Eng542ine

Funny... I just applied a few weeks ago...

Haix Airpower! Hands down the best thing I've EVER put on my feet! Steel toe, steel shank, crosstec bloodborne pathogen proofing... yada yada yada Expensive but i don't think i'll ever buy anything else... these are great!

How about we simply but the blame for everything where it belongs... with the individual. Whether it's the individual that thought it would be funny to put a sheet over a student... or the individual that comes to work with a crap attitude that makes everybody want to avoid him... or the person whose attitude brings down the wrath of everyone on them... It's not project... it's not shifts... it's the individual and the choices they make in the course of a day. Poor chioces are simply that, poor choices. It doesn't necessarily make someone a bad person, it just means they made a bad decision. Yes, one person's (or a few people's) decisions can ruin a LOT of days for a lot of people... evidence... this case. So all we have to do as people is think about what we do, are going to do, and learn from mistakes (our mistakes and the mistakes of others). Degrees, unions, certifications, licensure (as opposed to certification) will not elevate our profession NEARLY as far as common sense, common courtesy, and professionalism will...

CB... knowing this state, it's probably just another way to punish the masses for the sins of the few... Welcome to the People's Democratic Republic of New Jersey...

Dust... I think the easy answer here is availability. They're usually available, they're usually close, they come in groups of 3-5, and (at least here) they're usually happy to assist. I truly don't see many other viable options. You wouldn't want to take 2 additional EMS units out of service to get 4 more hands for the 5 story carrydown of the 200kg unconscious patient, would you? I'm a firm believer that many hands make lighter work and if someone's help adds years to my career (read: back/knees), I'm all for it!! That said, I don't believe that Fire should respond on all ALS jobs (somedays I'm not sure ALS should respond to most of the purported ALS jobs!). I think the application of a little common sense could eliminate most of the responses. Known obese patients, cardiac arrest, unconscious, AMS, MVA, ped/auto... sure. A diff breather on the outside... no need. Remember, all of this falls on proper call screening and semi-informed callers. In the case cited at the beginning of this thread, if the facility called... who knows what information the call taker did or didn't get. People have, by and large, figured out that the more serious they make things sound, the quicker someone will come. So, the upset stomach becomes a heart attack and the job gets upgraded. Drawing in more resources and bumping potentially sicker people, all because this one has a better "story." Let's not forget that as ALS providers, WE are a limited resource that should be preserved. There is no justification for unnecessarily risking injury to ourselves or our patients when assistance is so readily available.

Asys... Talk about stereotyping!! Talk about being WRONG!! 1) I am not, nor have I ever been a member of the republican party. 2) I am not, nor have I ever been a member of the National Rifle Association. You, sir, have just shown yourself for the ignorant ass that you must be. "Anyone that doesn't agree with me MUST be one of THEM" As far as paranoia goes, it doesn't live here. It doesn't even vacation here! Funny how disturbed you get when people disagree with your line of thought, as rational as the "opposition" may be... One moment, I'm just another Paramedic, the next I'm a fear-mongering, paranoid, anti-gay, anti-communist, NRA member, and... GASP... A REPUBLICAN!! Funny, I'm none of the above, not even close! Silly me, I thought this nice, respectful, little exchange of ideas was just a group of ADULT PROFESSIONALS exercising their right to free speech, their freedom of independent thought, and just basically exchanging ideas and positions. Then, BAM, out of nowhere comes one that insists on being EXTREMELY juvenile and defensive... next thing you know he starts with the libel. I respect your right to disagree with me, as much as I appreciate being able to express my opinions and thoughts in this open forum without encountering what amounts to a personal attack. So, grow up... just grow up...

Ah, the joys of a system divided... between public and private employees... I completely understand why the state would not want to provide a benefit to an employee of a non-governmental agency. If they wanted to do that, they could have easily included uniformed security guards employed by private companies or, members of a corporate fire brigade. I would say that this falls back on the system with people on both sides of public/private employment... a house divided... We either need to ALL be government employees or ALL be ready to be treated as less than our police and fire counterparts.

Can all sides agree on a few things here? 1) Typically, it's known/habitual/career criminals that commit an act of violence against others. Sure, we all hear about the guy that snapped and brought a shotgun to work... THAT is what the news outlets want us to hear/see... because it breeds fear... fear sells papers and makes people watch the news at noon, 5, 6, 7, and 11. When is the last time any major news outlet advocated ANYONE protecting themselves (through the use of a firearm, a pocket knife, fist, or the threat of a papercut)... they just don't. Don't take my word for it, watch the news tonight and tell me how many stories (before sports and weather) do little more than spread fear. Whether it's fear of terrorists attacking, fear of corrupt politicians, fear of criminals, fear of fear! 2) Your typical everyday, law-abiding citizen is called a law-abiding citizen BECAUSE he/she doesn't break the law! Criminals, by definition, do not obey laws. Laws only effect those that care to obey them. Really now, do you think the guy that is about to rob the local convenience store cares that the firearm he is going to use was banned under the Brady Bill, or NJ's Assault Weapons Act?? Not for a minute! If he cared about not breaking the law, he wouldn't be robbing the store in the first place!!! 3) Since the legal system is more concerned about the rights of those that have been convicted of a crime, than they are about preventing that criminal from violating their next victim's rights... someone has to protect the "every-man"... Why not protect himself?? Or, more appropriately, why should he not have the option of protecting himself?? Should we HAVE to depend on the police? My experience is that, in the absence of pure luck, the police tend to be more of a historical society than a crime-stopping agency. In the sense that... a crime occurs, the nearest officer is 10 minutes away, he responds as quickly as possible, and proceeds to take a historical account of the crime that just happened. Not to make light of a cop's work but, there just isn't enough of them to be everywhere that everyone is! Be a little self-sufficient, don't be so dependant on others to do FOR you, what you have is yours because YOU earned it... YOU should be willing to defend it! Not to mention being able to defend your person and your loved ones... Sadly, I'm writing this from smack-dab in the middle of "The Peoples' Democratic Republic of New Jersey." This meaning, myself and MILLIONS of other law-abiding citizens in this state do not enjoy a CCW law favorable to the average joe whose best friend doesn't happen to be a judge...

Off topic much??

Medic2588... You know... I find it heart-warming that we are prepared for catastrophic events which may never occur in this state... YET, they still refuse to change the laws necessary so as to guarantee a BLS ambulance on everyday jobs!!! 3- Step solution-- 1) MANDATE that municipalities provide EMS 2) REGULATE the EMS that is provided... training/equipment/response times 3) INVESTIGATE problems and correct them as they occur THEN you can worry about a task force to respond to the glory-jobs... Talk about backwards priorities... we can't make peanut butter and jelly sandwiches BUT we're gonna invest in a gourmet kitchen... wtf... typical NJ... who is the "task-farce" buying their equipment from and whose cousin IS he???

The next town over has their ambulance equipped with one... GREAT IDEA, on paper... 1st, you either kill your back dragging the patient/cot at ground-level to the bus OR you have to lift the patient/cot and lower it to a position where it will lock into the bus... 2nd, once at the hospital you are again either lifting patient/cot once you have off-loaded them (to bring them into the hospital) or you're stuck dragging again... 3rd, once next to the ER bed, if you didn't lift it before you have to do it now... the ER bed doesn't go all the way to the floor By my count... that's more lifts from a lower height than just doing it the "old-fashioned" way with either an X-frame or H-frame cot... Although, for an isolette, these devices are GREAT and work wonderfully... They're just SSSSLLLLOOOOWWWW... Granted, my ever-aging back LOVES the idea of a lift but, one that actually REDUCES the amount of lifting would be really nice...

Mediccjh... Point-by-point here... 1. I could not agree with you more... Maybe we can have them all just deploy themselves to Liberty State Park for an undetermined period of time...?? 2. AMEN!!! 3. I somewhat agree... On the medical side of things, the hospital is the place for us... BUT unless you're at UMD or another state facility, the pension is more myth than reality and Lord knows being part of a hospital also means that if your signature doesn't end in "RN" or "MD" they really don't want to pay you much more than housekeeping... Oh, and as far as corruption in NJ goes, the counties are only practicing to become the state's equal... Just ask anybody with time in Police and Fire Retirement System about that one... they took it hard and dry... 3a. I will buy into this whole-heartedly if "4a" were to become a reality... IF... 4. AND 4a. Yet another AMEN!!! 5. Agreed... Or fine the dispatch center who confused their Guide Cards with their Tarot Cards and just determined that the job "sounded ALS"... and never bothered to tell anyone the Medics have been requested... My additions... 6. Take the Epi-pen AWAY... 7. NEVER EVER, EVER think about BLS LMAs or CombiTubes... Dear God, I've seen the damage they can do with an OPA... 8. Ok... give them glucometers... Why not? Worst case... they prick their own finger... Imagine, no more "he's got a diabetic history" 9. Annual skill and equipment proficiency exams... so they know how to work the $4000.00 DeWalt powered electric "I'm a lazy-ass" cot that they put into their brand-new shiny "rig"... Not to mention so they know how to treat the patient strapped to that cordless drill on steriods once they finally get them into the "rig" 10. BAN THE WORD "RIG"!!! Anyone with more input or suggestions???

After we regulate ALL BLS... let's get Medics and Paid EMTs into the training fund. I love how the state only cares that you are a volunteer to provide free training... they don't care if you actually DO anything... The money would be better spent on people that we KNOW are doing this for their career... You would get a better return on your money than by training the hobbyist the might make a job or 2 a week... if not less...

Ok... How about a simple and reasonable start-point... LET'S FUND AND STAFF THE OFFICE WE HAVE NOW! There needs to be a structure in place before they are "spun-off" DHSS... Once their staffing is up, LICENSE AND REGULATE ALL BLS!!! Volunteer... Career... Private... Hospital... whatever... the job is the same... THE STANDARD SHOULD BE THE SAME!! None of this double-standard volunteer-coddling crap. Before somebody mouths off and accuses me of hating volunteers... I AM a volunteer and have been for 10 years. NOTE: The organization I volunteer with is not/has never been/nor will ever be associated or affiliated with the New Jersey State First Grade Council...

Ruff... Ford Expeditions... no ambulances here... on the rare occasion an ALS unit is assigned an ambulance it's referred to as a "penalty box"... FormerEMS... Honestly, no... it wouldn't change my opinion... having an ALS unit in a transport capable vehicle only serves to benefit the patient... I may be having difficulty answering your question as I simply see no advantage to a "fly car" or an intercept vehicle that is not transport capable... The simple fact of the matter is that transport-capable BLS should be there, in the event they aren't... SOMEONE has to transport... In all honesty, had myself and my partner on any of the jobs I mentioned been in a transport capable vehicle, we could have been at the hospital LONG before a first aid squad decided to grace us with their presence... and therefor it could also be accurately stated that even if the patient's truely were BLS patients and we would have been able to release, we could have transported the patient to the hospital and been available for another dispatch quicker had we had an ambulance... quicker than we WERE available after waiting for the squad to show... BTW... I could NOT agree with you more than I do with the whole hospital-based BS... this is what keeps us from getting REAL pay/benefits/pension... we're stuck working for the money-hungry private industry... not a municipal/county/state entity providing a government service as it should be...

FormerEMSLT297... I believe I am quite qualified to comment on this topic... in addition to my month as a medic... you can add 6 years as a career EMT... 10 years as a firefighter/first responder in a fire-based EMS system... good enough??? Ruffems... definately a broken system that is nowhere NEAR being fixed... and God-forbid a paramedic had to drive something besides an SUV... we can't control what the rest of the state does or doesn't do but we sure as hell can control what we do!!

CBEMT... I agree to an extent. Only in a truly Utopian society could one be guaranteed the availability of a transport capable BLS unit. Your most advanced providers should have the most basic tools of the profession at their disposal, i.e. a rolling ambulance cot and an ambulance to put it in!! Mediccjh... Agreed... But now who do we hold accountable and press for change?? We are all intimately familiar with the problem, the system is broken, there's no two ways about it. Where do we go from here? I don't know. I do know one thing though, if WE, as EMS professionals, don't have input in this, we're just going to get another system doomed for failure. Any ideas? All in all, I still think ALS Intercept could be improved upon by adding the fail-safe of putting your Paramedics into something as cheap and readily available as a non-custom mini-mod ambulance. That would be an excellent safety-net for the system. Don't throw the "it's too expensive" argument at me... the gas-powered SUVs common here can and do EASILY meet or exceed the cost of a diesel mini-mod. The costs draw very close, especially when one factors in maintenance costs, longer PM intervals for a diesel engine, etc.

ALS Intercept vehicles are one of those concepts that looks GREAT on paper but, TOTALLY SUCK in reality!!! Granted I've been a medic a whopping month now... I have had AMPLE opportunity to form this opinion and cite three instances off the top of my head where the wait for a transport unit seriously compromised patient care... 1) CVA... after BLS took the better part of an hour to grace us with their presence and the transport time to the Stroke Center he was out of the 3 hour window 2) Status Ep... 20 minute wait for BLS... that was 15 minutes after we completed the RSI... 3) Rapid A-fib... non-responsive to diltiazem (or any other damn thing we tried)... we had plenty of time to play in the FIFTY minute wait for a BLS ambulance that ended up coming from 7 towns away... in the next county!! Every unit ALS and BLS should have transport capability. There's no feeling I have ever experienced that can compare with the absolute helplessness that comes with having to wait almost an hour on a scene with a critical or unstable patient and have no way to get them to definitive care... WELL... except when you hear an ALS job go out somewhere (with no other unit available) and you're on a scene waiting for BLS to arrive so you can release an INFINITELY stable patient to them... First and foremost this falls on the State of New Jersey for failing to require municipalities to provide EMS. This is what happens when you let the people at the helm of the failing volunteer system dictate policy... fools...

Know anyone that steps into the shower before turning the water on?? All I will say is grape Kool-Aid powder in the shower head... It works GREAT!!!

Medic911... Another nice touch to add to that is INTENTIONALLY parking in the WRONG driveway (or by the wrong apartment building). Drives them NUTS when the neighbors start asking questions... I actually had a patient pull the cot sheet over her head, while we were wheeling the cot past 3 of her neighbors' houses to the driveway I parked in, so the neighbors couldn't see... Changed her mind pretty quick when she heard a few of the neighbors ask if "that cranky, whiny, old ***** had finally kicked the bucket".... When she flipped the sheet back.... the look on their faces was PRICELESS!!! Oh, by the way, before I get accused of delaying care of a patient... her complaint was a POSSIBLE broken little toe on her left foot (i.e. not the foot she should have been using on the pedals in her own car while driving herself to the hospital 1 mile away)................. God love the stupid people, they make for great job security!!

As far as the "cookie cutter" ambulance goes.... I can say our salesman that we're spec'ing our Wheeled Coach through has shown to be flexible (rare), honest (extremely rare for a vehicle salesman of any kind), and has even offered up a good number of suggestions for customization... Just threw that out there as we're nearing the end of the spec process right now...

Not to buck the trend here but, well, I'm gonna buck the trend. My volunteer fire company has a 1999 Braun Type III modular, with 40,000 miles on it... a baby, right? HA! Junk, complete and absolute JUNK!!! We had a 2 year run where it was out of service more than it was in!! This is our third Braun... and quite honestly, our last!! The hospital I work for has almost exclusively Wheeled Coach. My current ambulance is a 2000 Type III modular with 170,000 miles. Absolutely, unquestionably the best and most reliable ambulance I have ever used!! Needless to say... Yes, they still make Wheeled Coach and I'm personally quite glad they do!

Up here in NJ, every MICU project has its preference and about 100 reasons backing it up. Vehicles are about as varied as the response areas are. I know that's not exactly a help but, I did want to throw in a consideration that a local hospital is getting an expensive lesson in... PAY ATTENTION TO THE WEIGHT OF THE EQUIPMENT YOU'RE GOING TO LOAD THE VEHICLE WITH, ADD THE WEIGHT OF ANY CABINETRY, AND THEN LOOK AT THE VEHICLES CAPACITY!!! Sorry about the bold and "yelling" but that can be an extremely expensive lesson to learn and I'd like to think that as a profession we can learn from the mistakes of others. Good luck shopping....

Contact the local dealers for both Ferno and Stryker see if they can bring a demo model out and see which one works best in your workplace. They're both quality cots....

LOVE THE SAM SPLINT!!! Not to knock blankets and pillows... they work great.... but, the SAM fits in a jumpbag... no linen bag required... The more you use the SAM the more creative you'll become with it... it's a great tool... maybe not the end-all but DEFINATELY something well worth keeping a few of around!!