uglyEMT

Come on?!?! THATS not how it really is. Thats it I quit!!

LOL

That was a great article. It is amazing that that is the perception folks have of us, not the 3am water bed version.

What we really need is a show like Cops to really shed light on who we are and what we do. But then again who would want to watch a show with a bunch of folks in the puke mud and blood, dirty and sweaty, no glamourous lights or uniforms doing what we do some for free. Then again when I watch World's Dumbest I think I recognize some patients of mine LOL

Everything you said is true to my area as well chris. It is a crutch they use and we accomidate as best as possible but untimatly it is up to the patient and the patients needs. If I need a stroke center, divert or no divert (minus fire or natural disaster) I am going there. Same goes for cath labs ect. The divert thing is used mainly for the 3am stubbed toe want meds kind of calls where we could use other local resources.

I guess its just the verbage in my area the way we use it. Its not really set in stone but is fround upon unless it is medically necessary.

I agree that they do more than we think they do... I found that out during Paramedic clinical rotations! But what caught my eye that I wanted to reply was the above portions of your post, just looking for clarification. Do you mean to say that as you were rolling through the doors the triage RN was trying to tell you to go somewhere else? Sorry lady (or gentleman as the case may be) but once the patient hits the doors (actually some distance outside of the doors, just not sure the specifics) the patient belongs to you (the hospital as the generalized "you"), per EMTALA. Just curious about the way you worded this.

Chris yes as I rolled through the door litterly into the ED. Even though 15min prior during our transport to their facility I called inover H.E.A.R and told them what I had. If they said divert then, at that point, I would have made a different choice and went to the Level 1 even though it was farther away. I think it was the fact of it being middle of the night and apperently a crazy shift there for most of the ED Staff that it was said the way it was to us.

Off topic, but "divert" really doesn't exist, outside of a hospital having to physically close it's doors for an emergency condition. As far as EMTALA is concerned, your arrival is the same as a patient walking in the ED doors.

usalsfyre with long travel times in my area if an ED is filling up too much the ED usually calls MICOM and has them contact all the 911 dispatchers to notify all ambulance crews that they are on full divert so we wont even consider them in our disicion making process. We have several hospitals witht he same level of care within roughly the same travel time (albeit still 30 to 40 minutes) so we can plan ahead. In our case and that of the codes we happened to be there just when they made that call.

Had a particularly crappy shift last night (nothing super bad or major just a long drawn out one) and twords the end I was given a new found respect for the Techs and Nurses.

Twords the end of the shift we have a head injury w/ neck pain call so of course its off to the nearest Trauma Center. Wasn't bad enough for Level 1 and a medivac so we ground transported to the nearest Level 2 (still is trying for 1 cert / don't know the business end of that so I digress). Just as we pull up we get hit with we are on full divert effective immediatly.... well when we called you it would have been nice to know.... Well I state my case for at least taking my patient. Intake nurse agrees but notifies us no beds were available and we probably would be in a hallway. Fine at least we are at diffinitive care and should be on our way.

Partner writes up the PCR while I stay with my patient awaiting the Triage Nurse to take over care. Nothing.. great shift change. OK no big deal in a little bit things will get better. Out of the blue it seemed two CPRs come crashing through the doors.. intake nurse is shocked and tried to say divert but tell that to two seperate crews cot surfing and one riding the lightning. She hits the OS button but very few hands come (come to find out later 4 nurses called in sick). The main ER Doc see me standing by my patient and just says here now (now I know how my dog feels) I tell my partner to stay with the patient and get to the Doc's side. Basically I was just another set of hands to help out with compressions and bagging. No big deal at least it isn't in the back of a moving rig. After a short time some RNs show up and I am out of the way back with my patient.

Again I go to the intake nurse and remind her we are still there. I get the drop the PCR in the box and go. Ummmm NO!!! I have a patient with a head injury, in full C-spine, on O2, in and out of it so NO I am not just leaving the patient in the hallway until I get a higher level of care. Guess at that point my patient advocacy balls got twisted and the CMA abandonment light went off. She says fine someone will be over soon. Told my partner to grab a cup of coffee we will be a while. Figured with two codes back to back Im at the bottom of the toteum pole.

Well fast foward 2 1/2hrs, an O2 tank later, several more sets of vitals, PMSes, and reassesments on my piece of tape and I finally get a Triage Nurse. This Nurse couldn't A)believe I would stay that long and have my rig OOS B)Not through a fit and C)continue with O2 therapy and keep treating my patient. She was actually impressed and got on things fast. Before I knew it we had a Doc on the way, CT/X-ray lined up and were allowed on our merry way. On the way out even got a thank you from a family member that just arrived.

Ok so where in there did I find new respect? Being in the ED almost 3hrs, watching a short staffed nursing staff do their thing, and basically teching my patient until higher care arrived made me realize what still goes on after we leave. Watching nurses take care of multiple patients at once without missing a beat, going from full divert to getting a trauma and two codes within minutes of each other and realizing it was necessary to take them and still do their thing. I have heard some ER Techs say they are just babysitters or laundry services and I thought that is how it really was. But staying with my patient for so long and still doing what I can for my patient, having to go from that to working alongside ED staff working a full code, back to my patient again made me realize just what is necessary to be a Tech or Triage Nurse. Yea I know there are probably long stretches of pure bordum (doesn't the same go for us in the "streets"?) but in that few hours (which I have never had to do before) in the ED where it was hectic I witnessed and was part of something I would probably never have been in and to see how everyone shined opened my eyes a little more.

So the next time I am dropping my patient off and I get a snippy Nurse or Tech, maybe it isn't them. Maybe it was a bad day 5 minutes before I got there. I will try to be more accomidating next time.

Sorry if this sounded a little rambling or all over the place. I have had 1hr rest in between my EMS shift and here now at my regular job.

Yea man I guess I was being a sourpuss you know. But I do have to understand that I am a rookie and take ALL criticism. But all the advice from you guys really did help and gave me a lot of reassurance and confidence to be the best damn EMT I can be. thanks a lot I really do appreciate it

Thats a great attitude to take and have. Especially in the profession we call EMS.

As I stated earlier we here at The City do not coddle. If you messed up you will get called on it. Happened to me enough BUT it did make me a better provider. I made me push to "get it right" each time. Mistakes will be made but learn from them. Some of my best friends on this board started out as folks I thought were coming down on me hard. But it made me go back and look what I had done wrong and what could be done differently.

There is a vast amount of knowlege here, use it wisely.

A few quick things.

First: IT IS THEIR EMERGENCY NOT YOURS! Take a deep breath before going through the door and just try and calm yourself.

Second: It is rookie nerves. We have all gone down that road. It will get easier with time and experience.

Third: Dont see what you did wrong? ABCs patient was screaming and in pain check, check, and check. Neck pain - c-spine precautions. Tunnel vision would have been if you put on the collar but missed a pelvic fracture.

I will make a word of advise to you though and please take it as constructive critisim and nothing more. Calling the senior guys that may come down on you (especially here we don't coddle) pompus pricks will not score you any points. What may seem to you as pompus could be them just telling you like it really is. Sometimes reality needs to bitch slap you (again not you personally you as in generality)

LOL doc beat me to it LOL I'll leave it up anyways as it is good advice

We store our child seat in one of our side compartments. Nothing bigger then your average child seat bought at Walmart or other such store. They are usually donated by families who have children that have out grown them. After the manufactures specified experation date we get rid of them and if we do not have another we usually purchase then at a store.

As far as my opinion on size and weight I defer to the manufacturer of the product. We usually highlight the numbers with red paint or similiar so as to be noticed quickly. Also if necessary I defer to the parents, if they have a child seat in there car and use it so will I. Then of course we have to follow our State laws which of course superseed all others LOL

New Jersey's child passenger safety law requires:

Children under 8 years of age who weigh less than 80 pounds to ride properly secured in a child safety seat or booster seat in the rear seat of the vehicle. If there is no rear seat, the child may sit in the front seat, but s/he must be secured by a child safety seat or booster seat. Children under 8 years of age who weigh more than 80 pounds to ride properly secured in a seat belt.

Passengers 8 to 18 years of age (regardless of weight) ride properly secured in a seat belt.

Passengers 8 to 18 years of age (regardless of weight) ride properly secured in a seat belt.

Your local laws my differ so please follow all applicable laws.

Hope this helps some. if you would like more info feel free to ask away.

Great post. I needed a great laugh today.

Every pedi we have ever transported has been in their own child seat or our supplied seat if we were called to an area where the child's seat wasn't available. Yes we actually carry child seats in our rigs and all trained in proper installation. We occasionally use the Captain's chair pedi seat although we don't like it much due to it being upfront and not very provider friendly.

If the pedi is old and weighs enough not to require a child seat they are on our cot and fully strapped in (as is every patient for that matter) shoulder harness is adjusted as not to be too uncomfortable about the only strap not used would be the 3rd leg strap down by the D tank due to the child's legs no being long enough to use said strap.

I agree with doc sounds like a fishing expedition with this as your first post? Whats the background for the question?

My shirt has my first name embroidered on it. I think it is nice and makes working with others outside my squad easier as they can call me by my name instead of hey you. Nice hearing a medic actually talking to me by my name.

As for patients I usually introduce myself.... "Hi my name is _______ I will be your EMT today / tonight." Seems to break the ice and calm an already hectic situation. Yes it is not original, it was what was stated by pararescue jumper (PJ) David Ruvola during a rescue in "The Perfect Storm" to Melissa Brown a female passenger on a yacht caught in the storm. I do give credit where credit is due. His actual line was, "Hi my name is David, I will be your pararescueman tonight."

As for stalkers or what-have-yous. Been there done that have the TRO for it. Usually subsides after some time, thankfully. With all the PCR info and other laws it isn't hard for a patient to find out who you are so I don't see a problem with them at least knowing my first name.

Damn just found this thread. I am stepping up and taking a crack at it.

Liscensed 6/30/10 so I think I qualify even though I have been part of a squad since 09.

LOL yup we have less training then a beautician.

That was actually what my precptor in school said on day one...

"So you all understand what is ahead of you, after this class you will be thrust upon the world a Medical Technician. You will be assumed to have the knowledge to save lives, treat injuries, and be the one at the center of an emergency that knows what to do. All this in less time then your barber or manicurest(sp) had to go through. So to be clear hair and nails are more important in the eyes of the State then you with someones life. By the end of this course you will know just enough to kill someone."

It resounded in my so much I remeber it verbatum. That is why I try and take as much education in as I can. I am not just talking CEUs. I am talking lectures, classes, expert training details, ect. I am an advocate for better education, I want us to be seen in the same light as other healthcare professionals. We need a paradigm shift from the top to facilitate this, but as long as the ones in charge want to make it "easy" to fill the ranks our educational requirements will still be geared twords the lowest common denominator.

EMT Basic Level

The Basic EMT certification level has been reintroduced by the State Office of EMS to address primarily the needs of fire departments to meet NFPS requirements for the training of firefighters.

Ahem... point proven.

It is apparent that after you go through Basic and still want to do the right thing YOU need to step up and do the work yourself. Not just the 48 CEUs to maintain the liscense but actually go and forge ahead with college level courses and educations.

Wish things were different but alas they are not.

Haven't been back to this thread in awhile and I appoligize for that.

I think a few valid points have been made.

Ruff my school did NOT allow smoking anywhere on campus, you actually got expelled if you were caught. I really cut down because of it and started buying more gum. BTW while on duty I refuse to smoke on my own free will. I will goa whole shift without one. I couldn't imagine having a patient having to smell my stank on my uniform. Yes I am one of the few smokers that understands we stink to high heaven if your not a smoker. Also if I am doing an event I will not smoke while in public. Don't want to associate my bad habit with that of EMS or my organization.

As far as a fit test. I think I have a pretty good one. it was adapted from what my Squad required and also what my school required. Here is a quick run down. Maybe it can beused elsewhere.

1. Stair chair - 2 partner 1 pt (150lb simulaid) 4 flights of stairs with landings. Top to bottom. Not really timed but no excessive stoping or waiting at the landings other then positioning for the transition. Once at the bottom the simulation is reset and the EMT in the front goes to the back and vise versa.

2. Stretcher - 2 partner 1pt (150lb simulaid). Lift from ground to full wheel extention. Traverse uneven terrain to rig over 100 feet. Place stretcher in rig (1partner holding the whole weight while the other lifts the wheels then pushes in) Again not really timed but no excessive stopping. Again reset after and partners swap positions.

3. Equipment Carry - 1 person. O2 bag and Jump Bag. 4 flights of stairs 2:50

4. (specific to my area) Equipment Carry - 1 person. Scoop and Jump Bag 1/4 mile hike over difficult terrain. 5:00 (we have alot of State park to cover so most times the trail head is 1/4 mile from the rig SAR brings out the patient from deeper in usually in a stokes or specialized quad. if they are already backboarded we carry out that way if they are not in need of FSP the scoop is used to make transfer easier)

5. General Physical also checking EEG, BP, Sugar, Breathing and Lung Capacity

Some may ask why only 4 flights, in my local area most structures are single floor or 2 stories only so doubling what we may see is felt adaquite. BTW we are not fire based we are strictly EMS and as stated some of the above was from school and some from my Squad. We do have a few other tests but mostly it is specialized so doesn't really bare on EMS in general. I did add the hike one because of it being mentioned by previous posters. Also the reason for some not being timed is due to quote patient contact. We don't want to see our folks rushing with a patient on board we would rather see effectiviness, smoothness, and ability then a predetermined time.

We do stress physical fitness in my Squad but its not mandatory other then being able to complete said tasks. Yes I am over weight myself but am able to complete the tasks without difficulty and usually can go beyond.

140hrs a year? Can I have that volley number LOL Here I am doing 900hrs a year not including what my Line Officer position entails.

Back to the OP...

Alot of volley squads need members that will be long term due to a high turnover rate and being burned in the past. It takes time for a crew to gell and that wont happen if you have a revolving door of members coming through. I don't think you duffed the whole interview but might have put a bad taste in their mouth by telling them about your future plans. Not that that should be a valid reason, hell its called volunteer for a reason, but sometimes it does.

If you really want to get in with this squad make a follow up call to them and let them know your willingness to be part of their organization.

Hope this helps.

Thanks NYC. Did not report it, wasn't something to keep me down just "diferent". I did go to the Doc though and nothing remarkable showed on Xray, MRI, CT. After a little rest some heat and cold treatments and ASA everything is all well and good.

I wish we had medics on this call, they would likely have pronounced. Unfortunatly in my lovely rural area we got to the hospital before medics could meet us. Nothing unusual for our area.

I guess with past medical history of shoulder injuries it just aggrivated something but everything is fine now.

Thanks all for the responses.

To the OP...

In my own opinion. Take the Basic course and see if you like what you are getting into. When I went through school in the first weeks everyone was all giddy about becoming an EMT. By Module 3 once we started getting into the nitty gritty of it, some just dropped out because it wasn't their cup of tea. By Mod 4 or 5 some dropped out because they couldn't stand the gore others failed out due to not passing muster when it came to the tests. We even had a few drop the course twords the end because they knew it wasn't for them. Unfortunate yes. I don't know about the Cali side of things but I joined a squad and the course was paid for by them so no out of pocket expense.

I am currently applying for A&P courses from the local college because I feel it IS important as a provider to know these things. I learned here from Dwayne, Bieber, AK, Dust, ERDoc, and several others that education is paramount in our profession. Even Basics need to understand the body's functions and what glossing over you get in Basic class is woefully inadaquite. Yes they teach you the skeleton, major organs and placment, the O2 cycle and vascular system but not much else and not in much depth.

I want to be the best provider I can and be the best patient advocate I can so that is why I am continuing my education. I will state at this point I have no intention of going beyond Basic BUT I do want to be the best Basic I can be.

Dip your toes in the water and see if you like it, if you do get your cert, immediatly apply for A&P to get a firm grasp on the person you are helping. Plus if you are looking to go all the way and get your Medic cert A&P is a prereq anyways so you are just getting a step ahead anyways.

edit for grammer and spelling

Wait a moment, please?

Did Camping make the earlier pronouncement for 1994, or 1984? I thought I read he made the prediction for 1984?

here is the his infamous bio....

In 1992, Camping published a book titled 1994?, in which he proclaimed that Christ's return might be on September 6, 1994. In that publication, he also mentioned that 2011 could be the end of the world. Camping's predictions use 1988 as a significant year in the events preceding the apocalypse; this was also the year he left Alameda Bible Fellowship. As a result, some individuals have criticized him for "date-setting."^[30] Camping's latest publications, We are Almost There! and To God be The Glory, refer to additional Biblical evidence which, in his opinion and that of others mentioned by him, pointed to May 21, 2011 as the date for the Rapture and October 21, 2011 as the date for the end of the world.

Well I am still here with the rest of you all My folks always said that Heaven didn't want me and Hell was afraid I would take over

This moron was wrong as usual. Did it back in 94, said his "math" was off. How about now? Oh yea thats right "no man, nor angles in heaven, nor His Son will know that date or time only The Father of the Final Judgment." and these sheeple say they study the Bible???

Anyways, my 24 on 5/21 was uneventful just a tachy patient and a fire standby cancel. Figured it would be a busier day.

Ok whats the next date for us to fear and repent? 10/28? 12/21/12? Well I will still go about my day, pay my bills, pay taxes, and help people.

Stay Safe Out There Folks

They need to come up with some sort of pre-course 'dumbass test'. Because new EMT's make me hypertensive. Just thought I'd put that out there.

You know, like some test to weed out the ones that are too fricken stupid to perform as care-givers.

I couldn't agree more

That said I think a moderate physical should be manditory. I had to get one before school. Just to make sure no previous injuries or history would kill or injure me during the school or afterwords. I had a slightly more intensive physical because I had a PE at a young age but passed with flying colors. And I am by no means a small guy 265 6'2". Yea I might get a little sweaty after hiking a mile into the woods for a broken ankle or after CPR but hey I still get the job done.

I do think a mental health check should be required also. I see it too many times a provider lose it after a while and it is never pretty.

Haven't thought of that... I did contact the EMS director ... shall we say, cranial-anal impaction.

Hey, everyone, thanks for the input!

Yea contact the Med Director more so then the EMS Director. The Med Director is your local agencies contact and makes all the protocols for the area. If anyone can give guidelines it will be him or her. Plus with them onboard there is a nice continuity of care in place because the Director would be able to provide you information as to what your team would be required to perform before EMS arrivial.

I occasionally do non squad coverage and I make a call to the director explain whats going on, my level of certification (which gets verified of course) and within a few minutes we have a game plan established that we are BOTH comfortable with. I will say I have never been head or supervisor of any of these things only an extra pair of hands but I still CMA.

FYI must be nice to be in a state where Good Sam Laws apply to certified responders. Where I am the day I was liscensed I lost that privilege. One of the reasons I CMA whenever I am not with my regular squad.

Woooohhhhh Down Boy.

I assume it was stated that way only because you are a new member with little posting history and sometimes we get folks non qualified acting as if they are and it winds up being a shyt storm.

Back to posting..............

Thank you for the clarification as far as the transports go. I didnt realize you have to hand off because they are state. That does suck.

As far as the whole your volley I am paid I will not get into that can of worms (BTW I am volley myself). At big events I do see my fair share of egos. I occasionally have bad experiences, nothing to the extent of your scene, but have had times when I have had to demand, politely, certain things get done (thanks to all here for making me understand what different levels provide and some basic info on things).

I have found sometimes YOU have to be the patient advocate and stay with them. If it means holding onto them and contacting med control while having a hand on the stretcher then so be it.

Hopefully everything worked out OK and the patient is fine. Unfortunatly pride/money/ego comes before patients sometimes.

Keep us updated.

WOW

That sounds like a bunch of wackers if you ask me.

I know you are in Oz and things are alot different as far as EMS goes but I always thought you had to hand patients over to a higher level of care. So if I am reading this right you are Paramedic level of care (thus the IV start and pain meds) and the Transport ambo is basics with an intermediate. So wouldn't a CCP transport have been needed?

Beyond that....

These guys need to be wrote up BIG TIME!!. I am talking Medical Director notified, Service Owner advised, their Shift Supervisor advised, their Crew Cheif and Captain / Line Officers advised. I mean in writing advised as well as possible face to face. Something is terribly wrong with that picture. Person in full C-spine and they lift the head? They move outside their scope of practice and stop an IV? They remove the cannula just so they could transport? These bunch of wackers, yahoos, waNkers, whatever you want to call them do not deserve to have a liscense let alone be around anybody with more then a bandaid.

If I am off my mark and appologize being I am from the States and things are a little (alot) different here.

How about being a part of a large incident, multiple agency and discipline response, and the AM/FM starts playing Wagner's "Ride of the Valkyries"?

Haven't had the pleasure of an MCI yet, if at a MVA and Rescue is chomping away they usually have Rescue Me theme song playing on their iPod (bunch of wackers if you ask me).

As for Ride of The Valkyries... it was My Wife and I's wedding party enterance song at our wedding reception due to the size of the wedding party (16 plus us) We walked in to 2001: A Space Odessy Can tell we had a fun reception

A couple of things to assist you.

1. Get your insurer involved, find out what they need as far as "covered medical team"

2. Lawyer, get an ironclad permission slip. I would including wording along the lines of.. if ____ gets injured EMS will be notified immediately and treated initially on site by our medical team. If said injury is minor and treatment and /or transport is not needed do you _____ give _____ permission to sign a RMA. If transport and / or further treatment is necessary do you ____ give ____ permission to allow said interventions.

3. Contact your local medical director. Get him onboard and see what he will allow and or guidlines for you.

4. Contact your local EMS agencies as has been stated. They may be able to help w/ staffing OR are at least prepared for the added call volume. I know in our area the local state park hosts mountain bike races with their own staff. On that day, being my squad would be the responding squad, we put on extra crews just in case. Hell we have responded to numerous RMAs during the events and don't think twice about it.

Beyond that.. when in doubt call us out!

Nearest I have to that is, I listen to a station that concentrates on 1950s thru 1990s Rock and Roll/Pop/Doo-Wop (WCBS-FM, 101.1), and, on a few occasions, when starting to drive to work, they played "I'll Be Ready (theme from Baywatch)", the Beatles' "Help", Carol King (I think) "Help Me", Elvis Presley's "Feel My Temperature Rising", or numerous artist's renditions of "(You Give Me) Fever".

At least 2 times, after unsuccessful CPR runs, the ambulance AM/FM radio played Queen's "Another One bites The Dust".

I love 101.1 comes in fuzzy way up by me but when I am in Newark I listen to it regularly

Baywatch Theme is always good to hear to calls, kind of sikes you up.

It does seem wierd though LOL

BTW CDC just released their Zombie Apocalypse Survival Guide