strippel

I would like to be able to lock, but...

We were getting locks from the hospital, to make life much easier for the ER nurses. A big issue ensued, we are no longer allowed to have them.

The locks we have are tiny. It is much easier just to hang a line.

We transport to multiple hospitals, and none use the same tubing, so we use cheap generic. If the patient is sick, the ER must change the tubing anyway. It is actually less expensive for us to use a bag and line, than the locks we would like to use.

We run 10 ambulances during the day. 4 are BLS (2 EMTs), 6 are ALS (1 Medic/1 EMT, sometimes 2 medics depending on staffing).

We normally handle our own city/suburban 911 calls, but frequently get called to assist the volunteer BLS out in the county. They arrive first, or we get there at the same time, we ride along in their ambulance. Otherwise, it's our call, and they go home.

I have been in 3 "accidents"during my career. No one has been injured, and there has never been any damage to the ambulance.

First time, car pulled over, I passed, they pulled into the travel lane before I was completely passed. A pair of pliers fixed the damage to their wheel molding.

Second, I wasn't driving. Ambulance brakes failed, struck 2 cars in front, stopped at a traffic light. No damage to the ambulance, or front car.

Third time, just didn't see the other car. No damage. Other driver admitted to the cop he couldn't identify any "new" damage to the his car.

I've been safe and lucky, want to keep it that way.

I would recommend an all LED lighting package. For the last few years, we have gotten all LED (except for scene, headlights, and front turn signals), and it has made our maintenance guys life much easier. It has also drastically reduced the electrical/alternator problems.

We have center mount litters with dual bench seats. They work wonderfully. Our service constantly has students, multiple patients, and specialty transports, so the extra room comes in handy.

You might want to call JeffStat and find out what actually goes on during those extra 50 hours.

The Generic EMT class in PA (which by law is "administrated" by a college, but not acredited) just gives you an EMT and CPR card after passing the tests.

Some classes (like the one we run in Lancaster) also include EVOC, hazmat, BTLS, and (don't freak Dust) ALS assist.

Never really had a problem here.

The cops will always ask occupants. Usually, the call comes from a uninvolved party, so Fire and EMS get shipped. I have no problems going back home if the cops cancel us.

Every once and a while, we will get sent back, usually non-emergent for a sign off. Or... someone gets the idea to be sue happy, and claim injuries.

The county just north of us was pretty rural and behind the times, until recently.

It was not uncommon to hear a call dispatched to "Jakey's House", the township and complaint. When units would sign on, they would get the additional. "Go up the road to the old church. Turn right, and go aways. It's the fifth driveway past the barn that used to be there."

I was waiting for the dispatcher to say: "turn right at the rock that looks like a bear", or "ask the heifers at the gate for directions", but that never happened.

That is the same jumpsuit that the COs put on prisoners when we take them out of the jail. Does that have 'LCP' written on the back?

Dawn, I give you credit for wanting to do CNA work. From your posts, you are intelligent, and obviously care about other people.

My dad is in an ECF, which he hates with a passion. He has had issues on and off with the one full time CNA. She TELLS him how he should think about things, especially the Bible.

Anyway, back to you. Good luck, Dawn.

We did more than 29,000 last year, up about 2,000 from 2006.

Our average is about 60% 911, and the rest IFT.

Mike's got it right.

Although he is closer to the city than I am, I have heard and seen what he says.

One of our "newer" medics left PFD, and moved up here to the country. He has told stories. Also, we have had medics go down there to work for experience. They returned fast.

It is sad. Such a beautiful city, with so much to offer.

Darn, they are nice in Kansas.

In PA, you'd need to fully stock (by state standards--12 lead monitor with capnography, drugs and fluids) and provide a list of providers able to provide 24 hour coverage, and then apply for an ALS license. Then they would inspect your vehicle before allowing the license.

We pretty regularly have "observers" ride with us.

Our observers are either student nurses, or students with intrest in the medical field. Sometimes we have local goverment officials.

Other than that, why would there be un-certified people on the ambulance?

On the up side, we have out own EMT and Paramedic classes, with over 50 students enrolled. There won't be any room for student nurses.

We have used "residentially challenged", and "domicile challenged" before.

Our favorite is "urban outdoorsman".

Congrats!

I've been a medic here in PA for about 6 weeks.

Where are you?

I will gladly tell you, since you are the "new girl'.

It is an EMS term of endearment. It's kinda like noobie or probie, except not politically correct.

FNG = F-ing New Girl (or guy).

As far as DFO, if you work in a system that has any urban area, you will hear that term. If you find a person on the ground, either semi-responsive, unresponsive, or dead, the bystander will state, "I don't know what happened, he just done fell out". The bystander is usually the patient's best friend for many years, but only knows the nick name, and the patient's favorite brand of smokes and booze.

I have never used DIB ever, nor heard it used. It is definitely not on our approved abbreviations list.

My guess is the same as yours.

Since you are the "new girl", do you know what these abbreviations are?

FNG

DFO

It all depends on the definition of assault.

I can say I have probably been assaulted 100 times. Most due to true medical reasons, opposed to violent psych crack head customers. Luckily, I have either had good partners, or law enforcement on the scene. I have never been injured in an assault.

Following the broad definition, I was assaulted the other week. A drunk who is blind tried to swing at me, then spit. Luckily, I moved from where he last heard me, and when he swung he lost his balance, and almost fell. He started hocking up a loogie. When he spit, it got stuck in his beard. Luckily, the cop and I were on the same page, we took him to the ground. No harm, no loogie.

The cop and I dragged him to the cruiser, and I sent my partner for a mask.

On the upside, my partner was a noobie, and made me laugh. We were on scene about 3 minutes before the patient was cuffed, and the cruiser was leaving for jail. He asked me how he was going to write a PCR assessment when he didn't get any patient info.

I'm not a blogger. And for those excited about looking at my boots, I apologize.

I am no longer a "student" as defined by a previous Dust reply, but I still have a lot of learning to do. I have been working as a paramedic for about one week now. I figure I can let the students know how I've been doing.

I am currently an apprentice. That means I am a second paramedic on the ambulance. There is a senior medic and an EMT also on the ambulance. I will be third person for a few more days. After that, it will be just a senior medic and me for a few weeks.

I have run about 25 ALS calls. Most pretty non-descript. Couple of generic chest pain, difficulty breathing, weakness, dizziness, etc. My two current downfalls are: 1) IVs. I did OK with them in school, and in the ER, but now my previous phlebotomy experience is hurting me. 2) The protocols that I knew, I now find myself not remembering. I knew the ALS protocols as a BLS provider. I am probably thinking too much and doubting myself.

I was told I needed to cut my on scene times. I would like to be faster, and more detail oriented. Considering all of my student time, I really had no critical patients.

That is where my boots come in. Last night was it. Shooting victim, robbery. Single wound to an artery. He bled out and was in PEA. Supervisor and I were hoping he had no activity, but... Called medical command, who of course said to bring him in.

So, one week as a medic, I had my first critical call. Patient transported to the Trauma center, where they cracked his chest, open heart massage, gave him blood, to no avail.

So, two hours late coming home from work, spent that time in the police station. All of us had our boots photographed. Mine are sitting outside, still with blood and barf on them. Luckily my new ones just arrived UPS.

So students, take advantage of everything you can. Do as much clinical time as possible, maybe even more. Don't over think, or obsess. Pick a "diagnosis", and treatment algorithm, and run with it. Keep on learning.

ruff, we have been inserviced. Not that I want to, but I can't take the blame/credit.

Our Director talks of cutomers, as do our "member" hospitals. There are surveys. It is all about customer service.

There are signs hanging everywhere in the hospitals, and we need to follow along.

Also, there are not calls or jobs. They are requests for service. All are to be thought of the same. It doesn't matter if it is a wheel chair transport, litter return to a nursing home, specialized inter facility transport, 911 call to triage, or the biggest wreck you've ever seen.

We take a decent percentage of our customers to triage. There are many regulars, and people with small boo boos who call.

At our main hospital, the ER charge nurse has to look at the patient as you come in the door. (Either walking, or on the litter). They will either ask you the deal and decide, or just point to triage. We then put the patient in a chair, and put them on the list. If we have time, we find one of the triage nurses, and give them the story. Usually, they are busy, and we are going on another call.

There are many times we have to wait for a bed, or use the "gasp" dreaded hallway bed, until a room frees up.

The second hospital, you walk the patient past the ER staff, and then triage nurse, to get to the waiting room.

The other two hospitals, we always get a bed.

We use ePCRs, so we do not leave a written copy. Our computers are only located in the stations, so even if we had the time, we couldn't write in the trucks. Besides call volume is high, transport times are short. If there is a problem, ER staff knows how to find us.

If things go according to plan (HA!), we should have SCMODS* in the trucks within a year, including ePCR software.

*Blues Brothers Movie reference

All police cars in our county have AEDs. They were purchased by the cardiologist group (as a tax write off) with the understanding that they will be used.

If a call comes in where an AED could be possibly used, they are to respond, unless they are dealing with a felony, etc.

In the surrounding areas, it all depends how many cops are working. If there is one cop, you get one. Sometimes you get more.

In the city, sometimes you have one cop, sometimes 10. it all depends. The street sergeant usually decides, and only one or two cars respond lights and sirens. Remember, there is an ambulance, supervisor, and a fire truck responding.

The new PA Protocols require 2 EMTs on a BLS truck.

I have read it, and agree with it. I just don't see it happening.

Some services come in from over the river (west), or through the woods (east) to our hospital. Frequently on 911 calls, there is an EMT with the patient, and an old guy (60+) with a fire company hat, driving. The driver is lucky to have a CPR card.

Scary.

In PA, there are many ambulances that respond with 1 EMT, and someone else driving.

I I remember correctly, the DOH requires drivers to have EMS training, but there are volunteer ambulances that show up every day with just "drivers" driving. Many of them are three days older than Jesus.

Only once, many, many years ago.

A cop's wife overdosed, and was unresponsive. We were 20 miles from the hospital, and there was no ALS available.

In our system, it rarely happens.

We have a volunteer QRS (which rarely gets out because it's... volunteer, and the rest of the system is paid). If they have to beach their Subaru, then so be it. It's out in the country.

If our supervisor backs up a truck, someone is usually found to drive it in. If we are in the suburbs, either on a serious medical, or crash, volunteer fire is there. They get excited driving the Excursion. If we are in the city, PD or union fire more than willingly will drive it to the hospital. Both hospitals are in the city, so they can remain available. We have even had the mayor (who was riding with PD) drive the supervisor truck in. If that doesn't happen, another crew will stealth over, and pick up the truck.

There are two services in our county that chase. They leave the paramedic SUV where ever it sits.