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That OxyContin + valium = the new speedball?

Teenagers are going to continue to engage in premarital sex, just as they have been all along - regardless of if they have the vaccine or not. But don't expect to be on your priest's good side when you tell him that.

I tend to get sucked in to providing support for bike tours, fund raisers, runs and the like - character flaw, I'm sure. Inevitably, I end up in the middle of someone else's turf and try to remain cognizant of that fact. For example, just last month I was down at a state park supporting a 100-mile ultra run. (For the record, anyone who willfully participates in a 30-hours, 100 mile foot race is probably a good candidate for a 72-hour evaluation, but I digress... ). We received a call on the radio about a female patient, witnessed syncopal episode with about 2 minutes LOC. I asked for a squad to be dispatched and my partner and I headed over and assessed the pt. Once the local VFD showed up, I turned the patient over to the paramedic on the squad, gave the crew a patient report and told them, "Ok, I'll be standing over there if you need anything else."

Nope, you're not wrong - it is your scene. Anyone who has any field experience or street time is going to understand that and offer to be an extra set of hands for you, but isn't going to be offended if you decline. Your protocols may already address this. The guideline protocols by the Ohio Regional Physicians Advisory Board include the following: (Obviously, these don't apply where you are at, but I would suspect that the state of Nevada has something similar. ) ON SCENE EMT INTERVENER On a EMS run where an unknown EMT from outside the responding EMS agency wishes to intervene in the care of patients, the following steps should be initiated: 1. Ideally, if no further assistance is needed, the offer should be declined. 2. If the intervener's assistance is needed or may contribute to the care of the patient: a. An attempt should be made to obtain proper identification of a valid Ohio EMT card. Acceptance of borderline states' EMT cards are at the discretion of individual EMS services. Notation of intervener name, address and certification numbers must be documented on the run report. 3. Significant involvement with patient care or variance from protocols will require the intervener to accompany the patient to the hospital. PHYSICIAN AT THE SCENE GOOD SAMARITAN PHYSICIAN This is a physician with no previous relationship to the patient, who is not the patient's private physician, but is offering assistance in caring for the patient. The following criteria must be met for this physician to assume any responsibility for the care of the patient: 1. Medical Control must be informed and give approval. 2. The physician must have proof they are a physician. They should be able to show you their medical license. Notation of physician name, address and certification numbers must be documented on the run report. 3. The physician must be willing to assume responsibility for the patient until relieved by another physician, usually at the emergency department. 4. The physician must not require the EMT to perform any procedures or institute any treatment that would vary from protocol and/or procedure. If the physician is not willing or able to comply with all of the above requirements, his assistance must be courteously declined. PHYSICIAN IN HIS/HER OFFICE, OR URGENT CARE CENTER 1. EMS should perform its duties as usual under the supervision of Medical Control or by protocol. 2. The physician may elect to treat the patient in the office. 3. The EMT should not provide any treatment under the physician's direction that varies from protocol. If asked, the EMT should decline until contact is made with Medical Control. 4. Once the patient has been transferred into the squad, the patient's care comes under Medical Control. http://www.ems.ohio.gov/policies/EMS_Guide...rocedures07.pdf

Normally I'm more concerned with various folks out there on the street looking at us as a mobile drug box and trying to get in and remove said drugs when we are on scene. (Or as happened last month, someone deciding to throw a couple of 9mm holes in one of our MICU's as it went down the street.) I never did consider our patients trying to use us to smuggling their illegal wares. Either it isn't happening much up here, or I've been dangerously naive.

Airport Rescue Fire Fighting. The airport maintains their own FD.

LOL, as amusing as that would have been, I opted instead to tell him that I don't pretend to know how to do is job, that we're all on the same team out there, if he has a problem with one of our crews to call dispatch and I went back to enjoying my nice, sunny afternoon. I certainly wouldn't have tried to start a pissing contest at his house, I'm not sure why he felt the need to do so at mine - but some people are just jack*sses.

So I spent yesterday afternoon relaxing by the pool in my condo development and enjoying a couple of cold ones with my neighbors. I was wearing an ARFF T-shirt I had swapped a friend one of mine for. I'm in the middle of a conversation when I hear some guy in the pool (a guest of one of my neighbors) ask: "Hey, who's the hose dragger?" I just ignore this and continue my conversation. Again, "I said who's the hose dragger?" Me: "Well, you're certainly not talking about me, I'm not a firefighter. I traded one of my EMS t-shirts for this one." Guest: "Who do you work for?" Me: "I work for [private company x]." Guest: "Hey! Why the hell do you guys run hot all the time? One of these days when I see you running hot and I'm in my cruiser I'm going to stop you." Me: "Oh, you're a cop." Guest: "Yeah, I work for [suburb y]. So, why do you guys feel like you have to run lights and siren to go get a bag of chips at the gas station." Now I'm thinking... great, I've got a suburban cop who weighs at least 350 on a good day talking crap and calling people 'hose dragger.' You have got to be kidding me. Me: "If you want me to believe that you saw one of our squads running hot to the gas station, why didn't you pull them over or call the company and complain? I'm calling bullsh*t. The last time I ran hot was for a shortness of breath call at a nursing home. 90% of my runs I don't even think of the lights and sirens." Cop: "Well, see, that's what I don't understand. They've got a nurse there at the nursing home, you don't have to run hot to get there." Me: "Have you seen the way some of the nursing home staff handles emergent patients?" Cop: "Yeah, my wife trains them." :oops:

Nope, big rig drivers shouldn't be blowing through red lights... and neither should EMS. But the requirements to get a commerical driver's license require more traning than I need to drive a vehilce where I'm basically authorized to break traffic laws. Ideally, we should be stopping and ensuring that we have been given the right-of-way by the other motorists. Yet one doesn't have to search too hard to find a news report about an ambulance blowing an intersection at a high rate of speed. I know of five different suburban fire departments in Northeast Ohio that have implemented new transport procedures within the past 18 months which limit what sort of patients they should be running hot with, or leaving it to the discretion of the officer on the squad. To generalize what I'm seeing, departments are running hot to the scene, but if they assess the patient as BLS, they're driving with traffic to the hospital. They are making these changes based on the research similar to the links I posted above - that running hot puts lives at risks, many times only to shave a few minutes off of transport time for a patient that doesn't require an emergent transport. I agree with you. But there are also some real yahoo's running around out there. I've ridden with some. I'm sure you have, too.

I'm just not buying that argument. The onus is as much on you as on me to prove your argument. Yes, the more hours you spent behind the wheel of a vehicle, the more likely you are to be involved in a collision. However, there are plenty of companies that operate vehicles all day long without killing off their employees or other motorists - take just about any transportation or freight hauling company as an example. If you want to reduce the number of accident related fatalities in US EMS services, better driver training would appear to have a more direct result on achieving the desired outcome than universal healthcare. http://www.ncbi.nlm.nih.gov/pubmed/11446540 "Most crashes (202/339) and fatalities (233/405) occurred during emergency use. These crashes occurred significantly more often at intersections..." http://www.ncbi.nlm.nih.gov/pubmed/1015550...ogdbfrom=pubmed "During the four-year study period, 109 fatal ambulance crashes occurred producing 126 deaths... Seventy-five fatal crashes (69%) occurred during emergency use (EU) and 34 fatal crashes (31%) occurred during nonemergency use (NEU)." Based on that data, if you want to reduce the number of ambulance crashes in the United States, take the lights and sirens off the vehicles since we obviously don't know how to drive with them on.

Time for a quick reality check for you: Lack of Universal Healthcare != More helicopter midair collisions or controlled flight into terrain Lack of Universal Healthcare != Joe EMT crashing his POV while running hot to the station. Lack of Universal Healthcare != More paramedics blowing an intersection, swerving around an animal in the road at a high rate of speed, or some other type of mistake that leads to loss of control of the vehicle.

I belong to an organization that does a lot of event coverage (It's actually what led to me becoming an EMT). Our policies are exactly along those lines. If you're handing out a bandaid no report is required, but if you're assessing the patient you should be documenting your findings in a run report. As usual, common sense should dictate, but it isn't all that common, is it?

Given that the original poster is the same individual that started the last volunteer vs. paid flamefest and then disappeared, I'd maintain a high degree of suspicion that it is intentional.

LOL... You know, I never thought of any of that. Damn I've been missing out.

I'm calling Bullsh!t.

I think it depends on if there is a pt. in the back or not and if you have an out. I don't want to undertake any sort of sudden maneuver if my partner and the pt. are in the back of the squad. However, if we're both up front and buckled in, I'm less inclined to plow through the deer if I can avoid it, if I have an "out," and if I can do so without causing an accident.

I'm not sure if this was meant in sarcasm or not, because your argument applies. You still have space and gear constraints. I'm just saying that THIS particular system has a doc on board, which can raise the level of care provided in a pre-hospital setting, especially when you're considering the rural areas with volunteer departments who may only get a handful of ALS calls a month and a couple of serious traumas in a year. I don't want to give the impression that it is THE answer, nor that it trumps legitimate safety concerns. I was just answering one very small part of what you stated. Having a helicopter available is one tool in the toolbox. But it is just that, one tool. You don't use a hammer to put in a drywall screw. Ask me how I know.

I know a lot of agencies around here will call for Metro Life Flight (Cleveland) to be put on standby, especially the rural agencies, as they roll up to a scene based on what they see. (I've heard some departments make the request before anyone was on-scene.. :roll: ). While they get their intial assessment, the dispatchers are getting on the same page, agreeing on frequencies, and the flight crew is starting up the engine. If air is not needed, the bird never lifts off. If they are needed, they saved 5 minutes or so. One definate advantage that Metro provides is a DO or MD on every helicopter, so their playbook is pretty much wide open and limited only by what gear they can carry. Metro Life Flight

I know what you meant, I wasn't being serious. That said, I wish I could say that I didn't spend my early 20's attempting to ply women with ETOH, (or myself for that matter), and there may actually have been one flaming couch that I can recall. My girlfriend often reminds me when someone tells her a story about some stunt I pulled years ago, "I would never have dated you then."

I guess this is the wrong time to own up to my past as a Phi Tau at Bowling Green State University in Ohio.

... then my career would really take off.

My company policy states facial hair is only permitted above the upper lip. However, one of our directors recently started sporting a very closely shaved goat, and shortly thereafter a few others did to... so it is obviously becoming a lax policy. In my opinion, while OCHE may not prohibit it, there is still the issue of maintaining a professional appearance. I leave the debate as to if a goat or beard looks professional to others... Iamb staying out of that one as I did not wear my nomex underwear for the ensuing flames...

You can have those who are "doing this out of the goodness of (their) heart." If I call for help I want the provider who challenged themselves, paid attention in their CE sessions, and is the best darn EMT or paramedic in the system to show up at my doorstep. I don't care what their background is. Do you have a job? Why do you do that job? Perhaps you're just independently wealthy and the idea of working to put food on your table and provide for your family may be a foreign concept to you. However, I suspect you are not and you're just looking to stir up sh!t on the internet because you are bored or lonely. Tell me this, would you go to work every day if your employer stopped paying you? I think not. As for "being in it for the money," I don't know of a single person who went in to EMS to get rich. It's a calling for the paid folks just like it is for the volunteers. I am going to use Cleveland EMS as an example since it is the largest 3rd service EMS system that I am familiar with. The dedicated men and women who work in that system certainly aren't doing it for the money. They're the lowest paid of the city's safety forces and treated as red-headed step-children by the city when compared with Fire or Police. Most of the medics I've known there are in sufficient physical condition and possess sufficient aptitude to pass anyone's fire exam. If they were really in it for the money, why wouldn't they land a job on Cleveland Fire (or any of the suburbs) where they'd make better money, work ~100 days out of 365 in a year, and be treated better by the community? As for myself, I work my full-time job (non-EMS) because my employer pays me very well. That fact is as clear to my employer as it is to myself and I make no apologies for it. I strive to be the best in my field and do the best job I am capable of. Likewise, for the 20-30 hours a week I work with a private ambulance company I take the same approach. I work hard, keep educating myself, and am striving to be known as one of the better EMTs in the system. All of that said, any streak of altruism that I may have that keeps drawing me to this field stops short of me feeling compelled to return my paycheck and do all that work for free. If anyone has a problem with that, it is theirs and not mine.

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Ick, as the safety director for one of the ADA Tour de Cure bicycle rides, this is one of those scenarios that keeps me awake for an extra minute or two at night. The MS Society is known for their 150-mile bicycle rides, and I've worked with them on their northeast Ohio ride for the past 5 years dispatching for their EMTs at the county 911 center. Our biggest enemy used to be heat exhaustion, but we've seen an increase in the number of car vs. bicycle MVAs in the past two years. I'm not sure if it is due to an increase in the number of distracted drivers, a decrease in the awareness of the cyclists, or just the law of averages catching up with us after having a run of quiet, MVA-free years.