Just Plain Ruff

Ok, I hear both sides of the coin. But I have taken several steps back and evaluated what I would do and if I could take a life no matter what that person did and I find that I could not do it. We operate under the "oath" of do no harm. The being that I Have to answer to is God and I believe one of the commandments is Thou shalt not commit murder. I wonder what he considers murder??? Does he consider capital punishment murder (the taking of another life)????? I think I'll pass on the executioner's hood and face my maker with at least the knowledge that I didn't participate in executing someone.

I've sent you a pm and others have asked but we want to at least make sure you are not really dead. I understand how you can run off and not log off of the computer but I'm concerned that this might not have been a accident but some sort of foolish prank. The admin has told us what happened but we would like to hear from you. You have been conspicously absent from the forums which makes you look all the more guilty. Please let us know that you are at least Ok!

Let me ask another question, how many of us really want to deliver a baby in the rig instead of in a controlled area like a Birthing center. Now that being asked, inducing labor in the pre-hospital situation can only bring us providers headaches. We will have to be taught so much more on OB knowledge because we might as well just grab our ankles and say kiss it. Inducing labor in the pre-hospital environment is just a BAD IDEA.

that's all we're askin. You popped the question for us to list stuff we've done be they big or small. just remember, a journey of a million miles begins with just a simple step.

ACE I agree get your ass back in school and get your medic. But I think you have more important things to do in life and you have yet to start.

Imagine, I hear ya Maturity isn't always correlateble to age but it is a significant contributor. You may be mature for your age but you are in the very very very small minority. I believeyou can do the job and I believe you do it well, at least from what I can gather here. But you know, it's hard enough to get grown up medics and emt's to act mature as many of them act immature at times. But I would still be hesitant to let a 16 year old take care of me on a scene. I'd want to wait till an adult or someone older got there. Now if you are the only one then I guess I'd have to deal with it but not happily. Let's turn this around -------- Would you be comfortable with a 16 year old doctor performing surgery on you???????? because that scenario is no different than what we have discussed.

Holy crapola batman, where did you get that picture at Dad teaching his son the family business. He must be upper management as he's still alive. Pull the trigger kid, get rid of some of those zealots.

hey, wasn't that other Whacker from New Jersey too? Youknow the one, with 300 rotating lights and a 8 minute response time anywhere in the county? Wasn't he a whacker too?

GA that is exactly what I meant when I asked you. I don't have the heart to go back and re-read the thread, I'm really curious to what you have done. You say you've made a difference locally/regionally Please list them Maybe someone here can take it locally for their area. thanks

I read this article and yes med errors are a tremendous issue out there. No one has focused on med errors in EMS though. I am sure that everyone has had at least one drug error in the ambulance from giving Epi every 6 or so minutes in a code to a full major med error like grabbing the wrong medication out of the drug box. Other errors could be lidocaine to a pacemaker patient pulling morphine out of the narc kit instead of valium on a critical ob seizing patient 3 days past her due date Giving atropine IM instead of vistaril im Or nearly pushing 40meq of KCL to a patient via IV - not diluting it in a 1000ml bag of saline I've seen all these happen. so can we be more vigilent? Can we be assured that this will never happen to us HECK NO What we can do is educate providers more. Make the drug boxes more easy to navigate by having each drug in it's place and labeled with big black letters showing the med name. Make the drug companies be a little better in labelling. Case in point, the manufacturer of the potassium chloride bottles, the ones that have 20 30 or 40 meq's of potassium in them that are required to be placed in a 1000 ml bag of fluid so the drug is diluted used to have no warnings on them. It was not till about 8 years ago that the manufacturer had received so many reports of fatal drug administrations that they put right by the needle port in big letters MUST BE DILUTED did the errors decrease. They also decreased the errors by advising pharmacies to mix this stuff in the pharmacy and deliver it to the ER or floor. Deaths have dropped dramatically and only still occur because some hospitals are too cheap to buy either the pre-mix or to require their pharmacists to mix it up for the floors. Med errors can be nearly eliminated by doing the following things: 1. read the order 2. re-read the order 3. get the drug and read the drug name 4. repeat number 1 and 2 5. mix or draw up the med 6. re-read the med bottle or syringe and compare that to the order 7. Ask about allergies 8. Make sure the patient you are giving this to matches the patient who the order is placed on 9. Have someone you work with verify that the right med is what you are going to give. 10. give the med That's a lot of steps but what is more work - doing the 10 steps above or being named in a lawsuit and having to defend yourself after you gave the wrong drug and it hurt, maimed or killed someone???? Think of it another way - if it was your family member wouldn't you want the same vigilence done just as you would do?

As for telling the rookies what I did for ems I'll tell them, the same thing they will do for EMS if they stay in it long enough, I took care of patients, may have made a difference in someone's life, and came home safe every day so I could impart my encylclopedic knowledge base to them so they can take care of patients, make a difference in a few lives and go home safe every night so they can eventually do the same for the next round of rookies. If you want to make a difference and make changes then by all means go ahead and do it but I chose to concentrate on other models of making a difference and I have done my job. My patients have been happy, I've passed on my knowledge, and I've done my part for queen and country and my bosses. So GA let me ask you the same question: What have you done for ems? What are you going to tell the rookie?

What the heck is a pandemic summit? GA Enlighten us on that. Was it all about the flu or other things? I'm curious Also, didn't they also say Bird flu a couple of years ago was going to turn into a pandemic? This sounds strangely familiar.

Just so we can remember what started all this I put out the original post in quotes and in red so we can remember:: "I started a thread a few weeks back that asked what have you improved at your EMS Agency ? The results were miserable, hardly anyone could cite a single improvement. Atleast the Fire Departments can point to improved building code, reduced fire-deaths, and the overall reduction in actual fires. What can we point to: * Are cardiac arrest survival rates improving ? Seattle showed us the way to do it years ago, how many other agencies have stepped up to the plate ? * RSI is available in only a handful of communities * The ability to do lab work in an ambulance is now available through ISTAT, but only a handful of providers use it. * Have we impacted trauma deaths, which was our original mission -- probably, but hard to prove it is our accomplishment versus the surgeons. * There are many EMS services that do not have computer-based reporting, even though computers are cheaper than many of the other pieces of equipment we buy (stretchers, monitors, stair-chair) When the rookies ask what our generation did for EMS, what will you say ?" Actually, the results were not miserable. unfortunately if you really go back and look and review who consistently posts here, there are only like about 12-15 consistent everyday posters here. With the amount of views your controversial topics have gotten over the last couple of weeks it would seem that this number should be significantly higher but in my business we follow the 80/20 rule, 20 percent of the people do 80 percent of the work. I have yet to see on any of your posts what you have done to make EMS a better place and If I did indeed miss your contributions then please enlighten me now. Unfortunately here, I have seen you come in and post some pretty controversial topics and as Ace said, it seems that you are preaching to us about being complacent or not doing enough to get things done. Let me tell you a thing or two about what I have learned in my 15 years of working in EMS and now with my 5 years of working in ER consulting and seeing 40 different ER's in 12 different states. The current crop of people in EMS and also in ER nursing etc, are overworked, underpaid and underappreciated. They(me included) rarely have enough free time to spend researching things and trying to make things better. We have obligations such as WORK, Family and raising kids. I work 12 hour days consulting and on the weekends those are precious times that I do not work nor do I do research to make the EMS world and the consulting world a better place. My making the EMS And consulting world a better place focuses on two things and two things only - 1: taking care of patients 2: Making the client I work for have a cleaner, faster, better, quicker, more productive ER so they can go back to number 1 above: Taking care of patietns because I can make a educated guess that this is what everyone on this forum is here for, to make the lives of our patients better. I'll concentrate on my job duties and let the people who don't have the obligations that I have and that many others here on this site have make the EMS world better. Sure I have a lot of ideas to make things better but they have all been addressed, it's not my fault if they haven't been implemented in my area or your area yet. I think that the majority of this group understands and appreciates your idealism and enthusiasm yet a lot of what you have posted here in all your threads have come off as "insulting" and "preaching". I admire you trying to make a difference but to challenge us in a post to say what we have done and then come back a couple days later and say the response was "Miserable" that sounds insulting. I don't want you to stop posting these types of discussions because it makes us all step back and think but please decrease your tone in how you post them. They have all come off as "preaching"

I believe we scared this guy off. NO responses from him from this thread. Actually he drives a Yugo to the scenes but with his title HVAC and EMT I think he uses his flashy POV to get to his HVAC appointments.

Here's one: Everyone on this board develop a CEU class for their department. Doesnt' have to be much but it at least needs to be one hour at least in length so you at least get 1 ceu. Submit it to your EMS service and see if the education department (if you have one) can get it set up for ceu for your service or get it out to your states medics and emt's. M

well in KC MO when my wife was rear ended her bill was over 1500 bucks 450 base rate 5 bucks a mile iv, o2, monitor, c-collar and lsb and whatever else they used about 1580 bucks. GA you're cheap at a county service (major metro area) for residents it was quite cheap about 100 or so, for non-residents much more expensive At the small county service I ran - the bills averaged about 400-1000 depending on what I did At AMR in independence about 10 years ago the rate for a als call was about 1000 or so At the other small service I worked for our average was about 500 per call ALS

you must not be in the 80% who have tried it. I have not either but it's on my to do list on Saturday

I agree. so out of all the suggestions where do we start. What do we consider the top issues confronting EMS in the current scheme of things.

First off welcome to the city. And second - HERE WE GO AGAIN!!!!!!!!!!!!!!!!!!! Second, remove all that stuff from your vehicle. What kind of insurance are you using to cover yourself in an event of an accident when you are responding to a call. If you are relying on your personal car insurance to cover you if anything happens, then you are going to be completely screwed if you think your personal car insurance will cover you. I'd call your agent RIGHT NOW and discuss this with him and find out just how Uncovered and vulnerable you are. Third, why are you responding to calls? Are you a responding to emergency calls as a first responder in your car or are you a EMT that has to respond to calls in your car. What kind of coverage does your area have, paid providers or strictly volunteers? by the way, my car has a sunroof also.

any pill bottles lying around????? Let's do the basics, o2 15lpm nrb, npa or oral airway if tolerated Iv NS 12 lead Prep for intubation hospital 15 mins away so I'd not call the chopper Put the patient on a c-collar and board since unknown if he fell or what. I'd tube him if he tolerated the oral airway - protect the airway he certainly doesn't seem to be a good candidate for protecting it himself Get him in the ambulance, First responder driving, you and whoever else in back Drive 15 mins to the ER give radio report drop him off at the ER bed number 6 and that's it. Nothing really more to do.

Let's remember the 3 cardinal rules of EMS here. 1. Blood goes round and round - if we fix all the plumbing and do preventative maintenance then we can improve on that part. 2. Air goes in and out - if we fix the ventillation system and do preventive maintenance then we can improve on that 3. ALL PATIENTS EVENTUALLY DIE!!!!!!!! Well bubba, there aint anything we can do about this piece. 2 out of three aint bad

When people don't believe in God, a puppy dies. My puppy made me type this.

no no no whit this pregnant patient didn't need a helicopter, she could go in a wheelchair van and make it to the hospital 100 miles away. She wasn't a true emergency.

no no no whit this pregnant patient didn't need a helicopter, she could go in a wheelchair van and make it to the hospital 100 miles away. She wasn't a true emergency.

Tinman, I think we saw a different show. I'm not saying the tubing was done right nor whatnot. But this kid was truly in trouble and I probably would have tubed him too. I mean we all know kids, and they can crash at a minutes notice. I think that call was run adequately.