P_Instructor

Agree with Chbare....but, how long was the episode? Was this the only time it has happened? How long were you still with your head in flexed position reading/studying? Many other things to consider. If this has happened before, I probably would get the expert medical advice from the higher ups.

There is a difference between volunteering and working for free.

Depends on how you look at it, but volunteering for what purpose, and working for free for whatever purpose. Basically they are the same, but differentiate upon the obtained goals met. I do see what you are saying, but I know there will be many different viewpoints to this.

"Upon returning to the room staff discovered that the pt had lay down on the couch and 'was twitching."

....."Upon returning to the room, staff discovered the patient on couch and is now 'twitching'".

Do you do the reports electronically or by hand?

...in stride, the remarks made on scene do affect them and they try to make light of it in spite of their embarrassment.

Instead of taking it as a big joke, especially with the new EMS provider, maybe some education and some notes on how the notification system could be improved might be in order. Nothing like a bunch of snickering FFs to undo months of work toward building the confidence of someone who must live with a broken body.

Do whatever you can to improve the system instead of just complaining or laughing....

This post was intended to portray that EMS can and will be called for whatever reason, beyond our control. Because of our stressful environment and what we have to deal with, you have to make light of certain situations, or many will become stressed to the point of leaving the business. At no time were derrogatory remarks made around the patient. This patient was not embarrassed and gratefully thanked the FF's for there services, and did remark there was no one else to get ahold of.

By no means was this a 'big joke'. The seriousness of the call was portrayed to the new EMS provider, to have them again realize that we can be called for any type of situation. Our services were not needed, and the humorous point is that I had never had a call with this type of request. The laughing was intent upon how this call would be documented. This was done outside the home nowhere in proximity to the patient or others. It was a private collaberation between my partner and me, and both of us documented the call.

The Comm Center was questioned concerning the information received upon request, which was very limited. The system unfortunately could not have been improved any further and proper managing of the request was provided.

Must have been around this time of year.....halloween.....

Gotta love Lifeline. Safer and more comfortable in a different living arrangement....

Agreed. I actually was thinking of social services, but this patient's house was pristine, not a speck of dust. The patient had everything and was being taken care of very well. It was just funny that out of all the Lifeline calls I have had, this was a first. It comes without saying.....every call is different and you will never see it all.

Keep your vision clear..........

You've started your 0600 shift on a bright sunny Sunday morning, and are now settled down at your post, relaxing and waiting for the first usual 'church' call that eventually will come. However, the day is somewhat different as you fall asleep in the recliner, then wake just as the first NFL game begins. It's about 1300 hours and your enjoying watching your partners team get slaughtered when the tones go off......"EMS Engine 5 and Medic 4, respond Code 3 to (insert address) for a Lifeline call. Wow, first call of the day. Atypical Sunday. Easily getting up from the recliner, you get to your rig and go responding. Enroute to the address, Comm Center advises that the entry to the residence may be hindered as there is a coded lock system to the door. Upon hearing this, I look at my partner driving hot to the call and said, "OOOOOKKKKKKKay, this is going to be interesting". The response is approximately 2 miles, and upon getting to the scene, you see the FD/EMS engine crew getting their first response gear and starting to walk to the residence. The captain is already at the door and is now getting on the radio calling Comm Center (which we overhear/monitor), "AAhh, Comm Center, could you advise first, where is the code pad, and then if we can find it, what is the code......" Now exiting Medic 4, I'm thinking, "Great, I'm going to have to get my lard ass through a window.....this is going to suck!" Whoops, the captain gained entry. OK, go up the sidewalk and enter the house. Upon entering the kitchen area, I see the 3 fire personnel surrounding a patient reclined in a chair, blanket over them, TV blaring (with the same game we were previously watching) and the Captain asking/stating/inquiring....."You can't find your glasses?" I freeze and view the scenario from a small distance. Yup, the patient pressed the Lifeline, because their glasses fell off there head and they couldn't find them to put them back on. Sheesh..... I from across the room ask, "Do you need us?" The Captain smirkingly looks at the patient then us and states, "I don't think so...." He asks the patient, "Do you need the ambulance?", where upon the reply is a resounding "NO, I just need you to put my glasses on my face" (Subnote: the patient is a quad patient) I'm snickering internally now as the FD finds the glasses buried in the blanket and effectively and properly place them on the bridge of the patient's nose. Prior to leaving, I state from across the room to the patient, "Are you sure you don't need the ambulance?" Again a resounding "NO, I just need to see the game!" Exit, stage right...... Leaving the house, I'm giggling as my new partner looks at me, "Do we get a lot of these calls?" I look at him stating, "You bet, this is the first one of this type of complaint in my 30 years of EMS!" He stops, ponders with perplexed look and then starts laughing. Let's see, how am I going to write this one up.........hummmmmmm.........ah, patient had visual disturbances keeping them from seeing football game on TV. Yeah, I am sure administration will like this. Well, back to the rig. The shift was not a total loss, had 3 more calls, all refusals for total of 4 refusals in a row. Ah, the life of EMS.......

To the producers......please, please, please do not try to cardiovert this show back into a sustainable program.......oh yea, I guess they are not viewing this forum, or they would have done a much better job. Just like one of those patients....ah, shows......that will inevitable die a peaceful death despite proper care.......in their instance, improper care/production.

Note to self.......Do not watch the reruns.

You will see very little gore. If you are properly educated you will do your job and hardly notice it.

I guess I should have been more informative. I agree with Spenac that the occasions of encountering the 'gore' is usually infrequent, but again one must be prepared, and as stated, being properly educated to do your job, should hopefully get you thru it. To make you not notice it might be a little open for discussion, but don't become tunnel visioned because of it.

Everyone handles these type of situations differently. Some can cut the mustard, some can't. Almost everyone will have some sort of 'uneasiness' went confronted with the 'hair, eyeballs, and teeth; blood, guts, and gore'! My advise to you may differ from many other providers out their. Dependant on the situation, one must realize that this is a 'patient' that you were summoned to help. Whether is be a simple or complex scenario, always remember your there to do the job to the best of your ability, to provide patient care and comfort. Is this always possible.....no.....but you must always strive to do the best you can. Don't be afraid to step back for a second, take a deep breath and put yourself in the right frame of mind to handle the job. Again, this may not work for everyone, but it has for me. I've dealt with 7 pediatric codes my first year as a Paramedic before my first adult code. That's a pucker factor! I have also dealt with MCI's (aircraft crash of DC10) with multiple patients, young and old, with all the patient descriptors you could think of. Look back and rely on your training. Prepare yourself for the job and one addage I use is: never approach your thinking as 'if it happens, what am I going to do', but 'WHEN it happens, what am I going to do!' The right frame of mind and confidence in yourself will go a long way.

Good luck with your career!

The 5.11s aren't bad, but better with gel insole. Agreed from prior post, get what feels good for you.

If they are charging for obese patients without the proper equipment being utilized, how is that going to be justified in billing?

"OH yea, we charged you an extra $200 for equipment we didn't have because you are fat"

I stand corrected. The should not be charging unless having the equipment available.

Anybody ever hear of digital intubation for the newborn?

It is much safer than placing something too large and that you have little control over what parts of the soft tissue it will destroy. A baby asphyxiated by blood from a palate tear in not a good thing.

Sorry, I'll have to differ from you. Digital intubation of the newborn is not proper. I believe you could do much more damage than using a large blade. At least with the blade, you have the light and visual factors. It is not blind, and in my opinion, would be safer. With some the the providers around here, I would not want them sticking their 'nubbies' in my mouth, no withstanding a newborn. Not enough room. Many human fingers are larger/wider than some of the blades. Proper technique whether large blade or not, should overcome the not visible blind intubation.

Sorry, I guess I should add that if this is the only option to have, then again adapt to the situation and overcome. If you are good at it, go for it. Personally, I feel against digital in newborns, but would do it if I had to.

Charging for the specialized obese patient is an option, whether reimbursed or not from insurance. To get the reimbursement, you will probably have to have a specialized unit with cot capablilities to handle the heavy patient.

How are services charging for these patients? It it by the pound? Sounds like the meat packing industry. Oh, I guess sometimes it seems that's all we are doing. Is that where the term 'meat wagon' come from?

This scenario reeks of cluster and pucker factor.

Agreed, should be about a 17 on the 1-10 pucker scale, but sounds like they kept their cool and got the job done. When isn't a call like this a 'cluster......'?

Whether deemed appropriate or not (I believe this is why there are different blade sizes), it looks like what happened, happened to the circumstance. The job was done. Many times comes the addage that I will stand by:

Identify, Adapt, Overcome.

You don't do what you need to (in certain circumstances) and the patient suffers/dies. The outcome was, you got what you wanted done.

I believe she is currently working on a BS in paramedicine.

Sounds like instead of Bachelor of Science, it's Bu** Sh** in paramedicine for her. Follow the leads of my and the other posters. You want the best, and it sounds like you are not being provided what you request. Work the chain, but get it done soon or this will fester like a zit on her arse. Make sure that this is not a personality issue, but just the instructional issue you are dealing with. Tread, but don't stomp until the facts are evident.

Take care and good luck with the rest of your class.

Ahh......now I git it......you're trying to tell all of us you were the one who coined the phrase 'wax build up'.

Question.....What sort of credentials does this instructor have? What current EMS level are they at? How long have they been teaching this course? Have they ever been a provider at the level you are being taught? Are they a moron or not????? (Oh, I guess we might already know this one)

Not quite sure of what you are trying to obtain. Is this a specific degree for either ALS, ILS, or BLS? Or are you asking for what educational degree did you have upon taking these levels. Please PM me and I can give you the low down as why I did not vote.

washing hands, wearing masks, masking my patients, covering my patients infectious wounds with a dressing.

making patients stop vomiting with Zofran so they won't vomit in my ambulance.

Just the general Infection control precautions - not much more you can do.

Agreed. The standard precautions as Ruff stated. If there is more you can do, if it is available, great.

my 'quandry'....

How does one correct the information provided by an instructor (information that is blatantly wrong) without insulting the instructor and getting thrown out of class for being 'confrontational'?

Case in point, (at least in this case):

The instructor informed us last night that our textbook (shown above) gave the 'wrong deifinition' of a couple words. The words in question are:

chronotropy (defined in the book as: pertaining to heart rate). The instructor stated that this word was defined as "stroke volume"

inotropy (defined in the book as: pertaining to cardiac contractile force). The instructor stated that the word was defined as "cardiac rate".

The instructor went on to say that the definitions in 'our books' were wrong and that the definitions in 'her book' were the correct answers.

Having checked multiple sources for the definitions, 'our books' are correct in their definitions.

My issues:

1. If there is "our books" and "her book"; this tells me that the instructor is teaching out of a different source than what we're expected to learn from....

2. If 'our books' are always 'wrong', then why are we required to use them, instead of using the 'correct books'? I mean, after all; aren't we SUPPOSED to be learning the 'right stuff' before we hit the streets?

This isn't the first 'incident', and I'm sure it won't be the last. Do I approach the course advisor over this?

Do I just suck it up and score these questions wrong on tests?

Am I wrong for wanting the CORRECT information presented to the class, or am I just being too picky?

THis isn't my first 'go around' in EMS education, so I think I DO know what I'm talking about. I was an EMT-B for 12 years. I feel that since I DO know that 'bad information' is being presented, that I have a responsibility to make sure that the 'right stuff' is presented. I just don't want to get thrown out of class in the process!

WOW. First, I cannot believe that this instructor is so ignorant to the fact your research into the definitions is wrong. Any instructor that's worth their salt should percieve this as 'feedback'. Question that I have, is the National Registry still going to test this level or drop it before your class is completed? Who knows, as this process has been ongoing for some time now. The main thing that the instructor should be following in the standard curriculum and teaching from that, using the book as a supplement. You, confronting the instructor with supporting evidence should taken as a very caring and passionate response to what your goal is, to obtain this level of certification. You want to learn, but you want to learn the right information.

I will wait for further responses to add to this topic's subject matter.

You follow the course objectives, and if problems continue, it is your prerogative to take it to the next level, ie. the medical director for the course (as every EMS class should have a medical direction through the training facility).

an eye for an eye makes the whole world blind - Ghandi

Mahatma Gandhi, as you know, walked barefoot most of the time, which produced an impressive set of calluses on his feet. He also ate very little, which made him rather frail and with his odd diet, he suffered from bad breath. This made him (oh, man, this is so bad, it's good) ...

a super-calloused fragile mystic hexed by halitosis.

HHHHHHHaaaaaaaa.....snicker,snicker......I'll give you a 9 on the 1-10 scale for that one! Ya slammed me!

Eye for an eye, tooth for a tooth, penalty for driving while texting.....cut his fingers off.......stupidity is right!

I would like to thank all of you for the lively responses concerning this topic. It will be interesting to see the outcome of the changes, although maybe not for a few years. Thanks again!