strippel

Don't really have a name for them, just a$$holes.

Every now and again, we'd have someone use the ambulance as a taxi. Since we are stationed at the hospitals, we can see them walk out.

For a while, we had some druggies who lived about 10 miles north of the city. Just so happened there was a community hospital there. They would get a ride into the city, sell their drugs, buy others, and use them. They would then OD, pass out, and someone would call us. When we woke them, they wanted transported back to their hometown hospital, so they didn't need to call for a ride, take a bus or cab. Just after the second trip with them to their home town, it was figured out. Now, they go to one of our fine city establishments.

Patients with real medical issues get the stretcher. Anybody else (notice I didn't use the word patient) gets walked and benched. Walked in to the ER, and 99.9 of the time they will have us take them to triage.

Pretty much how we do it.

If we pull up, and the patient is walking (no matter what the complaint), they keep on walking to the ambulance. Especially the ones that run to open the door for you, let you in, and then run upstairs to get some stupid thing, like matching socks. When the return, they walk to the ambulance, and try to get on the litter. Ain't happening.

If someone is sick, and the litter will roll to where they are, they can ride on the litter. If they are upstairs, and are sick, I will use the (new) stair chair to carry them down to where the litter is on level ground (where the litter can roll fine).

There is no reason why someone who is not sick, cannot walk down the steps. The idea of carrying people just because is dumb. I also can't understand crews who carry patients down steps on hydraulic litters, or any litter for that matter.

I have been in EMS for way too long, and know within a block or two where I am going. Usually.

On the upside, it is usually easy to find the 0-hundred block of most roads, it starts at the square downtown. Other things that make it easy are...

If you have the dispatch computer up in station, the call lists cross streets, so you don't have to ask. If you have to ask the dispatcher, the county follows the ADC brand map book. Every call location includes the map page coordinates, and cross streets.

Driving, or walking around are really good ways to learn. We try to take all new employees to the busy streets, and high 911 activity locations. Either that, or we tell them to buy an ADC map book, and put it under their pillow at night.

Dust, "they" would be the NR reps, hosting the practical testing.

Just to make it clear, this was not the testing yesterday at Harrisburg.

My practical testing was a long road.

I would like to thank my instructors and preceptors.

I would also like to thank the evaluators who made me feel relaxed, and allowed my process to go smoothly. One is 'Doc' from Harrisburg. I wish I remember the name of the other. She is a tall Black woman from the Delaware County, PA area, who was a manager of a service there. She was very personable, and easy to work with, without her breaking any NREMT rules.

On the other hand, I did meet a few evaluators I would be glad not to see again. One screamed at me during my station. I don't know why, I don't remember doing anything to upset him. I thought I was in the military. Others would constantly 'sigh' loudly, tap their watch or pen loudly for the duration of the station. One threw down the evaluation papers, rolled his eyes, and then waved his hands rapidly to get me to hurry. I was well within the time allotted. I did pass his station. Luckily, these evaluators are not from my area.

I did file a grievance on the guy who yelled, but they decided nothing was improper.

Well, today I took my last practical station at the NREMT-P test today, and passed.

That means it is official, I am a paramedic.

Now the learning really begins.

We respond to too many "fire standbys".

Although some companies modify it, we have a county protocol to be dispatched on working fires, high risk alarms (nursing homes, high rises, factories that make dangerous stuff, etc). And gas leaks.

Unless there are injuries or entrapment, we respond without lights and sirens. We usually don't make it to the scene before we are cancelled.

We are dispatched on too many fire calls now, I wouldn't want to go on all of them.

That said, every now and again it is fun to pull hose, or throw ladders for the fire monkeys.

Volunteer FireMonkey Rant on.

My partner and I (two old timers) settled in for our 12 hour suburban shift. Luckily, it was a pretty quiet day. I had an EMT student with me, and spent time asking her questions. Just as I finished quizzing her while washing the truck, we get dispatched to a crash with the VFC across the street.

We have a plan. If the call is EMS in nature, we move quickly so we don't get run over by the responding engine. If it is Fire in nature, we sit on the ramp, and watch the volunteers as they cut off other drivers, then speed away in their $500,000 tax supported fire apparatus.

Today, it was dispatched as a minor crash. We arrived on location in about 1 minute, and found 2 cars on the side of the highway. As they, and no one anywhere near them were in a crash, we returned to the ambulance to call the county dispatcher. Police arrived, and we talked with them. The between EMS and PD, we covered well over a mile of bumper to bumper (5 lanes) roadway. No crashes noted. County had 2 different callers, none were involved, none still on the phone. We discussed with the officer, we would both go down the road, without lights and sirens, and look further.

By this time, volunteers had now staffed 2 engines, a truck, and a squad, and are screaming down the road at a high rate of speed, with Qs blaring. We advise them that nothing is found, and that we talked with the officer. They now devise a plan to split up their apparatus, and proceed to drive at high speed all over the interchange, and on multiple side streets, with sirens blaring.

PD and EMS have gone available after checking the likely locations. Fire apparatus is still speeding all around at a high rate of speed, lights and sirens on.

With all EMS in our county being at least partially paid, there has been increased professionalism. There have been many who have attempted to improve that attitude of the volunteer fire service. One local chief even works with nationally known instructors to bring safety education to our area. All of the other companies we work with show organization and professionalism. It is a joy to work with the union boys, or Amish firemen over these guys.

Rant off.

Do any of you work where there are "scary" volunteer services? What have you done to improve professionalism (especially safety related) with these services? We have tried talking to other chiefs, and they don't want to get involved. We try talking to the company members, and they tell us to mind our own business. They know more than we do, no matter what.

On the ironic side, our maintenance and EVOC officer USED TO be a member there. He was suspended because he was unable to attend their home grown driver safety class.

Twice that I remember, and it really pissed me off.

It can be very difficult, but I try to treat every patient with respect, and dignity.

One time, got called to the home of a then elected city official, his 90+ year old mother on the third floor was not feeling well. My partner and I introduced ourselves, and had good interaction with the official, and his very pleasant mother. I politely asked if I could call her by her first name, and she stated that was OK. Her very upset (and vocal) grandson arrived, and starts screaming at me and my partner, and calls us rude and racists for not being polite to his fine grandmother.

The father tried calming the son, to no avail. The son is now yelling outside, and a crowd is forming. (White EMS crew, fully Black neighborhood). Background, official is very respected and well liked. Son, self proclaimed preacher, wearing $500 suit, complete with leopard skin hat and cape.

We carry his grandmother outside on a stairchair to the waiting litter, where the grandmother now sees her grandson attempting to work up the crowd. The grandmother, in front of the crowd, loudly puts her grandson in his place.

Second time, had a Black woman with an anxiety attack. We got accused by her husband because we did not carry her out of the house. My partner, politely (but obviously without enough tact) explained to the husband that it was unsafe for us to carry his wife (larger than both of us combined) down 3 steps, which were missing nails, treads, and a railing.

Our supervisor arrived at the hospital, and before he could even open his mouth, the patient's husband screamed, accusing him of being a racist also. This in the middle of a crowded ER.

I'm sorry. True story, funny and stupid, needs to be shared.

That, and I am waiting for the sun to rise. It's my day off, and I need to finish staining my fence.

On Sunday, my partner and I got dispatched to K-Mart (outside our district, assisting another agency). Our call was dispatched as ALS, and the information was "two women fighting in the alcove". I didn't get it either.

Arrived to find a 16 year old female in the back of a police cruiser, her mother and grandmother are talking with officers. Basically a domestic/emotional problem. Since there is no real need for EMS, my partner is waiting for the BLS crew to cancel him, It is quite sunny, and I misplaced my sunglasses. There is a dollar store next to the K-Mart.

I tap my partner on the shoulder, and point to the dollar store. He shakes his head, and again tries to get the BLS truck to cancel him, to no avail yet (I don't think the combined age of the BLS providers was 36).

I find the ugliest sunglasses I can find, and get in line. In front of me is a husband and wife. The husband has only one tooth, and the corresponding number of brain cells. They feel the need to tell me that the girl in the cruiser was stealing cartons of cigarettes from K-Mart, and delivering them to Black men waiting outside. I think he also through in something about a government conspiracy. He then told me about how he is building a chicken coup, in detail.

A minute later, it is my turn. I hand the cashier my sunglasses and $1.06. She rings me up, and asks me if I am going to wear them now. I answer yes. She proceeds to take the tags off for me. She then holds them up to the light, and comments on how dirty they are.

Before I could close my eyes, the cashier, wearing a tube top and a green vest, whips up her tube top, and uses it to wipe off my newly purchased sunglasses. Thank God she was wearing a bra. After wiping them, she hands them back to me, and says "sorry if they smell like titty".

Needless to say, I didn't bother finding out.

Well, the sun is now out, so I will be painting. That, and avoiding the mess because W is in town today.

I have taken many patients who are either "in custody", or under arrest and in handcuffs, without an LEO in the ambulance.

Any patient out of the county prison gets two extremities cuffed to the litter, and a prison guard rides in the ambulance, another follows in a car.

With the city or township police, anything can happen. If the arresting officer is in a car alone, he will usually handcuff the patient (to the litter if a chance of problems), and then follow. Bike officers put the bike in the back of the ambulance. Mounted officers, we tried, but there is not enough room. We thought about a hitch for the horse trailer on the ambulance, or bungee cords for the roof, but... If police are in a two man car, not a problem.

We have regularly transported handcuffed patients without LEO in, or following. At the hospital, there is almost always a city officer working. Most security staff are LEOs, and are able to watch the patient until the arresting officer arrives.

Luckily, we have not had any criminal/EMS media circuses.

Let fire do it.

At my full time, we are lucky to have many qualified volunteer firefighters in are district. Our paid city department has VRTs, and runs two rescue engines.

There are also multiple volunteer heavy rescue units, and most volunteers are well trained. We thought about putting a tool and all of the associated equipment on a truck, be decided against it. Besides, our service has SERT medics, and the county MCI trailers. That keeps us busy enough, plus almost 30,000 calls a year.

At my part time, it's a different story. Capable fire departments are not pleantyful. Our supervisors submitted grant proposals for a vehicle and equipment.

In some areas it works great. Some of our guys are vollies with fire, and things get done well together. In other areas, you get a bunch of old pick up trucks arriving on scene (with light bars that are worth more than the truck), and guys running at you with pry bars, axes, and no gear. Scary.

Kanga's avatar is identical to a local township seal. They are Cumru.

Anyway, on to first reponders....

In the city, paid FD is dispatched on all calls that sound like they may be a cardiac arrest, so we have manpower. City Police respond on any possible crime related issue, and will try to show up on all calls; when available. Both have AEDs, and are very helpfull.

We cover many townships, and their volunteer fire departments vary. Some have QRS units which respond on all EMS calls. Two are suburban, and have live ins, and like to keep them busy. Others are very rural. Other departments just assist on cardiac arrest calls. Others don't pay attention to EMS.

Had a slightly similar occurrence a few years ago. I was working a BLS quick response vehicle, and was dispatched to a crash, car vs pole. (it was a small town, our truck for that area was out, another BLS was responding from a further station, along with my ALS supervisor).

A female with seizure history, seized while driving with her grandchildren in the car. Low speed crash, not too much damage (the car was still drivable), children were properly seat belted, self extricated, outside with friendly bystanders.

The patient was still seat belted in the car, seizing. Volunteer fire is pissed, want me to yank her out of the car, and place her immobilized on the street. Luckily, there was a vol EMT on the scene helping me. We had a collar and oxygen on her, and were attempting to keep her calm and still. She was sitting in the drivers seat, still seat belted. There were no safety hazards, and nothing for her to hurt herself on. When the BLS truck got nearby, the EMT and I finished immobilizing her, and placed her directly on the arriving litter.

The patient had no obvious injuries, and was not a load and go (with nowhere to go). I didn't see a need to lay her on the hot asphalt until the BLS Arrived.

I passed mine on Monday. I didn't think it was so bad. Took me about 1 hour. I honestly did not notice how many questions I had.

I got to work, but couldn't check the NREMT web site, as they were upgrading (more like slowing down or system). I got a phone call from our Ops Manager congratulating me around 1030.

Now if I could just take care of static cardiology.

I am by no means pro NFPA, but you will probably not find other emergency vehicles with amber toward the front.

We solved the problem with white/clear toward the front. On our older trucks, the white lights would turn off when the ambulance was in park. Those were either the center rotators, or intersection "sweeps" on a MX7000.

Some of our ambulances had the Whelen bar (rotators and flashers), with a center white flasher. They would turn the white flasher and rotators off when the ambulance was placed in park. We then replaced that with an Opticom.

Now our ambulances are all LED, with the white being an Opticom. The Opticom turns off when the ambulance is in park, allowing traffic lights to work normally, and not blinding oncoming traffic.

In PA, we are only allowed to have one white light (showing) front, and amber only to the rear.

In Pennsylvania, EMS is not "required".

Municipalities are required to provide police and fire services. In most places, that means state police coverage, and a small donation to the local VFC.

In our area, municipalities are becoming involved on the fire side. When you have multiple small VFCs serving one township, and they all want new apparatus at the same time, the costs add up fast. Most municipalities have forced the VFCs to work together, and in some cases merge.

Currently, municipalities CAN specify a "primary" EMS provider. There is a new law pending that will REQUIRE municipalities to "provide" EMS service. We'll see what happens.

OK. Looking for help, preferably from someone with Education or a psych backround.

Here is my story. Graduated from paramedic school, did alright. I took my national practical test, and passed 11 out of 12 stations "flawlessly" (per the DOH rep). The last station of the day was static cardiology. It was late, I was pretty tired, but confident.

I went into the room, and knew the proctor. My mind went out of control. Every rhythm and every protocol was running through my brain at the same time. I could identify the strip, but what I thought and what I said were two different things.

I failed. Now, I should have filed a grievance, as the cards were quite old, ink was faded, and the lamination very cloudy. I did not find out later that many did not pass that station, and there was an issue with the same cards at the last test.

Against my better judgement, I retested the same day, other strips from the same old, faded set. I failed.

On Thursday, I retested static, and my mind became a blur again. This time, a different location with different cards. I failed.

Obviously, I have an issue with the static cardiology station. I am not a brain, but obviously stayed awake long enough in class to pass dynamic, as well as ACLS and PALS.

Can anyone offer any assistance in surmounting my "phobia"?

Does NREMT offer an alternative testing style?

I see very little reason to go to the hospital with lights and siren on.

In my full time system, we have priority dispatching (Clauson via county government dispatchers). Callers are questioned, and calls are given a nature code of 1,2, or 3. One is an ALS emergency Chest pain, overdose, diff breathing, unconscious), and we CAN respond lights and siren. Class 2 is BLS emergency, (vehicle accident, fall victim) and we CAN respond lights and siren. A class 3 call is non-emergent in nature, and no lights and siren are to be used. If the class one call is severe in nature, our supervisor, or an engine company may also be dispatched. Many will respond non-emergent to priority calls. We are a city/suburban service.

That said, I can count on one hand the number of times I have an emergency response to the hospital in the last few years. Our facilities are pretty close, and patient care will not be effected by the few extra moments.

My part time is somewhat different. All calls are dispatched the same way, and most providers like to respond with lights and sirens. There is a movement to "slow" responses", but nothing organized. It is just a group of tenured providers with common sense.

Transporting to the hospital is different. The area covered is very large, with heavy traffic. There are only two hospital in county, out of county are much farther away. Many providers will use lights and sirens, as it can easily save a few minutes. This is a suburban/rural service.

I can't easily see the time savings (in safety and patient care), but some of my partners think they can.

And is she hott?

Her husband thinks so. 8)

Congrats to my friend Linnea, who passed her NREMT-P test.

She recieved her notification today.

Now she has to wait for the letter from the PA Department of Health. (It is temporarily shut down due to no state budget).

We must be neatly groomed. Long hair is OK, as long as it is neat. Facial hair must be neat and trimmed.

There are quite a few men who have beards, with about half being goatees. During hunting season, the number increases.

Keep in mind that volunteer firefighters in my area are allowed to do interior firefighting with beards. It is due to religious beliefs, and they must document a prior tight fit test. Also, volunteer female EMS providers can wear skirts.

Damn. 7%.

It would have been less, but I was honest with the scanners. I have one at home, unplugged. The second is under the back seat of my truck. I was going to install it when I got the truck new 2 years ago.

But to be fully honest, our county has an online dispatching system. The generic version is accessible from home. I do look at that from time to time.

We have many people (especially the old timers) who have been using the 3" tape for years.

I am an old timer, but never got used to tape. I just use pieces of scrap paper.

We use tape to keep track of times and mile. (We are a city service).

As an EMT, I had read the book, asked questions, and followed scenarios from my paramedic partners. In years past, they had talked about stories "conquering" the Megacode. They were damn proud to pass, because the code was not "by the book", or made easy in any way.

I now have ACLS, as part of paramedic school. I too wondered about the over-acted and dramatized video we watched more than once. The written test was way too easy. Luckily we had to take the old and new written tests.

Does the attractive recorder with the clipboard and lab coat ever arrive on anyones scene, keep track of your timeline, and then ask about considering the H's and T's? And what was up with that guy's eyebrows?