Just Plain Ruff

I hear ya doc but let me give some more info for you the car wreck happened 25 miles away from the nearest hospital. I suspect that the patient was not dead much longer than when they got their because the fetus was still beating away if I remember right the rate was around 160 or so. There was no way a physician(surgeon) was gonna make it there in time to save the baby by cutting it out. I guess they could have switched places but they didn't.

if he is a tree trimmer does he use a harness? if he uses a harness could the harness not have impinged on a nerve in his leg or pelvis or hip? If so, then let's do an MRI of the lumbar spine, the pelvis and the femoral area.

What you guys seem to be missing according to my information was that there was also a on scene doctor outside the car. there was just no time to remove the first provider since he was under the car and it would have cost valuable time to replace the first provider with the physician. the on scene physician also gave orders to do it. The on scene physician was on the radio with the base physician. I know no more of the procedure than that but I know that in the end a viable, healthy term baby was delivered. Would I have done it, maybe so, I feel competent enough to do this type of procedure but in the end it was a judgement call and the judgement of two physicians and one very experienced medic should be questioned but allowed. Mother was already dead(head 3 inches thick) so what kind of damages was she really going to suffer - that she wasn't presentable at her funeral????

so why did you restrict your profile on myspace to private? It sounds like you did that right after one poster pointed out your pictures. If what that poster said about your piercings and goth appearance, I'm appalled you lost the popularity contest. SHOCKER

And that qualifies you to manage people? I was a boy scout too and I got my eagle scout. Sorry to be so blunt but you came here bitching about your service passing you over regarding a 2nd lt position.

there is still time for you Ames. Pm me and I'll get you hired on this week.

sorry to burst your bubble but he's not my hero. Far from it, he's done some stupid things but in this I believe he did the right thing. Please don't make assumptions on my behalf. It just makes you look silly. I also never said that the doctor was scared to do it. My friend was in the ditch with the patient and the doctor talked him through it. Maybe I didn't give you all the particulars but please refrain from putting words in my mouth. You don't even know me so you have no idea who my heroes are.

I went to his myspace page and it's set to private. Can't see what his pictures are.

The first step you have taken, you realize you don't want to be like one of those supermedics and as long as you know this you will do what you can to avoid it. Just remember, there are always brighter, smarter and better medics than you will be. I know that there are better medics than I am so I am in all appearances Humble. It's just like Tae Kwan Do(spelling) if you are a 4th degree blackbelt then there is always a 5th degree blackbelt to teach you humility. Don't get caught in the tract that you are the best medic out there. I know that there is always learning to be done and I'm not smart enough to know it all. You will sense it from people who think you are a know it all, their facial gestures will tell you the truth. Remember that the reason you are in this field is patient patient patient - everything else comes secondary. You are in the job to support your family and no job is worth the damage that this job sometimes does to families but when you are working, it is the patient.

19 years old and he's ready for a 2nd lt. position. Skeptical i am.

ArcticCat, you are missing the point. There was a physician on scene and also a physician on medical control What part of the medic not putting his brain in gear do you have an issue with? plus the mothers injuries were so severe, her head was about 3 inches thick after being crushed by the car. I think her injuries were fatal don't you?

I'm not much further north of you buddy, maybe a couple of longitudinal numbers but i'm no-where near the great white north.

Your treatment is correct. But as for your comment about the medic going outside his scope of practice. the mother's head was trapped under the car, no fire department on scene yet to get her out. There was a physician on the scene but he was not prepared to cut the baby out but this was a very seasoned medic. The physician and the medic both did this but the medic was the one who cut and delivered. The state of missouri came in after this (remember this was over 25 years ago) and did an investigation and found that while this was out of the paramedic scope of practice they found that the benefit of doing this (live baby) versus not (dead baby and dead mom) outweighed the situation at hand. He was actually recognized for heroic measures and the director of the state of Mo EMS was in attendance. So even if he was out of his scope of practice it seemed that not many people had an issue with it.

i have a close friend who did just that, got orders from medical control to cut and deliver the baby. The mothers head was crushed under the car yet the baby still had a good heartrate. He delivered a baby, and the kid is still alive today. I would contact medical control and go from there.

in this day where anything can be construed racism if it is directed at a black child what the hell what this dumb ass teacher thinking. The NAACP is involved now, i'll bet Jesse Jackson and Al Sharpton are on their way to lead marches and have prayer meetings. The teacher is a freaking moron and should have known better.

ok this program we are looking at starting is more of a "hi how ya doin?" kind of check rather than welfare checks and review of their living situations. We have the support of our social services department and they will take the reigns of the ones we bring to them. It is also to cover our butts on welfare checks when we are looking in on our regulars and administration gets a call saying the ambulance was on our street and we don't want the disruption type calls. If you know what I mean. We have a few select patients who are strictly attention seekers and are good people and if we can "smother them with kindness" if you get my drift we think that they will stop calling. We will be getting guidelines and some training on what to look for when we are doing these so called "welfare checks" so we won't be hung out to dry. After talking to my EMS supervisor he says that this will be like 1% of our total duties when not on calls. thanks for all the input.

In central MIssouri. PM me if interested. We have two paramedic and two emt positions open. The coverage area is Henry County Missouri (largest city Clinton MO) PM me if interested.

but if that fractured toe throws a marrow emboli to the lungs and the patient dies, what happens then? hey it could happen.

fair enough, I knew it wasn't directed at me.

Jeminy Christmas guys, if you don't have anything constructive to add to this thread then just stay out of the thread. edited to take out my last comment

well it's not in effect here yet but it's not really follow up visits, but more like "Are you doin ok" in an attempt to decrease the number of calls from these patients.

Ok, we have a new set of guidelines starting in about 2 weeks. If we are the primary crew on duty and we are not on a call we are being asked to go to some of our frequent flyers to check up on them. Does anyone out there do that and if you do, what has your experience been with this? Many of us here think that this will bring an influx of EMS calls because oh what the hell "You guys are already here, so I think I'll go ahead and have you run me to the ER for a quick checkup" Anyone have any experiences in this area??? thanks

collective bargaining units are sometimes not too bad a deal for the worker. Just look at the auto unions, 78 bucks an hour to put together a car. ON the other hand, having a union at the EMS shop to somehow push thru safety initiatives such as sleeping issues is a great thing but there are many drawbacks of unions too. I'm neither for or against unions overall.

I prefer to cheat. nooooo seriously, I have always found that reading the material, outlining it, and then re-reading the outline worked well for me. At other times just listening to the lecture did just fine like for treatment of fractures and the like. but heart blocks, meds, 12 leads and many other things it takes repetition and writing it down, reading it and then writing what i learned down again that fit my bill.

I'm going to agree right there. If you are too tired to take a call then don't take it. IF a mistake is made and it's a sentinal event (in the hosp) or a injury or illness (fatal) to the patient then you must take the blame. No matter what blame you can lay on the company. I have taken myself off only 3 times in my career and all three were justified and no questions asked because I worked for a good company but those who work for these other companies listed that don't seem to care about their people being tired, I feel for you. I spent too many hours and days and too much blood sweat and tears to get it yanked because I was too tired to pull myself off shift and a patient died or suffered, it is my fault. I work night shift, 7p-7a and I routinely work with people who spent all day up the day before, they worked the night shift, then spent the day awake because they had stuff to do and now they are taking patients with 36 hours of no-sleep. This is a disaster waiting to happen. Case in point About 16 years ago I had a medic co-worker. He had worked a night shift, then got called in the next day to run a transfer. He then worked that night. At around 4:30 am he had to start an IV. He did. He was told to infuse a liter of saline with 40Meq's of KCL(potassium chloride). He put the liter to run and then drew up 40meq's of KCL. He was going over to inject the KCL in the iV Line via IV Push. I saw him going over and asked him to come help me NOW. He did. I asked him what he was doing with the syringe and he said he was going to give it IV. I pointed out that it needed to go in the bag and not the IV for PUsh. He then sat down and nearly cried. Had he have given the med the way he planned we'd have had a death in the ER. He told me he was so tired that he wasn't thnking straight. He took himself off shift and went to one of the empty ER rooms and fell asleep. This is just one example of sleep induced errors that I know of.