Dustdevil

I think both LE and the hospital let you down, BIG TIME! Their staff, security, and county delegate (who ever was initially involved) should all be reprimanded.

Good point. Although when it's an EMT vs. any hospital employee, the EMT always loses. Doesn't matter who is right or wrong. We are the low men on the scrotum pole, so we are always wrong. Regardless, I would write up a formal report and insist that your agency file it with hospital administration. I don't recommend you do anything without informing your agency though.

I have a theory that the entire theory of so-called "paragods" is factually invalid.

In my experience, those paramedics who are egotistical jerks were egotistical jerks well before they became a paramedic. They were jerks as EMTs. They were jerks in EMT school. And they were probably jerks in high school too.

I do not believe that it is a common phenomenon for simply being a paramedic to actually contribute significantly to ones jerkism. And therefore, the term, as well as the theory of, "paragod" is not based upon a foundation of fact, but merely utilized in much the same manner as a racial slur.

Comment?

...it seems like the incompetent people are chasing the competent ones out or trying to get them fired.

True. The biggest lie in EMS is, "If you always put your patient first, you will always be right." That's BS. The unemployment lines are full of medics who put their patient first and got fired for it. It's not enough to be medically correct. In EMS you have to be politically correct too. Killing patients is perfectly acceptable, so long as you don't question a supervisor or upset the boss' boyfriend. :roll:

Doesn't matter that your personal safety is universally accepted as the number one rule of EMS. If "everybody else" doesn't do it, then you're pegged as a troublemaker. Happens that way in both public and private systems.

Thanks Beagle!

What area are you in?

The transport was a non-emergent transfer, so no lights no sirens, and the family ended up leaving just before us and met us at the facility.

I understand that. And that is what lulls idiots like your partner into a false sense of security. Just like idiots who think once PD is on a street scene that it is somehow "safe." If that were true, there wouldn't be hundreds of cops being killed every year.

I am impressed to hear that you were thinking clearly and outside of the box. Next time, go with your instincts. Request a search before you accept the patient. Your partner is a clear example of what is being discussed in another thread. Just because somebody has experience does not mean they know wtf they are doing. Don't EVER conform to what "everybody else" is doing simply to avoid making waves. Do what is right, regardless of what everybody else is doing.

This is a great situation for the education of all those people out there who think they somehow "know" when a scene is safe and when it isn't.

There are no "safe" scenes! And I won't work with anybody who believes there are.

And nobody follows my ambulance anywhere either. Family either goes ahead of me and meets me there, or they get intercepted by police enroute.

What is "SI?"

... if it has gotten to the point where civilian EMT's are OK'd to go into people's houses with AR-15's, something needs to be done.

It's got nothing to do with EMT's. The law allows anybody who is not a convicted felon to carry a rifle wherever they want, except for schools and stuff. Nothing at all needs to be done about it, except for all you people who want the government to solve all your problems for you to take control and responsibility for your own kids. That's where all this violence is coming from.

So I think the poll question should have a third option: "I assess my scene and patient and then decide where I am going to work."

If neither of the given choices work for you, then you either did not read the original question, or you're reading into the question, which I specifically asked you not to do.

For that matter, I don't think anybody read the original post. Not one person so far has answered the four distinct questions I asked. :?

I never used amiodarone, but I can say that I do not recall ever having a single success with lidocaine in VF. Any VF I ever converted, I converted before I got to the lidocaine point. Same with bretylium and procainamide.

By the way, those AR-15's are kinda sorta yeah just a little illegal for us civilians to own.

Only up there in the northeast where you bent over like bitches and let them disarm you.

They are perfectly legal, and even common here.

Congratulations, Asys. You just defaulted the argument. :wink:

I've been a cop. Half my friends are cops. My ex is a cop. I can tell you with authority that there really is very little difference between the two. Most are belligerent yahoos with bad attitudes.

And if you don't believe there ARE a lot of government goons out there, you really need to get out more.

I'm sure law enforcement has never seen the likes of you before. :roll:

They do everytime they look in the mirror. :wink:

How many would agree that the cowboy days are over? Quality patient care versus fast driving and throw them on the stretcher and go?

Do not hijack topics. Discussions should remain focused on the original poster's intended topic. If a separate topic or concern arises during the course of discussion, post that topic or concern in a new topic rather than sidetracking the original discussion.

Our medical control keeps a close watch on our "on scene" times. We don't "stay and play" too often

Doesn't sound like a very progressive medical control. Better medical controls will be more concerned with the patient getting the care they need at the earliest possible time than with how long it takes to get them to the hospital. The point of ALS EMS is to take the hospital to the patient. And if the patient immediately requires something we have within our capability, any overriding concern for scene time is grossly misplaced.

Most Tactical entry medics up here are not sworn officers, nor on payroll as officers.

But are they armed?

I think I've already made my feelings pretty clear on this. I believe anyone who is an armed, tactical medic should be a sworn police officer first and foremost, until EMS brings its standards of hiring up to other agencies.

That's pretty well a standard anyhow, Asys. I don't have any knowledge of armed medics on any tac team who aren't sworn officers, even if only reserve officers. And reserve officers "hiring" standards do not significantly differ from those of regular officers. I don't think your concern is even an issue.

I don't ever feel safe on a scene unless I'm in my truck.

Did you know that the great majority of medics killed in the line of duty are killed in their trucks?

Food for thought. :wink:

When I left the field, there was still much debate among medics in the field over whether we should carry all our equipment into scenes and work the patient where we find them, like Johnny and Roy did it, or if everybody should be dragged back to the ambulance before beginning advanced therapy. Interestingly, there was never really any question over the matter in academic circles. They had long ago established the "proper" course of action. Yet, as frequently happens in EMS, a lot of undereducated technicians take it upon themselves to decide that they know better than their instructors and do whatever they want to when they get into the field.

My specific questions are:

• 1. All things being equal, which is your preferred method of operation on an ALS medical run? Why?

2. Does your agency have an SOP covering this? If so, what is it?

3. Did your instructor or school ever tell you which way was the "right" way or the way you should do it?

4. Does everybody in your agency operate the same way, or does the controversy still divide the profession?

Qualifiers: I don't want to hear a bunch of "what ifs." This is not a trick question. It is a simple, straightforward question that does not require any reading into. Your scenario is a safe, uncomplicated medical (not trauma) scene in a well lit suburban home with the ambulance parked close by and fair weather. You are not being rushed by low staffing levels, danger, or a lack of support. And I am asking specifically about ALS intervention, not ABC's.

I tend to agree. I am all for new medics spending significant time as a secondary medic before becoming a primary. But what Boston is doing smacks of pointless cronyism and snobbery. Considering none of the schools up there are even accredited, I can't figure out what they are so proud of.

How long has BU been running it? Any chance the new administration will revamp the system to be more professional?

Only personal experience, without actually watching the second hand while in the process.

You have to open up pads. You don't have to open up paddles.

You have to un-peel pads. You don't have to un-peel paddles.

You have to plug in pads. You don't have to plug in paddles.

You have to worry about pads sticking. Not so with paddles.

Simple math dictates it will take longer to shock with pads than with paddles. What that actual time difference is, I don't know. That would be the reason I wrote "about a minute" instead of "exactly a minute.

I can't disagree with anything you said, Scotty. For an industry who is constantly complaining about costs, they sure seem to be awful eager to spend a buttload of new money on pads now.

Losing the "quick look" capability is the first thing that concerned me. I'm sure I'll get used to it, as it's not really a huge deal to me. But still, time is muscle, and it takes about a minute longer to shock with pads than it does with paddles.

After that first look/shock, I'd rather have the pads because it will save both time and effort on subsequent shocks.

Of course, I do like that losing the paddles has made the defibrillators lighter and more compact. That is a big plus for the medic in the field.

That brings up a good point that I'd like to hear some of you address. How has the field use of 12 leads affected your use of narcotics for chest pain? If the EKG is negative for signs of an MI, does that make analgesia contraindicated in your protocols or judgement, or the judgement of your online medical control? Or do you still treat the pain the same way as you would have otherwise without a 12 lead?

And for bonus points, what commonly used chemical can induce OPP?

Well now, THERE is something worth dragging an old topic out for!

It's a shame that an opportunity this good was presented on the board and left incomplete. People would rather argue about basics intubating than discuss realistic patient care scenarios. That's what's wrong with the profession!

How can we possibly let this topic pass without telling EMTs exactly what "organophosphates" are and how to recognize them? The most commonly found organophosphates are insecticides. Commercial names like diazinon, malathion, parathion, Dursban, Spectracide and Real Kill are found in just about every garage and garden shed in America. While they are no longer sold in glass as they still were in the 1980's, you can still find old glass bottles of them in many homes.

And yes, Protopam was used in 1985. I studied it in paramedic school in 1979.

Now, does somebody want to discuss SLUDGE for us, or did everybody learn everything they will ever need to know in EMT school?

Have you been using the narcotics like candy?

Now that's funny right there, I don't care who you are!

Ah, Philips HeartStart AEDs! Very good choice. In fact, the BEST choice, as far as I am concerned!

They have two separate adapters. One fits all Lifepaks. The other fits all Zolls. Each is $30 bucks retail, which is cheaper than a set of pads.