akflightmedic

You definitely opened a can of worms by doing a write up yourself. There should be and you always should use someone from your service to present any complaint to a hospital official with regards to the care a physican gives or doesnt give. Doctors do not know all but they can make your life hell if you cross them, you should follow proper channels. Now, to offer a different perspective on this situation. The patient was DISCHARGED with no meds. Sounds to me like there was no femur fracture. Maybe the doctor did a thorough assessment and determined there was no need for pain meds, maybe the patient was a drug seeker. Just because you have not transported them does not mean they haven't been in there seeking drugs. No xrays were done....hmmmm, the good ole days do survive in some areas...areas where a doctor can perform an assessment and not have to run a full battery of uneccessary tests to prove what he/she already knows. Just as an outsider looking in, it seems to be you are a bit peeved that you were dismissed with no explanation. Maybe the doctor felt he did not have to answer to you. Maybe your attitude or tone set the mood from the get go. I dont know, I wasnt there but I am offering possible scenarios as an impartial observer. Whatever the outcome, good luck to you...you are going to need it. ps. I cant help but notice 4 failed IV attempts with an 8 min scene time and a 5 min tx time...you must be pretty damn good to try that many times and still back board, put them on a monitor, get vitals, etc....very impressive, except you missed 4 times.

It is not about being able to handle it or not. It is abouyt being safe and going home in one piece without killing or injuring myself, my partner or any other people on the road. As we all know, there are NO accidents. Something could have been changed or altered to prevent a crash. So why not remove one of the uneccessary distractions? Get in an accident and see if the lawyer doesnt ask you about the radio while you are under oath. It will come up. Why take the chance? Can you not go 6-10 minutes without music while you are responding to a call? Do you really need pumping up prior to arrival? I love music and listen to it every chance, but blasting it while responding Code 3 is not the appropriate time. It reeeks of unprofessionalism and whackerism.

Guess I am the only idiot here. I turn off the radio when responding L & S...last thing I need is any more distractions to add to the sirens, traffic, dispatch, and my partner. Oh well, I will remain a dweeb, but I am ok with that.

Its been said before and I will say it again. Read the terms of Service you all agreed to when you joined. As for Ace, he has been given much leniency. He recieved the maximum warnings which is 7. While earning these warnings, there was constant communication via email and PMs as to what the problem was and how he should correct it. He complied for a while and then went to his old ways, thus earning more warnings. 7 warnings is more than fair. Actually if you count all the PMs before a warning was issued, he far exceded the 7. Also in the terms of service, this type of stuff is not to be discussed in an open forum. You are to direct all comments and questions to admin. I am going to lock this thread and he may delete it. There is a lot going on aside from whatever happened recently that the general members are not aware of as we are very quick in removing offensive posts and a lot of the ones we edit or censor are never seen by the general membership. Yes Ace is a very productive member and a wealth of knowledge, however that does not give him the right to super cede the rules. One good player in a sport does not makeup the whole team, nor does he carry the whole team. Ace will be able to reapply in a few months. Until then...

Only comment I have is that is a heck of a time to find out they have a latex allergy. Of course is you want to practice your surg crics, by all means...

Excactly...it is a competitive market, therefore they are not guarenteed a job. May the best canidate win and if it happens to be a reformed convict that was educated on my dime and for some reason he outshines all the law abiding canidates, then good for him. We have much bigger issues than worrying about a few dollars being spent on inmates in a trial program that may be canned next year for an education that may do them no good. SUrprise, do you know how many inmates obtain HS education and college degrees on our dime? Its been going on for decades. While I struggle to pay for my higher education they get theirs provided. DO I care? Nope, not at all because I don't mind working for my stuff. In a free world, there is always going to be someone getting something for nothing. Sometimes its me, sometimes its not. I dont care...nothing will stop me from obtaining what I desire.

OK, please forgive me. I had a link to aa story I wanted to share the other night but the sever was down. Now I can not find the story and it is driving me nuts. Anyways, I can not recall which state it was, however they are proposing allowing/hiring EMT-Is to start the IVs and push the drugs on the inmate's death day. It seems they are having trouble hiring and keep anesthesiologists who have been doing it for years as required by the previous law. They will still have a doctor on hand to declare official death, but they think this will help by eliminating some of the docs ethical and moral dilemmas. The quote was "they are trained to do IVs, so why dont we use them". How do you feel about this...and if anyone finds the article, please post it. Edit: I found the story..it was jems.com http://www.jems.com/news/111464

How are the opportunities not avaliable? There is money out there, it just takes determination to get it. I put my wife through EMT school when we dirt poor simply by applying for a federal grant. I went through the fire academy on a scholarship by simply writing an essay on why I deserved the money. The only thing limiting us is our desire, motivation, tenacity, whatever. We control our destinies...

First of all, in order for us to have a student rider, we have to be approved as field preceptors by the school that is sending students to us. Since you are officially approved by the school, you then have the right to speak freely with the instructor when a situation arises. The students should also be arriving with eval forms that the field preceptor signs off on. Make your comments there and see what kind of feedback you get. As for how to handle the situation when a student states a wrong procedure or treatment, ask the student "are you sure?". If he is adamant that he is correct, send him to his textbook and say look it up. Show me where it is stated or taught like that. Let the student find the error himself. If it turns out you were wrong, say "I am sorry, we dont know everything, but thanks for looking it up. You wont forget it now". If the student is wrong, hopefully he will correct it in the future and take that correction back to class and present it himself.

OK, so lets NOT educate them, send them back in the streets to repeat whatever it was they did the first time because they have no skills...and then we PAY even more of our tax dollars incarcerating these individuals. I think it is a case by case situation. Felons can be national registry, if they meet certain requirements as outlined in the link provided above. I do believe in second chances as I have had personal experience with several situations. I say go for it. If it turns them around and produces a law abiding citizen who feels good about himself, has a purpose and contributes to society, by all means have at it. There are many situations where one could be classified a felon and not all of them are crimes of sex or murder,etc. Like I said, it is case by case, so no I do not want people here to start presenting scenarios and "what if'ing" this all day long. Fact of the matter is, there are already many twisted and corrupt individuals among us in the profession, some we are aware of and some not. I personally know of a few felons that are very good firefighters and one is a paramedic. I would trust them to this day with my life. One of them in particular, I had the pleasure of watching a total life change. No need to divulge the specifics, but I have witnessed it.

I agree...please list your accomplishments, I am very ineterested. We will not interpret it as you trying to toot your own horn. Maybe what you have done will inspire one of us to do the same in our area. We only learn by sharing and demonstrating. The floor is yours sir...

Totally against it in the field in most areas. If you are extremely remote or rural, then yes maybe depending on your transport resources and travel time. I have worked remote and I have given it twice prehospitally. By remote, I mean in excess of 1 hour tx time. For the average EMS system, our education standards are way too low for us to be administering this drug and our travel times do not justify the expense of having it on the trucks and providing continuing education on it. But the 2 times I gave it, it was a wonderful success.

Ace, you rock! Those will be posted in my classroom from here on out. Rep points for you....

We use disposable as recommended by OSHA. If they need the blade, I think they could care less if it was dirty. Not that I would do that, prior to disposables, I always soaked them in bleach as that is all we had at our disposal. Intubation is not a sterile procedure but merely a clean one.

Beautiful reply Ace!!! I am so proud of you. You said everything for me and made it much mroe interesting. From a flight medic position, this is a critical emergency and could have been flown. The only concerns with flight however, would be all the external noise, stimuli, etc...added stress on the mom and baby. Additionally, should she start to deliver it would be a wee bit cramped and personel would be limited. By ground, you have more working room and should take at least 1 extra person for the unexpected.

This all comes back to evidence based medicine. There are more studies out there debunking the efficacy of AC in the field and in the ER as well. Most times it does more harm than good. We no longer carry it here in FL, this happened several years ago actually, because we researched and realized it was useless. We pulled all our runs for a set period of time and the committee did some calculations and found it to not be indicated in the majority of OD calls. The calls where it was indicated, it was pointless due to the time that had passed. As for "seeing the light" now that you are working in a hospital, I find that very interesting, as I had the opposite experience. When I started working in an ER, I swore by AC because I did not know better. It was there in the ER that I learned how little as medics we knew about the pharmocology and pharmokinetics of the drugs we carry and administer. This is a Level 1 ER by the way. They very rarely ever gave charcoal and the few times I witnessed it, they fought the patient to insert a NG tube, then the pt either spit it up or puked it up. But regardless of this hassle, the doctor would say it really it isnt worth it anyways due to all the studies that say and I quote"When AC is given in a timely fashion, it still only has a 33% efficacy". With all the problems our EMS system is facing, our lacking in education, and our cookbook approach medicine, I am surprised that you are hung up on this singular issue. Do some homework before you come on here chastising medics for under treating. Please remember, just because this hospital you work at does things one way, does not make them right for all. Research, research and research. Doctors do not know it all and they are not all up to date on the latest studies. Just wanted to add that since 1996, I have given charcoal only once and that was due to my 2.5 hour flight to a higher level of care.

so......that means you redo the course and learn the new updated material regardless of when you were last certified. We do it all the time in this field.

Here is an interesting article. Amazing to say the least. Look at how long the extrication time was...does anyone think insufficient training had anything to do with this?? I love the final sentence of this article. When everything goes wrong, I guess its ok to say "Hey we are just volunteers doing the best we can" Widow claims multiple failures by rescue workers in fatal accident By THOMAS BROWN, T&D Staff Writer Former Santee Police Officer Brian Keith Brown pleaded guilty in connection with the automobile collision that took the life of John Donald "Donnie" Stroman in 2002. But Stroman's wife says the people who tried to save her husband are also at fault. In a lawsuit filed in federal court, Nancy Stroman says that many were negligent in responding to the collision that took her husband's life, from the agency that designed the intersection where the incident occurred to the rescue agencies that took an hour and 39 minutes to remove her husband from the automobile. She paints a picture of chaos in her lawsuit, with rescue workers requesting, then sending back, then requesting again, a medical helicopter for her husband. The Hurst Jaws of Life ran out of gasoline. She had to be transported in the back of a pickup truck after the ambulance broke down. According to police, Brown was driving a Santee police cruiser -- a 2000 Ford Crown Victoria -- east on S.C. Highway 210 on Oct. 31, 2002, on his way back to assist officers at an Elloree Halloween celebration. He struck the driver's side of a 1996 Plymouth Voyager minivan driven by Stroman's husband that had exited off Interstate 26 and was about to travel west on S.C. 210. The agencies that responded to the scene included the Santee Police Department, Orangeburg County Emergency Medical Services, the Santee Fire Service and the now-defunct Cow Castle Volunteer Fire Department. Stroman and her husband were airlifted to Palmetto Richland Hospital in Columbia. Stroman was admitted to the hospital in fair condition. Her husband died en route. In August 2003, Stroman filed a lawsuit naming as defendants several agencies and individuals, including the Town of Santee; Orangeburg County; Orangeburg County Fire District aka Orangeburg County Fire Service; Cow Castle Volunteer Fire Department; Santee Fire Service District and the South Carolina Department of Transportation. She is asking $1.2 million in damages for loss of consortium, wrongful death, survival of right of action and negligent infliction of emotional distress. In her lawsuit, Stroman and her attorney allege that when the Orangeburg County Fire District aka the Orangeburg County Fire Service, the Cow Castle Volunteer Fire Department and the Santee Fire Service District arrived on the scene, they chose the option of mechanically and forcefully removing the roof, hatchback door and back passenger sliding door of the vehicle with the Jaws of Life. People on scene asked emergency workers why they didn't move the town of Santee police cruiser from the side of the Stromans' vehicle so the couple could be removed more easily through the driver's side door, the lawsuit says. The lawsuit contends that emergency workers refused to consider the option of moving the cruiser. According to the lawsuit, when emergency workers from the Orangeburg County Fire District and the Cow Castle Volunteer Fire Department attempted to start the Jaws of Life to begin the removal of the roof, hatchback door and the passenger sliding door, it failed to start. After repeated attempts to start it, the lawsuit contends that an official removed the gas cap and found that the tool was out of gas. They were eventually able to start the Jaws of Life and proceeded to remove the roof, hatchback door and the sliding passenger door from the Stromans' vehicle. According to the lawsuit, neither Stroman nor her husband were pinned within the passenger compartment of the vehicle and no part of the vehicle had to be removed from compressing either of their bodies. The rescue workers later decided they would move the police cruiser and remove the Stromans from the vehicle through the driver's side door. The lawsuit states that Donnie Stroman remained in the van for more than one hour and 39 minutes, the whole time consciously suffering excruciating physical, mental and emotional pain. Nancy Stroman was forced to endure more than 99 minutes of her husband's constant pleas of "what is taking them so long to get us out of here?" as they both lay helpless during the prolonged extrication, according to the lawsuit. Nancy Stroman remained in the vehicle for more than two hours and thirteen minutes, also suffering excruciating physical, mental and emotional pain, she says. She suffered a torn descending thoracic aorta, a subarachnoid hemorrhage, left rib fractures, a right ankle fracture and various lacerations, contusions and abrasions. Once the Stromans were extracted from the vehicle, the ambulance in which they were being transported broke down. Nancy Stroman was treated and transported in the back of a pickup truck to the site of the Medivac helicopter. The lawsuit charges emergency workers called and then cancelled the helicopter. It had to be called again to transport the couple to a Columbia hospital. Brown entered a plea of guilty to reckless homicide before Judge James Williams in General Sessions Court on June 6, 2006. He was sentenced to seven years, suspended to three years probation. In the lawsuit, Stroman and her attorney also name the South Carolina Department of Public Safety and the South Carolina Department of Transportation. They are charged with "negligently and recklessly designing the S.C. 210/Interstate 26 overpass so as to produce insufficient sight distance to allow for the safe operation of vehicles," and failing to place appropriate signs, signals, warning devices and illumination devices in the area of the overpass. In a response to the allegations of the Stroman lawsuit, Orangeburg County, Orangeburg County Fire District and Cow Castle Volunteer Fire Department answered that the Highway Patrol or medical care providers that were not employed by them who gave medical direction or treatment either during or after the time that they rendered their services, or both, may have negligently damaged the Stromans. And in a later answer to an amended complaint, they categorically deny all the allegations of Nancy Stroman's complaint. Pete Poore of the S.C. Department of Transportation said his department does not comment on any case that is under litigation. Sid Gaulden of the S.C. Department of Public Safety also refused any comment on the case for the same reason. When asked for comment on the case, Gene Ball, Orangeburg County Fire System Coordinator, said, "I have no other comment than to say, as volunteers, we do the best we can to help as many people as we can. We try, but we're just people." T&D Staff Writer Thomas Brown can be reached by e-mail at tbrown@timesanddemocrat.com or by phone at 803-533-5532. Discuss this and other stories online at TheTandD.com.

I posted this on another site and it is advice I always give to my students and fellow co-workers. It is great advice for any newbies or even some old folks who just forgot about the simplicity of things. Many times I have heard, "how do I protect or keep my certification cards from getting worn out or damaged/destroyed on the job?". I even had to replace some cards for people that lost them or had them get water damage while on a call. The solution is simple. Photocopy all your certifications. As long as you have a legible, preferably color copy on your person, you are meeting most state statutes regarding having proof of licensure on your person at all times. If it gets wet, damaged or lost...no big deal. Grab the next copy, all the while your originals are safe and sound at home. When I am on shift, I do not even carry a drivers license. A color copy is legal and cleared through our service. SO all I carry is a debit card and a photocopy of my certs and license. Just some friendly advice....

Double post..this thread is locked....

It seems that someone has posted porn links in many members shout out boxes. I have found in excess of 15 blogs contaminated. It is up to you to resolve this issue as I can not edit your personal blogs. 1. Edit your blog and remove the links please. 2. Click the option in your blog that only allows members to access your blog. This hopefully will alleviate the problem from recurring. Thank you...

annoying (at times)

I agree...

who will it be

I am typing the congratulatory message now