letmesleep

Ruffems, As I stated, you were the first one there, you turned over care, and waited to pass c-spine appropriately.....your absolutely right she treated you like crap and that is uncalled for. a simple thanks for your help and c-spine maintained, and you would have stepped back as a professional. She pushed you by being an ass, and you should have gotten an apology for that. If I'm wrong let me know, but the original poster described people showing up to help after they were on scene.....my question is why? can't these "professionals" see that help has arrived, and go back to dropping their quarters in the slots? Really,Why? mshow00, Really, I see it as a professional maintaining MY scene. again as I stated, If I needed the help and you offered, you would be put to work....step on my toes and your gone. I do believe that is the topic of disscusion here. Helping is one thing, but sticking your nose in, and trying to take over is, oh so different. With that said if I don't need any more help, you will get a polite thank you unlike what happened in Ruffems story. Burnout? I think not, what if the tables were turned on you, and I showed up then started pushing you around on YOUR scene? Is that cool with you? help is one thing, being polite is another, but pushing me around is harmful to the Pt....agree or disagree?

HUH? I hope there is more to this story. I even took some time last night searching before I replied in hopes that may have missed something here. Shane, you said the Pt's skin dried up and returned to a normal color, but did she wake up? even so, I'm as confused as everybody else. Sorry for sounding like a d**k.

ok, use them as stated above just don't loose your scene too them. Drives me up the wall when people show up like this. They are off duty, go away and enjoy your time at the casino, don't they get enough "action" at work? It might be different if they got there first and then turn everything over to you (including a pt report), but otherwise they are nothing more than a glorified "rubber-necker". one word for these people.........whacker!

ok, another one that i use is taking a pen and rolling on the nail bed while applying pressure, it's pretty effective break the nose.......self inflicted..........hahaha!

back at work tonight working trade time...................

http://youtube.com/watch?v=SkbjTapkouU

First of all spenac, don't apologize for trying to make a positive change in the world. Sometimes change itself can be offensive. I'm going to make this statement based on my own opinion, and I'm sure after SKIMMING through this forum it's going to piss off quite a few people, but here it goes, and please read the whole thing before you bend yourself into a pretzel over it. Is it really a difficult concept for anyone to grasp in this day and age that a FT/ paid crew is going to provide better care than a volly service? Think about this for a bit, a paid crew will need to staff the station so they can get their check. Because they are at the station response times will be more regulated, trucks will constantly be maintained as well as the station itself. Walk-in PTs will get immediate care instead of hitting the call box and waiting for a response from home.....yada, yada! It isn't a matter of intelligents, or even education at this point, it's about insuring the response and better servicing the public. I always hear about "dedication" and helping people. If your are available 24/7 to respond to the public when they call, aren't you providing them with more sufficient care? I do this job to help too, but I'm sure as hell going to get paid for my time, shouldn't you?

I work for a district, this district covers 244sq miles and includes 3 counties (only because all 3 meet at the eastern end of our district). We staff 4 ambulances FT and paid, 24/7 working kelly shifts, and average approx 3000 calls per year and growing. We work with 3 different fire protection districts whom respond with us on ALL life threats and rescues. We are dispatched by an outside agency, and 2 of the fire districts are dispatched by 2 different agencies (this can be a nightmare, but after the past 8 years of doing it this way, it's at least under control). We are a tax based entity bringing in property tax at a rate of 28cents/ assessed $100, as well as a recent sales tax at .25cent/ $1. We also have a 3cents/ assessed $100 communication tax that pays for all dispatching, computers/ printers, yada yada! It's a sweet gig with decent pay and awesome benefits, been here for some time now, and don't plan on leaving anytime soon! We are also unionized with 22 of the 24 FT employees holding memberships with the IAFF local 2665.......agree with unionization in EMS or not, it works here and is needed to maintain our checks and balances.

http://youtube.com/watch?v=eUxAol0wbak&feature=rec-fresh or http://youtube.com/watch?v=UYGmX85sB4c

i guess i'm just wondering what is different about this call? doesn't stupid crap like this happen every day? get to know your fire fighters, they might have just been "pumped up" about this call. don't ever get into a pissing match while driving.....we had an emt in st louis about 11 years ago learn this the hard way by killing 3 people and damn near killing a couple more due to his own road rage....just not worth it! as far as the hospital thing goes, things change en route, just be able to adapt. slow down and take a breath when this stuff happens take care!

i'd have to say the simple calls that wake me up after 0400 till shift change.....if i could get a cup of coffee on the way, i'd be able to think better. give me a respiratory call any day tho, thats the call i really get into............... hope my 15 years gets me qualified to speak up!

AHHHHHHHHH!

Ok, basing this off of the dead woman in the waiting room thread, and I'm sure this has been discussed here before. We have tons of facilities out there that put up a white sign with red lettering stating "EMERGENCY" (or some variation of such) that can't handle a splinter under your skin. Just as a disclaimer: I have an idea how things work here, and you know your system, we know where to take OUR pt's, so I'm looking for an answer to the deception that occurs with the general public. for example: in this area our VA hospital has an ER that can't handle anything more than a basic sick case, or processing for the psych unit, and if the pt isn't a vet.....well don't even bother stopping in. So how is it that they are able to put up a sign stating "EMERGENCY" outside? they wouldn't qualify for anything more than an urgent care in my opinion. Psych hospitals are the same. My question is: How does a hospital get to put one of these signs out by the entrance of their facility, but then get to pick and choose what they will accept as an emergency? We as health care providers know the difference between an emergency and a cab ride to the hospital, but what if one of these hospitals are 20ft away, and your pt needs care NOW? How are these hospitals utilized in your system, and how often do you see the public walking into the great unknown?

ok, ok, it's possible, and no matter what you call it, or what it really is......it one of those things that you could go the rest of your life never hearing about! i have to go throw- up now!!!!!

with her having a language barrier and the fact that she is scared, also consider that her son is leaving the country......... is it possible that the bruising to her left upper chest is a seat belt mark that burns, and is continuing to hurting her now? could her v/s be what they are due to her anxiety of not being able to communicate? there are a ton of questions that can't seem to get answered at this point in time.......calm your pt as best as you can by explaining all your actions, then beat her up with all the precautionary Tx until you can rule out anything else. I am not disagreeing with the other guesses, and if i'm missing something i'll take the heat, but I just wonder if this is one of those cases that we need to slow down a bit and consider the pt's state of mind instead of focusing on the physical state.

All great questions. let me ask then, Why it is that there are places out there that are UNABLE to RSI when it is needed? Why are there districts that still to this day are not allowed to access port-a-caths? Why is it so difficult for some of us to get a Doctor and/or a nurse in the er to listen to you on the phone/ radio? All of these skills are common place for some of us, but in this day and age we as a group continue to struggle to prove our worth out on the street......why? development of a standard is the only way that ALL of us will be respected enough to preform skills that our PTs need. At this point in the "game" furthering your education is all we can do. We can sit here and argue the difference between a PARAmedic and a PAPERmedic till we puke, the point is to get your education, and better yourself at what you do. Medics these days are coming out of school smarter than my generation of medic did, but as a professional it is up to me to educate myself to that next level. How can anyone of us push to raise the bar on training for those coming through it after us, if we don't raise our own expectations?

also to add to 4cmk6's list: your insurance info.....because they run the world! a copy of your signature, and maybe a statement of consent to treat to go along with that.........thanks medicaid! find out if a private service is going to be transporting you, because you may need your credit card number as well......NO SLAM ON THE PERSONNEL....JUST THE COMPANY!

IF WE WANT TO BE VIEWED AS PROFESSIONALS WE MUST ACT LIKE PROFESSIONALS? hmmmmm........ Wouldn't a professional want to be as educated in his/her field of practice as possible? Or are we just "looking" like professionals?

Did I wake up this morning in 1930? I will make my opinion simple......mark me down for education!!!!!

sounds to me that your problem was with a single person who made an ass out of themselves, rather than the fact that he carries a badge. just because this idiot is a paid professional doesn't make us all that way. emt promises said it right by reminding you to keep your cool, and spenac nailed it down with his "warning". no matter who it is running the scene (volly or paid), it is their scene. this doesn't need to be a volly vs. paid issue

over the 15 years of service that I have, I would say that we have done more of a roller coster than maintained or even increased the professionalism of this field. I feel as if the newer generation is coming out of school smarter than I was at that time (book smarts that is). but things that I have started to notice in the past few years is the newer generation of medics and emts that feel they are OWED something instead of paying their dues and earning any respect. I'm not going to sit here and bash the newer medics and emts, because I'm sure that the "old schoolers" that taught me would have had similar complaints about my generation. My point is that WE need to grab hold of the newer medics hands and teach them, but this needs to continue throughout the future. the next time you see somebody park their ambulance in a handicap space because "they are an ambulance", or accept money as a "tip". remind them that we are NOT working for pizza delivery services, and that EMS is a profession......MY profession.

If the age limit is dropped to 18 now, then in about 20years we will have another thread about it being raised or lowered again, and these kids aren't going to obey the law anyways. Parents just need to be more involved with their children. Isn't this typical of us Americans to make policy, and then change it based on a generational change of leadership? If you look at the Hx of heroin or cocaine in this country, the laws have changed multiple times throughout the generations. This argument (discussion) would be headlined by some religious group to combat the youth groups and so on and so on............ I vote to leave it alone and tell the "kids" to just get over it, why do we let these kids run OUR world anyways, hell you can't even spank your kid without having to answer for it, that's why I just keep mine locked in a closet.....lol!

I'm going to sound like a butt here, but I still don't understand the need you have for these gloves on any pt. I agree with AK on this one, not only are they threatening to a pt, but the do little more than collect disease as well. let me guess they get stuck in your back pocket when your not wearing them? why aren't your POs (cops) doing a "pat down" and clearing the pts? that sounds like the bigger issue that needs to be addressed. I'm all for protecting yourself, but it would seem to me that the invitation for a fight is being offered when you show up on scene looking as much like a PO as possible. loose the gloves and save the money for a much needed vacation next year!

OK, what the hell I'll bite. what about his v/s? I'd really like to know what the outside temp has been, and was the day of the event. does he have any known exposures?

No problem Whit, and I guess this thread for was the start of the real discussion of the DECLINE OF PT CARE BY EMS. The problem I'm seeing is that we have soooooo many newbies out there that use tools such as MOI, and as whit stated, gadgets to assess their pt's. I have been doing this for a while now and was taught by the "old school" medics that laid the ground work for where I am today. We have the fancy LP12 with the automatic cuff and all the blah, blah crap. but there is still something to be said about taking that BP the old fashion way, and tell if your pt is oxygenating based of their skin color. The tools may allow us to go more indepth, but they are not the tell all. Here we have a minimal ETA to the ER of 20mins, and in most places up to 45mins. the air transport is typically used for level I traumas, and MI (which is not to say nothing else). I was never so happy years ago to see the MOI taken out of the protocols, and it forced this system to be stronger. It truly bothers me that the hospital staff has reverted back to such an obscene use of this tool. As far as the cost factor to the pt, well I have always said that I didn't get into this field to "break the bank" for the pt's. I do agree with the statements in this thread to a point, but lets look at the other end of the cost issue too. Would you push transport on somebody who had the Fx index finger after slamming their finger in the car door? I work 24hr shifts, and will transport anyone who demands transport, but they will be informed of a possible cost handed to them, this is our policy. I just feel with this TRAUMA ALERT issue, that the pt's are not getting to make a choice in their own health care (when it is unnecessary), it's just getting forced on them, and WHY? politics/ certs/ pride whatever the reasoning of the hospitals, and whatever the procedure should we have the choice as consumers? Where do we as professionals draw the line of being that advocate? Damn, talk about a rant!