letmesleep

Wait a second, If I read this thread correctly, what I saw ArkansasEMT72556 being accused of, was changing her story and potentially trying to cover up the truth. Did she change her story? Was she involved in a cover up? At this point only she knows the truth. I didn't see anywhere in any others post stating that she should be held responsible for the Pts death, again, unless I'm mistaken.

As a provider, ArkansasEMT72556 should be held responsible to tell the truth, otherwise she is as far away as she can be, from being a Pt advocate. Am I judging her at this point in time? No, but since she is here we should take the time to ask her for her side of the story, so, ArkansasEMT72556 did you try to cover this tragic event up to save your and your partners asses? Now before you answer that question (if your going to of course), remember that especially if were a cover up, pleading the 5th is within your rights as an American citizen. Holding ArkansasEMT72556 responsible for the death of this Pt is BS at best. Reporting it is a whole other issue however, and she should (as a Pt advocate) hold herself to a higher standard and be up front about what happened in this case.

ArkansasEMT72556, I believe the real issue for the "attacks" as you see them is that your story seems to read differently within this article, and the fact that said article is what we have to go on, until now, it doesn't paint a friendly picture for you or your partner. For example:

I once ran a MVC involving 7 Pts and 2 cars. Car 1 had a driver, and car 2 had 6 members of a family in it. Both car struck head on due to car 1 crossing over the HWY (70) and becoming airborne. Hwy speed at that time was 60MPH giving them an impact rate of speed at 120MPH+, but because we all know (if you have driven in Missouri) that us locals either drive well below the speed limit or well above the speed limit. The point I'm trying to make is that I remember those specific details, even after 15 years have past. It was a horrific MVC as I'm sure this call was for you.

Now as far as the "medic" on this call, the blame goes to him (assuming that the story provided is correct) one way or another. If he was up front and not with the Pt (no matter where he may have been sitting in the back), then he abandoned her....period, end of story. However If he was in back with her, and did not respond in an appropriate manner as it seems to be (again assuming he was in the back), then he is purely incompetent and either way he was neglectful in this Pts care. His cert should be shredded and as Rid wrote:

Write the check... Get the orange suit out for the so called Paramedic.

I was afraid this approch would happen with that question. Any lawsuites that may occur from one stepping outside their scope of practice is NOT, and I repeat NOT protecting the Pt, or being a good Pt advocate, it is fall out from one who has been less than a good Pt advocate, nothing more.

My point of asking that question, and it should be aimed at ALL of us (educated and less than educated) not just Dwayne. When we are with a Pt and a MD denies our request for treatment, and we take it upon ourselves to treat anyways, or we are in an extreme situation with the Pt in front of us that may require us to push the limit, who protects the Pt at that very time? Who are we to just blow off the direction from the MD(for lack of a better term), and preform the treatment as we see fit? Where is the line if we have the power to do such a thing?

I do agree that we are with the Pt and can see their immediate needs, but there is more that goes into medicine than we are trained on, as medics. With that I will also say that DOCTORS ARE NOT ALWAYS RIGHT, and we do have to question their orders from time to time, but isn't that how medicine works? Do we not "bounce" ideas off of each other to provide the Pts with what they need? Yes, we have to be educated, and we do have to be able to make desicions on our own, but if we take the whole role of medicine on ourselves and delete the rest, then who protects the Pts from us? If we had all the knowledge of that MD, we wouldn't have the EMT-P behind our name, we would be called Doctor.

For a couple of reasons. I was taught, and very much believe that the heart of paramedic medicine is pt advocacy. I am morally and ethically tasked with knowing as much medicine as possible, being physically fit, etc to protect my pts from illness and injury. I am also tasked with being mentally fit to protect them from poor advice that may be given by other medics, nurses, or even the medical director. That if, after bringing my education, training and experience to bear on a problem, I'm asked to provide or withhold an intervention that I believe to be in error, I'm morally and ethically obligated to refuse to follow through with it.

Does anybody else fell like it may be time to dig a trench along the Fl state line and sell it to Cuba or something? Hold off on building the great wall of AZ/NM.

Thanks Rid, I just threw up a little in my mouth................

I have stewed over this thread now for a bit. I feel the same as a lot of the others here do, ranging from doing CPR to help the family begin the grieving process, to pronouncing an asystolic Pt. Lets throw out another scenario for the sake of argument, and following YOUR (the OP) guidelines I'm not going to provide any REAL research to back this up, so here going just a thought (or lack there of).

Why do we bother transporting and/or treating CVA Pts? Most of the time they are left with some sort of deficit, that they won't necessarily recover from physically, so why bother? Heres another, Why worry about treating a chest pain Pt? Even tho the damage to the cardiac muscle may somewhat heal over time, they are still going to be a cardiac cripple to some degree.

What an irresponsible way to approach a topic for discussion..........

I thought for sure that once I clarified that we were talking about, not common practice, but that once in a career decision that most would say, "Oh well, yeah! If I know the implications for and against and am comfortable and qualified, of course I would choose to save a life." I'm truly a little weirded out that it didn't happen.

Even tho you may not do it daily as your previous post stated, if the highlighted area is true, wouldn't you assume that there would be a protocol in place for this as well? I see where your headed, but as long as your "comfortable and qualified" wouldn't you still be within your scope to some degree? If your not qualified and comfortable with a procedure it's because you may not have the knowledge to do such a procedure, and I'm thinking you should stay away from it, just a thought.

As far as making the paper, I have no interest in such, around here that stunt will cost the next round at the local tavern.

As I stated when I posted this e-mail, I have no idea where it came from so I will not even begin to defend the math, and that is just a disclaimer on my behalf, not trying to fight the point.

Even at just under $4000 it would still be a much better "stimulus" check than the $500 check we got, and yes thats greedy on my behalf, but If we have this kind of money laying around, while in the middle of this "war", then why not find something better to do with it. I do realize the ramifications behind letting AIG fail (the insurance policies noted as an example), but wouldn't that promote the citizens to look for those services elsewhere? I do realize that not everybody out there is going to be smart enough to see the need for shopping around a little more, but what make AIG then end all? Are there not other companies that provide such services and would be willing to buy said policies to build their capital gains?

I'm clear Doc, it just made me giggle this am, that all!

thanks for the entrainment

I couldn't agree more with you......it is obvious as hell that a "joe-shmo" wrote this and NOT a politician. The unfortunate side of this is that it makes sense for many reasons:

1) the money would be returned to the masses, and ALL 18+ adults would benefit from it, including the "big wigs" at AIG and the politicians

2) most would re-invest the money after paying our taxes, thus restoring the economy as we know it

3) due to the re-investing, another new firm can be born, thus promoting the "American way" of economic growth

Why is it that we are favoring this ONE company, and not looking at giving this money to the little guy trying to get started in the "bizz" in the form of grants and such? If I or any of you go out and get ourselves in a "s**t pot" of debt, what do we get? Last I checked it was called bankruptcy, and piss poor credit.........so how are we benefitting from this govern"mental" save?

This isn't about the candidates, but is a hot top currently. This is an e-mail I got this am and I just thought it would be fun to see the different reactions..........since we are throwing politics out there.

Subject: AIG Bailout

I'm against the $85,000,000,000.00 bailout of AIG.

Instead, I'm in favor of giving $85,000,000,000 to America in a We Deserve It Dividend.

To make the math simple, let's assume there are 200,000,000 bonafide U.S. Citizens 18+.

Our population is about 301,000,000 +/- counting every man, woman and child. So 200,000,000 might be a fair stab at adults 18 and up..

So divide 200 million adults 18+ into $85 billion that equals $425,000.00.

My plan is to give $425,0 00 to every person 18+ as a We Deserve It Dividend.

Of course, it would NOT be tax free. So let's assume a tax rate of 30%.

Every individual 18+ has to pay $127,50000 in taxes. That sends $25,500,000,000 right back to Uncle Sam.

But it means that every adult 18+ has $297,500.00 in their pocket. A husband and wife has $595,000.00.

What would you do with $297,500.00 to $595,000.00 in your family?

Pay off your mortgage - housing crisis solved.

Repay college loans - what a great boost to new grads

Put away money for college - it'll be there

Save in a bank - create money to loan to entrepreneurs.

Buy a new car - create jobs

Invest in the market - capital drives growth

Pay for your parent's medical insurance - health care improves

Enable Deadbeat Dads to come clean - or else

Remember this is for every adult U S Citizen 18+ including the folks who lost their jobs at Lehman Brothers and every other company

that is cutting back. And of course, for those serving in our Armed Forces.

If we're going to re-distribute wealth let's really do it...instead of trickling out a puny $1000.00 ( "vote buy" ) economic incentive that is being

proposed by one of our candidates for President.

If we're going to do an $85 billion bailout, let's bail out every adult U S Citizen 18+!

As for AIG - liquidate it. Sell off its parts! Let American General go back to being American General.

Sell off the real estate. Let the private sector bargain hunters cut it up and clean it up.

Here's my rationale. We deserve it and AIG doesn't.

Sure it's a crazy idea that can "never work."

But can you imagine the Coast-To-Coast Block Party!

How do you spell Economic Boom?

I trust my fellow adult Americans to know how to use the $85 Billion We Deserve It Dividend more than I do the geniuses at AIG or in

Washington DC.

And remember, The Family plan only really costs $59.5 Billion because $25.5 Billion is returned instantly in taxes to Uncle Sam.

Ahhh...I feel so much better getting that off my chest. Kindest personal regards , A Creative Person & Citizen of the Republic !

PS: Feel free to pass this along to your pals as it's either good for a laugh or a tear or a very sobering thought on how to best use $85 Billion! !

Obviously this is just an opinion of someone's (I don't know who), and we will never see anything like this happen, but I did find it interesting to read.................

Thoughts?

IV Fluid bolus and narcan.

Is she hot as a hare? Blind as a bat? Dry as a bone? Red as a beet? Mad as a Hatter?

'zilla

Sly as a fox?

sorry this just tickled me this am................please continue!

Who disagreed with using them on transfer trucks, I disagreed with recognizing basics in Georgia period, due to the fact that it could potentially lower the pay scale for us all. Just like the paramedics disagreed and raised hell when Georgia considered going to the 99 standard for EMT-I's. For the same reason.

I do believe you just agreed with my argument. This is only one of the reasons that being "less educated" in our field is a problem, and the fact that managers will utilize these lower levels of care for a desired effect should bother all of us. This is why I state that if your using this level as a stepping stone to a higher level of care then fine, but making a career choice out of it is just plain LAZY!

thanks for the debate!

Firstly, as I stated before, Georgia just within the last two years recognized basic EMTs, prior to that, it was EMT Intermediate, and EMIT Paramedic. They started recognizing basics to appease the private transport companies who wanted the basics for transfer runs. I disagree with this, but wasn't my choice, as it didn't appear on any ballot.

Isn't it funny that you disagree with using EMTs on transfer trucks and I disagree with using EMT-Is on 9-1-1 trucks?

I'm being a little sarcastic, but most of it is the result of absolutely no sleep.. and a lot of caffeine.

WHO? You our the dead stew in the vault? LOL!

Dwayne, I think I may understand what your trying to say, and I know that you will correct me if I am wrong. If MC is ordering you to NOT preform a procedure that a Pt needs while en route to the ED, and you know in your heart and soul that the Pt will die without it, then by all means do it. Your 100% right in that instance and you are being that advocate that you preach about being, I'm behind that thought process completely, error in favor of the Pt.

My question to you is tho, is that really outside your scope of practice? You used the IV analogy, so lets stick to that example. As medics this is a skill that we use daily, and are trained to preform this skill. Wouldn't outside our scope of practice be something that we are NOT trained on? A couple posts back I threw out the most extreme example that popped in my head, and asked about amputation. It is extreme but not unheard of either. Would you, for the sake of the Pt, take on this task yourself, or simply make the decision to have a surgeon respond to your scene? Obviously as medics we are not skilled or trained to preform this task, but does that mean there is no way we could figure it out in a pinch?

I may be completely off base here, but thats how I understood the question posed.

damn you Richard.....you stole my thought process...............

Is she suddenly turned on by you and your uniform? Does she seem to be kinda touche feely?

When I, and not trying to make this about me, but when I decided to get into this profession, there were no schools within 150 miles that offered the Fast Track Paramedic program. My only choice was to take the EMT course, get hired with a service, then solicit them to send me to paramedic school. The local schools require you to be referred, or "sponsored" by a service.

Going off to school was not an option for me as I have wife kids and related bills.

As for being a lazy bastard who uses EMT-I to "lord" over Basics, how is that going to happen when none of the services want Basics, nor hire them, other than the previously mentioned Private Transport services?quote]

So what your saying is that YOU used this level of care as a STEPPING STONE, right? Isn't that what I said a couple of times now, and how I personally understand this situation as a means to an end? So why exactly are you upset? Also too assume that I know nothing about GA's EMS system is way off, even with me living and working in Missouri (for the record). As a matter of fact I believe that yes private services do utilize EMTs for basic transfers, but is it not true that Rural Metro in both south and north Fulton counties use EMTs to fill the second slot on a truck with a medic? I do believe they run 9-1-1 calls in those areas as well. Sounds like you may need to do some research about your own state before pointing a finger.

Agreed and thanks!

If you can only see stupidity here then you very much should stick to your protocols. It's not time, nor may it ever be, for you to think on this level that demands you may make a sacrifice for your art. For me, the very soul of paramedic medicine is pt advocacy. If I remember that, that I must defend them from sickness, from trauma, from insufficient care, and yes, also from possibly poorly written protocols, then I stay on track.

I think the view you have is a smart one. I think it will guarantee you a career much longer than mine, but when you choose to forfeit a life to follow a rule then you are no longer fulfilling your obligation as a paramedic. You may do complex medicine, but it is soulless, and I'm willing to bet your practice suffers for it.

Thanks for sharing your thoughts....

Dwayne

I think your being a bit harsh here Dwayne. Being a Pt advocate is the goal, right? That is what we are supposed to do and be, but how is stepping out of your scope of practice being a Pt advocate? Sticking to your scope of practice is your job, anything beyond that requires a higher level of care. If a Pt is so trapped in a vehicle that amputation is the only way to save their life, are you going to do it, or get a surgeon to respond to handle cutting the legs of your Pt off? Amputation is outside your scope of practice, but not the surgeon's. I totally agree with being a Pt advocate, however their is a limit in your skills that can be preformed in the street. Your not doing your Pt any favors by stepping outside that scope of practice when your not trained in a particular procedure that maybe life-saving. Who is going to protect your Pt's from you in this case?

Nor would you want a paramedic who is a fire fighter first, and doesn't give two shits to even study..........

People, there is a scope of practice for a reason. If you want to exceed it, go and get the additional training which permits you to do so. Otherwise, if you like your job, and like not being in court, then stick to what you have been trained to do. As one so eloquently stated earlier - how many lives will you save if you lose your license? I think HERO mentality seriously plays a part here.

Also, what many of us simply forget is that many times basic procedures which all of us are trained to do WILL get the job done. Now that's not saying there's not a time and place for ALS. There certainly is, or we wouldn't have it. However, when all your ALS toys fail, you better have darn good BLS skills to back 'em up. It's amazing how many medics I've seen that simply seem to forget their BLS if they can't do their IV or get that tube. Their world falls apart. Oh the things we forget.

Personally, no I wouldn't exceed my scope of practice. And yes, while it would be hard to sit back and only be able to perform up to what I was trained to do, I understand that training and oversight is there for a reason. How many basics run on an ALS stocked truck? Lots in our area but it functions as a BLS truck unless they intercept. If the rules and oversight weren't there, we may have basics doing all sorts of things that aren't within their scope. Ideally you shouldn't be doing anything until you know the reasoning behind WHY you are doing it. We SHOULDN'T (note I said shouldn't ) be training basics, intermediates, or even medics just procedures. They should understand the reasoning behind why they are doing it. If you don't, I think you are doing your patient a disservice.

All that can be summed up in what I've told people many times, "I've worked way too hard to get and keep this license to lose it to stupidity". Exceeding your scope of practice is just that - stupidity. Period, end of story.

ut'oh.....sounds like another one advocating the whole continuing education thing..............I couldn't agree more, GREAT POST AND POINT!

It's good to see an Obama supporter who loves him! :shock:

Question: Do you he likes Obama's mama?

NO, she was trash......didn't you listen?

LMAO

His mama and her mama said so.............................

rookie, I don't think I ever asked about your pay, quite honestly I DON'T CARE, and that is me personally. As I stated before, If you choose to make the EMT-I level a career choice you are the fool, but using it as a stepping stone is understandable so the fact that YOU have a plan is acceptable, and not that YOU need my approval, but that is what I have been saying the whole time. The fact that you felt the need to defend that level of provider fell on your shoulders. As far as you using my career as a stepping stone does bother me, BUT only if you are using it as a hobby. There are plenty of us here and abroad that make EMS a career and raise our families on it. I have no issue with you or anyone else working in this field to make the rent while your on your way to the L&D floor, but have some respect for those of us who have chosen to make this our lives, and we will help you on your way up the ladder.

sirduke, The EMT-I level is only the lazy way out of being a medic, and yes it is a simple way for one to be the "big man on the truck". It is the easy way of obtaining rank over an EMT without committing yourself to the education of being a medic. EMT-I is pulling the wool over the eyes of the people we serve....period. The public as a whole really has NO idea the difference in levels and what those letters on your collar mean. They see some lazy, uneducated EMT-I starting an IV based soley off of the "cookbook" protocols, and assume that they are medics. You stated that your plan is to further your education as well, and head off to nursing, so why did you get so damn offended by the statements made?

If you are making EMT-I your career choice, then you are lazy and on a power trip. Get off your ass an get a REAL education! If you are in this position for paying the bills so you can continue your education then fine, I understand that you may need to do this, but don't sit here and tell me or any other medic that deserves the respect of being an educated medical provider and/or professional that this level is anything other than insignificant, it isn't!

As for AK and Dust, apology requests for jumping the gun on page 1 can be made by calling 1-let-me-sleep........LOL