EMT Martin

Speaking as a non-paid EMT...yes, that's right, a volunteer: Take her out of the system. ...not all of us are motivated to serve biased on what we can and can't get. And some of us don't even earn money to motivate us; some of us just do our jobs because we have high hopes that when we're in trouble, someone will come to our aid. My department still hasn't recieved H1N1 vaccinations; we've had them going out around us, just not to us. You don't see me throwing down my stethescope and refusing to answer calls. I have N95's if I feel in real danger. We've also had more than just one confirmed case in our area, thanks to the county fair. :/ Thank MFRI for keeping us up with that...

With an eighty year old male on my squad running day crew at a volunteer EMS squad, I say go for it! You're never too old unless you make it so. Welcome to the City!

He signed. He just didn't accept the canary copy that was supposed to be his. He -almost- walked off without signing. We do have officers document it when we can't get the patient to sign, per protocol.

Very unsure. The cops basically wanted him to just go about his business. The more and more I sat and stewed on it, the more I couldn't agree more. If I had to load him onto the ambulance and deal with him for a whole 25 minute ride to the hospital, I'm 99% certain someone would've pissed him off and we'd have had to break out the restraints. Which, honestly...isn't a fun night for me. I'm the 'big guy' on everyone's crew, and ergo, the de facto one who's supposed to contain a patient when they get violent. God knows I didn't want to be bashing on a hippy (should be noted he was wearing an awfully shagadelic tie-dye shirt and had long, I'm-the-son-of-God hair).

So I just got in from an...oddball 911 call. Ambulance 68 was alerted to the report of someone jumping from a car into a roadway. At the time of the dispatch, police had been alerted since the subject in question had run into the woods. When we got to the scene, we find the guy sitting on the hood of the deputy's car. No cuffs or anything, and the only visible injury is a small scrape on his arm. The patient's awfully beligerant, won't sit still while I'm attempting to auscultate his B/P, and is more concerned with saying he's just going to leave than anything else. Apparently, he and his girlfriend got into a fight and she'd hit him. After a half mile of being hit, he jumped. The last I saw before we cleared, deputies were simply advising the girlfriend not to go home with him as he walked away. Without his copy of a refusal, I might add. Guy wasn't ETOH either, ergo there was no reason for them to keep him. So here's the $25,000 question. Should we have taken him? I continue to think that it was better we didn't, but given that we had no idea the speeds at which he jumped, nor the police taking him, I wonder if we should've. Thoughts?

This issue has started to recently show it's nasty head in my squad. EMS workers are all for getting the piss tests. The fire guys aren't. Guess which side is doing more weed than the other? Why get high when there are so many other ways of achieving a false sense of smug superiority? That's the way I've looked at it. We already have a no-tolerance on boarding and manning any piece of apparatus while intoxicated to any degree. There's a specific command in our SOPs that states that if you drink, you turn your pager off and do not come to the department until you've slept it off. This says nothing for the installation party every year, though.

Take advantage of every free bit of training you can get. Period. It will help you in the long run of things. Also be prepared to go from highschool to college when you take those classes: things won't be easy, but the rewards are tremendous.

Agreed, wholeheartedly. I've got a repeat offender in my jurisdiction, who consistantly 'tries' to kill himself...but we take him everytime. I just make sure that the state and local law enforcement officers know that I want him cuffed or that I'm going to restrain him myself if they won't do it. It'll be that one time I think he's 'okay' that he'll flip out and attack my crew... But, yeah, I find most suicide attempts to be someone's attempt to get help because they need it. Best to let them go to the hospital for an overnight evaluation.

Definately a transport. As everyone's said; alcohol really throws out the red flags as far as mental capacity to make the conscious decision to sign a refusal. Furthermore, an attempt at suicide really is an altered mental status sort of area, isn't it? In that regard, there's no capacity to sign a refusal, at all. Add on top of that an altered mental status with the suicide attempt...and you've got grounds to transport. Would've asked the PD to assist and document what happened, as well...for legality's sake.

We use Strykers on all three of our ambulances, with a charged battery in the cot, a spare in a compartment, and a spare in the station on charge. This enables all ambulances to constantly have a charged battery, one way or the other. They are definate back-savers, as I've used some of the Ferno manual crap in neighbouring jurisdictions and hated them. As for stair chairs, we've yet to get an electric one. However, in one of the responses I made with a friend's squad on a 911, I got a chance to sample Stryker's version. It's a backsaver as well with the nice treads-instead-of-wheels business.

We have one of those neat, confangled auto-pulses. I've watched the EKG's when the medic shows up, and it's got a very consistant compression set down. Every spike shows up neatly as the last. But we tend to use a combination of EKG, femoral pulses, 12 leads, SpO2, and the old saying "if you're not breaking ribs, you're not doing it right." ...should be noted I haven't been on very many codes, though. Three.

Unfortunately, as a young guy, I can't really comment on the sleep routines. Some people, it gets to them...others, it doesn't. Of course, this is from the volunteer-side of things; four duty nights a month, 2100-0500 served time, et cetera. However, I do know that both vollies and paid have a lot of heavy lifting. In America, at least. With obesity on the rise and people unwilling to do much but laze about in their 'off' time, you often get the big people with chest pains/trouble breathing/et cetera that need you to lift them. If you're working on the volunteer side, no problem: call the fire department for hose jockies to come out and assist. Not sure what the poor, paid guys do...