CBEMT

http://www.facs.org/trauma/verified.html

Ok, and how much time did that save you? Yeah, the fact that they're ESRD and immediately post-dialysis. Translation: everything and anything is fair game. I don't understand this. I used to transport dialysis patients whose history and at least part of the med lists I could recite from memory because we had to write out everything for every trip the patient made. One of my coworkers used to have some people's SSNs memorized.

Possibly the smartest thing Gary's ever done, from what I've seen.

Sure, why not. They're not dangerous enough as it is. In fact, they should have RSI too. PS- your MedWreck badge is on the wrong side, isn't it?

I refuse to believe this is actually legal. This has kickback written all over it. I'd love to see Medicare descend on that place like the Fist of God. I don't think I've ever seen a company go to such desperate lengths for a contract in my entire life. I can't even see how they're making money off this, considering what fire medics get paid on the Left Coast.

I never once falsified anything regarding necessity of transport. Considering I was never from my first day asked to specify how the patient got from where they were to inside the truck, I didn't. I didn't falsify. I just didn't specify. ...Unless I was trying to get rid of a problem patient. We'd have these BS frequent fliers that loved to call us because the policy was we took every request for transport no matter how blatantly no-pay it was. The hospitals hated these types so much that they'd go out of the rotation and call us to transport them back to wherever they came from just to punish us for bringing them in in the first place. Problem was, that no way in hell were we getting paid for the ride if I documented everything, and no way in hell was the patient ever going to pay out of pocket. When that happened enough, the owner would finally authorize supervisors to refuse transportation to those individuals. As much as he hated risking pissing off a hospital that had us in the rotation, he couldn't justify tying up a truck for a freebie- especially on the overnight when most of these skells seemed to always get discharged. So I took great pains documenting such things as "ABC ER MD refused to sign Physician Medical Necessity Certification due to lack of medical necessity for transport." :twisted: And you know what? As underhanded and cheap was the owner was, I was never once asked to re-write a report like that. Could be because on the runs that were clearly justified, I did everything I could with my report to make sure we DID get paid. Unlike the floors, the ERs had no idea what a Physician Cert was, but if I knew it would help I'd wait as long as it took to get one signed. You just have to know how to work the system in your favor. :wink:

Can't see it.

To be fair, if I was a professional paramedic looking for a job, why the eff would I want to work there? Sixteen calls in three months? I didn't get into EMS to keep a recliner warm.

Everybody gets a lock. Right at the end of their IV line. Locks are a grey area here. It's not in line with current protocol, but nobody's ever been called out for starting JUST a lock. That I know of. To me, doesn't matter either way. We restock out of the hospital, so no matter where we've transported to, we have their stuff on board. And cost is not a significant factor as a result. Yeah, we have stuff in stock, but in terms of IV supplies we hardly ever have to dip into them. Same with collars, first-aid supplies, etc. The only things we really have to order on a regular basis are monitor paper, glucometer strips, and headblocks (we use disposables).

It is the intent is to make obvious one's complete and utter disgust with same. :wink:

Not always a fantastic idea. If I'd had a politician riding along for my last volunteer shift, s/he would've seen me do not much more in 12 hours than normal station chores, napping, TV, eating, and reading. Oh, and we checked the reserve trucks at the other stations. Exciting stuff! Oh yeah. They'd be in a SERIOUS rush to raise taxes in order to pay me by the hour instead of by the call.

Because not every jurisdiction allows that.

My grade school used to have "Grandparents Day." Then, after a few years, they realized that more and more kids were entering school having already run out of grandparents, and were getting heartbroken at sitting in the classroom alone while everyone else did fun activities. Then it became "Special Person's Day."

People seem to be dealing very gently with this situation. To me, he sounds like a trainwreck of a medic.

That's pretty much what I was implying. :wink: :wink: I just wish somebody had given him the opportunity to say so for the record.

That sound you hear is the District's DEA field office laughing their asses off.

*shrug* We have statewide protocols.

Richard Serino, Chief of Boston EMS, according to published reports did not attend the final meeting of the committee, and did not attend the report's unveiling. Unfortunately, I don't know of any media outlet that actually followed up on this to ask him why. I think his answers would have been quite enlightening as to the process the committee used to justify their craptastic conclusions.

Disagree completely. The governments of the cities in my area whose EMS providers are paid firefighters are not paying ANY attention to the level of quality they are receiving. If they were, chest pain patients would not be walking to the truck, and trauma patients would be strapped to the backboards they lie on. A paid service does not a quality service make. If my (ALS) 911 job (volunteer to be on shift, paid for making a call) was eliminated in favor of a paid service, the town council would go with the option that wouldn't raise their taxes like a municipal service (fire or otherwise) would. They'd contract out with the private service I used to work for, who I wouldn't contract to transport my pet rock. They do not have the equipment or caliber of personnel to provide quality 911 EMS. The only thing they have going for them is that they do place emergency calls (at their contract facilities and urgent care clinics) ahead of transfers.

This was a vehicle belonging to a small private service, who typically do not pay for things like kill switches, keypads, or anything like that. The one I used to work for even disabled the power locks.

Unfortunately, my state doesn't issue wallet cards, we're given an 8.5"x11" piece of paper. Not exactly portable. I've taken the step of making a photocopy, folding it up 5 or 6 times, and carrying that. One guy on my POC department had a copy of his shrunken down to wallet card size, and laminated it.

The providers in the largest FD/EMS system in my area want type IIIs, but the mechanics want type I's. So they're sticking with type I's. :roll: The rest have all pretty much moved to type IIIs, but with the recent Ford issues, medium-duty units have made a resurgence. Both of my agencies have type IIIs. Having worked on everything except a medium duty, my preference is III for all of the reasons listed, plus they seem to allow more compartment space both inside and out. A medium duty will never make some of the turns in my POC job, and the FT job will never pay that much for an ambulance. So I guess, short of getting a job on the local CCT, I won't get the experience.

Why the hell did he get fired for getting nailed even after taking all precautions?

Considering that they have ALS engines, they might have too many as it is. Just poorly distributed/deployed. I agree that "DCEMS" needs to happen though.

1. I've had more than one hospital give me their pump on faith that I'm bringing it back (short transport times help). Some will send a nurse for no other reason than to make sure they get the pump back (direct quote). Dial a Flows were required equipment until our last protocol update. At that point they were banned due to research showing serious inaccuracies. Now the ONLY option for a drip, interfacility, 911, or anything in between, is a pump. 2. And the way the protocols are written, if your service is too cheap to shell out for any, there is NO treatment for stable VT available to you. And if it's unstable VT with a pulse, you're still screwed- sure you might convert, but you won't hold the rhythm!