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Inter-facility transports


brentoli

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Tinshee, (sorry I edited out my comment for sarcasm) but I digress

Tinshee you speak truth because that is what most services have a paramedic and an EMT but 2 medics are better because codes can be run without having to have the lone medic do all als procedures.

the patient benefits from two medics. But if your service has only one medic and one emt on the truck then that's the hand you were dealt.

But to point out what you pointed out in your statement above, was just pointing out the obvious.

I for one would rather have 2 medics working on my loved one but if all you have is a medic and emt then I'll take that. To have two emt's working on my loved one when there is room in that system to employ paramedics and they don't then that's just unconscionable(sic).

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ok, so what as an EMT can you do for a dialysis patient who "Codes" on you?

By your reasoning, they actually should be transported by 2 Paramedics who can actually do something more than bag the patient and perform CPR.

Ruff,

You forgot to mention they could taze the Bro to with an AED. :)

There anit nothing like walking to a food fight with a shotgun. :)

And as far as the duel medic response, it is so true. The only way it could actually have a good outcome between an EMT and Medic working a code, is if the EMT is a little more advanced, but still cert at the EMT-B level. Reference: The agency I work for has a lot of training that would ordinarly be reserved for medics. Example: EMT's here can take a 10 hour course and work with an FTO for a shift to get 10 live sticks before our Medical dir. will allow the EMT to be IV certified. Another is the King tube is our friend. :) That is the definitive airway for cardiac arrests in Lee County, simple, fast, effective. Loop, swoop, and pull. The good thing about our county is that 17 of the 22 FD's in Lee county are ALS non-transport. :) So BTT we get there, they normally have CPR, Rhythm interpretation, and airway implementation (not in that order hopefully) in place. If it's just us, the EMT is in charge of CPR, IV's, monitor and pad placement, Fluid administration, prepare drugs for Medic (pull out syringes etc). No rugs in a code many one has certain jobs assinged but with my experience since our trucks are EMT/Medic, that is the general norm for a code. Not saying there are variations which of course there are.

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Tinshee, (sorry I edited out my comment for sarcasm) but I digress

Tinshee you speak truth because that is what most services have a paramedic and an EMT but 2 medics are better because codes can be run without having to have the lone medic do all als procedures.

the patient benefits from two medics. But if your service has only one medic and one emt on the truck then that's the hand you were dealt.

But to point out what you pointed out in your statement above, was just pointing out the obvious.

I for one would rather have 2 medics working on my loved one but if all you have is a medic and emt then I'll take that. To have two emt's working on my loved one when there is room in that system to employ paramedics and they don't then that's just unconscionable(sic).

echo Ruff...

Nice post though, that it only takes one paramedic and a competent partner to run a code. That may be right on scene, but what do you do when it's time to transport? (Because we transport all full arrests, right? /sarcasm) I've actually run a code where it was just me and my EMT partner, and I didn't have anyone in the back with me. When you're out in BFE, there's not much you can do. You can't do anything for the patient. It's an exercise in futility. It's impossible to do effective compressions for 20 minutes.

Now if you meant something else, please correct me. I couldn't tell from your one-liner if you did. If you meant "well when you have a firefighter driving and an extra firefighter blocking traffic and it's across the street from the hospital and you have the auto-pulse and you get them back and don't have to do compressions anymore and blah blah blah without punctuation....", please tell me.

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sorry Vent, I misunderstood what you were trying to say.

No you didn't misunderstand me. There were just so many points I would like to make even after my long post earlier.

In the city we do have more options for transport. I don't think EMTs and Paramedics actually realize how many people are transported in and out of a hospital per day by all types of vehicles and personnel. Ambulances truly do not bring in the bulk of our patients or take them away either. If the physician signs for ambulance transport let him/her worry about it. Chances are there is something in the medical history that definitely warrants it.

Many times the admitting diagnosis or reason for transfer will only say the immediate such as fever or HA. It will not say heart transplant last year on a current diagnosis.

Granted in smaller communities, the ambulance may be the only game in town. Of course there probably aren't taxis in the small towns either.

Even after I had a small outpatient procedure, I knew I couldn't drive afterwards, but the would not allow me to leave by bus or taxi either. I had to have someone see that I got to my house.

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ok, so what as an EMT can you do for a dialysis patient who "Codes" on you?

By your reasoning, they actually should be transported by 2 Paramedics who can actually do something more than bag the patient and perform CPR.

What are two medics going to do? One of them still has to drive, and the other is not going to tube, obtain access, place pads, and do CPR, and ventilate at the same time. In fact, even if they pull over and the driver gets in back, one of them is still stuck doing CPR and the other is stuck doing all the procedures that aren't, more than likely, going to change the outcome anyway. You're never going to prove in a million years that two medics doing that are going to have a better patient outcome than two Basics who decide to make tracks for the ER while the tech does CPR by himself.

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well cbemt this is where we disagree.

you are saying that 2 emts who make tracks for the hospital are going to provide the same outcome for let's say a cardiac arrest where defibrillation would be in order or someone who needs an advanced airway would benefit from 2 emt's

you've got to be kidding me if you believe that or are you just saying that 2 EMT's in a cardiac arrest are just as good as two medics because you are an emt and you don't want to face the fact that you are wrong.

I have done everything other than cpr on a patient, my partner did the other thing so I know from experience which provides the better treatment. 2 medics or a crew of one medic and one emt - I know which provides the better treatment.

I guess you have your world that you live in and I have mine. I prefer to live in mine.

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