Just Plain Ruff

I am not in the arena where bls should not be dispatched emergency. I also agree that (brent forgive me) many dispatchers couldn't claw their way out of a paper bag let alone get a correct history from a caller. I thing that bls calls should also have ALS behind them for just the above reason. How many times have you gotten called to a sprained ankle and it be something more? Or called to a man down but conscious and it really is a code. And don't get me started on nursing home calls. OY VEY. But I think that ALS should be dispatched with bls on all calls until the bls crew calls and cancels als. But if you don't have the resources and all you have is 1 als unit and several bls units then that's a moot point I believe.

that was my question that I asked. i have a number of colleagues who believe and some of those colleagues are on this site, they do not believe that a bls ambulance has any business being dispatched L&S unless there is an als ambulance behind them. That's why I asked my question. so again, I ask you, was the What ever !!! comment directed to that question?

Traumaking, was that Whatever smart ass remark to me? I hope it wasn't.

ok let me ask a controversial question. Which I'm sure will bring some wildly heated and probably angry responses. Should bls ever be dispatched emergency?

i had a guy who got hit by a metal object in the head. We boarded and collared him, oxygen and IV and routine transport to the ER When the CT was done he was diagnosed with a linear skull fracture 3 inches long with air in the skull. He was CAOX3 and was joking with us all the while in the ER. We flew him to a trauma center and he expired a day later due to a brain infection. a laceration is all my guy presented with too.

what makes you think that the drunk who has parked his car on the sidewalk is a BS call? I'm not sure what else to make of your single sentence other than the fact that dumpster fires are more important than the drunk.

Anthony I used that as an example of what makes me chuckle. Traumaking, I was working with the red cross and I knew the dispatcher who took the call. I called in on their non-emergency number and said I told him there was a dumpster on fire and then we shot the sh*t for a bit. I heard him dispatch the call. As a matter of fact it was the same crew that I just finished working a fire with and helping the fire victims out with red cross assistance. He dispatched the call as a non-emergency run for a small dumpster fire. They still ran emergency. It made me chuckle, I wasn't criticising them at all. Don't get your knickers all in a bunch. Plus, your paragraph was really hard to read.

reminds me of the calls from our dispatchers telling us that the patient is a full code. we get there and the patient is sitting up in the wheelchair. What dispatch meant was that the patients code status was full code.

I guess what I'm asking is why is it so different around the country? What do we think the reasons for one area going L&S all the time and another area being very limited on this? Is it lack of training? Is it that the ones going L&S all the time just have not been in a significant accident to where it requires them to re-evaluate their position on this? Lots of questions in my mind. My opinion, of course you know you were going to get it, is that there are very limited reasons for us to go L&S. It's proven to not save time, or just save a minute or two. It's proven to be a liability and dangerous. What about the services who use the lights but not the sirens. Can you say dangerous. One thing that really always made me chuckle is the fire departments. I called in a trash fire in an isolated dumpster at 3am(don't ask why I was up so late and driving around). About 100 feet from any building and the top doors that cover the dumpster were closed so all you saw was smoke and not fire. The fire department responded with Lights and sirens and their station was 3 blocks away. I had to laugh. The fire departme

doesn't know jack

To further this discussion: I've spent 6 months in Miami at the busiest trauma center in the country(some would argue that statment but the hospital is who says it) and every patient that I saw bringing a patient in woudl come in hot. I watched them many times and the patient was no-where near critical enough to warrant L&S. I spent 1 year in Tampa at Bayfront Hospital and 1 in 100 or so ambulances came in hot. In Queens New York at the New York Hospital Queens every ambulance came in hot, even the ones coming in to get grandma for a transfer to the NH. I think it might be a New York thing. In Patterson New Jersey, at St. Josephs Hospital they all came in hot it seems but that might be because it was so unsafe anywhere in Patterson that they wanted to be a moving target. In Colorado Springs, AMR is king there. Limited L&S. Olathe, KS - Olathe Medical Center - limited L&S too. Detroit Michigan(11 months assignment) limited L&S but these were smaller hospitals and not actually in the downtown area of Detroit. Dubuque Iowa - 1 week assignment - limited L&S So what are these statments saying, Why in some areas they run hot all the time and others they rarely use it? I do not know that info. I think this is a good topic to discuss.

I spend a lot of time in Jacksonville and my office is between Baptist hospital (quite a good hospital with almost every service you can imagine for adults and peds) and St. Vincent's Hospital with nearly the same facilities. Neither are trauma facilities. What I see is a lot of transfer services (Century and others) that run l&S many times. I have seen BLS Century ambulances running hot on the highway which I just don't understand because Century has a lot of ALS ambulances I believe. I have close relationships with some ER Staff at St. Vincent's as well as St. Luke's hospital here in Jacksonville as a matter of my job duties. None of those contacts I have say that Century and others have critical patients as often as I see them running hot. Heck, St. Vincent's has their own critical care transport units I believe so I'm not sure what the requirement for running hot is down here. I could be getting erroneous information but today I sat around my office day dreaming(should have been working) and saw no fewer than 10 ambulances of differing services from Jacksonville Fire to century to ASI(that's all I could read on the side they were goin so fast) that were running hot on the stretch of highway I can see. I have worked in nearly 11 different ambulance services and never have I seen so many ambulances (transfer ambulances I believe) running hot and this is a day to day occurrence. What am I missing here? Am I seeing things or is there truth to this? Is it just that the transfer crews are so incompetent or unsure of their job that any cardiac transfer gets lights and sirens or is it deeper or more problematic?

All patients eventually die remember Here's how a redneck gets to his funeral [web:3bc5d5ebc6]http://boortz.com/more/funny/redneck_pics_hearse.html[/web:3bc5d5ebc6]

my work firewall blocked it

Please define the following and please do not go right to google for the answers. By the end of these education pieces you will have a excellent reference packet for your flash cards. Indications: Contraindications: Dosage How Supplied Side Effects Drug interactions Warnings: Precautions: Pregnancy: Overdose and treatment of: Description: Clinical Pharmacology:

ok, let's discuss this a little further with a alternate issue. Let's say your service allows you to take a family member along to the hospital with you. Let's say that this is a 3 year old child and you are running hot to the hospital. Is there a place for this? What's the liability then? I remember a couple of calls I had. Both calls with different services. 1. elderly man taking care of his 5 year old grandson. He collapses and codes, there is no-one in the house to take care of the child. We need to get out of there and get him to the ER. Do we take the kid? 2. 30 year old mom, pregnant, has 2 children in the house. She seizes, status epilepticus, we are out in the boonies with just myself, my partner and the ambulance. Her one son called the ambulance. Sheriff is 30 mins out. Nearest neighbor is a 1/2 mile away and we don't know the number. We took the kids against policy of no riders. We got a stern talking to about breaking policy. Do these kids warrant an exception in having them in the rig. I know they are relatives of the patient but if we go down the road that many are taking then we would not have taken them? Thoughts?

Might be hard to prove hippa violation. IF the child is present with the patient then that might be provable but if the child is not in the room with the patient probably not.

plus there is a good chance that you may get a hole where the ribbon is if you go into combat. If there is a hole where the ribbon was, then it defeats the purpose.

Well, STOP IT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! :roll:

Grammar and spelling and the use of spell check, what the heck are you talking about. Is there such a thing as what you refer to? I thought we all talked and wrote like that. I am constantly reviewing my typing and my grammar and sometimes I miss things but some of these posts lately have been headache inducing. See those two little words at the bottom right of where you are reading right NOW That's spell check. Use it, learn to love it and you won't get criticised nearly as much.

Dang it Spenac, stop that.

Standardization of the Paramedic basic standards (education, training, licensing, competency maintenance, medical oversight, leadership) may have to come before "standard of care" will really be adequately defined Leave it to Vent to sum this entire discussion in 25 words or less.

I'm going to submit a eye injury quiz based on a article I wrote for a journal. I'll submit a scene safety quiz after the eye injury quiz.

ok, if you do it all on line how do they verify that you have taken all the classes. I'm not registry numbered or certed so I don't know how they do things anymore. Do they still go on the trust system and if a question arises or a desire to audit then you have to show the certs?

Dust, your math needs some work. 22 - 10 equals 12 supervisor units. Still seems top heavy that's one supervisor for every 3 ambulances.