medicnow911

SHOCKING!!!! (get it??, hee,hee)

I was told it is known as "the closest car concept" and it is written into the Michigan 911 Legislation. I can't find the exact wording for it yet but the excerpts I have found basically say that in an emergency it is in the public's "best interest" to send the closest, most appropriate agency/unit regardless of jurisdictions, contracts, municipal aggreements, etc. The Michigan State Police initially were the ones to lobby for this because they were not being dispatched on calls due to so many County, City, and Township police agencies, but the legislation is written to apply to all emergency services.

Does anyone know the name of the law, public code number or whatever that states that the closest, most appropriate ambulance must respond to an emergency. My township has 2 fire depts in its midst and one is MFR and one is basic EMT. They always send the MFR unit because they like the crew more. Does anyone know where I can find the law? Thanks, I live in Michigan, if that helps

I work for a private EMS (ALS only) company. We employ about 25 Basics and 40 Medics. We are in the midst of a war right now, because it has come to light that there are about 9 Basics that are making a significant amount more per hour than some medics. I am angry because I make $12.22/hr as a critical care paramedic and a guy who hired on the EXACT same day as I did 8 years ago is making $11.07 as Basic EMT. He had 18 years experience as a Basic when he hired but has been unable to pass a state medic test and now has decided to stay a Basic. If I didn't have my critical care cert I would be making one cent less an hour than he is right now. I don't believe a Basic EMT should ever make more than the lowest paid paramedic. We only run ALS and company policy forbids EMT-B's from attending on even a KVO IV. (so we can bill ALS charge) The medics carry the responsibility, do most of the patient care and paperwork and get paid LESS! We had a meeting with management and they are leaning towards not doing anything. They don't have the budget to raise the medics wage and will not take wages away from the higher paid EMt-B's. There is talk of freezing their wages but it still burns me. Any advice?? Don't get me wrong, I value my partner whether he is a medic or basic. I blame my management for this not my coworkers.

Here in Michigan the EMS services follow the protocols written by their County Med Control. My service carries Dilaudid and Morphine for pain. Genessee County which includes the city of Flint is required by protocol to manage ANY & ALL pain equal/greater than "4" on "1-10" scale with Fentanyl or have good reason why they didn't. (Medics are complaining about the "frequent flyers" who have caught on to the game.) Detroit EMS ALS does not carry ANY narcotics at all.

My private EMS company runs nine 24 hour ALS units in the county we service. We have no basic units. Over the past few years the call volume has increased dramatically, but management has taken to hiring more EMT-B's and we rarely get to work with another medic. The paramedics work 24hrs on and 48 off. The basics can work either 12's or 24's. There is now a new company policy that basics cannot attend on a transfer pt. that has an IV even though it is within their scope of practice in my state under routine iv maintenance. I would speculate that 95% of our calls have to have a medic in the back. Management's motto is that if they are sick enough to call for an ambulance than they at least need an IV. So most of our calls are ALS. And it is not a billing issue. We don't fall into the BLS billing category for the insurances because we only have ALS rigs. So for billing purposes they get billed the same amount, IV or no IV. My question to all of you is how are you partnered? Do you have double medics on your ALS rigs? Our medics at our company are getting really burned out. Our company pages out for people to come in to work for double time when it gets busy or we have a lot of out of town transfers. We had a double medic crew 18 hours into their busy shift the other night and at midnight managent split them up and paired them with 2 basics that were getting paid double time to come in for the extra car. Well the one crew ended up taking a trip from a hospital 50 miles north of Detroit to the Cleveland Clinic. The medic that got stuck going on the trip and attending on the critically ill pt didn't get double time but the basic did. I'm just curious how other companies staff their units.

sorry, didn't mean to offend. Our med control" guidlines" give us 20 minutes on scene time. You can document in the report why you needed longer. extrication, large patient, whatever. There are, unfortunately, some people who will abuse it. There are probably even some medics, I can honestly say, I don't think CAN start an IV enroute. You are not going to be "tagged"by med control for a few minutes, but people who regularly take 30 minutes or longer are going to be questioned unless a legitimate reason can be documented. Our service area averages from 1 mile to 40 miles to the nearest hospital. I haven't had a problem staying within range of 20 min on scene time and we are an all ALS service with MFR non transport Fire Depts. My pt's don't just get thrown in my rig and treated with Diesel. They get all appropriate care and treatment.

Bring the gear in , in case it's needed immediately but the ultimate goal is to get them to the truck. Our medical control keeps a close watch on our "on scene" times. We don't "stay and play" too often

I think I'm a good paramedic and a very empathetic one too but when it comes to suicidal patients I have no tolerance whatsoever. My grandmother hanged herself when I was 8 y/o and I remember what my family went through. She was terminally ill so the family was somewhat understanding of her reasons. This past February my ex-husband, whom I was still good friends with, overdosed on Benadryl and his body was found two days after he "ran out to the store". He was found in the woods on the property of an Interstate rest stop. His truck was parked in front of the bathrooms with the keys left in the ignition. No note, no explanation. He was 33y/o and the father of my 16 y/o and 14y/o. He had remarried 18 mos before and had moved to Indiana so we hadn't seen him very much. Anyway ,whenever I have a pt. who threatens suicide or has made an attempt, I get so angry that I want to scream. These people have no clue what they would do to their family. The hardest thing I ever did in my life was to tell my kids their Dad had taken his own life. I am so angry at him. How can people be so SELFISH! Normally when I have this type of pt. I either have my partner attend the call or I bite my tongue during the entire call and barely say two words to the patient. Any ideas on how to relate better to these pt's without wanting to rip their heads off?

Pads! Even with the pads I'm standing on the bench seat in the truck during transport if I need to defib. During my paramedic class years ago I saw a Resident at an ER shock herself using paddles while working a code . We carry Zoll CCT's ,Pads are kept in the package until needed and we do have a set of paddles kept in a seperate equipment cabinet in the truck, just in case. I've never had any problems with the pads and all of the first responder departments use the same pads for their AED so we can just "plug and play"

Does anyone remember "Johnny Soko and his Flying Robot" ??? It was usually on after Ultraman. And don't forget about MASH and Giligans Island. Also does anyone remember a show called "Code Red". It starred Lorne Greene, Andrew Stevens, and Adam Rich. It was on Sundays.

We get requests for that all the time. It's even better when they "request shut down" prior to arrival. They want you there "NOW" but they don't want the neighbors to know.