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The fire department brought in a CPR ... you mean they brought in a code??? Ok, I can't really say much more than Jwade because he said everything so perfectly (+1 for that one, I'd give more if I could). Here are a few very simple and non-technical things I'd like to point out. How many codes have you actually been on and participated in? Have you NEVER seen a head turn purply/bluey from prolonged CPR? What about the veins in the forehead and temporal areas popping out? Would you also assume someone with cherry red skin complaining of nausea, headache, dizziness, maybe some altered LOC was fine because their sats were 99% on room air? Maybe just a little out of sorts hey? Or not ... I can't top what Jwade said quite honestly because I'm sure he's got more on me than 4 years, and I'm a little too tired to go browsing through my resources. What does meme think about all this?

Yup I agree, and further my point to involve more people if you can such as supervisors, medical director, whomever. Heat is less on you should something go south as a result of the patient not accepting your care even if they're a/o x4 and GCS 15.

I don't know of a service in Alberta that uses these things either. There were a couple that trialled the electric stretchers however found them to be more cumbersome than anything, due to the additional weight. Your average Ferno or Stryker weighs anywhere from what, 50 to 70 lbs? Plus your patient, plus the weight of the electronic thingy ... I'd rather just be responsible for my own lifting instead of depending upon a device ...

I do my thing as per protocol, unless the patient is of good frame of mind and able to make an intelligent decision and refuses treatment. In such a case if they were refusing something they absolutely needed, I would call in a supe to further my intentions. Who knows, maybe they'd call the medical director (which seriously NEVER happens). If the patient still refuses, well, I've involved more people so I've made a good effort with regard to due diligence. Now, if I had someone who was unconscious and say needed blood products and we gave those to said patient, and later found out he was Jehovah, would I feel bad? No. It has nothing to do with the fact I don't believe in the same things they do. It has to do with the fact that I had a job to do and I did it. I would rather treat when required or under "implied consent", than do nothing at all and lose my medical license. I do what I need to do for the betterment of my patient regardless of religion, unless there is a legality (patient refusal) that tells me otherwise. I couldn't give a krap about religion. Now I am respectful of others, don't get me wrong ... I really don't care what stuff people observe. Just don't force it on me When it comes to say a Muslim woman needing us and her husband is on scene, I will ask the hubby to wait outside of the unit while we do our thing. Those women don't really say much around their husbands and I get a more complete and thorough story and history when they're not around. I will always respect if they don't want their skin displayed, and take care to say re-clothe after a 12 lead, and ensure legs are covered etc etc. Each situation is different, so just react and treat accordingly. Involve more people like supes or docs if possible, that way the heat is taken off you somewhat as you've made an effort to do what you are medically and legally obligated to do.

Roll with the punches, even though on some days you get more punches. Find a HEALTHY out, take it when you need it be it another job, hobby, whatever. You may not be able to change the whole world, however it can change you. In turn, you can change your own. You will in your own time figure out what is best for you. Gastroenterologist?

I think if those ski patrollers you know actually had any good sense, they wouldn't be using illicit drugs in the first place. Alcoholism isn't encouraged. Liquor however is a LEGAL substance; that's why its use might be TOLERATED more so than that of the ganja/crack/meth or whatever your snow bunny friends are using. When it comes to showing up for work while under the influence of ANYTHING, there is and should be a zero toleranace everywhere. It is not only your partner's life and medical license on the line, it is yours. Most of us I would assume wouldn't drink anything if we got less than 8 hours of rest prior to the start of our next shift. That is standard around here, some places might even observe a longer period of "dryness" before starting work. And most of us wouldn't be dumb enough to actually show up for work still reeking like the night before. Worst case scenario: Your partner shows up for their shift with you, they're hungover++++/unrested from snorting coke/hazy from smoking weed half the night. You see this and don't say anything because it's your partner and you don't want to "upset the balance". They're driving with you and let's say a term pregnant women in the back. You're near the hospital and your partner has an accident and crashes the truck. Somehow they manage to walk away, yet mom loses the baby and mmmmmm let's say bleeds out, the car your partner hit contained an elderly couple and kills one of them, the other is permanently brain damaged and has "no life" for the rest of their life. You're in traction in hospital with several pins in your femur, looking oh so forward to months of physio and bills building up because you can't work. Sorry kids, no clothes/school supplies/haircuts/proper food for you because mommy/daddy can't move their legs right now; make your own KD for breakfast. No money for anything again this month because the comp claim was AGAIN denied. Yes I made that up but who's to say it couldn't happen? We all know lives can and do change in the blink of an eye. Could you live with yourself knowing you could have prevented this? Sure, your partner is a retard for showing up for work in that condition. If you knew, could have done something beforehand but didn't, wouldn't you also have to share the blame?

Good point, spenac.. and on seeing your post, I did...

If I remember correctly, AMR got popped 3 times last year, and I believe that 2 cases were in Colorado alone!

I think there are big differences here in what "on line medical control" means to each of us. I see some people commenting that they have to call a physician and ask about first round analgesia dosing, and I also see people referring to their protocol as "guidelines." These are two opposite ends of the spectrum, and both are represented here. Personally, I don't think we should ever be without on-line medical control for some things. Where I work, we call a physician on the radio when we truly need another opinion on a difficult topic (Should I give a third SQ epinephrine to this 55 year old woman with severe asthma? Do you agree with my assessment of this STEMI patient so that we can bypass the ED for the cath lab? I've got a difficult syndrome here in a critically ill patient and I'm not sure which path to take...). It is my feeling that these calls are open and honest consultations with colleagues, and a recognition that there is a whole lot out there that we Paramedics, or any individual for that matter, doesn't know. Even doctors call other doctors to discuss things if they get in a bind. Who's to say that we are too good for that?

I'm not sure, but I do know that Trauma is not the first to fail in that department. I can't think of a single show about medicine on TV right now (or recently) that is genuinely realistic. My guess is that in order to show realistic medicine, producers would probably have to compromise a portion of the drama, and nobody has been willing (or able) to do that yet. Maybe the compromise is different with cop shows, I donno. I bet it is really hard. This isn't unique to cop or medical shows-- I would imagine that EVERY show struggles to get their audience to connect with the characters on a level like that. If there were a simple formula then everyone would be doing it, but it seems to be pretty difficult because very few shows have attained that level of viewer involvement. Shit, you had to go back thirty years to find an example!

Reading this article was just painful. Dust, you should have been handing out ativan to all readers when you posted this one…. And now, after reading it, my BP is so high I may need Labetalol… What are they thinking? OK, the first line got me “Every day across Louisiana, firefighters are busy battling blazes and, in some cases, saving lives.” What dramatic effect – maybe the writer should have started the article with “it was a dark and stormy night…” This “proposed House Bill 1030, written by state Rep. Karen St. Germain from the Baton Rouge area, makes all firefighters exempt from any medical or emergency oversight when they're at a scene,” is very very scary. No medical direction? What will the scope of practice be? Who will ensure that firefighters maintain that scope of practice? In the event of negligence, is this the loophole that allows firefighters to say “we are not medics, we are firefighters, and we were just doing what we thought was right.. sorry someone died..” “the intent of the legislation is that we don't need the EMS board in on our discipline. A lot of the firefighters think they treat us like criminals, like we’re always wrong." Ahhh – so you want EMS as part of fire, but you don’t want to play by EMS rules. You don’t want to be regulated, you don’t want to follow direction, and you want to just play with drugs and shiny objects without having to report to anyone. Maybe there is a reason “we’re always wrong,” and maybe that reason is exactly because the firefighters involved in pushing this legislation through are more concerned about their bruised egos than the reason EMS is in place – to provide quality care. These same people should ask themselves if they would like to be treated by an unregulated doctor or dentist, or if they would like their child to have surgery by someone who doesn't have to answer to anyone else. The theory is the same. Very very scary…

They did not violate a state law. That's far different than saying they didn't do anything wrong. No apologies from me yet. This was a disaster situation and by definition, normal rules do not apply. By definition, a disaster overwhelms local resources, which means tough decisions need to be made. Technically, any medical complaint can develop into an emergency, but the whole point of triage is to take care of the immediate life threats. In the vast majority of cases- and especially in a disaster situation, abdominal pain would not be considered a priority 1, or red. We can "what if" this thing to death, but think about this. What happens if you have a disaster situation where you have dozens of victims, and you need to make decisions as to who lives or dies. What if someone comes by after the fact, plays Monday morning QB and second guesses every decision you made? Is that fair?

Seriously, this is the most blatantly brazen anti-EMS move that I've seen the firemonkeys ever make. I have to say that I am genuinely flabbergasted. They have truly soared to a new low.

Sorry, I think that they lose a little bit of protection when asking the patient to walk the trek. Sorry, but if it's safe enough for the patient to brave the weather, then it's safe enough for the crew. What's next? Fire fighters refusing to enter any burning houses because the people inside should just walk out on their own regardless of their condition? Regardless, the crew would have to walk from the ambulance to the house even if the ambulance was parked out front. In the mean time, some suggestions: PLUS equals Or use a to move patient from house to ambulance. or at the very least, set up shop and administer care on scene.

Dont let them bother you some folks just like to spank there monkey

I will be most pleased to post the reply from my letter from the MP as soon as I get an official reply. Oh and Phone call first thing in the AM .... the thing that bothers me the most is WHY did ACoP suddenly become the Canadian Authority, and last AGM divested from PAC, besides this will be boosting my dues to pay for this "incentive" I am bamboozled to get my head around why and how ACoP was appointed in the fist place when the president is an EMR ? And no of experience actually working as a health care professional ... you guys and gals know ... like on a real Ambulance. This is the most distressing paragraph and has NOTHING to do with advancing the Profession it has everything to do with (______ fill in the Blank)ps try nepotism and check the link to the MPs website makes things clearer http://www.timuppal.ca/ I would encourage every Canadian Trained Paramedic to write a letter to this MP and ask the how and why of this decision and without consultation from the actual members currently providing care, you know the true stakeholders in this profession not those that sit in an office and regulate ... and I am getting input from BC and TOBA saying they have not heard one word of this. Perhaps it is time to look through the mist and the REAL motives for this "incentive" and protect our Profession, perhaps fund present Canadian Citizens to upgrade in their education first, give the Canadian tax payer's a chance ? Attention: Mr. Harper your going to meet me very, very soon ... I AM CANADIAN AND I'M PISSED !

Sure does ... once you learn it, it's like riding a bike. You never forget how to do it. Regular practice is required to maintain group uniformity and to 'brush up' a little ... never hurts

... and then there was the time I watched The Green Mile from beginning to end in the middle of a night shift without getting paged out ... only because I've seen it 5000 times already.

I was told a long time ago I was too short to do casket carry (I'm 5 foot 1, the shortest Guardsman) ... I can however carry a sword (not a butterknife) and participate in flag drill as well.

Quite ...

Sleep ... eat ... goof off with the cops ... never had a naked pillow fight, but there's a first time for everything ... study ... talk about what kind of call you WANT to get ... get excited when you get the call you wanted to get ... get mad because you got blood on your pants on the call you wanted to get ... stick things to co-workers cars ... fill station mailboxes with random crap ... clean - NO ... watch 5 minutes of the ending of a movie you keep missing the ending on ... go for coffee ... fret about whether or not you'll get off work on time ... have "meow" night on the radio ... dream about days off ... think about how nice it would be at that time to be jumping out of a plane ... help your partner play tricks on their spouse ... go up to their house and ask for random things from the fridge because you "need them for a call" ... I dunno ... I think a lot of us are ADD. Whatever amuses us ...

I think camels are Egyptian aren't they? Or Saudi Arabian? Dunno ... don't think they're Aussie. Whatever.

Freak is correct pretty much all the way through here ... thing is, with the province taking over funding and everything else now for EMS, a lot of people are looking at leaving. It didn't work in BC (as we can see), it won't work here long term either. Yes, and our trucks aren't modified kangaroos with dingos and didgeridoos for sirens

I'm not near your location, so I'm not sure how you'd go about this ... Dunno, try these, I just searched for "honor guard": http://honorguardtraining.com/ http://www.honorguardtraining.org/honor_guard_101.htm http://www.honorguard.af.mil/bhg/ http://nationalhonorguardacademy.com/ Talk to several services with Honor Guards maybe in and out of your state if you can, perhaps speak with the military as well. A number of the Guard members I am associated with are current and past members of the military. They're experts in related topics such as proper marching, drill practice including formation, calling command, etc. It's highly professional, serious and formal on several occasions as you may be called upon/volunteer to participate in funerals, weddings, memorials, etc. You will need training from someone experienced in this. Uniforms can be costly as well, be prepared to look at that. Ours were nearly $2000 ... each ...

From another news article. http://www.wpxi.com/news/22580232/detail.html Here's a Google Map of the area. Map According to the call review report (link), one ambulance got stuck near the bridge on Elizabeth St and according to the news report, another ambulance was able to make it to Chaplain. Additional quotes from the call review Second ambulance crew: Sorry, but with something like that then I absolutely can't buy a 'scene safety' argument. It's not about scene safety if you expect the patient to trudge through the weather instead of sheltering in place. I've had calls where I've had to think on my feet and get additional resources and make solutions. I can't imagine calling dispatch and simply saying "we can't make it" without offering either possible options to be implemented or advising dispatch that I'm going to have to use alternative methods to get to the patient. I agree that it's a systematic failure, but we shouldn't be dependent on either management or dispatch to devise all of the solutions to complications.

This is some very disturbing discussions. A professional has to live up to higher standards. They must be able to understand that their actions reflect directly on their service even when off duty, but especially when easily identifiable equipment is involved. All that went outside and did not try and stop this photo from happening should be fired and stripped of their peace officer certification.

It is unacceptable that fellow professionals would degrade one another even if in another specialty.

The ignorant arrogance displayed on this forum has caused me to not post here often. I post now because the idiocy has overflowed the river banks. To continue to condemn the actions made by individuals during a disaster situation that you have limited knowledge of is a view of the pomposity that is your supposed higher ethical standards. The bits and pieces displayed by some as some supposed evidence of dereliction of duty is nothing less than laughable. It is time now to move away from your imperiousness and acknowledge you are of limited knowledge of this incident thus in no position to stand in judgement. I bid you adieu.