whit72

I have a few points to make:

Red cell wrote:

Well, the smart ones go on to bigger and better things...medic school, nursing school, RT school, or perhaps they get a teaching degree.

No, the smart ones get out of the medical field altoghether

Redcell wrote:

The drones do nothing. They go to work everyday and complain about how there's no chance for advancement and complain that the pay sucks. They hope that the State will create a new Advanced Scope EMT certification so they can do the same "neat" things medics do....but instead of a year and a half of night school/internship they'll expect to be able to knock it out in 4 weekend

Actually this drone you speak of works in a professional 911 system. Advancement in my place of employment has nothing to do with certification, it has to do with ability, as most promotions take you off the road. The pay does not suck, I make equal pay, if not more then many of the medics that work with me. Its called compensation for longevity.

My job isn't measured by amount of neat things I can do during the day. As my ALS counterparts would also echo those same sentiments. Only here would a person brag about a year of night tech school and consider that a an accomplishment. I have more then a year and a half of anatomy and physiology, so there goes your argument. As far as skills, I could teach my twelve year old nephew to perform both yours and mine in a weekend. Its the hows and whys, where education is crucial.

Sassy EMT wrote:

A word of advise....it's hard enough to be a basic in this field......don't make those of us who love what we do for a living and are trying to prove our worth to the medics look like a bunch of idiotic fools.

I guess it would be hard if I spent most of my day, trying to prove my worth, and craving acceptance. However I don't. You shouldn't either.

Mobey wrote:

First step towards being taken seriously as a BLS provider: DON'T PI$$ OFF ALS WITH UNNECESSARY INTERCEPTS

My job description dosent state to fulfill my duties without pissing anyone off. If its warranted ALS will be called. If that pisses you off, get a new job. If you have a shitty attitude with me when you arrive, get ready for a long night cause I will call you for everything, drunks, lonelys, and stubbed toes. You will be my ALS bitch

I would recommend you arrive in a timely fashion, with a smile on your face, and check your attitude at the door, assume I know the aspects of my job and be ready to complete the aspects of yours. Then we will both have a good night. I'm pretty sure my nights going to suck, how you treat me will determine if your is going to suck.

The medics I work with would never disrespect me or anyone in my position as I wouldn't disrespect them. Yes trust and confidence in a provider has to be earned its not assigned because you wear an EMT or medic patch on your arm. There are plenty knuckleheads that fill the ranks of both professions. Trust me. I have witnessed it first hand. There are also many that are more then capable to handle the demands of EMS. It isn't rocket science, so if the need to shit on a lower level of provider is how you justify your existence thats fine. Whatever makes you sleep at night.

We used to administer Everclear between the cheek to the unresponsive pt. However many clinical trials have proven that signifigant education was needed to completely understand the effects of it on the entire system as a whole. So its an ALS skill now.

We are only alowed to administer beer and wine now. If through assesment you believe the pt would benefit from a hard liquer tx, you must activate the ALS intercept vehicle. They have a fully stocked dry bar per protocols, complete with secondary tx's of salt and lime.

Those who have trouble detecting sarcasm. None was used here.

Doc, I guess it all depends on what you consider quality. I am mandated by the state to work all fatal accidents we encounter unless obvious signs in compatible with life are present.

I guess we have no idea what said pt would consider quality of life. I agree, I have no right to make that decision for them or their family. I do, and will continue to my job unconditionally, without regard for my personal beliefs, whether futile or not. It is hard at times though. Hey if its a one percent chance at survival, who am I to not give them every opportunity to be that one-percent.

A side note, in my EMS career I dont believe I have seen a traumatic arrest pt. live. Where we arrived and the pt. was pulseless. I have seen them arrest in the back of the truck and be resucitated, maybe once or twice. However I have idea what their final outcome was.

The only thing I would disagree with is, that a femur fx can be considered to be non-life threatning in the field. Without diagnostic testing the inclusion of great vessels can not be ruled out. If that pt does begin to spiral out of control, due internal blood loss while you are in-transit, there is not going to be much you will be able to do to stop that process, or anyboby else for that matter except a surgeon

I treat all femur fx's as life threatning injuries until proven otherwise. In the ER. I have seen them stable on scene and en-route to the hospital their pressure ends up in the toilet. Unless your hanging blood in your area. As a trauma surgeon from the south once said to me "Aint much you gonna do for lacerated femoral artery in the back of that ambulance"

Anthony, I was stating in my area. Helicopters dont transport arrest pts. So on arrival if our pt is in arrest we dont even call for the helicopter. So the study would be a mute point in my area.

If we have a pt with traumatic injuries, if we call for the helicopter and that pts arrests before they arrive. They get cancelled. They go by ground. If they are on the ground and they arrest they at times will ride in with us. Not usually though.

As far as the results, a 3.5 percent survival rate and a severly disabled out come is not somthing I would be doing jumping jacks over. I am sure most pts suffering from those those survival rates, wouldnt be either. There is such thing as quality of life over quantity of life.

Just my opinion.

Timmy wrote:

When patients ask how old I am or how old I was when I started… It’s so not reassuring. Or when members say ‘I’ll get Tim, his one of our more experienced members’ But how can a 17 year old be experienced?

I would state your the exception rather then the rule at 17. I would be a little concerned if a 17yo showed up at my house when I called 911. However once I knew you had a grasp of what you were doing I wouldn't have a problem with it.

Ok. I just have one point to make, the medical helicopters in my area due not transport cardiac arrest victims, whatever the cause. Trauma or medical.

Traumatic arrest pts never live. If you find them without a pulse chances are they are going to stay that way.

So of course the survival rates of pts taken by helicopter will be higher due to the fact that the pt had a pulse when they received them. All their arrests will be witnessed, which as you know has a significant higher level of successful resuscitation. Not nearly as high as medical witnessed arrests.

My thoughts. I don't believe severely disabled is a goal we should be striving to attain.

Cosgrojo wrote:

If whit72 is grading, he'll just agree with Dust in the end after attempting to put up a fight.

Umm.....You obviously haven't been here for the past year.

Unbelievable. :banghead:

Ruff wrote:

Whit, are you still an automaton or are you yourself again?

Are they still around, if they are I am not coming out of the basement. I think Dust sent them here.

NO question is dumb, just the one that isn't asked.

When I first began, I used to ask everybody questions, my partners, co-workers, nurses, doctors. I wanted to know everything. They began to hide from me

You have to crawl before you walk.

I agree with Ruff. It will take time, but you will find your way. You will learn to ask the pertinent questions. The answers you receive will lead you to other questions and so on.

As far as the ABC's you should be able to answer those quite quickly. I hope.

The steps as you say, will begin to blend together. Its like a child when he goes up the stairs he has to put two feet on everyone till he is comfortable enough to put one foot on one and one foot on the other. Soon enough he is running up the stairs. He hits everyone and dosent even realize it.

Good luck, welcome to the party

I have never heard of someone taking alcohol through and IV, but have seen heroin addicts mainline vodka or whatever they can get their hands on, when they cant afford heroin.

Yeah we used to do it, but carrying the Volkswagen up and down the stairs really got my partner tired. He is a wicked cry baby

Seriously I have never heard of such a thing.

What a lovefest :pukeright:

Lets see I have heard some classic lines from nurses: Some nursing home, some hospital.

We think it was a syncopal episode without a loss of consciousness.

He is afebrile with a temp of 102 rectally.

He isn't unresponsive nurse Kim he is dead, No he isn't he just unresponsive. Ummmm....No he dosent have a pulse. You cant get a good pulse on someone who is unresponsive. Is he breathing? No I am pretty sure he isn't breathing if he dosent have a pulse.

Some radio reports:

Enroute with a 29 yom with a penetrating gsw to the upper right chest. Nurse: Well which is it penetrating or GSW.

Enroute with a 58 yom full arrest. Attempting ALS interventions enroute ETA 3 mins any questions. Nurse: What are the pts vitals.

I work with many competent nurses. I thought these were a few of the funnier ones.

Are proticals now state. For Acute CVA

Administer oxygen through appropriate delivery device, as clincally indicated.

Some areas do not transport outside their city limits. So there you wouldnt have a choice.

I dont have a problem taking somene where they want to go, within reason. I am not driving halfway around the country so you can go where your cousins sisters stepdaddys daughter is a CNA. You can call a cab for that.

A good EMT has the ability to recognize, and understand what the pts needs are. Knows his limitations and isn't too macho or cocky to admit that a pts complaint is out of his reach.

I am sick of hearing about skills, and interventions. That is maybe 10% of the job, the other 90% is recognition, through thorough assessment. If you use the excuse that you cant assess a pt because you only received a 120 hours of training, then you doing yourself and the community you serve a disservice. assessment is not ALS or BLS, if you cant conduct one properly, you shouldn't be working in a PB or a tiered service.

Our ability to treat a pt is so minute at either the ALS or BLS level. How many conditions can you realistically treat? Not many. I don't consider a monitor, BP, or pulse ox. or BGL a form of treatment, there tools of recognition.

The BLS meds we use, ASA, oral glucose, epi pens, albuterol, glucagon , are idiot proof if you can conduct a proper assessment, if you cant distinguish wheezes from rales. A serious allergic reaction needing immediate intervention as opposed to a slight reaction. If you continue to administer oral glucose to unconscious parties, because thats what it states in your protocol, your an idiot. I dont care what your protocols says nothing goes in the mouth of an unconscious pt. unless its an airway. Aspiration of oral glucose is not good take my word for it.

I have numerous repeat diabetics in the area I work, I find them in all different states of hypoglycemia, from unconscious to belligerent. I can treat a belligerent diabetic with a BS of 30 with oral glucose appropratley, (just because their sugar is 30 dosent mean they will be flat on their back, every diabetic is different, their needs will be different.) and I have done it many times. It takes a little longer, however its not impossible. The ALS providers also use this technique frequently. We don't fight with a pt for an hour, to help put an IV in him, if he is taking oral glucose calmly. I can also identify through assessment who will need d50, ones that I have no ability to treat as a BLS provider.

The problem with BLS providers is 80% of all EMS calls are BLS, they just lack the ability to recognize which ones those are.

So as a BLS provider I don't want an expanded scope, or more meds, or fancy toys. I don't need them to conduct the aspects of my job. If I want them I will go to medic school. If their complaint is unreachable for me, then I have the ability and knowledge to understand that. We encounter blown aortas, gunshot wounds to the chest with cardiac inclusion, traumatic amputations, herniated brain injuries. Are those treatable by the ALS provider? I would say no. Do you think

So yes more education is needed at all levels, but if you use that as an excuse not to be able to fulfill you obligations, and on your own, you don't educate yourself to be able to handle those obligations, then your not helping anyone in the long run, and probably hurting some in your travels.

All medics are not created equal, don't assume that all EMTs are. With some education either formal or on your own. You can conduct an assessment, to the level of any pre-hospital provider. This isn't f'n rocket science, don't turn it into it. If you cant recognize it, get someone who can. If you cant treat it, get someone who can. If you cant recognize it, and cant treat it and cant recognize that you cant recognize it or treat it. Then quit now.

I understand all areas have their own needs, and should be staffed to reflect that. If you have transport time of 2 hours, I dont care if god is on that ambulance your pretty much f'd, with any life threatning event if you dont have helicopter.

So it wouldnt make much sense to have a BLS provider on those rural ambulances. Then again it dosent make much sense to live two hours from a hospital.

P3 medic wrote:

ER docs seem to think they've got "dips" on all the hot nurses...

And with all that education, they must be overcompensating for something.

Sorry to hear of your injury.

First off as of treatment:

You would have had traction splint applied. Then fully immobilized to a LSB. Hear the term distracting injury? Ifthere was enough force applied to break your femur. Then we will be sure to fully protect your c-spine even if you don't believe its injured. You might walk with a limp, its better then not walking at all. If you wish you can refuse, I would have definitly advised aginst it, but thats up to you.

As far as transport to appropriate facility, if your hemodynamically stable you can go wherever you like, If your not, you got to the closest facility if the birds not available. I am sorry its life over limb. You also will be advise that with the severity of your injury I can not gaurentee you will stay hemodynamically stable throughout the trip.

I am all for pts decision to be treated at a certain facility. However when your dead its going to be tough for me to prove why I drove by three hospitals, with a life threatening traumatic injury.

Again I hope your feeling better and your treatment is going well.

Ambulance driving safety is a great point. It needs to be addressed more often. Instead of just handing over the keys to someone and stating have at it.

If you have a problem with me examining the facts befor making a decision on guilt, I am sorry. I dont automaticaly place blame on someone, till every side of the story has been heard. Your article didnt make it clear as to who was at fault.

JPINFV wrote:

honestly don't know what, if any, prehospital instructions are given. Just going through the Regional Paramedic Advisory Committee minutes (I was bored), there was some talk in April of returning Aspirin to the field.

Why was it removed?

This is constructive.

I am sorry if theses people were friends of your or co-workers. I hope all are doing well.

I just like to get my ducks in a row, before I pass judgement and one article in a newspaper written murky at best isn't enough for me.

If his actions were cowboyish and he indeed blow a stop sign, or red light, I hope he is dealt with accordingly.

The vehicle entered the intersection of Seventh Street Northwest without stopping, striking a Chevrolet Malibu driven by Thomas Vogel, 19, Faribault, according to the police.

I still dont see anything about a stop sign, or a red light.

The only mention of the intersection, was by the ambulance spokesperson who stated it was controlled.

Controlled by what a light, a sign, a crossing guard, aliens?

Yes I like to get all the facts before I pass judgement. Call me foolish.