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Yeah, in fact it sounds like they've taken the spirit of implied consent and simply made up a new definition out of whole cloth. Unless I've forgotten how this went, it sounds to me like this pt is AAOx 4. How does implied consent come into play concerning a pt that is able to continue to coherently advocate for themselves? Do I WANT to transport this patient? Of course. Do I have the right to take an alert and oriented pt against their will? Absolutely not. I would get the pd involved, if that didn't work I'd request a pd supervisor while I contacted medical control, and do what I could to bring the entire world raining down on his head. But, you know what? If all of that fails to put this pt in pd custody, he's staying home. It really is as simple as that. I'll run on him again when he's less responsive or dead. It's a shame, but it's also his right at this point. I ran on an 86 y/o woman tonight after a fall. Large abrasion center of her forehead, nose obviously fractured with anatomy pushed a few mm to the R, mushy to palp, significant swelling at apex and continuing up into medial/superior orbits bilat, slight drips of clear fluid from R nare, airway patent, including nasal passage, AAO x 4, PERRL at 3mm, eyes tracking properly to all fields, yadda, yadda. She refuses transport, no way to shake her. I even bring a mirror from her bedroom so she can see how screwed up her face is. I finally call her son, a priest, to help convince her. His response is, "A broken nose isn't the end of the world, she's had one before, she falls almost every week." Pt lives alone. Police called, ER physician notified. Police refuse to place her in custody, physician states that pt is able to refuse though explains to pt and son that he and I both believe that there is a significant chance of a cranial vault fracture currently and many possible current/future occult live/limb threatening pathologies possible if not likely. Son refuses. She is home now, asleep, or dead, and I await my call back to either treat or pronounce her. Does it suck? Oh yeah, I was fucking livid! But you know what? She has the right to determine the course of her own life, either safely, or not. Tonight she believed she did right, I believe she made a terribly foolish and dangerous decision. So, it sounds to me that what about 90% of these posts are saying is that I should have followed a logic tree similar to, "I've told her that this injury can, and may, kill her. She has decided that she finds that risk acceptable. Therefore she is purposely endangering her life. Purposely doing so is akin to suicide, so this woman is suicidal. Because she's now suicidal I have the right to throw her on my cot, tie her down and force her to the hospital for evaluation based on the fact that a suicidal pt must be altered and altered people can't advocate for themselves.' Etc, etc, etc. Doesn't this seem like long, long, long bullshit path to follow to attempt to treat someone against their will? I transported 99.1% of my patients this year, so it's not about wanting to dump anyone. It's simply a strongly held belief in a persons right not to have medical/psychological treatments physically forced upon them if they are able to show that they understand their situation and are biologically sound/mentally able to advocate for themselves. Do I think that true suicide attempts fit into that category? I do not. Do I believe that 95% of reported suicide attempts do? I do. Can I tell the difference? Fuck no, mistakes are going to be made. But that sometimes is going to happen in a free society. Or so I believe. So, in case I got to wandering, it's late at the end of a long week, NO, if the police would not put this pt in custody, after my righteously aggressive, very best attempts to convince them to do otherwise, I would not have taken this pt against his will. Dwayne

http://www.emsa.ca.gov/ http://www.emsa.ca.gov/laws/ EMSA Phone Number: (916) 322-4336

Today I was given a pin for 11 years of service. Kind of an odd deal, but I can add that to my dress uniform and take off the guardian angel ambulance one.

A a spotless truck...

We better start a string on unusual calls. I'll do the honors.

Latest EMS week festivities: One of our Regional Hospitals put up a "Happy EMS Week. Thanks for all you do." banner, just inside the Ambulance entrance. And apparently one of the nursing homes in North District had a muffin basket. But they were letting fire have some too, so...

yea, that or the treadmill

How about Joes mortuary and ambulance service 'You stab em we grab em, you kill em we chill em'

http://www.kbtx.com/home/headlines/54321212.html (Click to view this embedded page in a new window)

i am interested in becoming an emt, i want to start taking the emt course next semester, but i have a misdemeanor charge that is 7 years old for being under the influence of a controlled substance. i live in california. Does anybody know if this is going to hold me back from becoming certified? i would rather know now and not waste my time with the process than find out later.

While I agree with purging "Technician" from our titles, its not the title that makes us 'professionals'. Increasing education (even if it's not mandated), pushing away from the 'cookbook bandaids' toward evidence based medicine is only the begining. You can call the guys that go around picking up trash 'Sanitation Engineers' all you want; but at the end of the day, they're STILL picking up trash. Until NHSTA, D.O.T., NREMT and other associated organizations stop advocating their minimalistic approach to education and training and start pushing to require REAL education like an advanced degree (like the other Allied Health fields require); EMS will continue to be looked upon as nothing more than a 'job'. It will just be a job with 'really cool sounding titles', and nothing more.

Yes, by 2014, it will only list the position as "Paramedic". But since that hasn't happened yet....My point is valid. http://www.emtcity.com/index.php/topic/18424-is-there-an-i-85-to-i-99-upgrade/page__p__241887__fromsearch__1&#entry241887 This is exactly the kind of 'title love' I'm talking about! You'll notice in the article directly from the NREMT that it clearly states EMT-Paramedic. I'm not here to quibble about titles, I could really care less. I've got more important things to worry about; like getting my advanced degree so that I can be a better practitioner, and treat my patients to the best of my ability.

If you go to central booking for an internal bleed, and find a he/she with a draining boil on it's ass

It wasn't "we". It was firemonkeys. Nuff said.

What's with Floridia firemonkeys these days? They're getting arrested more often than the Dalllas Cowboys. http://www.sunnewspapers.net/articles/llne...3080&bnpg=0 Sarasota EMT's charges amended SARASOTA -- Charges against a 28-year-old North Port man accused of sexually battering a 15-year-old girl known to him have been amended. Christopher Kilduff, a Sarasota County Fire Department EMT, has been placed on administrative leave pending the outcome of an internal investigation. Kilduff, of the 5000 block of Brack Ave., was arrested this week and originally charged with two counts of lewd and lascivious battery and a third-degree felony sex offense. However, the charges have been amended to lewd and lascivious act on a child, and use of a child in a sexual act. Kilduff remained in the Sarasota County Jail Friday without bond. A Sarasota police officer arrested Kilduff Wednesday after the teen said he allegedly made her perform sex acts with him last week at her Sarasota home and at a nearby playground, according to a police report. I wonder if the girl is an Explorer or Junior Firefighter.