crotchitymedic1986

How about this instead -- lets lobby medicare for a new billing rate: BLS, ALS1, ALS2, and FA. FA will be the fatass charge we get to charge any patient who is in excess of 300lbs. Then we could also add the FA2 charge which would be for a fatass that lives on a floor higher than the ground floor. The medics and firemen who run the call get to split the FA and FA2 charges.

The reason you make double in Alaska is the same as those who are making double in Iraq -- no one wants to go there, so they have to pay a premium. The same would happen everywhere if medics quit working 100 hours per week --- our pay is a supply and demand equation, we just wont let the true lack of supply be seen, so our pay stays stagnant.

Being against the law is news to me ---- its usually because many EMS agencies are private or not government based, and since we are a younger industry, we dont have the traditions that fire departments do. But i have seen EMS bodies transported via ambulance, with the long ambulance procession, reading of the "Last Call", and playing of amazing grace or other songs via bagpipes.

Dont be a EMTCITY STALKER, hiding in the bushes, come out and play. And most of those people who criticize others dont know their ass from a hole in the ground. Thats how they boost their pitiful egos, by trying to be superior and by putting others down. Its like how you can always spot the worst medic on a mass casualty scene -- its the one that is yelling and screaming at everyone else. So when the so-called intellectuals bite your head off in here, just realized that they are lonely, miserable, people. Feel sorry for them, dont let them chase you off.

You dont have to respond to any post, but it would be nice if you would post something from time to time. Just reading and not contibuting is like being one of the oooohhhh--aaaaahhhhh bystanders on a scene, or the firefighter that sits in the truck when everyone else is working.

I agree with you ltchick, this number is completely backwards from what i expected. Maybe times have changed ????? Nah, I think some people are lying cause their spouse reads here too.

Aeortic Aneurysm (higher up) or left sided heart failure

Sorry, not trying to insult anyone's intelligence or skill level with my "rules of transport", it is just that it is these patients that medics typically get in trouble with (rookies and veterans) due to the absence of the ability to do x-rays or labs. Almost every horror story of the patient that should have been transported and wasnt, falls into one of those groups. And lets face it, in alot of systems the new guy gets put with the asshole no one else can work with (after orientation), who is likely to be lazy and not transport patients that they should. Its a bad situation to be the rookie medic and new employee who is questioning the crusty veteran who has been doing this for 5-20 years. And arizona gave you a good pointer there about a deep breath -- I would only add, when intubating, suctioning, or bagging a patient, dont forget to hold your breath until you have ventilated them. Patients dont get brain damage because medics fail to intubate them, they get brain damage because medics fail to ventilate them. If you hold your breath every second that a patient isnt being ventilated, it will remind you to get back to bagging (rookie medics tend to dig around in the airway for 2-3 minutes before they remember to ventilate the patient again).

BUT YOU HAVE 10 FINGERS, so you should type 5x as much as you read ---LOL . All answers posted so far are valid, but to me, it seems like there are about 25 regular posters of topics and hundreds of readers. I am not advocating that you respond to every post, but rather I would like to see some of these readers get off of the bench, and put some good topics on here.

You dont have to live in a rundown house cynical. How much are your car payments ? You only have to look back at your grandparents and parents --- most didnt have a new car or a mortgage until they were in their 30's. But we have to have a 250k house and 600/month in car payments before the age of 25 now. Other things you might waste money on, that many see as necessities: How many EMS folks have: 1. A cell phone bill that is over $100.00 per month (along with a home line that is 50-100/month) 2. An internet bill of $20-50/month 3. A cable/satellite bill of $50-100/month 4. A huge expenditure on meals at work, instead of brown-bagging it. 5. $20-50/week tobacco habit (or more). 6. $ 5 /day at starbucks. 7. A house that is way to big or expensive for their family --- When the foreclosure mess first hit, i remember seeing a teacher on CNN who was bitching cause she was loosing her house that she mortgaged for $370k, when her and her husband had only $72k in yearly income --- DUUUUUHHHHH I am not saying it is easy to live off of $40k, but most families do -- you just might have to wait on buying the biggest and the best until you have saved money.

With what has been presented, I would rule out in this order: 1. MI or AAA 2. Left sided Heart Failure 3. PE (already semi-ruled out) 4. Spontaneous Pneumo (maybe 10-15% at this point, so still satting well) 5. Pleurisy / Pneumonia / Lung CA or GI event

Post after post, i see that 200 people have read it, but only a handful ever type a response. Look down the line of all the current threads --- very few responses, but lots of reads. I know it is better to stay quiet and let them wonder if you are stupid, versus speaking up and proving you are stupid, but there is supposed to be some dialogue here. Speak UP !! Opinions are like buttholes, everybody has one.

Used both, prefer Phillips for 911. Cant get the wavy baseline out of zoll, Medtronic to bulky. Prefer Zoll for transport service

Good choice, and by the way, how the hell did it get to be our job to weigh dialysis patients ? I dont need a weight, i say lets revolt and tell them to weigh their own damn patients.

I would be very careful about what you ask for, as federal regulation of any industry has rarely resulted in a positive outcome. Look at education, DOT as it relates to truckers, VA Health Care, Medicare, Airlines. Can you name any program that the Feds have improved ? I think taking local control away would be very dangerous.

Not sure if this is it, but this is what google brought up: http://technorati.com/posts/vSVP2AXNI45kn_...ItXE4tqhBkG0%3D

As stated before, if only people who truly needed ambulances called ambulances, we would all be out of work. Flagrant abuse should be penalized, but stupidity shouldnt. If you are a plumber, part of your job has to do with dealing with other persons feces. If you are a cop, part of your job is directing traffic in the rain. If you are in EMS, part of your job is dealing with those who use it as a taxi, or a mobile minor illness clinic. The sooner you stop letting stuff like this control your blood pressure, the longer you will live, and the happier you will be --- Serenity Now !

Unfortunately, you have just died, and due to your evil ways, you have been sentenced to EMT/Medic Hell for the rest of eternity. The good news is that you can choose your hell, which do you choose: 1. Dialysis Hell. You do nothing but dialysis transports, and the clinics in hell dont have the stretcher scales, so you have to lift every patient into a wheelchair, weigh them, and then place them in the dialysis chair. 2. Standby Hell. You are on constant emergency standby at scene, but you never get a patient. You must sit in your truck with the partner from hell (300lb female medic who loves her cats and romance novels, but never shuts the hell up. When she isnt complaining about something, she is boring you to death with endless, mindless, conversation). She smells like ass and chain smokes in the truck. 3. Code Brown Hell. You get to transport only nursing home patients, all of them long distance, but everyone of them waits to get in the back of your truck to take a massive smelly dump, that you have to endure for the whole transport (if you clean them up, they just dump again). And in hell, their dumps dont smell like the normal dumps, they smell like lysol, puke, and shit combined. Which hell do you choose ?

Referencing sealed cabinets versus sealed tubs: The company i was talking about started with sealed cabinets, and found the same issues you discussed, which is why they went to the smaller sealed tubs. It was easy to pick up the unsealed tub to see if you had 8 NRBS or 2 left. It was your truck, and your responsibility to keep it stocked. Obvioulsy the reserve trucks had to be checked more closely, as they would get raped while sitting at the station. But having an open and stocked supply room, cut down on the need to steal from other trucks. As far as the list of equipment the poster put up : It seems that you are working for a service that is cutting corners. You really need to think about whether or not you want to stay with them. Where else are they cutting corners -- No workers comp, no vehicle insurance, no liability insurance or insufficient amount ? Will your paychecks cash next week ? Are they paying your taxes to the feds, or pocketing that money ? Are they commiting medicare fraud to maximize billing ? It is not uncommon with this type of company, to come in and find the doors deadbolted and chained by the feds.

Varies person to person, I always liked acronyms (like SAMPLE), poems, or songs --- for instance, the old vfib protocol was remembered with this short song or poem: Shock, Shock, Shock, Everybody shock, Little shock, Big shock, Everybody shock. Where shock was the 3 progressively higher defibs Where the e in everybody stood for epi L in little stood for lidocaine B in Big stood for bretylium Also note my message for Heart Blocks under the student section, same logic. But in some things, I just had to write it like 50 times to get it to stick in my head --- flash cards were also useful. You have to figure out what works best for your brain

You only have to go to 48s if you chose too. You guys can stick together, resign all on the same day and get it reversed if management will not listen to you. You should bust up one of your 24 hours into two 12 hour shifts (can use the 6 that are on it now, and add 2 part-timers or people on OT to cover the extra shifts) . Then the night 12hour shift can run those long ones.

One of the best layouts that i saw was a service that had all of your softgoods sealed in plastic storage containers (everything in the interior cabinets --- This was a shoebox size rectangular bin with a lid on it). This allowed you to quickly check those cabinets; if all 20 something tubs were sealed, you were good. If not, you replaced the unsealed tub with a sealed one from the supply room (tubs were numbered, and were universal -- tub #2 had the same supplies in it in all trucks). This just left the exterior compartments, jump seat compartment, ALS equipment to check. You could check a truck in less than 10 minutes if everything was there. Most states have a list of equipment that is required for an ambulance to get certified, and a critical list of what must be on it to roll out the door everyday. My philosophy was, is it nice to have, or NEED to have. I can run calls without tegaderms and INT caps. I cant run without oxygen, a working laryngoscope, a working cardiac monitor, etc...........

You have to love the Union. I wonder how pissed they will be when they privatize the EMS ?

You can live off of one EMS salary (as long as you arent EMTB), you choose not to live within your budget.

To answer your question, everyone will be at fault --- we are fortunate that this has not become a bigger problem, probably because lawyers havent thought to look at total hours at work in a week's time (full-time and part-time). As mentioned above, many hospitals have changed their residency hours to something much more reasonable (it was nothing for them to be up 36-72 hours with little sleep).