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I'm clear, Ace- this sky guy just cracks me up. It is one thing to defend your opinion- another to lash out based on a perception of injustice that is unsubstantiated.

I finally watched it- can someone tell me where to get that wasted hour of my life back. Mabye I could use it more productively...... like washing my fire engine :? :?

6 posts and none are productive or intelligent...... may be a signifigant problem on your end. This thread was not meant to have the vitreous flavor you have lended it sky- it was meant to vent and have some fun. Thanks for ruining it with your bruised ego driven rant.

James, read the post right before yours. This site is often used to vent, and I thought this topic was humorous- except for one post. Skyline- ditto on my respnse to James (just for clarification, my previous post was not to take this thread to task, but was meant to inform others how I thought fire departments should do things and any that don't need to get a clue.)

O9E- Just wanted to get this in before the posting is locked thanks to you- Blanket statements are usually due to a lack of comprehensive thought or the ability to see other points of view. As for my experience, I am from what is traditionally called fire based EMS, but the tide has turned now and it would be more accurate to call it EMS based fire. Our FD's minimum hiring standards are EMT-B currently and a neighboring department is switching to EMT-I. Most hiring processes don't bother with B's anymore, and go directly for Paramedics. This is because they have figured out that if 85% of our runs are EMS related and firefighting is just a bonus, they would quit wasting time with hiring people who will be unhappy not getting the big one. I started in the FD just to get into EMS and about 80% of the people coming in are at the same place. We are lucky to be in a progressive system in that they do see the real picture and fire is only a small piece of the pie. You have to pass a BLS written exam as part of your hiring process, then it is on to fire aptitude and physical fitness. They are willing to train you for firefighting, but want the EMS basis to be there.

The opticom systems I have seen work extremely well. It gets the traffic in front of you out of the way to allow a clear path through an intersection, instead of a traffic jam- the trick is to have it turn green when you are still far enough away that the other drivers will take the light before seeing/hearing you.

Train Horns- people will drive off the road trying to get away from you :shock: :!: :arrow: :twisted: :twisted:

??? Whit- your post seem to contradict one another. Why not just advance your training and education to the point where you are able to utilize all available interventions, that is the only way to ensure the highest level of care for your patients. Arguing with a MD is a route that will only get you run out of the business. You say you are not worried about being blackballed, but you are passionate about your job- seems that some tact mixed in with your passion would serve you better than some ranting.

If you are only able to provide BLS level care on a cardiac arrest, then wouldn't you get going as quickly as the situation will allow? If you have ALS interventions being performed, then it is less critical to transport.

I am pushing for all responses to be non-signal 10 until the scene is safe for our department (the SD/PD says it is clear- which does not mean safe). There is no reason to go L+S to just wait a block away. This is a time when it is important to make sure there are several EMS and FD units available so that whoever is attending the patient can focus on the patient while another is watching his/her back and yet another stays outside. This is regardless of how many SD/PD are there.

Quint........ DUCK! As B's, we are under-educated. The fact is there is so little physiology in our training that we are woefully unprepared for any variation from our training. Protocols, unfortunately, are all we have to base our patient care on. But that point has been beaten to death, and a little investigation into this site would have prepared you for the onslaught you are about to experience.

SSG- it is a real problem, we had to institute a rule of 3 max on the ambulance. There are certain personnel that actually prefer more than three. Personally I think an engine can take the additional manpower, but I am generally confident enough that a driver is enough in most cases.

Evacu-splints have a cervical immobilization device- works for any size person.

In Indiana, most systems allow EMT-B's to intubate with the dual lumen airways. I, at a BLS level, will gladly utilize this device to provide a better airway if ALS is unavailable. However, I would much prefer using simple adjuncts and have the medic make the decision as to what kind of advanced airway to use- because when you are taught the A+P you have a greater understanding of the consequences of your actions. If you have ALS in a reasonably close response area, then BLS providers should not use combi-tubes :!:

Or sending your runs off to another district- happened this weekend, after I had questioned them about it. But I will save that for a more appropriate forum.

How about you try to improve your level of care instead of being upset at others for trying to improve the effectiveness of EMS, or would that require too much time and effort?

15 minutes = dead (most retones are on a 5 minute spread).

We have this requirement as well- once on, a Dr. has to clear removal of any "immobilization" device. Usually a nurse just asks and the Dr., without looking, says "whatever you think".

The location of the pain may be indicative of an aggrevated injury originally inflicted in the MVC, and the partner was focusing on the location of the injury. I agree that a board equals collar under most circumstances, but if it was localized it would be of less concern- but does not coincidee with my CYA theory.

Mabye it was concern based on the pertinent history? I am not sure it was the best decision, but it certainly would be a CYA maneuver. I hope he at least padded it to comfort.

OOPS! :roll: :roll:

Are you sure you are in the right line of work? I am not trying to be mean, but the whole point of being in EMS and fire is to get out of the station. The tones should be a relief. My concern is that you got into it for the "fire side" and are not wired for the granny runs. Always wanting the "big one" and being disappointed 95% of the time is certainly going to burn you out. In most areas the fire service is no longer that (at least if they are willing to address the truth) it is EMS and public service (as you have pointed out) with the added benefit of an occasional fire to put out. I would suggest taking a LOA and getting some psych help the same as the others have metioned. Just take a general leave and go to a psychologist on your own to protect your reputation. Mabye another career altogether would be more to your liking.

Andy Rooney is so played- I can just hear that whiney voice saying "you ever wonder why".

First thing is scene safety. Do you have PPE? Are there fuels on the ground? Do you have powerlines down? Is there anyone who appears suspicious (combative drunks)? Is there any odd smoke or sparks coming form a vehicle? Are there DOT placards on any of the vehicles? What may have caused the accident? These are things to assess prior to exiting your vehicle or an apparatus. Next is give a brief radio report and ask for any additional resources that may be needed above the standard (tactical or box) response. Tell whether there are any vehicles that are inverted or on their side, how many vehicles, the way the may have collided, etc. Then guesstimate how many patients. Next, approach the scene in appropriate PPE and triage the patients. If there are no serious injuries or life threats, then instruct the patients on what to do (stay in vehicle, exit the vehicle, stay still, or whatever is appropriate). If there are life threats to one patient (quick interventions can be done while triaging), you treat that patient to the best of your ability after triaging all the others. If there are life threats to multiple patients then, treat the one who you can make the most difference with- refer to START triage/protocols/common sense. If opening an airway is all the intervention they need, then they become the priority, -etc. there are chapters and entire classes on this. Direct the next arriving fire/EMS units to the next most serious patient(s). The walking wounded will have to wait until sufficient resources are available. Finally- POV's rarely have a place on the scene of an emergency, unless you would have to drive by it to get to your station.