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Boston EMS


joeydisasteroid

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How dare you insult me. I'm not from Jersey, I'm from Brooklyn NYC. I merely work in Jersey.

Hey, someone had to break the ice.

Ahhh...come on now..It's all the same really. They're all like right up the street from each other, No big difference...errr..deal...eerrr..matter..Right!??!?! :wink: :wink: :D :shock: 8) :lol: I mean, garbage washes up on all of your beaches just the same as I recall.. hahahaha,,,.... :wink: :!: :P 8)

You tha man cchjh.

Ace

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HTN was the chief complaint with their monitor reading over 200 prior to arrival. The patient was slightly altered, which was a combination of a possible psych Hx (dictated physical in the records that we recieved stated this) and just finishing a dialysis treatment. In my area, you only find ALS with the fire department, so all private emergency calls are dispatched BLS by a lack of choice. She was also complaining about SOB (not really showing it, though), but I believe it was psychosomatic based on the rest of her presentation (she still got a mask, which she held on to and used PRN). My unit had a 20-30 min ETA (first call of the day leaving from our base) and a less then 5 transport (just down the street from the hospital).

This is also why I believe that interfacility EMTs should be held to a higher standard then 911 EMTs in a system where all 911 calls get an ALS response (ALS can triage down to BLS in the field).

I guess we just have a differnece of opinions and leave it at that. That's what makes the world go round. I am not a fan of that type of system. But if works well for you, then good luck!

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I guess we just have a differnece of opinions and leave it at that. That's what makes the world go round. I am not a fan of that type of system. But if works well for you, then good luck!

Oh, I've never said that this type of system was good for patient care. It forces basics to treat patients that should never be BLS AND is way out of the scope and education for basics. I do not consider the decision to call ALS or transport easy, especially for the borderline patients. Simply calling ALS because a number is above or below a specific limit should not be the only justification for a reroute or for summoning prehospital ALS. A good physical exam and history, though, does. The skills and education that is required to obtain and interpret the results is very lacking for most EMT-Bs. Combine this with a system with no online medical control at the BLS level and you have a recipe for disaster. Add in IFT companies that are willing to transport anything called in and basics that want to treat dispatch as medical control (ex. one idiot at my company recently called dispatch to get ALS [we are supposed to just pick up the phone and dial 911] when he was less then 2 miles from the hospital [i.e. transport code 3 would be the correct transport plan]. Because he was too stupid or scared to make a decision, definitive care and ALS was delayed).

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Ahhh...come on now..It's all the same really. They're all like right up the street from each other, No big difference...errr..deal...eerrr..matter..Right!??!?! :wink: :wink: :lol: :shock: 8) :lol: I mean, garbage washes up on all of your beaches just the same as I recall.. hahahaha,,,.... :wink: :!: :P 8)

You tha man cchjh.

Ace

The only good things to come out of Boston:

The band Boston.

The band Aerosmith.

Dropkick Murphys.

Clam ChowDAH.

Fenway Park (I've been there, great place).

And Jersey is full of wanna-be New Yorkers in the north, and wanna-be Philly people in the south.

And it's cjh.

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The only good things to come out of Boston:

The band Boston.

The band Aerosmith.

Dropkick Murphys.

Clam ChowDAH.

Fenway Park (I've been there, great place).

And Jersey is full of wanna-be New Yorkers in the north, and wanna-be Philly people in the south.

And it's cjh.

Pff, the entire US is full of wanna-be Southern Californians...

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I was having this bad day in the ER the other day, trying to fill out a report, and this guy who was bagged and tagged behind me was going on and on and on as somebody on cocaine will do annoyingly. So he keeps going on and on and on about being from California and California this and California that. Finally, I had enough, and asked him, "Hey, since your from California, let me ask you this. How come everybody out there are such overly sensitive wimps?" He looked at me blankly for a few seconds, then went into a detailed diatribe about the mentality of people from the West Coast and being laid back and this and that. The point is, he never denied it or argued the point.

AND THAT FOLKS, IS WHAT I THINK ABOUT CALIFORNIANS. The blondes are cute, though.

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I was having this bad day in the ER the other day, trying to fill out a report, and this guy who was bagged and tagged behind me was going on and on and on as somebody on cocaine will do annoyingly. So he keeps going on and on and on about being from California and California this and California that. Finally, I had enough, and asked him, "Hey, since your from California, let me ask you this. How come everybody out there are such overly sensitive wimps?" He looked at me blankly for a few seconds, then went into a detailed diatribe about the mentality of people from the West Coast and being laid back and this and that. The point is, he never denied it or argued the point.

AND THAT FOLKS, IS WHAT I THINK ABOUT CALIFORNIANS. The blondes are cute, though.

That's just Northern California (Especially Berkeley) ruining our good name. Or maybe I've just lived too sheltered of a life behind the Orange Curtain [Orange County, CA = conservative. Rest of the Left Coast is liberal].

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I am a fan of the system that I work in. I do not believe that you have to be a paramedic to provide a quality assessment and treatment. I personally think that the way our system works due to the training we receive. In my system the dialysis patient that describe would have gone BLS because realistcally, nothing more was needed than BLS care. (o2 and a ride to the hospital) Without getting to much into the details, not everyone is going to be a fan of every system. It works fine for us and I am proud to say where I work. But from the other side of it, I am one of those folks who has their medic ticket but is working as a basic. Maybe I am a little more comfortable with this type of system because I know what needs to be done. If I was the medic on the call and was going to work it up, then I would keep the ALS coming. But if as a medic I was going to just BLS the call, then I am going to take the patient to the hospital and not have the medics come "just in case". Also I work in a system where we have a lot of advanced practices as basics, as well as a lot of leeway with medical control. Such as nasal narcan, glucometry, BLS albuterol, and pulse oximetry. So a lot of stuff we deal with more on our own. Not to mention we are never more than 10 minutes to the farthest hospital, so in a number of cases it is quicker and easier, as well as the patients best interest to just go to the hospital. I supposed my comfort level is due to my advanced certification, but I know plenty of good EMTs in this system that I would put against a lot of medics. As a whole, I feel that our system works this way due to the training that we recevive, I do not think this system would work everywhere. We make this system work. I would put 90% of our BLS against 90% of the private companies ALS in the area. There are definately things that I would change, the system is not perfect but overall I am proud of it.

Oh, I've never said that this type of system was good for patient care. It forces basics to treat patients that should never be BLS AND is way out of the scope and education for basics. I do not consider the decision to call ALS or transport easy, especially for the borderline patients. Simply calling ALS because a number is above or below a specific limit should not be the only justification for a reroute or for summoning prehospital ALS. A good physical exam and history, though, does. The skills and education that is required to obtain and interpret the results is very lacking for most EMT-Bs. Combine this with a system with no online medical control at the BLS level and you have a recipe for disaster. Add in IFT companies that are willing to transport anything called in and basics that want to treat dispatch as medical control (ex. one idiot at my company recently called dispatch to get ALS [we are supposed to just pick up the phone and dial 911] when he was less then 2 miles from the hospital [i.e. transport code 3 would be the correct transport plan]. Because he was too stupid or scared to make a decision, definitive care and ALS was delayed).

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