MedicCraig

Rules is rules.....no matter how dumb they may be. We had a local paid FF die in a casino hotel of an AMI while in bed with someone other than his wife. But since it was within 24 hours of his last emergency call, it was considered a LODD. (I will point out he did not get the traditional FF funeral)

Something along those lines. Those of us oldtimers rose through the ranks, were promoted up, but received little in the way of management type training. I've been to a few conferences and seminars, some good... some not so good. I have even planned a couple of conferences, but I'm having trouble trying to find a course or speaker that is geared towards EMS leadership. What I want to do is have a 1 or 2 day educational/motivational seminar for our area EMS leadership. Team building might work, if it is geared towards EMS.

Well Mobey..... The providers in our region have suggested I find a management type "seminar" geared to EMS. There is nothing locally, and I'm about googled out. I have to spend this grant money soon, and all the agencies are tired of the PHTLS,AMLS, PALS, ADLS, BDLS and any other alphabet cards I can think of courses. Here in Louisiana we also have the degree courses, but I'm looking for a 2 day workshop type deal.

I'm looking for an EMS management course. We need to find a program that is 1 or 2 days long, not an on-line course. We have a large classroom available, and federal grant money to pay for it. I represent 18 EMS agencies in our region, and class size should be about 20-30 EMS supervisors, managers, and administrators. Anybody know a good course? Thanks!

Times are tough, even for doctors. The other day I over heard a cardiologist and an ER doc talking. The ER doc told the cardiologist that he had just pronounced a cardiac arrest patient and sent him to the morgue downstairs. Things had been slow for the cardiologist, so he ran down to the morgue, thinking he could heart cath him before he went to the funeral home. When he opened the door and pulled out the tray where the patient was supposed to be, it was empty.......except for a note that said.............."Gone to Dialysis" !!

These are are all interesting opinions. I would like to see someone from law enforcement chime in on this. If you read the quote earlier about law enforcement rights to HIPPA info, it's pretty clear he was not entitled to view the PCR. I think this is really a educational opportunity for our LEO friends about what they can and can do in this situation. Just for the record, I have contacted the driver on this run and asked her to read these posts and weigh in on it. Stay tuned.

I thought this topic might stir up some interesting points. All are valid points, too. Just for the record the officer involved was a Texas DPS officer. Thats a state trooper or hiway patrol officer in other states. My crew said that he told them he was unable to get a response when running the plates on the ambulance. That's not our problem, though. The ambulance is correctly licensed, driven and attended by a licensed crew on a legal, authorized non-emergent run. They were doing nothing wrong to be treated in this manner. They were guilty until proven innocent of an unknown crime.Maybe this should be a wake up call that we need to suggest that LEO needs to be trained or inserviced on HIPPA. I'll bet most of them don't know what it is. Any officers care to comment?

All good points.... personally, I think I would have complied with the officers demand after I contacted management first. I have read over the laws that were linked earlier, and my interpitation of it says he can't ask for PHI in this case. After talking to my crew about this run, they still were more upset by the way the officer treated them. I believe if an officer, or anyone, wants respect, they should treat people with respect.

Well, Island EMT, I think you hit the nail on the head. This incident occured south of Houston, where the illegal immigration and mexican drug cartels cause some problems. I heard just this past week they busted 12 illegal aliens dressed as US Marines down there. I guess the smugglers are getting creative!

My problem is, When does law enforcement have the right to view confidential patient info? The patient was not able to consent, and in this case, not involved in a crime.And I understand the situation you describe. Sometimes it's better to pick your battles, and not start a war.

This situation occured at our service last week, and it's been bugging me ever since. Tell me what you think. One of our crews went to a neighboring state to pick up a dementia patient from an assisted living facility and transport him back to our city for nursing home placement. Just a simple BLS, non-emergent run. After picking up the patient and being on the road back for about an hour, they were tailed by a state trooper for about 20 minutes, then pulled over. The officer was more than a little rude. He had the driver exit the vehicle and produce all the usual paperwork, then insisted that all the compartment doors be opened, which he searched.Then he opened the back doors and insisted on viewing the patients paperwork. After being detained on the side of the road for 20 minutes, they were finally released to continue the run. The driver received a warning for "following to close", but both the driver and attendant verify that no vehicle was in front of them. It's my belief that the trooper was looking for something. Since our ambulance was about 7 hours out of our area, and from another state, I guess it looked odd to the trooper. My question is, does law enforcement have the right to inspect the patients paper work (HIPPA), on a routine traffic stop? Has anyone else ever encountered this?

One other option if the house has a porch. If there is enough room beside the steps, place the loading wheels on the porch, retract the legs, then push the stretcher onto the porch. It's just like loading the stretcher into the ambulance. It's a good idea to have your partner get up on the porch first and hold on to the head end of the stretcher so it doesn't back off the porch and fall. You might want to practice this trick with an unloaded stretcher first to get the hang of it. I've used this technique 100's of times without any problems.

If you are considering Louisiana, here are some things to think about. We are a National Registry state. Reciprosity is filling out a couple of forms and paying the fees, if you are National Registry already. Cost of living is low. Summers are killer wth the humidity. Although I don't work for Acadian, I know many that do. They are a very structured group. Lots of rules. Uniforms are tailored. Short haircuts. You may go on duty in one area, and be sent anywhere they operate, which is about half the state. Opportunity to advance is good. They operate off-shore on drilling rigs, have a couple of helicopters and fixed wing. The occasional hurricane helps with the overtime. One thing to consider is cost of housing. While real estate prices are low, insurance is high along the coast. Check it out before you buy. I believe they offer a signing bonus, too.

I love that response. It's nice to know there are still medics around who realize that we are in the business of taking care of people, whether they're 8 or 80, getting their feeding tube replaced or having the big AMI. For 26 years I've been making the transfers, 911, stand-bys, etc. And I still learn something new everyday. I enjoy talking to the older folks. Listen to their stories. They have a lot to pass on. Some have had amazing lives. One patient told me about his life growing up as a sharecropper. His parents were slaves! That's living history. He was 106 years old and still sharp. Another told me about emigrating to the US from England when she was 12. Her father was the Captain of the steam ship that brought her here. He later died when he went down with his ship off the coast of Holland. Yes, the transfers can get a little boring, but only if you choose to make that way. Try to learn something on every run. Pay attention to your patient. I've had patients arrest while taking them out of the hospital. I've had to intubate patients that were only going to diaysis. Keep your eyes open and don't get caught up in the "It's only a transfer" mentality.

CDP provides some of the best training you'll ever get. They have very knowledgable instructors, outstanding equipment, and great facilities. It's nice to train all day, then their staff do all the tear down and clean up. Food was good, rooms were nice and clean,(Maid service!!). Only down side, sharing the bathroom with the room next door. I would recommend meeting the person in the room next to you on the first day and agree on a shower schedule so you both don't try use the bathroom at the same time. One part I enjoyed the most was meeting all the people from around the country and talking shop over a beer at the responder lounge. Bring a few bucks to buy a couple of shirts, or buy someone a beer. And don't be late for anything. If the bus to class is scheduled to leave at 8:00, it will. Security is tight, make sure you bring an ID. Have fun!!

Greetings all.........Last week, the Louisiana House of Representatives passed House Bill 1030. (HB1030) In a nutshell, this bill will allow all municipal EMTs and paramedics to operate without the oversight of the La. EMS Commission. As written, if a municipal employee is convicted of a felony,or has had any other action against their certification, the employee would be subjected to possible disiplinary action by their own department, but not the state. The unfair part is the law WILL NOT apply to employees of private services. This creates 2 sets of rules for one industry. It also may prevent private employers from hiring part time fire medics because we may not know that employees record or background. I encourage you to research this bill, and contact your state senators and urge them to vote this bill down. It's not fair, and encourages a return to "the good ole boy "system, where infractions could be swept under the rug because he's a "good ole boy". This kind of legislation sets us back 20 years.

Some valid points are made. I am a paramedic, working for a private service for 19 years, but a total of 25 years in EMS. I have worked for municipal agencies, privates, even volunteer. Yes, there are times the burn out factor takes over, but overall, I still love my job. The money is ok, good benefits, good retirement. I think too many medics seem to lose sight of the fact that we are here to take care of people. Wether they are 8 or 80, in a car wreck or going to dialysis, they are all people who need our care. I have started to branch out into disaster management, not because I don't love the job, but because I know that I'm only one bad patient lift from being side-lined with a back injury. That's my biggest complaint about this job. The lack of advancement. I've had the chance to move into an office job, but the cut in hours did not make up for the pay increase. Overall, I'm happy with my career choice. It has provided me with a good life.

I thought it was pretty funny.

Search You tube for "firefighter and nurse" Several more of these videos that will make your bladder empty!!!

On a hat I have........ Medic 911 makes me come!

It is a little more than signing off on a "skill". To give the vaccination, there should be a public health clause in your statute which also provides for additional education.

When you give an IM,SL, SQ or IV med, you are acting under a certain set of protocols for a field diagnosis as signs and symptoms appear.

For a vaccine, you are working off of what if and must provide the necessary education for whatever patient population presents for them. As a parent I would be hesitant to have an EMT(P) who is only going by "I can give a shot" mentality vaccinate my child.

That being said, your state may already have established the legislation necessary.

Here are some updates:

http://www2a.cdc.gov/phlp/H1N1flu.asp

One another thread here, MA had passed a very comprehensive Bill which I am surprised LA doesn't have one similiar. Many of the other states updated their statutes for Public Health and Disaster Preparedness after they saw what happened with Katrina.

http://www.mass.gov/legis/bills/senate/186/st02/st02028.htm

Hurricanes are just one of the reasons Florida has vaccines in its statutes for EMS. However, it has still been controversial for allowing Paramedics to administer them to children. A couple of counties (Lee and Indian River) was even trying to be active in Public Health but eventually some of the momentum was lost and projects scrapped due to a lack of interest from the Paramedics as they did not want to do "clinic work".

Thanks everyone for your responses. I do agree that we should not be giving vaccinations to people just because we know which end of the needle goes towards the patient, but I would think that a short class would bring us up to speed. As of right now, there is no emergency declaration or any other order that will permit us to do it, but who knows what the future holds!! Currently, there are 1264 confirmed cases of H1N1 in Louisiana, but the CDC estimates that the actual number (unconfirmed cases) is about 70,000. I think I'll go wash my hands again.

I'd like to hear from some other states about their vaccination plans. Currently, Louisiana EMS providers, both public and private, will receive the vaccinations. However, I just received an E-mail from our state bureau of EMS that says paramedics WILL NOT be able to give the injections. It says the injection must be given by a doctor or RN. Is this how other states are doing it? We do not intend to give the vaccinations to the public, just our own employees. If this pandemic does get bad, they are going to be overwelmed by the general public seeking shots, and the local health units can not handle it. Also, our state has allowed pharmasists to administer the shot. Are pharmasists train to administer meds, or just dispense them? I'm curious what other states are doing.

Thanks everyone for the tips. This sounds like it could be more complicated than I thought.

I'm looking for a little help here. I've come up with an idea for a new EMS product, but I don't know where to start. It's a simple, low-tech, cheap answer to an on-going problem. Has anyone here taken an idea and turned it into a reality? Ever get something patented? Marketing isn't the problem so much as getting it manufactured. Where do I start?

Title changed to reflect content...AK

I do agree we must have the facts and statistics to verify that we have a problem. As far as I'm concerned, one accident involving an ambulance is one too many. The general public calls us to resolve their problems, not create new ones. By driving recklessly and too fast, we are endangering ourselves, our patients and everyone we come into contact with. We must learn to slow down and concentrate on the task at hand. When I am attending a patient, that's all I'm concentrating on. The same goes for driving. Nothing less than 1oo% focus on the job at hand. TV and movies need to stop portraying us running all over town at wide open throttle, because that's how the public expects us to act. How many times has a member of the un-informed public asked you "how fast will it go?" while pointing at your ambulance? How many times has a concerned family member told you to speed up or asked why you didn't have the red lights on? The public has come to expect our behaviors based on the percepcion created by the media. Just like "Emergency!" , the TV show from the '70's that introduced EMS to the world. The public expects us to act and perform like the images they see portrayed on TV. We need to slow down. We need to pay attention. We need to attend defensive driving programs and pay attention to the lessons. Don't just sit taking up space and hoping to past the test. Take an active part in the safety of those around you. The ambulance I currently use is one of the best I've ever been in. It's clean, drives great, and is set up just the way I like it. And everyday at shift change I relay this message to the on-coming crew..........................If you scratch it, you fix it, if you dent it, you die! Be safe.

....with visions of self-cleaning ambulances, dancing in their heads......

....Not a patient was stirring, not even the drunks...