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I'm going to respond to you in a different way... the way in which I wished some others had done when I had first posted one of the original badge posts with pure innocence. Although I believe I later made somewhat of a point, it seemingly didnt cross the path due to the utter thrashing :roll: the original topic had. Just for the sake of concluding it, and to tell some newer folks about it: We as EMS providers have no authority in written law. Although we are at times labeled as public safety officers, this in fact does not mean anything but the fact that we are protected by laws that deter violence against a profession that is more susceptible to dangers compared to your average job. The same goes for your postal worker or meter maid. As dust was pointing out, we have as much authority as any other citizen. "Authority - "the power to influence or persuade resulting from knowledge or experience" As surgeons have as much "authority" to tell another to step out of his/her OR, or a gas attendent has as much to tell a patron not to smoke their cigarette by the gas pumps. We may tell a bystander to remove himself from a scene, but that individual has all the power to decide for himself whether to leave or not. Thing is, you can't lawfully do squat if they decide not to obey your command. Same goes for the surgeon, or gas attendent. The POLICE is the only official that is able to determine whether it is lawful or not, and can forcibly remove the individual. Therefore, why would EMS individuals wear a shield then? Perhaps to have the individual believe that EMS does indeed have the "authority" to tell them what to do. If the individual concedes, then very well, the badge has actually made your job easier. But this is as equal to the surgeon or gas attendent wearing a badge to create this false sense of authority. And when you look at some other points, the negatives far outway the positives. The shield attracts attention, dangerous bystanders and any other individual who deem authority figures as a threat will only put you in harms way. One day you find a uncooperative bystander looking at your shield and immediately listens to you by backing away from your patient, a few hours later, a drug dealer see's that shield and shoots you. I think it's safe to say that the EMT in question would rather have an annoying bystander looking over his/her shoulder then to be shot later on. A bystander may also be swayed by the uniform, or just the sheer fact that you are trying to do your job. To many factors, and the risk in regards to other negatives are just higher. "Quite simply put, you have the authority to restrain a patient vs. letting them kick your ass in the back of the truck," Regarding the restraints, You have absolutely no lawful authority to restrain a pt. These laws vary from state to state. Here in NY if the pt is in medical facility, 2 onscene MD's must cosign a restraining order. Outside of this environment, police MUST be present/and or will be the ones restraining the pt themselves. If EMS were to forcibly restrain a pt without either of these, then they would have lawsuits flying up so far their... well you get the point. Some may restrain them when it comes down to the EMT's own dire safety, some also wouldn't hesitate to knock the o2 tank in the combative pt's face when it comes to their life and it happens, but you don't have any lawful authority in doing so. So the conclusion is.. run.. run far away and get the police to avoid the lawsuits. But hey, if I thought restraining the pt would save a arm and leg, then I might think of breaking this protocol. "you have the authority to force a patient that is mentally unfit to make their own decisions seek further medical care." So does your average ER doc... And finally of course there are those people that dust seems to like thrashing about EMT's that drive 100mph with sirens blazing for any type of call... those that have a authority complex that believe they can do whatever they want with that shiny piece of metal on their belt. Those that just fCk up the face of EMS. Oh, by the way, I heard recently that a EMT upstate was arrested for impersonating a state official by have a NYS EMT shield while working for a private company. :shock:

tues... wait a minute.. that wasnt by any chance at NYU was it? Yikes, feel better.

:x Yeah. Boo on the transfer work.. Getting my time in I suppose. Hopefully I won't have to deal with it much longer after medic school. Albuterol is a medication that the BLS side is allowed to administer here in NYC via protocol. Although, as 2leads has said, I guess asthma is an ALS treatment, since that's not even enough... Epi-pens are by assist usually, onboard epi (Correct me if I'm wrong here, its been a while) can be administered via medical direction when pt is exhibiting signs of anaphylaxis. Dust, By emergent I mean like any other residential emergency. Although this company is mainly transfer, and they do have a 911 division that are participants of the FDNY, oddly, some people call this company (Transport Dispatch instead of FDNY 911) for emergencies instead of 911. This may be because they are used to calling this company for non-emergent transports, or perhaps they are seeking a specific language division. And yes, some nursing homes will also call the private, even if it's a dire emergency. If you ask me, they should just call 911 because of distance, and as I said earlier, a lack of equipment. However, it's because of this that I can actually get some semi- "911" experience. But what irks me is that we are missing so many things. Granted it's a lot more rare to need to use them, but since we are open to such emergent calls we should have them. I recieved an average of 2-3 emergent calls/ 3 days. Here's a more dramatic example of the stupidity. BLS crew from this company recieved an emergent call in residence. Pt is supposedly just unreponsive. They get on scene and find the pt in cardiac arrest. And of course, they do not have an AED. So they do with what they have, ask dispatch for ALS, and being a private, they don't exactly have ALS crews all over the place. So what the heck does he do, the bls crew calls 911.... :shock: derr.

Just curious. I know there are services - private companies that mainly do transfer services, but do take emergent calls as well. However, their ambulances are missing certain medications/equipment. This is for the BLS side. I've worked for a private company that lacks : AED :shock: Kind of stupid if you ask me... An ambulance without an AED... Albuterol Activated Charcoal ASA Epi-pens KEDS (They have shortboards) These are seemingly not part of the part 800 as these vehicles pass DOT inspection. As if the BLS scope of practice isn't small enough to begin with... Just to add... this company is huge.

If it is a transfer from a place of medical care : A restraining order is required to be signed by (2) MD's ON location. If it's a pvt : Police will do it. I once saw someone use a sheet. Kind of a reverse mummification. Instead of having the sheet under the pt, the sheet was on top and was tied at the bottom of the stretcher. Sounds a bit iffy though. Apparently restraining is only when you tie around the pt's wrists and ankles (or at least what I heard a while back) I'd prefer to stay away from the possible lawsuits and get the heck away until the docs or cops are there.

"In these cases, the EMT first responder usually feels they are equal to the ambulance EMT, therefore, doesn't have to turn over the patient." So whats the genius going to try do? Transport the pt in his pov? :shock:

One of my jobs is at a transfer service that also takes emergencies... 911 around here never takes the cot.. for good reason. The only time I ever had some "trouble" with this was this one time I was at an apt with my stair chair and what not. The family member that called started yelling at us and telling me that he had "specifically" requested for a stretcher... maybe thats why he called a private instead of 911? :? The apartment's hallway had so many scratches at the turns.. from previous stretcher's I'd assume..

Kind of like how some people are "allergic" to epinepherine... when it's actually the material used to sustain/preserve/suspend the medication.

Read forums like these... sometimes clips/journals are posted... some discussions can be educating... EMS / Medical Journals... Skim/read over old Brady Textbooks when something sparks a question in my head... Friend of mine just finished the EMT course/exam, I helped him study and in the process went through some stuff myself... About to accept a 2nd job in a busy ER, hope to learn a lot more from that experience. You just really have to stay curious.. if it's a field that you truly enjoy, than you'll keep learning along the way if you're curious enough to follow through.

mmm how did this revolve back to the volly issue on this topic...

wow.. its like... *bling*

LoL Well, Over here AMR is mainly a transport service with a couple competitors, however some people will choose to call them even when it's an emergency. The reasons for this may be... 1. For some reason nurses at NH's who screw up call transport services because they may think that they will get into some sort of trouble if they call the city's primary 911 service. (Why I don't know, but it's just something I heard) Or they may have a contract with company's such as AMR and think to call them anyways even if it's a dire emergency. 2. Some patients will refuse to go to the closest hospital (due to their own opinions of the level of care/conditions of a hospital), and will call private services thinking they will be able to choose the destination. (Sometimes they do get away with it) Local 911 services will usually refuse to do this, especially if the emergency calls for it - which is something that is completely agreeable with.) 3. http://www.nydailynews.com/boroughs/story/...3p-341305c.html Maybe it's a language barrier, dispatchers may be able to get translators (I think) but EMS crews don't have that luxary, and care may be impeded. Private services sometimes offer specialized units to deal with people who don't speak english. (This article also talks a little bit about the problem with competition, it can get messy.) Like the article says... sometimes the magic 911 number isnt the way to go... So they'd choose to "1" It may be true that they have a higher level of standard for hiring, thus it may be construed as being hostile when firing the previous that didn't make the cut. As for replacing even the good ones - it's business, of course they would want their own people in place. They want to make sure things are run their way. But keeping some of the previous workers in management would help the rest cope with the change, but since it's such a large corporation, I highly doubt that's a high priority for them.

Yes... I believe that would be abandonment. As an ALS provider who has rendered any type of care as dwayne stated, the patient would be the ALS provider's responsibility. The Medic, as the higher certification level cannot transfer care to a lower level, thus they must maintain pt care. But hey, in my opinion, if there's a higher level of care on scene.. which rarely does happen around here quick enough... as an EMT I'd be happy to let the medic take over. If I were a paramedic and my medical director (MD)just happens to be around, by all means... etc. Sure, if you really want to continue care, and just have the higher lvl of care ready to jump in anytime, that works too, but why tie up two crews if it truly is a non-emergent situation?

conclusion... let em wait... or pee with you standing by a open door. +Check with company protocol.

Some things I've heard about AMR over here : 1. They're infamous for having ambulances that are equiped with a black-box type machine that records the daily activities of it's routine. Everything from speed, how hard one were to break, how sharp turns are taken, and if the partner steps out to "back-up" the ambulance by pressing a little black button on the rear. It also records everytime the lights and sirens are used. The little blackbox by the driver's side makes a "tic-tic" noise everytime there is an excess of speed or sharp turn. If you turn hard enough or speed, it'll start screeching like a crazed alarm clock. They also have a point system which ranks their driver's safety/mile. Kind of funny, but I'm sure it ensures safer driving within the company. Although I did hear that the division here is the worst in the nation when it comes to it's driving record. 2. They're stringent with their uniforms. During the winter employees must wear clip on ties, which many of which I've spoken to hate it with a passion. But again, I can see the reasoning for keeping a clean look. 3. They seem to have bouts of suspensions/firing with large hiring classes during the summer. 4. A lot of old-timers around here have worked for or still work at AMR. A lot of them used the place as a starting point. Management over here is held by several big names in the ny EMS field. 5. The pay is significantly lower than private hospitals, FDNY, and such, but I guess it would still be called the average wage. 6. They manage to hold several large contracts with hospitals in the city, so they are kept quite busy - I think their main competitor would be TransCare. But then again, like others have said, it would depend on how it's managed locally. I wouldn't be able to tell you much about AMR on the national level. Lastly, I was managed to catch a couple minutes of "the worlds wildest police chases" a while back :roll: and saw police chasing a stolen ambulance which ended up flipping over and crashing. Can you guess what the logo said on the side? :shock: And yes, I heard they played a big part in the hurricane aftermath, the city division did send some ambulances down there to assist along with some other notable hospital EMS services.

When exactly is the care officially transfered over to the recieving department? Example that had me wondering : A stable Psych transport from ER to recieving Psych facility infamous for it's long admissions process had us waiting for 1hr + at the facility. Our PCR was not signed, but admissions knew we were waiting, and the did a short prescreening interview with the pt and continued to do the paperwork. After this process we would usually drop the pt off to the designated floor. The potentially suicidal pt with numerous mental problems wanted to go to the bathroom. I asked the nurse if it was ok - she said yes, and the pt followed to lock himself in the 1 person bathroom to do his business. Now nothing bad had happend in these numerous times, but what if the pt had locked himself in there and followed to hurt himself. Would we be held liable since care had not been officially transfered? I usually will tell the pt to wait until we were able to transfer him upstairs, but some of them can get a lil riled up. EDIT : Just an additional note, this situation(s) occurs on the admissions floor with offices, there are no beds/medical equipment - ie. Urinals.

haha, you're a funny guy. But thanks for the input, no matter what, you still get the message across. If it's one thing I learned in EMS is to not take anything personally. So it seems the reasons for not having a shield outweighs the reasons for having one. Maybe if we weren't allowed or weren't issued we wouldnt be having this problem. So why the HECK are they around EMS?! (I'm not arguing here, I'm merely wondering about the history of this.) Who get's to decide, and while we're on the topic why do firefighters have them?

which is exactly what I am asking. What extra roles are we being given when designated as a public safety officer? I was certainly not trained to do anything more than a EMT entails. But they continue to give us a label. I certainly don't mind that we have extra protection when it comes to being assaulted, but what more does it entail? Perhaps there IS none.

As dust has stated, it is a responsibility of an EMS provider, not the authority there of. Minor case or not. I can agree that EMS providers have no legal authority with this as n5iln as stated. But I repeat again, is this assumed authority by the bystander purchance a benefit to us when they may follow our directions at the scene? Because it's without a doubt that police will not always be on scene to disburse non-hostile bystanders. And you can't tell me that you havn't asked people to move aside so you can do your job. You have no authority in doing this, but you will ask them anyways. The point is arguably countered by the fact that having a shield may actually act as targets. (However what I deal with on a regular basis is not in fact a very hostile environment - perhaps this is why I see it being more of a benefit to have a shield. Then again, people that actually follow my suggestions may be following it simply because they realize I am trying to do my job - not because they think of me as an authority figure). The debate continues... But I wonder this, why is it that certain employers will issue their employee's badges? On a side note, though I recognize this may differ from location, I am curious as to what exactly a "public safety officer" is defined as and what role do they serve.

There is no attitude given towards that bystander. I will ask politely, I will not force him/her to do anything. If he/she complies then good for me. So wher eis this false sense of authority? I absolutely do no believe that I will be able to arrest the douche for not complying!! Can you not see that I am merely bringing up a possible positive point for wearing a shield as part of the uniform?? I would be approaching this the same way as if I did NOT wear a uniform or badge at that. But the question of debate is this - is that bystander more apt to comply because they saw a badge on my uniform? Maybe yes, maybe not. Hell, is the bystander more apt to comply because you have simply a UNIFORM on? Regarding the MVA, I said they were going very slow. This is an example of minor problems/minor dangers that can be dealt with. I'm saying that these instances are not huge situations. Don't get me wrong, I do acknowledge some of the points you've made. "And I am telling you that you do not want people making that assumption! Use your head. Cops get killed and assaulted everyday by people who know for absolutely certain that they are armed cops. Why? Because they either fear or resent the authority."

Your responsibility to provide a safe scene is in fact made easier if certain assumptions of authority are made by the general bystander (NOT THE EMT). I reiterate that these are for the general direction of bystanders that we deal with everyday, NOT the dangerous scenes which require police assistance. Because let's get real here, we're not going to get police assistance on a majority of our calls, especially if the questionable bystander is a nuisance, not a danger. This is where such "authority" can be helpful. I am NOT saying I am using my so called "authority." I AM saying that the bystander may ASSUME that authority and have a better ear? Capisce? I am CERTAINLY NOT shoving the badge in anyone's face. No bravado, no invisibility. It's a silent tool that may sometimes have an effect. In no way do I believe that I am relying on it. Dust, You seem to continue to misunderstand some of my points. Your critisicms wouldn't cohere to my points if you truly understood what I was trying to say. In order to "quickly block the scene" you ARE going to have to get traffic to stop. To make a long story short, it's just a quick 10 seconds of traffic direction to position the ambulance correctly at times when you do not arrive directly behind the accident - simple/safe, cars are slow moving. No I don't feel that people will pull over for me if I'm wearing a badge. They can't SEE it, nor would I think that b/c I don't think I'm supercop. That was an example of how the public treats EMS in this area contrary to those that they DO know wear badges (Law enforcement). Get this through to your head, it's not like I am acting differently as an EMT because I have a badge and "think" I have so much more authority than I really do. I'm talking about the ASSUMPTIONS of the PUBLIC. We are going to deal with hundreds more bystanders that are going to be a nuisance, than drug dealers that WILL shoot at you. I would NEVER jeapordize the safety of my partner and I. Dust you don't know me. If you'd like to debate on the subject than so be it, but your assumptions on what kind of EMT or person I am is simply unfounded. You are the one stroking your ego by trying to use your experience and knowledge to make others look ridiculous.

It's been almost 9 months since I first brought this topic up, and it's been 9 more months since I've been working as an EMT. I'm seeing the valid point's you bring up Dust, but in my opinion, having the badge as part of the uniform reinforces your duty as a public safety officer and a EMT. I'm not 100% sure of exactly how much AUTHORITY we do indeed have, but I can safely say that you need to peform some of the duties law enforcement has when the situation permits. I don't know how it is in other locations, but I can tell you that not many people will respect or so much as to listen to EMS authority here. Cars cut off ambulances all the time, you don't ever see them doing the same to squad cars. If you're the first unit to respond to a street job, forget about it - you'll find yourself surrounded by a buncha people just adding to the confusion. If you're on the road, you better keep looking over your shoulder because you're guaranteed to either get hit or have yourself a real close call. Since when was directing traffic, setting up road blocks part of the job description? Sure it's part of "scene-safety" and this comes BEFORE the "authority" to render patient care. They teach you to light a couple flares in basic class if you're lucky enough. The uniform isn't enough most of the time. People see a badge, and they seem to think twice before not listening. If it helps you stop the moron trying to squeeze pass a scene of a accident, or that potentially hostile idiot standing a couple feet from you then I'd rather be standing there with a shield. I didn't tell them I was a cop, they can assume what they want. And that assumption that you DO have authority may prevent the other BS that slows you from doing your real job. Sure it doesnt always work like that, but for those few times it does give a notion of authority, why not? "I'm only calling you a wanker if you went out and bought that badge to stroke your own ego. Or if you carry it around in your wallet, or worse, on your belt or around your neck off duty (both of which are the case of the individual in NYC whom this topic is about). But if your employer issued it to you, then I am calling your employer a wanker." Whoever said anything about stroking the ego? Or wearing it around your neck or belt when you're off duty? Back to my original post I was told by somebody in my company to go get one and that was all. And no, I don't have stickers all over my car, nor do I wear my badge around my neck while dropping by the post office, nor do I have a belt with a hundred things clipped onto it. You have the Authority to provide a SAFE scene until law enforcement arrives so that you may render medical care. (I'm talking about the direction of bystanders, not gang bangers with guns)

Yeah, it happens, I can vouch for that. I work 13 hr fri-sun shifts - except for one thing, I don't work on saturdays because I happen to have a class that decided to be on saturday. That provides the person who does our scheduling a nice headache. Thus, I'm the "company whore" as they say - at least for the semester. People who start out here on weekends usualy are. I completely understand what you're saying, it happens. I use to think working 13 hrs with someone like that would drive me nuts, but I cope. But if it really starts to get to you, then you might just want to try talking to your supervisor. But try this - instead of telling him/her that you don't work well with "that person," throw a couple names out there that you WOULD like to work with. Just saying that you DO work well with some of these people might make you look better instead of vice-versa. Of course, it's a request, not a must-happen. After all, work's work, it's not a place where you can partner up with your friends all the time, but its worth a try.

I was looking at one of the earlier posts in this thread and did a little bit of a double take. The post revealed that transport EMT/paramedics get paid more than 911 EMT/paramedics. Someone needs to tell that to the people in NYC!! But I suppose there can be a bit of debate with that. (Transport EMS is lower pay than 911 here - at least that's what I've been seeing.) In transport, you usually end up doing more of your fair share of lifting and is USUALLY busier than 911. Yet there is less medical intervention at times. So I could see why transport ems could be paid more (and maybe should). Then there's 911, less lifting, USUALLY less busy, but comes with more high risk when it comes to danger, and medical/protocol mess ups. Just wondering what you all thought about this. ~ 10.50/hr as an EMT in transport and 18.50/hr in 911.

Queston on Parking Brakes... Where are they usually? My conception is that they are usually in the middle or on the bottom left of the dash. Are they usually in one location for SUV's differing from regular cars? ALWAYS make sure the parking brakes are on at a scene of a MVA. This was a lesson learnt from an experience that made my partner and I look somewhat ridiculous. I was preparing some paperwork on our way to a regular transport last sunday in "the great snowstorm" of NYC... More than 2 feet, crazy. Anyways, this was in the morning when the snow was still incredibly heavy with extremely low visibility. We were traveling at around 25-35 mph on the right side of a 4-lane highway that was on a slight uphill when my partner suddenly said ohh.. shit.. I looked up and a suv driving in front of us did a full 90 degree fishtail to the right and slammed face first into the cement side guarding. Granted they werent traveling fast but there was some loud crunching and the windshield partially popped up. We stopped the bus blocking the two right lanes and went out to take the call. Despite my partner insisting the driver stay still in the car, he quickly opened the door and walked around to the passenger door and exclaimed that he did not want to go to the hospital and we should go away. (At this time the suv was turned off so I didn't have to worry about that...or so I thought) I opened the passenger door and began examining the passenger when suddenly the car started rolling backwards! At this point we were all on the passenger side, and the wife sitting in the car who was already in distress couldn't do anything but sit there in horror. My partner jumped behind the car and pushed as hard as he could (This is a pretty big guy), I grabbed the passenger door and did the same on instinct, I took a quick look behind me as the car rolled backwards, and noticed the oncoming cars in the remaining 2 lanes had stopped (Thankfully, or else I would just grabbed my partner and let the damn thing roll). There was a big smack as the back of the suv hit the other side of the cement median, good thing it didnt roll down into traffic and my partner had plenty of time to get out of the way. (Rolling car that gets exponentially faster=impossible to stop, expecially in snow :shock: ) At that point I grabbed the keys and ran back to the bus to block off the whole highway (Police still not there) b/c it was just getting way to out of control. The other driver's that i had gotten to stop didn't seem to want to wait as I was pulling the bus to the left - it got to the point that my partner had to walk about 5 feet away from our patients to help stop the traffic. Sigh..NYC drivers.. But thats not the worst part, when I finally got the bus into position, the driver of the SUV had hopped back into his car and suddenly sped off. My partner and I just looked at eachother and was like.. wtf. Nothing we could do, we just reported it to dispatch and continued to our original call. People can be strange...you'd think if one had to be an accident they'd be grateful if it happend right in front of an ambulance...