Happiness

So Im not going through all the posts but the one thing I am going to point out is that first of all, Why is the 3rd exposing a pt fully in public if they are pretty okay. That is the problem. If the medic had put the pt in the ambulance where it is private then there would be no reason for the bystander to take pics. I have not had to deal with this ever so I dont know what I would do. I would try to ask politely and hope for the best Im not wasting time that should be spent on my pt.

My husband who is a VFF had this come up when they got the call to attend a fire at the Propane outlet. Of course it was a Saturday so we were all at home, he called as they were getting ready and we left as this outlet is a block away from my home. All worked out for the best and I am here another day

I get a bit snippy when it comes to mental illnesses because I've seen how being needlessly agressive can negatively impact a patient, I've seen stupidty, both from system protocols, the people writing holds, and other EMTs, and I've seen how a patient can be completely different even a few hours and a couple of meds later. Not necessarilly enough to let them off of a hold 2 days early, but definitely in the right mind set to not require them to be strapped down in 4 point restraints. Similarly, my undergrad research project was in schizophrenic and bipolar patients looking at how well they filter stimuli. It's a big difference when mental illness is looked at as a neuro problem and not a mind problem. OK JV just so you know I get the snippy part. Please understand I am trying to find a solution to a problem. I am starting to feel abit shreaded by you because of something that really I have no control of. I dont like this policy but I understand it from a flight crew point of view, as if they are not compfy with the pt they just dont go. It really is that simple. Be aware I have not refused any pt. I have been the advocate for them, also with this policy I dont let it run my call I make it work for me. The one thing that is not mentioned in this policy is required doses, so that in its self gives the Drs the ability to work outside the box.

In the field I use my body and velcro straps. In the hospital setting They will start with adivan and gravol and use haldol if required. The stretcher itself has to be secured to the aircraft. What are the normal procedres briefed. for evacuating a stretcher patient? Would they be evacuated on the stretcher or removed from it? Perhaps that provides you with the answer. Again it will normally come back to the individual airline's policy in their adherence to the regulations. My question was does the stretcher become a fixed part of the plane and this is the answer that I recieved. Systemt that is a good artical but they got one very important discription wrong. The guy who jumped was being transported by a seaplane not a heli from Masset to Prince Rupert with a guard. This guy on his way down the ramp to the plane was yelling at the top of his head he was going to jump and take the guard with him as he was hand cuffed to the guard. They get over the straights and he flipped out and lucky the guard (a 120 lb female) was able to get the key and unlock the cuff. After he got to the door and the grabbed her by the belt and she hung on for her life. The guy finally let go and hit the ocean. The hx on this guy is that he had held his GF hostage in a hotel room in Port Clements and repeatedly raped and assualted her. Not only was he depressed he showed alot of violent tendencies that not one person considered a red flag. Now remember this is RCMP not BCAS but it can happen. Also the plane had other people on the there and not one person helped. Oh just so you know I personally knew the guard and this is where my information comes from. The guys name is Donald Biggs.

yep we do, i guess i just have the vison of chunks and a bit of a brain fart I am going to contact transport cananda and directly ask if the Number 9 is cocidered a fixed part of the air craft. I reread the reply from them and it is just implied.

I did ask transport canada qne got an email back Next issue with restraints is the what if, if your pt is strapped to the stretcher and they start to vomit, if you cant roll them over then the you will have a whole new set of problems. This whole thing is just a dammed if you do and dammed if you don't.

So the solution to me is for Northern Health to have a Psychiatrist on the islands. The money that is saved by not transporting them would pay for that. Now with that being said we are not rural we are isolated and you really have to love living here to stay here. Our system just sucks all around in the north and then being isolated makes it 100% worse.

Thanks for your comment. The only thing i didnt like about the artical is the mentioning of kids. I have had two pts at the age of 16 be sedated because of violent suicide attemps. thanks again

Thank you Mike. Is the litter the portable Stretcher we call a number 9. If so, once the stretcher is snapped it becomes a fixed part of the plane. I am familular with welcro wrist straps and have used them many times. I would like to use less drugs because, for one thing not all patients are violent but on the other side of the coin you never know how someone who is being committed is going to act. The other problem with drug sedation with this intensity is that it can take a few days before the doctors can even deal with them (so I have heard). We are in such a unique location it not going to be a win win in this case but if I can some how make it better, maybe these pts will get the help they need.

http://www.theglobeandmail.com/news/national/british-columbia/bc-rules-requiring-sedating-mentally-ill-for-transport-risks-lives-mds-say/article2436519/ So I am looking for a solution to a problem that we deal with here. This is a fair artical as far as I can see but the one thing that is not mentioned in this artical is the policy for Transport Canada. I did get a response from them when I enquired about their policy. It says that no patient being tranported in an aircraft can be physically restrained to any fixed part of an aircraft. So using physical restraints is not an option. Now we had the old shackel type of leathers at one time but they are also not used these days, and the pt could still do damage I hate everytime I go into the hospital for a phyc transfer because there is going to be a problem between us and the drs. I get their side of things but our safety in any situation has to be first and foremost. I also get the fact that some people are pigon holed into this mental health senerio even if they are not being sent out for a mental health issue at the time. This is a problem being in a small town you know most peoples issues. I was even subject to that not long ago, knowing violence what a pt did days before they were medivaced and they were to be sedation or they were not getting on the Heli. Our policies are also PDF on the side so you can get the whole idea of who is sedated. Also some of the comments are interesting. I would like to know what you guys think and how do your flight medics deal with this. Also if anyone can point out other policies for other places I could take a look and compare. We have had a few suicides here that have bothered me and mental health is really on my mind lately. Living on a island our mental health system here sucks the big one. They go off for a week or two and are sent back with pills. To me that is a lazy way to treat them. Thanks Happi

Same questions as above. Also what time is this call comming in, did he eat just before this event.

Tough one Bernard, you sit him down and say " I so appreciate the fact that you want to do this. You have some very good qualities but there is an issue. With this volenteer job there is a certain amount of training and attendace required in able for me to feel safe of you doing this job. If you really dont think that you can give me at least the minumum amount of time I will have to ask you to step down. If you can right on and lets start again."

Really dont know what to say

http://www.cracked.com/article_19798_5-terrifying-secrets-about-riding-in-ambulance.html interesting

take care lotus, you are always a pleasure to talk to in chat....

This is not a concideration when I do CPR for the simple fact of living on an Island in the Pacific that has no surgeries at all. When I do CPR I am required to follow my guidelines. They do include the what seem to be universal guidelines for not starting CPR for example rigor is set. We all know from experience dead is dead but yet we will in some instances still perform this act. I will do CPR for the sake of the family in some cases and my reasoning is that in my community (and I can only speak to that) they truely want you to do it even if they know what the final result is going to be. The one and only time I have successfully brought someone back, the family even went to the point where the pt was acually medivaced to Vancouver, with the knowledge that the result would most likely be death. I think us as human beings always want to believe in miracles, and in truth miracles do happen so who is to say that the person you might not think as viable is in fact not a miracle waiting to happen. When it comes to people that are in end stages of a terminal disease, I am a advocate of making sure that the family is aware of DNR orders, both for the hospital and for the home. I also make sure that they know to let the local RCMP know there is an expected death in the family so they have no need to go to the house and disrupt what can be a very cultural event in the community. This topic is to some degree a very personal senerio in ones career, as we are in this job because we want to do everything in our power to save lives. Also Kiwi to be able to say that one did everything they could is very important for ones mental health. We are in a depressing job and when you have that little sense of dout, that is what can fester into the start of a persons PTDS. I for one have one call from many years ago of a pt because of CHF.He was so full of lung fluids I couldn't even get to the CPR and I had a hard time with the fact that I never got past A. I delt with the fact that in all my training I assumed I was always going to do my ABC's, I now make sure that my new trainies know that there are those time you will not get past A.

http://www.cbc.ca/news/canada/british-columbia/story/2012/05/10/bc-stabbing-no-charges.html?cmp=rss Ya you want to talk about justice systems come to canada. As for your relationship, it is always up to you what you are going to tolerate. Dont become blind but also do become accusing. If you dont want to be around this person then dont. Yes it is as simple as that. good luck

Well Mobey I certainly had a big WOW come out of my mouth after I read your post. Its a good thing that you have recognised the red flags in your life. The fact you have seen them, have taken the appropriate actions to get your feelings in check and have a supporting wife is half the battle. The other half will just happen with some work. A friend last week said "I feel like Im fighting a loosing battle" I responded "You only loose if you quit" We all have our things in life and we all have our ways to figure it all out. Take care Mobey and I hope it all goes well for you and your family, remember you too are only human

I certainly hope thats sarcasium

Hey CM me again . You are doing right now what you feel you Need to do, and that is perfectly ok. You will eventually need to do what you want to do for your own sanity. There is the saying "After me you come first" this says to me that you can't do anything productive for others unless you take care of yourself first. I know you will make the best decision for you and your family. If this position is not available under your terms then it isn't the one for you, and there will be more jobs out there. Take care Happy ps you know how to get ahold of me if you need a vent

good idea maybe you should send that to CN rail since the dead mans peddle dosnt work so well and you never know that may be what makes you your millions

I don't feel its a poor example at all, this is exactly what can go wrong if the two medics in the car are not conversing in some way on long drives. When you drive at night you can so easily become hypnotized or fall asleep. When I was in the military and we did night manuvers we always had a second person up front for this purpose, to keep the driver awake. I also believe in learn from others mistakes and this is a fatal one I am making the choice to learn from. I have told my crew that if they are to tired to drive you pull over and that is the end of that, no exceptions. The reason for the giving our numbers is because alot of us being part time we change our shifts, or we might take a few hrs of anothers shift. If you are looking for someone you should know who your looking for, and in this case they didn't know who they were looking for at the beginning. Your right this is a tragic event and in reality the cause could have been an animal in the road, as there was a bear hanging around the accident site. But if I remember correctly there were no tire marks which would indicate braking (you can look on the pics) and if no there is no tire marks it is a good indicator that the driver was asleep or if it was an animal it jumped out at that crutial moment. Im not going to say your wrong in this case as alot of people sleep in the back on long trips. It has been done forever and will continue, all I am saying is that in my Station because of this incident we do not sleep while the car is moving.

I just want to point out this comment. Please read below, one of the things I will not do is sleep while the passanger and I will talk to the driver, I also expect the same if I am the driver. The idea of catching a nap is good in theroy but sucks in reality.......... http://www.bcas.ca/assets/News/PDFs/2011/miit-report-ext-2011-06-07.pdf the findings and recomendations are on the last few pages. The one good policy that came out of this, is that now when I answer a call I am required to give dispatch my employee number so they know who is in the car, at the beginning of this dispatch didn't know who the crew was.

AK sounds like you are a good employer that appreciates the work done. I have a question though, why does it always come down to money. I go to work because to be honest I like the people that I am around. When I walk through the door, the receptionist says good morning with a smile. My office mate and I laugh at the stupidest things. Now this isnt to say we dont have stress or moral issues in some of the offices but when it comes down to it, It is my responsibility to make my life happy not my employers. There is something to be said for someone just saying "great job" or "thank you" happy