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TRAUMA Premiere, 20 Sep 09


Dustdevil

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As far as the shrapnel in the throat issue - there are a few reasons why you may have to go to a cric (and I understand not everyone has the option of RSI and surgical cric). If there is damage to the vocal chord area short of air bubbles, which yes I have used to guide me before, the landmarks may be indistiguishable. Also, there may be significant swelling preventing passage of an ET tube. In addition, if you RSI and cannot get the airway, then you have seriously compromised an already bad situation. If significant bleeding, then guess what - a supraglottic area such as king of combi is NOT going to secure that airway and so you have no choice. I wouldn't condemn the situation though I would be taking a look before just jumping into a cric unless there was an obvious reason to not do so. Others may handle differently. However, I think a surgical cric was a little more glorious for tv and gets a frazzled mom involved in the bunch over just a regular intubation (can you see the medic going hey mom, press on his chest so I can follow the air bubbles okay?) Not quite as exciting I guess. Also did anyone notice the lady medic was going for a sternal IO ? Thought that was rather interesting.

As for the show paramedics, at least it was real runs and they had protocols to work within instead of the wild cowboy mentality that this show seems to follow. I know if I practiced medicine like rabbit not only would I be receiving a strict discipline from my medical director, but I would be answering to the state board and most likely lose my license. Not a happy day. I'm not saying paramedics was perfect as Lord knows there were some things that definitely made me go huh? I'm already not a fan of AMR and that made me even less of one. However, there was the reality factor as they followed an actual crew (same applied to Trauma life in the ER though I had to laugh at an episode which was at university). They just went for the drama all day long and didn't show the intern that's now on his 5th rectal exam and ready to curse out the world. It seems they went for the warm fuzzies which I laughed at 'cause it was all for the tv - I KNOW some of those doctors aren't warm and fuzzy in real life. It was all for the camera.

Sadly the public does base their perception somewhat on what they see if they are unfamiliar with it. Alot of people that didn't frequent ER's formed their opinions from the show ER. They thought it was trauma and excitement all day long with people screaming and drama every two seconds. They also thought that all doctors were like Dr. Green all warm and fuzzy. When they experienced the real ER and found out it is mostly overworked docs that are a bit crusty (some more than a bit) and that there's not that much drama even in traumas or codes (yeah people they run actually pretty quiet and aren't much like they portray on TV - recall first time I saw someone shocked I went "that's it? I thought they jumped higher" when the guy just barely flipped on the stretcher. This was shortly after I first got into EMS and it was far different than I imagined it. I think contrary to what we want to believe, the public is going to form opinions about us as they did with ER and with Third Watch just as with many years ago opinions were formed with Johnny and Roy in Emergency. The opinions don't come from nowhere, they are formed from something and sadly it's usually tv. It is up to us to break those opinions and educate about reality no matter how boring it may be.

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The cric thing was more than a little hokey. Beyond the fact that it is the quintessential stereotypical paramedic move (which, in reality, damn few medics will ever actually perform once in a career), it was just pretty suspicious scenario to throw it into. The cure for a hole in the throat is not another hole in the throat. And if it wasn't in the throat, why a cric? Every cric I've ever done in thirty-five years of practice was either facial trauma or burns (or a pig at Doczilla's cadaver lab!).

That scene was just so predictable. I mean, I totally knew they were going to throw a cric into that episode somewhere along the line. That's what Hollywood does. Predictability and stereotypes. They don't think non-Hollywood audiences are sophisticated enough to appreciate intelligent originality.

Edited by Dustdevil
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That scene was just so predictable. I mean, I totally knew they were going to throw a cric into that episode somewhere along the line. That's what Hollywood does. Predictability and stereotypes.

Not to mention getting the mother to "Hold open the skin"

WTF was that about?

I definatly missed the part where the kids airway became too difficult to orally intubate.

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Instead of bitching about how bad this show was why don't we rid our proffesion of the undesirables that were portraid on the show ?

What they don't exsist ?

It was just Hollywood ?

We all know they exsist and yet very few of us ever speak out against the behavior.

I did not like the show at all but I am not about to say it was all Hollywood and the stuff we all saw on the show dosen't exsist.

The NAEMT voiced their disapproval of the show but when are they going to disapprove of the behavior by persons in our proffesion that the show depicted ?

When is the NAEMT going to suspend a providers certs for sexual misconduct,public drinking, falsifying a report.......etc.

This show should be a wake up call to our chosen proffesion that it is time to clean our own houses.

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The NAEMT voiced their disapproval of the show but when are they going to disapprove of the behavior by persons in our proffesion that the show depicted ?

When is the NAEMT going to suspend a providers certs for sexual misconduct,public drinking, falsifying a report.......etc.

NAEMT? This organization has no power to suspend any cert since they do not issue any certs. This is an organization you join voluntarily and pay membership dues.

This show should be a wake up call to our chosen proffesion that it is time to clean our own houses.

California has been trying to clean up its act when it comes to screening and discipline.

Other states also take some offenses very seriously. Many professional EMS companies do care about what their employees do when wearing their uniform. However, those that make the newswires are the most interesting for Hollywood to write their scripts around. I would also tend to believe that the consultants who advise the directors and producers may get a little full of themselves when talking about their life as a Paramedic just to make it seem a little glamorous. I might even compare it to what Bubba instructor does when teaching an EMT or Paramedic class to keep the students awake and make the profession more attractive. If Hollywood had wanted accuracy they would have called Dustdevil, spenac or RidRyder911 to be a consultant. Instead, they probably wanted just the dirt and fish tales so they called Bubba.

BTW, I didn't include myself as a potential consultant because they already know me as the one laughing hysterically during one of the scenes when they were filming on location in SF.

Edited by VentMedic
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Here's something I'm having a small issue with that's only partially related.

I quickly looked up SFFD online and found that apparently they have 42 engine companies, 18 truck companies and only 18 ambulances for the city of 1.4 Million. Is this like NYC where FD runs EMS, but a large chunk of the work is contracted out or what?

The region I work for has a population of 1.1 Million (suburban, urban and some rural) with a large commuter population and some of the busiest highways in the country. At a time there are approximately 38-40 Ambulances on the road, 3 district supervisors in response units, 3-6 other response units (depending on the day), the Special Response Unit (Tactical, Bariatric, MCI, Hazmat, etc.) and the marine/ski-doo unit. The city of Toronto with 2.5 million people keep over a hundred Ambulances on the road in a given shift. I don't understand how a city like SF could be covered by so few Ambulances.

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I believe since they screwed up the merget with Department of Public Health EMS so bad and are having to "un-merge" the Fire Department has a significant number of ALS trucks with a contract agency; AMR is also in town (Oakland/Alameda) and I think they handle parts of SF too.

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.... Many professional EMS companies do care about what their employees do when wearing their uniform. However, those that make the newswires are the most interesting for Hollywood to write their scripts around. I would also tend to believe that the consultants who advise the directors and producers may get a little full of themselves when talking about their life as a Paramedic just to make it seem a little glamorous. ...

Come on,

We all know the REAL reason they stay away from “True to life” costume / casting is our USAR gear makes us look fat… laugh.gif

-w

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