crotchitymedic1986

No there is not a breakdown. I read every accident posted on the emsnetwork's website (http://www.emsnetwork.org/artman2/publish/ambulance-crashes.shtml) and compiled the numbers myself. I can tell you that the death numbers are probably much higher, as many of the injured people were reported critical at the scene (often flown), but there was no follow-up if they died or recovered later, unless you were interested in searching for all of those stories, and knew everyone's name (occassionally you would see a follow up story if multiple people died from the same accident over a 2-3 day period, but you know that many probably died in ICU two weeks later, and the obituary is all that made it to the newspaper). The overall numbers are also low, because this data only represents the crashes that made the news (as you are aware, many do not). I did not categorize by L&S or by who was at fault; my recollection was that it was about 50/50 for L&S versus not, and about 75/25 the other driver's fault versus the medics (other driver did not yield or was drunk more often). When it was the medic's fault it was usually during a critical transport or enroute to a critical call, that the accidents occured, so you can surmize that they were probably driving emotionally and not defensively. The numbers are actually lower than I thought they would be, but as I said throughout the year; most of these deaths were preventable, and just "1" death is too many. Also, I did this month by month, not all at once, and it may have taken me a maximum of 20-30 minutes per month, so now that we are starting a new year, you might want to start keeping a runnin total for your department.

Man do i have an invention for you, unfortunately I can not find a link to it, but this product is very similar: http://www.buckleboss.com/ It is a buckle guard that covers your stretcher belts/buckles, so that the patient can not unrestrain themselves. If you are using the over the shoulder harneses, along with abdominal and leg/knee belts properly, it would be difficult for a patient to come off of the stretcher during transport. Even if they do, it will take a few minutes of them trying, which gives you the chance to defend yourself or get out of the vehicle. I am not a proponent of abandoning the patient in the vehicle while you watch them tear up your rig, as when they escape into traffic and get hit by a car, you will have alot of explaining to do (not advocating you put your life in risk, but its kind of hard to garner public sympathy when the patient is dead, they had no weapon, and you are scratch/bruise free). You should also google the old Merginet article "Positional Asphyxia - Death By EMS", as it is a very good and indepth review on how to deal with these patients, proper restraint, and improper restraint. P.S. There are several soft buckle guards used for children, I am recommending one that is solid steel, and very heavy duty. The one i am thinking of is simply a steel rectangle that encompases the seat belt female coupling, with a slit in the middle that is big enough for a car key to fit through (can use any key or straight/slender item to go through the slot and push the orange seatbelt release button).

The totals for the year are as follows: There were 207 serious ambulance accidents reported to EMS Network Those 207 accidents have produced the following: EMS Personnel Injured: 191 EMS Personnel Killed: 5 Patient Injured: 39 Patient Killed: 9 Passenger in Amb injured 3 Passenger in Amb killed: 2 Other Vehicle Injured: 119 Other Vehicle Killed: 20 Pedestrian Injured: 3 Pedestrian Killed: 4

How in the hell did this get to be about Obama's vacation ? Anyway, lets redirect to the 800lb Muslim in the room. I hear this morning that Canada will no longer allow carry-on luggage due to this latest fiasco. On all the Sunday morning TV talk shows, I heard people ask why we are not profiling muslims ? As many of you have described, we are focusing on the wrong people due to political correctness. Not all muslims are terrorist, but it seems that 99.9% of all terrorists are muslims. Being of the african american persuasion, I know what it is like to be profiled for no other reason than my race (DWB, driving while black), so I can not be impartial on this subject. What say you guys, is it time to start profiling every muslim on a plane ? I heard another news story about some muslims on another flight who scared the other passengers by talking loud in a foreign language and watching explosions on their laptops. So they seem to think this is all a big joke.

Taking pictures of an accident scene is wrong on so many levels. "Hey Roy, can you turn the patient's head a little more to the left while you are holding C-Spine there, I cant get his other eyeball in the shot" ! If you feel the need to keep trophies, you need to get out of the business.

I am about 99% sure that this is as bad as it sounds, but the articles do not mention what type of injuries the victim had; ie.... shot in the head and brains all over floor = dead, shot in the chest and heart laying on floor in several pieces = dead. But it brings up a question, I know medics who will not run a strip on someone that is obviously dead just in case there is some PEA still going on. Then there are those who feel that you need that strip on all dead bodies for proper documentation. What would you do if you responded to a decapitated patient; run a strip or no ?

On or off shift does not matter, the facts of the call are this: 1. You did not cause the injury. 2. If the neurosurgeons could not save this person, then it is doubtful that a paramedic/emt could either. 3. You mention mistakes were made, but again, those were not made by you; they were made by others. If you could magically go back in time and respond to the call, I am guessing that there is a 99.99% chance the outcome would still be the same. Maybe the call would have been smoother, maybe you would know that EMS did all that it could do, but massive head injuries rarely have a good outcome no matter what is done. There is only so much that we superheros can do. A famous quote can be borrowed from the TV show MASH that relates to this issue: "1. Young men die in wars. 2. Doctor's can't change rule # 1." The same is true of EMS, definitely go talk to a counselor.

What were the little cars called that were like a demolition derby; you ran them into each other and the fenders and hood would fly off ? Couldnt get that through today's safety standards (flying objects could cause eye damage), but atleast I am pretty sure that it didnt contain any toxins in the paint, as it was probably american made -- maybe ? And who had the glow in the dark monster models (frankenstein, werewolf, dracula, swamp creatures, godzilla, kingkong) ?

This will sound like a smartas* comment, but it is not intended to be one: "Please stop working 48 hour shifts" ! I know you may feel as though you have to, but it is the quickest way to burn-out that there is. I have always told newbies that if you took a job that just required you to watch porn for 100 hours per week, it would not take too long before you would be tired of porn. It is no different in our job, and the long hours are just unhealthy. Please try to cut back, as there is a future full of people who will need you to respond in their hour of need; you may not be there if you continue to work this much ?

Follow your heart, like the commercial says, if you do what you love you will never "WORK" a day in your life. Dont worry about money as your decision driver. But if you are getting into EMS, you really need to go for EMT-I, then Paramedic. Nursing and EMS are getting more aligned: CNA = EMT B LPN = EMT I RN = Paramedic.

Please bring me a "SWAT" lunch box, a Stretch Armstrong, and a Big-Wheel. My brother would like a Coleco-Vision hand held football game, a huffy bicycle,and a "pong" game for our Tandy computer (these computers dont do much Santa, not sure they will last long, if computers are just a passing fad, he would like a Farrah Fawcett poster).

Try being an over-the-road truck driver, gone for 21 days, home for 3-4. Or try being in the Military stationed overseas. We got it easy, quit your bitching. And Paramedics and Firefighters do not get divorced because of their job, they get divorced because they have sex with other people (usually at their job).

I have heard of several of these companies, and saw a show on TV that highlighted one, but not sure if it was the A&E show that people referenced. From what I can tell, it would be very difficult to be profitable, as it did require more work than I envisioned. As mentioned, you have to be capable of removing whole sections of carpet and drywall while in a hazmat suit, and then replacing it. Then you have to find some place that will accept the hazards you removed (the local landfill apparently isnt thrilled about accepting your king size, blood soaked, mattress). I have no idea what they do to get the smells out of some of these dwellings. Although I can see the demand, I am not sure the typical homeowner could afford such a service, and I doubt the manager at your local hotel would be willing to spend that kind of money or file an insurance claim when he could just get the maintenance man/maid staff to do it.

I know there are semantics and generalities in your statement, but you should always treat the patient before you treat the equipment. When I started out, we did not have glucometers, pulse oximeters, or 12 Lead, and it amazes me to see how many Paramedics trust the equipment over patient presentation, history, and signs and symptoms. The first thing I did for any new Paramedic on my truck was to take all of that equipment away, so that he had to assess the patient first.

Yes, in my humble opinion, the 12Lead in the field is useless unless you carry thrombolytics on your truck, and use them. My rationale is that it rarely changes out-of-hospital or in-hospital treatment, WHY: 1. 99% of patients will be treated the same way in the field regardless of what the 12 Lead shows; do you withold NTG, O2, and MS because of a negative 12 Lead ? NO Do you not transport due to a negative 12 Lead ? NO Does it change where you transport the patient to ? In rare circumstances yes, but I hope that you do not transport chest pain patients to hospitals that do not have cath labs, regardless of what the 12 lead says. 2. As we all know, 12 Lead changes may not occur until many hours after the onset of symptoms, so a negative 12lead 20 minutes after the onset of symptoms means nothing. 3. Positive 12-Leads in the field do not speed-up door to needle times or door to cath lab times in most facilities. Most facilities already have time parameters for these patients regardless of how they arrive. The hospital will still redo the 12-lead, and will not call the Cath Lab team until the hospital 12-Lead has been read. 4. But rather than me blather on and on, please provide any scientific proof that you have that shows that 12-Leads done in the field increase survivability or muscle. Who knows, maybe I am wrong, but I doubt it. 5. If you want to invest in something useful, ditch your 12leads and buy Istat machines so that you can do a cardiac lab panel on the truck. But even those levels may not rise right away.

You guys are kidding right ? You would withold treatment that could help for a diagnostic test that is worthless in the field ? Let's try this thinking in other situations: You have an arterial bleeder; do you put pressure on the wound or do you wait until you have a blood pressure palpated ? You have a COPD patient with serious respiratory distress (tripod, cyanosis, accessory muscle use), do you put on the O2 and start an IV immediately, or wait until your pulse ox confirms distress ?

You guys are totally missing the point on this one. A small percentage of doctors have decided to go into private-private practice for those who can afford it. No one is forced to see these doctors, it is a choice among patients, who have to decide "do I want to pay more to get a higher level of personal care ? No one's doctor has been taken away, those who want to use traditional insurance for medical care, can still choose many physicians to see. These doctors have just chosen a different business model that allows them to provide more personal care. Its like this, I use an oil change place that charges about $45.00 to do an oil change, but with that oil change, my car gets fully detailed (cleaning) inside and out. Now there are plenty of places that I can get an oil change for $29.95 or less, but I just get an oil change. For me, it is worth another $15.00 to get my vehicle washed, waxed, vacummed, and have all of the glass cleaned. If you can not afford $45, then you can change your oil yourself, go to a cheaper oil change place, or go to a standard oil change place, but wash your vehicle yourself. The fact that I paid an extra $15.00 does not mean that your oil change is not as good as mine, or that you have been wronged. I have the means to pay more to get more, and I spent my dollars to attain that. When you supersize your value meal, you get more than the standard guy who just orders the value meal. Under you guys thinking, this guy just starved because the other guy paid more for his meal. They both ate !

I know we agree on little, and that I know that I have made many of you curse in 2009, but I still want to wish each and everyone of you a Happy Thanksgiving. I hope all of you have the chance to celebrate Thanksgiving in a way that brings you and your family closer together. Eat too much, laugh too much, care too much, make every moment count, and I hope that we all have a better 2010.

There is nothing elitist about this, it is just the free market working, and it has been around for years. Following you guy's logic, there would be no need for any vehicle with more standards than a Ford Focus. If you can and are willing to pay for a BMW, Lexus, or Mercedes does that make you elitist because some people can't ? If you do not eat Ramen noodles at least twice per week, are you elitist ? If you can afford a good steak restaurant instead of Krystals are you elitist ? How many times have you been really sick, and called your Doctor to find out that they were booked solid ? How many of your Doctors will call you in a script without seeing you, or doing a bunch of expensive labs you dont need ? And this is great for the Doctors because they dont have to see 40 patients a day just to keep the lights on (because insurance reimbursement sucks).

I have noticed that the concern over lawsuits frequently creeps into many categories of questions; whether or not you will do a certain procedure, the problem with protocols or lack of protocols, when to use medical control, or how you document to protect yourself. Then I asked myself, "Crotchity, is this lawsuit fear a founded fear ?" I got to thinking about it, and I could not recall one person that I worked with who had ever been sued over patient care issues. I know some that were sued, but all of those were over vehicle accidents, not patient care issues. So how real is this boogey-man ? Do you know someone personally that has been sued ? If so, how many ?

Are you actually saying you would want your child to be taken care of by a sex-offender if she ever needed an ambulance ? Just because you forgive someone, does not mean that you have to employ them. Would you send your dog to a neighbor for the week, who has been charged with animal cruelty ? Would you let a sex-offender teach or babysit your child ? Would you give your identity information to someone who has been convicted of identity theft ? But since you asked, I believe it is God's job to forgive them, not mine.

I seriously doubt your instructor has actually shocked 300 infants in his career, but his point is correct. Shockable rhythms are rarely seen in children under 1 (unless you count tachycardias, but you shouldnt be shocking those, or if they had a preexisting cardiac conditions). The question you have to ask is one that has been asked before on here, in any situation, where are you most likely to get into trouble ? Not everything in EMS is black and white ? In this scenario if you had a child in V-Fib, do you think you would get in more trouble for using the equipment you have on hand to try to save the child, or letting the child die because you had issues with AHA guidelines (or protocols), or lackthereof ? This is what Medical Control is for.

It varies by the type of insurance the company has. Smaller private companies tend to purchase the cheapest insurance, which will also have a higher standard (may not allow anyone under 21 or 23 to be employed even with good record). Many municipalites may choose to be self-insured, which could have much more lenient standards; then there is everyone who is in between. Most insurance companies will pull your full 7 year record, and my guess is you are somewhere in the middle of bad and OK because of 3 violations in 6 years, but luckily you havent had any recently. The following study (didnt have time to find the original, but you can google from what you read and find it) shows that EMS folks who have had an accident or moving violation in the last 3 years are far more likely to be in a fatal ambulance wreck: http://www.emsresponder.com/print/EMS-Magazine/Ambulance-Crashes--Fatality-Factors-for-EMS-Workers/1$1796 Quote: "Nearly half of the ambulance drivers in all of the fatal crashes (both overall and among those involving EMS worker fatalities) had some kind of collision or moving violation in the three years before the fatal event. Several drivers had more than one offense listed in FARS; one in particular had been cited for speeding five times, had had his license suspended or revoked five times, and had been convicted of one other moving violation--all within three years prior to his fatal ambulance crash. The authors of a study examining 11 years of fatal ambulance crashes were similarly taken aback at the high numbers of previous citations among drivers of ambulances involved in fatal crashes."

I did the same, if it effected the time intervals of the call, I just documented in the notes that daylight savings had occured; Dispatched at 01:59 and arrived at O1:08

How do they pass the national registry or state exam if they do not speak english ? Please tell me that your state does not offer the test in foreign languages.