ALERT Medic

It is.

Mass casualty? I'm sorry to be the critic but correct me if I'm wrong...are you not going to black tag the patients who are not breathing? I believe that's standard procedure in using S.T.A.R.T triage. As for the use of condoms, not really a bad idea but I believe someone put it quite simply somewhere in this thread about blocking your view and decreasing your light. My question is why not just use disposable blades? They don't expire like rubbers do. And thanks to everyone who is displaying their inner comedian. I just didn't have the heart to screw with the thread as the original poster asked not to, but thanks to those who did. It was a good laugh.

We do our scheduling around call demand. Every year we re-evaluate our call volume for the different times of day and days of the week and that's how we determine our scheduling for the entire year. If no significant changes in call volume, we don't make big scheduling changes. If they need to re-align the shifts a little, then usually there is a bid process that, sometimes, everyone has to participate in but usually you only have to bid if you want another shift. So, therefore, we have set schedules for at least a year. Downside to this is the new employees might have been temporally placed on a good shift for them but when the bid comes around they get screwed into one of the most least desirable shifts. It's done on seniority. I hate it for someone who has to work in a system that is mentioned in the original post. Hope someone can change all of that.

Oh yeah, one more thing. It's easy to get frustrated with psych pt's...trust me I know. You have to remember that even though they are labeled by society as being crazy, that they have a legitament disease process that makes them that way. They can't always help the way they are.

We have to transport psych pt's if they have done something to harm themselves...i.e. taken too many meds or tried and failed miserably to cut their wrists. If it's just a simple matter of someone who is depressed or hearing voices but has not done anything to harm themselves, the police will transport them to the local mental health facility. Only in cases that need medical clearance by a physician do we take them to the hospital...plus, the mental health facility here won't accept ambulance patients. I've had a couple of voluntary commitments coming from hospital ER's that we've had to transport but for the most part, we're dealing with the people who call us from home as a 911 call than the inter-facility transports.

This is the meaning of implied consent...Thanks for clearing that up for our brother in the great white north.

Best post yet Marty!

You're not causing conflict...trust me. There's just a few people who come off as being more than frank with people and it seems like it causes conflict. Dust and Rid, I will say this, I have to agree with just a little bit of what you say. I've seen people come around ems that have plans to go on to PA or MD school and never leave the back of the truck but that's the exception not the rule. I've seen more people actually follow through on their goals than become complacent in doing ems. Either way I think wolfe got a little embarrased just for introducing herself and last I checked we were supposed to be posting here to encourage our colleagues, not make them feel like less of a person for choosing ems. Anyway, not trying to further cause conflict here, just sticking up for someone who has dreams and goals...and for the record, I never took her comments to be complaining. Don't know where ya'll came up with that one.

Ok Dust, I think you're being a little harsh on this one.

Ok. Thanks for clarifying.

I guess I'm showing some ignorance on this one...but what do shaved heads and oakleys have to do with being considered a paragod? I agree with the stupid vanity plates and the wacker tattoos but I'm a little puzzled on the rest. Maybe it's just an old joke that I haven't seen before. Anyway, just wondering.

Neither do fire fighters but every fire department I've ever been around wear badges. A badge doesn't automatically mean you have "authority". I could comment on this thread all day but it'd be futile in so many ways.

I think this could be a hot topic. First of all, I think too many people have been watching too much television. I've read all the posts and for those paranoid paramedics out there...if you're that worried, get a female nurse to go with you. I tend to agree with the others who have posed the question of how common this happens. I mean, think about it folks. If you are a good medic with a good reputation for delivering excellent care and displaying outstanding professionalism and you happen to be one of the very few medic's that ever get accused of something inappropriate with a female psych patient, I don't know how far it'd really go. The doc's should know you well enough to be able to consider it to be a bull sh!t accusation. Most of these patients will be doing the same crap when you get them to the hospital anyway. Lighten up a little bit. If you're that paranoid about a call like this maybe you should look for another profession. There's way too many other opportunities for us to get caught up in some trouble. Think about it.

Sorry dust, I disagree.

Oh, heck. Just to get someone going....yeah. I'd stick around! No, seriously, I understand where you're coming from but I was in a hurry when I typed that response. We are also the banking capital of the south. Yep, that's right, lots of big important targets if you know what I mean. Maybe none that everyone would recognize but ones that would cripple our economy. DHS has labeled our area as a high probability for terrorist attacks. Now, as for training, that's a whole other subject. If someone would start the thread, I'd love to respond. I'm not going to cross subject lines on this site like others I've been to lately. Be safe.

It's grant money from DHS strictly for the purpose of responding to MCI's and terrorism. Also, if you want to ask me about our current training situation, just ask. I can tell you it's more than most big city ems services do. Anyway, not trying to inflame anything, just thought I'd explain a little. When you work in a city within 50 miles of 2 nuclear reactors you have to be prepared for anything.

I can't really speak for the hospitals but I can tell you about ems preparedness. We have an extensive MCI plan that involves mutual aid agreements and things like that but if you're asking about terrorism response, well that's a whole different discussion. We have a team that was developed by our medical director and medical services director that involves multiple different agencies. It's called the Advanced Local Emergency Response Team or ALERT. We all train together to respond to terrorist attacks. Our service has the MCI unit, the fire service has the decon units and hazmat units, and police have the EOD type units. I think the team consists of the following agencies (hopefully I don't leave anyone out) U.S. Marshall's office, FBI, local police (SWAT), fire, ems and sheriff offices. We also have a state of the art mobile emergency department. Some of you may have seen coverage on Oprah and other shows of our response to hurricane Katrina. The Mobile E. D. or MED1 belongs to the local trauma center. It's staffed by Md's, Rn's and paramedics. Anyway, that's our basic MCI/terrorism response capabilities in a nutshell.

What fire station do you guys work out of?.....

We all second guess ourselves at some point in our careers. Some more than others. My medical director put it pretty simply to me...if you don't second guess yourself then you probably don't care about the patient or your job. My point, like others, don't sweat it. I still second guess my actions sometimes. It's human nature. You may have done just fine as far as others were concerned but your own self evaluation of the call will always be more critical than others. As ems professionals, we are our own worst enemies. Learn from what happened and move on. Take care.

I carry a small medical dictionary with me for cases just like this. When we went to using ePCR's the software maker conveniently left out spell check. Does that make me a lousy paramedic? I don't think so. There are some of us who just never were good at spelling or grammar. Now, if I had poor grammar while talking to a patient or other medical professional then you can call me ignorant.

I'm not even touching this one!

Charlotte, NC. 542 square miles and 75,000+ calls/yr.

Never heard of do not intubate orders but I'll throw this one your way...I had a doc recently get pissed because I treated septic shock in a nursing home patient who had a DNR. Last time I checked, intubation and cpr were considered resucitation, not dopamine, iv fluids and oxygen.

I think denying care due to certain religious beliefs is no different than denying based on race, sex, ethnic background, or socioeconomic status. I have read this whole thread and I can see how this is going to become a heated debate, and that's good. Bottom line is, if you have certain religious beliefs that might impair your judgement on weather to treat or not to treat, then maybe medicine isn't the best line of work for you to be in. I don't agree with some of my patients problems but that's not going to change my treatment.