mshow00

A part of me likes what is being said... but I do not want to be the one to make that call of wether I believe someone deserves my care. Call me young, nieve, and/or idealistic, but I whole wholeheartedly believe in in 'Primum non nocere'. I fear not going to a legit emergency because someone has decided that a pt has "abused" the system in the past. Just because we(EMS/ERs) do not deem a call an emergency does not mean the pt feels the same. We would have to educate the entire public on a true emergency, these being the same people who can't figure out to pull to the right and stop when an ambulance is running code behind them. Just my thoughts.

I do now, sorry I missed it the first time...

More facts: it was a basic truck(our comp only runs basic units in that area due to cost), going 65 + mph going down an interstate, unknown car passing the ambulance opens fire... sprays the divers side with live rounds... DwayneEMTP If 'almost all of the shots were in the patient care area' then how was the patient or medic not hit? But the basic, in the cab, hit twice? thats why I said almost all rounds DwayneEMTP And besides, Dust would tell you that as the patient was already being cared for from the original call, the basic should have simply been shoved out of the cab and left to the next ambulance to be dispatched. I NEVER want to be your partner. The EMT driving took two rounds one in the chest on the interstate and you want to "simply been shoved out of the cab and left to the next ambulance to be dispatched" while driving at high way speeds? (I know thats not what you meant, but still the way it sounds) The EMT in the back jumped up front and finished the very short ride(about 3 minutes) to the hospital.

At this point, the police believe it was the original gunner(s) attempting to finish what they started possibly followed from the scene, almost all the shots were in the pt care area.

According to the local news, it was the EMT "driver" going down the interstate at 60+ mph when a red/maroon car pulled along side and pepper the drivers side of the ambulance with an automatic riffle. The EMT took one the the left arm, and one center mast chest. The paramedic and the pt in back were unharmed. The basic pulled over, the medic jumped in the front, and grew wings to the hospital. The EMT was air lifted to a level one trauma center across the river(MO) where they were able to retrieve the bullet in his arm, however the one in his chest is too close to the aorta. The scene where the initial shooting was secure, but how the hell are we suppose to keep ourselves safe when we are hunted on the road?

Let me try this one..it is more updated information http://www.ksdk.com/video/default.aspx?aid...w=hi&cat=33

http://www.kmov.com/video/topvideo-index.h...46863&shu=1 apparently there is no safe place. This happened in the same area I live.... the person they are referring to works for the other private service... prayers to him and his family...

I hate to ask a stupid question, but ROSC is not a term I am familiar with, what does it mean? Return Of Spontaneous Circulation?

That it actually causes more harm to back board geri pts than to do sheet lifts/pt movers/etc in regards to falls > 6hrs with no complaints of injury or pain and hip fxs with "no suspected spinal injury". I don't understand it, thats why I am asking for speculation on their though process.

What about the idea of spinal immoblization being more detrimental to health for the elderly? After talking to several more experienced co-workers about this; a couple of them made the statement that they would have done the same as us, due to the fact of the question/statement above.

My partner and I got called to a local SNF about 0930 to take a Pt to a hospital with a c/c of a head lac secondary to a fall around midnight. We arrived on scene to find 80's y/o female walking around with a walker. She had a 2-3 cm wide and 3-4 cm long "T" shaped lac. on the bridge of her nose mostly scabbed over. Our protocols say if it has been more than six hours the pt does not need to be trauma packaged, and seeing has how she was up and moving with no complaints of pain my partner (the medic) made the call not to package her. He continued his assessment and decided to BLS her in. Anyway we took her to the hospital and gave our report. ER nurses came and did their initial stuff. The Dr. was going to glue and release her. I later found out due to a paperwork mistake at the hospital the pt was taken and had a x-ray/CT of her head and neck. Thats when they discovered a C 2-4 fx. When I did my assessment on her she had some weakness bilat but over all PMS was WNL x4. She had no complaints of pain, tenderness, LOC, loss of sensation, pain, SOB, CP etc. Just the lac on the bridge of her nose. Did I miss something, or does anyone have any suggestions on some assessment/ question that I can do to prevent this from happening again?

I think I have to place a chunk of the responsibility on the most experienced crew member, who left the two "rookies" to take care of the Pt. IMO he should have had "lead" on this call. He should have been there for the inital assessment, seen the potential for the danger the Pt was in, and sent one of the other to talk to the family. My basic instructor beat into our heads to keep all pt talking(except those with a c/c SOB) no matter what. Sounds like the arthur had a deadly case of tunnel vision as did her partner who was also treating the Pt.

We (BLS truck) got a call (non-emergant) for a Pt who was having trouble going to the bath room. It was in the middle of a heat wave in July. We came on scene to receive a report from the nursing staff of: Pt has a hx of paranoid schizophrenia, DM, aggrestion and agitation. She came on with he had been refusing meds for three days, refusing food and drink for two days. The Pt had been outside all day (in the extreme heat) and they call because he is not going to the bathroom. I walked up and introduced myself to the Pt to be greeted with "Take another step and I'm gonna f*** you up!" Needless to say we had to call for PD back up and the Pt almost got himself tazed.

I am one of those who fully intends on following this career as long as possible. That being said, I know there will come a time when I need to get "off the streets". I am currently working towards an AAS in Paramedicine, and was thinking about getting a Bachelors in Business(work in office somewhere in EMS). I hear my other counter-parts talk about doing a bridge program into nursing etc. I was wondering what you guys here think about doing when the streets are no longer a viable option?

Sorry I guess I failed at my attempt to be sarcastic. I was just making a point about the fact of our governing agencies are willing to do what ever to make your points about being on a P/P truck mute. Seems like they are trying to phase out the basic and medic, and make them one and the same.

I have no idea, but I would not be suprised. The state seems to be very interested in micro-managing and making terribly terribly slow changes with the advancements made in the field.

Would you consider an EMT-Enhanced Basic a partner or bigger liability? I just heard about this but in the regions surrounding mine, they are "developing" enhanced basics, they can start IVs and I believe they can read and use EKGs. I personally see this as a way to get the "bigger/basic" paramedic skills at the pay of a Basic.

To be completely honest, our base rate is the " C" rate, some $8/hr for EMTs. We then move up to "B" and "A" rate. and then the select few that qualify for it even get "A+",think that is $.50/hr more. So yes it it legal. Like I said in an early post I get a $200 "bump" in pay per pay check for being at "B" rate and another $200 "bump" for going "B" to "A". As I understand it, the plan was implemented because of our counter parts across the river taking way to long on transfers, which is what they mostly do; and the paperwork became a big thing (according to office personal) so that we could get paid as much as possible from public aid and Medicaid.

I whole heartedly agree that patient care comes before all else. I can usually make my times up, get the difference back on some of the other calls. As for the union, usually to get something you have to give something up, would you be willing to loose the instance program, to gain a small raise? and then there is always the fact that Abbott already will not get rid of its employee's that are subpar. You KNOW who I am refereing too. A union will only make it all that more worse.

One last question from me on this topic: Would you rather have a fully trained moronic Paramedic partner or a knowledgeable albeit limited in skills EMT?

Honest opinions is it ever ok/good/proper to lie to a patient? In my EMT text book and my Paramedic text it says never... on the street I have seen both done. What is truly proper?

Don't know if you have heard yet, but the rumor mill here is that AMR already tried to implement this plan somewhere and all of the medics walked. Anyone know if that is true? Like I have heard it said here, if you don't like it leave. It is obvious nothing at our company is going to change, and a union would only cause us more trouble. PS I still don't know who you are lol

Would this become a possible alternative to those pts that are "drug seeking"? I fail to see how this would be implemented in the field. Where I work I'm 15 to 20 mins to two level 1 trauma centers, and no more than 10 to 15 mins from any other general hospital, and we have Arch(helicopter units) that can fly. I am not sure that this would be all that practical here in the pre-hospital setting. Or, am I missing the bigger picture?

Congrats

In my company we get docked pay (about $200 for a month) if we don't get the signature. If the patient can't sign then we HAVE to have a legitimate medical reason why they can not (being spinal immobilized does not count), and we have to have a proxy signature. It is not that difficult to obtain them and it is easy enough as saying can you sign right here for me. IF for whatever reason everyone refuses/unable to sign it merely needs to be documented in our PCR.