whit72

Silence is deafening

Ssaint wrote: whit, what'd you think of it? It was a little tough to stay focused at times. However, it seems like in theory it could work if we were to adhere to the guidelines that have been set up. Its just getting everyone on the same page. Using the resources you have available in the best possible situations. In my experience that was the biggest issue. No one new exactly what they were supposed to be doing, where they should be doing it or when they should be doing it. It dealt alot with setting up distinct people in charge. One incident commander, under him there are chiefs for all agencies involved, fire, EMS, and police. They in turn have supervisors under them to carry out their orders. They also explained universal radio communications, using plain language so there was no chance of mis-interpretation between different agencies involved. I just think it is focused planning. We should have had these types of systems in place years ago. In theory I believe it could work, however we seem to revert back to what we know when the sh*t hits the fan. (My ways the best way, so thats how im doing it. Screw everybody else.) Time will tell.

Anyone had any experience with this. I just finished the training. Wondering if anyone has seen it in action. On paper it seems like it could possibly solve some communication problems. Thanks.

Green hat Wrote: I was quite distressed upon reading this topic. This patient, in my honest opinion should have been transported to the nearest trauma center... level two as she was A/Ox3 and life flight should not have been activated. What we do here in Oregon is put them on standby until we arrive on scene then activate after we have done an assessment, but conscious patients almost never require life flight... of course, we have two level one trauma centers within 5 miles of each other and a 3 level two's within 10 miles It must be nice to get choose between 2 level ones, and a level two.......LOL.

Chvostek's Sign Spasm produced when you tap over the facial nerve. Trousseau's Sign Not sure of this one. Here is one: Kernig's Sign

Thelawisforall wrote: So the breathing with these pt's. are not labored, but shallow breather's, so thus my question before mentioned ACE wrote: Just reading this leads me to believe that you have no idea how respiratory distress presents, and or that the pts you are 'transferring' may have medical conditions which would cause them to have 'emergent conditions' which may present as 'shallow breathing'!!! Meanwhile I'm going to continue to do some more research and request help from others on the streets here.. Best of luck, Boy.....I knew that statement wasn't going to go uncontested.... LOL

Rid wrote: This should had been posted in the "help wanted" section. There apparently will be 2 openings at the Sr. Paul's Fire EMS, as there should be. I agree. In the second video the chief stated they were suspended for one day. There really dropping the hammer. The union also stated they were filing a grievance, so the medic will probably get that day of pay back. Go figure...

Interesting I heard that we were never supposed to separate the service dog from owner. I have never been presented with this issue, however the articles will be a good read. I was told in a con-ed class that if you remove the halter from the dog, he realizes that he is no longer responsible for his owner. If maybe the halter was removed you could then put him in the front seat, of course with a seat-belt on....LOL This would make for an interesting post. EMS and the service dog. With the frequency of these people being able to live on their own with the help of their animals, we might be in contact with them on a more frequent basis. Just a thought.

I'm sure education has has a lot to do with it, the driving factor however is demand. Nurses make the money they make due to the demand. You become an RN in a little over 2 years. Does that justify them making 40 to 50 dollars and hour I doubt it. When you get into the per diem realm forget it the money is astronomical. I have a couple of friends both of who are RN's one has an associates degree the other a BSN They make basically the same money. Because hospitals are not concerned with their education level, they both have an RN after their name. The demand is high in my area for nurses. The hospitals compete by raising the starting wages, sign on bonus's, etc. I also have friend with a masters degree in social services and works in the field, he makes roughly 40,000 a year as a supervisor for the state. That's six years of education. Why because the field is flooded, they can pay a recent graduate 12 hr. So education might determine earning potential, but demand also plays a major role.

Thats great.....Why did they take the other crew members with them in the first place? If they knew they had a exam, why did they go?

Asys Wote: My feeling is my life is a lot more important than my job, so if for whatever reason I think someone is carrying, they're not getting a ride to the hospital unless I'm confident they are no longer carrying. Heck, a lot of my patients have ended up at the hospital with cut pants pockets if I'm afraid they have something sharp in there. Legal or illegal, unless they are a licensed LEO, no one carries a loaded gun in an ambulance I'm riding on. AMS + firearm = dead EMT. The first rule of EMS is if you don't feel safe, don't be there. Rid wrote: Very awakening video Ays.. makes a good point, that all patients should be patted down and never ASSUME anything. One of the most dangerous situation I was placed in was from an 80 year old granny.. who wanted her purse to check to see if she had her medicare card. She did as well as a .38 caliber, in which she pointed at me .. and demanded we not take her to the nursing home.... we didn't. I never hand purse, medication bag(s), etc, without searching first, and I attempt to "patt" all patients down 1'st. I can't tell you how many patients arrive in ER "packing" ... Hmmmmmm......... Interesting that my thoughts seem to have echoed the comments of these two posters. Yet I was the one told I was half baked, and hadn't spent enough time in the real world, and I was trampling on everyone's civil rights. Quite typical of this forum. Im not suprised.

Savoy6 wrote: BUT, emotion does not trump, as you say, the law or a person's rights. I don't believe I stated anything about emotion. The fact of the matter is. You should be a little more concerned about with personal safety. I have been in instances where my safety has been in jeopardy, therefore I have these beliefs. Its not about a pissing contest. We have different protocols throughout this country to suit the surroundings, why wouldn't we have different policies that also suit your surroundings? My practices are defined by my experiences. If my experiences were different, my practices would reflect that. I have a question for you. RID If you come in contact with an enemy soldier, that has just been shot. If you were to treat him, and transport him to your hospital. Would you leave him armed. He well within his right to be carrying a weapon. He is at war. I believe not, why? Because he is a threat to your safety.

Dust Wrote: I get the distinct impression that whit hasn't spent much time in the real world No None. Fact is Ive spent a little to much time in the real world, your statements would conclude that you don't. If you believe everyone you come in contact with poses no threat to you. That's fine. I don't. Okay, so the patient who was perfectly calm and no threat to you, I believe I stated if the person poses a threat to me. Why would I search a person that was no threat to me? If he is illegally carrying a firearm, I'm assuming he has no problem using it. He just wont be using it on me. You better spend some time really thinking this stuff through, my friend. These half-baked ideas of yours are more likely to get you hurt than to protect you. You do it your way, and I will do it my way. I am going home in the morning. Do you search purses too? Was that an attempt at humor. You failed miserably. I'm glad you believe this is a humorous topic. I however take personal safety very seriously.

PPrg wrote: I must ask, cutting pockets whit? For all patients? Searching them? How do you decide who gets searched? Nevermind, dont answer that. Its a civil rights violation no matter how you cut this. You don't check pockets, what do you do? Hope you don't get stuck with a dirty heroin needle? If their is reason to believe and I cant ask due to your unresponsiveness, or there is paraphernalia around, you have track marks, or are laid out in a known drug area. Yeah I might cut your pockets. No we don't cut everyone, but we have done it? My safety is of the utmost importance. If you give me a reason to believe you might want to harm me, or have a track record of doing it in the past. You going to be searched probably by the police if not by me. I'm not strip searching anyone but checking the usual areas where a weapon might be kept, waist line, under the shoulder, or around your ankle. I wish I worked in an area where the last thing I had to worry about was somone trying to hurt us, however I don't. So That's just the way it is. Call it a search, a pat down, a thorough head to toe assessment. Whatever you need to call it, just make sure it gets done.

Walrus wrote: I am sure you would rather a few guys (and women) laughing and joking around in a little immature way in your station that the above stated where all you can do is watch Barney, sing Kumbaya, and discuss Dr.Phil episodes.... We should have the right to do what works in our station....not worry about some whiner that is gonna try to sue the company. A little immature way.......... Joking and practical jokes is one thing.........Dry humping your gay partner is another. But hey I may be the exception to the rule. If you haven't been sued yet, I'm sure its just around the corner. If not jail time. Anyway good luck.......You might ned it down the road.

Walrus wrote: how does making gay jokes to your buddy or pretending to dry hump him affect you Your kidding right. Maybe if your in a motel room. Keep your closet gay relationship to yourself. Thanks. If you tried to dry hump me I'd break your neck. do you know how many times either I call a friend gay etc in a day... I just told my partner 10 minutes ago he was a F&cking Ugly stupid ba@tard and he says the same to me. Somehow I bet you both resemble those comments But me calling my partner queer and putting Vaseline on his toilet seat... or having women pretending to be hookers calling his wife Gee.....let me know when he leaves so I can bid on that shift.....I would rather have my fingernails ripped off. part of being in fore or ems is team work loyalty and trust for your fellow brothers and sisters I play softball and golf with my co-workers, and you know what we never once thought about dry humpnig each other. What was I thinking I could have saved a ton of money just dry humping my fellow brothers and sisters. You cant be serious.....

EMTuKnowMe wrote: The fact that EMTs are so far underpaid is beyond question. But, I just wanted to add something here to think about... If you don't like what you are doing and get paid a lot of money for it, sooner or later your discontent will take its toll on you and your family. You will grow resentful. Perhaps more important is the fact that your children will be affected by your unhappiness and frustration. On the other hand, if you WANT to be an EMT, and you really ENJOY being an EMT, then be an example to your kids by showing them that its ok to pursue a dream; that its great to be able to help someone who really needs it; and that its better to be happy in life than miserable. Good luck to you, and be safe. Great post. As far as the dream, I wanted to be a football player, but they got this stupid rule that you need to be able to catch one..... go figure. I have seen way to many good people ruined in this field. Whatever the reason. As far as the dream. Maybe before, however sometimes it feels like a nightmare....LOL. When the bad days start to out number the good ones. I think it might be time for a change. I have been on calls that it took me months to shake, some names I have never forgotten, and never will. That is the nature of the beast. You just have to keep it in perspective. A wise ems man once told me its alright to remember, however its healthier to forget.

Techmedic wrote: I do believe also that there are patients we see who do not need to be evaluated. It's not every patient, but they're out there. Why not let them sign off? I agree with you totally, I go to mva's all the time where bystanders called 911, there were no injuries they sign and there on their way. We come in contact with people who never called 911 it was called in by someone who witnessed something. If they have no complaints, they sign off. I just don't talk anyone who wants to go, out of going. Our policies on refusals are simple you still have the fill out the paperwork, plus a refusal, so in many cases I would rather just take them. I think that was the reasoning behind the policy. It also may eliminate multiple call backs at the same address. My transports also do not take 2 hours, I can be done with a call from start to finish in 30 mins especially if its bullsh*t. If your call takes 3 hours to do people may be more inclined not to transport a pt without a true emergency. I cant speak on that, I have no experience in that situation.

GAmedic wrote: How do you know that your employees educated the patient properly, and did all that they could to get an AMA patient to go to the hospital ? Is what the patient is being told consistent, by all crews, and at all times of the day or night We cant, you just have to hope that the people you put in place reflect the practices you desire. The ones that don't need remediation or removal. This like any other field isn't perfect however our mistakes are magnified due to the consequences that could arise from our actions or lack of action in this case.

Joshua Benton wrote: It is commonly referred to as respect. You cannot demand or even request respect unless you first are capable of giving the same Your looking in the wrong place. This is a nice place to sharpen your brain, (I have actually learned a lot here) brush up on some things you do not come in contact with much, to bounce off ideas, review treatment decisions, or see what going on in EMS in other areas. You want respect look at the person sitting next to you the next time your out on a pedi code or a double fatal. I am not diminishing the role this forum plays. It would be nice if posters on this forum thought I was an asset to this profession. However it is not essential to me, I have the respect of the only people that matter to me, the ones I do this job with day in and day out.

I don't believe there is an acceptable refusal percentage, it should be on a case by case basis. They should be audited by your Q/A dept. I can say that I have never discouraged one pt from being transported to the hospital. If they want to go they go. This might have to do with the fact that we have to fill out the SARF whether we transport or not. Being so close to the hospital its easier to transport then sit their in argue with them. If we cmed a stable pt with a complaint that can be fast tracked, when we arrive a nurse eyeballs them and they go to chairs. Its maybe 30 minutes from when my feet hit the floor till my head is back on the pillow. No sweat. Its not my job to educate the public of the proper use of the 911 system. especially at 3 in the morning......LOL

paramedic Mike wrote: If you go EMS as a foot in the door to becoming a firefighter, then you're doing yourself and any patient with whom you come into contact a disservice in that you're not really interested in what you're doing. And no patient deserves that. I mean no disrespect with this post. But there are too many people out there who think this is nothing more than a foot in the door to becoming a FF. If you want to fight fire, go do it. If you want to work in EMS, go do that. But please, pick one or the other. Its not that cut and dry in some areas. The state of Rhode Island most fire departments and EMS are one. So I believe its possible to do both if you choose. I myself do not want anything to do with fire, the act of lighting my fireplace makes me nauseous

As far as the original post. In my experience we have a higher incidence of refusals then some other areas Urban areas in my opinion will show a higher spike in refusals for the simple fact, the pt or injured party is rarely the one who calls 911. So you have bystanders or neighbors witness something and call 911. A person might be changing his oil under his car someone will see him, call 911 and state he was run over. We have a large amount of homeless people, they sleep in certain areas, if someone drives by and See's this person lying on the ground they call 911 and state someones passed out on the street (PLO). We still have to get a refusal There is a little fender bender, before the police arrive 30 people have called 911, on your arrival there are no injuries we still have to fill out refusals. The list goes on and on. Depends I guess on what your service requires of you. If we make pt contact whatever the reason there needs to be a refusal, if we dont transoport. In a suburban/affluent area you don't have those, at least such a high incidence, usually the person will wait until they are critically ill before they allow anyone to call 911.

Hmmm.....I remember those same feelings regarding ACE, along with a couple others I cant repeat If you have an opinion state it, you better be prepared to back it up. Think of him as the resident Q/A office. You can not question what he brings to these forums. I don't always agree with his tactics or delivery, but you cant deny the importance of the role he plays. He wants you to be prepared not just here but in EMS as a whole. I cant argue with that. Don't worry the feelings of wanting to snap his head off will subside.........LOL There is a compliment in there somewhere ACE, You might have to dig a little to get at it, but its there. I have come to respect him.

Safety is my main concern. If I believe you are carrying a weapon you are going to be searched, patted down, call it an assessment if you need to. If that impedes on your civil rights, call the ACLU. You are not getting in my ambulance with a weapon unless you have a badge to go along with it. Even in that case I will try to secure it with another police officer. It only takes one instance to end, or severely impair your life. I'm not willing to take that chance. I do care about your rights, however I have the right not to be stabbed, shot, assaulted or stuck with dirty needles(we cut pockets also) while in the process of doing my job. If I feel threatened at any point my rights trump your rights.