paramedicmike

In line with Ruff's questions, was the kid not breathing but still purposefully moving? And then ceased moving on attempted ventilation? I realize the OP wasn't there and this happened more than five years ago, but the set up for the scenario is a bit puzzling. If that was, in fact, the case (movement up until attempted ventilations), I'd have a hard time dealing with myself after the call knowing that I probably didn't help this kid as much as I potentially could have. I know this is a bit of a tangent, too, but 80 kilos on a kid between the ages of 10 and 13? Wow! If the kid had been fully coded on scene, no pulse and not breathing, an argument could be made to not work the code. If there were movements or a pulse but no breathing, you don't have a choice. You work it. You don't get a lot of time to think about it. Once you make your decision, however, you're committed. Tough call. -be safe

Just so long as he's not listed under "Johnson, Navin R" and standing by "defective" cans! -be safe

You'd NEVER see something like that in the States! That's awesome! :headbang:

Sorry if this is a duplicate post...but I think it's worth watching again. -be safe

I found these news stories today. Interesting investigation and reporting. And I have to say it's nice to see the abuse outlined in such a manner. It's nice to see at least one public official sit up and take notice. It's a shame that the Cleveland EMS commissioner made it so easy for the reporters to make him look incompetent. Thoughts? -be safe

I had a long post for here but decided that if I can't say anything nice I shouldn't say it at all. Besides, most of what I would have said was already brought out by others. I do wish, however, she had picked a less prominent forum for her attempt at easing her guilty conscience. If anyone is looking for evidence as to why basic EMT education should be expanded beyond the meager three weeks currently required, this would be near the top of the pile. -be safe

Good question! An even better question would be why aren't you following your own advice? Are you afraid of what you're going to learn? Sounds to me like you are. That's the thing, though. Most of us were in your shoes at one point. We opened our eyes, looked at other points of view, weighed the evidence presented to us and came to the conclusion that none of the beliefs we had (which for many here were similar to what you've posted) were, in fact, true. So, basically, you're being hypocritical as you can't follow your own advice. Which is a shame. Because if you opened your eyes, listened to what the more experienced providers have to say, and weighed the evidence accordingly you'd come to the same conclusion we did. Sounds to me like you're afraid of being marginalized. Too late for that. Sometimes the truth hurts. Good luck to you anyway. -be safe

Manda: Go through and read the forums carefully and thoroughly. You will find much more information to justify the positions held by many of us who have been in the industry for a while (several of whom who've been doing this longer than you've been alive). I think you'll find the cliche inherent in your post will be, on many levels, shown to be outdated, wrong and a detriment to the industry as a whole. Good luck. -be safe

I really mean to tell you I see no logic in any of your points. It's not that hard to believe if you remove yourself from the small slice of experience you have and look at not only the wider picture but include the medical side in it as well. There's another problem. EMS in NJ is so messed up it's almost beyond comprehension. Using this as your basis of comparison is laughable at best. If you think any response you've received has been hostile you're terribly mistaken. Actually, I'd be willing to bet punches were pulled in any response you've received. Which one? The one about the 400 pounder on the 5th floor? Two providers can work that effectively to one of three end points. The first is the code isn't even started. The second, and possibly more likely to occur, is that the code is worked and then called due to no ROSC. The third, and least likely, is that there is ROSC and then the patient is moved to the hospital. Or are you referring to having an engine 3 minutes away and an ambulance 11 minutes away? To this I would suggest that the system is broken. If there are not enough ambulances on the street to handle the 911 medical calls then the mismanagement of the system in question borders on criminal neglect. If you can't send the appropriate resources to a call (and an engine, a non-transporting unit, is not an appropriate resource for a 911 medical call) then the system is broken. You can "what if" yourself to death. That does nothing but produce broken systems very similar to those being discussed in this thread. And just because people disagree with you and your limited volly BLS experience doesn't mean that we're all wrong and you aren't. People who've responded in this thread have been doing EMS longer than you've been alive. That experience and knowledge is worth more than you're giving it credit for being. -be safe

Congratulations!!!

It's called medical command. If you decide to work a code on scene and you don't get any changes despite your interventions, call the doc and ask for permission to stop. You're not calling anything. You're just ceasing resuscitative measures. It'll either be the doc on the phone making the call or the coroner when s/he shows up. That's even if you decide to work the code in the first place. Your assessment when you initially arrive on scene should tell you if a code is "potentially viable" or not. If it's not, then why go through the measures? Transporting a cardiac arrest is one of the dumbest things EMS does. It's just outright stupid. Lights and sirens and crazy driving for a dead person who will stay dead? Where's the logic in that? Anyway, back to the topic of the ER staff falling apart... -be safe

Not to direct attention away from the ER staff, but why was a cardiac arrest transported anyway? That might be the first part of the problem. -be safe

Based on meeting with the *entire* shift? No. However, I have done interviews (both as a crew member and as the interviewee) in a similar situation. It was just one crew meeting with the potential hire. One of the crew members was the boss. The shift was by invitation only and generally people don't realize that it's part of the interview process. It allows for a more relaxed interaction with the potential hire as s/he doesn't feel the same pressure as may be felt during a known interview. This actually worked pretty well and is a current practice at my FT gig. Proven and demonstrated experience shouldn't be negated in such a situation. I'm not sure where age discrimination would come into play. Yes, the potential hire is older than most everyone else. Were there signs that perhaps the candidate's age would cause problems? Another question to ask would be if the candidate, with the extra years behind him, would be able to work with the younger staff. Perhaps this would best be asked internally by the candidate. Does this go back to the resume issue? I'm not sure what you're putting on your resume but really, unless there's false information I don't really see the big deal of people seeing it. Now, if you're including an application as part of the resume (including such things like a tax ID, social security or other potentially ID theft information) then I could see the problem. If it's just a standard resume (name, contact info, experience and education) then what's the big deal? Taken as a whole, it might be wise, though, to determine if such availability is standard practice. If so, run! You're hearing warning bells for a reason. If it doesn't feel right then it's not and you wouldn't be wrong to walk away. Let us know how it turns out. -be safe

I'm not sure that response fits entirely with the point Matt is making. If you limit access to the weapons, then, by Britain's example, it could be argued people generally won't act out on whatever it is that drives people to partake in such acts. So, it's not the guns themselves that are causing the violence. It's the position of the gun as a tool in the hands of the person creating the violence. The sentiment of the actor in these situations doesn't change. Further, I don't believe that responses to stress are that vastly different in other countries as they are here. So one may react with rage towards a particular incident but may not be able to act upon that rage in the same way if a firearm is unavailable (as opposed to having one available). It's true. Guns don't cause violence. However, their role as a tool in such violent acts can't be ignored. Would some of these events still have happened if guns were that much more difficult, or near impossible, to obtain? I don't know the answer to that. I don't think any of us do. But I don't see reports of mass stabbings (or other acts of violence with the use of tools other than a firearm) by deranged lunatics nearly as often as mass shootings. -be safe

You're finding way too many instances of sarcasm in this thread where none exists. I understand you're passionate about this discussion, but come on man! Relax a little! We're not *all* out to get you! [humour] Just the guys in the black uniforms and the black helicopters. They're the only ones.[/humour] -be safe

I agree. However, your parenthetical statement of "albeit more likely" is the key. And this further supports the point that attention is diverted from the real problem at hand because now the cops have to handcuff this guy and either leave the scene personally or have someone take the individual off scene diverting attention to the problem at hand. Despite how it may sound, I'm not arguing one way or another. My personal views aren't all that important here. I'm just playing devil's advocate. It's interesting to see discussions like this evolve before the degrade into lame-arse shouting matches. -be safe

True. But how many shootings like the VT shooting happen on a daily basis? While this is anecdotal at best, I do know of several instances with the local PD where their attention is diverted away from the real "threat" (reports of person with a gun) because law abiding citizens who were licensed to carry (not the person the cops were looking for) had their weapon out in anticipation self defense. I'm not saying it's right or wrong. Just that it's not as simple as people on either side of the argument would like to make it seem. I read the same article. Utah is a unique state, though. Another poster mentioned mixing of alcohol and weapons on a college campus. I think this is a valid concern. However, it's probably not something that is going to be a problem on many campuses in Utah given their strict alcohol laws and the anti-alcohol component of the predominant religion. And no, I don't understand why people are freaked out simply by someone next to him/her having a gun. A feeling of powerlessness perhaps? -be safe

Will it end a rampage sooner? Possibly. But what happens when it doesn't? Then the cops arrive and instead of one nut job walking around with a gun there's one nut job and 20 law abiding citizens legally carrying. How's the cop supposed to determine who's the nut job and who isn't? And then what? Now there's a nut job with a gun out there and a few innocent, law abiding citizens who are dead because the cops couldn't tell who was who and shot the wrong guy. Then suddenly the cops are the bad guys. Or, the attention of the cops is diverted to those who are legally carrying and away from the nut job who's the real threat. There's not an easy answer. The pro-gun side will yell and scream that they're right. The anti-gun lobby will yell and scream that they're right. Everyone has statistics that supports their side. Nobody wins. Do we really have to go down this road again? -be safe

Just trying to understand the original post... ...You're the director of the service and you've never encountered anything like this before? How long have you been in EMS? -be safe

That sounds like consent for transport to me. This might've been good to include from the very beginning as this changes everything. Granted, you spent more than two hours browbeating her until she submitted which is questionable in and of itself. In fact, I'm so baffled that you spent so much time on this one call that I rather at a loss for words. -be safe

Like I said, based on the info the OP provided, she sounds like she's well within her rights to refuse. Is she refusing to answer questions? Not exactly. When asked how old she is she gives a reasonable response. Looking in her chart would give the answer to the age question. By maintaining the line of it's within her right to not answer any questions it sounds, again based only on what's presented here, that she's with it enough to know what's going on. Does an assessment need to be completed? Yes. Does failure to cooperate with that assessment suddenly mean she's incompetent and need to be taken against her will? No. Couple that with the fact that she's still in a legal position to make her own decisions. The doctor and/or family don't have the POA. As such we have to take this lady at her word. And for now, her word is "No!". I've been in similar situations before. If there's nothing to indicate that the patient might be even the slightest bit unable to make his/her own decisions then what they have to say in terms of going stands. Even if it means that the patient could die by not going. (Which, coincidentally, happened in one particular case that stands out in my head.) Calls like this suck. We know just by looking that they need medical attention. However, the patient is well within his/her rights to take any action even if that means they may die. If patient injury/death is such a concern then, as VS noted, the doc and/or family needs to take action to have the patient declared a danger to self in which case the patient's refusal can be overruled. Unless the OP is holding out on some crucial piece of the puzzle here, the information posted pushes me to agree with the idea that she was taken against her will. Hope this helps. -be safe

Yeah. I gotta agree with VS on this. Based only on what you've provided you kidnapped this woman. Nothing about what you presented gives any indication that she should have been forced into going. Completely disregarding what the doctor and family had to say, she was her own POA. If she says she's not going then she's not going no matter how much you think she needs to go. This is one of the unfortunate facts of EMS. I hope you followed your medical command's suggestion and documented the hell out of this call. Because if she's as sharp as you make her out to be she's probably got a lawyer on retainer. Good luck. -be safe

Last I heard, Dust wasn't in Texas. I know he was in Florida last weekend. Perhaps California with his lady? Either way, I don't know that he "blows" much at all. Unless he has some strange balloon fetish. In that case, I don't want to know. Now, if you had said Kansas, or Nebraska, or any other of the "rectangle" midwestern states I'd have believed you. -be safe

I hear it snows a lot in Rochester. Can anyone confirm that? -be safe

I read the original post to ask if EMS uses them...as in uses them on patients. Craziness, I say! -be safe