reaper

CC, if an FTO program is setup correctly, then an FTO and mentor are one in the same. I agree that not everyone can be an FTO and as you stated, just because they are great medics or EMT's does not make them good teachers. New hires should be placed with an FTO. They should be required to ride as a 3rd rider for minimum of 14 shifts. This gives them time to learn the system and get to know what is expected. Then they should be kept with their FTO, as their partner, for at least 6 months. This is the time that the mentoring is there. As Ruff stated, FTO's need to stay consistent across the board. I have seen this in many services, where FTO's train to their way and not consistent with the system. I also believe that you need to review with the new hire, after 3-4 days. Find out if they are compatible with their FTO. Not everyone will get along. If you leave a new person with an FTO that they can not get along with, then they will never learn anything and will hate working there.

Common Sense? If you have ever worked a SSM system that works, this is not hard to see. It takes the average crew 1.5-2 minutes to get in the truck and go en route to a call. If you are already in the truck, you have just cut 2 minutes off your response times. Not everyone can work SSM. But, if it is run correctly, it is a better service for a busy city. The same goes that not every city is set up to run SSM. This is where a lot of them fail. It depends on the demographics and geography of the city, as to whether it will work or not!

There is nothing wrong with SSM, if it is run correctly. Your bosses have no clue what they are doing. You can not run SSM with 24 hr shifts. It has to be 12 hrs or less, to combat fatigue. If it is run correctly you will improve response times by 2-3 minutes. Moving trucks constantly and reposting with every call is not how SSM is designed to work. Most systems set themselves up for failure from the start. They have no idea what they are doing and are to ignorant to take advise. They all learn in the long run, but that may be after they have run off half their staff!

Google EMS FTO program. You will find what you need.

Yes, it is basically the same type of software that has been pushed for years for SSM. They don't work very well. Anyone that has worked a system long enough can tell you where the majority of your calls will be and when they will be there.

Can you even fit that many candles on one cake? :wink:

Well I was gonna answer with some help for you. But, I realized ignorance can not be helped. I am American and I would take our Canadian posters over you, all day long!

Yes, I have done Smith Driving System. It is a joke. A lot of systems have tried to use CEVO, which I think is another joke. Evoc is a joke, unless you need to know how to park a truck. I would like to see an extensive driving course for ambulances. But, you will still see just as many accidents. It is the nature of the job. We can not control what the public does behind the wheel!

AK, I agree that there should not be a law mandating that we collect samples. Everyone that we did in FL, we chose to do. If it was a major trauma, we told them no. They would then get it at the ED. We did them more out of a courtesy to the LEO. Like I stated, we only drew if we had the time and an IV was being started anyway. I never started an IV, just to draw blood. Ter, I am with AK there. LEO transported the samples. I have no clue how they did or what lab they went to. I was told by a lab tech that BAL could be tested on blood that was up to a week old. I do not know it that is true or not. Just what he said when I asked him about it.

For ours it was not a problem. LEO sat next to you and handed you everything from the kit. You handed the vial back, they bagged it and both signed it. it is that simple to keep the chain short.

If you want non union or non fire based, then you need to stay to the north of the state.

Why Private?

The IV's were done for medical reasons. The ED blood draws were done for medical reasons. The Pt's gave consent for draws! So how is that unethical? :roll:

I don't think it would fly with EMT's doing it. In FL we were doing draws on DUI scenes for years. The cops carry there own draw kits. They would ask the pt for permission to draw blood for DUI cases. We would draw it as we were preforming an IV. You must use the swabs and tubes that came in their kits. We drew blood for the ED, so a few extra tubes did not matter. This was paramedic discretion and we would refuse if it would hinder care. They hold up very well in court cases and I was never subpoenaed to court for one!

Yes, that is a problem with it's use. If you have IV access, you would have no need to use it! It is the same as using D50. Once they are alert and can control their own airway, Have them eat something. Something high in carbohydrates is the best thing for them. As Doc stated, you could back it up with oral glucose, if needed. But food is the best thing for them. You should always know the dangers of every med that you can administer. Again, if you have IV access, then you would not need it. Besides the fact that it is an expensive alternative to using D50!

Move v4,v5,v6 over to the right side of the chest. If you just want a quick look for right side involvement do a V4R. just move V4 over to the right. Make sure you mark the 12 lead as a V4R, so there is no confusion!

No he was actually talking about V-4. He stated that they found in 98 out of 100 cases they studied that elevation in V-4 along with II,III and AVF, indicated right side involvement. He said that the Dr. at Emory has been studying this for a while. I thought it was pretty interesting.

We had them at one service I worked. I love them and wish everyone would carry them. I have tried to get them here, but they cost more, so it's an up hill battle on that front!

Just had this discussion with the cardiologist in the cath lab the other day. We were talking about NTG in RHF. He stated that you can use NTG in a inferior MI, with fluids. If you prove that Right side involvment is there, push lots of fluids. He stated that they will push any where from 4-20L of NS on these pt's, over a 24 hr period. Then they will be taken to the cath lab. He was telling me about a study that Emory had done. They found that if you have and inferior MI with elevation in leads II,III and AVF, look for elevation in V-4. If elevation is present in II,III,AVF and V-4, it almost always points to right side involvement. If you have the time, run a right side 12 lead. This will confirm the involvement. I have always pushed fluids on a right side MI, but I was surprised at the amounts they push, prior to cath lab!

I think that is up to the manufacturer. We run a different way. Narcs and refrigerated drugs have a month/day/year expiration on them. All other meds are pulled off the truck 3 months prior to expiration. This way you do not miss one on the truck. Most other systems I have worked go by the first day of the expiration month!

Yes we have. We were just hoping the Viagra would have wore off by now and you would wither away! :wink:

POTASSIUM CHLORIDE! :shock:

I will tell that to my old partner! Working in a small quiet rural town. Responded to a diabetic call. Arrived on scene, family told him that pt was in bed room and that his bgl had gone low again. Partner walked in bedroom, pt not there. Partner called out his name. Pt walked out of bathroom and shot partner 4 times in the chest with a 30.06 hunting rifle! Yes, PD did have to shoot and kill the pt, as he tried to shoot them when they showed up. This is a wake up call that any call can go south quickly. You never know what you will walk into, on any call. Partner did survive and returned to ems 2 years later. He is a lot more cautious on every call he goes on. He also wears a vest fulltime now. It would not have stopped a rifle round, but may have slowed them down some! Be Prepared for the Unexpected!

I understand that you must study and gather facts, then make changes to help prevent things from happening. This is not a suddenly new subject. It has been hashed out for years. Most EMS services work hard on driver safety and ways to prevent them. Probably all of them could have been prevented, but you will never be able to do that. I don't think those statistics are that bad, considering how many calls are ran in a month, all over the country. Your poll brings nothing to the table. Everyone in EMS knows that crashes happen. Maybe coming up with a new way to prevent them, would have been a more productive poll?

Yes, I do. Lividity was just starting to set in. If you want to work it, go ahead. While your at it, can you try and bring my grandma back, she has only been down for a few months? :wink: