EMTDenny

Hmm welcome. But I am curious, why would some one post their credentials?

Just so you know, you get more than one edit...it's only limited by time. At least, that is how it used to be.

(no edits...just double checking...twice.)

Maybe I am not allowed to edit more than once. I am still not able to edit. It's alright. Lesson learn.

While the conversation was going on during the orientation, all I could think of was sharing this with you guys. And hell, 48 replies within 24 hours, pretty impressive.

Now that I scrutinise this event more closely you can come and stay in the yard, but you have to still keep an eye out for the Emergentologist bloke

Your services will also be required after I've eaten so much I'm not able to stand up under my own power and need assistance

Hmm, it might also be required that you keep Dwayne in line, prick is liable to get rotten fucking drunk and start trying to be inappropriate or something, you can restrain him while I talk the cops out of taking him to jail and showing up with that van full of cops who show up to shut down parties, which means they basically club everybody over the head with a nightstick, if you put up a fight you get a dog set on you and your beer and food gets confiscated and goes toward the next Police Association fundraiser

Jesus, I wonder when the fun actually begins! That last part had me dying laughing LOL Police association fundraiser LOL

Did we say you were invited?

Any BBQ that aims for completely rotten drunkenness is pretty much an open invite.

Did we say you were invited?

Fine, you are invited but you have to bring a dish, and potato salad isn't a real dish, nor is anything pre-made from the deli section

Oh, and don't be bringing any of your damn New Yorker mates, especially not the snobbish kind nor those who tawk funny that you can't understand and none of those damn upstate volunteers who dont even carry a blood pressure cuff yo?

Actually, on second thought you can bring a dish and leave it on the picnic table and sit down the end of the street and watch out for that Emergentologist bloke, he's bound to try and crash our BBQ, if you see him text me and you might get a hot dog or something at the end of it

Also, bring beer

LOL you wrote that one quick. Funny ass hell. But just one hot dog.

Nah bro I was taking the piss, now get your white ass into that water and start swimming down from Kiribati or wherever the fuck you are, we can have a BBQ and get rotten drunk

I am going to start the EMT City treehouse club or something and have a big sign that says "NO EMERGENTOLOGISTS ALLOWED / COMPREHENSIVE DRINKING / KIWI ON DUTY 24 HOURS UNLESS UNCONSCIOUS"

That's a piss take on those signs you see in California which say "Emergency Department / Comprehensive Medical Care / Physician on Duty 24 hours" just in case you were wondering

Now that's a BBQ I would go too.

Oh and good to hear you volleys are now carrying blood pressure cuffs .... bloody hell

And yes, I'm taking the piss, hmm looks like another case of Piss Takeoccus which is unfortunately resistant to all penicillins, cephalosporins, macrolides and tetracycline antibiotics ... even sulphonylureas but I forget if you give those to people with bacterial infections or diabetes, oh well people with diabetes are more prone to getting bacterial infections anyway so that probably works out right?

Oh and if you call the medical control must you talk with a Consultant Physician or can you talk to the Registrar or House Surgeon? Here if you find yourself in the exceedingly rare situation where you need to seek advice from a Doctor, you must speak with the Consultant, you're not permitted to take advice from the Registrar or House Surgeon. Probably something to do with the fact the Registrar died last week from fatigue and we've yet to find a locum to replace him, and the House Surgeon is dangerously overworked and underfed over in minors putting in sutures or doing rectal exams.

Stunning me as always.

I'd have to strongly disagree with this. A competent patient always has the right to refuse treatment and/or transport until they are proven not to be competent; somebody who consistently says "I don't want to go the hospital" is competent.

*scratches that idea from the light bulb notebook." Damn I was seriously going to mention that idea to the right people... LOl just kidding. I have so much to learn.

The last interview I was in which was a couple of weeks ago, kept asking me over and over if my driver license record is CLEAN!! Some companies really care about those records.

i was in the same boat as you were a while ago. I receive my card on Sept of 2011, and I just now got call backs for jobs.... I mean, I wasn't that mad or pissed off cause, I already had a full time job and i was just actually looking for either perdium or part time work. I now have 1 part time job doing inter-facilities transports while driving Mercedes Benz sprinters for ambulances which I have to say it is freaking awesome! And I also have a perdium job on the side another IFT. the pay rate sucks.. 11.25 and 11.00 and hour. But I'm just grateful I finally got my foot in the door. I do too want to get into paramedic school. Hang in there man. It's great your keeping us updated. Something is bound to come a long soon. It sounds like you have a great passion for EMS just like I do, which is awesome.

Good luck bro

Denny

This is where, in my opinion, you begin to go off into the ditch. First, and foremost, we're patient advocates, right? Why would you want to make even more rules, that will be abused even more than the ones that we have, that would remove more of a patients rights?

Good point point Dwayne.

I agree with ERDoc. Once the patient gains mental faculties, and is aware of the health risks and the consequences of their actions, then they have the right to refuse any treatment they choose. The paramedic instructor needs to take it down a peg and maybe a refresher on patient rights and responsibilites. My M.O. would be to call medical control and get the blessing on it, then document the hell out of it and file away under 'possible shitstorms later'. My documentation would include the fact that we strongly and strenuously advised the patient to be transported to the emergency room of his or her choice in addition to performing as through as possible neurological exams and also advised him to call 911 at any time if he changed his mind. Tell the paramedic instructor we mock his value system.

Exactly what should have been done. During the conversation there was no mention of medical control being called.

Love you too bro

Unlike Dwayne or that Emergentologist bloke, they just say they love me, pricks!

Damn Emergentologists posting before me, I know naloxone only has a short duration so I am going to go look up this relapse thingamajingle, interestingly nobody here has mentioned it when we talked about leaving patients at home who have recieved it and refuse transport

Aww hell, I love Denny too. He's from the best state in the union. What's not to love?

Great Nation of Indiana > New York

Damn New Yorkers, can't understand a bloody thing they say, and their volunteer EMTs in the upstate don't even come with a blood pressure cuff!

HAHAHA, damn those upstate Volleys. When I volley we have blood pressure cuffs in the bag.

FYI Denny: Naloxone = generic for Narcan. Good thread start!

Thanks! Wendy.

Your instructor is an idiot and should have it written across his forehead in big red letters

A patient has the right to refuse treatment and transport including that which may be lifesaving until proven incompetent

Because you overdosed and got woken up does not mean you are not competent

Bottom line if they can consistently tell me they do not want to go, why they do not want to go, that they understand the risk and they can call back to go or go themselves if they change their mind, then I have no problem leaving them at home.

I've seen it happen before with my own two eyes in fact!

Wow this is why I love EMT city. Plenty of opinions to go around. Love it.

I'll agree it's a shitty situation to be put in. Sued by the family or sued by the pt. Which is worse? If you let them RMA and something happens, yes, the PCR will be looked at. That is why it is so important to document everything. This also why on a NYS PCR there is a place for a witness to sign the RMA. If you can, have the family be the witness and make sure you explain everything to them so that they understand why you can't make the person go.

I agree.

A few years ago we had a rash of OD's here where the heroin was laced with Fentanyl, and it took "gallons" of Naloxone just to get some of these folks breathing again. We saw many times where they would become fully awake and seemingly competent- only to see them nearly go apenic again. No, not every OD is so profound and intractable, but how can we be sure? Seems like a huge liability issue to me.

That does look like it can be a liability problem. I have no experience what so ever with this drug Nalaxone , but maybe they should come up with some kind of protocol, when it is given to the patient they can not RMA. It seems to me that every time a patient is breathing again, once Narcan is used they can be competent and A&O to the max to RMA. Just saying. I've experience this before.

I'd also like to suggest you watch your spelling and punctuation. It does make it difficult to follow.

(BTW, it's narcan.)

Yeah i know, I wanted to make changes but I used up my edit....

We've been through this before. These people absolutely CAN refuse transport. It doesn't matter what was wrong with them before or what they will be like in 30 minutes. If they are competent to make their own decisions at the time they refuse you CANNOT take them. It is your job to try to convince them otherwise, but ultimately if you assess them and they understand the risks and benefits and they have the capacity, there is nothing you can do to make them go. To force them to go is basically kidnapping. Having the capacity to make such a decision also means more than being A&OX3 or 4. They have to understand what is wrong, why you want them to go and what the consequences of not going are. Denny, your instructor may want to review the law before he gets himself or one of his students in trouble.

As for contacting medical control, that all depends on your protocols/jurisdiction.

This is another good point. But couldn't the lawyers of the pt side have a field day with this if the pt family gotten involved and decided to pull up the PCR to look at what happen. The PCR shows, yes the Pt was clearly competent after NARCANE was given and died hours later? The lawyers would go thru every detail and side affect of that drug and turn everything on the unit that was called to the call. It sucks but it happen I hear.

that was the point the EMT was trying to make. Forcing the pt to go to the hospital is more like kidnapping. I find this interesting cause I really don't want to do something like this.

Bottom line- these people are NOT competent to refuse transport. They need to be monitored for awhile at the ER until it can be determined the are no longer under the influence.

Extremely good point you got there. Those detail were left out while the EMT was explaining the story to us. Evidently that paramedic did not care. Then again, we do not know the other side of the story.

I also want to apologize in advance. I could have written a better post then the one I just posted. I did not know the edit feature can only be use once.

During orientation, an EMT who is already riding with the service brought up a situation in which the instructor thinks they erroneously let the patient sign a "refused medical assistance" form?

I don't think you can force someone to go to the hospital if they really don't want to... but I'm not in your area, so maybe "found down" = ride in whether they like it or not...

Wendy

CO EMT-B

What was told, and what I heard.

Emt and paramedic responded to a over dose call. "My partner the paramedic gave narcane to the PT. Once the PT woke up after a while the PT kept asking us to not take her to the hospital. We took it to out best judgement since the PT was A&Ox3 they were able to sign the RMA and not be taken to the hospital" I am not a paramedic but after giving narcane is it alright to RMA the PT if they asked? With out even calling medical control?

I don't know if that cleared it up.

So, today was my last day of a 3 day job orientation for my new part time EMT position. I am not going to go into detail

of how everything went cause I will be saving that for another post.

Around noon, we started talking about documentation. Blah blah blah and so on falling asleep... etc you know...

Then we got to the topic of RMA. Now here comes the fun part and please Anyone can give their opinions cause it was a hell of

a conversation that woke me right up.

One of the new EMT said. "My partner and I who ride as EMT and a paramedic responded to a call of a drug addict who OD

themselves with opium's. My partner( the paramedic) gave narcane and of course the PT was now alert. The Pt said Oh I want a

RMA Thanks for helping me... EMT and paramedic said, she looks A&Ox3 sure" Now that started a major debate! It was

intense. The orientation instructor was furious at what he just heard. He is a paramedic, health specialist from OSHA something

like that and risk management. He Said " If I knew or find out who that paramedic is, I will have his card in a heart beat"

Of course, during the argument the instructor was saying and most of the paramedics in class also that after narcane is given the PT

needs to go on some 6 hour watch cause they can go into an arrest and needs to be transported to the hospital. this surely looks like

the paramedic was just being lazy. and not following protocol at all. The EMT strictly brought up this conversation cause he thinks

the PT should not be force to go to the hospital if they do not want to. Which led to that insane topic.I mean seriously Implied consent

was being thrown at him the whole time of the conversation. I just wanted to share that story cause it had me on the edge.

Denny

Awesome! I hope everything works out for you!

Welcome, nice to have you join!

Just leaving my print for this 4 year old topic.

Looks like anything these days makes you a hero. I'll definitely keep my eye out for people who have motion sickness on airplanes and boats from now on! It will make me a hero!!

Something or someone ( in his head) is telling him to injured/kill people in uniform. That is just sad and to think he is on bail.... It's a good think they were not injured.

Oh wow I saw her on "The Voice"!! And she got picked by one of the judges. Amazing!

Good thing you are asking for advice! I was almost stupid to buy all this EMT stuff that would have been nice to have but not needed. Instead I bought books. apps, and a good stethoscope. Good thing for EMT city being around they made me realize that such things are not worth the money. Gift certificate is the best thing or a good good stethoscope. You can never go wrong with those two. Congratulation to you brother!!

Denny