mikeymedic1984

How does small bowel obstruction being transported 5 hours rise to an ALS call in any dispatch center ??

I suck at golf, can't even do putt-putt well, but since it is time for the championship this weekend in Augusta, the annual arguement has surfaced again. For those not familiar, the Augusta country club where the masters is played is a PRIVATE club, where members are selected by invitation only. Women are not allowed to be members, although they are allowed to play the golf course. Obama thinks this age old tradtion should die: http://ca.news.yahoo.com/obama-thinks-augusta-golf-club-allow-women-white-173653725--golf.html What say the women (and men) of EMS: Do you say it is a private club, therefore they can pick and choose anyone they want as a member ? Or do you say discrimination against anyone in this day and age is wrong ?

I agree whole-heartedly Capt, I have always subscribed to the theory of eating the elephant one bite at a time, but the problem is that we typically take one look at the elephant, say it can't be done, and then walk away. It seems as though we are always waiting on someone else to start the process (AHA, DOT, Medicare, Pharmaceutical and Equipment companies). So I guess the first question is what should EMS look like, without looking through our blinders of 30 years of the old way ? If we can envision the future, we can take steps to get there, but as long as we stay on the same road, nothing will change.

I know these stats are not near exact, but they are in the ballpark: 1. Less than 5% of EMS 911 calls are actual truly immediately life-threatening emergencies, meaning most could go to hospital by car and arrive alive. 2. The out of hospital cardiac arrest save rate to a quality stage of life afterwards is and has been less than 10% for the past 20 years. 3. Less than 1% of traumatic arrest patients survive. 4. I think you can say we CAN have an impact with AMI and Stroke, but is it our treatment or quick recognition and transport that improve patient care (we get the hospital teams moving faster, but we may actually delay arrival to the hospital versus being thrown in car), and if you do claim that, these patients are a small percentage of what we run. 5. Less than 10% of multi-system trauma patients have a spinal injury. So with that being said, from a bean-counter or government official point of view, can you continue to justify all of the expense involved in your EMS system, for just a handful of patients ? Would the millions that are being spent, would it not be a wiser move to put the money in patient education and/or just staff twice as many one-man emergency taxi-cabs throughout the community, versus half as many traditional ambulances to transport patients. Can you justify it with facts and statistics ? Sounds silly, but many EMS agencies are being looked at for takeover by privates or fire departments, so this is a serious question.

http://www.sixwise.com/Newsletters/2009/April/29/21-Photos-That-Will-Make-You-Smile-Big-Time.htm

I am sorry, but I put 50/50 fault on you and the Nurse that transferred care to you. The two of you should have thought this out before you loaded the patient. Anytime I did a long distance transport (anything over an hour), I asked these four questions: 1. How have you been managing the patients pain, when was the last dose of meds, do they have enough on board to make the trip (if not, can you please give her another dose, or give me a dose to administer when this wears off). 2. Has this patient had any anxiety issues, sometimes patients who are already anxious get clostrophobic or nervous on long rides (again give them a pill then or one for the road). 3. Has the patient had nausea or vomiting recently, or a history of motion sickness. Patients can get nausous riding backwards for hours. 4. When was the last time the patient went to the bathroom (or when was last time diaper was changed ? (Can we go to the bathroom now, or can you send a couple of diapers with me) Just because you were ignorant to the fact that you should have asked these questions, does not relieve you of the responsibility of treating your patient. But the good news is that now you have learned from your mistake, and will probably not make it again. This will not be the last time you experience this in EMS, there is no way your employer, your technical school that taught you, or your current training officer can prepare you for everything you will encounter; you have to be able to think on your feet and outside the textbook box. I am not trying to diss you, if my typed words sound that way, this is just a longwinded way of saying welcome to EMS, own your error, and move on.

My opinion is that most LODDs result from stupid actions (note I said most)--- Going in any burning structure is stupid to me, thats why we have fire insurance --- driving too fast or carelessly -- Not living a healthy life-style causing an MI --- engaging in dangerous activities. With that being said, if you are on-duty and die from a call related activiity, I would call it LODD. Are they stupid union members who deserve to be fired, YES !!!!! I imagine they violated enough policies to earn that. Now the question I would ask, is less change it up a bit. What if the firefighters were playing basketball on-duty, one of them lands the wrong way and gets a compound fracture of his ankle, then the next day he dies of an embolus. Is that a LODD ?

I agree with dwayne and capt, with one exception. Instead of the question being "can you" maybe it should be "should you"? Without knowing the disease at play here it is difficult to say, but most terminal illnesses at some point or another result in a weakened immune system, so being around sick people as a career might not be wise for your long-term prognosis. You also have to figure out whether or not you can complete the course in time, you did not say how long you think you have. Most classes are nearing the 2 year mark with all the core courses they have thrown in now. I am not sure that I would choose to spend my last year(s) in school, but if that is your dream then go for it. As far as "can you ?", the only things that I see in your way is if you are so frail that you can not pass a physical at hiring or can not meet the lifting requirements due to weakness, or you are so visibly frail that anyone could tell you were sick and would not hire you out of whatever rational or irrational fear they have about that. Good luck to you, we are here to help in any way that we can. ** add Wendy in there too, I agree (she posted right before I posted, did not see her comments prior to sending mine).

Just a heads-up to all students, especially if you are in your teens or early 20s --- Please keep your driving record clean, and if it is a mess, take a defensive driving course to shave off some points. I can not tell you how many applicants I have had to turn down this year because they were under 23 years of age and had 7-10 violations on their record. The EMT schools should warn you about this before taking your money, but apparantely in my neck of the woods they do not. I had one guy with 7 pages of violations on his report with his license being suspended twice, and he was shocked that no one would hire him. If you do have a bad record, consider going straight to Paramedic School if you are already to deep in EMT school.

Google "Corportate Training and your city/state". I used to work for a hospital-based EMS as a manager, and they would bring someone in to teach us something at our annual management planning sessions (usually 2 days of speakers). You would be amazed at how much regular corporate training crosses over into healthcare. Since you are a multi-department group you might want to focus on teamwork or communication skills. Updates in medical law or grant funding could also be useful, strategic planning and or budgeting would also be useful in this economy. Or, many of these companies will come out and do "events" that teach instead of just speaking. I remember one on where we were divided into teams and we each had to build an exact replica (every color block had to match exactly) of a lego building that was in the center of the room, we could view it, but we could not touch or move it. We had to take turns being the "viewer" who went and looked and then reported back to the builders (could not write stuff down). Sounds corny, but we learned alot about communication and teamwork from that one simple exercise. Anyhow, one of these people would be much cheaper than a celebrity, and if it's local, you wouldn't have to pay for a hotel room for them, unless you keep them over for both days. I would get the group together via email and just ask, "What do you think you or your department's biggest weakness is?", and go from there.

Maybe this will help, I have not taken the test, can not open it on my phone, so sorry if this is not the link I hope it is: http://www.tolerance.org/activity/test-yourself-hidden-bias (definitions) https://implicit.harvard.edu/implicit/ (the actual test)