Conflict on Dual Medic Units

[ccmedoc]

I've always thought that dual medics cut back on the burnout. Never had much of a problem with butting heads or arguments. Just lucky, I guess. Dual medic should be standard of care for a number of reasons...especially with shiny new medics running around..I never ceases to amaze me how a basic EMT becomes gods gift to paramedicdom once the patches are applied.. :roll: Just as the spankin' new medics need direction, the old farts need to be kept on track also..I think more conflict arises between EMT/Medic teams than Medic/Medic teams....Just my thoughts.

[CBEMT]

I am also one who likes to D-stick, IV, and ECG on every patient.

Every patient?

[firemedic05]

Every patient?

Why not? What does it hurt?

[Paradude]

Dust you know my opinion on this. I think that budgets may disallow dual medic trucks. That is fine, in that at least they have an ALS unit.

Ok, first of all, I work for a service that is working toward 100% ALS. We don't have that yet simply because we don't have enough medics. Working for a busy service where we do alot of critical calls in many of our areas, having two medics has two main advantages.

1. On a critical patient, you have two heads thinking as trained Paramedics. The many things that must get done go faster because two people are doing them. I don't know about stats, but I can say that better patient care IS the result. I work both ways, and do just fine with a basic, but I do better with another medic.

2. The paperwork load is split up. If you are working P/B, you may get many ALS calls in a row, and find yourself way behind in paperwork.

This is an arguement that is solely based on cost. This can get you in trouble, especially when it comes to prehospital medicine. Any arguement or statistics that say that P/B is better that P/P will simply be a matter of justifying a less than optimum system in order to get by more cheaply.

If there is a problem with people fighting over skills, that is another matter entirely, and obviously some personal issues should be ironed out. We take turns running each call, and whose ever turn it is, calls the shots. The other assists without question. This works out well, and I can't recall anyone fighting over skills. Unless they are poking fun. On a critical patient such as a chest pain, respiratory emergency, or significant trauma, there are many things that have to be done very quickly, and 4 highly trained hands are better than 2.

I can recall some medics saying they would rather work with a basic, but generally they are medics that tend to be somewhat unsure of themselves, and don't like the idea of making decisions when somebody is watching that knows what they know, wondering what the other person is thinking. Or they may take suggestions or constructive criticism as being second guessed, patronized or generally made fun of. Two medics with confidence in their knowledge and skills can work well as a team.

Honestly, I can't see how this can be a serious arguement. In a surgery suite, there is usually more than one surgeon when it is a complicated case. Why would that not be the case in an ambulance?

-Paradude-

[p3medic]

Our ALS trucks run with two medics and rarely is there a problem with a conflict regarding patient care. If a situation exists were the two medics are in complete disagreement, medical control can be used to make the decision. As for skills, again no real problem that I am aware of, if its your case to run (every other) then its your airway and assessment, the other medic will apply monitor, gain access,etc...The medic running the case is not in absolute control, your partner is an equal share holder in the pt care decisions, and should have a say, IMHO.

[CBEMT]

Why not? What does it hurt?

Usually we argue about the need for all-ALS systems. I've NEVER heard anyone argue for all-ALS patients. Overkill much?

[firemedic05]

Usually we argue about the need for all-ALS systems. I've NEVER heard anyone argue for all-ALS patients. Overkill much?

I haven't killed anyone yet in five years of being in EMS. So works for me, maybe not for everyone?

[medic001918]

I haven't killed anyone yet in five years of being in EMS. So works for me, maybe not for everyone?

I haven't killed anyone either, but I don't do IV, monitor, finger stick on every patient. Well it may work for you, is it always appropriate for the patient? I prefer to make decisions about interventions based on a need, rather than a routine or practice. It does more for my patient to prevent them from having things done to them without a need, and also forces me to do a thorough assessment in order to determine that need. How would you feel if you were getting charged when you went to the doctor's office and they applied a "blanket" set of tests/interventions to you without a need? Not every patient that you come into contact with requires those interventions.

I'm not posting to pick on you. But I would like to know more about why you perform those interventions for everyone? Just because you haven't "killed anyone," doesn't make it the right thing to do.

Shane

NREMT-P

[akroeze]

And what about the patient who gets cellulitis from that IV you started when they really didn't need it?

You have now caused harm

[flight-lp]

Or the pt. who gets a $1000 bill for interventions that didn't need to be done in the first place......