medic_texas

Sometimes they have to do another ablation. A guy I worked with had 2 done locally then had to go to another facility in Houston before getting it fixed. I'm not sure why that is the case but that's the facts. He's doing fine since then.

Terrible news. Dust provided me hours of entertainment when I frequented the city.

RIP dust..

You started a good list, but you missed the most important reason for ER backlog, but thats ok cause its an inside industry secret that will not get published. Those hospitals that have improved ER flow have done so by attacking the problem on the floors and in the ER. In most hospitals, doctors come and make rounds once; they see all their patients, sit in a cubicle for an hour or two, and then dump 12 charts at the nurse's station at one time. When doctors are forced to round at certain times, turn in charts as they complete them, and are forced to take care of potential discharges first, the flow of patients moves much better throughout the facility. The second sacred cow is the OR. Doctors are assigned blocks of time in the ER, and those times are never altered. If Doctor A has OR room one reserved from 9a-12p, no other surgeries occur in that room, even if he has no procedures that day. By forcing the surgeons to use time and rooms efficiently, again flow improves, but no one will touch the sacred surgeons.

There should be a new law passed nationally, if your hospital is on diversion, you should not be allowed to perform elective surgeries until such time that you are off diversion. The Diversion Problem would be solved overnight.

I don't think your example is accurate at all. I've worked at several ER's and I've never seen anything similar.

I think Ruff and doc have posted very good information and also ACCURATE info.

This was a topic that was posted many months ago. The firing is new news related to this incident.

Yet another boo boo

Big oops. I feel bad for the doctor - can't practice, disabled, lack of income, etc. The family should win this case easily.

http://www.emtcity.com/index.php/topic/18057-medical-helicopter-requirements/page__st__30

Moron.

I ignore kiwi 99% of the time. He's an expert in everything (look at the topic about starting an HEMS service he states he has extensive experience with radio communication and a few posts later someone is telling him how wrong his info is; typical kiwi).

This situation is a mess and is turning into a political game orchestrated by the Sheriff to try and promote the public safety officer. This situation can only get worse (unless the sheriff backs down or is kicked out of office).

The bottom line is - the firemen/EMT was on scene to assess the patient and assist the transporting unit (and beat them on scene). The Deputies interfered with this and possibly violated his civil rights, falsely arrested him, interfered with an emergency call, and acted like idiots. All at the expense of the patient (who I believe should file suit against the SO).

Kate, keep us updated if you hear anything. I'm really curious as to what happens next.

Kiwi, shut up.

I've worked for a dual-role department and trust me, it's a nightmare. Currently, they have moved away from the police/ems role and have separated the sides within the department (with a director of EMS and a chief of police).

Cops should be cops.

Medics should be medics.

Firemen should be firemen.

Firemen and policemen are more than welcome to help on an EMS call.

Regarding this; I'm not sure how the laws work in Colorado but being a police office does not discount you from being charged with "interfering with a 911 call" in Texas. Sounds like the Sheriff's department is not dispatching correctly (with prejudiced) and not utilizing resources appropriately (dispatching fire to medical calls which I understand is protocol there).

The nearest helicopter is 1-1.5 hours away? Is that flight time or you driving to where the helicopter is; that's a big difference.

I just don't believe that however it could be true; I've never been to that area.

I won't even waste my time on the topic in general. Starting a HEMS service requires many things that 2 individuals wouldn't be able to do without a huge sum of money.

I think you should change "self training" to "professional training" or something similar.

Taking certain martial art classes could prove to be very valuable in case of an altercation on duty. Certainly we all realize that Karate won't do much good in the back of an ambulance. Also, Brazilian Jiu-Jitsu won't much good outside of the ambulance with several angry people waiting to stomp your head in if you were to take someone to the ground.

LEO training is based off several things; Hapkido, Brazilian Jiu-Jitsu, Akido, Judo, and a mix of other tricks that are proven to work but loosely based of a martial art of some type. But unless you practice these moves several times, get your timing down and muscle memory down, and being able to recognize different options during an altercation - you're left with your own survival skills.

Personally, when I was in paramedic class I joined a gym and began taking Brazilian Jiu-Jitsu. I was concerned with not being able to defend myself or subdue someone if I was ever in that event (I was 5'9 165lbs then) Fortunately, we shared the space with a boxing club and my instructor also enjoyed and made us practice kick-boxing, muay thai, and boxing so I was exposed to striking as well as grappling. I enrolled back into Brazilian Jiu-Jitsu in December and for being 8 years older, heavier, and out of shape; it's been murder! I don't do it for self-defense, I do it because I truly love the sport and the fitness aspect of it.

Bottom line - training is great but common sense and instinct will serve you best by not getting into a dangerous situation.

It breaks my heart to hear about another HEMS crash. This one seems to have been an unnecessary risk that was taken by this crew. When will this stop? Soon I hope..

Everyone stay safe!

I remember the original story and now this? I'm not really surprised - he sounds like a piece of work. Good riddance.

I haven't seen that one. I guess it lets everyone know how poor EMS people are.. Now if we can install tip jars in the ambulances we'll be set!

These commericals have been playing locally and this is my favorite! Glad it's on youtube:)

http://www.youtube.com/watch?v=rjdThaJVTW4

What do you mean by "get my hands dirty"? You mean experience or blood and guts?

Experience will come with time. If you work with a busy service, experience comes sooner than later. If you work with a busy 911 service, you could have the blood, guts, glory, and experience.

It just depends on where you work. If you plan to stay in a rural area, you'll get some good experience but again, how busy is this service?

Good luck to ya!

Why would you want a lab value lesson from a nurse when you have an obvious critical patient? The "INR is 6", wtf can you do about it, especially since you have no idea what INR is, start treatment and rapid transport then pass that information along. The patient comes first.

If you don't have radio communication with the hospitals, why the hell are you running pre-hospital calls? That should be reported or brought up. If a jackass crew brought me a patient like this without a radio or phone call, I'm raising hell. Especially a trainwreck like this.

Info regarding PT/PTT/INR

http://www.labtestsonline.org/understandin...es/pt/test.html

Chalk this up to experience.

This issue will always be difficult due to many factors. As someone said before, different guidelines exist for trauma and neuro patients. Generally with EMS, we have multiple things going on at one time.

Does the patient have a brain injury or hypoxia? If they are just "unconscious" it could be difficult to determine this (unless there is obvious s/s of skull fracture, CSF coming from the ears, posturing, etc). If you suspect any neurological issues on your trauma patient, make sure you do a thorough neuro assessment (GCS, pupils, extremities, etc).

Hint: If their LOC is decreased - try to assess all extremities, not just one side. Ex: nail bed pressure to both hands (withdrawing, posturing, no response), babinksi reflexes (correct or reversed?), etc.

Basically, ASSESS ASSESS ASSESS!

As a pre-hospital provider you need to do everything you can to assess, treat (IV, ECG, intubation if indicated, bleeding controlled, etc), reassess, and transport accordingly (air support, correct facility).

Don't base everything on the numbers (SBP 90.. 110.. etc) because every patient will be different. As long as you have done a good assessment, treated life-threatening injuries, and relay this information during report (HEMS or ER staff) you should be ok.

Working with many neurosurgical/trauma patients I can tell you that albumin is never given to them. Of course, this is in the hospital. Pre-hospital as a volume expander, I could see it's potential. The post-op CABG patient's receive albumin on a regular basis, however that's obviously different criteria.

Hope this helps..

Actually not entirely correct. In Texas FR's are known as ECA's and they can transport. In fact the minimum required staffing for a BLS ambulance is 2 ECA's. Scary aint it.

He's right. I've met with small town ECA's on the highway several times. Typically, they are staffing the ambulance because their community does not have higher level of care or that person is unavailable. It's hit or miss with the patients they transport to us, some need MICU transport, some would be fine with BLS. I generally get the feeling that they "freak out" and hurriedly transport the patient to the city and request us en route rather than requesting us when they get an idea of the patient's condition on scene, both BLS and MICU patients.

I wouldn't want my community to have mostly ECA's manning the ambulance..

Congrats! Very impressive to pass back to back, that's very stressful.

I'm not surprised to see how far off topic this has gotten but I enjoyed reading everyone's opinion. Most of the posters have a drawn out explanation of their side of the story and this issue. Forgive me if someone has already stated this but...

I agree with the Supreme court's decision about discrimination against the white firemen. It is not the fault of the "white" firemen the outcome of the test. I assume that the test wasn't the only thing that is used to promote firemen.

Bottom line.. I consider myself color blind. I have black friends, brown friends, yellow friends, pale friends, etc. Judging a person by the color of their skin and not by their character really reflects your own character.

I know we've all had some hardships growing up, I believe everyone did but did you learn from it? Did you grow as a person from it? Are you still bitter about it or grateful for the experience to grow, learn, adapt, and mature? Terrible things have happened to me, I've made some horrible decisions that I live with daily but I feel that my attitude and my ability to learn from them, grow as a person, and strive to be a "good person" allows me to grow as a person, a provider, and as a human being. I'm proud of that.

I think that most of you share this attitude and probably think like me - you are well beyond what you picture yourself being when you were on dire straights.

Watch out for the hill billies

The actions of the LEO in this incident shouldn't change anyone's opinion about other LEO's. We all work with other areas of public safety and we should all respect each other and their duty.

My opinion, the LEO acted inappropriately and should be reprimanded. He delayed medical treatment (by a physician) to the patient, he took away the primary attendant from the patient who was being treated in the ambulance, and they did not handle the situation in a professional matter. They could have followed the ambulance to the hospital and then stated their case.

IT WAS NOT AN EMERGENCY TO STOP THE AMBULANCE AND DELAY THE TRANSPORT OF THE PATIENT! The detention, restraining, and altercation with the paramedic was unjustified and I would believe will lead to the trooper's dismissal from the OHP.

I believe the trooper(s) were acting on emotion, anger, and authority (which in this case is abuse of).

The paramedic, also acting out of frustration (which I can't blame him for), did put his hands up to the trooper. True, the trooper was in his face and had him pushed against the ambulance (in an intimidating manner). Cooler heads will prevail.

Honestly, I would have been pissed. I probably would have acted the same way as the medic. I hope we are updated on the outcome of this. Not to mention the civil suit that will probably be filed by the family.

Turns out, the driver of the other vehicle was intoxicated.

I remember playing baseball against Dee on the playstation, he loved the Astro's.

He leaves behind a wife and 2 boys.

http://www.kcbd.com/global/story.asp?s=10253380

Dee was a friend of mine who will be missed by many. Keep his family, friends, and the Lubbock County Sheriff's office in your thoughts and prayers.

It's all about money however Rid is right, if they use a pump you can charge the higher rate for specialty transport. A lot of hospitals may lend out a pump for your service to use for transfers but for 911, I'm guessing you would have to buy a pump.

When I was the DO of a service I bought some refurbed AED's and LP 11's, they worked great, had a warranty, and it was way cheaper than most other places.

My license/certifications is what keeps me eating so.... I'll protect them