Just Plain Ruff

After 15 years in EMS, my back is terrible with all of the scars from being stabbed in the back. I had a few pulled muscles here and there but the stab wounds have been the worst.

Don't forget the broken heart from all the sad calls we have seen.

Also the loss of one's mind comes shortly after you start the job.

Then the breakdown of your washboard abs from eating ems style quick dinners.

Having been involved in a number of QI/QA projects what you need to do is to maintain anonymity if all members of a service are doing this project.

I would start off on reviewing your run reports for completeness and all boxes checked. Keep a log of these.

I would not assign crew members to review other crews reports as this can turn into a quagmire. One crew member reads anothers report and spreads it around that he did something or didn't do something. Leads to monday morning quarterbacking.

What you need is one person assigned to reviewing the reports and bringing deficiencies up to the report writer in a private method. One person is good for a service which runs less than 1000 calls a year but you need more if you run more calls. Or more if you won't assign that duty to someone as their full time responsibility.

You can allow rewards for most percentage completed tickets or what not. Incentives you know.

If you do decide to do a Peer review - confidentiality agreements should be signed. As they are looking at run reports that they had no part in and could be considered by some a HIPAA violation unless that person took care of the patient.

UNDER NO CIRCUMSTANCES ::: SHOULD THE PERSON WHO WROTE THE REPORT BE ALLOWED TO REVIEW THEIR OWN REPORT

What we did at our service is assign on a monthly rotational basis each crew member to take a specific type of call.

Mike takes cardiac arrest

joe takes trauma

john takes chest pain

Barry takes medical

etc etc etc

The people reviewing the reports should not talk about the quality of the reports to anyone except the person in charge of the QI initiative.

QI is a good thing but it can be taken too far and you can get way to into the nitty gritty of stuff. If you can get ahold of someone to come out to your service who is certified as belt level in Six Sigma that would be best. Local hospitals who do six sigma usually have someone on staff. That would be a good place to start.

I think I have some stuff for six sigma and qi programs for ambulance services so let me see what i Have.

so they get these 1099 forms saying they were paid, no payment was made, they guy admitted that he didn't pay em yet he has gotten 7.9 mill from FEMA. I'd say that he can be investigated for IRS Fraud at least.

This guy is a dirt bag if you ask me.

This is an article I found regarding paramedics, Katrina and a bad consulting company. Read and be prepared to get mad.

http://www.emsresponder.com/article/articl...n=1&id=2913

so EMT-W is the emt who get's to play in the woods and be so far from help that they both die of exposure and starvation before getting rescued.

Wilderness EMS is something I have always wanted to do.

I spent the better part of 8 years in and out of hospital based EMS systems. worked the ambulance when a call came out and then worked the ed between calls.

I was trained on so many different skills from foley cath's to ABGs, to picc lines to subclavian. Even was trained on how to evacuate a pericardial tamponade. Surgical airway skills practiced and taught.

The only thing I could not do in the ER was to spike a bag of blood. Could do everything else with that blood but spike it. Finally the state of MO put together a course on how to correctly admin blood from getting it from the lab to spiking it to turning on the pump.

So I can say that my training was pretty thorough.

your guest instructor is a maroon and an Id10t

What other blatant falsehoods have they told you?

Is De-Protocoled similar to De-veined or De-boned???

organic chemistry and physics I don't think are needed for ems education. That's putting too much onto students.

I agree on points about ems not being a volunteer service and if it is it's destined to go the way of the dodo.

you cannot support yourself on a volunteer salary.

When the volunteers dry up, and Grandma moses needs an ambulance or the mayor drops dead of a heart attack and no volunteer's showed up the city will get off their butts and find the money somewhere to start paying for EMS.

I cannot believe no one has said Leaving sharps on the floor after a code or a bad call. They have sharps containers for that. For those who have been stuck you know what I mean.

Also fast driving

not stopping at intersections and stop signs

no restocking the units

instructors having relations with students

supervisors having relations with the supervised

not being able to read a map and get me to where I want to go

GRAMMAR AND SPELLING especially on patient run reports.

Drug Errors

inappropriate statements made around patients. "We only drop people on thursday" silly

Lying to Patients

those are a few that I have

Oh one other not taking responsibility for your actions. "I didn't do it"

Quoted from Mamam

We do have an agency around here that sounds an awful lot like this Medic One unit. We call them the "God squad" because that is what they think they are. Just recently given the powers for MFI (last year) they have had to had to cric 5 people in the past 7 months alone. Never mind that they should have done this, but SHOULD they have done this? Not being on the scend, I cannot clearly say. But seems to me that you should be able to ascertain if you are going to be able to get a tube before ya'll go and paralyze someone!!

Ok what does MFI mean? and Cric 5 people in the past 7 months. That seems high but since you weren't on the scene you cannot judge what should have or should not have been done.

As for the statement that you should be able to get a tube before you paralyze someone, there are times when RSI is clearly indicated and there have been times when even then you cannot get the tube.

Before you go off blasting people you should walk at least a baby step in their shoes.

But in all defense, even though you clearly say you are a lowly baby EMT-cc don't cut yourself short. Keep learning and never never never stop asking questions.

Jake that is true but once the instructor puts himself in that compromising position of having any type of romantic relationship with a student this could happen:

Said student breaks up with said instructor, gets a failing or poor grade or is cut from the class due to poor performance so the instructor says. She files complaint, or worse sues the educational entity for being cut after she broke up with said instructor. WINS the case, school stops class.

This has happened countless times where an instructor and the student get together and BAD things happen.

I don't see how anyone here can be defending this if it happens. To me it's black and white. There are just too many bad things that can come out of a relationship between the instructor and the student.

Then we get in to the arena where all the students know that instructor A is banging student A. Student A is getting great grades, better than anyone in class is. They file complaints because they foresee either cheating or extra help(cheating) and it gets ugly. I speak from experience since this happened in our class. The worst student proven by her first 3 tests of 65%, 50% and 70% started a relationship with the instructor. She miraculously jumped to 98% and above on all subsequent tests. We went to the instructor and he told us it was not our business what he did with anyone. We then went to the director of the class and both instructor and student were removed from the class.

new onset seizure

Any fever?

no evidence of trauma but could have a bleed from a bump on the hear a day or so earlier and then it manifested at work.

I'd say no on the drug overdose but who knows

ok, what are we supposed to answer now.

IV, O2, monitor, give 5mg valium(or whatever antiseizure meds you have) and transport. There's not much more to do with this guy.

Unless he codes

There has to be more to this than what you posted but not sure what you want us to do with this.

I get paid 45 per hour but then again that's in Consulting

I was paid 42K as a medic in my last job

It is absolutely inappropriate for any instructor, be in college, high school, church sunday school, ems, nursing to be in a relationship with a student.

There is absolutely no excuse for it. The ethics and moral's of this are self explanatory.

I would not tolerate it if it was my school

Supervisors and managers should also not be involved with employees.

Let's not forget our favorite Levophed or just Leavemdead

ANY course that emphasizes spelling and grammar.

Spanish

Healthcare organizational behaviour

Math

Any class that teaches or focuses on critical thinking

Negotiation classes

and my favorite "How to deal with difficult people" type classes.

no supervisor/preceptor should ever even think about getting involved in a relationship wiht student. END OF STORY

If so they should be terminated. These students are impressionable and vulnerable due to the stress that is put on them. Work stress is different but theyshould have that extra stress on them.

Student and student relationships - what ever floats their boats.

well the 2nd most important man in the US (some would argue that point) who has a significant medical history deserves to have a medical team near him. they don't want him to suffer the 30 minutes from ALS syndrome.

I definately do not have a problem with him having a medical team with him 24 hours if needed. Seems only logical.

The person who broke the news from the Corpus Christi News Collar or some tipsheet paper like that said and I try to quote "I was just sitting at my desk waiting for some news to come in and I got the call of a lifetime" "I heard the story and immediately knew I needed to start transcribing" She sounded like a truly green reporter but in a town the size of corpus christi I think that when important news like that breaks she becomes the hero.

Really the only people trying to spin this and make it into a scandal is the media.

well here's my 2 cents

Give em water if they can protect their airway. Give em water if they are not going to the OR or on a fluid restriction

My first foley placement was on a 78 year old man with a penile implant - wierd

I've placed more foleys that I can remember and count.

Straight cath em if you can.

Foley placement is easy on a guy, ONE hole. Just getting over the male touching male thing that was the hardest thing for me.

I agree with some of what you are saying but when you say you do not like fanatical beliefs to extend to your hand unfortunately, and I say this not to discount nor to be argumentative but it is a two way street. You cannot extend your fanatical beliefs to others either.

I do believe that with you having no beliefs and are a self professed atheist that your beliefs in and among themselves are fanatical. Not trying to put your views down but I do believe that Atheism is a fanatical belief.

I don't know what went on in your life to get you to that point and I respect your views of atheism but that is not what I believe. I consider myself a religious moderate, I would never shove my beliefs down anyones throat and I expect that the same courtesy is extended to me.

There are too many crackpots out there that take both ends to the extreme.

As long as we can have a healthy debate along this subject then all is well and good but the moment it gets to be too intense then we step back and in the immortal words of R.K. "Can't we all just get along"

I don't understand the current uproar of the muslim world about these cartoons but then again I'm not muslim.

It all comes back to tolerance but some people are not tolerant towards anyone but themselves.

I've got a headache so I'll close here yet if you want we can debate this more later either in PM's or via chat or IM

I'm always on in Yahoo IM ultramone@yahoo.com

Benanzo, I don't agree with you.

Sure we have free will. Sure it's god's will that things happen.

Not sure exactly what you believe but I considered working in EMS as my god given talent and I always knew that no matter what I did, The final authority was God's, IF I saved some guy then it was thru god's grace that I did, If I did not then it was that person's time to go.

I'm not defying God's will, he is the one who guides my hand.

I do believe one thing you said, it's not our place to minister to someone in the ambulance unless that patient asks me to pray with them. I will do that. I did carry a bible with me on the ambulance. I worked with my pastor to highlight certain books and versus that would be relevant to injury and illness.

But it does not make them look silly or stupid if they do minister to patients. Your opinion of course but not mine.

On the subject of treating people from different religious beliefs.

In palestine, the pallestinean ambulance authority treats everyone that needs help. The Israeli ambulance service also treats everyone that needs it.

So if those two diametrically opposed religions can treat each other in a crisis then I can't imagine why we are discussing this in our forums. For two religious groups to be so vehemently opposed to each other yet treat the enemy should be a basis on how we do our work.

Michael