Christopher.Collins

It may have been RIH... honestly I cant remember. Just that it was out of state.

Check your PM. I sent you a few links to the common medic classes taught around here.

Supprisingly I didnt suffer too much. My knees were torn up, but thats about it. I think it didnt draw as much attention cuz I didnt get hurt, just got up and laughed it off.

In my neck of the woods, alot of people on the job are also volunteers elsewhere... Medics, EMTs, Firefighters... etc. One BLS, volunteer ambulance company I was with has quite a few paramedics within the ranks as well as a couple nurses and a PA also. Since it is a BLS company only they could only work at the BLS level. While I do agree that there may be more liability on the person with higher certification... I disagree that they are technically "in charge" from a care standpoint. While yes they are higher certified and have more formal training they are only able to act as an EMT-Basic. Again it is a BLS only company, they do not have medical control to act otherwise (the medic or the company). Therfore they cant diagnose or perform any ALS skills... of course some medics utilize them more than they would the basic if it is an ALS call. Ethically of course, I would still expect them to perform better and perhaps give a more thourough work up... but legally they are still just a basic while working with their BLS company. ~~~~~~ In terms of how I deal with anyone not a part of a responding company but still higher certified... I ask them for ID including their certification card. If they cant prove they are a healthcare provider or the good Doc has a PHD instead of an MD, they're off the scene. If they dont have PPE and the situation calls for it, they're out also. Then of course if they are a medic and want to help they are told they by law have to go to the hospital with me, unless a dispatched medic shows up. Same for the Doc, only they have to go, medic or not if they choose to help. Be very carefull if you have someone outside your agency trying to help though. I had a minor MVA once (hardly a scratch on either car). First person there was an EMT from god knows where... but not near or in my PSA. We take over patient care, shooing off the outsider, and the young lady decides she dosnt want to go to the hospital. I gave her the rundown on refusals... if things should change or you change your mind, and asking 3 times if shes sure... etc. And just after she signs the paperwork that freaking EMT comes running up to MY patient and harrasses her. Before I could even get the damn cops attention I hear crying and, "allright I'll fu*%ing go, just leave me alone." I documented the hell out of that situation, unfortunatley and regretably I didnt get that EMTs certification number. But regardless the damage was done... This young woman who didnt want any assistance was badgered into it. Therfore an emergency ambulance and hospital bed (and whatever other recourses) were put out of service to help someone who never even wanted it. All that aside I was more upset for my patient who was lying on a backboard in a cold ED for whatever length of time before she was finally seen (it was busy that day). I mean how embarassing can that be, just because some dumb schmuck was on a power trip and wanted to play para-god. This should also go as a reminder if you help out in someone else's jurisdiction... be smart, as you would in your own area. Of course... if your not smart on the job with your own people, your better off to keep driving past whatever you come across :twisted: lol

While responding to another post I mentioned a leutenant in my old department being only 19 years old. So I ask you all, my peers what difference if any age makes. Should a 19 year old be able to command a vehicle and group of people, even if they know them back to front, suit to nuts? For that matter, if an insurance company permits it (and there are plenty in Connecticut), should anyone under the age of 21 be able to drive an apparatus? Ambulances, fire trucks... etc. Think about it... you cant legally take Firefighter-1 untill your 18. Even if your just a sponge for knowledge and learning (theory and practical) could you possibly be ready to have the responsability of an officer? In that one year between the ages of 18 and 19 you may see just one fire... and even if you get alot of wrecks or medicals they may not be serious enough to call for hard core leadership. The same holds true for EMTs, though you can take it at age 16, your still not on your own untill 18. In regards to driving. As laws tighten more around teen aged drivers in the State of Connecticut, it is starting to become easier to just get your license at the age of 18. In my humble opinion an 18 year old is an inexperienced driver, even if they've been driving since 16. With talks and arguments of lowering the states drinking age to 18, one of the key arguments is that inexperience drivers shouldnt be mixed with inexperienced drinkers. I for one see no reason why inexperienced drivers should be given lights and sirens either. Now... age in iteself is not the issue, but age restrictions on what you can and cant do up untill your 18 is. There are many people teens and adults alike who are fast learners and there are many who are slow. But is a years worth of experience honestly enough to be a leader in such a dangerous proffesion? I dont mean a "follow me" or "take you under my wing" leader, I mean a line officer. Back to driving is 1-2 years of really enough to throw someone on the road with lights and sirens? In fairness Ill ask the same question regarding a 34 year old who just got their drivers license for the first time. I dont doubt that someone lacking true experience can be a worthy asset by any means. Ive had junior firefighters and EMS explorers (MRT certified) that I would rely on more so than some senior "experienced" members. But lines need to be drawn. There are plenty of short handed fire and EMS agencies out there today... some just itching to get bodies in, even if the pulse is faint. A quality that can be fatal.

Im not a female, and most deffinatley not a lady lol but if you dont mind my posting an opinion: Im also in agreement with the others. Some of my best partners have been female. Ill say that there are some that cant lift... but you know something, different body structure aside, theres no reason that cant be changed. Ive been in a fire department where the Ladder, EMS and Rescue Leutenants were all females... and Im not talking (with all respect ladies) older "butch" type women either. They were all younger attractive femanine types, and they all knew how to do their jobs very well. Hell, the Ladder LT was 19 years old! I dont particularly agree with her being an officer so young but thats a different topic. In terms of guys being guys (but having to worry about it when a female is around) Ive seen women dish out trash talk and other obscene things just as well. That of course isnt entirley relavant or important... but the fear of sexual harrasment has never been a problem in the stations and companies Ive been a part of. If people are offended they usually speak up or go elsewhere. ~~~~ Sorry, I got caught up in my rant and forgot to reply more so to what you were asking. Personally, I rarley see a patient who seems to be biased twords personel on scene. I wont go as far as to say its just you... Im sure it does happen.

You think thats embarassing Doc? Try falling down an escalator at the Providance Place Mall :oops: Not only are thoes freaking things really tall, but the mall itself is huge and always packed. Lucky for me I was already halfway down and there were no people below to slow my rapid decent or file a law suit. In pre-retrospect... maybe this isnt something I should go telling people. Im still waiting for a video on youtube or even better Americas Funniest Home Videos... cuz then Ill sue their a$$es and try to claim part of the winnings.

I think maybe Im misunderstanding your overall point, but Im not posative :? If so Im sorry. Anyways, havnt heard back from OEMS yet but I have spoken to many peers. The general concensius thus far is that no you can not deny care... and that even if you talked them into refusing that theres still huge liability. They all were in agreement that theres plenty of abuse in the 9-1-1 system and in theory it could be usefull practice... but while other states may allow it, Connecticut is just not set for it. This state is pretty big on being by the book. These were exact words from one medic I talked to: Sorry that I dont have any actually written proof that we can not deny transport. I know that these opinions are pretty much just beating a dead horse. But even if we were allowed to do it... it seems that the majority of providers (that I spoke too) here would likeley let the Doc sort out the abusers and fakers. I even mentioned to them about how many many times Ive been taught to just try and talk the patient into refusing, and they freaked out. Fortunatley, its not a practice Ive used. Im just hoping that the OEMS Chief dosnt think Im crazy or negligent if he reads my letter :roll:

Maybe we fall under doctor/nurse... but otherwise how would a police officer be above us? I agree they have their share of yucky situations, but above us? Anyways, I guess I shouldnt complain... they diserve to get something thinking they are above us parking in the way on scenes all the time :twisted:

Dispatched to a cardiac arrest, CPR in progress at a local bar. Arrive on scene to find two persons severley ETOH both concious... one doing CPR on the other.

If I may throw in a personal experience though (it dosnt involve transporting, but someone related). About a year and a half ago I started to develop my usual seasonal sinus problems. I start getting sore throats, stuffy noses... etc. Its something Im used to... but this time was different, sore throat lasted for a couple of weeks and was only intensifying along with other symptoms. Im a stubborn son of a b*tch mind you, and Ill only go to a doctor or hospital if I absoloutley need it. I just couldnt justify going over a nasty sore throat. And Im sure that at the time an ambulance wouldnt justify transporting m either. Eventually I started to feel swelling in my throat and started to labor my breathing, and thats when I decided I had to go. Got to the 24hr clinic and they took me right in instead of treoge. Diagnosed me with epiglotitis, an infection that is common in children but not so common and sometimes potentially fatal in adults. They started me on IV antibiotics and checked on me quite frequently (it was a busy night no less). I was also told that there is a slim, but still a chance no less, they may need to intubate if it got serious. Fortunatley the antibiotics worked. ~~~~~~~~~ Now, take that scenario and tweak it a bit. Someone calls EMS for a sore throat and states they want to go to the hospital. Pt at the time is not presenting with any life threataning symptoms, RR and vitals are normal. EMS talks patient out of going, and says that they should follow up with their physician in the morning if symptomes dont clear up. Later that night EMS is called back to the same location for the same patient, now in respritory arrest. Would EMS be liable? I dont think they would per say be liable, afterall the patient was AAOx3, presented with no life threataning signs and was stable throughout the on scene time. But could you imagine living with that? And regardless of if they did right or not think of the consiquences... bad public image and who knows how much in cost of attorney and court fees untill whatever law suit / grievance is blown over.

True, forgot you were FDNY. Im sure traffic must be a mess there during such events.

I sent a brief but descriptive letter to Connecticut OEMS inquiring to our local protocols and laws in this regards. If I hear back Ill post it. I dont know though... I mean wouldnt it be abandonment to just deny care and transport? Even if it isnt an emergency? I was always taught to politley talk a patient out of transport if they truley dont need it... but I was never once in 5 years told we can legally deny transport. Dont get me wrong spenac, I agree 100% that we should have the power to deny transports (given certain critera are met and propper documentation perhaps). It would be a good step twords slowing down abuse of 9-1-1.

I think mom fell asleep :evil: *pokes with a stick* How does the patient present... whats he look like, hows he acting?

"So let mercy come, and wash away what I've done." "Ill face myself to cross out what Ive become." ~Linkin Park

Oh yea, Any recreational drinking or drug use?

Ok.... Whats his SPO2? Whens the last time he ate? Allergies? Whens the last time he took the prozac? What was he doing when he started to feel ill and how long ago was that? Any medical history?

I always thought that whole you can "asisst" in the administration of epinephrine w/o medical direction by placing it in the patients hand then putting your hand on theirs was pretty stupid. If the patient isnt capable of administering it themselves then somethings wrong... and they obviously need OUR (and/or the doctors) help. If we are actually taught to do it this way then why bother with med control to administer it ourselves? I know why it would be important to consult with med contril prior to the admin of epi... but my interpritation of this loophole makes it almost not essential. Also, should we really encourage a patient to take any med on scene that we personally cant give to them, without talking to a doctor?

They dont close down roads for department funerals in your area? I havnt been to one where traffic from other roads was open. They were all run just like parades. Even ones on Route 1 in the middle of the summer... and hell that was a few miles covered in that service. Ive seen the stickers just recently, its a very smart idea... unfortunatley it dosnt mean people will respect it any more. I think the flashers and headlight thing is a bit outdated... with most cars today having auto headlights that run during daylight also... and well, someone like me just might be hauling a couch in a small car too! As far as the subject at hand... Im sorry to be disrespectfull but if I can get in Im getting in. Of course I would exercise due regard to safety and not force my way through. If I need to get through an intersection Ill sit there with the lights running and whelp the siren every few cars that dont let me through. I wouldnt keep running the siren the whole time, to be a bit respectfull. Of course however the catch is (at least in Connecticut) your not a street legal emergency vehicle unless both your lights and sirens are operating simultaneously. If I get hit by another vehicle, it could theoretically be my fault.

HEY THOES ARE MINE!!! Takes them BACK! Leaves a toilet paper roll... no paper though.

Yea. He rearended a stopped (turning left) Ford Explorer doing at least 75 on a crotch rockect. Hit with such force the Explorer 180'ed in place. The guy was wearing a full helmet and leather jacket though. Airlifted from Backus to UMass I think. Surprisingly; with a major laceration of the chest cavity including a severed carotid artery and vein as well as severe blood loss, he survived. Would have been slightly curious to see how much further the extent of the damage would have been without the leather coat, but that as well as his body were torn open. Would have made a great Case of the Month for JEMS.

Leave it... its already raining, thanks alot Terri!!! Leave this months issue of JEMS (without the Chemical/Biological Suppliment, Im keeping that!)... that damn buyers guide is just a list, not pictures. Id buy stuff if I could see it :evil:

Wow, that joke was great! :twisted: Thats great doc... Ive learned the hard way on two occasions not to power walk twords automatic doors. Apparently there are smart a$$es who like to turn them off.

http://news.yahoo.com/s/nm/20081113/hl_nm/us_bleach CHICAGO (Reuters) – Bleach has been killing germs for more than 200 years but U.S. scientists have just figured out how the cleaner does its dirty work. It seems that hypochlorous acid, the active ingredient in bleach, attacks proteins in bacteria, causing them to clump up much like an egg that has been boiled, a team at the University of Michigan reported in the journal Cell on Thursday. The discovery, which may better explain how humans fight off infections, came quite by accident. "As so often happens in science, we did not set out to address this question," Ursula Jakob, who led the team, said in a statement. The researchers had been studying a bacterial protein called heat shock protein 33, which is a kind of molecular chaperon that becomes active when cells are in distress, for example from the high temperature of a fever. In this case, the source of the distress was hypochlorous acid or hypochlorite. Jakob's team figured out that bleach and high temperatures have very similar effects on proteins

Thats whats great about this job though, the spontanuity... errr spontaneousness (lol??) of it. One day we're doing ALS runs to Yale and then at the end of my shift bam! Now we're Pulling a guy off the street, torn open from his juglar down past his rib cage.