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Sin City Medic

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  1. I'm posting this topic after an argument with a supervisor at work over the nature of a call. Let me preface by describing the event. We were dispatched to a MVA where by, in the initial dispatch and over the radio, the dispatcher stated that there is no patient but that they needed a "refusal". We arrived on scene to find just that. The subject was sitting on a set of stairs near a side walk with 4 FD personel standing next to him with their hands in their pockets. Upon our arrival and subsaquent conversation, the subject stated he advised the on scene FD that he was fine and didn't want an ambulance called. His vehicle had very, and I do mean very, minor vehicle damage. Vehicle speed was so slow that, while impacting the front of his vehicle, his airbag did not deploy. No starring on the windshield and the subject stated he was wearing a seatbelt and denied any LOC. He advised me that he didn't want to be assessed or vitals taken. I spoke with the on scene fire department EMT who advised me that they needed me to complete a refusal on the patient. I don't like doing AMA's because I am of the belief that if someone calls me, they should probably be transported because they felt it was bad enough to call 911. That being said when I do an AMA I make darn sure to cover my butt! The point I made during this argument with my supervisor is over the definition of a medical patient. This individual had ZERO complaint, didn't want us to be called, and was irritated when we actually showed up. My supervisor stated that this is how things are done. Obviously that's not logical answer! I made mention to the fact that the MOI was minor if there was any at all and that the individual specifically instructed FD not to call us. I'm new to the area and from the sounds of it, this city uses the ambulance company to refuse EVERYONE regardless of complaint for shift of liability reasons. In my opinion that is ridiclious! Am I wrong, what are you thoughts on the matter? BTW I know what my screen name says, I'm no longer in Las Vegas. I currently live and work in the NorthEast.
  2. Let me preface this topic by saying that I am seeking opinions for any and all who care to discuss the topic below. I have been with my current company about five years now, and have had the privlage of working in multiple operations through out the nation. As of recent I moved to the North East and found a practice they have had in place to cause my stomach to churn with doubt. Post a run I am to call into the dispatch center for my run number and times. I do this and am then asked to give to the dispatcher the pt's name, SSN, DOB, and any insurance information should they have insurance. Please understand that I have never done this practice at any other operations I have worked at, and all of those operations have been with this company. I don't feel that a dispatcher has any right to this information nor do they have any need for it. Could this be construed as a violation of HIPPA? While I realize that it's simple patient demographics, I am intrusted with caring for that patient's information and I just don't feel right giving it to a dispatcher. Is my feeling justified? What are you thoughts! This topic has been plaguing me for a month now!
  3. The ghost of Mary Jo finally got'em!!!
  4. I can see where you might assume that the fire department is capable of taking over EMS, the fact is that compared to AMR and the shear number of transports we do, they are WAY understaffed. Figure Las Vegas AMR alone transports anywhere from 300-700 patients a day. We have anywhere from 30-50 trucks on at any given time. The simple fact is that the Fire Departments just don't have that kind of staff, which is why it's written into the franchise agreement that at anytime the county deem action by AMR may pose a health threat to the community they will assume the operations, it's employees', ambulances, equiptment, etc.
  5. Maybe it might help for some first hand information from someone who not only works in Las Vegas but is a union member and bargaining team member as well. This strike comes down to Dave Banelli trying to flex his muscles, period. AMR is simply not wanting to acknowledge our union. To clear some things up there are not two unions in Las Vegas. LV AMR is SEIU Local 1107, however IAEP was elected by the membership on Sept. 2nd and 3rd of 08 to service our upcoming contract and, upon completion of the contract, LV AMR will become an IAEP Local itself. What AMR is attempting to do is interject WHO they bargaining with, something they know they can't do. Most of you don't know but the initial contract took 3 years because of the same stall tactics by AMR. This is nothing new for most operations and the real question here is how far does AMR really want to push us, are they willing to lose their franchise agreement? Also just a little side note AMR last year posted a $37 million dollar profit in Las Vegas alone, doubt they are wanting to lose that! Again these stall tactics are nothing new, and in the end should it go to strike I'm sure AMR will face severe punishment from the city up to and including losing their ability to operate. This, in turn, will force the county to come in and take over the operations including employees, ambulances, etc, effectively making it a 3rd service. So where we go from here is AMR's decision and my guess is that they are not willing to lose this contract, it's one of the very few that are profitable!
  6. I'm going to comment on this topic because my company is pushing this whole "green" idea with the hidden message of saving money. I work in Las Vegas were today was 115 degrees. Anyone with a brain knows that heat is amplified through windows and interior car temps can reach into the mid to high hundreds EASILY. So by my company telling me to "not idle" is, to me, saying we could really care less about your safety and we'd rather save money. The fact is that I, and my partner come first. I'm useless to a patient if I myself am suffering from heat exhaustion. Lets not forget that it's hot enough here that the AC can't actually keep up with the riding temp in the rigs to begin with. With the AC on full blast the interior of the truck registers a cool 98 degrees, I took it today for kicks.
  7. I'm not sure what you mean by "lack of stability". Again it's a real ball busting system. Name me one other place that gets as much traffic from all different cultures all over the world. Not to mention our population nearly doubles on weekends and major holidays with an average rate off between 150-300k tourists and business people daily. Granted it does get hot but there's not a better place to test your emotional response to EMS better than Vegas. I can pretty much guarantee you'll see more hot calls in a month that most medics get in a year. It's busy, very busy but if you're looking for affordability and salary it's golden right now. Base medics start at 40K and with the housing crunch most places around here are from 100k to 200k for new homes. Very easily affordable in my opinion.
  8. If you want good experience and a ball busting fun system...check out American's playground! Las Vegas rocks! Not to mention currently it's fairly affordable as well!
  9. I'm going to have to correct aryan on a few points knowing first hand about San Joaquin County and why it is the way it is. Originally their were two private companies plus the fire department all doing transport and response. The EMS Authority wanted a singular agency and AMR was selected after a bid. The ONLY reason their are new "toys" in that county is because it was mandated in the bid that any ambulance and it's supplies (monitors, gurneys, bags, etc) that will be a system designated car (911 cars) must all be new. Believe me when I say had it not been in required by the EMS agency they'd still be using LP10's! I give credit to that EMS agency, they have "balls" and are not afraid of using them. Now about the county in general. The street people are good people, for the most part. As with any operations their are those that tend to have a large chip on their shoulder and that will never change. The management is something else and I'll leave it at that. They will hire just about anyone and their more apt to fire the good people then the losers, I've seen it too many times which is why I left. I did, however, come back in another operation and love it so I'm not going to bash AMR, you get out of them what you put into them. This company has done a ton for me, and taught me a lot of life lessons. Personally I've grown leaps and bounds and I atribuite that to the people I used to work with. So I know aryan that you're somewhat new to that county (I was their for a few years) and I do hope you enjoy your experience.
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