CBEMT

20 bucks says the patient wasn't properly secured either.

In other news, water is wet. Film at 11.

Sounds good to me. We had Solu-Medrol in our protocols for years. Now we've been switched to Solu-Cortef. Good to see some validation for what we've already been doing. Thanks Doc.

My first EMS job orientation was two 10-hour days as a third rider, with a third added on at my request so I could get some driving in. Currently most employees get two 8-hour days as a third, second day should be driving. But that second day could be eliminated if someone calls out- in that case, the new employee fills that slot.

From what I'm getting via various means, when the supervisor showed up and ordered CPR and transport, the crew was in the truck with the patient, and were in the process of getting medical control clearance for cessation of efforts- but not actually performing CPR. So it would seem to me at first glance that the supervisor walked into a situation he knew nothing about and changed everything. Should they have been doing CPR while calling the doc? Probably. Would have changed ANYTHING? Nope: I'm also wondering why the supervisor writing the letter didn't consider this an issue of deficient care until he got laid off. Maybe it proves his point, maybe it doesn't. But the timing is interesting. The only person who gave the family false hope was the cop who started CPR and the supervisor who forced the transport of a dead body. Further, newspapers always say that the patient "died at the hospital," because they like the lay public have this idea that transport (even with CPR in progress) must mean the patient was still alive. Happens all the time with shootings, stabbings, and car crashes in my area where I know for a fact the patient was a trauma code from the moment of EMS arrival, but the media always reports that "the victim was transported to an area hospital, where s/he later died." "Later" being the ER pronouncement about 5 minutes after arriving. As for "Why did they need a supervisor," it's common practice in many systems with field supervisors for the supervisors to respond to potentially serious calls and assist. I'd say a dispatch for "baby not breathing" would qualify, wouldn't you?

Let me know how you make out Doc. ( http://www.emtcity.com/index.php?showtopic=14938&hl= )

I think its safe to say that BEMS' style of education, training, and clinical exposure are pretty rare among EMS systems in general. If you guys say he's dead, I'm comfortable saying he's dead. Random City Fire Department.... maybe not.

http://www.yumasun.com/news/victim-50358-accident-dies.html

Cousin of mine graduated from Embry-Riddle. Started out flying executive private jets, and now works for Fed Ex. He's one of those rare people who can't wait to go to work.

Better than Roll With It, that's for damn sure. Didn't make the department look bad, didn't embarrass anybody. I don't hate it.

Sweet Caroline - Neil Diamond Where are you right now?

"Very high standards" and "California" don't even belong in the same sentence on an EMS forum. And I'm sure he does an excellent job at driving fire trucks. Its the fact that you're holding him up as an example of a medical provider that bothers us. Since when do you suddenly care about the effects of volunteers on EMS as a profession? Unless you're being a stereotypical IAFF thug wanting to get rid of all volunteer firefighters.

Nope. Here 911 transfers the caller to whoever dispatches an ambulance for that community (FD, PD, etc). At that point what questions get asked is purely department policy/common practice, and nobody has actual EMD certified dispatchers (in many places the dispatchers are actually the most recently hired firefighters), and none that I know of give pre-arrival instructions. At my 911 job the PD dispatcher will get a chief complaint, and most of the time if the calling party reports an unresponsive patient, they'll ask the caller if the patient is breathing. That's pretty much it.

Then by all means feel free to drop your card and vacate the "jobe." I have a hard time calling a fire engine driver/pump operator a "paramedic." He may have a card (obtained to get his job as a firefighter) but I seriously doubt he's anything remotely resembling a provider of pre-hospital medicine.

They flew a victim of a pre-prom demonstration? I mean, really? Too many people from ACTUAL crashes get flown, now we're doing joy-rides on FAKE VICTIMS?

A quick Googlemapping shows the scene as being 49 driving minutes from the scene of the crash to the trauma center the patient ultimately died at. I'm not 100% sure I'm willing to make that long of a drive with a Level 1 patient who could decide to crump on me at any time, especially given my protocols (no RSI, OLMC for benzos, etc). I have a hard time arguing against the crew for defaulting to the closest facility given that they couldn't get a scene flight. If I were the family, I'd be MUCH more interested in why Hilton Head @#$%ed around with my son for TWO HOURS before deciding that he was beyond their capabilities. The article doesn't mention what shape he was in at the time of transfer.

Yeah, the IAFF is really interested in quality medical care. Have you even been paying attention to the events in Collier County, like firefighters failing previous tests on the drugs they carry? Of course not, you just see union firefighters who don't like somebody, so without even looking for facts, you bash the doctor. Brotherhood before the public well being- the IAFF unofficial motto. Maybe if your hands spent more time holding a book and less time dragging on the ground, you might actually have some credibility here.

How many years did you have to get all that done?

I do. Because that's what is required of me. When they give me another option, I will use it as appropriate.

You're goddamn right. Like the first of an angry god.

I should be surprised that LA didn't use Broselow tapes until 03-04, and that despite using them they're still effing it up, but...... I'm not.

Same boat as Fiznat. Nowhere even CLOSE to injuries incompatible with life in my system, and traumatic arrest is a mandatory station in our state practical. I have no doubt in my mind that if he's still in arrest when I reach my trauma center, he's going to be called in short order. They'll even call a PEA arrest after preforming an ultrasound to confirm that there is no movement of the heart. But they can do that at the hospital. I can't. Let's be clear- I have zero problem calling him DRT if he fits the bill under our standards Failing that, he gets everything. Anything less could cost me my license. I'm willing to accept the indignation of EMTCity in order to avoid that.

Who needs all that CME, recerting, and standardized qualification of competency.

I can't treat a patient I don't have yet. It's a dispatcher's job to send them a truck. I have a patient in front of me. This is the one I treat, or don't, based on THIS PATIENT. Not some imaginary one across town.