certguy

You know guys , I really enjoy this site . Having been away from EMS so long a lot has changed over the years . I think this is better than any magazine because it's an interactive info source . I'm glad I found this site , it's an info goldmine .

Hi Doug , Sorry to hear about the closing . It stinks to lose your job . I worked for Southwest Amb. (the major provider in Pheonix area ) when they had a BLS operation in San Diego . The manager did such a great job (he was the best I've ever worked for and I'd work for him again in a heartbeat ) he was promoted to the CEO's assistant and transfered back to the main . In less than a year , this guy wrestled several contracts from existing companies and had us up to 6 units running 10 - 12 calls per day . In his place , they put a bonehead who intentionally ran the operation into the ground to get back to the main and there wasn't a thing any of us could do about it . ](*,) We were given the oportunity to work at the main , but I was offered work back at Schaefer and turned it down . Keep the faith , god'll work things out for you . My thoughts are with you .

It seems like you guys have really debated this one . Just a couple thoughts . #1 we're all just as likely to become victims in a disaster as anyone else , though training helps cut the odds . #2 If LAFD realized it doesn't have the facilities to cover a major disaster , what makes you think you do ? # 3 Suppose you and your family do become casualties and your area's cut off , if you can't take care of yourself , wouldn't you want someone with at least some training coming to your aid ? Remember , we're not superheroes and contrary to the movies , it takes a while to get the calvary riding to the rescue . One of the things that ticks me off about Katrina is that there was a huge area involved , and yet all you heard about was New Orleans . In a disaster that huge , all hands will be working ( and needed ).

I agree with the guy who talked about good documentation in addition to the refusal form . It's been a while since I've worked the field , but this is something that never changes . Good documentation can save yours and other people's backsides . I once had a product demonstrator for a large chain store who fell , did the classic arm lockup and shattered her humorus and upper shoulder . A year and a half later , I was called to our main station to give a deposition . I was met by a lawyer and a PI who aked me about the call . ( my partner on that one had left the company to join the navy ) I remembered some of the details . Then they produced copies of my paperwork and gave me a few minutes to refresh my memory before going on . As we talked , she claimed she slipped on spilled eggs in the dairy section on the OTHER side of the store . This place was huge and she was in so much pain , she could barely walk . We found her in the employees lounge on the second floor , at the base of the steps was a water fountain . There on the ems form , was the statement , " pt. states she slipped on some spilled water at the water fountain . " along with a description of where we found her . The lawyer thanked me and said they'd recontact if they needed me . They never did and I found out later from my manager she was trying to sue the company for a cool million . Apparently my documentation helped blo w her story out of the water . I always tried to document well , but especially if it was a crime scene or something like this that well coud involve a lawsuit .

Cool rig ! Does it come with a winch so I don't have to land ? Gatling gun's a good touch . May I suggest contacting Q to make it submersible ?

Sounds like the transit company I work for now . I work for a private company the county contracts to . We started out with a small operation headquartered out of Gresham , Oregon that took pretty good care of us , though we didn't make a lot , now I work for the largest transportation company in the world , owned by the brits , that doesn't care about thier employees .

My first 6 months with Schaefer amb. I worked as a relief dispatcher prior to going into the field . One night I was working graveyard shift . It was a hot night and our a/c was down , so I had the door open with the screen door shut . It was about 2:00 am and I was busy with calls when I heard the door open and shut behind me . The 24 hr. crew's quarters were in an apartment right above me and they were in station , so I thought it was one of them coming down to talk . Soon I heard the loudset snoring ever going off right behind me . I got mad and turned to wake him up . I was shocked to see what looked like the perverbial confused Alhzheimer's pt. snoring away . The first thing I thought was that he got confused and walked away from home . This guy was wearing an old , stained nasty T - shirt , khaki pants with suspenders , and old sneakers . I thought about calling PD , but figured I'd check with our crew first to see if they knew him . I woke one of them up and met him outside to explain the situation . When he went inside , he broke up laughing and told me the guy was non other than Walt Schaefer , the millionare owner of the company . Man , did I almost make a bad career move !!! The family had an apartment at the station I didn't know about and stayed there when they were in town . A week later I was working the same shift when he again came in . he was quiet till I had some free time , then while I was drinking coffee , he said , " So I hear you almost called the cops on me ! " I choked on my coffee . Before I could answer , he laughed and said it was okay . That was the start of several late night conversations I had with him before he died . He was a cool old guy who's 15 min. of fame was when he transported Marylin Monroe , thus becoming a witness in the investigation . He was a great story teller and on slow nights , he helped pass the time . I definitely learned that not all things are as they seem after this .

Hi Scaremedic, Your luck sounds like mine . Over the years I've discovered Murphy's an optimist with a sense of humor . Everybody's got to make thier own choice , but if we all stayed home , a lot of folks will pay for it . Maybe I'm old fashioned , but if EMS becomes just another job , time to move on .

Yeah Marty ! Good advice . I forgot to mention that caddy corner from your staging area , a CERT response trailer is parked . You now have triage / treatment area setup equipment , a large treatment kit ( supposedly can treat 150 pts. ) c-spine equip. , stretchers , a generator and floodlights , light rescue tools , cribbing , and misc. other equipment. The trailer can also be used as a command post.

Thanks for the info guys . By the way , Anthony , where do you work ? I worked a total of 7 years for Schaefer in San Diego . Found myself at the main in LA on long distance transfers a few times .

Hey Brentoli , Did you know during the Mexico City quake , spontanious volunteers saved over 800 lives but lost 100 of thier own doing it . CERT also trains people to do LIGHT urban search and rescue and how to do it more safely with the realization that people can and do jump in and help out in a disaster . Those 100 could've lived if they knew the do's and don'ts .

The point of this scenerio is ; What if you find yourself suddenly on your own in a widespread disaster with no backup ? You don't have a fancy unit to work out of , no FD backup , no PD . Those CERT personnel may be the only organized help you and your community see for a while . They may not be pros , but in a disaster they can and do save lives . In this scenerio as in the real thing , you have to come to the realization that you can't be everywhere at once , and there are a lot more pts. than you can handle . With a whole community involved , where do you set up your treatment area ? Many of us take for granted our normal resources and are in for a real eye opener when we have the big one . Are you and your family prepared ? Sounds like a DAH ! , but I'll bet some of you aren't . Do you have disaster supplies set aside ? Do you have a family plan ? Do they know how and when to shut off the utilities ? A family that's prepared is a family you don't have to worry about as much . Sometimes we're so busy teaching the community , we don't practice what we preach. Knowing you're area's disaster plan also helps , but just in case , don't be afraid to look at alternatives . What resources ( non - emergency ) are available in your area to help ? Picture the FDNY earthquake scenerio , how fast will they be overwhelmed ? I got you guys talking about the scenerio , anybody care to take it on ?

Anthony brought up a good point about cap refill . this is only thought to be reliable in infants and kids now . I like checking the pulse better , but I'm trying to find something in writing to show our training officer to get it changed . I want to give my students up to date info . Our training officer and coordinator are both ex - paramedics very set in thier ways in old protocals .

I heard recently that START was changing the circulatory protocal from checking cap refill to checking whether the radial pulse was present . I haven't heard anything officially , has anybody else ? Present protocol as I was trained ; resp. over 30 , red tag , cap refill greater than 2 sec. , red tag , inability to follow basic commands ( squeeze my hands ) red tag . Resp. under 10 also used to be included as red tag criteria , but isn't covered in our training DVD . Is this still included ?

Hi Dustdevil , Family will always come first , no offense , but I find it kind of hard to believe that an EMS professional would turn his back on his community in a disaster . I can't speak for you , but as for me , once my wife's okay ( the son's grown and out of the house ) my next priorities are the nieghbors , then the community . I don't know where you're from , but the midwest and the east have also experienced quakes . No matter where you live , there's potential for some form of disaster , and normal responders can't be everywhere . For info , CERT was started in 1985 by LAFD who realized after the Loma Prieda quake that even they don't have enough resources to handle a disaster . FEMA and homeland security like it so well , they're going nationwide with it . The program's about teaching ordinary folks how to better take care of themselves , thier families , and thier nieghbors in a disaster . They are also trained to be part of an emergency response team ( if they so desire ) to be activeated in the event normal responders are overwhelmed . Studies have shown that many disaster victims can be saved using even basic first aid measures if they are started soon enough . CERT is trained in many areas including triage , disaster first aid , and treatment area setup so they can get treatment started till EMS can get to them . This can be a valuable asset in the big one when your resources are stretched thin . The scenerio I laid out is a likely situation we could be facing . The area is my valley with an earthquake fault capable of a magnitude 7 running under our dam . ( it was thought to be inactive when the dam was built ) . Back to the scenerio . I didn't tell you before , there's one other target hazard , a board and care with approx. 30 pts. that hasn't been heard from . In community resources , you have a medical clinic ( closed for the weekend ) , an equipment rental yard with all sorts of goodies . A rafting company with several busses , coolers , first aid equipment , and other assorted gear , and a couple stores and gas stations . All utilities are out .

It's 10:30 on a sunday morning in your rural community . Suddenly the area is struck by a mag. 6.5 earthquake . You're off duty at home . You are also a CERT ( community emergency response team ) member . You check on your family and nieghbors they're okay with a few minor injuries . You secure utilities as needed at yours and the neighbors houses , then do a quick recon of your area . You find many damaged buildings , several structure fires , as well as power lines and trees down . Luckily , it's winter in central CA . No danger of wildland fires and not many tourists in town . Daytime temps in the 50's , nightime 20's to upper 30's with heavy cloud cover and possible rain . On arrival at your pre - determined staging area , you learn all 3 ways into town are blocked by landslides or bridge damage cutting off all normal first responders . People see you and are already arriving with injured pts . Then reports come in that all 3 churches were in services and sustained damage . ! light , but with reports of injuries , 1 moderate , with reports of trapped victims , 1 heavy , also with reports of trapped victims . You and your small band of CERT members , as well as some spontaneous volunteers are the only help this community has . Your town is in a large valley that has 2 ambulance stations with a total of 6 ambulances . ( medic /emt crews ) The valley also has 3 fire stations each having 3 men with a patrol rig and an engine . Each station covers several communities . There are 10 communities in this valley.What do you do ????

Guys , I've got a problem . about 20 years ago , I ran the most emotionally draining call I ever had . A father tried to kill his 2 week old son . The parents brought him to a Kaiser clinic because he was crying too much . All 4 extremities had angulated fx . , as well as head and chest trauma . This was a twilight zone call from the start . I had a brand new partner fresh out of EMT school who wasn't driver certified , and a DR. insistant on taking the baby to Kaiser hosp. versus Children's Hosp. ( pediatric trauma center ) . I was ordered by our manager to go to Kaiser . When we got there , the parents were waiting . The husband looked predatory - coal black eyes with no emotion , and the mom was terrified - head down , totally silent , about 15 feet behind the husband the whole time . To this day , I believe I was looking at pure evil . We were met by several staff members and escorted directly to the ped floor . On the way , I asked him how this happened . He looked me square in the eyes and said " Beats the He-- out of me ! " At the time , I thought it was a great idea , something in me snapped , and I started for him . If it meant me going to prison , I was going to take him out to protect mom and baby . Thank god , several security guards , doctors , and my partner jumped between us . I didn't realise it yet , but I'd had a CIS reaction . Afterward , our field supervisor did his best to talk me down , then gave me several days off with pay and gave me the option of getting help . In those days , this wasn't considered much of an option , so I John Wayne'd my way through it . So here I am , 20 yrs. down the line with a call ( the only one ) that still tears me up . Any ideas ? By the way , the baby made it , though I don't know about brain damage or other lasting problems , and law enforcement hooked the guy up the moment he stepped off the elevator on felony child abuse charges . It should've been attempted murder . I wondre if he got jailhouse justice ? CERTGUY

This is interesting , 1 point I think that's been missed is ; Is the child a U.S. citizen ? If she was born here before the law changed , yes . In San Diego , where I used to work , we often went into Mexico to transport americans out , but , there was an organization called the bi - national health council that coordinated all transports out . In my mind , I'd definitely question the need for an ambulance , but I would refer this to them to determine if there's a genuine need and go from there . She definitely doesn't need an ALS rig though .

Guys keep in mind our roll . Fire handles rescue needs , we get them after they're out . Figureing out who goes where is the realm of the transport officer , not the IC . 150 miles isn't that far for military helicopters . Let the IC know your needs , he'll channel them to logistics , who'll get what you need . CERTGUY

Okay , I guess your ICS system is different from the one we use in CA . Wouldn't the MIO position be covered by the PIO ( public information officer ) appointed by the IC and not medical division ? I'm just as stumped as the others about the other 2 . This brings up an interesting point though . That is , the need for a standard ICS system for the entire country . Katrina and 9/11 are good examples of major incidents with people coming from all over who may not be using the same system . We need to standardize so we're all on the same page . Here in CA , we started the ICS ( incident command system ) concept and it's a very good system , unfortunately honed through a lot of practice . I keep hearing about this being a problem , you'd think it would've been dealt with by now . CERTGUY

I'm with several of the others . If there's a problem with the DNR , get it squared away prior to transport to avoid headaches all around . In situations where there's not a valid DNR , CYB ( cover your backside ) and follow your protocols . When the actual death occurs , families have been known to change thier minds . The family may not understand at the time , But you're covering yourself , your partner and your agency from a potential lawsuit . Make sure everything's documented well . CERTGUY

Mentally step back , take a deep breath , here we go ! Call a Med Alert . :shock: Are there any reports of walking wounded who can verify roughly how many victims and location of the bus ? What type of water ? river , lake , pond ? How deep ? Current ? Is there a possibility the bus drifted downstream before sinking ? Do we have dive rescue units in the area ? ETA ? Get em' rollin' Availability of boats ? Start your 2nd unit , and 6 additional ambulances , 2 helicopters ( the other 2 on standby ) Work with IC to establish staging ,copter landing sites , triage , and treatment areas , and communications . Sr. partner on 1st in EMS - medical Div . partner - Triage 2nd unit - establish treatment areas . Sr partner treatment officer As additional manpower arrives , assign transport officer and staging officer if not already in place . Activate CERT for additional manpower and equipment . Yes , they're MCI trained ! Availability of military resources ? Start an additional 4 ambulances to a secondary staging 5 miles out due to time factor . Request highway patrol shut down acess to all but responders if not already done . Additional FD resources ? IC decision . Notify coroner of likely fatalities and get them going . Establish rehab areas as personnel become available . Start critical incident debriefing personnel . GIT ER' DUN !!!