Ridryder 911

Sorry, I think comparing the two is totally different and irrelevant. I personally will send a medic home if they become in contact with a patient without gloves. There is medical reasons for such.. medics can never determine which disease states the patients may have. Just because grandma looks sweet and nice, or that small child appears innocent can be very misleading. In fact most of the exposures that I have sen resulted from these patients. Look at your own hands, your partners hands and see if there is not any small cuts, open areas or even cracked, chaffed areas. Folks these are not large molecular size viruses, or bacteria, research even shows that they might even be able to permeate some latex. If you get in contact with these YOU CAN GET SICK & DIE... short and simple ! Sorry, I have friends that was contaminated by patients, then afterward had to receive treatment. Playing Russian roulette, is foolish. As well, employers may pursue if you were not wearing the protection they provided you , they may not cover or be responsible to cover you for medical costs, etc... Sorry, I am not phobic, but I sure have seen people lives change in horrible situations from not wearing protection and those not wearing protection at the time. Receiving chemo-toxic agents for a year because you received Hep. C, because you did not take the time to wear protective gear is very regrettable. When you are unable to work for a year or a greater, loose your hair, weight etc. from the treatments or worse become ill or even die. Responsibility, not just to yourself but to your loved ones as well.... As well, you can honestly tell me that your hands are free from viruses or bacteria from touching materials (steering wheel, door handles, stretchers etc..) when you touch that patient?.... How many patients have immune suppressed diseases and syndromes.. Our patients deserve better... Be responsible to glove up.. if not for your self at least for your patients ! Far as wearing a helmet.. sorry I have worked the past 29 years in the back of a EMS unit.. & I am 6'4'' and have as of yet luckily..been severe injured. If it is safer to wear a helmet .. so be it. Yet again, let us not skip a process. Let us examine WHY these injuries occur, HOW these injuries occur, WHERE these injuries occur. As well wearing seat belts while try performing care is a nice idea but realistically not feasible. Proper emergency vehicle operators instruction and continuous education of such. Monitoring of driving skills, and performance, placement of equipment as well as design of unit definitely need to be explored. These are some of the major issues that needs to be researched and worked upon. Be safe, R/R 911

Although pursuing a B.S in EMS in plausible, I do question a B.S in EMS. After researching the EMS degree, I have found most are major in subjects other than really EMS. Most are applied science etc... As well, there is no room for specialty for advancement. the costs for the degree also needs in question of how it will be used. Although,I definitely agree a B.S. in EMS is nice, will the pay off be worth a >$25 thousand dollar student loan ?... As well, how are you going to apply this to ? management, research, education ? If so, would it not more wiser to pursue those specialty degrees and if need be later in career not be locked in "EMS". Again, not downing the EMS degree, I think one needs to be certain when pursuing education the costs, the advantages and long term use of it. Having an over whelming student loan, being frustrated with a dead end career choice need to really evaluated before jumping into any career. Good luck, R/R 911

Again, the full article also states that we should also buckle up while in the back.. nice idea,not realistic. Hmmm...conflicting points more agressive CPR without interpruption but, remain seated ? Now, I also question the study as well as no mention about cervical injuries..maybe we ought to wear cervical collars as well. The patient was never mentioned...? Hmm .. nothing was mentioned on remodeling the rear compartment to make it better...I smell a skewed study... instead of adressing the problem ( I am sure he did not want to upset the ambulance manufactures) . Why is there not air bag type compartments for side impact in areas? Again. why are not protuding devices recessed into the cabinets and all sharp corners removed as well steel borders and stainless steel ?... I would like to see the study of traumatic brian injuries (TBI) in coparrision of laccerations, soft tissue injuries, fractures from striking sharp objects and loose materal flying debris in EMS accidents. Sory, until I see more data that is more relevant, I doubt we will see major EMS changes of enforcing helmet regulations. If it is simple enough of something simlar to bicycle type helmet so be it.. but, I wonder if it will make it through AAA (American Ambulance Association) for endorcement. ...yet again, EMS xometims knee jerks over one study. Besafe, R/ R 911

Actually this was a publicity stunt James Page suggested when he was a consultant for Emergency.. after the stunt that Jack Web agreed upon, it was mandated into policy then.. Be safe, R/R 911

If you are going to that extreme of not transferring emergency transporting.. then get protocols to cease the resuscitation effort. Don't play !.. Either treat the patient as a emergency .. can't get worse than no pulse... or cal it in the field.. be done with it. Sorry, working my butt off doing compressions and giving medications .. bagging etc for additional 10 minutes or greater does not make sense. Be safe, R/r 911

Sorry, I understand, but we can never be "totally" protected. I understand Helo's etc.. there is a difference in fatalities and injuries R/t those incidents. Although. I believe in safety, I will not wear helmet. Sorry...Let's design the units to be more safer... WOW ! What a concept ! Be safe, R/R 911

I try to use the "golden rule".. Funny, how we posted about stopping off duty on how many responded they.. I will not. Although, I have never acted to get the way .. usually the opposite, glad to leave ASAP.. Usually, (although there is always the abnormal) placing to work.. like someone said get a set of v.s. etc.. usually, works. even physicians I inform I working under the direct orders of the physician or medical control. In which unless they are a advanced practitioner do not have a license to perform. As far as customer service, all people are all our customers.. patient, family, potential patients.. etc.. Again, the Golden Rule... Rule # 1 in medical school on Malpractice is ... If they like you the chances of them suing you is very slim...keep them happy & tx . appropriately. Be safe, R/R 911

Actually we have been under NHTSA for several years, before the name change of DOT. At least now they have a special division for EMS. This is better than "lumped" into one .. and definitely better than under Homeland security or fire services which was being considered. Be safe, R/R 911

There is a difference from being empathetic and sympathetic. Empathy, is caring and giving care, with the understanding. There is times you can only say so much and apologize so much. Far as sweety, honey, etc... it all depends on the region you live. The geriatric little women in my are love it !!! especially the older men from a hot female medic.. you can see their eyes light up.. Calling them sir or miss ms.. etc, actually insults some.. so you have to be cautious & use appropriately. The first time I always ask the name and address such with proper title. usually, I get told off by then... Again, common sense, YES you should be nice to your patient, YES be empathetic.. use common sense Be safe, R/R 911

I t will be interesting if the recieve any" federal funds, state grants etc..".. in which I am sure most do. If so, I am sure they violated trust in the grant etc... maybe federal investigation should occur as well as state. Hopefully, this will open and close furher actions simlar to this. Just because the area is rural, does not excuse action to be involved, the same as private as well. Be safe, R/R 911

Little over dramatic for me... I'll wait for the movie. R/R 911

Sounds like a typical day........ for the past 29 years in EMS. I have not seen much differently. Unfortunately, this scenario happens everyday to thousands daily. People, usually put the geriatrics into nursing home to die. Until, the Americans learn to have a different behavior this will continue to occur. But, I doubt it will .. it will get worse instead of better with the increasing number of geriatrics and immaturity of some younger people... look at grandparents taking of the children now.. Be safe, R/R 911

EMS Finally Has a Substantive Home The National Highway Traffic Safety Administration (NHTSA) is pleased to announce the creation of the Office of Emergency Medical Services (EMS). Recognizing the consistent and long-standing contribution of the EMS program and its increasing responsibilities, NHTSA is elevating the stature of the EMS Division to match its expanding role. The Office of EMS will report to the Associate Administrator for Program Development and Delivery, Marilena Amoni, and will continue its mission to reduce death and disability by providing leadership and coordination of comprehensive, evidence-based emergency medical services and 9-1-1 systems. This national EMS office, in close coordination with its Federal partners, will serve its constituents with a coordinated, consensus-based process to reinforce the vital role of the EMS community in shaping and realizing its own future. With a vision of universal and quality emergency medical care leading to optimal patient outcomes, the Office of EMS will function specifically to improve all aspects of EMS systems, at the local, State, and national level. With its Federal and national partners, and through management of the statutorily created Federal Interagency Committee on EMS (FICEMS), this national EMS office will continue to provide the EMS community with a mechanism for ongoing Federal coordination of EMS programs. If you have any questions or need more information, please do not hesitate to contact Mr. Drew Dawson, who can be reached at (202) 366-9966, or drew.dawson@nhtsa.dot.gov ////////////// Yea ! we are not under Homeland or Fire Service !! What we can be EMS ?.. What will they think of next ?... R/R 911

Got Priest ? ............. Hmm... Sounds like an omnious triple A .. of with other things.. mets might have went systemic into arteral walls.. notify the Doc.. go ahead with some fluid and monitor the pressure..If it is a AAA, want to keep her pressure down. Hopefully, you can get a larger line after some fluids, but you take what you can get at times. Expedite since she is a full code, I really would prefer not to be working on her if she does arrest with term. Ca... Good scenario as usual Doc! R/R 911

There is a wonderful book called "What Color is Your Parachute ?" .. I highly recommend young people to read, on how to become more professional, write resume versus curriculum vitae (CV's), seek and get the job you want, etc.. It has been published several times and volumes now.. it is worth the investment of few bucks and repay itself many times. Good luck, R/R 911

WOW ! What an inappropriate way to deal with people! Ever heard of customer service ? First, after the RN was inhibiting your treatment< I suggest that you get the patient into your unit.. close the doors, and thank her. Simple... If she continued, I would tell her I am going to have to "ask you to leave, again thanks good-bye". For the person about the CPR.. did you refer her call to someone ? Sounds like the person was confused, time to shift it someone whom could answer her questions. Remember the old saying "it takes 10 people to compliment to replace one bad mouthing"... Sorry, I believe it should be handled more diplomatically, and appropriately. Although these people do GET ON OUR NERVES.. we need to try to handle it more professionally. Especially, a volunteer service is more dependent on the attitudes and respect of the local community. This is the second or so post you have an encounter with "nurse" in a negative tone. You list yourself as a former ICU nurse (what license level ?) It tends to appear that there is definitely problems between EMS and nursing, that is a shame since both goals should be the same. Be safe, R/R 911

Good points Micheal. Apparently there are many newbies that read and take some these forums very seriously. I know of students that does clinicals with me (never knowing whom I am) talk about the posts. Veteran EMS workers really do want younger participants to survive and do it successfully (Hey, who is going to take care of us ?) It is not we think we are better, just we have seen so many before you ... make the same mistake(s) , have the same though process, etc.. Why re-invent the wheel and learn life lessons again with the sacrifice to the patient and the medics as well. Although, we did SERIOUSLY get side tracked, it is also nice, that there are diversified thoughts and opinions. If we thought all alike this forum would be VERY boring like some other EMS forums... *UMStudent I had just graduated from high school & entered my freshman year @ OSU (OK. State Univ) as a President of the local "Young Democrats Org."...luncheon for him ( about 25 of us total). I was trying to be a delegate. Be safe, R/ R 911

Ironically, I just finished the protocol to access "ports" for my service. PICC line are really not considered a "central line" since they are really placed peripheral and inserted with a long catheter. I am PICC certified, to place them in ER, and access them all the time in the field... it is just an I.V. Central lines should be easily accessible as well, many patients are sent home now these days. It is asinine to try to establish a peripheral line... (there is a reason they have central line). Use aseptic procedures, and follow local protocols. Don't have any, I highly suggest getting some. More and more patients will be sent home with ports, central line devices, PICC lines. So many now receive in-home chemo, antibiotics therapy, etc.. EMS needs to step up and become familiar with these devices. Be safe, R/R 911

Oh please, don't get me started with Jimmy Carter.. what an a*shole, and fake. Sorry, I had dinner with him as a young Democrat representative. After meeting him personally, and reviewing his polices and his FAKENESS it is then I changed parties and seen the light ! Such as the charade of carrying his own clothes on Air Force 1, when his garment bag was empty!... What a joke.. sorry, I remember the hostages and his poor dealings of it as well as gas rationing !... give me a break.. I don't have to read about it I was alive and dealt with it ! He is still a disgrace by turning a funeral into political platform, sorry Jimmy the people spoke LOUD & CLEAR when you were voted out !!! Get a hint ! .. go back to Plains and get a hammer .. you serve the nation better that way! R/R 911

Actually there are Doc's that work 24 hours shifts as well... albeit in rural areas. I believe what your L & D was going by was the rule for nurses (some state boards prohibit > 20 hr) and residents. They used to work those poor guys to death... with several hour of shifts and studies without a break.. thank God some of that has passed, lot better than it used to be. It only took hundred years and several thousands of lives to change it. Most of the EMS around here still does 24 hr shifts.. although as we increase our volume it is getting more difficult. I still rather have a 24, if I can grab some winks of sleep and down time, than some other type of shifts. I like my 10 days a month Be safe, R/R 911

Awww. Uncle Harvey.... I suggest, that you might explore and write both sides of the subject (pro & con), then come up with a hypothesis and conclude your opinion on your findings. I suggest a heavy pathophysiology (he loves that) but I forewarn you to be sure you understand it as well... such as Fick principle, Rouleaux effect in shock syndromes.. as you probably know he loves shock syndromes. Remember to follow APA format as much as possible and be sure to cite references appropriately. Good luck, I am sure you will do well... this is the difference between paramedic programs and paramedic classes. Be safe, R/R 911

With all that above and if she is getting any palliative therapy such as chemo or radiation tx. Chemo tends to dehydrate as well.. Last time how the platelet count was, if she does have tx.'s Is there any associated fever? See if she is taking any analgesics such Oxycontin, fentyl patch etc.. and last time she had any. Be safe, R/R 911

I have sent my message... Be safe, R/R 911

It is shame that any emergency worker would be exempt, as well as families suffer, but ever action has a consequences. They same was true on child seats.. Police, Fire, EMS was exempt in my state... until I wrote a bill and pushed into legislation not allowing an exemption. Now, with this I was able to write a special needs grant and purchased every EMS a child seat, that wanted one. So there are no excuses. If we want to be pillars in the community, we have to at least uphold what we preach. Hard to say "wear your seat-belts.. they save lives" then get into the unit without buckling up. Creditability goes a long way. It is very heartbreaking that these young men died.. and yes, there are times that moving around etc.. I unfasten to get the map book etc.. but I truthfully I can say 99% of the time I am fastened in in the front. I don't know if it would had changed their outcome... tragic, if it would had. As you can tell the press definitely picked up on it.. again, we need to lead by example. That is why we should not smoke in public view, keep our waist lines down..etc..image is very important. Be safe, R/R 911

I find it hypocritical for those that not wear seatbelts. Here we preach it .. but don't do it. I personally, would agree for insurance companies not to insure or cover those that was not "buckled up".. Be safe, R/R 911