RuralKSEMS

We used to have one several years ago. Now we've got lifepaks.

I apologize for what you view as a negative statement. It was not in any way ment to come across that way. I've had family members that were in hospice. He was no less deserving of any form of treatment. We were down graded by my director after having already being cancelled by dispatch. We were continuing to the scene to offer assistance as we could until the chosen ambulance company could get there to assist the family in this person's care. We just did not reach the scene to offer assistance before the other company got there. I've been canceled more time then not and I can understand the families point of view also. I probably could have explained myself better in the OP. My frustration was more to the point that dispatch more then likely f'd up for the upteenth time which gets extremely frustrating. We'd have gone to the scene no matter what it was, arrest, hospice (which I've transported several times), cut, splinter or to pick a drunk ass off the floor. We (or at least I) was more worried that a pt was not getting the most appropriate care by choosing a company that was twice the distance from their home. I could care less about the money, I did it for years with out getting paid and what I do get paid now doesn't amount to want somebody makes working for minimum wage at Mcds. It's not why I do it. Sorry again if I've been offensive, it wasn't meant to come off that way. Just more frustration then anything.

That is just nasty.

There apparently was a gap between when first reponders went and other service was dispatched and when we were dispatched according to my driver (he can hear more dispatch frequencies on his handheld/ pager then I can). I've not got the county wide channel on my pager, only local. We downgraded response when we found it to be hospice pt and the family requesting other service (about 12 miles out still). They only got ahead of us by about a mile. Other boss was pissed at my boss because my boss had us responding anyways even though other service was requested and we were canceled. My boss had us respond despite being cancelled because we were under the impression that it was an emergency and not a hospice pt that just needed a non emergent transport from home to the hospital. He (other boss) felt his toes were stepped on because we went anyways despite his service being requested. It's a small area, so it's not unheard of for egos to be involved. I was worried at first that the family didn't understand that if it were truly an emergency, that their loved one would possibly suffer by waiting double the time for the other service to arrive instead of the one that was closest. 15 minutes, as we all know, can cost a life several times over. To my boss it wasn't about money (fairly sure anyways) it was about what was best for what was thought to be an emergency. That is how it's supposed to be. If it's in our area, we go, period.This was in our area geographically. Doesn't matter if it's transfer or transport. Unless, for some odd reason, another service is requested. This is the first time in six years that I've had it happen. I'm guessing the family requested the other service to respond because it is in the town that the hospital that they were wanting transported to. We have the ability to transfer to any hospital in the area (rural hospitals) or to any of the city hospitals should we deem it medically needed to go there.

10-22: Cancelled. Not so much in pointing out blame, more interested in why this fell through the cracks and turned into such a cluster. We never made it to scene but other service did so I'm under the impression that the pt got the care they needed. Boss is more pissed because other service boss called him on his personal cell phone and bitched him out for sending us to the scene even though dispatch cancelled us. I don't care who's "fault" it is really, just more frustrated with the situation and looking for a place to vent. Apologies if I put this in the wrong place

So, I get home from football standby last night just getting ready to change (already have boots off) and the pager goes off for an unresponsive pt. Toss some shoes back on and head back out the door. Get to the station, get in the rig, we get 10-22'd because family requests an ambulance that is nearly 30 minutes away as opposed to our 15 minutes or less. Not to mention this is in our call district and we can transport to pt's choice of hospital. I'm wondering who has lost their minds because this pt is unresponsive and if he's coding, he's going to be dead by the time the other service gets there. My director comes over the radio, tells us to disregard dispatch because we are less then half the distance so we hit lights and sirens and head out. I radio the first responders about 5 minutes later asking for pt information so I know whats going on. First responder comes back across saying its a HOSPICE situation and family has declined first responders. We then go non emergent. Our boss calls on the cell and says to continue and if other service gets to the scene first, we 10-22, if not, offer whatever assistance until they get there. We get a mile away and other service gets there. We 10-22 back to the station. My boss is pissed because A: somebody gave/ got the wrong information and it went out as unresponsive and not as a HOSPICE transfer. He's also mad because the other service director called and crawled up his ass because he had us disregard the original 10-22 from dispatch because we were thinking we had a dying pt. Who does the ultimate blame (mess up, what have you) lay with? Dispatch, the other service, the family (I admit, incredibly stressful time if you've got a family member on hospice) or us for going ahead to the scene to provide care. Opinions and points of view appriciated.

Now that's just flipping amazing!

Awesome. It makes sense when you think about it really. They use service dogs for returning military members that are diagnosed with PTSD and TBIs. It could only help prevent PTSD in those that are in the search and rescue field.

Oh the fact that I let my self get into a near anaphalxis reaction to some medication after suffering for three days and I should have known better. I had hives from head to toes and everyplace between (HUGE hives, so bad I have scars from some of them) Ended up with a crashing bp of 68palp, having to have lots of fluids (ranging from NS to LR to potassium), solumedrol/ diphenhydramine IV q6hrs and a hospital stay then further benedryl/ prednisone after hospital for 2 weeks. Yeah, I needed a Do Not Ignore button after that. It was totally sucky and it messed up my body for months.

I also see no issues with you having attend the funeral of a long time pt. I work in long term care, we often attend funerals of those that we've cared for. I've only attended one funeral of the people that have been a pt of mine on an ambulance and that was one of my husband's best friends. I If you felt it was appropriate, then it was. It's not as though you go to every funeral of every pt that's ever been in your care and sob uncontrollably. The other guy's an asshat.

Sorry you vacation was messed up and I hope the young man recovers fully! Must of been scary.

I'll have to look into that book! Welcome from somebody who was born in 1980 (almost right at the damned end of it). I've been here a VERY short time but I already love it.

Wow. And some people wonder why the kids of America act the way they do today.

I was taught Manual as a baseline then the monitor PRN

Since we have very few paramedics that run with us (only 2 medics, we have four nurses) the major portion of airways we put in are Kings because of their relative ease use.

Funny because I've got one painted by yours truly in Centralia, KS (Nemaha County~ Seneca EMS st. 2)

In KS, all ambulances, volley or paid, are required to have 2 certified attendants on bored with one being at least the level of an EMT (if a nurse runs, the other attendant must be an EMT or higher). All services, regardless of who runs them, are under the KDOT and KSBEMS rules and regs. We aren't, however, required to have back round checks though I don't think that it's a bad thing in the least. Our AOs (drivers) are all CPR certified so they can help if we need them to. I think all or at least a good portion of our fire fighters are CPR certified if we need them at a scene. The only ones that don't have certification or a license of some sort are the firefighters but they do a great job at helping us at the scenes that we need help at. I can't believe you can have an operation like that in NJ. That's just asking for trouble. They should all at least have some worth while training.

Not the ones I run with, lol. As a "vollie" I've ever only been truly offended once. That was when a staff member of the STATE board questioned our intellegence, training and dedication. I was pissed as hell at that one. I tell each of my drivers/ partners in advance (I don't have a set shift partner, we all run with each other and I'm one of the techs with the most training) that if I offend/yell/ get annoyed with them, during a call to please not take it personally. I'm just trying to get what I need done in a timely manner. I try to be polite to everybody that I run with but when you ask an AO four times to clear the bench seat so you can transport a second pt rather then wait for a second unit and the sheriff has to step in and do it for you, my paitence is VERY thin at that point.

Yup, it sucked. And yup, he was agonal when we got to the scene. He put a 22 at an upward angle in his chest and hit everything he could. We tried but we all knew he was gone before we got there. Could have happened in the middle of an OR and still would have turned out the same. I guess I'm just worried about having a SIDS pt that's been gone awhile but you still feel like you have to do something because it's a baby and the parents are right there. I was scared when we had a prolapsed cord pt in the back of the ambulance. Knowing that if the baby died inutero, we couldn't do a damn thing about it. Proud to say, however, that that baby is now a thriving five year old.

In six years I've never had a farming accident. Car wrecks, prolapsed cord, one gunshot, a crap ton of "granny runs" but never a farming accident. But I've learned to never say never. I'm sure I'll see it sometime. And, you can bet that we were thankful that we have a doctor in our rural area that is able to do emergency c-sections if no surgeon is available (nearest one is 1/2 hour away and only in house on Mondays). Most of anything serious gets shipped out (we also do interfacility transports to larger hospitals). But, a number of us have PHTLS training, we run with a few medics and nurses, about 15 AEMTS and quite a few EMTs. LOL, it's my mother's weird spelling idea when she had twins and didn't know she was having them until the doctor says "hold the shot there's another one coming". I'm a woman. I guess I could have grouped my husband with the kids, as he acts like one part of the time. The dog think's he's human all the time, lol. I've been busy looking around and commenting on threads that interest me as I get to know everybody here I live in a town of 500, two small hospitals with in 20 minutes, another with in 30 minutes, a level 1 trauma center with in 60. (I'm an hour north west of Topeka~ the capitol, 25 minutes south of Nebraska, 75 west of St. Joe, MO) And you would be correct on gender I don't scare that easy. And it's all in good fun, which makes life interesting.

Several years ago, our county made uniform addresses mandatory for the county. Starting at the far southwest corner, every road and cross road is either numbered or lettered at the mile depending on which direction the road is going. If it is a road that is on a quarter mile it gets a number after it (A2 for example). Each house is required to have a reflective sign at roadside with the proper county assigned address on it. Helps with fire, ems and police dispatch. I still sometimes have trouble finding and address when I drive (I've only lived here for a 10 years) so I will ask one of the "old timers" where I'm going if I'm driving. Otherwise, all of our AO's know pretty much where we are going or I'll wait for police/ fire to get ahead of me and I'll follow them.

We have an issued polo and a lightweight jacket.Also a NIMS tag that serves as our ID. Anything else we have to provide. I have two other navy shirts with my call number on them that I wear. If I'm on a standby, I wear my EMS pants and my polo or tshirt with my boots. If I'm on call (from home) I wear black pants, tennis shoes and the tshirt or polo. If I'm going on a call that requires extrication, I'll put on the EMS pants and grab my boots to put on on the way to the scene. I bought my own stethescope, and shears. Anything else is in our jump bag on board. According to new state rules, (KS), unless I'm on call or duty, I can not do anything but basic first aid/ CPR measures.

No discounts here in the towns that I serve. Of course, we're pretty small. I think one of the larger hospitals has an EMS room that has snacks and stuff but that's about it. A store in one of the larger towns that sells uniform pants gives a discount with an idea but that's all I can think of.

Because of the place that we live/ run (very rural) we often have to leave our equipment with the pt at the hospital. The hospitals that we routinely transport to, store this equipment in a designated area for us to retrieve later. Anything beyond basic illness/ injury is transported to another, larger hospital that is better equipped with the doctors/ ORs/ surgeons needed to deal with certain injuries and illnesses. All equipment is marked with our service name and number so that we can get them back from even the larger hospitals later.

In my six years in EMS, I've only had one code that I've worked on. I live in a very rural area. There have been other codes but I've just not worked them (I think between five and 8 in my call area total). It was one of my first runs. A gun shot wound (self inflicted in the chest) in a man that was one of my husband's best friends. He'd held my children and eaten at my table many times. Even now, five years later, I tear up about it. I was involved in the code (pushing the AED button). How I managed to hold it together the 15 miles to the hospital I'll never know, but I did. I walked passed his family that was waiting, out the ED doors and around to the other side of the ambulance and lost it. I did it out of view of his family, which was my only goal. How death affects a person is a deeply personal issue. In the last five years, my family has lost a best friend, another friend (both to suicide), an aunt to a motorcycle accident, another aunt to lung disease (both under the age of 43), two grandmothers, my husbands stepfather, my dad, my husbands dad (all between 46 and 52) and a cousin. That's enough for a life time. Add that to the fact that I used to work at a long time care facility, while I'm not "immune" to death, it just doesn't bother me as much anymore, unless it's a close family member. I'm terrified, however, of running a call that involves a child, especially one around my own children's ages. You'll never forget your first code. I still have moments (few and far between) where I see my husband's best friend and think of the what ifs.