letmesleep

Lone Star, you are absolutely correct and +5 for calling me out on this line. I wrote that more as a state of mind than reality. My point is that that the bondsmen are NOT going to control the medical side of any argument, and I do agree that a shouting match would be less than professional, hence forth refereing to PD.

In my district we have LTs (we are an EMS system only), but other districts around this areas (also only EMS) they have crew leaders. The county has also changed the Admin title to chief for political reasons I'm sure. Every system needs structure wether private or tax based. There has to a certain level of supervision to avoid "freelance EMS" from occurring. I will agree that the terms Capt and LT are not necessary, but no matter what they are called they are needed to maintain control of the district or company. I also believe that management classes and training should be required in order to promote. With that said, I still can't believe this thread has taken off, looks like spenac understood that the last time I said it!

No offense taken here, but in all reality they have the same arrest powers that you and I do. Last time I checked the citizen has the right to arrest, and thats what these men and women really are as stated by Asysin2leads above. When it comes to keeping everyone safe on our scene we use the PD not a bounty hunter, so in this situation the PD will be dispatched to protect us from the "skip" as well as the bondsman. It is a territorial issue at this point. It's my responsiblity to run that ambulance, and maintain order in that ambulance while I am on duty. Thats what the taxpayers pay ME for, and if I allow somebody (PD included) to take control of my truck, then I haven't done my job. Trailrunner, your right, we are responsible for the medical "stuff", and that includes the safety of the "skip" if they are requesting medical assistance. If the bondsmen don't want to follow the "rule of the truck", then sign here and take the "skip" to the ED yourself, or talk to MY officer about it.

Let me start off with saying that I was keeping up with this thread, but today just skimmed though some posts that I had not read yet. I think it's fair to say that there are many factors in play here, but as far as EMS being to blame, we have to take our hit as well. In the past it was not uncommon to show up to a call, and transport to the ED just based off the request of the Pt. Now we are trying to reverse said Hx because of multiple issues, but Medicaid being the biggest reason. Medicaid has started requiring us to more or less justify transports, thus forcing us to cut back on the unnecessary movement of the public to the ED. (stand by, my dog just slobbered on my arm....damn it). I do understand the reasoning for the changes to the payment system, and this is were most of the "billing forms" are coming from. Having to get signatures from those not needing EMS transport after being advised of such is just one HUGE change since I started. This has also become a generational issue. We are now seeing the children of the Pts from 15 years ago using EMS in the same manner as their parents did while they were "growing up" (I use that term loosely). This is where our struggle to educate takes effect, Pts today saw their parents using EMS as a means of transport for every little thing from splinters in the fingers to cold-like symptoms. Trying to explain to the Pts of today that their insurance (medicaid) will not pay for this is near impossible, and that they should find other means to the ED or (light bulb just went off) a doctor's office. I think that we have some of the burden to bare because of our past, but to take total credit for the decline of health care in the US is ridiculous.............

All I have to say is get PD there to protect you, your partner, and your Pt, as always. If a bounty hunter wants our assistance, then there has to be some rules to follow, in MY office, otherwise they can assume responsiblity for there "skip", and risk themselves to the hospital.

Bob is an amazing instructor for sure, and I recommend that everyone sit in on one of his lectures, if not every one you can get to. Rid, I think we finally came to an agreement that this deal is both right and in some cases wrong, thanks for the discussion....

(Bruce darlin', thought you might enjoy this one!!!) Down south, Bubba called his attorney and asked, "Is it true they're suin' them cigarette companies fer causin' people to git cancer?" Yes, Bubba, sure is true," responded the lawyer. And now someone is suin' them fast food restaurants Fer makin' them fat an' cloggin' their arteries with all Them burgers an' fries, is that true, Mista Lawyer?" Sure is, Bubba." And that lady sued McDonald's for millions when she Was gave that hot coffee that she ordered?" Yep." And that football player sued that university when he Gradiated and still couldn't read?" That's right," said the lawyer. "But why are you asking?" Well, I was thinkin' . . . What I want to know is, kin I sue Budweiser fer all them ugly women I slept with ?"

I'm wondering, as an employee of this company, if you are truly violating any privacy issues by sharing this info with other company employees. Check this out, if you all (you and the cooks) work for this company, and are sharing info about a child for the health and safety of said child there is no breach. The parents of this child have already given this company the information at the time of registration for camp. Let me ask you this to clarify, Is it wrong for a Nurse in the ED to share Pt info with the Doc in order to treat or care for the Pt? I'm thinking you'll fall under similar guidelines in this case. Ruff makes a good point, if you don't use this info and something happens, your going to be opened up for bigger legal issues.

Jake this is an example of the billing for ALS I AND ALS II: Resident ALS-II ER $500.00 Resident ALS ER $425.00 Resident ALS Non-ER $350.00 Resident BLS ER $325.00 Resident BLS Non-ER $250.00 Non-resident ALS-II ER $600.00 Non-resident ALS ER $525.00 Non-resident ALS Non-ER $450.00 Non-resident BLS ER $425.00 Non-resident BLS Non-ER $350.00 Mileage per loaded mile: $7.75 (ER=emergency Non-ER=non-emergency, ALS=Advanced Life Support BLS=Basic Life Support) I pulled this from my Distrct's billing department. Hope that helps a little, Thanks medicwithabullit, but CCEMTP simply showing up does not warrant being able to charge as far as 9-1-1 is concerned. I will agree with Rid and saboats on that one. There does have to previous interventions preformed prior to transport. My argument (I use this term loosely) was that since we do transfers from hospital to hospital with drips and vents much like those stated above, and don't charge a SCT charge to the Pts, we don't need a CC prior to our EMT-P. I will agree that it does put a spin on the standardization issue, and for those of us who have taken this class, knowledge of these practices are very benifical. The problem is that there are hospitals out there who will give a medic a crash course on how to work the pump, and send us on our way. The next step for the discussion would be to find out the percentage of Pts who suffered from the lack of SCT support in these situations to justify the charges.

ARE YOU KIDDING ME WITH THIS S**T? Ruff, you said they need more ambulances, I think they need an entire overhaul starting with the Admin who hired a 16yo. Is it really any wonder when you read stuff like this that the public has no respect for us as a profession? I understand riding a bike the mile and a half to the station to pick up a truck, but any one responding to a call on a bicycle direct, and especially when there is question if they have hit puberty yet, is scary for sure. I have heard of some stupid crap in my career, but holy s**t!!!!! With the above stated, this does not include those who are "bike patrol" during major special event. I'm solely talking about some prepubescent responding to a 9-1-1 call. rant, rant, rant, rant..........................

I just can't believe this thread has lasted this long.

In my 15 years I have had 2 accidents, both responding to a call. The first was following a bout of rain, and a non-urgent response. A car headed towards us came around a curve way too fast. He lost control, over compensated, and slid in to the truck. The damage to the truck was minimal in all reality, but it took out the entire drivers side starting behind the front tire, including the rear tire. The other driver continued back in to his side of the road, and eventually in to a ditch. His pregnant girlfriend was transported to the ED, and he was transported to jail.......he kinda let his pride get in the way of his better judgement, and none of us were injured. The second, was an urgent response, and also during the rain. While I was proceeding southbound I came upon a car stopped to make a left-hand turn out of my lane. On coming traffic had halted to allow me to proceed past this driver, which I attempted with caution. He apparently was "jamming out" to his favorite song, because he started to turn left in front of us. When he noticed that he was on a collision course with a large moving truck, he pulled back to the right, as I pulled to the left. We managed to miss each other except my ambulance ended up on the side walk between a telephone pole and a fence which I grazed. Damage done to my truck was very minimal about a 6x6 inch area on the front quarter panel scratched from hitting the fence, other than that there was no damage and/ or injuries other than the 3 skid marks left in all the seats. Turns out that the fence involved in this accident belonged to this guy's father, and once he found out that his son was getting 2 tickets, he wanted me charged with property damage. His son received a ticket for failure to yield, and 1 for making a left on a double yellow line (no turn lane). The cops told the man that they were not going to charge me, and that "he was lucky that his dumb ass son didn't get killed, now tell him to turn down that damn radio"........true story! Anytime you turn on those lights your asking for trouble, remember to give due regard to all of those on the street, and be careful.

As he should have!!!!

Ruff, agreed that we should not allow such a little thing effect the job we do, but it is also our job to educate the public in regards to our title or anything medical. The public will be the one's voting for taxes, and Board members, thus effecting pay and benefits down the road. My point here is to teach them the difference so that they don't replace us with the second best. As long as they know the difference then they can make an educated decision on the type of service they are paying for. If they choose to have "ambulance drivers" instead of medics, they will certainly suffer in the long run. I do agree whole heartedly that this should not effect the JOB we do.......ever!

With all due respect to her life experiences....my question was NOT meant to be harmful or uncaring. As I stated the skin head can go to hell, it was simply a question since she had only asked for him to be moved. I have no doubt that she had plenty to tell, and I'm sure she could teach all of a few life lessons.....NO offense intended

I think it's all about public perception tho, if the EMT-I or EMT is allowed to get away with calling themselves "medics", then the public will not understand the difference, thus hurting us in the long run. The only thing worse than this is being called "ambulance drivers", think about it.

DAMN YOU FLY A LOT Ruff, hey that is a bad ass story, and quite honestly that skin head can go to hell for all I care. My question is this tho, Why did he have to move just because she was offended? She didn't seem to have a problem with him being on the plane, from the way it sounds, so why did she ask to be reassigned to a different seat? just curious. I will agree that there has to be a certain level of professionalism in our appearance, as far as the public is concerned, but does it really matter if you have visible tattoos when your Pt is on their death bed? I have many tattoos, and they are very large as well, but they are all covered by my uniform. I do this because of policy. My district will hire those with visible tattoos, but with the agreement that you will not add to them. On the other side, if you don't have visible tattoos when hired you are not allowed to get them. As I see it, there is a lot of misunderstandings about tattoos which lead to discrimination towards those who have them. Do I agree that we should NOT look like gangbangers? YES, but on the flip side should you judge somebody for having them? Very simply, for a district and/ or private service not to hire based of body modifications is discrimination in my book, but regulating how their employees look following their hiring is acceptable. Case in point, when I started here I had no piercings but there was no policy stating that I could not have one. I made a request to the admin office who then presented it to our Board (old school, and small town), they gave me premision stating that I would have to adhere to the policy laid out for ear rings in regards to nothing dangling. This policy was put in to place approx 15years prior to me asking, and was established for the women of the district. I was the first male requesting to wear ear rings, and they approved as long as I followed the policy of such. I have never had any issues with my Pts or Admin, and have frequently talked about tattoos with numerous Pts on the way to their destination. A little common sense goes a long way!

http://uk.youtube.com/watch?v=TudtpEUAkEw&...feature=related

Something that our director is attempting to put in place is some monthly sit downs with EMS. Just showing some interest goes a long way. With that he has talked about joint training (con-ed) as well as establishing some ride-a-long time in both directions. He has even tried to find money to be able to pay his nurses for this, thus making it somewhat mandatory (for lack of a better word). I knew a director that would just show up to a station, and sit down with the "guys", drink some coffee, and talk shop. He was able to make changes to protocols based off of the one-on-one interaction with the crews, and the level of respect was raised to a higher level. Training is always going to be a good thing, but getting to know those that you regulate on a one-on-one basis will rock your world Doc.

HOLY CRAP!!!! first of all this was a JOKE. The fact that one person posted a response that was somewhat demeaning to American men and women on the internet isn't really something to get up in arms about. Secondly, if people found his statements or mine to be offensive and they take the time to voice their opinion about it, doesn't warrant further judgement by others, it's how they feel. As far as Baron is concerned, he made some statements that I didn't care for either, but in the spirit of the forum I fired back at him. The problem is that he seems to be one of those few Englishmen who still hold a grudge against us Americans because they couldn't control us well over 200 years ago. I have talked with tons of people from the UK via internet and every once in a while you find some stick in the ass that still sees us as colonist. For whatever reason they can't seem to get past the fact that this is the greatest country in the world, and they were not born here. Again, these people are very far and few between from MY encounters on the internet. I would like to thank ALL of you who found humor in the OP, and who have been supportive of the OP. I will certainly continue to post these jokes as I find them, as long as they aren't found to be offensive. I would also like to thank those who found humor in Baron's response, and stood up for him, That is the American way, standing up for the weak! Remember it is the "funny stuff" section....laugh it up and chill out!

I'm not sure, and not to pat myself on the back, but I think that was funnier than the OP. How was that for "witty"?

Oh how it pains me to be an American......I weep every day that my eyes open following a nights slumber only to find myself in such a wreched country. Oh how I wish I could ram a stick up my ass and walk around so full of myself in a most dignified way as an English gent.......oh bloody hell! Get over yourself!!!!

I HATE NIBP!!!!!!! sorry had to let that out. I still take the manual BP on all my Pts. we have this fancy gizmo attached to the monitor (LP12), but for me it stays in the side pouch. I'm won't judge any one who uses it for continued monitoring, but it's not for me. As far as bare arms, that is of course the optimal means of getting your BP, but the trick is being a "MASTER" of this skill. VS are far to important in Pt assessment to slack off on. I will back up for a second as far as not judging, any student that rides with me does not get to utilize the NIBP either, this gets back to mastering the skill. Ekg lead placement is as follows for me: RA to the right forearm (the meat as posted above), LA repeat to the left forearm, RL to the right calve (again to the meat), and LL to the left calve. I was taught many years ago (hammered in to my head that is) that there is a reason they are called "limb leads", they go on the limbs. I will also agree (before any one comes after me) that there are exceptions and the "limbs" are not always available..........

Just thought I would share this with you all, This just shows that kids can get hurt in any sport out there, even a simple game of catch. I know the medic who ran this call.......... http://www.ksdk.com/news/local/story.aspx?...322&catid=3 (KSDK) - This weekend's baseball tournament at the Arnold Athletic Association complex has been suspended after the death of a young player. Tanner Boynton, 13, of DeSoto was hit in the neck by a pitched baseball while practicing. It happened Thursday evening. He died Friday. A bouquet of balloons and flowers were placed in the empty Koury League Field. There's no word on when the tournament will be rescheduled. His death was certainly on the minds of some parents watching their children play baseball on Saturday in Affton. Steve Tobey immediately thought about both his sons who play youth baseball. "My son did get hit in the chest between the chest protector and guard this season catching," Tobey said. "Nothing happened, but a few weeks later this happened with that one boy and it really, really scared us that something like that could've happened to our son also." While Tobey is concerned for his son's safety, he won't let that fear keep his children from playing baseball. Because of privacy laws, the hospital would not release what was the actual cause of Boynton's death.

Rid, lets stop for a second, let me ask you if you are charging for ALS I and ALS II? If so are you also charging for SCT on top of that (when needed)? Is there a charge for transport milage? I do know that we charge for ALS I and ALS II, but there is no extra charge for SCT, and we also charge for loaded miles. I also agree with not charging the broad spectrum of tax payers, and I will also state that money brought in from transports are used solely by my district for supplies and maintainance for our equipment, it does not fund my pay or benefits other than keeping that money available in the annual budget. I never once said that this class and cert was a waste of time and/ or energy, but I don't feel that it is always a need beyond education and billing. I think the mud is starting to clear a little (hopefully).