Just Plain Ruff

Tinshee, (sorry I edited out my comment for sarcasm) but I digress Tinshee you speak truth because that is what most services have a paramedic and an EMT but 2 medics are better because codes can be run without having to have the lone medic do all als procedures. the patient benefits from two medics. But if your service has only one medic and one emt on the truck then that's the hand you were dealt. But to point out what you pointed out in your statement above, was just pointing out the obvious. I for one would rather have 2 medics working on my loved one but if all you have is a medic and emt then I'll take that. To have two emt's working on my loved one when there is room in that system to employ paramedics and they don't then that's just unconscionable(sic).

Ventmedic, that was just my point during my rant. Who are we to judge who we transport to the hospital on doctors orders or just the patient wanting to go. To them, we are their ride to the hospital and to judge them is human but to make a big deal out it is just counterproductive and will make you a cynical or negative medic over a period of time.

ok, so what as an EMT can you do for a dialysis patient who "Codes" on you? By your reasoning, they actually should be transported by 2 Paramedics who can actually do something more than bag the patient and perform CPR.

the thing I want to ask is this in regards to nursing home calls or other bullshit calls and here is where my RANT starts "How do you know it's not an emergency?" The physician knows certain things about their patient that you do not. The physician knows if a certain patient is a brittle diabetic who's sugar crashes at the least opportunity and wants the patient at the hospital to manage this. Who are we, as medics and emt's to judge what the physician says about the patient. To do this don't we put ourselves on the same level of a physician? I know that my grandmother has certain things that cause her to get pneumonia. Allergens, chemicals like soaps and such and then just not keeping covered. When she starts to have a fever and that's all it is right now but you just know that within a day or so she's gonna have pneumonia, so bad once it required intubation. Who are we to 2nd guess the physician who knows my grandmother better than you who have never seen her. The arrogance of people in our profession who say that nursing home calls are bullshit and that the minor complaint doesn't warrant an ambulance. There are factors behind the scenes that you nor I know about. This is what I consider to be one of the most pressing problems in our profession. The providers with 120 hours of class or the providers at the medic level who second guess physicians and say that all nursing home calls are bullshit. Sorry but I'll say it again and again, if you don't like running nursing home calls, if you don't like running bullshit calls for the drunk who fell or other calls like that need to SHUT UP and do your freaking job. It's what you are paid to do, transport of the sick and injured and if someone calls for an ambulance and they request to go to the hospital, just put up with it and transport. If you don't like it then EMS is not for you. The problem will never go away, it will only get worse and to listen to this constant complaining makes me glad I don't work in ems as much as I did in the past. I know that this may touch on some nerves here from some but so be it. To hear it all the time and the non-stop complaining of those at the companies I worked for and to here it here just makes me feel sorry for our profession. I have no easy answers, I have no crystal ball nor am I as vested now as I have been in the past to fix the issues. At one time I would but my career now is away from EMS and frankly, I'm happier for it. RANT off so in conclusion, you can see where my opinion is at, agree or disagree with it but remember it's just my opinion and if you don't like it tough. I've had a long day and this thread as well as the Hate thread has just about made me sick of this whole deal. We aren't in high school anymore we are considered professionals here and to be professional we have to walk the walk and talk the talk and I can't imagine that posting what you hate and other negative comments make us professionals. Be safe, god speed and adios.

Offshore, I agree totally with you Yes I believe that we should partially play the eyes and ears for this but to mandate it would be preposterous to assume we should do it I think we should report things we see but a mandate is not the way to get it done.

A - activities M - Motives or machine guns P - people involved L - E - Equipment seen

keep the books. They WILL come in handy of that I am sure. Sometimes it takes a major re-evaluation of ourselves to get some good out of life. I have done just what you are doing in re-evaluating my self and it has strongly affected my ems career for the better. It has also affected my current and permanent career choice and I'm the better for it.

one time in band camp........ no wait, that was someone else.

sounds like we will never know what the issue was between this particular student and the instructor, the nurses and their fellow students and everyone else but (not them)........ I've seen a couple of people in this posters shoes and yes those people are usually the actual problem and not the other way around. I would go back to medic school at a different school and see what happens. If it happens like this again then I think you might want to re-evaluate the "i'm a victim" claim. Most of the students that were treated this way were one of the following 1. arrogant and bossy 2. know it alls 3. didn't take direction 4. interrupted all the time 5. just plain unlikable 6. not cut out for ems Maybe the reason your instructor told you to go away was that they were there on personal business and you interrupted. Some instructors do not like to be bothered on their days off. Heck maybe that instructor was there to hit on the nurses and he/she felt you were intruding. I"m sorry but questions are usually left to be asked during class time. AS an instructor in the past, I gave my home phone number but I let the student know that unless it was a question about a clinical or a problem with the class I would take questions during class. I even had two hour office hours before each class. That's definately enough time for students to come in and ask questions that they wanted answers to.

this idea is about as bad as the police using medics as officers on hostage situations. I remember the fire department that was used to go to a house (some type of crime was committed there) and used the fire department as a ruse to enter the house. I can't remember what it was but the fire department came under fire for that one.

ok thanks I didn't realize that. I suspect then it might be a foriegn body in the thigh that got infected but that is really a lot of pus.

Doc, would this amount of pus come from a septic joint?

I'm also thankful for Scarman's avatar. It rocks. but seriously - I'm thankful for so much that it would take up an entire encyclopaedia to post it.

We had a post about what we hated about our job and it was a depressing thread so let's liven it up a little. What are you thankful for in your job? In your life? It can be anything that you are thankful for. I'll start I'm thankful that I have a job that I really like and it allows me to travel to various parts of the country. I am thankful that my wife and son can come with me anytime I want them to, to visit me and the city I'm currently in. I'm also thankful for my wife and son.

I go to my 5year old and we wrestle or box. he usually kicks my butt(I let him) but that is my stress relief. Or I ask him to tell me why the sky is blue and his response is usually classic.

I would suspect without seeing the rest of the leg or knee that there had been some sort of surgery on the knee. I would suspect that the knee repair had gotten infected and this is the result. but EWWW can you imagine the smell.

actually L&S was only a small portion of our discussion. I, 911emt911 and aussiephil and others were discussing the validity of the golden hour. some statements were made that I think made 911emt911 uncomfortable because they had never heard the statements. the main statement we made was that the golden hour was a number that was consistently given to the public and ems in order to necessitate the need for more trauma centers. It was our position that this number was a arbitrary number and I believe Aussiephil referenced the 3 stages of dying, immediate, hours and then days. Correct me if I got that wrong phil. So it is my opinion, and my opinion that the golden hour is a mantra similar to global warming. If you don't sign on to it then you are not a good medic. That's not true at all. I worked in a rural area where the golden hour is often used up just getting to the scene. Traumatic injury occurs, takes 2-10 minutes to get the call, then 30 minutes to get to the scene and then packaging the patient for transport and then transport takes another 30 minutes. That's over an hour and their "Golden" hour is shot. I've had many many patients who by the wisdom of the golden hour theorists and believers, those patients should have died because they did not get to definitive treatment but I saw those patients walking around out in public many many times. So the golden hour isn't golden. Now before those of you who are going to nail me for my opinion, I can almost guess where your criticisms will come from, "MIke, they must not have been hurt all that bad" or some other statements. Remember this is my opinion and my opinion only. I believe that the golden hour was used a lot in the past to justify additional trauma systems and centers. I also believe that those who came up with the Golden hour also had a vested interest in keeping their trauma center especially when we all know that trauma centers lose money not make money. (what else in EMS or medicine makes money) So this is my opinion, I have no real stats or sources to back it up but I do know that the Golden hour has had some good things come of it like having trauma centers to send patients to, making ems decrease their scene time in order to get them to definitive care. But let's discuss decreasing trauma scene times, many times on a trauma where I worked, it was myself and my partner. Doing everything in under 10 minutes often was impossible. Rushing thru things also makes you miss things and possibly further injure the patient. Just my opinion

Cap, I tend to agree with Dust, your post here has been spot on. I could not have said it any better only differently.

whew, Capman, that was about the most veiled insult to connie I've ever seen. kind of calling her stupid weren't you with the comment I like to treat the patient with my hands and my brain. Kind of arrogant if you ask me. and just so you know, I stand behind connies statements 100% - of the 5 times I've been assualted by patients they have all been psych patients. Go figure. And yes, I think if you ask the seasoned medics and emts here who have been doing this for 10 or more years, you will find that many agree with Connie.

never said that. What I dislike the most though is a partner or someone who I work with bitching and moaning about something. Unfortunately you are correct, all jobs have aspects that we all dislike but to hate every aspecte of nursing home calls which 100% of them involve nursing homes, then that is a unfounded hatred and really calls me to question whether it's the nursing home that the person hates or is it the fact that they are going to a nursing home when they could be running a "cool" call. This is no way directed to the poster who said he hated every aspect of nursing homes but it is written to make a point. You can dislike nursing home runs but to "hate" them is just foreign in my book. Hatred is a very intense word that should be left to more bigger things. I have felt the intense dislike of nursing home calls. I have felt the dislike of nursing homes when in the middle of sleep time they are calling us to go get someone who has pulled their foley out or pulled their j-tube out. A Strictly outpatient procedure that could be done in a docs office or at the OP clinic and should not require a 4am trip to the ER. I've been there in that aspect. But what really gets my gall up is a partner or co-worker who complains and bitches about hating every type of call that comes out unless it's trauma or a car wreck or a code. Those people get me down and I just don't want to work with them. It's one thing to dislike a type of call or a type of aspect of EMS but to put a word like Hatred towards defining it is just not the right slant on things. And yes, I have plenty of consultants in my line of work who hate some sort of aspect of their job but we are adults. The word Hate and the "attitude" of hating some sort of aspect of the job should have been left on the doors of high school. If you hate an aspect of your job then it's time to look for other work. It will only get you more and more bitter and make you less of a provider. And if you hate something then you cannot be completely professional no matter how you want to sugar coat that you are. Your attitude comes out, not so much in spoken word but in gestures and unspoken things.

what I hate are partners or co-workers bitching and moaning about having to take another call or a transfer. I also hate people who bitch and moan about doing the job that they were hired to do, be it running calls, taking care of grandma or whatever. I've seen it all before, I've been there too but people, get over it if you want my opinion. If you hate doing the job or parts of the job enough to complain about it here then maybe EMS is not your cup of tea. Just be glad you have a job to go to and to hate.

Strippel wrote "We take a decent percentage of our customers to triage. There are many regulars, and people with small boo boos who call" So let me ask you a question - who's idea was it to call your patients customers instead of patients. Is it your own or your companies idea? The reason I ask is if it was your companies idea to call them customers instead of patients then your company must be employing someone who came from the customer service arena. I'm just curious where you got the idea to call your patient a customer. no slam on you, just a question

www.bobcox08.com Go there and look at his platform. There's no freaking way he will even be a serious candidate because he's so unknown but I like him.

I can't believe no-one has mentioned the Milli Vinilli cd in his hand.

Let's ask the public what they want. Other than the fact that the public doesn't know what the hell it wants let's ask them. I thought about this question and post and said to myself. If I had a choice between a responder who could only put me on oxygen and take me to the hospital providing strictly bls service or I had a responder who could reverse my CHF or fix my critical blood sugar level or give me medications during a anaphylactic reaction. Which would I choose? I of course would choose the latter. I'm a little biased but I can almast guarantee that anyone would want the latter. unfortunately when you factor in cost of providing and ALS service versus a BLS service then the public (naive as they can always be) will choose the BLS service because it's cheaper. Again, the lack of education of the public needs to be taken into account here and addressed. What usually happens is someone in power, like the mayor or a prominent citizen suffers an illness or trauma that a ALS responder would have been much more able to handle but instead is treated by a BLS service, then the system will more than likely change. But until that catalyst occurs, until a situation where a ALS provider could have made a tremendous difference in the outcome of that particular citizen then most communities will blissfully sit back and say "As long as it doesn't happen to me, then I'm happy with the status quo" Ignorance is bliss