Kaisu

Yeah.. I figured that out

See.. now I went the other way. Before EMS, I didn't give germs a second thought. Now, I won't even use the handrails on stairs and escalators.

I beg to differ..

OK.. how do you know my name? I am the medic on the team.

Something I totally rely on is the eyes, ears, heart and brain of my partner. We are a medic/EMT pair, as are most in the cost conscious private ambo world. A lot of medics treat their EMTs like underlings and totally discount their value as a team member. I don't make that error. Two are better than one.

I run CCT ground.. paramedic with an RN and an EMT partner. Is that what you are getting at?

That used to be what we did too... then the new protocols came out and the doc in the box WILL NOT make the decision for us. He says "I'm not there - you call it" putting the decision back on me as the medic on scene. If I genuinely believe there may be an issue (trauma to the head, face, poor vitals, etc.) I will do everything in my power to talk them into coming in. I can usually do it too... I have taken in 3 or 4 patients in the last half year or so against their will. Not an easy call to make but I make the decision with trepidation and based on my best judgement.

No, according to the OP the issue is drunkenness you just decided to stop assessing at "Altered mentation of unknown etiology." You were actually called for a cardiac arrest, almost certainly by another drunk. There was no cardiac arrest, or anything that would lead anyone to think that there might have been, therefore you have no further business in this mans house if he's asking you to leave. Have you been smoking crack? You really meant to state that if a dispatch complaint differs from an actual complaint you leave? Your argument is based on the faulty assumption that someone that is drunk is in a position to make good decisions for themselves. There is a famous case in tort law where a drunk falls into a construction hole and sues the city. The city argues that the guy was drunk. The judgement states quite succinctly that a drunk has just as much right to a safe street as a sober person, and is in twice as much of a need for one. Figures from the Center for Disease Control for 2007 quote alcohol related deaths as follows: Liver and liver related 14000+, non-traumatic (aspiration, etc) 23,000+. These numbers do not include accidents, crashes..... Just because you like to get shit faced does not mean that it is not risky behavior. You do have the right to be in the home. Someone was worried enough about this person to call 911. They want your help. As a paramedic, I have the education, training and experience to be a better judge of what is safe for this person that is intoxicated and unable to form a good judgement. It's not cover my ass.. its looking out for my patient. I would rather stand in front of a judge to defend myself for taking in the patient against their will when it was my sincere and honest belief that the patient was at risk than to explain why I left them and they drove their car into a bus stop full of children.

Holy way to revive a dead post batman.....

Nice! People like you make this site worth visiting. Good stuff chbare. Thanks.

Denial is one of the hallmarks of addiction... People in denial are not going to ask for help. They deny there is a problem.

Absolutely not true. AMR has AVL (the eye in the sky) and they know exactly where the ambulance is at all times. Secondly, AMR has 15 minute scene time standard. If the ambulance is on scene for longer than that, they have to fill out paper work stating why and the call is looked at. If anything, there is incentive for crews to go on scene later rather than earlier (to avoid paperwork). With a standard that has to be met for response and another one for on scene time, the total time to scene and on scene washes any possible shenanigans.

Did you happen to take a look at the salary tracker? What on earth is other? How can a FD engineer earn over 300K? A volunteer coordinator with the salary of a CEO? It boggles the mind.

communist a**hole

A little aside.. I run CCT ground with an RN and an EMT. We are in 911 rotation from 1800 to 0800. When we arrive on scene, it is our scene. Drove the powers to be in fire absolutely nuts. They pulled out all the stops to try and eliminate us from 911 runs. Put my partners and I under a microscope, trying to nitpick our calls. It backfired on them in a big way. I am better educated than most of them and my nurse rocks. They came out looking like fools.

Very timely article Dust. The worm has turned in a big way. Here in our local community, city budget cuts are taking the biggest bite out of the fire department, and city council is in talks with the private to take over all medical response. As an employee working for the private, it is grim satisfaction. For years, the fire heroes looked down on us as they "owned the scene" and considered us hewers of wood and haulers of water for them. Things started changing a couple of years ago, when the economic downturn caused fire hiring/salaries/benefits, etc. to come to a screeching halt. The private medics received large raises, due in no small measure to the fiscal responsibility that is an absolute requirement for a private company. I admire the special training that good fire departments acquire in extrications, tactical rescue and of course, fighting fires. They are in shape and sharp and good on them. What always infuriated me was the strangulation of para-medicine due in no small measure to the fire department's opposition of increased educational requirements. By the way, I realize the large privates are to blame for this as well. Very interesting shift in the landscape and long overdue. Thanks for posting.

Everything was going pretty good... till this negative and ornery post....

Well said paramedicmike. My sentiments almost exactly, but I was not motivated enough to write it as well as you did.

Jesus also drove the vendors out of the temple, telling them they had turned His Father's house into a den of thieves, called the Pharisees a pit of vipers, and cursed (and killed) the fig tree for not bearing fruit.

Jesus wants a repentant heart. He forgives, and then says "sin no more". This man obviously repents nothing, as his family members are still blaming the victim. The man will march headlong into hell.

pshaw... my humor was obviously obscure... you are anything but dense. cheers Kaisu

I didn't mean to imply that the energy correlates to the medication. I was just suggesting that the inadequacy of the dose of electricity(energy) is as inadequate as the dose of medication (epi). And the precordial thump suggestion was tongue in cheek

And in the wilderness scenario described, try a precordial thump. I believe it generates approximately 4 joules - about the same under dosing as the epi pen... Can't hurt, might help.

Amen brother. The answer to that is supposedly the bi-annual paramedic refresher required by NREMT. I just took it a couple of months ago and it was a joke. I would like to audit the last 2 semesters of my paramedic program. (not any paramedic program, the one I took.) Not sure how I would work that tho...

I was investigated for possible HIPAA violations for postings that described on scene incidents with very hazy personal details but pretty specific medical findings. (BPs, HRs, etc.) The corporate compliance attorney stated that I had violated HIPAA in that people could make a pretty good guess as to who I was talking about, based on some of the incidents occurring in a small town. I got a slap on the wrist after promising to sin no more. Whereas I was under the impression that I had NOT violated HIPAA, he was the lawyer. Be very careful out there folks.