Arizonaffcep

Well, Granny's coded, but think of the response time!

Ok...seeing as I seem to be the only person who said "yes-major-with death" involved MVC. It was actually a dual fatality...I was driving the box back at about 2300 hrs in Oct. (gets dark in AZ at that time around 7pm ish), driving down a non-lit road returning from a call. The headlights were misaligned and I didn't see the black cow standing in the middle of the road until it was about 6 feet in front of the vehicle (speed limit there is 55mph). So...we hit it. No people were injured (thank God), other than my now wife (gf and fellow medic at the time) hurt her shoulder, which did not require transport (no-she didn't sign a refusal either :twisted:). By the time we had pulled over, the ambo died and we couldn't get it started again, and Marana PD showed up and put a bullet in the cows head (you could see it's stomach distending). So...when we all got back to the station via a different department vehicle, I called my friends and told them to get their trucks and get some free, pre-tenderized hamburger. But alas, they never did.

In Southern AZ, as long as you have a good rapport with the hospital staff, you can let them know if the "patient is triage-able," meaning they are ok for triage instead of straight to and ED room. EMS is not allowed to transport patients to anywhere but an ED (from a 911 based call).

Viagra man!

Strangest one I saw was on a hispanic gent who lac'ed his L. FA open with a table saw. From the looks of the ground, it was bleeding bad, but when we got there, the family (who no one spoke english...of course :twisted: ) had put sugar on the wound to stop the bleeding. It worked...when we got there, there was VERY little bleeding. So...we were stuck with a situation...irrigate the wound and blow the clot out, or leave the sugar in place (which had totally congealed by then) and let the bacteria munch on it for the trip to the ED. Short story long, we left it in place and let the hospital irrigate it (Pt went to OR for the irrigation...wound was VERY deep).

From what I've sene of the "bashing," it's focused not on the health care professionals who volunteer their time, but rather the volunteers who have a whole other career--ie the used car salesman who a few times a month volunteers as an EMT for the local department. The argument being that how can the "profession" of EMS evolve if this is continuing. Using the same example, you don't see people volunteering their time a few days a month to sell used cars.

Just got to keep in mind that paralytics don't control a seizure...they only stop the physical manifestations of it. To steal the topic from a different thread...it's time to SNOW this patient!

My mother always did say to start something on a low note... :twisted:

Well, to quote Dust, "FAIL"! Not a personal fail, but a fail for scene control. As one who, when I was with the FD, would run on what was euphemistically called a "bean spill" (a vehicle FULL of undocumented aliens--no, the ones from south of the boarder--that has rolled, on average with 10+ people) about every other month or so-take it from me, the worst thing to happen is to not have control of the scene. The fly medic should have taken command, with the thought that the next due unit would initiate START triage (what is used in Southern AZ). Then...sort out your patients and send them off as appropriate. Honestly (this is not a ding on you or your crew...so please don't take it that way) but the way we ran things was the first transport in was the last one out. The thought on this was because our manpower was limited, the first transport (from our department) would take the Triage Officer position, and coordinate with the staging folks to get other units into the scene. Actually, it worked very nicely, obviously, the "reds" would be the first off the scene. And to top it off, (aside from the 20 mile stretch of part of the I-10, which is one of the deadliest parts--no not from providers :twisted: --we also have a railroad which as AMTRAK as an occasional user running through the district) so we would also run training scenarios where the AMTRAK train derailed and had 100+ people as patients. Here is a link for the ICS=100 course through NIMS: http://training.fema.gov/EMIWeb/IS/IS100a.asp There are several if you want to take them, they are free and decent knowledge. If you REALLY want good ICS stuff, check this book out: http://books.google.com/books?id=T9Gz2Vnr6...=result#PPP1,M1 (should be Alan Brunacini's IMS book) I know a LOT of people here are against fire doing EMS stuff (can't say I disagree) but, Alan Brunacini is the retired chief of Phoenix Fire, and he literally wrote the book on which the national stuff is based on. The cool thing is, IMS (incident management system) along with NIMS stuff can and should be used for any event, which requires a multitude of responders. The only difference in them is the sectors/divisions/groups (whichever is appropriate for local terms). Other than that, they are all the same. Hope this helps!

What happened to your ambulance? :twisted:

Soybeans and baby farts! Great!

The responsibility of being a medic, I think is ok for anyone over 18, but MUST be coupled with maturity, otherwise big egos that can adversely affect the job and partners can thrive.

I agree, I've always thought of it more like a person who works in adverse conditions with an incredibly high call volume and often must improvise on their feet for various reasons. Not an insult, although I could see how some could think of this this way.

This brings a good question for rural responders. What about the 3 man crew who are the only people responding for a code? 1 medic and 2 basics (common where I used to work), respond for a code, everyone's hands are busy, defibing, IV's, baging, tubing, drugs, compressing, etc. etc. etc. Basically, when you push a drug or perform an intervention and mark the time on your glove...heaven forbid the IV gets a little bloody, or the pt pukes on you and the ink gets smudged/illegible in some fashion. I'm sure I'm not the only one who had come across this situation in the past. This being said, would it be considered a "falsification" of the PCR to have to estimate the time(s) of certain activities, even if they got smudged? Keep in mind the very negative connotation of "falsification."

In Arizona, the Good Sam laws are in effect for when someone gets sued. Basically, anyone for almost any reason these days can get sued over anything. Crappy, but true. It's there so that WHEN they get sued, it is dismissed if it meets the Good Sam statutes...from my understanding. Now, should this friend have left her friend in the car? Probably-very doubtful it would have caught fire or exploded...things typically don't spontaneously ignite like that. The good news...I believe it's the "prosecutions" burden to prove the friend caused the injury-which I would think would be damn near impossible.

When I was with the FD, we had guidelines for practical jokes (unwritten, of course), where they were generally considered "ok" only IF: 1. It didn't involve PPE or personal gear (ie putting water in fire boots and freezing them) 2. Didn't involve the service status of apparatus 3. The person was able to respond without delay 4. There was nothing "offensive" about the joke 5. At no time would the safety of the crew come in jeopardy Outside of this, the department would discipline those responsible.

Much better story without the clarification.

What procedure?

Currently, the only doughnut magnet I have is the MRI. But seriously, I don't know enough about them, other than what they do as opposed to how they function to be comfortable with that. With proper education...maybe, but as of now...no thanks.

I agree in that the whole Taxi Driver thing shouldn't exist in the first place...but, the sad truth is, many patients view us as just that...expensive taxi's with extra crap. I've had patients tell me, "I'm Fine! Just take me to the hospital" and refuse to let me to an assessment on them. Once at the hospital...they spill the beans about the crushing CP they've had for several hours, etc, etc,etc. Not much we can do as a "profession" to correct that until we significantly boost our educational requirements. The classes listed are TRULY a MINIMUM to have a foundation in any aspect of medicine, including prehospital. With those classes "under your belt" allows one to better understand what and why things happen with a patient, moving us away from a "see this, push this" mentality.

Congrats!

There we go...fixed it for everyone.

This is interesting...what is the mechanism for this?