cynical_as_hell

same here

Always transport to the closest most appropiate facility. That is our job. The way I look at it is, You called 911 because you felt that you needed our services so let us do our jobs and quite making requests. Like someone previously stated, we are not a taxi service. I have always felt that the people in our field are not going to intentionaly cause harm to a patient. If they transport to one hospital over another then there was a reason for it and that medic or emt only did what they felt was best for that patient at that time. The common community is full of a bunch of morons....that's why we all have jobs. Just like you can't believe everything you read on the internet, you can't believe everything you read in newspapers or trust that you will have a great experience just because someone else you know did. Circumstances determine everything.

Prayers go out to the family members and friends of these three brave individuals.

I think that driving with lights and sirens needs to be done away with. Why are we putting ourselvers, our partner, and the community we work in at higher risk just because someone else called 911??? Most of the time when we get there, it really wasn't needed to run with lights and sirens and was only done because it's in policy. In my company, even if you are running code3, med3 whatever each area calls it, we STILL have to stop at stop signs, red lights, and all intersections. What time is really being saved??? It is an unnecessary risk if you ask me. We already have enough responsibilities and liability, why add more?

hey girl i was told to send you a messege from johnnie and it states: "You always crack me up. Always, Johnnie." Can't wait for you to get home. I've moped around the station commenting on how it's just not the same without you and other things like "well if kaisu was here that never would have happened" and so on and so on. When I heard you were coming home I was at work, ran into the dayroom, and started cheering and dancing singing Kaisu's coming home, kaisu's coming home!!!!! Gosh I miss you girl. Glad to hear things are working out for your mom.

I feel that the standard of education needs to be higher. Some of the programs I've seen in my area are so focused on just pushing people through because it's their buddy rather than stating " Hey you didn't make it." that people who are truly not qualified are being certified. I also think that the public needs to be educated on what our capabilities are. They need to be reminded of what truly is an emergency and what isnt. We are not a taxi service and I agree with previous statements that some patients can be left at home. Just because someone calls 911 doesnt mean they need our services and therefor we should be allowed to leave them at home. Time after time after time our services get abused and our resources drained because there is no cure for stupidity. I also feel that if it is a medical call that fire needs to stay at their station and let us do our jobs. More time is spent on scene than needed because fire feels they have some obligation to do something rather than turn over care and allow us to be on our way with the patient. EMS will never truly get the respect it deserves or the recognition as long as fire continues to accompany us on calls.

while some live by the saying of "Keep your friends close and your enemies closer" i am not that person. To be labeled a "trouble maker" is ignorant when you don't know what really goes on. While my thoughts and ways of doing things definetly come out of left field sometimes, there is sanity to them and cause. Since meeting Kaisu, i've become a better person. She has taught me things and is what I consider to be my best friend. Management knows they couldn't get me to throw her under the bus. We would end up going down together. However, thank you for your concern and looking at another aspect. No hurt feelings.

Everybody has their own points of views about what should or should not have happened. Were these two wrong for their behavior? Absolutely. However, what is it that everyone expects them to do in regards to the treatment of a seizure patient? The only thing EMS does in treating seizure patients is keep them from harming themselves, provide oxygen, and if called for and allowed, perhaps provide some drugs to help stop the seizure, if you can even get an IV. If these individuals had their unit outside and were able to access the aboved mentioned equipment then absolutely they should be held accountable to the fullest extent. But if they walked over to this coffee place or took their own vehicles, then what more do you expect of these "EMT'S" that somehow makes them more able to help this woman then what the public already knows to do? Again, i agree 100% that their attitude and behavior were inappropiate, but before you call them to the carpet and demand that their certs be pulled, ask yourself if there was anything they could have done with the situation they were in that would have changed the outcome of this woman and her child.

I don't think that anybody is getting the entire story with this. Of course I have all the same questions that have already been asked, but even more so is Why was a second ambulance called? Firefighters have the same training that ambulance crews do and most fire departmants staff a minimal of 2 employees on their units. Why couldn't one of the firefighters ride in the back with the ambulance crew member that had patient care and be on their way? I also understand about not allowing non-employee people driving other company vehicles....however, it is a child in arrest so why are you going to wait? I would rather have to face my boss and explain why a non-employee drove my ambulance than face the family of a child who thinks that my delay in getting their child to the hospital was a possible cause in the death.

My first question is with this medic being the Deputy Chief for your department, was he on call as a medic or was he just on call in the sense of supervisor? If he is in fact on call for the medic side of this, then yes, he is in breach of duty. But he cannot be held negligent because to be found guilty of such, the patient, or whoever is doing the sueing, has to prove that there was a duty to act, that there was a breach of duty to act, that the patient suffered actual damages, and proximate cause. All four have to be proven for a medic to be found guilty. The lead emt made an apropiate decision in requesting the other fire department. Remember, ask yourself "What is in the patient's best interest?" and make your decisions in accordance to that. I'm glad to read that your department has handle the situation and is continueing to do so. The last thing anyone wants is to have any issues arise. One more thing to add and a previous poster asked the same question...Would it have been quicker to just go ahead and transport to the hospital even though you are bls or would it have significantly benefitted this patient to wait for ALS?? If it would be quicker to transport and you wait on scene for ALS than you could potentialy get into trouble for a delay in getting the patient to defenitive care.

we use CCR already in the area i work in. its a very simple concept and from my understanding with the base hospital, they are seeing more positive outcomes with this technique. It makes things a little easier when working a code because now you have another set of hands free to help out seems you are not "bagging" the patient. But as with anything else, only time will tell rather this is a good decision or a bad one.

that is exatly 100% correct!!! I made that same statement to my superivisor and other coworkers after only 2 months of working for AMR. They do bring in some great changes when they take over, but there is also the bad ones too. I guess you just have to look at it with each take over. My biggest problem with AMR has been with the payroll department. There have been many errors with not only mypay, but that of my coworkers as well. And most of the time you are told "too bad. its your faiult, wait until next payday" but that's really been the only major problem with them as an employee.

I agree with you. There are reasons why we don't do some things. But now I have a question for you, and anyone else that wants to dig in....Everybody already knows that the chance of survival from trauma related injuries(severe) are extremely low...but my question is this: Are the chances of survival for a multi systems trauma patient any higher or lower than that of a blunt force trauma patient?? Now this question is asked under the assumption that the trauma the patient suffered is what caused them to go into arrest in the first place.

Great post. Although I must say, reading some of those brought back some unpleasant memories. You can't help but laugh at it though too!!!

i feel that I need to do some clarification on this topic. I'm not certain as to why some of you are thinking that this patient might have possibly had a cardiac event that may have caused him to have this accident. This patient was the motorcyclist and he t-boned the suv that turned in front of him. The estimated speed for the motorcyclist was 65-70mph. The suv was thought that they could successfully turn in front of the motorcyclist without any problems. Unfortunately he was wrong and the motorcyclist didn't even have time to try and brake before hitting this suv. As far as some of the comments on what the cardiac monitor showed....I am only an emt and its not in my scope of practice to interupt rhythms on the monitor. It was my medic that was on scene with me that said the patient's rhythm was PEA. The fire department took over cpr from the bystander when they arrived on scene and when the fire medic put the patient on the monitor the rhytm then was also PEA and the patient did not show a pulse on the monitor. Due to the location of this accident we were not able to obtain any past medical history as there was no one on scene that knew the patient. We were aproximately seven minutes from the accident scene and our transport time to the hospital was fifteen. My medic did work this patient following acls protocol of course however the outcome was not in favor of the patient. As far as having other patients on scene there were no others. The person that was driving the suv never seeked any medical attention. I hope this will help clear a few things up. I'm sorry if some of you are offended by anything, I was only wanting the perspective of others to better understand why some would work this code and why some would not.

I have been asking my coworkers the same question I am asking all of you. I have gotten mixed answers and all have provided reasons for why they would have or would not have worked this full code. I look forward to your input. The Call: On scene to find a 50 year old man in full arrest. The fire department that is on scene already was performing cpr. There are a handful of bystanders, one who witnessed the accident. This patient was a motorcyclist driving at an approximate speed of 65-70mph and t-boned an suv. The suv had made a turn in front of the motorcyclist. The bystander who witnessed the accident stated that they had started cpr right after the accident and that they had gotten a pulse back. On the monitor the patient shows a rhythm of what I'm told is PEA. We load the patient into the ambulance and work him all the way to the hospital. Shortly after arriving the patient was pronounced dead. The only visible injuries to this patient are some lacerations to his head, but only one of the being deep enough to see the skull. This patient was not wearing a helmet. My Opinion: In my opinion I feel that we should not have worked this code. Given the circumstances and how he was presenting on scene, there was nothing we could do to change the outcome. When we arrived on scene and I looked at the patient his eyes were already fixed and staring off to the side. Now I understand that we had bystanders who all expected us to do something, but I guess I'm still stuck on the question of at what point do we just say "I'm sorry but there's nothing we can do." I also understand that in a way it's arrogant of us to sit there and say that we can't do anything, but if there's obvious signs of death, who are we trying to fool??? I know I will get some mixed answers on this and I'm fine with that. I just want to see how others feel and why they feel that way and if I'm wrong in this then those of you who feel this should have been worked can help me understand why. Thanks again

SWEET

First off, its "We don't trust your monitor" If you're going to reply to something, make sure you get it right and not twist it around. Trusting us and trusting our monitors are two different things. Secondly, our medical director has us providing substandard care to begin with out in the field and the hospital does nothing about it. My understanding however is that this is about to change now that the medical director works for our ambulance company as our personal medical director and our company wont allow us to provide care that is not up to standard. AnthonyM83: Im glad I could be of some help to you. Good luck and hope you find what you are looking for.

I dont know how much I will be to you means how Im just an emt, but lets give it a try. I have heard from the medics that I work with that 12 leads in the field can be beneficial, however, sometimes when somebody has a heart attack, you won't see a change on the monitor for up to 12 hours later. My understanding is that they could be having one right in front of you but when you put them on the monitor, they may still be showing a sinus rhythm. In my area we dont do 12 leads in the field. The biggest reason is because everytime we bring in a cardiac patient and show the E.R. our strips, they just crumble them up and throw them away then do their own. And when asked why they do that, they reply with "We don't trust your monitors." In regards to diabetics, im certain I don't have anything useful. I'm reminded of a call though where the patient had a glucose level of 1400. Maybe in being able to teach in this area, bring up how a patient with a significantly high glucose level can present. My patient was obviously altered, would go in and out of consciousness, was slightly combative at times, had a fever, and was shaking like she was cold. Maybe touch on the fact that sometimes when you get an error read on the glucose monitor, their sugar levels may be too high or too low for the monitor to be able to pick it up. The elderly is kind of a fun topic and make for great patients because when you speak of the elderly, you are essentially referring to a group of patients that grew up not having the 911 system. One thing I have noticed with this particular group is that when they call 911, they usually truly need you. Also with this group, they should have called sooner than they did, but didn't want to bother anyone or thought they could take care of whatever the problem is by themselves. The elderly in the nursing homes will sometimes complain of something minor just to get out of that place. And I have to touch on the pediatric section. One very valuable piece of information that everyone needs to know is that even pediatrics can have high blood pressure. Allow me to use myself as an example: When i was 13 I was getting a physical for a sport I wanted to play in. I was sent over to the er for evaluation because the dr was not certain about my blood pressure reading. When I got there and the hospital did their eval, they discovered that my bp was 200/184. They were stunned because as everyone knows, that is not normal by any means for a healthy 13 year old. After further researching, record pulling, and testing, the doctors discovered that my hypertension is secondary to a chronic kidney disease that I have. They discovered that I have one kidney that is the size of an infant's, and the other kidney is twice the size of an adults. The biggest mystery in all of this is that I had no signs or symptoms of having high blood pressure. So when taking a blood pressure on a pediatric, pump the cuff up to the same level that you would do with an adult. I dont know if any of this will be helpful to you, but good luck on your paper and let us know how you did....

It states in our policy that you can drive 5mph above the speed limit when responding med 2 to a call and that you can drive 10mph above the speed limit when responding med 3 to a call. This also applies for going to the hospital with a patient. On our highways the speed limit is 75mph. Our policy states that we cannot respond med 3 on the highway and that we cannot exceed a speed of 80 mph. But then again, it also depends on who's policy you are following....the old company that used to own you or the knew company. I asked for clarification from my supervisor as to which policies we were following and the only response I got was " Well, it depends." So much for the right hand talking to the left hand on things.

1.If the patient is an adult, normally AOx4 confirmed by parents, and is confused due to seizure. Can patient be legally turned over to parents in the absence of medical POA?? The patient is an adult. If you cannot confirm AOx4, the patient gets transported. 2. If parents talk to patient's physician concerning txp, is it prudent for the medic onscene to make contact with the physician? The parents can consult with the pt's physician all they want, however, he has no say in rather the pt gets transported or not. Remember, you work for your medical director, and if you have any questions or concerns, you consult him/her, not anyone else. 3. With the lack of medical POA, unconfirmed request by patient's physician, and the patient obviously confused. Would you have made transport decision for the patient on the side of the family's request or the side of the patient. I would have transported this patient. You have no proof the the pt's parents have power of attorney. Like others have said before, the allegded physician has no meaning or say in this matter. The responses I got from the medic I was working with was that the decision was on the side of the patient, and that the parents can sign on behalf of the patient, and hold up legally. (not sure I agree with that, but I dont know) The decision your medic made was not on the side of the patient. They just didn't want to do another report. The parents cannot sign for this pt as you have/had no proof while on scene that they have power of attorney. Although they may have the right and have the paperwork at home to support it, it is not with them at this time and you have no way of telling rather they are telling the truth or not. Any attorney will tear you to shreds with this if this ever went to court.

Report it. I don't care how short this company is on medics, it is still illigal. And like stated in previous comments, if you don't say anything you could get into trouble too. I wouldn't go around talking about it however, that could also create problems you don't want. Be ready for employees of this company to somehow retalliate against you for speaking up.

sounds like just another bs call and abuse of the 911 system. If i were on this call I'd make sure the nurse lost their job. And nursing homes wonder why ems has such a bad attitude towards them..... Let me wake you up at 3 am for a bs reason and see how you like it!!!

My company used mass text messegeing like what you are describing. I don't know how they have it set up but I do know that when there is a message sent out all the employees have it on their phones in less than 5 minutes. We use it for a variety of reasons, like needing more personnel for stations, transfers, emergency recalls. The nice thing about it is that only the supervisors are allowed to request a message to be sent out so we as employees know that it's not a scam. Again, I dont know any details for your questions, I just know that we use it and it works great.