triemal04

Aren't there more vehicles than needed in reality though?

Do they not put more on because they have to assume that some of them will be out on EMS calls and not available to respond to a fire call?

To some extent yes. It'll vary a lot from department to department though, and more often than not, even if they stopped running on EMS calls, closing down lots of units would cause problems down the road. Hell, take the example of Denver that Amhet put out; if they've got 44 units covering 150 square miles that means that each unit is covering roughly 3.5 square miles. So each should be able to get to anywhere in that first due district in under 5 minutes. Is that good? Sure. Does that mean that there isn't any waste to be cut from the budget? Probably not, but looking at the actual numbers it isn't as bad as he makes it out to be. Now, does that mean that more ambulances shouldn't be put on the road? Hell no. 9 minutes to get to a given address is to long far as I'm concerned. But, if more ambulances are needed, then where is that money going to come from? Has to come out of someone's budget, and nobody will want that to happen. Hence why the stopgap of engines responding comes in.

Fire and EMS are two different things; they've been grouped together for so long that way to many people (including a hell of a lot here) assume that they are the same, and that the same standards apply. (they don't) Or that they can be an expert of one with no real knowledge of the other and still speak accurately about it.

EMS gets the short straw a lot of times, due largely to the fact that the public is uninformed, and that nobody is able to get together and form any sort of group to advance changes, mostly due to the apathy that most providers seem to have. Seriously, if you want change, the for the love of god, don't bitch about it here, start working on making it happen! Sitting back and blaming Fire everytime is getting to be a cop out; if you want improvements to happen, then get to work.

JakeEMT-

Yeah, it's got nothing to do with the topic, but then, most of the last 3 or so pages don't. Gotta love that, and regardless, it'll probably pop up in other threads too.

Like I said, yes, some departments would be losing personnel, and for the reasons listed; sending everyone and their mother to a chest pain or general medical is pointless. But, not every place (in fact the majority) operate like that, or have the bloated personnel roster that reflects that type of thinking. Like I said, most have stations (and units, maybe should have said that) are placed in various locations because of how long it will take to get to a given area of the city; hopefully less than 5 minutes from the 911 call to arrival at the front door. Beyond that isn't good. And that does mean for the entire city; so there will be more stations/units/apparatus/rigs whatever you call them than it looks like are needed (but maybe not as many as some places have). And again, that has nothing to do with "the big one" just ordinary calls.

Without just repeating myself, I don't know what else to say. It's fairly simple; when you need a service, whether it's police, fire, EMS, garbagemen, an accountant, a cup of coffee, you don't want to wait for it. And sometimes you can't wait. Hence the numbers increase.

First, let me just apologize on behalf of Flasurfbum, or Firegaurd, or BLSBoy, or whatever he's calling himself today. He's an idiot. There really isn't a better way to put it. While his heart may be in the right place (for him at least) it doesn't change the fact that he isn't fully informed about most of what he speaks. He's also 20...something worth remembering.

Now to the heart of it. There's lots of lines that keep getting tossed around here that aren't accurate, probably the most repeated being "Fire want's EMS so they won't get shut down." That's not quite accurate, for several reasons. If a fire department were to stop running EMS calls, would there be a risk of stations and units closing? Yeah, probably. Would that be appropriate in some cases? Sure. Lot's of departments (and not just fire departments but any city service) could cut money from their budget if they had to without a huge drop in their service quality. (whenever I hear about 4 units responding to an average call it makes me want to boot the bastard who thought that up and anyone who agrees with it in the balls) Would that be inappropriate in the majority of cities? Yes, and here's why. (This isn't the best analogy sorry, but bear with me)

How many here have every done a cricothyrotomy or tracheotomy in the field as a civilian paramedic? And how many times, and how many years have you been a paramedic for? The specific number aside, it'll be fairly low, and for some, a lot of years in the field. Which means that, due to the lack of use and associated risks, many might say (and do say) that it should never be used by paramedics. Fine, except that if it's needed it will need to be done rapidly, correctly, and without hesitation, and will very likely change the pt's outcome. To relate this to Fire Departments, you need to realize that the number of stations that a given city has is not based soley on run numbers, but on response times. As with MI's and catheritization, rapid response and treatment is a must; same for fires. If an engine takes 7 minutes to get to a given address in their first due district, that's not bad, but not super great either. If it takes 12 minutes, that's really, really not so good, and if it takes more then it's really bad, and alomst pointless. That's part of why there are a lot of fire stations and units out there; fire will generally double in size every minute, so any delay in the first unit getting there (more can take longer to arrive) should be minimized. And with the huge increase in lightweight materials and new construction techniques, a minute can make the difference. So, while fires don't happen super frequently (depending on the city, keep that in mind), as with a crich/trach, when they happen, the response needs to be fast and appropriate. Which in this case means that you should be getting at least 12 people to the average structure fire initially, which will be at least 3 units, generally. (20 is just...well...no way.) And they need to be there in a timely manner. Just try and remember that; most stations are not placed because of run numbers, but because of response times. And it has nothing to do with "the big one," just average calls.

Of course, what this means is that any given city will need a fair amount of fire stations manned with units that (if they aren't running EMS calls) have a lot of down time. So sure, cut the fire departments budget, close some stations, and add more ambulances. Sounds great, right? That way there isn't a lot of unneeded waste in the fire department, and the EMS service will be able to staff more units. (excellent idea) Problem with that is, and I will gaurentee this, that the dollar loss (and life lost) due to fire damage will begin to climb. Why? Because it will take units longer to get there to do their job. As with MI's and a crich, a code, respiratory arrest, the response needs to be there rapidly, not 2 or 3 or 5 minutes after it should have been. Best solution would be to fully fund EMS and Fire at appropriate levels. Of course, that takes a lot of money. But this does happen, in my part of the world and elsewhere. Wether it's because it's a wealthy city with a good tax base, lot's of industry that's paying out the nose, or because the politicians have the stones and brains to realize what's right and actually do it, it can be, and is done. And my hat's off to those who do it.

Unfortunately, many, many, many places can't afford to do that. There is only so much money in a city budget and to add to one department means that it has to come away from another. Each time there will be a downside. That is part of why some fire departments get stuck with EMS against their will; they have to provide at least a first-response because there is no money to add more ambulances, and closing stations will lead to problems down the road. Just like removing an ambulance would. That's where the real robbing peter to pay paul comes in.

The only real solution would be to cut the wast out of ALL departments, keep the services at the right level, and bring the ones up to standard that are below it currently. Oh, and raise taxes, because that is what it would take. Part of why it won't be done. Which means that we'll still be stuck with this situation and this same fight will keep going on with the same arguments and reasons that aren't always true.

Nutz.

No. What you're describing sounds a lot like someone who took to much insulin. The last thing they need is to dump their bodies stored glycogen. What they really need is a meal, and a supervised setting where they can be monitored for awhile.

While the bodies stores of glycogen/glucose might longer than the D50, when that's gone you don't have any options left. Get them to wake up with D50 and get some food into them.

Probably for the same reason why there's _______-American for everyone who isn't "white."

Are you kidding me? I'm proud to call myself a Russian-Polish-British-Welsh-Irish-American. Of course I also often call myself the original mongrel...people always seem shocked when I say that...

You must not be paying to much attention...or Florida really is the pits when it comes to education. PIO=good thing. Working with the media=good thing. Clear enough?

Show me where I've contradicted myself please. And as for arguing the same point over and over...um...yeah...kind of like you in arguing against giving info to the media.

Your first post said exactly squat, so how is it relevant? Your first reply to scaramedic just said the same thing you keep saying; the media isn't worth it, it won't help, the public knows enough and people shouldn't look for recognition for their actions (that I more or less agree with, but it's not what I'm talking about).

Everything I've been saying relates directly to what the OP asked. Everything you've said...not so much.

Skilled PIOs can educate the public very effectively with good press releases with different news items. The PIO and the media can be be very useful together. How hard is that for you to understand?

Dear god, what have I been saying this whole time? Did you even read any of my posts?

Huh. So far my only real point has been that giving information to the media and developing a relationship with them is a good thing and will pay off if done right. You just seem to disagree...

And don't worry, I read all of each of your posts...each just seems to say the same thing...that working with the media really isn't worth it because it won't be done right, because it won't help educate the public, because they (the pubic) already know enough (now that's the biggest load of bullshit I've ever heard) and so forth. Far as confusing TV with reality...wake up and take your head out from the sand sally! Where do you think the average person gets most of their info from? And no, I'm not talking about TV news either. Having an effective way to disseminate info would help counteract this.

Apparently we do both agree that having a PIO who knows what they're doing is a good thing. And it's also apparent that I think that the PIO should actually give out information while you think they should give out...what exactly?

Ventmedic...I'm really not sure how you're coming up with some of your replies and why you have such an issue with this. Getting more exposure for EMS is wrong...why? Starting a relationship with local media is wrong...why? It won't be worth it...why? My only point is that working with the media, giving out press releases, letting them know that you exist will more than likely pay off in the end, and, if done properly, be a large benefit down the road in helping to make changes with EMS (that's way down the road).

And no, people in my area aren't extremely educated about EMS, and I'll go ahead and say that people in Florida aren't either; where do most people get their info from? TV and to a lesser extent newspapers and the internet. If the media is misrepresenting what is done in EMS (which they are) then how do you expect people to actually learn more? And if people don't know anything about something, then why should they care about it?

This isn't about knowing that an ambulance has paramedics on it, but about knowing what paramedics can actually do and why they are needed, as well as what an EMS agency does, how it's funded, etc etc etc.

You've got way to much faith in the average person's knowledge about emergency services in general I do believe.

Ventmedic...I'll just ask this question again:

So you don't want the public to be informed about what EMS does, how it operates, when it operates and so on? Does that mean that you're ok with the lack of understanding that the average person has about EMS right now?

Does the public need to know every little detail? No. Do they need to know more than they do now? Yes. Nice and easy. Do you really disagree with that? Do you really think that showing that there are non-fire, non-private for profit services out there and how they work is a bad idea? Do you really think that showing that paramedics really aren't ambulance drivers and just EMT's is a bad thing? Do you really think that showing people some of what paramedics can do is a bad idea?

The point I'm trying to make is that if you AREN'T ok with the way things stand, this is one option to start changing it within your state/area. If you ARE ok with the way things are, then do nothing. Simple as that.

Ventmedic...yes, the lack of standardization will definitely be a drawback and is a huge problem that needs to be solved, but it doesn't completely apply here; least not with what I posted. National media attention is one thing, but what I was addressing was more for local agencies, not beyond 1 state; get people in the area served by your service and the surrounding areas to start thinking about non-fire based EMS, and EMS as a whole. Will that fix the problem of lack of standardization? No, but it will at least get people in one area and potentially statewide to be more informed and aware of what happens there. That's a start, and good for the reasons I listed before. Going nationally would present a bigger problem, sure. At this point though, with all the problems that exist, starting small is probably going to be the way to make changes and inform the public. Do I wish that were different? Sure, but, unfortunately, this is the system we have to work with right now.

I don't think you give the public enough credit. For EMS week our stations are open to the public, we have a ambulance with crew inside one of the malls. The local fish wrapper and idiot box media have been informed and did a small piece on the news. We are trying. Do you really think the public knows all about the FD other than they put wet stuff on the red stuff?.

You won't hear me bitching. Frankly, I couldn't care less if we get equal photo ops as the FD. FD's get more funding because they have a huge lobbying group. It's not rocket science. Every time a EMS funding increase is brought up in congress the IAFF has a cow. I don't pretend to know the answer. However, I do know there are people trying to increase awareness of EMS to the general public and more importantly, Washington DC.

You may be giving them to much credit. EMS week is great and I think, if run well, will pay off in the future. But, how many people come by your stations? How many stay long enough to really get informed, and how many come to show their kids the flashy thingies that took grandma away when she got sick? If you put information out there on a regular basis, using a medium that many, many people get the majority of their info from, people will start to pick things up.

And yes, I do think the public knows more about fire departments than that. Not everything, but compared with EMS, they know a hell of a lot more. Changing that would be a good thing, and now is the time to start.

Kudos on the not bitching; bothers me that people will complain about fire while doing exactly squat to fix the situation. Yes, there are people working on the EMS lobby in DC and elsewhere, but it'll take more people, more money, and a hell of a lot of effort. Results should be worth it though.

Dustdevil...like I said, for starters this really should focus on individual agencies within 1 state; the standards will be similar and many of the problems that come with comparing EMS nationally will be removed. Again, put of press releases on incidents, offer them access to training, case reviews, ceremonies...eventually they'll take you up on the offer, ad you'll get your info out there. As well, you'll start to build relationships with the media, something that is always good to have.

You just can't go off half-cocked about it and go in spouting off smart-arse remarks to them about how indignant you are. You have to present an educated and articulate, media savvy representative to the media agency and educate them on the concerns for proper identification of your agency and personnel. Again, they are almost always open to this approach. Problem is, too few EMS agencies have such a person in their entire agency to represent them. The best they have is Billy Bob tech-school medic with the ball cap, t-shirt, and attitude.

If you're expecting to be recognised and treated as professionals, first you need to actually be professionals. And no, your paycheque does not make you a professional.

This has nothing to do with being indignant, just getting the media, and by proxy the public, to realize that EMS exists and actually does things. Will the PIO need some extra training and not be a idiot? Well no shit, never would have guessed that. All that means is that more people in EMS need to be willing to step up and go the extra mile instead of sitting back and saying, "naw, it's to hard to change things, so screw it."

If change is going to happen it needs to start now. Getting public knowledge of EMS to increase, even if it starts on a state-wide level or less is still a good thing.

I like this!

While it would be nice to have the news media give us a little bigger piece of the pie, I wouldn't lose any sleep over it. Personally, I get more satisfaction of shaking my partners hand a saying " Good job".

So you don't want the public to be informed about what EMS does, how it operates, when it operates and so on? Does that mean that you're ok with the lack of understanding that the average person has about EMS right now?

One way to change things is to educate the public about EMS, and one way to do that is to have the media get things right and start mentioning EMS agencies at major/minor incidents that get reported on.

If you don't want that to happen...then don't complain when fire departments are the only ones that get mentioned in the news, and don't complain about how fire departments get more funding, respect, whatever compared to strictly EMS services.

What it comes down to is ignorance. Fire and PD have centuries of PR and history behind them. We on the other hand have been around for less than half a century. I would guess that 90% of the public have no idea what we do. Think of how many times in TV or movies have you seen crews throw the patient in the back and both crew members jump up front and drive off L&S.

That is the part to remember; not only is EMS very new when compared to other emergency services and health careers, but there is nobody lobbying on our behalf and educating the public, and rarely, if ever, does a televisions show give an accurate portrayl of what actually happens in an ambulance. (If you don't think that's important then you haven't been paying attention to the average person for the last couple of years) That needs to change in a hurry.

Starting on a local scale, like someone said, having a dedicated PIO would be great. Anytime there is any type of major incident, or something that sounds like it might make the news, put out a press release. There is a lot of info that can be given that doesn't violate the pt's privacy or HIPAA; number of pt's seen, number transported, general outline of their injuries, emergent/nonemergent transport, number of ambulances that responded, number of personnel and their certification level that responded, hell, even what procedures were performed might raise some interest.

Anytime a drill is conducted, invite the local media. And not just for large scale drills either; get them involved in the normal training so that they start to see (and hopefully report) and what really get's done in EMS. If you train multiple new hires at once offer to let them observe their training, if you do any sort of promotional ceremonies invite them to that too. If you run any kind of public education, call the media, even if only to give them an overview of what was done.

Start doing this, and start if now. Honestly, if every service was willing to do this, do you really think that the public perception and knowledge of EMS would be as low as it is now?

As has been said about a thousand times until we are seen as a profession and a separate entity we will always be lumped in with Fire. My greatest hope for the future is that as funds tighten more and more FD's realize that EMS is a money pit and drop it.

That's an interesting theory. EMS is a loser as far as revenues go for most fire departments and with medicare it's only going to get worse. Do you really think it'll get bad enough to cause any to stop transporting? And if that happens, who will step in to fill them vacumn? Logically it would be a private for profit service, since a city/county run third service would have the same financial difficulties.

It's really going to depend on what type of service you belong to, and how involved you are in MVA's. If all you do is wait until the fire department brings you the pt, then no, you probably don't need a set of turnouts that much. But, if you're getting involved in pt care while extrication is still going on, or even doing pt care while the pt is still on the ground, then yes, having a set is a good idea. And should be mandatory to have on to be inside a car during extrication. The turnouts won't provide only heat protection, but also acts as another fluid barrier, and well as keeping you pretty well protected from those nice sharp objects that are often found at accident scenes. Kneel down in broken glass once without the pants on or have a piece of metal lodge in your arm and you'll see the need.

Agency dependant though...I wouldn't run out and buy a set for yourself, but if you are getting involved in the initial care at accidents, might be a good idea to talk with the management about getting a few sets.

Don't forget what an MCI means; your resources are gone, fully committed, and you've got possible more people to deal with than you can handle. Triage in an MCI does not in any way mean that the normal level of care will be given.

I wasn't there, but just going off the scenario given, think of it like this: you've got a bus with 25 teenagers and 1 adult on it that just rolled over. You are assigned as the initial triage. The first 6 people you come to are complaining of various minor pains with no other associated problems. All are able to move out of your way so that you can assess the rest of the occupants. What do you do? Tell them to walk out of the bus to a safe zone where they'll get re-triaged and further assessed. That is standard across the board. You don't treat each and every person as you come to them; you treat the worst injured and then the less severe.

Far as not using the door...sure that's the easiest way, but it may not always be available. Best way to get access to a rolled school bus is through the roof, which it looks like they did.

Yippie-skippy. A fully trained and experienced whacker comes to Oregon. Maybe he can show us how they do it in the big city. Why can't he just move to Florida like everyone else?

Actually, some DNR's really do mean "do not treat." (here it's split up into 3 different types: comfort measures only, limited interventions (pretty much everything but intubation, pacing, cardioversion, or other invasive procedures) and full interventions. But, the second the heart stops in all 3 types, so do we.) How did that come up anyway?

If you are allready transporting then yeah, turning around would be wrong. That would be the situation where I'd be ok with taking the body to the funeral home, long as you've got family there to agree to it, or even continuing on to the ER. Done that before actually. But, like I said, if you load them up and prior to actually leaving the scene they die...be tactful and talk to the family, but there really isn't any reason to transport them. Unless you service allows you to make funeral home runs I guess. Nobody is saying turn around, just that if you haven't left yet you need to go over your options. Waiting for the funeral home/ME would be ok too most of the time.

Happiness, the point of my question was that if you are a PCP (as you are and I figured you were) then some of your unintelligent, uneducated, drivel-like comments could be ignored and written off as the ramblings of someone who doesn't know any better because they've never learned it. In fact you might have even learned a few things.

But now...well...sorry girl, you just plain ignaent!

. I am pretty much 5 minutes away from the hospital.

the closest er to me is in prince rupert a 35 to 45 min heli ride away

Which is it? If it's the later, then even a basic here or a PCP without a brain in Canada should have been able (over 12 frickin years) to figure out why intubation would be a good thing. If it's the former...guess you are just living proof that the Canadian system of training it's lower level EMT's has problems too. Just remember, to intubate someone without paralytics takes nowhere near 5 minutes, and the benefits can be extraordinary. And while using paralytics takes longer, the benefits can be extraordinary. As well, if you walk into an ER with someone needing an RSI, how long will it take the docs and RN's to do it? As long as it would have taken in the field? Longer? Start thinking about that and brush up on the basics of how the body works. It'll be beneficial, trust me.

Your comments about seizures were already touched on...wow...do you really think that's acceptable?

You may want to note in your profile that you are a PCP...it'll help people from thinking that you actually have knowledge about any kind of advanced topic, and will keep them from thinking you are even more dense than your posts make you out to be.

Happiness...since you're in Canada, what type of paramedic are you? Primary, advanced, or critical? I'm only asking because if the answer is what I think it is, you'll save yourself a lot of grief and ass chewing.

So, other than lacking some compassion and tact (maybe, I wasn't there and the article doesn't give many details) the AMR employees really didn't do a whole lot wrong. This wasn't a pt that had a chance at resucitation; hell, it wasn't even going to be tried, so why take him to a hospital? Mass laws prohibits carrying dead bodies around, so why take him to a hospital?

I can get behind leaving him in the ambulance and waiting for a funeral home to arrive, but that may not have been possible or event thought of. Really, that would have been the best course of events; allow the family to see the body, say goodbye and do what they need to. And there would have been nothing wrong with explaining to the family what had happened and asking if they wanted their loved one brought back into the house to wait.

This has happened before and it seems to get a bit overblown each time. While I'm happy to help someone start the arrangements when a family member dies, I'm not (and I doubt any paramedic is) required to get ahold of the funeral home. I damn sure am not required to take the person there, or to the morgue at the hospital. Like I said, the employees may need to work on their compassion and how they interact with the family of the newly dead, but other than that, don't think they did much of anything wrong.

99% of all DOA's are transported by ambulance to the ER for pronouncement.

Dear god why? Are you saying that you actually transport dead people, not workable codes, but dead people to the ER? Why?

Naw, I agree for the most part with your original premise; just some of the points you brought up I have minor disagreements with. Some of your explanations for why the paramedic shortage is a myth seemed a bit skewed. Semantics maybe, I guess part of my point is that turnover does need to be looked at; at the very bottom line it doesn't matter (ok, it does, but not for this type of argument) why people aren't willing to stay paramedics, only that they aren't. You seem to be saying that because the cause of people leaving the field is poor management it doesn't count.

But yeah, doing the same thing again and again doesn't work, and creating 10 times the paramedics every year when 80% won't work as one for an extended period of time won't fix it either. The entire system needs to be redone here.

Or maybe I've just been up for to long. Damn...it sucks getting old.

In at least four ways right off the top of my head:

• 1. The number of either certified/licensed paramedics (and educated medics who have expired, but are eligible) in this country is not particularly inadequate. The shortage is not in medics. The shortage -- just like the nursing shortage -- is in people who choose to remain in the field.

Now hold on, you're being a bit disingenuous here. The number that needs to be looked at isn't the total number of certified/licensed paramedics out there, but, as you said, the number who are still in the field, or trying to get a job in the field. And while I wouldn't say that there is really a national shortage, I think the number would be significantly lower if you remove those who won't/can't do this job anymore. And if it were truly to get low enough (not there yet) then sure, it would be a shortage. If you need 10 medics and have 30 certified but only 5 who are willing to work as one, you've got a shortage. If someone has moved on with their career and still happens to be certified...well, if they aren't going to be working as a medic then why should they count?

2. As alluded to above, the "shortage" is is self-perpetuating because of the actions of those in system administration and management, who intentionally drive medics out of the field in order to keep salaries low. If you are intentionally running off your workforce, you do not have a manpower shortage. You just have shitty management.

I wouldn't say it's to keep salaries low, but yeah, piss-poor management definitely contributes to people not wanting to work on an ambulance anymore. But again, regardless of why, if someone isn't willing to use their certification, then they shouldn't be looked at as a potential paramedic, and regardless of why the problem exists, it is there, self-perpetuating or not. I wish that our system wasn't as screwed up as it is, but it is what it is and we can't ignore all the consequences of it.

3. Poor management also contributes to the illusion of a shortage, because they FAIL to maintain a career that attracts candidates to the rural areas, or is even attainable by those living in the rural areas.

Again, I agree, poor management is to blame, but that doesn't' mean that it isn't still part of why some areas can't attract new medics, and it doesn't mean that it won't be a cause of a future shortage.

4. Fire departments pump out paramedic classes by the thousands every year, only to utilise those medics for only 2 to 5 years before sending them to a fire truck for the rest of their career, further increasing turnover.I'm not sure what this has to do with the myth of a national paramedic shortage.

• We sucker thousands of people a year into going to paramedic school with the promise of a professional career. Then, having not done the basic research before going to school, they learn that they have to be a firemonkey just to get a job, and being a 5'3", 200 pound female, they simply aren't getting that job in this lifetime. Consequently, there's one more "paramedic" that never makes it into the EMS workforce.

If you don't research your future career, that's your own damn fault far as I'm concerned. Again, not sure how this applies.

There is not a single place in the United States that claims a "shortage" that is not directly to blame for that shortage. There is no shortage of medics. There is just a shortage of medics who will work for them.

I'm not sure where you were going with this. If you can explain it a little better that'd be great.

For the record I don't believe that there is a national shortage. I agree, many services are unable to find medics because of poor leadership, and many people who are willing to learn to be a paramedic seem to tend to not want to go to, or go back to, a rural area, causing problems there. Does this mean that we need to churn out even more paramedics? Nope, just that American EMS needs to be streamlined, revamped, overhauled, whatever word you want to use. Yet another sign really.

Far as the original topic, I was going to go off about how idiotic this was and how it'd never fly, but I think that's been done to death so far. I'll just say that giving returning military medics preference into getting into a real paramedic program and the money to go through it would be fine with me.

Nice to see technology improving yet again. Although I'm betting it'll be years before this becomes an accepted practise, and longer than that for it to really make it's way to ambulances, it's defiantly another tool that's worth while. (while it's been possible to test for troponin prehospital for years the only place I've heard of it being done is Alaska)

Having another diagnostic tool for atypical or non-stemi's would be great...even if it isn't done prior to arriving at the ER, the wait will still be less than waiting for blood tests to be done. If it allows more systems to implement "cath alerts" and take pt's directly to the cath lab it's another bonus.

Of course, the drawback could be that the need to interpret 12leads could be seen as being diminished...not a good thing. I mean come on, who needs to know what those squiggly lines mean if you've got the spit tester?

I doubt this will be the end-all-be-all for telling if someone is having an MI, but, if it works out with more testing, it'd be another good tool to have.

It would appear that approx. 85% of the crew already does.

So what is the point you were trying to make?

Dwayne

No, 85% are of hispanic decent. (forgetting that this may mean 85% on ODF employees, 85% of all brush bunnies, etc etc) Doesn't mean that they all speak Spanish. Or that they all are fluent in Spanish.

My point is that this is a worthless solution to what is a very real problem.

Edit: I do like it that you think that because someone happens to have a different skin color they automatically are able to speak a different language. So tell me, does that mean that all blacks speak some African dialect? All Native American's speak their tribal language? Asians speak a language from that part of the world? Or, hell, does this mean that every Irish-American should be able to speak gaelic? I'm part Polish and Russian...is it a bad thing that I can't speak either? Just wondering... :toothy10:

"Jim Walker of the Department of Forestry said "what we do know is 85 percent of the crew make-up is of Hispanic decent."

What say you to that?

First I'd like to see the figures to back it up. Second, what exactly count's as hispanic decent? Third, is he talking about ONLY ODF or all crews based in Oregon? (if it's all I still think 85% is high, but it'd definitely be up there) Fourth, could this be...I don't know...a small distortion of the facts to help back up a very unpopular rule? Fifth, I suppose I could be wrong and my own experiences have only been with the small minority of non-hispanic ODF employees.

Edit: Forgot sixth, how many ODF employees can't speak adequate english? Hell, how many wildland firefighters total can't speak adequate english? That is what really needs to be looked at, not what color someone's skin is or where their anscectors came from.

Actually, JPINV is more or less on the right track, though this might vary depending on the area you're in and the resources available. If there is a MCI and you're dealing with this type of patient, these questions need to be answered:

Where are the next closest units?

How many are there?

How long will I be busy with this prick before I'm available?

Is this really an MCI, or did someone just see something that looked bad?

What is the potential scope of the MCI?

If resources are low and it's the real thing, triaging this person as green would be appropriate; it's the same thing that will be happening in dispatch; the guy who calls in because his finger hurts won't be getting an ambulance anytime soon. Like it or not, a honest to god MCI will effect more than just the people on scene, and triage will not only be done there either.

Now, if you have everybody and their brother able to respond...well, you probably aren't needed and it's a moot question. But, if resources are scarce...an MCI is not a local or immediate problem; it's going to cover a much wider area than the origin and effect a hell of a lot of people beyond those initially involved.