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I just finished the most recent you tube lectures by CHBare. If you do not have access to those videos I would suggest you send a message to CH and ask him for the links or better yet, maybe CHBare will put the links here. VERY VERY impressive. Kudos to CHBare!!!!!!!!! Thanks for the learning CH. Ruff!!!

So you dont concider a False call a BS call. Have you ever been in a situation where your dealing with an ass that abuses the system for a ride up town and the real pt dies because of it..... I have and it sucks the big one. Maybe in big cities where there are 50 ambulance you can deal with the BS call but if you only have one that is manned it is a danger. It dosnt have anything to do with wasting my time it has to do with wasting the time a pt that is in a real emergency has. Oh and there is no difference with time being wasted if you are a volly or paid.

I see alot of "students" in this forum, so I am wondering how you would rate your ambulance third rides ? Did you learn anything, were you allowed to do anything ? Did the service try to put you with medics who enjoy students or did they just put you with whichever crew was closest ? What could we do as an industry to make your clinical time more rewarding ?

I had some young parents bring in their 4 day old because he hadn't pooped in 24 hours and was fussy and seemed to be really hungry after they fed him 1oz of formula. We got called to a house once for a GSW to the chest only to find that the guy had a dream that someone was shot in his home.

These are some great PR stories (which are always a good thing) but they go against what EMS is. Emergency: A serious situation or occurrence that happens unexpectedly and demands immediate action Medical: Of or relating to the study or practice of medicine, requiring treatment by medicine Both were taken from thefreedictionary.com That is the essence and purpose of EMS. Anything else is an abuse of the system. We do need to keep in mind that an emergency to one is not an emergency to another but I think we should be able to safely apply the reasonable man arguement to decide. The person who was cold and wanted a ride home was neither an emergency nor a medical case. The parents should have been sent the bill to reimburse the taxpayers or whoever were funding the ambulance for their expenses (gas ain't cheap). Even the wheelchair is an abuse of EMS resources. It may be an emergency but there is nothing medical. I will admit that there are times when the lines need to be blurred, nothing is black and white. Does it sound callous, yeah probably but life isn't easy. People are constanly screaming about how much waste there is in the government, this is just as wasteful not to mention it puts others at risk by tying up limited resources. If we lived in the utopia that flaming does it would not be an issue but here in the real world it is a very real issue. People need to start being accountable for their actions and have some skin in the game. You call 911, you get an ambulance. If you don't have an emergency medical issue, we'll take you but you will need to pay a co-pay or fee. Start making people responsible with their own money and you will see the abuse come to an abrupt hault. I'd love to see the same thing applied to the ER. Just because your PCP cannot see you for 2 days does not mean you should go to the ER.

I don't consider this a BS call. This woman is stranded and does need help to get home. The wheelchair most likely doesn't fit into a police cruiser. The ambulance is most well equiped to transfer this person home. However, the overall tone of this thread is correct. There are BS calls, and I think EMS folks should have a little responsibilty in who is transported to hospital. The old "you call, we haul" mentality is outdated and there should be alternatives to mindlessly tranporting every pt to a hospital. If one truly wants to "touch" the life of a pt, educate them about alternatives to calling 911; your feet are mildly sunburned? A recomendation for aloe at the local drug store may improve this pts quality of life much more than an expensive hospital trip and a long hospital wait.

I'm not sure it matters all that much if the child was in arrest upon the FD's arrival or not. The question here is a logistical one: Is it appropriate to send a fire truck to an ambulance call? The answer is a resounding "NO!". Do we really think that this mother was on the phone with a lazy, "Yeah... I might've run over my kid with the car. Can you send someone out when they have a minute?"? Or was she on the phone hysterically crying, "OMG! IJUSTRANOVERMYBABY!COMEQUICK!!!!!"? What on earth would make it appropriate to send a fire truck over an ambulance?

Oh Dwayne... They so respond on calls and for the most part we have the same problems you do, it does depend on the crew and place. I have worked with some amazing firefighters but not as a rule.

I didn't mean that an off-duty medical personnel shouldn't render medical aid if they aren't dispatched to it and don't have their entire tool kit. I personally believe it is the ethical thing to do, when necessary, to see if you can render assistance. What I don't appreciate is the small, yet very vocal contingent of our profession that insists their is some sort of obligation for any person who ever learned CPR to stop and render aid whenever something occurs. It isn't an obligation. It's a personal choice. If any provider ever said "No, I am not going to stop for this..." for whatever reason, I would respect their decision. I may not agree with it always, but I would respect it. Given the amount this line of work takes out of your personal life, those few moments you get off-duty might be the only chance you have to spend time with your family or friends. You shouldn't have to give that up whenever someone else needs something.

You mean a lot and grammar? grammar (noun) = The study of the way the sentences of a language are constructed; morphology and sintax

For the real world, just remember Mr. Murphy's laws: Everything takes longer than expected. Nothing is as easy as it looks. (and the ever popular...) If something can go wrong, it will go wrong, at the worst possible moment! Pessimists are happier than optimists, because they can either claim that they were right, or be "pleasently surprised" that it wasn't as bad as predicted. ...and even with all this, somehow, most of the time, the system works.

I have precepted a lot of students in my time. At one service I was paid extra as an FTO and at another service I was the senior medic on my particular shift so it was laid into my lap with no extra pay. Luckily I would do it for free anyway. I enjoy teaching new medics and EMT's. I still teach CPR, PALS and 12-Lead ECG for Zoll although being offshore I don't get to teach as much as I used to when I was still the PALS Faculty Member at UTMC. I basically was the one that taught all the new PALS instructors how to teach PALS. I got to mentor them and advise them on different teaching methodologies. I have always considered it one of our assumed duties and an honor as a seasoned provider to teach and mentor the newbies that are coming into our field and show them that we are not the all powerful paragods that they had assumed. I hate to hear stories from students that say their preceptors acted like that didn't want them around. It has nothing to do with you in most cases, it merely another person forgetting where they came from and that someone had to teach them how to be one of us. I think other medics may feel threatened by a student who can talk the talk sometimes better than they can. Its a sad story but please don't walk away thinking we are all like that. Some of us love and even live to teach. We teach not only the art of paramedicine but how to deliver caring and compassionate treatment to the masses and bring order to chaos like only a paramedic can with just his body language and demeanor.

My original ride time was a horror and nearly caused me to quit EMS all together. I honest to God used to get sick to my stomach starting on Wed when I had clinicals to start on Friday. After that I rode in the Springs (CO) where they had a mentoring program. Preceptors were educated in the role and paid for the time they spent preceptoring. Those rides, my next 4 144hr chunks, were each spent with a different preceptor team and did what they were supposed to, shaping the rest of my opinions on medicine, the morals and ethics of EMS, and the spirit of paramedic medicine as a whole. Great topic, as I think that preceptoring is the Achilles heal of EMS. Many times services are providing the preceptorship as a 'favor' so the schools are afraid to rock the boat and chance losing them. Students become victims to limp dick ambulance teams that finally have some power to man handle those that are defenseless. On my first rotation my preceptor would stand over me while I was trying to start an IV yelling, "You can't start an IV? Jesus Fucking Christ! C'mon! You wanna be a medic?? You'll never even make a decent basic!" Crazy that I had put up with that, but my family had sacrificed terribly over the last three years and I couldn't imagine going home to tell Babs that I had quit. I also had no idea that I had options other than being kicked out of the program because, 'I couldn't hang.' I've done very little preceptoring, but when people came to learn, I loved it, when they came to log time so that they could get their fire certs, I hated it. I was seldom given the task as, though I know this may come as a shock, I was considered too abrasive. I don't think the committed students ever felt that way..we had a great time. But those that I could find no way to motivate, well, they often got tired of being given a shitty task every time they tried to lay down in the back of the ambulance. I've heard of few that do it well. Hell, at the last company I worked with you didn't need any type of preceptorship to be a remote medic. You went to a ridiculously simple class, the majority of which was spent explaining how macho you were for wanting to go offshore, and then away you go. No clinical time necessary, no significant EMS time necessary, no remote time at all....Craziness.. That's why when you see me gush over someone like Eric, maybe you can udnerstand. To run into another medic that truly gets what being remote means, takes it to heart, and works every day to be good at it...well, I'd rather spend my day looking for hens teeth than trying to find another... Dwayne I will take that a step further to say that, with few exceptions, it's only the mistakes that really matter. You may learn 50 things from a mistake, but how much do you learn from a success? That one line of thinking works. The real learning begins when things don't go according to plan..anyone can run the calls where things go right the first time... :-) Dwayne

Doing the preceptor role, my job seemed to just "do" next available on the roster, no "dedicated to role" ambulances or specific personnel (hence they don't have to pay extra). Disclaimer: I am retired FDNY EMS Command, grandfathered in from NYC Health and Hospitals Corporation EMS in the 1996 "Merger". EMT-B "Cert" still active. Opinions and observations are mine, and may not reflect official positions of agencies mentioned, including the EMT City.

Definitely have been learning a lot on my rides, although it really depends on the preceptor i have. Most are very helpful and eager to teach but there are some who make us feel like we are in the way. Not only are we 'allowed' to do help, we are required to. If you just sit back and watch you wont get credit for going on the call. We also have some numbers to meet (IVs, meds, intubations, etc.) so things are rarely boring. We are scheduled to ride with whoever is available. Things that the system could do better? Ensuring that we are with preceptors who are willing to teach. Its rare, but ive been stuck with people who clearly dont want me there. Its a waste of my time.

You guys need stronger industrial representation; Police have the PBA and Fire has the IAF/IAFC while by comparison EMS has very little.

Thanks dwayne, I say irregardless all of the time

Yes, it was intentional, you guys found it quicker than i thought anyone would. Was going to mispell "spelling" but that would have been to obvious. How many errors do you see in above sentences ? juxtaglomerular apparatus (never heard that one, thanks for teaching me something)

This might not go anywhere, but I see that alot of members in this forum have trouble with grammer and spelling, so I thought it might be good to have a "word(s) of the day posted on here, as an educational tool. I am thinking we take turns, and add: 1 medical word that we would use in our work-life. 1 word that you have probably never heard of. So here goes day 1, someone else find something for tomorrow please, who knows, we might actually learn something: PANEGYRIC = Elaborate praise. DIARRHEA = Watery feces