WANTYNU

Or the hey, I saw this one on TV.... another famous "jumping off" point.... w-

Do I still count if I'm not really into it? I signed up for a tour 1 tonight, don't want to do it, and couldn't find coverage.... w-

LP should provide a tester, that you can shock (little black box), just plug in, charge up, press shock, we do it before every tour. Richard B, I know you and I are almost saying the same thing, I think the difference in what I am saying is, as an example, what we accept, like the wires on the defib cable not working, as "well it happens", is not acceptable. Instead the wires should come with an expiration date, and be tested before they leave the factory, and be designed with redundancy with a test circuit so they do not pass unless 100% OK, and still work even when damaged in the field. This is possible, and would not cost the Moon to do, we just need to demand it. I learned the hard way, that in manufacturing, there are processes and procedures that cost pennies, but add TONS of security, pennies add up, so is the temptation to skimp and save, but in doing so you get an inferior product. I made the opposite choice, it costs me more to make, and because of the market demand I make less profit per unit, but when I’m in the field I know it will not fail me. Priceless! Like I said, a few pennies in additional work and quality, provides the security of dependability. In my book well worth the cost. A simple analog would be using a seatbelt, takes a second to do, but that second can possibly save a life. Be Safe, WANTYNU

Thank you, but this is very old, the stats are about 5 years out of date (I know it states 2005) but add in that state data is usually 1 to 2 years old when it is published in the first place, then the delay of pulling it together. My point, is current numbers are not easy to come by. Be Safe, WANTYNU

In conversation with the advertising department for this magazine, I asked “Just how many field EMS, meaning EMT’s and Paramedic’s, not counting Firefighters are there currently working in the US”, she gave me a number. I have found that it seems to depend on who you ask what the “count” is. I was hoping to see if anyone knew of an actual censes. I’ll post the number I was given in a few days, just would like to see some opinions first. I was once told the NY count used to be 50,000 EMT's and 5,000 Medic's, I have no idea if that is accurate. Be Safe, WANTYNU

Pretty nitpicky anyway, But for the facts sake you are correct, there is no square in the formula, good catch (if it’s any defense, I did mean to take it out, but missed it on my read through before I posted). I hope the humor of this post was not lost in the writing, I was thinking the criticisms were pretty inane. Thanks again for the catch, I’ll correct it right away. Best and be safe, WANTYNU

Just looking for your best guess here. I just got a number from a major EMS magazine, it was not what I expected, but then, when you look into it, it’s a hard number to find, as we are a very diverse community. I’m just wondering what our own community’s perception is? Be Safe, WANTYNU

This my Point yes uncle Murphy can and will show his ugly head, but there are so many other places he can play, emergency equipment shouldn’t be one of them. Equipment is engineered, designed and built to do a job, if it fails it was used wrong, or built wrong. Or was never meant for the job in the first place, you would substitute sewing scissors for trauma shears and expect the same results or for them to last as long? I think half the problem is we as a community are so used to getting someone else’s hand me downs, or second best, that we except it as the standard and say nothing. Just IMHO… As Always Be Safe WANTYNU

So I am taking a moment in this busy holiday season to add to my list, First why is it that management decided to put into service new equipment before the busiest part of the year, four years ago it was the Scranton ACR’s (ePCR) on no better than midnight January 1st (New Year’s Eve) to figure out new paperwork, just the busiest night of the whole year… So this year are new stretchers, now I think they’re great, it’s about time we went to the One (and a half) man stretchers (we keep the new half crew in the spare tire cabinet), BUT it would be nice if they tested the release or adjusted them properly before deploying them in the field. Ours stuck, (of course on a call) and we had to lift the patient into the Ambulance, transport them on the cot, then again lift them out the bus to transfer them to a hospital stretcher… Found out later a tension adjustment screw was too long so the release locked… Or how about the new easy reset circuit breakers, you hit one good bump and one in the bunch pops. Then you get to play circuit breaker bingo, pull the circuit cover and it’s like looking into the inside of a star Trek computer, a thousand blinking lights, cryptic labels, and little tiny popup breakers… you end up hitting everything until the stuff that stopped working (HOPEFULLY) resets. Call me crazy, but I think equipment meant to work in an EMERGENCY, should be tested before it is deployed, so it actually WORKS when you need it to. (I know it completely blows the surprise factor, but hey, I like to know what my equipment will do in an emergency, before I am responding to one…) As Always Be Safe, WANTYNU

OK so I figured I'd start a thread to share the jobs that leave us scratching our heads trying to figure out what our patient was thinking. I’ll start, I don’t know if it’s the season, full moon, or coincidence, but I’ve had more people do incredibly dumb (and fatal) things lately, that just has you wondering what were they thinking (beside just plan out trying to kill themselves). Case one, listening to local police band, there is a call for an EDP jumping in front of cars, and at the last second jumping out of the way, (luckily no innocent people were harmed in this stunt). The road a two lane highway that runs down the north east side of Manhattan, has a speed limit of 55, but most travel around 70. I guess he mistimed his last jump, or didn’t jump out the way fast enough, he was struck by two cars, and run over by the third (a full sized ford explorer, air bags deployed), When I got to him, all I saw was a bare ass sticking up in the rear wheel well, between the front and rear tires (why do their pants always seem to come off?). Head under the driveshaft, legs out towards the road. ESU is on their way to free the “Pinned” patient, I get out thinking the guys dead for sure, ready to give a TOD, when he turns over as if he’s working on the car, folks are still saying wait for ESU, I say why (after all he’s no longer “Trapped”), Longboard under and a quick pull, and viola fresh idiot on a board. We get him trauma naked, and I am amazed to find nothing besides a bruised butt, and a small lac on the head, a little road rash here and there, but otherwise the kid (28 y/o) seemed untouched, moving all extremities, and to some extent following commands. I am not kidding, no tread marks, no gross deformities, no broken bones, no crepitius, no discoloration, nothing. O2, Two large bores, fluid, and away we go… 8 minutes to the trauma room with a team on standby, kid is still following simple commands (keep you arms on your chest, etc), But in the end, all is for not, as the kid dies a day later, from massive internal injuries. No “moral” to this story, we did all we could and moved fast, but a stupid act on his part, cut short his time on this planet. Anyone else care to share? Best to all, Happy holidays, Be Safe, WANTYNU

Oh I forgot to mention the nasty super strength "paper" cut I got, cleaning the back of the bus, I ran my hand down the side of those new plexiglas cabinet doors, cut my finger and I didn’t even feel it, just saw the blood, sharper than a razor.... Can you say OUCH!!! :shock: -W PS OH COME ON, WHO DOESN'T KNOW APE stands for Acute Pulmonary Edema :?

(That WOULD be scary!!!) (Thank you, I think, besides, I can’t sell snake oil, I have no ice….) (Ya, that is good stuff, we call it hockey tape, cause its like the stuff you wrap the hockey blade with, basically tough as nails, {also does a great job on eyebrows, or so I’ve heard…) 8) Improvising is our First, last and middle name, Notice the last answer in my poll? I did have a pager break once, seems it wasn’t made to withstand hitting a cinderblock wall at high velocity…. :roll: ;-) Best -W

Where’s the other dog, and what have you done with him… Seriously, are you dangling a hook? I won’t take the bait, you know I’ve answered those questions, not here, but I have answered them. Suffice to say I made it to suit my standards and I’m not an easy customer. -w

I can understand routine maintenance; ya gotta change the oil once in awhile, but that’s pretty much spelled out. In our business catastrophic failure should not be an option; failures can be planned for in the design and testing stage and a backup should be configured into the final model. For lack of a spring, a stretcher should not collapse, it should lock, and the user then should be able to manually release the part that needs to move. I know some of the stuff we use is built this way, and not all is crap, but a lot is. I started this thread to see what we in EMS have learned to put up with (and possibly why), I think we should start to demand better quality in the equipment we use, and (comfort?) safety in vehicles we drive. It’s all very feasible, but the vendors don’t think we’re worth it. Micky-D’s has to have a warning label that their coffee can be hot enough to scald you. If all the manufactures had to put warning labels on the equipment that could potentially injure us (or the patient), I wonder what they would say or do, and if we knew what they know (how and when their products fail in testing), would we still use the product? As always IMHO Be Safe WANTYNU

Ever have a piece of equipment break on you (when you needed it most)? Over the years, I can recall the following pieces of equipment failing during use: I had a life pack show a Brady rhythm, when the person was NSR at 80 (even after cleaning the electrodes and skin). An O2 regulator thumb screw snap in my hand, (and of course the previous shift moved the spare) during a conscious intubation on a decompensating APE. (talk about fun times). Stretcher lock (the one in the bus) handle literately blow off the locking bar (rivet failed). (shot at least 15 feet past the back of the bus). Knife fall apart in my hand (handle rivets came undone, the whole thing fell apart). O2 wrench snapped. Radio knob fell off. Flash light bulb on a new flashlight. Anybody else? Any good stories? Happy holidays, Be Safe, WANTYNU

Well it has been scientifically confirmed that stab wounds , penetrating trauma is bad. I hope this video helps. http://www.joecartoon.com/videos/556-multiple_stab_wounds Be Safe WANTYNU

I've been to the shows and seen the new LB, they are better, (I don't think our's have changed in 20 years), but the new ones do take longer to set up, even so, in my book its time worth spending if it prevents further injury. remember the golden rule: "Do No Harm" -w

It seems pretty much anything that has MOI (bat to back would count) or is suspect of internal trauma gets a LB, but thats NYC, I sure someone here could give a better answer. Be Safe, WANTYNU

Huh? OK let’s take either case, the traumatic cardiac arrest or the A&OX3 with the needle decompression, please explain how a long board is not part of the standard of care? Are x-ray machines now on the ambulance? How do you know where the bullet stopped, where is it resting, has it fragmented (with or without an exit wound), spinal immobilization serves more purposes then to protect the spine, it keeps the body stable, takes 1 minute (add a minute if your patient is moving) to get the patient on the board and ready to move, no big deal. Because a treatment takes longer than a minute does not mean it should be discounted. Moving the body causes the internal organs to shift, expand and compress, now if you knew your A&Ox3 Pt has a bullet fragment sitting on the aortic arch ready to puncture it, so that if improperly moved you could find your patients condition changing dramatically for the worse, would you still say throw him on the stretcher? Better yet, he’s ambulatory on scene, walk him to the bus? The point is you don't know, so how can you treat like you do? I’m not arguing the point of a peripheral puncture wound; however, have you ever seen a bullet fragment travel from a leg wound to the heart? Bullets are nasty little buggers, they puncture, tear, rip, bruise, bounce and fragment around the inside of the body, and people who have been shot should be moved with care. Bullets can cause just as much and more trauma as a blunt injury, would you even think transporting someone that fell off a moving bicycle without a LB? Of course not (at least I hope so {hint mechanism of injury} so tell me how a bullet is different), that’s why GSW’s go to trauma centers. There are more than enough cases on record where an entry point was peripheral, and the wound was fatal. As Always IMHO, Be Safe, WANTYNU

Seems like regardless of the area of central injury, restricting movement would be a good idea (limiting internal bleeding, tears, bruising, etc), and it is still part of our protocols, so we really have little choice anyway. It’s also easer to “scoop and run” with a backboard (on the street with crowd forming) and treat on the way to the trauma center (keeps the golden 10 minutes down). I did my PHTLS 6 months ago and they were still teaching long board, but I am nowhere near an expert so I’ll ask one, my instructor, if I can get an answer in a reasonable period of time, I will post it here. Be Safe, WANTYNU

Just a heads up, made the changes, let me know... Be safe, WANTYNU

Remember to drink responsibly and only with friends, Jim, Johnny, and Jack....

ICE GOOD (To keep my beer cold), PASG GOOD (to Demonstrate past stupidity), Snake Bite BAD. Beer Good. :occasion5: :tongue3:

The act of Bribery implies the Bribe-r has money or something of value to give for a favor to the Bribe-e, the bank owns me, perhaps I could interest you in my sister, she’s almost a virgin…. Here’s the tricky part, I feel by talking too much about my individual situation, I am on thin ice (no snakebite jokes please) forum wise here. So in general terms: Manufacturing is already done by a company that can conform to specific requirements, (the same used in both automotive and aircraft), this is the reason not to use China, as cardboard won’t work, I would not buy or make a tool I couldn’t personally rely on. The expense of manufacturing here is unbelievable, :shock: hence low margins, leading to a lack of distributor interest. Super mass production is still a consideration, abet a very expensive one. Although a lot would have to be produced, it would lower the per-piece cost somewhat. To answer the second part of the question, having a large quantity on hand, I believe it would take time to sell but there would be a market for it. I mean how many EMS personnel are there across the country anyway, a couple of hundred thousand? (18K on this site alone)? If what I am reading on this thread is true: that there will always be a market for true quality. As long as we continue to give our Pt’s O2, (as well as a percentage of the o2 bottle manufactures maintain the current stem valve design), then there should always be a market. Thank you! (It still won’t get you a freebie…) :? Be Safe WANTYNU