EMS49393

I won't let anyone bring a spit bottle on the ambulance either. It's gross, and although I can handle nearly every bodily fluid when my adrenaline is rushing, I still have a problem with spit and mucus. Lone, that dude in your pics had some nice looking teeth, what a shame they'll be old, brown, and falling out shortly. Many fire department based services in Maryland have adopted a tobacco-less policy. They even do random testing. It significantly cuts the health insurance premiums on these people, not to mention all the money an individual will save by not having that gross habit. It's not just the cost of the tobacco products, but the cost of the medical and dental treatments one incurs as a result of such a habit. If you don't believe me, Montgomery County Fire is an example of a tobacco free work environment. They also require physical training during their shifts, again I'm sure to help off-set the cost of health coverage for their employees. It's gross, it's expensive, and you could wind up significantly deformed. Why would anyone want to start or continue such habit?

My doctor deflated the balloon and pulled it in the office during my visit. No reason to knock me out. I had some drainage but it cleared up within a day after the hole had closed enough. I'm not sure why you'd have to be put under to have it removed, unless it's much different then the g-tube I had placed. Mine was placed to pull my stomach down into its correct anatomical position because I had been having issues with recurrent, and quite large, hiatal hernias. This was done during my third major open abdominal surgery to repair a nissin fundoplication that continued to unravel. In theory, my stomach was supposed to adhere to the abdominal cavity during g-tube placement. I doubt it worked since I had another incarcerated hernia less than a year later, and yep, another surgery, the most brutal one to date. Years ago I contemplated gastic bypass myself, but with all these GI issues, I was scared to do it. I'm not a candidate now because I don't weigh enough. My appetite has been exceedingly poor since my last surgery and I lost over 60 lbs in two months from not eating. I've slowed down quite a bit, but I'm still losing 10-15 lbs a month and do quite a bit of force feeding. What helped you decide between bypass and lapband?

I've had a few different physical exams for different jobs. For the last place I interviewed I had to do a megacode for my physical, which wasn't at all demanding. In another instance I had to work with a preceptor to load a 180 lb dummy onto a stretcher, move it from low to load positions and down again. We then carried the dummy via spine board up and down a flight of stairs. It wasn't too demanding either. The worse one I ever did was for a fire department EMT job years ago. First we did CPR for 5 minutes, when we finished, we climbed a 15 foot ladder, touched the wall above it, and came back down. Then we did a 180 lb dummy drag for 20 feet. Then, we had to carry three loaded gear bags up and down four sets of bleachers, followed by running without gear up and down four flights of stairs. Finally we had to sit and put together five different size nuts and bolts. It was June and I ended up with a pretty raging case of heat exhaustion as it was an outside exam. I passed, and nearly passed out. So, as far as a physical ability exam, you can have anything from hardly no effort to "think I'm going to die" effort. It depends on the company. I worked on the ambulance without any problems with my G-tube in place. Lifting wasn't a problem. My biggest fear was accidentally pulling it while moving a patient. I covered mine with an ABD pad and a big tegaderm. I also wore a tight under armor shirt under my uniform. This doesn't matter since you're having yours removed, and I'm only bringing it up to ease any fears you might have about lifting post G-tube. I also had no problem once mine was removed. The hole closed very easily and quickly, and aside from an ugly little scar, it doesn't pose any problems. I worked the day before and after it was removed with no discomfort or problems. Good luck, I'm sure you'll do fine!

Yeah, nice rant. Again, you have FAILED to give any information that has been requested from you. I think this is a game for you.

Wow, what a broad statement. I have to improvise quite a bit and I'm fairly certain not one of my colleagues would call me a shitbag medic. You may want to choose your words a little more carefully.

With idol sitting and not being able to work while you are recuperating, you should be mindful of a possibility of some depression as well. They never tell a person that, but a person that is otherwise always busy and always working can become very depressed in a short amount of time not being able to work. IMHO, depression is much more a possibility in these cases than addiction. Keep cheerful, it's only a few weeks of much needed rest. Harass some friends, start a new hobby, torture your significant other with sarcasm and practical jokes, whatever it takes to keep laughing. Hope you're better soon.

Why, yes, you have all seen this post before, and by the same person. Duplicate Posting Just as vague, but a somewhat different story. I admit, I stopped on page 1, it was all I could take. I have a ten year old boy that believes everything that goes wrong is everyone's fault as well. I expect that from him, he's ten. You're an adult. It's time to take some responsibility for your own education and actions.

Did anyone tell you this is career-ending? I was told my career was over in January when I had to have my third surgery for a hernia. They did this repair via thoracotomy and had to cut two of my ribs. Since they cut shingles in them they will not grow together. I was told by the surgeon that I needed to find a way to accelerate my other degree program because I could not return to EMS. April 3, I returned to full duty. I have some awful neuropathy up and down my torso on the left side and I can feel my ribs rubbing nearly all the time, but I'll be damned if some doctor is going to tell me I can't work. If you are determined to heal and determined to work, only YOU can stop yourself. Good luck and get better soon!

Good luck with the IQ testing thing, they won't even do that for paramedic entrance exams. Lifestar is a private ambulance company, based in Baltimore, with an office in DC. They had what was the MedStar contracts in the DC area, however I don't believe those hospitals are MedStar hospitals anymore. Like most private ambulances in that area, they'll hire anyone with a card and a pulse.

I got yelled at by a co-worker for EMS week. As a present to myself, I took the rest of the week off after tonight. Happy EMS week.

My favorite movie of all time, forever! Anyway, I've handled double inter-facility transfers before. They were always VA ER transfers to the VA psych unit and apparently approved to be done by the VA. Apparently, that is. Whether it was truly legal, I will never know. Sadly, most people are forced into doing things they deem inappropriate because they need their jobs, and they just don't know any better.

Wait a minute. I spent two years of my life in school when I could have only spent six months and still be called a paramedic in four years time? I got scr*wed. But seriously folks, this really isn't any better then what we have now. Transition course this and transition course that. How about college degree this and college degree that instead? Save me a seat on one of those lifeboats, I hear they only have enough to save half of us.

Very true, no system is perfect. We have map books and a GPS in our ambulances, and the GPS almost always gives us problems. Although it locates the address quickly, it often has us come out to streets where left turns are impossible secondary to median barriers, doesn't account for one way streets with much accuracy, and often gives us a route that is much longer in distance and/or time. In my humble opinion, the best system for preventing this type of error is continual updating of district map books (as opposed to commercial map books). There are numerous programs available to create and update maps, and there is always the old fashion way of drawing out the maps. For years I was on a department that did continuous in service district study and mapping mainly because the growth rate in the area was so fast that this was the only way to insure we had every chance of finding the residence in an emergency. This was not optimal in the high volume urban system I worked in a few years ago, and as such, they employed a person that was solely responsible for map updates for the service area. Mistakes are going to happen, and this is a prime opportunity to learn from a mistake and try to figure out a way to keep it from happening again.

I wanted to update this story after this article was brought to my attention by my husband. While I understand it is not fair to "Monday morning quarterback," both my husband and I know the people involved and are NOT at all surprised that they were involved. There comes a point and time in a person's career that they are a liability, they are crusty, uncaring, jaded, and simply do not care about patients, education, or their job. My husband and I have a combined total of nearly 40 years experience in EMS, over a dozen of those as ALS providers and we know, absolutely, without a doubt the difference between dead and alive. If there is even a remote possibility that a patient is alive or shortly arrested we work the code, completely, and give that patient every chance for survival. There is just NO DAMN EXCUSE for this, period. You're right, Mr. Swanson, your paramedics did indeed "drop the ball." It's nice to screw up so badly that you get a months worth of paid vacation. Mistaken Death MEMS disciplines 2 for mistaking a death Woman left on ground for hours an `error' By ANDY DAVIS ARKANSAS DEMOCRAT-GAZETTE Publication: Arkansas Democrat-Gazette (Little Rock) Two ambulance workers have been disciplined and one of them will receive extra training as a result of an internal investigation into their failure to detect signs of life in a woman and allowed her to lie in a Little Rock yard for more than three hours. The ambulance service determined that paramedics Pat Bajorek and Brandy Johnson followed all the appropriate procedures last month when they attended the patient, 52-year-old Pamela Harper, but they made mistakes nonetheless, said Jon Swanson, director of Metropolitan Emergency Medical Services. "They did everything that they were expected to do in terms of protocol, but it's a question of interpretation," Swanson said Monday. "Obviously there was an error made because we left her on the scene, and we accept that, and we have to stand up to that." Harper, dressed only in undergarments, was found in the backyard of a home near Napa Valley Drive at 6:30 a.m. March 26. The senior member of the first ambulance crew to arrive determined that Harper showed no signs of life and called in Little Rock police detectives. But while investigating, one of the detectives noticed that Harper appeared to be alive, Pulaski County Coroner Garland Camper has said. Another ambulance crew arrived but that crew detected no vital signs. That crew then called the on-call emergencyroom doctor who handles death pronouncements for people who show no vital signs after paramedics have performed cardiopulmonary resuscitation. The doctor pronounced Harper dead at 9:29 a.m. Then Camper, Deputy Coroner Patrick McElroy and Chief Deputy Coroner Gerone Hobbs arrived at 9:55 a.m. to examine what they thought was Harper's dead body. During his examination, McElroy, a paramedic who previously had worked for the ambulance service, saw "several signs of life," Camper has said. McElroy, Camper and Hobbs looked after the woman until a third ambulance transported her to Baptist Health Medical Center-Little Rock. She died at the hospital two days later. In a statement the ambulance service issued Monday, Swanson said the service has concluded its internal investigation of the episode, and members of its staff "now understand the unique circumstances of this call and accept responsibility for our actions." He could not say why the paramedics failed to detect signs of life in Harper because of patient privacy concerns. But the ambulance service would "take the opportunity to apply the lessons learned to our training and protocols going forward as we return the paramedics involved to duty," he said. "This is an extremely unusual case and is the first time in our 26-year history involving hundreds of thousands of calls that we have ever been called back to a scene after determining a patient was deceased," Swanson said in the statement. "We take this situation very seriously and sincerely apologize to the family." In a phone interview, Swanson said that Bajorek will return to duty this week, and Johnson will return to duty after receiving additional training. Both been disciplined, he said, but he declined to elaborate. The two junior members of the ambulance crews, who are emergency medical technicians, were not suspended because it was the paramedics who were responsible for determining whether Harper was alive. Swanson stressed that while the ambulance service takes responsibility for its employees' actions, it would be inappropriate for it to take responsibility for Harper's death because her cause of death has not been determined. The results of the ambulance service's investigation will be turned over to the state Health Department, which licenses ambulance services in the state, Swanson said. Camper is continuing his investigation to determine the cause and manner of Harper's death, Camper said, as well as why it took so long for emergency personnel at the scene to determine she was still alive. He is waiting for autopsy results from the state Crime Laboratory. Three hours is "a long time for someone to just [lie] there exposed to the elements," Camper said. "It's clear that the ball was dropped." This article was published 04/20/2010

We use the Philips MRx monitor, so it defaults to whatever is plugged in as far as SPO2 and EtCO2. If I want to use EtCO2, I have a waveform the moment I connect the device. The ECG itself defaults to lead II in the first and second waveforms on the monitor. I would prefer it default to II and V1. I'm not entirely sure anyone knows how to change the default screen without calling in the rep from Philips.

Death has never bothered me, which is a good thing since the first night back from medical leave had me bless two DOA's and work a cardiac arrest. I'm a bit of a magnet for the nasty deaths as well. I agree with what was stated above, don't bullshit yourself into believing you're not bothered when you really are. Although dead calls never got to me, I did have a period of a near nervous break down a few summers ago because I keep running critically ill kids. I'm talking end-stage cancer bloated, seizure kids and kids with horrific deformity and disability. The pediatric "nursing home" was in my first due area for a year, and they never called until it was really bad. I started seeing all of those kids when I would close my eyes to sleep. I started smoking so I could stay awake, I had horrific insomnia. On top of it, I felt guilty because I should be tough and able to handle any of these calls without a problem. I got help real fast, and I'm glad I did. I'm pretty well-adjusted now. (Aside from the fits of sarcasm) I wouldn't over analyze your response too much because you'll continue to relive those calls instead of letting them go. As for the ecg thing. I hate to say this, but I'm not sure if I have to run one or not where I am currently. I will say this, if I think at all that there is a crime scene, I do on what is absolutely necessary to determine death. I look at skin signs, rigor, pooling, breathing, feel for a carotid, and I check an apical pulse. If I listen and hear nothing, they are cold, decaying, not breathing (obviously), I determine death and let the police handle the rest. Some places I've worked made you determine death in this fashion because if you thought they were alive enough to attach a monitor, they haven't been down long and should be worked. It's a little foolish, but that's how the protocol was written. Unfortunately, we have several medics in our field that are unable to determine if someone is indeed pulseless and apenic, so I can understand the service wanted an ecg.

Younger people make up a majority of my current department. Having recently become an ALS service, the youth is expected as most people I know do not remain at the EMT-B capacity into their middle ages. Many will never become paramedics, but all of the older EMT's at my service have outside careers, i.e. pastor, funeral director, registered nurse. They work as an EMT because they enjoy the work environment (I hope) and because it's actually a fun place to be employed. The younger EMT's in the service are fine to work with, and of the 20 or so very young EMT's (under 25 is pretty young to me), there is only one that I cringe at the idea of having to work with and it's because he has an attitude. Listen, I don't care if your daddy and your daddy's daddy was a paramedic and attended to Jesus at his Crucifixion. That does not make you, as an EMT with 120 hours of basic first aid, eligible for Sainthood. It makes you lucky that you have someone that close to you that can show you the ropes, or unlucky for the same reason if you're daddy or granddaddy is a tool. The latter happens to be the case with this kid. When I was a young EMT, I thought medics were the bees knees. I loved working with a medic, and I was lucky, I rarely got a medic with a God complex. Most would be more then happy to show me or teach me anything I wanted to learn. They never put me down or made me feel inferior. They took up for me when I needed help. They were great partners, and they were my role models. Unfortunately, most of the younger EMT's I see today have little to no respect for paramedics and that makes it pretty hard for me to be kind. Personally, I don't get the 'tude, and as far as I'm concerned they can park it in the bushes outside of my station. I'm lucky to get along fine with even the young ones at my station. I have to admit though, that I prefer to have conversations with older people. I really just don't have anything in common with the younger generation because I'm on the cliff of and old codger. You generally won't find me hanging out in the room with the xbox screaming at the TV with the under 25 crowd. I'm usually cooped up in an office doing paperwork, or in the general lounge with the other old farts talking about the good old days.

That sounds an awful lot like Transcare. I've never done more the curb an ambulance so far, and thank goodness. We have an employee that hit a patient's house last year and he's still employed. When you break it down this employee was worth much more in service years, commitment, and work ethic then the damage he did when he crashed. He used a spotter, as per SOP, but apparently wasn't pay enough attention to him. Work made him pucker a few days because we are governed by a Board of Directors, so all firings are finalized by them, but in the end, he's still there. His name is the endearing term for hitting a stationary object. I think in many instances the employer really needs to pull the files on their employees before just firing them for an infraction, or accident. If you never get in to trouble, have good attendance, do above and beyond, then firing them for a small crash seems like a colossal waste of money and resources.

One thing I often worry about when I see this type of student would be "how much is this an act?" Really, I've seen a lot of students, and I hate to say this, but a lot more female students feign this no confidence "I'm never going to get this" attitude because they are seeking attention. The more time you devote to telling them how good they are and that they can do this job, the more a person that needs attention is going to crave what you're feeding them. As a result, you'll be spending all your attention focused on one student and making sure they know how good they are then on your group of students, many of whom will probably end up going on a lot further in the long run. First things first, make sure this person isn't playing the "show me attention or I'm going to cry" game. If they truly have no self confidence, I'm not sure it's something that can be taught. They have to be comfortable. Unfortunately, if they never get to that point, they won't go far as we are driven by confidence and have to master it before we can really function by ourselves. People will see though a weak person and consequently, they'll walk all over them on a scene. Once again, another fantastic post by Dwayne. People don't need smoke blown up their butts, the need quality educators that understand the learning process and are able to teach effectively. I am all forward a daisy chain learning approach. Master one small skill and move on to another small skill. Eventually all the small skills will equal one gigantic mastered technique.

Strange you should say that EMTAnnie. The county I grew up in was pretty much against traffic lights anywhere because they were costly. Select public entities were against this practice and found out that the county would only install a traffic light at an intersection after there had been a specific amount of recorded fatality accidents at said intersection. Not illegal, but unethical. I've always wondered what exactly is the price of a life?

You and I would say it's wrong, because we are human and believe in taking care of people aside from profit. Morals and ethics do not dictate laws, and the law says they are not in the wrong. My point is, where lies the flaw? The company acted in an unethical manner, but the government that writes the laws permitted this unethical behavior. It's not a single-fold problem, it has many levels, and it's a fantastic lesson on the American Way.

Several have hit the nail on the head... No contingency plan. No "what if our trucks are out" plan. Is it wrong to refuse to respond to another area? No, it's not wrong, it's highly UNETHICAL, but not wrong, nor illegal. Is it wrong to be in charge of taking care of a community (a township, a county, etc.) and not have an emergency plan in place? Yes, very wrong. It's your job as an elected official to make certain that taxpayer money is being allocated to provide EMS, fire, and police services, or you're not protecting your community. The problem has several parts, and neither side will ever admit fault, and ironically, it was this refusal to compromise that led to a story such as this. The private service can't do it for free, and they state that if the county would have thrown them a bone with some 911 calls they would have played nice in the sandbox. Its a pile of BS (as I know of this services practices personally) but at least they were at one time willing to be in the area, and the town was unwilling to let them make a profit. So instead of refusing to run calls in the city that peed in your cheerios, how about send them a bill every time they call you to bail them out? Makes entirely too much sense. What am I thinking? I'll tell you what the problem is, it's money and penises. It has nothing to do with the public or patients. It's the dollar and the pee pee size. It's freaking sad. Regarding the government health care issue in my country. There is no way Americans will go for this for long. They are already mad about how much they pay in taxes. Could you imagine if we had the taxes most other countries that have full services such as health care and EMS pay? Tea party that tax hike. I am an average person with an average living. I paid roughly 10% in income tax last year. Its no wonder I can't get decent health care and my roads are covered in potholes. Most other countries would kill for 10% income tax, but what do you sacrifice with that?

Ambulance refuses call Discuss... Ambulance Refuses to Respond to Rural Medical Call McCrory - Medical emergencies happen everyday, and patients expect an ambulance to come quickly when they call for one. Channel 7 News, however, has learned of an ambulance company that refused to come in certain cases and the next-nearest service was more than 30 miles away. Melissa Bumpers, 57, was at her home in McCrory when she fell to the ground around noon December 31. When a neighbor called 911 for her, the dispatcher promised an ambulance would get to her soon but Woodruff County Ambulance Service had its only two units out of the county on other calls. The only other service in the county, Southern Paramedic, which was not obligated to respond, initially refused to go on the call. This was the radio call that ensued: SOUTHERN PACIFIC: "Medical Dispatch. What's your emergency?" 911 OPERATOR: "Yes, ma'am. This is Alex at Woodruff County. I need your Augusta unit, southern, it is 10-8, right?" SP: "Uh, huh." 911: "I need it to go to McCrory for me....I have got a lady who is unconscious. Her neighbor found her on the floor and can't get her to respond." SP: "You all don't have any units to go to McCrory?" 911: "No, we do not." SP: "'Cause I don't think we can take the call." 911: "Yes, I assure you, you can." SP: "Does she have a membership?" 911: "I do not know that." SP: "You don't know?" 911: "No." SP: "Understand. We can't take it." 911: "Okay, thank you." 911 Dispatch Log: "I then called my supervisor for some guidance what to do. She advised me to get an ambulance, so I called North Star (Searcy)!" While the 911 operator worked to get an ambulance from North Star in Searcy more than 30 miles away, Southern eventually agreed to make the run. SOUTHERN PACIFIC: "Medical Dispatch. What's your emergency?" 911 OPERATOR: "Yes, this is Alex with Woodruff County. I need your unit to go to McCrory NOW." SP: "Excuse me?" 911: "I need a unit in McCrory. I have a possible heart attack." According to a dispatch log, it took 25 minutes for an ambulance to arrive, and relatives tell Channel 7 News by that time, Mrs. Bumpers had already died. (O.C. Bumpers, Victim's Husband) "It's frustrating. The only thing I can say is if they have some kind of problem going on, they need to straighten it out in case it happens to somebody else. They really could have saved somebody else's life if not her's. The situation going on right now, it's just a sad situation." Say It On 7: Click Here to Comment on this Story (Chief Deputy Jim Harrison, Woodruff Co. Sheriff's Office) "I was born and raised in Woodruff County. This is my county. The job I have, I help people and I cannot understand why somebody would refuse to help somebody in need." It's not just a problem for the residents of McCrory, but for anyone who travels through the area. (Gary Padget, Southern Paramedic Service CEO) "It's a major highway. It's very well traveled. You have tourism that comes through to go to Greers Ferry Lake....There is a lot of traffic there, so if you have a major wreck and there is no ambulance, you have a problem." Padget says his company stationed an ambulance in McCrory last year and asked the McCrory City Council to place his ambulance service on the 911 rotation. (Gary Padget, Southern Paramedic Service CEO) "The city council constantly gave us, 'Well, let us think about it and evaluate it,' and time rocked on and they didn't do that so we felt like, 'If you don't need our services then we will leave,' and we did." McCrory Mayor Ronnie Pittman says the council followed the advice of the Arkansas Municipal League. (Mayor Ronnie Pittman, McCrory) "The council felt we should not be involved in the decision making of which ambulance each citizen uses. That should be their choice, use any ambulance they wanted to use." But Padget says it comes down to money, and if Southern Paramedic isn't on the 911 rotation, the company can't afford to keep a unit in McCrory and would have to break its current contract with the nearby city of Augusta to respond to emergencies there. So, right now Southern is refusing most calls to McCrory. (Gary Padget, Southern Paramedic Service CEO) "If you're not welcome, you have no tendency to go somewhere." Channel 7 News asked Mayor Pittman if the city would reconsider putting Southern on the 911 rotation, but he said he has not heard from anyone with Southern since the ambulance service closed its McCrory office. To help the situation, Devin Barker, owner of Woodruff County Ambulance Service, says his company is in the process of adding a third ambulance to its McCrory base. (Devin Barker, Woodruff County Ambulance Service Owner) "I'm doing the solution that I think's best, is offer my community and my county another ambulance on the way so there is no problem." But Deputy Harrison is concerned that is not enough. (Chief Deputy Jim Harrison, WCSO) "I just need some help in straightening this situation out. I need ambulance services to work together and to help the people of Woodruff County....[Otherwise,] someone is probably going to lose their life." Bumper's relatives don't know whether a quicker response time would have saved her life, but they hope no one else ever has to go through a similar situation. (Ellar Vann, Victim's Sister-in-Law) "I pray that whoever, if you call, if someone calls, you don't tell them, 'I'm not coming because I don't have a contract with you over there.' I think you should come. If there is a need, I think you should lay aside whatever and just be there for the patient." Channel 7 News' investigation uncovered the fact that not every city in Arkansas has an ambulance service, but the state says there is one in every county. Officials with the Arkansas Department of Health say help is on the way in the form of grants to upgrade emergency medical services across the state to make them ready for the new trauma system. More than $2 million is set to go to ambulance services that have applied for upgrades and special training.

I used to work at St. John's Mercy Medical Center in Missouri! That's awesome that it closed. J/K

I carry myself, really well for the most part. I'm a paramedic, not a cop, and a darn sarcastic paramedic at that.