SSG G-man

Funny this came up at my Volunteer station yesterday. I am in a county that is in transition. We are getting paid ALS as the funding is available. Though a volunteer I support the paid crews coming.

We were discussing how we consider ourselves Unpaid Professionals. We have running gear, and you better not be caught going on a call without it. We do not respond to calls in POV. We have training weekly, miss to many and you are gone. We have a leader who is a paramedic on one of the state patrol medevac helicopters who is always trying to keep us up to date.

I personally go out of my way to keep up to date on things. I read JEMS, attended EMSToday, ride with out ALS crew when ever possible.

On a side note about volunteers not running enough calls to keep skills up. I was looking at our call stats this weekend. December was our first full month with a paid crew in our station. Most of the paid crew members ran between 10-20 calls. I ran 30. So who is keeping their skills up.

I just had to vent a little thanks!!

Sarge

We have pretty good gear, especially considering we are a volunteer department. We have pants and jackets made by Globe, the pants are pulled on over whatever you are wearing.. We wear a department t-shirt with them. Then biggest change I would make is to make the side pockets more like standard EMT pants with the snaps and extra glove compartment. I would also like to have regular pockets like a pear on jeans. I hate stopping on the way back from a call and putting my hands inside my running gear to get my wallet or money out of my jeans. I think polo style shirts would be nice too, in addition to the t-shirts.

Sarge

I might comment if I was able to view the pictures.

This is a Lose-Lose situation. If you stop and get signed refusals and the original accident had a high priority patient you are screwed. If you pass the accident, call it in and go get the refusals and the accident you passed ad the high priority pt, you are screwed. This is a situation that I do not think will ever be a black or white situation. Has not happened to me, yet.

Almost did. On way to call told to stage in area because police in route, history of domestics at location. We were preparing to turn on the street to stage at corner, and caused an accident. One car saw us in the turn lane and stopped car behind did not. Minor fender bender. While checking them out one of the passengers started asking why we stopped if we were on way yo another call. One pt signed refusal because he did not want to miss the Redskins game. Had to get there to tailgate!!

Sarge

Damn, Pot this is kettle. I screwed up.

Wow, Dust you read a lot in the post. I see a statement of what she is doing and a request for information. I did not see any kind of plan which could suck. Not saying that your statements in and of themselves are not true, I just think you read more into the post than was there. I saw nothing to say "I am looking for the shortest route to my goals." Yes, she mentioned a bridge program, but that is usually just to avoid reteaching information people have from the previous education.

You arrive on scene of a rollover and the experienced Incident commander tells you with an odd look in his eye, "you guy is over there and he's really f*#%ed up!

Vehicle had rolled multiple times and ejected occupants.

Being in MD we have a great medevac system. Our state protocols list several categories of injuries which are to be used to start the process of should I fly the patient. To CYA, most will fly just about anyone who meets one of the categories. The nearest Trauma Center is close to an hour by ground, but we can get a patient to a local trauma center or Baltimore Shock Trauma in a relatively short period of time.

So I fly pts out when they meet the protocol category and I think they warrant it.

Sarge

I work part time at a MX track. Most of the METs ride ATVs with an aid bag. WE have one vehicle, I will have to check the make, we call the mule. We have LSB's strpped to the top ans can strap on down acrooss the back with the patient. Works well for our needs.

SARGE

Department just issued me steel toed ProBotts. Loving them. Lace in zipper. A Little heavier than what I am used to becasue of the steel toe. I think I am adjusting to them.

Well, maybe they put two sets of ALS equipment in the vehicle, so it could potentialy meet up with two seperate BLS units. Having double the number of vehicles may be too cost prohibabtive. Just a thought.

Sarge

I am a member of a volunteer department. Our department Chief and the deputy and assistant chiefs for fire and EMS are voted on. Our bylaws set up minimum training requirements. All the requirements are classes taught through the Maryland Fire and rescue institute. Right now 3 of our chiefs are also paid to do what they are volunteering for. Chief and one fireside chief are paid firefighters. Our head EMS chief is a paramedic on for Maryland State Police, who handle most medevac in MD. Below the Chiefs are Capt, LT and SGT. Once again there are requirements for these positions. Those interested submit letters of interest and the chiefs chose the officers.

Mostly the rank structure is used within the building. Most ranks correspond to different duties which must be accomplished and provide a chain of command to work problems through. I only ride EMS, so once we get on the scene, who ever is the OIC of the ambulance is in charge. If there are several crews, usually a command will be set up using ICS, so each OIC has someone to report to. Seems to work good for us.

If I did not make any of this clear enough let me know and I will attempt to clarify.

The fire guys at our station have a saying:

EMS: Everyone Moves Slowly

Well I could post something that says it is pornography, which would be tasteless, but what if no one followed the link. Then no harm no foul. Also, who is to define tasteless? It is like what a Supreme Court Justice once said, (I am paraphrasing) I can not define pornography, but I know it when I see it." Which I think proves the point all is in interpretation. You thought it tasteless, I found it funny. I should have known it was that kind of clip because the wife already stated the video was sealed!

Sarge

I admit the sick side of me had me watching. Pretty funny!

In addition to the box of condoms:

carrot, cucumber, pineapple, Ky, Tucks pads and preperation H.

But lee County probably has a bit bigger budget than the county I was describing. A rural, agricultural based county with a population small enough to support only one high school. I think county Pop is around 35-40K.

I am just surprised the VFD's in the county do not pick up some of the slack with ambulances. A first responder in a pov does not have all they need. In MVA is there a KED, backboard. IF it is inclement weather, no where to put pt for further assessment. Have a ambulance would help, I think. Maybe the county based EMS could provide ALS, which the response time would still be tremendous, or the county based system could stage units at VFD's throughout the county.

Sarge

When I started this I hoped to hear about other rural systems and how they worked. The sysytem I am in is different from the one I described where my mother lives. I was not looking for a pissing contest, more of an informed exchange of ideas, which is what I look for in most of these forums, other than humor.

This site has imparted a great deal of knowledge for me, and I am sure for others. Lets try to be civil and remember the spirit of the thread.

This was not started as a whos better rural or urban thread. Thanks!

Sarge

Ain't that the F'in truth!!

I do not think Police should base how they handle a situation on "PR". They should base it on training, experience and officer saftey. Not necessarily in that order.

Sarge

And the original intent of the thread was not to see who was better. It was to discuss the problems related to rural EMS systyems with long response times, etc. Maybe we should look back to the origianl topic and get away from the pissing contest!!!

Sarge

I have always felt it oxymoronic for any kind of healthcare professional to be way out of shape. Not only is it bad for appearing "professional" but can also impair ability to do the job. This is why I do not smoke in public in uniform. (trying to quit again)

Sarge

I guess it is only an issue if some needs ALS immediate and dies from the wait. I was surprised. I guess I did not pay attention when I lived there in my teen years.

I am just surprised none of the VFDs throughout the county have added EMS as a service. I guess the area I live in is not as backwards as a lot of us there think.

I visited the county my Mother lives in over the Thanksgiving weekend. I am considering moving back there so I made a few inquires about the EMS system, and was scared by what I heard. The EMS system is run by the county and all ambulances stage out of the hospital. This could result in a25-30 min or longer response time to some areas of the county. I was told there are volunteer first responders throughout the county who will POV to scene to be there until ambulance arrives.

I know an EMT is not much above a FR, and I am not sure if the county ambulances are all ALS or a mix of ALS/BLS, but at least there is more equipment on the ambulance. I am a volunteer EMT, but at least in my county when you call 911 you will get an ambulance with at least an EMT on it within a reasonable response time.

Has anyone ever known of a similar system? Just curious to see what your thoughts are.

Sarge