thrutheashes

I wear these boots, http://www.511tactical.com/All-Products/Footwear/8-Boots/XPRT-Tactical-Boot-8-Boot.html, produced by 5.11. They cost a bit more, but they are bar none, the best lasting, most comfortable boots I have ever worn. I would recomend them to anyone in a heartbeat. best feature they have? the protection over the toe that prevents your toe getting scuffed to crap, and making your boots look horrible. Must have piece of kit, in my opinion.

That was an oversight in my post. I was off work due to a fractured bone in my left foot. And since I've been back have been having a hard time getting back into the swing of things, as per my first post.

Hey all. I'm writing because I feel like I am in a slump. I just returned to work after a 2 and a half month absence, and I in all honesty have been having a hard time getting my head back into things. I have yet to do a run report that I am happy with, am having a hard time getting myself motivated to do our hall duties, and am in generally feeling blah. I don't know if this is depression, a demon I have battled before, or something else. This does have me concerned, because I love my job, and just don't know which way to go, just want to get it rectified before impacts my patient care. Thanks for letting mr rant.

Definitely sounds like the town I live in. We bought our house in October, and when giving directions to locals,I still have to reference the house by the previous owners in order for people to have half a clue as to where I live. The sad part......I live right behind the hospital...............

Fred, I've heard stories like that. Smith always got riled that, after 25 years living at a place the locals called the Jones' place, after a previous owner. He finally sold the place. After another 25 years, with the Brown family, and then the Green family, living there during the interum, the place was owned by the Dworkins, who complained to Smith, that the locals were calling it the Jones place.

As much as it is the responcibility of a caller to get you there, it is your responcibility to find your way. This is why I take my own local awareness seriously.

When you work rural, you have too learn all the major landmarks in the immediate area. The locals may call a large body of water "Bare-ass-beach", and you may one day get called to the south end of that beach. If you have not made yourself aware of the local hangout, that is your problem. You now have to deal with locals trying thier best to describe where they are.

I fully agree with there, Mobey. We need to take some responsibility ourselves. That's why we en devour to keep our maps fully updated, and new hires get oriented to our area. However that only goes so far. One of the first, and most frusterating calls I had working for a service was a cardiac call. They had beautiful directions. However they substituted west for east, and we were half a county the wrong direction before we/dispatch/the caller managed to get things straightened out and get on the right path. this despite having the directions confirmed four times, and requesting for the legal land four times. This was all on an industrial site. They should have had that information readily available. They didn't. And no one thought to run outside and check the sign on the flipping bldg. Our already crappy response time, as they were in a spot near the edge of our response area, was turned even crappier because they did not know where they were. The patient did not survive. would he have survived had our response not been more than doubled due to lousy directions?? Who knows.

Mobey, you and paramedicmike both have valid points. However why can we not educate the public on the importance of knowing or having ready access to this information. Not only for us, but for other emergency services as well. Yes breakdowns in communication will happen. But are we doing everything we can if we see the problem and don't try to educate people on it?? That's the whole purpose behind this thread. Not to bitch and gripe about crappy directions and people not knowing where they are and expecting help. It's about trying to figure out what we can due to educate the public on the importance of this issue, and try and keep the crap directions and "I don't know my legal land, but turn at the burnt out field" sort of comments to a minimum. To be honest, if we only reach 10% of the people in our area, it would make a change to our calls.

I thank you for correcting me there. However, that does not take away from the point I was trying to make. We are only as good as the information we have, and if the info we get is incorrect, it doesn't matter much about the technology. A lot of people can save everyone a lot of grief just by knowing their address.

I just want to point out two errors.

First if the e911 system is not correct, whoever handles 911 for your area needs to get with their ANI/ALI provider. That is their responsiblity to keep correct, and when errors are found they should be fowarded to them.

Secondly, there are several modes of GPS on cell phones.

All new phones can transmit exact satellite based lat/lon to the 911 node. The only error in those coordinates would be on par with error in your GPS in your car.

Some phones/carriers can triangulate positions. That also comes with a decent rate of reliability. Also 911 centers can contact cell phone companies to get subscribers name and addresses in cases with extigent circumstances.

Finally, old cell phones send the tower location to the 911 center.

Just wanted to clarify some statements you made.

We all know that rural EMS has it's challenges. The shifts where absolutely nothing happens. Followed by the shifts where you don't stop moving. Some challenges are easier to deal with than others. But the challenges of trying to help people help themselves has become a sore point with me lately, and it' s due to issues that I have dealt with off the job, however if dealing with them on the job the consequences could be disastrous for the pt's.

While ferrying my sister's friends all over the country side, I've been asking for range road numbers, or township numbers, and instead I get the typical "turn at the red barn (conveniently repainted white), turn at he rock, first house on left in the second driveway on the right." Confused yet?? For providers who grew up in the country, and are still working in rural, you are definitely a rare breed, and have some idea what I am talking about. For the good chunk of providers that come into the boonies to gain experience, before heading off into the nicely organised city, you are confused as hell. And after dealing with the third or fourth such interaction such as this in under a week, it got me thinking, if you don't know where you live, how do you expect people to come help?

Sure, home phones are supposed to be tagged with Legal Land descriptions that show up with e911 systems, however as one of my colleagues found out the other night, they are not always up to date. Cell phones can be traced via gps.......if the phone is tagging enough cell towers. In december I had pleasure of responding to someone who kept giving the wrong address in town, was calling from his cell phone, and when 911 attempted to gps the phone, it was showing 3 miles away in the middle of a field. So GPS is not the most accurate way either.

So ruling out telepathy, how are emergency services of any variety, expected to make their way? Yeah, the directions work most of the time, when it's good visibility in the middle of the day. However at 2am in the middle of a blizzard, I dare you to find those same landmarks.

I am looking for ideas for a public awareness type campaign. Something to get people thinking about knowing their locations. So far I'm thinking magnets/stickers with a place to write Legal land descriptions or street address's and directions on it. If anyone can come up with any constructive or different types of idea's please let me know.

Thanks,

thrutheashes

That joke is completely, totally, and utterly horrible.....I love it!!!!ROFLMAO

THE BLONDE MORTICIAN

A man who'd just died is delivered to a local mortuary wearing an expensive, expertly tailored black suit.

The female blonde mortician asks the deceased's wife how she would like the body dressed. She points out that the man does look good in the black suit he is already wearing.

The widow, however, says that she always thought her husband looked his best in blue, and that she wants him in a blue suit. She gives the blonde mortician a blank check and says, 'I don't care what it costs, but please have my husband in a blue suit for the viewing.'

The woman returns the next day for the wake. To her delight, she finds her husband dressed in a gorgeous blue suit with a subtle chalk stripe; the suit fits him perfectly.

She says to the blonde mortician, 'Whatever this cost, I'm very satisfied. You did an excellent job and I'm very grateful. How much did you spend?'

To her astonishment, the blonde mortician presents her with the blank check.

'There's no charge,' she says.

'No, really, I must compensate you for the cost of that exquisite blue suit!' she says.

'Honestly, ma'am,' the blonde says, 'it cost nothing. You see, a deceased gentleman of about your husband's size was brought in shortly after you left yesterday, and he was wearing an attractive blue suit. I asked his wife if she minded him going to his grave wearing a black suit instead, and she said it made no difference as long as he looked nice.'

'So I just switched their heads.'

( I BET

YOU DIDN'T

SEE THAT

COMING !!!)

Well despite the obvious American references in the song, I think that it can be equally applied to politicians anywhere, US, Canada, anywhere. Because, let's face it, politicians, and morals do not go hand in hand!

Your opinion on the new protocols people? Its my first week back after holidays, so haven't really used any new drugs/equipment yet. However, I see major problems on the horizon with the regressive new on line medical control (OLMC) that we need to contact for certain treatments. Yesterday our crew needed to contact a doctor simply to talk someone into going to the hospital, we had to go through one automated menu, and two different human dispatchers, and one dropped call before a doc even got on the line. With all the waiting it was about ten minutes to connect. Sad.

and let me guess......you were reprimanded for being on scene too long?

I agree with you mobey!

I wouldn't worry about the ability to handle the job, especially if you have dealt with similar type situations in an emergency setting. What this guy did just strikes me as plain nasty, and without reason. I've always been a believer of pushing people slightly past their comfort zone, but this is going through that and throwing them right off the proverbial cliff.

I would register a formal complaint with the school, at minimum.

Do you know if anyone else was affected by this quack's slide show? Like Mobey said...a petition going to get this crap stopped is not out of line.

Take Care

Thru

I just want to say for the record that I do not support euthinasia, and I also know that if my own elderly family were involved I would hope to have everything possible done for them. The transfer yesterday just had me thinking from the other side. How much care is too much? Etc. Just food for thought.

Thrutheashes

Hey everyone. I had a call today...ok, a transfer today....that got me thinking.

Was was 92yoF query Abdo obstruction, going from a small tertiary care centre to a major facility for a surgical consult. All in all patient was in relatively good shape, only major exception being the pace maker implanted in the summer. That said the patient was in reasonable shape...for a 92year old. Her hearing was going, definite 1 person+ assist to ambulate, even with a walker. And this was before the questionable blockage. Cognitively she was ok, but according to daughter starting to go.This is the part that got me thinking.

I got into EMS in order to help people, and I love my job. However I couldn't top myself from feeling horrible for this poor patient. Here she is, 92 years old, living in a nursing home, going to see a surgeon for invasive surgery. I know we can't, nor should we, deny the patient the care. But are we really helping her? Or as a medical community have we become so driven to preserve life at all costs, damn the consequences? All of that being said, let me play devil's advocate. We decide to reduce the surgcal interventions in seniors for the "good of the patients". How does medicine decide who they will help? Age? Weight? Predisposition to medical problems? Or previous medical problems? Or how about, better yet, social standing?

I'm probably going to get called out on this thread, however I needed to vent, because, for whatever reason, despite the many geriatric transfers I've done before, this one is kinda bugging me. I know there is no right answer to this topic. Or an easy answer. However I would appreciate any thoughts or feedback anyone has.

Thanks.

Thrutheashes

I\m pretty sure the comedian Bill Engvall did a bit on this very topic. Something along the lines of his plane hitting a deer, him calling his wife and saying "honey, my plane hit a deer" and his wife responding, "Oh my God, were you in the air????"

I never ceases to amaze me the crap that people will make.....or buy.

I read an article here awhile back, I believe it may have been in Jems. Any way the article shed light on why a paramedic/emt crew is BETTER for pt care than a duel paranedic crew. Quite simply, it is a matter of roles. EMT strength is in the BLS call. The assessments. The silly little things like ABC's etc. Whereas paramedic strength is in the ALS calls, performing the invasive procedures, pushing the medications. The article pointed out that paramedics spend so much time learning all the new sklls, that the in a lot of cases BLS skills are lost. I'll see if I can find a link to that article and post it here later. All I know, though, is that what it said made sense. The cost savings are an added bonus, but in my opinion not the only benifit to a medic/emt car.

edited to add link:

http://www.jems.com/article/patient-care/back-basics-lost-art-bls-care

While I've always been of the opinion that needles of any sort are better to give than recieve, doing I.V's on someone else are way better than doing them on an IV arm. As well, yeah, you may get some bruising, you may get some pain, but it's all short term stuff....and it gives you a connection to your potential patient's, because you understand first hand the difference between a good stick and a bad one. You'll know how much it hurts if you have to fish for veins...vs. those who have just have practised on IV arms.

While I think the councillor is being ignorant, let's not freak out here folks.

First, for him to get any traction on this he has to first get past the relevant legislation that requires siren use. In fact, I bet if he thinks it's bad right now, the crews can start following the letter of the law and using their siren constantly rather than intermittently, as needed to clear traffic and intersections. Second, EMS in Alberta is (and specifically Edmonton) is provincial. I don't see them changing their policies jurisdiction by jurisdiction to placate local politicians.

But finally, what does it matter if he gets his way? L&S is psychological and PR more then it's good medicine. Let the service and the politicians hash out the effects on response times, all the crews should worry about is arriving safely and providing competent care. If that means that do to no, or quiet sirens they have to inch through every intersection and drive slower, with due regard to conditions, then great. They should be doing that anyways. Sure in heavy traffic this may make a bigger difference and if so, report the delay to dispatch, continue to respond safely and once again, let management and the politicians hash this out.

I think you are completely correct doc. And yeah, I find it difficut to believe that AHS will change thier policies for a few bone head politicians. However, what really gets me here is the complete and total lack of thought behind the purpose of the sirens, as well as the comparison to loud motorcycles. Som people just have no thought process behind ideas they have.

All I can say is WOW.

http://www.edmontonsun.com/news/edmonton/2010/06/10/14338911.html

Some people have noooooo clue. Do they think we run sirens 24hrs a day just for the fun of it??

...Or, for that matter, Christopher Walkin?

I said unstable......not bizarre.....LOL

Wonderful, gald to see that our college is making good use of our ever increasing membership dues. Any explanation as to why it was cancelled?

Apparantly all this money was being paid out for it, however nothing was being accomplished.....(furnish typical appropriate government jokes here)....

Apparantly elements of the vignette's that were written for CBT are going to be brought into the current written exam process, so not a complete loss.

Or so they say......who knows....

Ashes, did they7 hand out a package which includes the year end financial statements? Yes they did. If I get a chance I will scan it and e-mail you a copy, if you like.

I asked for a copy last year, and was told that financial statements are only provided to members who show up at the AGM. Personally, I think that the financial statements should be available on the website - we should be able to see where our funds are going. Agreed

I am assuming that the statements have to be audited, based on the dollar values alone. That they are.

That whole CBT thing makes me mad... what a waste of money - they could have subcontracted it out to organizations who already use CBT, paid them, altered some of the questions to meet our scopes, and been done, rather than take the route they did. Fully AGREED!

Was there any discussion on why there has been so much staff turnover at ACP? No, nothing was mentioned.

It isn't rocket science to add email addresses to a website.... I have it for my business... it took 10 minutes, cost me almost nothing, and I can have up to 200 email addresses, with 5 main emails having 5G storage, and the rest smaller amounts (when the day comes that I have 200 employees, I will be laying on a beach somewhere..) so if ACP says it can't be done or costs too much, I will call their bluff. LOL

I wish I could have gone, but I was working, and already covering for someone who had a family emergency, so I couldn't have made it.

I do wish ACP would provide more information to those of us who can't make it to AGM. It isn't like we can just shut the province down for the day so we can all attend. Agreed. Considering the nature of our profession, we are always going to have issues bringing large numbers of people together for this meeting due to work schedules. Add in large amounts of ACP related Apathy....not much wonder that ACP is doing whatever the hell they want.

Read the book, way better than the flick.

I have to agree, the book is excellent, hough as I recall, it was a complee pain trying to find it. I think I had to order it through Chapters.

As far as the movie goes, I believe it was well done, and captured the essence of the book perfectly. Nicholas Cage was perfect for the lead in this movie.

On another note...is it just me or does Cage play a good unstable person??? Just an observation.....

Initially I asked if they were checking a pulse with their thumbs, the instructor said "I hope not." Shot it the wind, but possible.

ROFLMAO. As sad as it is, I suppose you gotta ask! BoCat, please be sure to let us know if you find out anything else.

I agree that the information provided about this call is sketchy, at best. However like someone else in the post said, the wording is misleading.

Just a thought though. Could it be intentionally misleading, because the OP was told they can find information from any source they could find. Thats telling me that the instructor is deliberately holding information to make the students think.

The discussions so far have been very thought provoking, and I look forward to the answer when/if posted.

Basically the AGM was same BS, different year. We were informed that the Computer Based Testing (CBT) which has been under development since 2005, and has a whole lotta money into it, is now canceled.

Apparantly Health Disciplines Act is "just around the corner" which we've been hearing forever too.

And the college was stating that they are a governing body, so they can no longer do association type functions...such as perhaps try to bring the trade show back to AGM in a bid to draw more members out.

Speaking of members, we had maybe 250 members represented at the meeting, with not even 100 there in person, the rest were prox's.

Major bone of contention during the meeting was the inability of our membership to get in contact with our ELECTED governing council. A motion was passed for the college to establish e-mail's for them through the college, as their contact information cannot be posted due to FOIP issues. So we'll see what happens.

A bit was said about the national stratagy ACP is helping develop. Two new members were voted to council.

All in all the AGM has me debating whether or not I want to go next year ( which I probably will because if I don't go vote, I have no right bitch).

On the bright side the education sessions on friday were good!