KSEMT122

I think in a Pre-Hopsital setting maybe we could be more aware of somebody that may be at higher risk for DVT's and so forth by taking a good history. I'm just glad this subject has made it onto EMT City. I'd like to state for the record that young people can also form DVT's and we as providers may not catch on to that due to their age. I can tell you from experience that my wife was almost killed by ER Doctors who failed to diagnose and treat her massive DVT and 2 Pulmonary Embolisms. She was seen twice! And they failed to diagnose her both times. Even with me beating the PE and DVT drum they failed. Let's all make sure to give our patients our utmost attention and get detailed accurate histories. Don't forget to ask about possible genetic disorders that can cause clotting and things such as that. I feel that is where we should be at in a pre-hospital setting in aiding the treatment of any type of clot. Sorry to ramble, but it's a subject close to my heart.

Sounds a little like Clay County EMS to me. In Kansas EMS ground services can be licensed in two main ways. Type I (ALS) and Type II (BLS). If you choose to register yourself as an ALS agency that means you have to have Paramedics available on 100% of the calls you respond to. By the way there are only 30-35 Type I services in Kansas due to the requirement of having a Paramedic on EVERY call. However, what most services in Kansas do is register as a Type II (BLS). Even if they have Paramedics on every call, just in case they can't fufill that requirement. It is very typical in Rural EMS systems. The agency I used to work for was a BLS agency. I had a Paramedic Partner and our shifts were set up that way. They registered as BLS because we didn't have many Part-Time Medics to cover Medic shifts. So that way every once in awhile they could run a BLS only truck. That is how it is in Kansas. The BLS Trucks can operate either way as long as protocols are in place to do so and there is a Medic available. The ALS trucks in KS MUST ALWAYS have a Paramedic on board. Personally I wouldn't work for a service that didn't have ALS protocols in place.

I am glad to see you have a Love for both. I do as well. At some point though, you will need to pick one of those as your Full-Time profession. I have yet to see a Full-Time Police Officer AND a Full-Time Paramedic being one in the same person. It just doesn't work due to scheduling conflicts and other things. You will end up doing one Part-Time, and even then you will favor one over the other. So my advice would be to think about all this in advance and pick one to go to school for. Being in Explorer programs is a GREAT way to start. Started off that way myself in a Law Enforcement Explorer Program. That is what an "Explorer" program is all about "Exploring". So keep "Exploring" until you gravitate towards one or the other. If you never gravitate towards one I guess you can try both, although you may find out that you wasted your time with one. Good luck either way!

You did the right thing. The ALS crew should have a complaint filed against them for taking too long. The Patient trapped in the vehicle is dead. Walking wounded's can wait. You helped save this woman's life. You should feel darn good about it. Those 2 Large Bore IV's of NS may not have kept her BP from falling, but I'll bet dimes to dollars that it helped slow it down. I would start them en route, which I'm sure you did.

I think this is a job related issue. Or at least a Public Service job related issue. In every job I've had, which covers all three basic Public Services', (Firefighter, Police Officer, and EMT) I've seen and had issues with people backstabbing and gossiping. It happens on this site as well. I believe it has to do with the fact that we all have a brotherhood and get too comfortable with each other. When that happens we tend to not be on our "best work behavior" and these things start happening. The funny thing is, even if you just "go to work and do your job" like so many suggest, you will then fall victim to it because you will be perceived as being rude and so on. It's a never ending vicious cycle that can ruin good peoples careers and lives. It's a delicate balancing act that I have yet to master. I wish you luck if you are dealing with it.

Well I was just about ready to say I'm glad noone I know was injured and then I read that Teresa was on that bird. She's a sweetie, Everyone calls her "tweety bird". Anyway I've been up in the air with LifeTeam before during 45mph sustained winds with gusts well over 60mph. I actually have it on video tape. I'm not sure what the standard is in Rotor Wing Aviation as far as what wind speed is to fast to fly in. I just know from experience that LifeTeam will push that limit and this time it may have bitten back. Glad everyone is expected to be ok. God is good.

I've been following this on the local news. My sincere thoughts and prayers go out to his entire family. He will not be forgotten.

Wow, sounds like this has been going on for a long time for someone to get arrested over it. That makes me wonder though, why the heck were they arrested? It sounds like a civil issue as far as penalties go.

Well now I am curious. You get B/P's over zero? I would like to know if this is possible. Because hearing it all the way down doesn't make it whatever over zero. You should listen for a change in tones and that is your diastolic. I've had several people who I hear all the way down. It doesn't mean their Diastolic is zero. So my question to the big wigs out there is...Am I missing something here or is a Diastolic over 0 impossible unless your dead.

Fire Based EMS...I agree with Twister, you have people being forced to do something they have no interest in. I know around here the Box is the whipping post for Firefighters who have pissed a white hat off. Everyone dreads the days they are on the box. Keep EMS out of FIRE Dept's! I don't want them doing First Responding to my calls either. I'm so sick and tired of pulling up on scene to find 6 Firefighters who have been "on scene" for 5-10 minutes already and they are all standing around outside smoking and there may be 1 Firefighter/Paramedic, if we are lucky, who may have found the time to take 1 set of incompetent Vitals. And that is their PARAMEDIC!! It's just been dismal in Kansas and I wouldn't recommend it elsewhere.

Hey p3medic, Have you found my watch yet? Oh and you can just leave those underwear on the front porch.

Holy Moses! I want to work for Mount Horeb! What the heck is that? lol. Very interesting, I guess it was just a matter of time before that happened. And the best part is it has seating for a football team.

I'm not sure anyone in here is going to touch this hot potato, at least not me, lol.

Here we go again. I think the point is being missed. I would suggest a re-evaluation of your desires. You are 16, you are right in your feeling right now that you don't want to drive an Ambulance. When you are older, that will more than likely change. If it doesn't you shouldn't go to Medic school, you should just get out. Because if you can't embrace a big part of the job then the job won't embrace you and you will always worry about having to drive at some point. You need to learn your city and learn it well. And you need to be confident of yourself and your abilities with an Ambulance. It doesn't happen overnight by any means. Onto the post about busting balls getting to Officer Down calls and Pediatric Codes. Everyone started bashing that person for stating a fact. That it happens where he is at. Nobody said it is right, however, that's just how it is in reality. Reality- Tech's will bust balls to get to a Ped Code or Officer Down. We can say it shouldn't be that way, but "one way all the time" is not applicable. I don't know about you, but if I'm responding to the same frequent flyer for the 5th time this week because he "doesn't feel well", I pretty much drive with the lights on for show and because for some reason dispatch classified it as something that requires yet ANOTHER hot response. If someone calls in a Ped Code, my human nature will want to bust through traffic quickly AND SAFELY. Just my two cents which I'm sure will turn into a half a peso by the time everyone is done lecturing me. Another side note, alot of places won't hire you until you are at least 21.

Sure in a perfect world you wouldn't and shouldn't have to care for this piece of crap. However if he just killed your family member I suspect this isn't a perfect world. Rural services you might well have to do something like that. I would be doing everything possible not to have to treat that person, such as calling another unit. But when the cards are dealt, there is no turning back, and I darn sure don't want a criminal and civil charge. I would do everything in my power to make the bastard live so I could torment him daily while he lives in prison being bubba's bitch.

Not much else to say except Dust is right. I can't ever see a 9 month old Seizure as stable. They shouldn't have stopped plain and simple. Nobody is over reacting when they say that. The liability they opened themselves up to is beyond their comprehension. And they are "heros?" lol. Unbelievable, I would lose my job if this crap happened.

I've always wanted to be a whacker, never had enough money, although I did manage to own a few vehicles. lol. I think my ultimate whacker day came when I became a Police Officer and got issued a take home patrol car. I was on top of whacker world that day, and every day it sat out in front of my house. Then I quickly realized it was a target and put it in the garage. That was my whacker moment, fun while it lasted. So I'm in whacker recovery now, still painful, and still miss it. I think it's like being an Alcoholic, I'm not "no longer a whacker" I'm just "a whacker in recovery".

I would say your certification doesn't stop at the door. You don't automatically forget your training as soon as you step in there. Anywhere you work you are going to have a Medical Director of some sort. You would operate under his established protocols within the correctional institute. Of course check with your state rules and regs first. That is just my guess.

Not from the FDNY, but I"ll shoot out an answer to ya. Plain and Simple, people can refuse care at all levels. Well as long as they are A/O to person, place and time. So they could have just had their neck broke, but by god if they are NOT going to have a C-Collar than by god they won't. Their choice, your duty is to try and talk them into it, but if they won't just document. Now, I have seen this happen as well in different hospitals and you know darn well the Medics were too dang lazy to board and collar this person or carry them. In that case, they should be punished by their department, if not at a state level.

It all revolves around what your passion is. From a strictly unattached point of view if you compare the two, I would choose nursing. People harp on the "Paramedic Shortage" well if you think there is one then it's 100X's worse for nursing, so you're always going to get good pay for little work... lol just joking nurses, I know they are some of the most overworked people in the profession right now. If you can get yourself to embrace the nursing dream, then go for it. FDNY is a very proud job to have, tons of politics, and not much pay for ALOT of grunt work. Go where your heart leads you my friend. I would much rather work a job I LOVE for little pay than work a job I hate for tons of pay. Of course that all depends on your family status and things like that. Be responsible in whatever you choose to do.

Paramedicmike said: Here we go again with the BLS bashing ALS and vice versa. I wish this thread would be locked, because all we're doing is going around in circles. And when we come to the end of the line, everyone starts over on bashing eachothers skills. Then we have people making this an issue of America VS the rest of the world EMS. INCREDIBLE!!!! I"m so sick and tired of seeing people on this forum trash the United States of America and the quality of OUR pre-hospital care! Especially when you are from the USA! If you aren't satisfied with the quality of OUR prehospital care then move to a country that best suits your needs! I doubt you'll find better, but hey if you do, more power to ya. I'm all for discussing the differences in world EMS, but to start putting down the quality of service in one country verse another is just inappropriate.

Sure you need a command structure, volunteer or not, I would dare to say ESPECIALLY as a volunteer. With that being said, most "ranking" people I"ve dealt with always have a complex and really don't have a clue what they're doing, but they can push a pen and paper better than anyone this side of the Mississippi! In all reality I've seen it both ways. I've seen people who don't need a command structure at all other than a Director or Chief. And they do just fine. Then I've seen groups of people that without leadership at ALL levels, things would fall to poop if they had to rescue a cat from a tree.

I've been hearing about this for the last couple of years and have always thought it sounded like a very logical theory. I've also heard some very promising results, but like everything I'm sure there is controversy. I would like to hear from Rid or anyone else that might know of a hospital or even EMS service participating in a study. I know there were some that were doing it a couple of years ago, but it just never seemed to catch on across the USA. Rid, I"m thinking Wesley Medical Center in Wichita was doing this, are they still or am I just wrong, or have you even been to Wichita in the last couple of years. lol

Strippel Said: Some do, Some Don't. The places I've been to, most don't. It's just a fact of nursing homes. I think they all, for the most part, start out caring. With the increasing amount of patients in nursing homes, they get overworked and start not giving a crap about those poor people in there. I will describe ONE of MANY cases in point. Called at shift change (7am) for a fall at a Nursing Home. Walk in and can't find ONE SINGLE EMPLOYEE. We walk up and down the halls looking for someone, anyone, and find NOONE. We FINALLY stumble across an elderly man laying prone on his bedroom floor with a large pool of blood around him. The blood, has in fact already congealed. As we are preparing this man for transport the RN on duty comes in and says he's only been like that for about 10 minutes! My partner and I started laughing outloud. According to the patient and circumstances on scene, this man had more than likely been laying there 7 hours! Do you want to know the kicker, He was able to reach the call string on his bed and pull it right after he fell. Noone came. As we were leaving, the light outside his room was on for ALL staff to see that he needed attention. This is what we're dealing with folks, and it's not getting any better, it's only getting worse.

All the replies to this post at this point are getting way off topic, but I"ll endulge in a little controversy. I take exception with that comment I quoted above. Although I too, never ironed my pants, I did, and was required by policy to iron my uniform shirts. I never polished my boots either, except touch up work on the toes and heels. EMS is about image. My department was BIG on image as well as patient care. One of the first things I was taught in EMT school is that image is a big part of what we do so that people feel comfortable with us. The better someone looks, the more competent you will "think" they are. That is just human. That is why we wash the trucks EVERY morning. I'm sure someone will argue patient care is more important... I would submit Image is part of patient care. Something to ponder. Thanks folks, I'll be here all week!