sevenball

There is alot to answer, sorry if I don't get to all your questions. As for my own level of education, I have been in the field of medicine for 17 years, attended college for an associates in fire investigations and fire science. I have been a Paramedic for 6 years, am currently employed with the largest 911 provider in my state. Have worked on the CAAS accredidation team, I am a field Supervisor. I also worked as adjunct faculty to a large education company teaching paramedic courses and recently became their clinical coordinator. Big fancy titles which mean very little in the grand scheme of things. My service is strictly ALS on the streets. We do have a BLS division, but it is ift's only. I'll give you one thing, I don't have any hard evidence that proves that calling a trauma team in from the field does anything to improve mortality, but I have to believe that they wouldn't have created that particular protocol for no reason. Much like the recent changes in calling in a "cath alert" to call in a cath team. As for my own experience, maybe I am an exception to the rule, WHEN I call a trauma team, it's for real. I don't needlessly call. One of my jobs is working in an ER, I know that money motivates. I think that it's sad really. Changes should not come about because money dictates it. Thats just the game though, I get that part. BEorP- you said that "all too often uneducated field providers disregard what more educated people say because "they don't know what it is like on the road."' my intentions were to drive the point home that many times (just like you said is often the case) people who make the rules and changes in protocols, do not account for all situations, and often make knee jerk reactions based on some surgeon that feels his time is being wasted. Or worse, makes knee jerk reactions based on some insurance company that is leaning on him to tighten the purse strings. Instead of just pulling the plug on trauma alerts, why wouldn't these rule makers have a sit down chat with those who run the streets to comprise a smarter, more efficient system, instead of just taking their ball and going home? No need to pull the plug so hastily.

I wish it were just to get the activation criteria to change, and I'm sure that it is just to keep cost down, but there is industry wide speculation (and I stress speculation) that trauma alerts will no longer be used, that the call will be from the accepting physician based on the information provided to him from EMS. That would be fine, but that takes away from the "hunch" aspect, that takes away from the simple fact that the physician cannot see the pt. and will only go by mechanism of injury, and if the pt. is hemodynamically stable, which can provide false readings if the pt. is compensating.

be or p, No, I don't. That was kind of my point. It was the hospitals stance that it did nothing to help the pt. in the long run. I have no numbers to support that claim, nor can I find any out there. So my question is, why do they feel it necessary to tell us this, if they cannot support that claim with facts. As for the desk jockey comment, sorry if it offended you, but lets face it, EMS has changed. If someone has been riding a desk for the last 15 years, they are out of touch. Much like the politician who has been in senate for 30 years, there is no way they can relate to a street medic, or common man. You have to be able to work the streets to know the caliber of medic that is out there. Granted, the system isn't perfect, this I know, but certainly, we are able to think outside the box alot better now than we ever had in the past.

Thats the thing! I could see if there were a large amount of level 1 centers around, but there aren't. The majority of hospitals are level 3, maybe a level 2 here and there. So clearly, there is a need for early notification of the trauma team so they can get in.

I have a pretty good laser printer, do you think I can make up some fancy schmancy looking degree? I'll hand them out to all of you, 25 bucks a shot. Any takers?

Amen brother!!!!! I've been beating that drum forever. Microwave medics can be dangerous. Aggressive medics are a double edged sword. Finding your groove is key. Above all do no harm. Be a pt. advocate, not a skills whore.

it doesn't seem all that off base to me. I've often used the pressure by pulse method. I've been doing this long enough to know a "ballpark" number for systolic pressures, just by feeling the strength of the pulse. If your good enough, and practice enough, perhaps you could get good at ballparking the pressure off the pulse ox. HOWEVER! we have all been taught not to trust our equipment, but to treat our pt.'s and trust our guts, so I believe that this practice is dangerous. Furthermore, if this guy can't hear a blood pressure, I'd hate to see him differentiate between failure and pneumonia.

Hey all, Ran across a great debate subject the other day at work. I was talking with a fellow employee about calling trauma alerts when he told me that our state was looking into eliminating them all together. Their justification for all this was that we (emt's) didn't call them properly, and in the long run, didn't do much to change the overall mortality rates. Now, I really don't call them all that often, even if I think it's necessary, but I was really offended by all of this. How could some desk jockey tell me that I didn't know the difference between a surgical candidate, and one that needed some boo boo tape. Maybe I'm overly sensitive on this one, but I was enraged.

this whole situation just furthers my opinion that, contrary to some beleifs, EMS is equally as dangerous of a job. I'm sure that you all agree with me on that one. It's just that I hear it all the time about fire and police being in harms way all the time, never a mention of EMS. Not to take away from the CONSTANT danger that fire and P.D. are exposed to, I just think more awareness is needed on our end.