Just Plain Ruff

Cosgrojo, you are correct about absolutes - But I'm relatively certain that only one of our providers goes into scenes with nothing but their body. But I cannot be 100% certain of that. I can be certain 100% that the policy would more than likely never happen. Am I 100% completely well maybe not but there have been other incidents over the past 15 years or so where a policy would be a fine idea but it doesn't happen. heck I submitted a hypertensive crisis protocol and it was approved by our medical director 6 or so months ago and it has yet to be implemented. If I listen and harkin back to the presidential election rhetoric the words "Change, something we can believe in" just never made it into my organization.

First off, my condolences to the family. Having a member of your family die of this disease is terrible and sad but I always say "WE all die someday, some sooner than others, others not soon enough" here is karma for ya in 2004 when the dem's in the mass government thought Kerry might be the next president they changed the law that would allow the governor to appoint who he wanted to appoint and changed it so there needed to be a 145 day waiting period and then a special election to elect someone to the seat. At that time Mitt Romney was the governor and the dems knew that he would appoint a republican which would have ended democratic reign in Massachussetts for a long time. He would have appointed a republican to replace Kerry. Fast forward 4 or so years and we have ...... Well Kennedy spent the last several weeks of his life trying to get the current democratic led state leaders to change the law back so the democratic governor can appoint who he wants to appoint. The republicans are fighting this tooth and nail and say that the dems should have to live with their decision of 4 years ago. To change it now per people in the know "sparks of hypocrisy of the highest order" Unfortunately the mass legislature and the governor are controlled by dems so I see this getting changed again. But for now, that decision to make the change has bitten them in the ass. ROCK ON I too do not respect the man. I respect that he was a senator but that should not make him to be above all of us. How many people who died on the same day are being remembered as he was. One of the only reason that he is being remembered like this is that he was a Senator. No one else who died on that day are being remembered in the media. sure the man did some good things for Mass like bringing home the PORK PORK PORK but he also had some things that were not worthy of the respect that everyone is being given. The main one is chappaquiddick, anyone who would go off and leave a woman or a man drowning in a car does not deserve respect. He left the scene and his cronies for both him and his family made it go away. Yes they did, do not deny it. You or I would have been charged and imprisoned for what he did but since he was a member of Camelot (stupid name if you ask me) this Mary Jo incident was swept under the rug and he faced no consequences nor any political consequences for his actions of that fateful night. I respect that he was a senator but that's the extent of the respect.

Screw the union, this is just another tactic in their vast array of stalling and delaying tactics. I think unions are useful to a point but..... Can't they get something like a contempt of court or like congress does "contempt of congress" but that is all over the place now. Even some of my most staunch democratic friends have a contempt towards congress. Maybe after a while Congress will get into this debacle just like everything else they shouldn't be involved in. Oh crap, I've been monologueing (sic).

He might want to model his new website after this one. This webmaster of this site ROCKS! He sure knows his stuff. Maybe he might want to contact the webmaster here and ask for pointers.

the problem is that if it took this many drugs to get michael to sleep I think it's safe to assume that he was taking these medications for many many months if not years. He more than likely developed a incredible tolerance to this stuff and the doctor (idiot) had no problems giving him this much stuff. In our Er, when we give the amounts of drugs that were given to Michael we assign a nurse to be with that patient one on one. That's the only patient that they get for the duration. RIP Michael but I can't say I was surprised at this turn of events.

He's dead move on - nothing more to see here. I still am waiting for him to be buried and then the lights go dim, the thriller music begins to play and here comes Michael clawing his way out of the ground dressed all to his thriller days get up. "Thriller, thriller da da da da da dada" Now that's what I want to see. But seriously is anyone surprised by 4 mgs of Ativan, 10 of valium, X amount of Versed and then 25mg of Propofol that he was unconscious or *gasp* dead.

Seconded and passed. She is HAWT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Dust, are you saying the sanction comment is that referred to the policy that they won't put in effect? I'm sure you are correct but this is something that has never been a problem in the past. I don't think that they will make an example out of someone because there is only one person that I know of that does not bring equipment into the scene. If there's only one person doing it wrong is it wrong to make an example of that person? If there is only one person who's care sucks is it wrong to deal with that person one on one? If only one person does something wrong, for example gives 500mg lidocaine versus just 100mg and no-one else does then by your example we not make an example of them. I don't see it as picking someone out to make an example of them. I'm saying that that person needs to be sat down and discussed the ramifications of their not doing something that everyone of us in this organization is doing correctly. Not saying fire them but I'm saying to get them on the same page. I have an idea as to why this person is doing what they are doing and it stems from past employment but I can't make a case that that is the true reason. Maybe they are lazy but I think there is something more to it.

Matt, that is hitting the nail on the head. Hard to be a medic in a house without equipment The medical director was not so happy. A policy will not cure this problem. As if the person goes in without equipment which common sense would say they should, what makes me think that they will go in with equipment after the policy is implemented. It's only them and their partner on alot of the calls. No accountability Sans means "without" Like Sans Equipment "without equipment" I let the medical director know of the issues I had, I will let them investigate and figure out the other stuff. I've done my part. I did tell the medical director that if I heard of this person not bringing in equipment and just bringing in a refusal then I was going to the state and he said for me to do that. He was on board with that. Our medical director is a great doc and I have become quite good friends with him. Not good enough friends to where he would hesitate to deal out discipline to me but I rarely do anything that would put my licensure or my self at risk. He's the kind of medical director that if you do it for the benefit of the patient and you can justify why you did it then he will back you unless it was illegal or immoral. I'll keep all posted on what happens from here on out.

No way is this discussion of a policy on what equipment to take in will hold or even be set up. Our service prides itself in allowing our medics to work autonomously and every one of them sans one takes at least a med bag or all three pieces of equipment (bag, monitor and oxy) in on EVERY call. It's just this one person. I'm not going to go any further into this discusion on the "lazy" because of several aspects which I cannot discuss. Thanks for everyone's input.

The distance issue was asked or pondered in my second post on this thread. If the distance of the ALS intercept by this medic was further than the distance that the ambulance was from the hospital then would the patient have benefitted from ALS intercept by the on call medic. Was the fire department that the emt's used onthis call on the way to the hospital and was it less time to get them there to meet you than it was to get the on call medic. I know that many times one person may be at the center of the county and you are either at one or the other end. You are heading away from the center of the county (using my service area as a reference our hospital is in the center of the county). You are on the way north to the hospital north and the medic that may be requested will have to drive to catch up to you. Not saying that this is the case but it might be. The key question to ask here and I think it's the only question right now to ask. We need the medics side of this. What is his side of the story since all we have are interested 3rd parties and the medic has not spoken. The key question is this - Did this patient suffer from this medic's refusal to respond? If the patient did not and the patient did get the care needed then we need to realize that in the end, patient care truly did not suffer. If the medic was basically in their way on the way to the hospital and the distance was negligible then discipline should ensue. Discipline should ensue either way but the level of discipline should be appropriate. I'm a patient advocate, I advocate patient rights every single day. If the patient was taken care of and given the same level of care who really cares which person provided the care as long as the care was appropriate and correct. If it would have taken longer for the medic on call to get to the ems crew than it would have taken for the fire department to get to the patient then closer wins!!!!

fair enough. I wasnt' of course questioning your involvement but merely pointing out that as someone who wasn't there you or anyone else may not have all the information which you prove so far because the medic hasn't responded. This was by no means a question of why you were involved. I think a impartial (hopefully you are) second party is very important in situations as this. Too many times we allow our personal prejudices get in the way of doing the right thing or doing what should be done. It's human nature to not want to cause undue harm or duress to a friend or co-worker. If it all comes down to the way it really happened, what is your departments disciplinary process in dealing with a situation like this. Has the medic in question been written up on the previous incidents or did people just bitch and moan about them. Remember, if it's not written down you didn't do it in your care of a patient and this applies here as well, if the events or problems are not written down then they didn't happen. You need to have a good paper trail on this type of thing. Good luck, I hope the correct outcome happens.

So what would it take to break them of it? Is it something that requires one of those Holy Shite moments like entering a house on a chest pain or back pain and the patient being in cardiac arrest? Having to go back to the rig to get your equipment because you were too lazy to bring it in and the patient is critical? Or does a patient need to file a ethics complaint or some type of complaint with the state for negligence? I'm just curious how some have broken attitudes like this?

what most people don't realize or know is that McDonalds should have gotten sued for this incident that happened to miss stella. Many many burns had happened to customers because McDonalds at that particular restaurant had their coffee at nearly 200 degrees. they had been asked repeatedly to turn the temperature down on their coffee and they refused. There were over 100 complaints of the coffee being way to freaking hot. There were many employees who had suffered scalding burns from their coffee at the restaurant while serving the coffee to patrons. McDonalds at this particular restaurant refused to decrease the coffee to below 150. Stella sued them and she won. on the order of TMI here were her injuries Her injuries included 3rd degree burns to the groin, 3rd degree burns to the labia and 2nd degree burns to her inner area. She from what I understand suffers pain to this day. She also suffered 2nd degree burns to her legs and inner thighs. so yes, in this particular case McDonalds deserved to finally be sued. and guess what, they turned their coffee temperatures down to 145 or so degrees.

How do you deal with Lazy providers? Those who walk into houses with no equipment and a refusal in hand? Late calls that the medic doesn't want to run and they already have a refusal of service in mind for the patient? For example - Call to a person who choked on formula. On arrival medic on ambulance tells the medic first responder "why didn't you cancel me, I get off at 7am" call came in at around 6am. Crew begins to go in the house with no equipment. Medic sends emt back to truck to get monitor and refusal form. No other equipment was brought in. No drug bag, no oxygen. Originally no equipment but the medic decided to bring the monitor for a pulse ox. First thing out of the medics mouth before she even saw the patient was "baby's ok" Family heard the cancel statement outside the house. (uncle heard this) Medic got a refusal and I'm not saying that a refusal was wrong in this case but from the first responders on scene her decision to get a refusal was already made even before she got out of the ambulance. How do you break someone of this type of mindset or do you???? if this scenario sounds familiar to someone on this board then maybe it should and you should take it to heart and change your ways.

Ok for starters, at least the patient got ALS care. As for the medic in question, they are the on duty on call crew so they are responsible for responding. Their response is their responsibility and they are in the hot seat which rightfully so. I would let the state investigate this as it sounds like they are. If there is a pattern with this individual then department policy should be followed and discipline should rightfully follow. Unfortunately you are a interested bystander and you really only have input as far as the chief has asked you and since you were not there I would be reluctant to become very much involved unless you have witnessed this type of behaviour before firsthand. Otherwise you become just a material witness with hearsay evidence. If it truly happened the way you say it did then I would allow the wheels of discipline turn the way they turn. You cannot really get involved if you were not there on this particular call. What you have to keep in mind is this, and I'm not saying this is what did or didn't happen but remember that many things get blown out of proportion on calls like this. Did he truly say this or did he have other things to say. Would it have been quicker to get the patient to the hospital than it would have been to get him to the rendevous point? Would the delay in getting this particular person to you be more than the time it would have taken the bls crew to get to the ER? Did the medic actually say what he said or was there more to the story/phone conversation that was not relayed to you. I'm sure your medic has a side to the story that you were not privy to. There are a lot of unknowns on this so I would be hesitant to call for his head until the investigation is concluded. If indeed it truly went down like you say it did and that is proven then by all means discipline up to the level allowed. If not then a different tact needs to be taken.

I don't see the difference Scantily clad fire fighters or scantily clad waitress? Where do you draw the line that one is acceptable and the other isn't? The only problem I see is that the girl was holding a department gun and I think that's out of line. But seriously where is the difference? oh hang on I do see the difference, scantily clad firefighters for charity = OK but scantily clad waitress for just fun reasons = NOT OK but....... scantily clad waitress not holding the gun but laying on the department car and for charity = OK I get it now. How dense can I be??????

Vent you've taken some significant heat from people on this forum and I understand that you might have thought I was singling you out for criticism but you were not even on my radar as to the judgemental issue. You were not the subject of my criticism.

but that is what we do on these forums. We jump to judgement without knowing the entire amount of facts. That's why some people do not return to these boards. They consider many of us too judgemental or quick to pounce. I'm as guilty as some here but there are others who are very very quick to judge.

you need to get a picture of your hotness posted here. Some people think that since all the guys who were at the party in Orlando were over 40 with the exception of Matt that we were just some horndog guys who think any girl is hot.

non-fire based ems show - aint gonna happen. I'm sure that the IAFF is pushing this show big time. as for the previews, over the top and it makes me just not want to watch it but I will watch it and then critique it the next day. No armchair quarterbacking becuase I'll have watched the show.

I never disputed that the right decision was made. I also know the wholesale destruction and death that an atom bomb brings. The decision to drop it was good but it's not one to take lightly. I think the A-bomb is one of those weapons of last resort and if all other options were explored and used and the a-bomb needed to be dropped then by all means drop the sucker and go on. But to wholesale advocate to drop the bomb on Iraq, or Iran or Israel or whatever country that we have a conflict with just because we can and just because we have the bomb is a stupidly ludicrous statement to make. My grandfather did not serve in the military nor did any in my family and for that I make no excuses but to make a statement that had we not have dropped the bomb on Japan when we did then none of us would know our grandparents is a blanket statement that is wrong.

But what about the duty to the patient you were taking care of first. It's not like you can just say "Oh the original patient is dead so I'm gonna work on my partner" What a conundrum. Not a place I'd like to be put in. But if Spenac's most recent post of getting a pulse back is true then who's the more viable patient? The one who has a pulse or the one who doesn't. You would have to treat it like a mass casualty incident where your personal resources are overstretched which they are and you treat the one with a pulse and do not treat the one without a pulse. I truly understand the partner thing but it's a very bad situation to be in. I would think the family would have a very good shot at a settlement or judgement if you just stopped working their loved one while you tried to save your partner. I'm not sure what kind of help the guy had but if there was help there then he should have been able to treat both patients until a 2nd ambulance got there. Seriously, isn't this what we are trained to do? Treat multiple patients at the same time. It may tax our resources but we do this all the time don't we? Now if you are all alone with you and your partner and you are already working a code you do the best you can.

but this woman was under the influence when she got in the ambulance. This should have been reckless homicide but I wasn't there and I can't truly pass judgement but I can say that she needs to be held accountable for this action.

Isn't thiis type of behaviour what our soldiers and past soldiers went to war for? That's what you hear about all the time, Soldiers going to war to protect our freedoms. I don't agree with these types of people or their groups but I will allow them to do what they do (peacefully) if it allows me to peacefully express my views.