Chief1C

Ban cell phones from ambulances? What do they want us to do? Stop, climb a pole, and send a telegraph? Radios aren't always on our side.. In fact, I've been to a few hospitals that had no radios.

You have to take him off the stretcher at some point. I'd use a strong, cloth tape in 3"; two multi-trauma dressings folded and tape it on nice and tight. That could be an issue if he's diaphoretic. You could always tie cravats together and go all the way around. However, I've done it several times, and always used tape. Early 90's single cab pick up, no belt, no bag... On a board in the roadway, left chest immobilized, 20ga. cath sticking out of his chest, intubated; and the MAST on for bi-lat femurs and pelvis.

Flail Chest - BLS? PPBVM would be a good start if they can't maintain. You'll want ALS, clearly, it's a trauma. Consider various modes of transit, depending on the condition, your location, etc. BLS treatment, IMO. Splint it how you were taught. Either a couple trauma dressings and 2 or 3" tape; or cravats; less likely to move (or pop) like some who suggest using 1000ml IV bags or other heavy items.. If they're awake, alert, and not in any danger of having that change. You can kind of have them support it on their own too, but I'd still immobilize to protocol. Don't let them move around too much.

We usually run a two man crew, three if we're doing CPR; but the extra lifting assistance is nice. If fire will come, they don't always grant the request for assistance. The state police will assist on occasion, uninvited. They don't give much aid, but they'll carry our stuff back out.

slightly

6000 Pts.

With our recent purchase, we always kept the PPE stuff in the compartments over the bench. New ambulances aren't allowed to have those any more. All sorts of wasted space. I'd like to see a redesigned, improved, stretcher hanger in its place. Sometimes, an extra place for another patient would be really helpful when we can't get back up or mutual aid.

Welcome. The extra padding is good for insulation in the winter.

Nobody cares about EMS till they need it. Maybe you could coax the Mayor into an MI, in an area that lacks EMS coverage?

I've been utterly horrified, by the sight of a body after an attempted murder/suicide by a very powerful gun. Clearly the dead victim shot the surviving one with a different gun, or there wouldn't have been much left for us to find. It was also clear, that either the decedent was a really bad shot, or plastered drunk. I thought I was alone, outside of a house where another victim was being treated. I heard something and got spooked, turn out the person breathing and making sounds was a child that ran to hide. However, with my penlight, I found a horrifically disfigured, body just a mess, all in one area against a wall from like the nipple line up. I almost vomited, but I didn't crap myself; although it took a long time to get rid of the image, mentally.

Yes? No? I guess I never think aboat it, eh? Mainly for the purpose of general humor.

National Farmedic Training Program http://www.farmedic.com/ Farm Medic.

Chopper! No, not the kind that flies. You should expect no less than five augers on Combines, gives you can idea of where to look for limbs, entanglement, etc. There are also several different kinds of Combines, some are even tiny, some have 8, 6' wheels; four on the front, four on the back. Similar to a dump truck at a strip mine. Farms always yield the nastiest calls. Had the power not gone out, and I got to post earlier.. I'd have said "FAIL". Remember your scene safety. Don't go near the patient until the machine is disabled, assuming it can't do anything because you turned it off, will possibly cause your legs to be lopped off too.. You cut the power, but the gears freely go to their resting place. Always, always, always crib farm machinery. Immobilize the machine and all it's parts. Chock the wheels, crib the cutter bar in place, sides and along side the patient. If it has a reel, crib that too. Jam wedges in the teeth, lock out what can be locked out, put hydrant wrenches through any large chains. Then, pull the cable free of the spark plug; never cut unless you know 100% how it works, in case you need it to run again. If possible, get other farmers who know the machines, they can usually be more help. Ag. rescues are very much, back to the basics, you'll need it all. Rescue tools, jacks, cribbing, lift bags, porta-power, and several tool boxes. The older the farm machine, the more likely it is to have exposed workings.. and there are lots of things sitting around that can rip a human to shreds. Oh.. and the MAST. This is the only picture of a Combine that I have. This farm incident had no injuries, the motor caught fire. Typical with machines that collect a lot of grain dust, which is extremely flammable.

I don't see what the difference is, as long as they did get an ambulance. Suppose all of their ambulances were on calls? Would they have gotten ALS, or would they have had to wait? It's not always our fault. I notice extreme inconsistencies in the rip and run time sheets. Personally, I've had it take between 30 seconds for a fire; to 7 minutes for a heart attack to be dispatched. In the case above this, they may as well have not responded at all. Was the patient in Cardiac Arrest when 911 was activated? How long between the time the call was received, and when it was dispatched? I've had the unfortunate luck to have had to call 9-1-1 several times, from medical emergencies, to the house being on fire. Luckily, when the house was on fire, the whistle was blowing before I even hung the phone up. Unluckily for my next door neighbor, an EMT in NJ in the 70's, there was some sort of delay. After they hung up, yes, they were given the okay to hang up w/ a woman in cardiopulmonary arrest. No CPR instruction. They came knocking at our door when nobody was showing up. My pager went off about five minutes after they knocked on the door, and we did CPR till the ambulance arrived, about three minutes after dispatch. It was too late for the AED to be of any use.

Just my opinion, as all of our services fire/ems/pd seem to work so well together. May not work where you are, but it works fine here. I always felt that Rescue and EMS should go hand-in-hand, since there is usually a victim being rescued. Cross training to an extent, and the capability of working well together may be enough. Clearly, you need more than a rescue tool on an ambulance, you'd need additional personnel other than what is on the ambulance. But it's my opinion that the better rescue and ems can work together, the safer the outcome for the patient. If they know a little first aid, they won't be man handling the victim. Likewise we won't be out with our chisels, hacksaw and wreck bar trying to get them out the way a tow service driver would have fifty years ago. Since it's more than just snipping metal with a pair of hydraulic shears; stabilization, fire suppression, hazards, etc..

I don't think the shake & charge ones get bright enough to be of much use. But if it's all you have, it's something to work with...and I'd spend money on one of those, before I paid $170 for one. If you're crafty, wire one up with a solar panel and leave it on your dash.

Unless this is someone trying to defame, or slander his name. Could be, anything is possible on the internet.

Today it was more like someone was writing a script for a movie on Lifetime. People normally get paid good money to sit and listen to that crap. Does that make us volunteer, amateur, psychiatrists?

Well, if it's like any other incorporated voluntary service. There is a board of directors and the members sit as stockholders. All those in good standing have a vote to decide who is in charge. Then nothing was done wrong. If you want to go for it next year, take some officer courses, maybe become an instructor in something. But if you stomp around, whine and complain when you don't get your way, they will want to stay away from that. In fact, if I came in here and found a member posting something like this, using our service name.. The only position I'd vote you for, is off of the property for 60 days. Maybe sit and think, ask yourself how you can become a better leader, how you can improve your relationship with your peers within the organization. I always say, just because a person has skills, an education and can do the job properly; that doesn't mean they'll be the better leader. I look for the person that can offer their personal best in all categories. I've met people that were horrible EMT's, but had very good leadership skills.

Crush them right away. Had a medic the other day, "unresponsive" from a SNF. All sorts of meds that could have been the cause, in fact, from the list one could believe they wanted him to be unresponsive. I said, he's blowing bubbles in his milk, brings it up enough to be suctioned, he needs some assistance that O's can't provide alone, hx of aspirational pneumonia. The student sat there and managed a muffled "wasting my time". The preceptor just glared at him, so I was sensing the two weren't so happy to be paired up. The almost-a-medic wasn't interested in my report, so he had to keep asking questions as he didn't pay attention the first time. I said, no CPR, but IV's, and comfort treatment are fine. He said under his breath, but audible, "he's a DNR, just let him die already". I wanted to hit him. Badly. So, we sat along the road, for over 45 minutes while he used a caliper on the EKG, looked it up in his palm pilot, and tried six times to get an IV... He of course had to blame us, because of "this type of ambulance" he couldn't get it.. So, I said, what do you do when the ambulance is actually moving? He says, I can't work in a moving ambulance.. So, I ended with a .. maybe you should become a nurse instead. Killed his attitude issue.

"No patient found"

...and? So what.. It's illegal. Since when has that stopped us from doing something?

What do we do for a crushed larynx, clearly all they had there was possibly fire and PD? What can be done, BLS, for that? Surgical airway, prehospital? Even if BLS could beg permission to do something from command, wtf would be use? A scalpel from the OB kit and a 20FR NPA; try to do what Macgyver did with a knife and a bic pen? Maybe they should just leave the fricken doors open for people to come in, most Wal-Marts are 24Hrs anyway. Allowing people to huddle together at the doors like a mosh pit is the most asinine thing I've ever heard of.. Maybe because I don't shop there... but still.. Buy the hard to find in Nov/Dec stuff in July.. when it's not hard to find.

A couple years ago, one of our oldest, and most active members passed away. One of those guys that you don't realize how much their friendship meant, till they aren't there anymore. He was like everyone's grandfather. I went on my first call with him; and I was on his last call. We don't talk about it, because when we start to share our memories, there isn't a dry eye in the room. It was probably the most highly attended funeral in twenty years. It was so difficult to remain composed, but we did an honor guard made up of our crew. He was very well respected, aside from being like a part of our families, it went so much farther than us; ER staff, doctors, other services, patients, hundreds of people. A paid service from out of the area had read about it in the paper, and before the funeral, they showed up w/ a MICU and donated their time to cover our calls during the funeral. We tried, but couldn't secure a hearse style ambulance for his funeral. So, we removed the cot mounting equipment, covered our light bars and draped the ambulance that he drove on his last call in black sashes and put his casket in the ambulance. Lining the ambulances up, myself an officer at the time, and the other two officers; and our guys best buddy, got in the back of the ambulance with him; and the rest of the crew in the second ambulance. We took him to the church, and onto the cemetery. I thought it was very fitting, and respectful to a man that had served actively for over 53 years.

[marq=up:5d778dee87][align=center:5d778dee87]Bite me, dough boy.[/align:5d778dee87][/marq:5d778dee87]