MedicCraig

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...

Some simple words of advice from an old school paramedic..... It takes about a year to really get comfortable and confident in the back of the truck. Use that time to listen and learn. It's better to keep your mouth shut and be thought a fool, than open your mouth and prove it. Ask questions. Research diagnosis and treatment you don't understand or have never heard of. After 24 years I still learn something new every shift. When treating a patient and you "think I should...." you probably better. The first pulse you check should be your own. I've never got in trouble for over-treating a patient.......But under-treat and see what happens!! Establish good, trusting relationships with the ED staff and doctors you deal with. Gaining their trust and respect will go a long way when calling for orders, etc. I think a lot of medics, new and old, have lost site of the fact that this job is about taking care of people, young or old,dirty or clean, short, tall, fat or skinny. This job is not about us. Not wanting to make the routine nursing home runs or dialysis transfers is a sure sign that maybe you picked the wrong job. Yes, we all love the truama or complicated medical calls, but it's all about taking care of people. As long as you ALWAYS place the patients best interest first, you'll do fine.

These may have been seen here before, but, what the hell, I'm new here. How do you tell the difference between an oral thermometer and a rectal thermometer? Taste! How do you tell the difference between a male chromosone and a female chromosone? Look in their genes!! What is the medical term for the surgery that changes a woman to a man? An Addadicktome!! How do you make a hormone? Kick her in the knee!! Anybody else have any??

While walking through the ER one day, I overheard a nurse explaining to an elderly female patient that she was going to insert a foley catheter in her. She explained the whole procedure, then pulled the curtain for privacy. As the nurse began to prepare the 'site', I heard that sweet little lady's voice from behind the curtain say, "It's been a long time since somebody touched me there". I had to run out of the ER to contain my laughter!! The nurse was right behind me, as she needed a few minutes to compose herself, too!!

Our services policy is "no cell phones period at work" We found that our crews were calling each other during the day and sharing info about up-coming non-emergency transfers, then doing their best to get out of that area to avoid the run. We also had many close calls while driving due to phone use. Our insurance provider finally sent a memo asking us to ban them while on duty, which we did. Now, I'm realistic, and I know our people still carry them, but I always tell our staff, if I see it, I'll take care of it from my supervisory position. I do, however, believe that asking my people, who are on duty 24-36 hours at a time, to not have contact with their families as needed is asking too much. Yes, we have land based phones available for them,but they're not very private. I think a little common sense, some manners, and respect for those around you would go a long way when it comes to cell phone use. And, yes, I'm one of those that were around before cell phones, when we still were using APCOR radios like "Johnnie and Roy"!!

My idea would be make everything south of I-10 a national park. You could visit, but you can't stay!! All these evacuees are killing us here. They were asking for FEMA debit cards the first day they arrived!! It seems like all they do is stick their hands out wanting more, more, more. Now, I'm not a woman, but if I were traveling with a baby, I might want to bring some diapers. Not these folks. They are griping about diapers since they got off the bus. They also are complaining about the availability of feminine hygene needs. As I recall, that issue comes up about once a month or so, so you would think they would carry what they need. I have been transporting patients out of the shelters ever since I got back, and even they are complaining. Our system assigns evacuee patients to our 9 area hospitals on a rotation to avoid overloading anyone, and if they end up going to one 5 minutes farther away, they pitch a fit. Most of them have never been here, and don't even know one hospital from another!! But I guess I'm the stupid one, as I just signed up for a 12 hour shift at our biggest shelter tonight, working the first aid/stand-by. We had several fights break out at the different shelters in town, and I guess I just want to see what happens next....................Can't wait to see what happens with Hurricane Ike!!!!!!!!!!!!

I'm back!! Our task force left Shreveport before sun-up Saturday morning. We left with 9 ambulances, 3 law enforcement vehicles, 1 generator trailer, our 30' disaster response trailer, 4 communication trucks, our 105' portable radio tower with repeater system, 1 fire mechanic service vehicle and 40 staff. We took enough food and water for everybody for 3 days. We traveled to the ambulance credentialing point in Alexandria, La., where we were expidited through the inspection process. We were able to get all vehicles inspected, crews fed, and trucks re-fueled in about 2 hours, then off to New Orleans. We had 2 minor mechanical problems enroute, but having the fire mechanic with us kept us on the road with minimal delays. We set up our base in East Jefferson parish, set up our comm. system, and received our first missions. As all our ambulances come from different providers, both public and private, and our comm. staff provided us with portable radios and GPS units for every vehicle. We were tasked with moving bed-bound home health patients to the airport for evac. to Baton Rouge. Myself and one of our law enforcement officers went to the airport to verify the situation there. We found a military C-130 ready to load, a federal D-MAT strike team and a fuel truck ready to supply our fuel needs. We began dispatching our ambulances and were able to move approx. 30 patients to the air marshaling point that night. We were only slowed by aircraft turn-around time, the inability of the D-MAT team to accept our patients without an aircraft on the ground, and the patient capacity of the plane(19). When the flights stopped, we transfered several patients to the train station, 5 more were transfered by ground to Baton Rouge, and 3 by ground all the way back to Shreveport. We were able to split our ambulances into 2 shifts, allowing some to sleep while others ran. We also had enough people to staff 3 medics per truck, as we often double loaded. We left Sunday morning, and during the return trip home, our disaster trailer was diverted to help establish a evac. shelter in Bossier City. All this was accomplished in 36 hours, including travel time. We are very proud of the job we did, and the time we did it in. Yes, we did encounter some problems, usually related to the EOC and other state officials, but overall, things went well. We will be having a de-briefing soon, and we will iron out the problems then.

Just got off a conference call with the state folks.......The trigger has been pulled.......we are expecting about 500 ambulances tomorrow. My fun meter is pegged!!! Our state medical director put it this way......"plan on evacuating the entire southern half of the state" All you folks up north better get ready to start listening to some southern drawl !!!! HERE WE GO!!!!!! I'll get back when I can. Wish us luck, and keep us in your prayers

So far, no evacuations yet. They plan to "pull the trigger" tomorrow or Saturday. EMS seems to have everything ready, but the hospitals, LTACs and nursing homes seem to be having issues. Hospice patients at home are begining to panic. When were you last in Natch? I used to work there part-time. I was the first paramedic on duty the day they went ALS. That was an exciting place to work!!

A good place to start would be education. Check for basic and advanced disaster life support classes.(BDLS/ADLS) They are taught all over, and some are grant funded (FREE) Also check out the the Center for Domestic Preparedness. They are located in Anniston, Al. This is a federal facility, and all their training , including room, food and even airline transportation to and from are free. I admire your willingness to get involved in this area of EMS. I can't stress enough the need to educate your self. Be safe, and remember, You should always train the most on the skills performed the least.

GOHSEP.......Govenors Office of Homeland Security and Emergency Preparedness

Sorry for the delay getting back here, I've been a little busy. In answer to your question, I wear many hats. I work full time for as a paramedic for a private ambulance service. I am also a EMS/ designated regional coordinator (DRC) for my corner of the state. There are 18 of us state-wide, and we coordinate and plan disaster response. I am also the vice executive officer for Louisiana 7 Medical Task Force, our regions disaster response team. I have also been trained as our area task force/strike team leader. So, I guess you can see why I've been a little tied up lately. We anticipate being deployed to So. La. Friday, and the logisics of pulling together 60 medics. 20 ambulances, a field treatment area and all the equipment we take is a little time consuming. Did I mention, that all these medics and equipment come from over 20 different providers ? Between conference calls with state folks, and calling all the services involved, I've feel like I've got a cell phone growing out of my ear!! Thank goodness for roll-over minutes!!

Thanks,we tried our best. When the incident command is 100 miles away and communications are zip, things got a little difficult. I am a firm believer in keeping things simple, and if I just could have convinced the on-scene command that the same transportation that was bringing all the patients to the 'dome could have taken some out, we would have done a lot better.

I've been getting multiple E-mails today from GOHSEP concerning Hurricane Gustav. The powers that be seem to think we might have a little rain storm next week. I've spent all day gathering resources and commitments for possible deployment. Wish us luck down in Louisiana. We promise to do better this time!!!

Thanks for the info. I'll be watching for it. I saw the demo and it looks good.

I recently read about a new video game called "Zero Hour, America's Medics". It was developed my George Washington University and the Dept. of Homeland security as a training tool for disaster and MCI response. I have seen the preview of the game, and it looks like a good training tool, but I am unable to find where to purchase it. Has anybody used it? Is it worth purchasing ? Anyone know where to get it? nationalEMSpreparedness.com has info about it, but no info on purchasing. Thanks for the help!!

Although the situation I was involved in was a very trying time for all involved, some very important lessons were learned. Our response requirements with the parish (in Louisiana we have parishes, not counties) say we must respond RLS to all 911 calls. Thats understandable since it seems dispatch info is seldom accurate. However, after picking up the patient, it is the paramedic/attendant who makes the decision whether or not to return to the ED with RLS or not, based on patient condition. If your patient is not in a life threatening condition, don't do it! It our situation, it was determined after the investigation that the patients on board, (there were 2), were not in a life threatening condition, increasing our liability. Also, be very careful of the statements made to the law enforcement offials investigating. Our driver made the comment to the officer that when the light turned yellow, "I stomped the gas". This statement came back to haunt us. The lawyers grilled me on that statement. "Do you teach drivers to stomp the gas?" "Have you ever used the term stomp the gas?" "Have you ever heard the term stomp the gas?" etc., etc. Are all your training records up to date? What about daily check sheets? Maintanence records current? All of these will be requested, probabley dating back a year before the accident. Again, I highly recommend a standardized training course, such as CEVO 2. Although it may not be the most exciting course you ever take, it is recognized nation-wide as an acceptable emergency defensive driving course. It is available through the National Safety Council.

Never, never, never mention the name of a "frequent flier" who hasn't been to th ED in a while. As soon as someone says their name, you can count on picking them up before the end of your shift! And the more difficult the extrication from their single-wide mobile home back bedroom at the end of the hallway with the rotted floor mansion, the more likely that you will receive that call after consuming way too much of something way too unhealthy!! And don't forget the stink factor. If they offend my olfactory senses, you can bet the call will come in at the begining of my shift, so I will be reminded of their visit throught the duration of my 24 hour tour!!

Oh, the dreaded ambulance accident!! Ask any medic who has been the subject of a lawsuit and/or deposition, and I'll bet he slowed his roll. I was deposed one time several years ago over an accident that occured, while I was off duty! One of our drivers blew a red light with RLS on and broadsided a deaf, elderly gentleman who pulled out in front of them. The driver was DOA at the scene. I had to give a deposition because I am our services driving instructor. After 2 hours of "grilling" by the lawyers for the plaintiffs family, they made me feel like I was the one who killed the guy! The bottom line is.....SLOW DOWN!!.....ALWAYS STOP AT INTERSECTIONS!.....SLOW DOWN!....Take an approved emergency driving course.....SLOW DOWN!......Oh.did I mention SLOW DOWN! One more piece of advice I always give our new drivers, and also applies to all those new to this field......always remember, "The first pulse you check is your own"

Anybody want to add to my list of "Official Medical Abbreviations"? Here are some of my favorites........ DRT....dead right there DLE....dead like Elvis DWPA......death with paramedic assistance PIT...........paramedic induced trauma