FireGuard69

I really have to say thank you to the most of you who have been respectful about your overweight / obese PT's when talking about how you handled them. I used to be a big girl, but have worked hard to take it off, and keep it off. Its a shameful world to be in, and any amount of dignity and respect is always much appreciated by them. Knowing where I used to be, I will always treat them with respect and dignity. Part of me will always be a fat chick, and that fear of going back is always there. But there is no reason to be mean, or hurtful, or to call them names.

Lisa, we don't disrespect our pts. We don't know all the circumstances behind the illness.

Plus, its grossly unprofessional.

I can't recall if anybody else mentioned this yet, but one important point that is missed by many neophytes is getting the catheter and the stylet needle well into the vein before advancing the catheter over the stylet needle. Too many people seem to want to immediately start advancing the catheteter as soon as they see that flash, and they end up either outside of the vein, or else so traumatising the venous wall that it blows. Once you get that flashback, be sure to go a hair deeper into the vein before stopping to thread the catheter into place. That alone may go a long way towards raising your success rate.

Dust, thanks for that ti.

I have been getting the flash, but have just not gotten the catheter in. Hopefully, this will solve that problem... 8)

Hell...I'm actually on board with you this time AJ.

I certainly did take the comment tongue in cheek, though I don't disagree with spenac calling him on it.

It was meant to be funny, coming from a person that claims to honestly believe that all patients should be at least evaluated by EMS before the cops take control...So he gets my 'atta boy.

There are some things at the City that are always going to get someone's back up. Be pro-volly or anti education, Dust is going to speak up, mistreat patients-spenac, make retard jokes-me. Obviously there are many, many others passionate about these same things, these are just the first that come to mind. It's a way of keep us all honest, no harm meant. Plus it's a way for us to get to know each other a little better, something that comes in handy when the topics really get hinky.

You both have much to offer...let the criticism roll off when it doesn't apply...and let's keep on a learning curve here.

Dwayne

Dwayne, I would be honored, if you didn't curse, and thusly bring down your professionalism rating! :twisted:

Seriously bro, I am joking.

Hakuna Matata! Hope ya had an awesome Christmas!

That being said, some actually think I was serious about pleasuring in causing harm?!? Oh, that's rich.

Seriously, does ANYONE know what "facetious" means?!

Does ANYone joke?

I know my last thread was locked, but seriously, if you are THAT turned on, that serious about EMS, that you can't even joke about things, then you need the kind of help we are discussing.

From what I understand, we have two dispatchers per shift that take care of: Police, county and 1 city; EMS, two services; First Responders, about 5 services; Fire, about 8 services. I should stop by there to see how they request and process information.

Seriously, do it. You will learn WONDERS about what goes on "behind the scenes", and dispatchers, albeit strange creatures, love the company.

As for their staffing, it sounds damn near criminal. If you get a serious working fire, that would tie up minimum of one, preferably two dispatchers.

I am very sorry to hear of the understaffing. Perhaps you need to bring this to light of county commissioners?

What happened to interviewing the patient while on scene?

Psst. That wasn't me. :wink:

The intent wasn't to take that away, but to get more information before arriving on scene. I don't think that every response needs to be emergent, but I'd like to make the decision for each call with the most information available. Also, if I can eliminate some time on scene, even better.

Granted, alot of calls don't need L&S response to them, let alone EMS. Just drive like everyone is an idiot, and don't haul ass.

There are few calls worth the balls to the walls responses.

It's not that I want to get rid of or demean the dispatchers, my thought was that being able to better understand the call, respond appropriately, and get a history ahead of time would be a benifit and free up the dispatcher to take other calls and communicate with fire or police regarding other calls.

I've never been in a dispatch center so I don't know what information they process during a call. Maybe that's part of the problem. I just assumed that they are usually multitasking when they may not need to be.

As it was explained before I got here, there is a call taker, an EMD, and then the dispatcher.

Call taker (depending on area), is a PD/SO employee, who asks, 911, what is your emergency. After telling him/her that you "need da bambulaance", they forward the call to the EMD. The EMD then collects info, location, nature of emergency, and makes the determination (at least in Jersey) if it is an ALS, or BLS call. If it is hopping, and a BLS call of low priority, they will then give pre arrival instructions, (put pets away, go outside to flag down), and hang up. If it is an ALS call of high priority, then the EMD will be collecting info, and forwarding it to the Dispatcher on the fly. That is often the reason we, as street crews will not be getting the whole picture. In small cities and towns, often there will be just on person for all three services, but don't get me started in regionalization of emergency services...

I can see where this wouldn't work in urban areas as well regarding traffic. Good point.

Half the time we will have a bag spiked and ready already in the ambulance. If I think I'll need a second line or the previous shift didn't put one together, I will enroute.

If my partner is on the phone while I am responding, he better be getting directions, or getting me a date for that night!

He needs to be working the siren, horn, and assisting me in clearing the intersection.

As for spiking the bag, if the previous shift didnt do it, shouldn't you find that in the AM check?

Hmmmmm..... sounds like that is a yes.

Jump to conclusions much?

Why not ask me, "well, are they ALS pts?" or, "why do you do that?", or "is that part of the standing orders you give?"

C/P, hypo/hyper tension and glycemia get them, as well as "real" trauma pts. No questions asked.

Most of my Medic preceptors, as well as myself, have worked in the local EDs as techs, either ED Tech I (EMTs with phlebo, and EKG) or ED Tech II (Medics). So we KNOW what kind of pt will be getting IVs in the ED.

Why let the ED do it, when I could be getting the practice?

Yes, FireGuard69, we all know your pet names for people, especially your patients as you mentioned in the Ambulance Driver thread.

Please darling, AJ will suffice.

I am so damn TIRED of those uber professionals. IMO, you are nothing but up tight stiffs who need to get laid.

Guess what, people curse. I am on a dry spell with IVs, I can't hit the broad side of a barn with a 14 gauge. FCUK! FCUK! FCUK! Get over yourself.

This isn't 1955. People curse, get over it. You want real professionalism? Show up early, in a clean, pressed uniform, clean shaven, and a decent haircut, and most importantly, learn as much as you can for the betterment of your pt.

Some of the best Medics, EMTs, cops, and Firemen I have ever met curse like sailors.

Same with Docs, RNs, and dispatchers.

Ya know how our Medic instructor gets us to learn the dry material? She throws in sexual connotations. And you know what, it WORKS. Is it PC? Fcuk no. Does it work? Fcuk yes.

Do I have an attitude about people who don't know me telling me about my language? Fcuk yes. :roll:

No, of course not. I intubate ANYone who says they are SOB. Chest pain from coughing so much from the Red Tide? Thats ASA, ntg, and morphine! Neck a little sore from the minor fender bender? Well shoot, thats a Trauma Alert, RSI, and a helo flight to HRMC, nah, ya know what, make the ORMC, since they are a Level I Trauma Center. :roll:

Yup. We (preceptor, partner, and myself) used it to confirm Benedryl IM doseages on a 12kg pede with an allergic reaction to peanut butter.

And since I am a Medic Stud(ent), almost every pt of mine gets IV, (if I can get the fcuking stick :evil: ), and monitor, for practice.

Even minor C/P gets a 12 Lead.

Better to practice on the well, the the sick.........

Thats why EMS should not deal with psyche emergencies!!!!! Police matter! Like I said before!

CONTENT REMOVED - ADMIN

How many male nurses do you call "sweet heart"?

Never had a thought that you didn't vocalize?

And if I know them, I will call then sweetheart. Maybe its a Firefighter thing, but we fcuk with each other that way. Sweetheart, snookums, honey, sweety, etc.

Dont get your panties in a bunch over something so trivial.

ART. Assuming Room Temp.

As far as DFO, if you work in a system that has any urban area, you will hear that term. If you find a person on the ground, either semi-responsive, unresponsive, or dead, the bystander will state, "I don't know what happened, he just done fell out". The bystander is usually the patient's best friend for many years, but only knows the nick name, and the patient's favorite brand of smokes and booze.

I used DFO the other day, and the 2 Medics looked at me like I just admitted I was a Liberal

I suppose it is a North Eastern term, since I am in Fla..... for now

My facetious post aside, NO ONE should be administering ANY drug (save for the ones rxed to the pt, and O2), until they go through pharmocology, as well as a test on the medications they will be administering, including, but not limited to;

How the medication acts with the body,

Contraindications to said med,

Indications to the med,

Side affects,

and doseages to be given, even if it is an auto injector.

Knowing is half the battle, and when it comes to my pts, the more you know, the better off they will be!

I just stated an undebatable fact: Administration of a prescription drug, requiring the order of a physician, is ADVANCED Life Support. This is the BASIC Life Support forum. How difficult is that to comprehend?

So O2 is ALS?

You can dispose of any pain meds through me. 8) :twisted:

For cryin out loud, its a JOKE. :roll:

I thought it was a great piece. I am a new EMS manager in a small rural area in North Dakota`and I have approached the local high school about starting an EMT course. We are constantly short staffed and have to so something. Thanks, it was interesting.

Oh Christ, we are spawning more of them..... :roll:

If you are short staffed, HIRE, don't recruit children!

But, make an Explorer Post to start the education process of these kids. Nurture that spark of wanting to do something, give them direction, and keep them out of trouble. But, for the love of God, don't use them as manpower.

The thing that seems to really be agitating me right now, is most of you are saying "at age 16 would they know how to treat it." They are EMT's they are TRAINED AND CERTIFIED EMTS. By the DOH. Therefore they are just as qualified as a 20 yr old taking the EMT class...the difference is they are younger!

I am going through here late, and you keep making stupid comments. I know there will be more after this, but damn, do you even think before opening your mouth?

EMS is a PROFESSION. Not a hobby, not an activity.

We keep allowing CHILDREN to do this JOB, how are we expected to progress?

What you have on PAPER, and I have in REAL LIFE EXPERIENCE just doesn't match up.

Time to weigh in.

I have seen all sides of this.

Fire Dept does no EMS

Fire Dept does EMS when EMS is busy

Fire Dept does BLS, No txpt

Fire Dept does BLS txpt

Fire Dept does ALS, no txpt

Fire Dept does ALS txpt

That is not even counting the ones who have an EMS division but ARENT Firefighters.

Heres the bottom line...

FD SHOULD be doing, at a minimum, BLS level care. If you got an Engine out in the sticks, with no bus around, have em do ALS.

FD should NOT make FFs become Medics. Nor should they make Medics become FFs.

I know several depts that make all FFs become Medics within 2 years of being hired. And they made all the Medics become Firefighters. That is just WRONG. Being a Medic is a damn hard enough job without adding Firefighter to it. And being a Firefighter is a damn hard enough job without adding Medic to it.

Hmm. I forgot I was registered at floridatoday.com.

And did it ever occur to you that I am well aware of the fact the employers do google searches, and that I have a professional AND personal email addresses?

like go_screwyourself@blowme.com?

You have stabbed your Brother and Sister EMS Professionals in the back for less then "lizard slingers"?

You CANT make me like treating certain members of our society.

Chronic alcoholics, nursing home pts. who are being kept alive despite being in extreme pain or are being neglected in "Nursing Facilities"

Homeless "skells", oh wait, does that offend you too?

Granted, most of those people are there due to an addiction, or they are incapable of making their own decisions.

I will treat them with the respect and high quality pt care that they deserve, but you can not make me like them.

You know those "lizards" are human beings. They are someones mother, father, grandfather, grandmother, brother or sister. They have lived through the Depression, WWII, Vietnam, and a 1,000 things you will never know. That elderly man might have been a Medic at Bastogne or a Teacher that was loved by his students. That elderly lady might have worked at Boeing during WWII and helped build planes that won the war. She might have been the mother of a soldier killed in Vietnam.

My point is that these people are not happy being "stinky" and old. They are proud people who deserve our respect. Would you want someone referring to your Grandmother as a lizard?

It's time for EMS to grow the f*ck up and quit using derogatory terms when referring to the elderly, they deserve a sh*t load more respect than that.

Off Soapbox

And now he is lying in bed, GCS of 7 on a good day. Being kept alive by a massive cocktail of meds that is prolonging the aganzingly painful wait until death arrives.

By whos choice?

I have NEVER, not ONCE called a pt who did not put themselves in their condition a derrogitory term to their face, nor did their pt care suffer.

I know that myself, my parents, and their parents do not wish to end up like that, and have specifically detailed that out in legal documents.

If you can get on here and say that you never, not once got back in your truck and said to your partner, "Damn, that was one stinky pt! Good thing I was up here driving!", and laughed it off, then congratulations you truly are SuperMedic.

But guess what, we are not all perfect, and while we don't say it to their face, we drop all pts down, to relieve stress, make light of a serious situation, whatever.

After a trauma, you have never said, "damn that guys road pizza"

or "hamburger"

never called a chronic drunk who leaches off welfare to buy his booze "a waste of taxpayer dollars"?

Sure, we make our pts look inhuman, take them down a few pegs, but guess what, I will treat all of mine with nothing but the utmost respect to their face, as well as their families.

Oh, and IF my pt is CAO enough to make conversation, then I do. And I have taken WWII vets, and a teacher from the HS I went to a near half century before I was even born.

Do not mistake my making humor of doing a job I didn't like to pay the bills with disrespecting the pts.

CC64;

My post was being facetious.

The only time I like just driving is when I worked lizard slinging, cause they all stunk to high heaven, and there is no challenge to B(L)S interfacility.

I like being into back, especially on a tough call where its the Medic and I working our asses off to deliver the pt alive.

I just HATE writing. With a passion

spenac, I'm guessing that was directed at me?

I was typing late at night, so not everything I was saying was making sense.

Basically, here is what I was trying to get across.

You can take every class that is offered, and still be the dumbest mofo around.

Education does not equal intellegence, but it sure as hell means that you are trying to further yourself.

The more I learn, the better off my pts are, provided I can make the info I learn in class jive with what I see on the street.