hate what some one has done. There is a definite difference. As to the original post, there may or may not be reasons for what this girl has done, but I believe that there should be consequences for your crimes. These consequences should be more than just having to see a shrink for a short while. Should we take the time to understand why she did it? Maybe we should, but that still doesn't take away the fact that she tried to kill her baby. She should still be punished. Let me give you an example that happened a couple of years ago. I tried to find the link to the story, but it no longer exists. I do, however, remember the story very well. A newborn infant was found wrapped in bloody towels and a plastic bag, and left on the side of the rode. It was December and the temperatures were above normal (but still cold). A county worker spotted the bag and went to pick it up when he heard a small cry. He opened the bag to find a baby inside. Well, the mother was found two days later. She was 17 y/o and came from an average income, two parent home. She was part of the "in" crowd in school, homecoming queen, and the all American Girl. When asked why she did what she did, she responded, "I didn't want to give up what I had and didn't know what else to do." Charges were filed against her for child abandonment and child endangerment. The baby lived but did suffer some frost bite to her fingers resulting in the amputation of two of them. After about three months the story aired again and it was reported that the girl would never serve a day in jail. All charges were dropped against her and the baby was returned to her. The one stipulation was that she had to finish high school. There were cries of outrage from all over at this decision. A friend of the girl told the reporter that the girl had visited a clinic while she was pregnant and they explained to her what her options were, yet she still made the decision to leave her baby on the roadside. An update on the story a year later found the girl at college enjoying her life but her baby was no longer with her. It was never reported as to where the baby was. All they could find out was that the mother no longer had custody of the baby. This is what I am referring to. In most cases, these girls just don't care. That's what upsets me. It's a total indifference. I will say this. I don't completely blame these girls either. I do feel some it comes from their upbringing and society. Many parents don't take the time to show their children how to love. They are too busy with their careers and their own lives. Society makes it acceptable and almost glorifiable for girls to have sex at earlier ages, to have babies without being married, and to dispose of those babies without consequence. Then, when they get caught, they give some sad story and they get their baby back. How is that right? How is that fair to those innocent babies? I know that I have very strong feelings about this topic and for that I will never apologize. I feel some one has to be there to speak for the babies as they are unable to speak for themselves. I also realize that I am only one voice, and one voice can't change the world. My hope is to help others to understand why I feel as I do. This problem in and of itself is very complicated and there is no easy solution.

Got another one that happened this last week. Called out for a male having chest pain. Once on scene, a quick assessment shows it wasn't chest pain but pain in the upper abdomen. Upon questioning the patient en-route to the hospital, he states, "Well, you know, it's been four days since I've pissed." HMMMMM...after 24 hours you would think that he would have some one take him to a doctor. But oooooh noooo! Gotta wait and call the ambulance. Job security I say!

Sorry if I mislead anyone, I was not talking about abortion. I am referring to mothers that deliver their babies and then kill them. And yes, it may have happened, but I bet it wasn't very often. Unfortunately, I wasn't alive back then so I don't have the statistics. Tolerance has always been a problem in society, regardless of what act we are talking about.