GhostMedic29

Let's talk pay?

He was convicted of Manslaughter in Montgomery County, Alabama in the death of EMT Pullam. As for his sentence I'm not quite sure the time he received but I do know his license was revoked and he had hefty fines to pay.

As a paramedic in Alabama (which as some think we are all inbred and have no teeth) the Department of Public Health Office of EMS and Trauma require mandatory background checks upon your initial licensure. The Office of EMS and Trauma also conducts background checks when an EMT or Paramedic apply for re-licensure every 2 years. The programs here are also required to complete background checks on ALL new students into EMS program. They also require students to submit to random drug tests.

In order to be in compliance with the Americans with Disabilities Act of 1970, the EMS service must allow the patient and the service animal to be transported together. Most service animals are well behaved and highly trained. I had a situtation such as this one arise and the firemedic commenced to telling the patient that "pets or animals are not allowed in EMS units". I reminded him that my unit is my responsibility and I decide who rides regardless if it is human or animal. Needless to say a complaint was filed against me by the firemedic with my company and state medical review board. When I produced documentation from the USDOJ Disabilities Division regarding the ADA and service animals...the complaint was dismissed with a formal apology from the firemedic ordered by the fire chief.

ER nurses are a great asset to EMT's and Paramedics. Nurses are not required to "ride along" in my area in order to maintain ACLS or any other professional certification. At the present time I have inquired to my state public health officials about making it a requirement for nursing students to be required to complete a set number of hours riding with a paramedic service just so they can better understand our job. Some nurses not all of them but some seem to regard EMS workers as cot jockeys and ambulance drivers. As a paramedic I for one HATE being referred as a cot jockey or ambulance driver. The nurses in my area have received several tongue lashings from my collegues and myself. On a more personal note it would be nice if EMS workers were paid more than what we are.

The service I am employed with uses Morphine as do most other services in my area. Our protocols allow our medics to administer Morphine for suspected or confirmed fractures and suspected cardiac related chest pain with no relief from the initial NTG. Our initial dose of Morphine is 2-4 mg, up to a total of 10 mg before we have to call for OLMD. I have been in EMS for 13 years, I personally don't like using Fentanyl but that is my opinion. Morphine is great because of it's analgesic and vasodilation properties. I will choose Morphine over Fentanyl any day and twice on Sunday. Also since Morphine does routinely cause nausea, I usually give Zofran 4 mg after the Morphine.

The medic in this situtation was considered "on call" as he was being paid to be on call. Secondly the EMT on the truck made the right decision when requesting ALS intercept. Third as for the dosage of MS @ 4mg, that is OUR state protocol. This medic was negligent in his duty to refuse an ALS intercept from his OWN crew. No he does not have a department issued vehicle with which to respond but when the transporting unit goes by his house....there is no excuse. This medic has been suspended without pay pending the results of an internal investigation into his actions. It is likely that the state will also investigate his actions as well should our agency forward the results of the investigation to them. No it is NOT this agency's policy to do anything like this medic did. I understand this medic was spending time with his kids but it is HIS responsibility to get his on call shift covered if he can't cover it himself. No one with this agency was advised that he would be unable to cover his "on call shift". Therefore as far as the department is concerned he is guilty of breach of duty.

Maybe I should have made myself clearer with this point. As of right now we are a volunteer service which utilitizes a paid on call system. We do have medics who help out from time to time, but they are not always around to respond, although it is helpful when they do respond. As for requesting the medic to respond, we are dispatched by the county 911 center so the EMT whichwas on the truck made the decision to call for ALS intercept. Unfortunately the medic refused to respond, which left that BLS crew twisting in the wind. So rather than attempt to risk it, they called for ALS intercept from a neighboring FD that runs Paramedic Engines which in this case was the right call and the department supports that EMT's decision. We have several members who are currently completing a Paramedic program, and I am one of those members. Sorry for any confusion guys, I didn't mean to mislead anyone about the situtation. But anyhow, the situtation has been handled internally with this individual being placed on administrative leave (unpaid) pending the outcome of the investigation. We are hoping this situtation can be resolved internally but we are going to have to see what develops.

As an attorney once told me, it's hard as hell to prove negligence. But then again I think this attorney is plain out full of shit. As for the ethics complaint, that's a very distinct possibility. Me personally I would take the peer approach and have a sit down just the two of us and discuss the situtation at hand. If that didn't solve the situtation, then I would involve a supervisor or member of management. If that doesn't work, then I suggest time off (unpaid of course) and remedial education. Worst case is where you have to terminate the employee. Personally I would only suggest termination as a last resort. Usually a write up and time off get's the attention of the individual who is "lazy" and doesn't want to do their job.

As of today, the situtation has been handled. After careful review of the information submitted by the individuals who went on record and stated that the medic outright refused to respond to this request for ALS intercept, the medic has been suspended without pay by the department pending the outcome of the investigation.

I don't think there is anyway you can break this mind set. So many medics have this type of attitude. I work with several medics who have this exact same attitude. Medics deciding before they ever get on scene that they are "not gonna haul" this patient.

I've witnessed various other actions with this same medic. Your right, I was not on this call, but I have read the PCR with the Chief as part of the internal investigation and it was documented who the medic was, what has requested, and what his response was. As for the bystander, I am actually assiting with the internal investigation as requested by the Chief of EMS. In a way I guess I am a bystander per se, but not so much as I have interviewed all crew members who responded to that call, all members were interviewed separately and all gave basically the same consistent account. The medic in question has yet to provide his statement regarding his decision or refusal to respond with regards to this call. As for the state, they are involved with this investigation but they are allowing our department to conduct the internal investigation first. In the event the internal investigation uncovers any violation of protocols or state rules, then the state steps in and follows up from there. I just posted this to see what other EMT's and Medics think about this situtation, that's all.

This question is open to anyone who can provide a professional answer. This question involves a small department who utilitizes a paid on call crew with a volunteer back up crew. The situtation I am about give you in an ACTUAL situtation that occured here very recently and I just wanted some input from other medics and EMT's. Our department was dispatched to a medical call this past week. The c/c from the patient was for CP. A BLS unit responded initially to the call. Upon their arrival they initated patient care in accordance with our protocols. O2 therapy was initated at 15L via NRB. The patient was also give (4) 81mg ASA as per protocol. The patient describe her pain as a dull crushing type pain which radiates into her left arm, left jaw, and back. Patient rated her pain 10/10. NTG gave minimal relief. The lead EMT on the truck made the determination for ALS intercept. The medic who was scheduled to be on call was notified via cell phone of the situtation and informed that due to the patient's condition, the crew felt that ALS care was required. The medic informed the crew "I'm not responding, I'm spending time with my kids. Just take them to the hospital". When I heard this conversation after the call I was livid for one. The lead EMT on the truck made the decision to have ALS intercept from a local fire department which operates ALS pumpers. When the medic from the FD got on board our unit, a 12 Lead EKG was obtained and showed elevation in Leads II, III, and AvF. An IV was established, the patient's vitals were WNL. Due to having minimal relief from the NTG, Morphine was administered at 4mg for pain. A copy of the 12 Lead was transmitted to the ER. On arrival of the patient at the facility, the patient was taken immediately to the Cath Lab for placement of a stent. My opinion is this. The medic who initially refused to provide ALS care on this call even though he was requested is guilty of negligence and breach of duty. This medic was being paid by the department to be available for calls and refused to respond. This medic is also our Deputy Chief. The EMS Chief is investigating this matter internally for now, but the state has also be made aware as has the family of the patient. The chief has asked for my opinion about this situtation and I informed him the best thing we could do is terminate the individual who refused the call above and hope our agency isn't sued by the family or sanctioned by the state authority. This is not the only call concerning this individual, but one of several. It in my opinion that this individual is a liability to this agency and those that we serve. What are the opinions of my fellow EMS professionals.....

I'd say you made the right decision not to perform the procedure. I don't know where your a medic at but in my state our protocols are very strict when it comes to Needle Decompression. If it is the opinion of your boss that you were wrong in not performing the procedure then ask him to support his claim that te patient needed that procedure performed. If your boss felt so strongly about this procedure then he himself should have assumed patient care and performed the procedure, not telling you to do so without first confirming the patient's condition warranted this procedure.

My agency operates under the ICS guidelines but as most departments have, we have implemented our own version of the system. When our agency is dispatched to a MVA or any call, the first arriving engine which is staffed with a Captain, Sergeant, and (3) Firefighters, the Captain has command, until he or she is properly relieved by the Battalion Chief on shift. Anyone can establish command at the scene, it doesn't necesarily have to be someone of rank or even someone with the agency who is responsible for the area.