crotchitymedic1986

movie cameras make cars explode

Next time, ask the medic to move the leads around or turn up the gain, so that a clearer strip can be obtained. A.Flutter would be first guess, possible BBB, possible electrolyte or medication induced abnormatlities.

OK, so you send him home and then his lawyer calls you and tells you that you are violating the EMT's rights under the Americans with Disabilities Act. Now what would you do ?

Most insurance companies do at least an annual license check of all personnel, some more often. So even if the employee fails to notify, the insurance company will catch it. I wonder if you are dumb enough to get one, if you should just refuse the test. You will still lose your license, but you wouldnt have DUI on your driving record.

You have an EMT who reports to duty and asks to see you (the supervisor). He has been out "sick" for several shifts, and is returning to duty. He tells you that he has been depressed and has an anxiety disorder, and his doctor put him on "Xanax". He shows you the prescription so that you will know if he later tests positive for anything in a random drug screen, that he is supposed to be on this medication. The medication label clearly states "do not drive while on this medication". What do you do ? If you dont like that scenario, as you go through the bunk room to get to the bathroom. You see an employee taking a dose of Nyquil (which contains alcohol and diphenhydramine), because he is sick, but didnt want to call-out on you. What do you do ?

If you are writing the policy now, then I would write that any "conviction" of DUI/DWI will result in automatic termination. Upon being arrested for it, they would be put on administrative leave until their court date. Insurance companies who write your insurance look at it this way: If you are looking to hire someone who had a DUI at ages 16-21, but have now had several years of an excellent driving record, they will insure them. If you are 27 and got your DUI last month, they will not underwrite you. In our industry, we see the results of this crime everyday, for one of our own employees to get behind the wheel after drinking is just not acceptable. It shows poor judgement, immaturity, and a probable substance abuse issue. But you also need to address what you do with employees who are on prescription drugs that warn that you should not drive while on the medication. Many daily psych meds carry this warning, and we all know a medic or emt who has a bad back and may be on flexeril or lortab. Most employers state that if you have a prescription for the drug, then you are OK, but that is not always the case in a job that requires you to drive a vehicle. I will add this as a spin-off topic

Such policies are in place to prevent insurance fraud, which typically does not exist in these isolated incidents. If someone called and asked if they could do something, I would ask them to send something the whole group could share -- cookies, pizza, etc (no cash). Refer to your policy manual, if it states you can not accept it, I would not -- or ask your supervisor if it would be OK to accept the gift and then donate it to charity. That way you dont rub the patient the wrong way, as they are going out of their way to say thank you.

Check with insurer as dust suggested, they may not write insurance for him as a driver anymore. If you do not have a policy in place that addresses the situation, you may be stuck with him in an alternate roll, or as the roll of permanent "tech".

i dont know that high call volume necessarily means higher turnover. usually services with higher call volume have better pay and benefits (not always).

I think i took a seatbelt off of a dead patient maybe twice in over 20 years. I have seen a few patients who survived without wearing one, like you suggested, that probable would have been killed if wearing one, but they are the exception, not the rule. Google "ambulance crash test" or Nadine Levick's ambulance crash study. If you find her video'd ambulance crash tests you will have no questions about whether you should or should not wear a belt on the ambulance. Did you know that ambulances are not required to be crash-tested or crash-worthy in the states ?

You can give your life in the military, but you cant be a medic ?? But on the flip side, all careers that require a degree have a pseudo minimum age in that you have to have 2-4 years of college to get the job, which means you cant be 18. This is why so many fire departments are unprofessional, because they hire kids who have never worked in a corporate environment, and do not know how to behave.

Like all technology, i dont think brand matters, as every one of them is built by the same three kids in china (but not the three that build all the DVD players). They have improved alot since the first ones came out, but like everyone else has stated, i always took a manual one first

thats why i dont use those things. I tried it once, and chipped my teeth.

more pros and cons to consider: 1. Hospital work usually means "work", which isnt to say EMS isnt, but you can expect 8-12 hours on your feet working, with little down time or break time. 2. Hospital insurance usually sucks, unless you are with one of the giant mega hospital chains. Things that are covered now, may not be covered there, and it may be more expensive each pay-check. 3. Working for a hospital usually earns you tuition reimbursement for medically related training (maybe not paramedic unless they have an EMS service). 4. You need to figure out what you love, regardless of pay or benefits. Nothing worse than being stuck in a job you hate because you cant lose pay or benefits. 5. Hospital may be more boring than what you are doing now. My advice, start at the hospital part-time, try it for awhile (all jobs are perfect for the first month), then decide when and if to switch.

and a side note: about giving up your rights when you enter hospice. You would have had to have been around in the 80s, before hospice was around in any legitimate form, to understand how it progressed to this. In those days, grandma got cancer, she reached the point where hospitilization could not improve her condition, and then the family doc would write a script for a hospital bed at home, and discharge the patient. Everytime grandma coughed, or was hard to wake-up, or did anything unusual, the family would call 911 and we would transport to the ER. Or when the patient was actually in the process of dieing, the family would get scared and call 911 because they didnt want her to die in the house, or they changed their mind. Since hospice has progressed, you youngsters dont have to deal with this as much as many of these patients go to a hospice facility (instead of home) and hospice does not call you when they code.

This is actually quite common, and the family is correct (although I imagine it can vary by region, country, or state). Once you enter hospice care, the family is supposed to call "hospice first" not 911. The on-call hospice nurse will determine if the patient requires an ER visit or an in-home visit from hospice nurse. Each patient is unique, and their's or their family's wishes (which were determined at time of admission to program) are followed. Those who say DNR does not mean do not treat are correct, but you have to ask yourself what do you really think you can fix for this patient ? You can not fix his cardiac output, nor can you restore the lung function of a terminal lung cancer patient who has dyspnea. If his G-tube or foley had come out, or if he had a suturable laceration as a result of the fall, the hospice nurse may determine an ER visit as beneficial. But it sounds like (with what little that I read) there is little that an ER or an ambulance crew could fix for this patient. Healthy people dont go to hospice care; death is expected in the immediate future, thus at some stage they will become unstable. When in doubt in any situation like this, it is best to contact your medical control and/or your supervisor for guidance. There is no "catch all" solution, other than that, as each patient, each DNR order, and each living will may be different.

Jan 1 - Feb 28th 2009 statistics: Ambulance Crashes: 46 EMS Personnel Injured: 47 Ems Personnel Killed: 0 Patient Injured: 10 Patient Killed: 1 Passenger in Amb killed: 1 Other Vehicle Injured: 31 Other Vehicle Killed: 7 ** Note one emt died in an accident, but preliminary reports indicated that he suffered a heart attack while driving, which caused his death, not the crash. Never got confirmation.

There are lots of OSHA violations that occur everyday in EMS, so that wouldnt be my first concern. What you should do is get a culturette from your local hospital lab, and swab the inside of the cooler to see what is growing that you cant see. Then you will see what you should be worried about. Most ambulances smell like a cross between ass and french fries, so what harm could a cheesesteak do ?

Yes, the government does such a fantastic job at healthcare; just look what they do to i mean for veterans.

Could you clarify: "i was on a long transport and picked up some food"; were you patient loaded at the time ?

Expanding on ruff's point. Remember when you were 10 years old; if you wanted to fight someone, all you had to say was "your momma _____________________" then the fight was on. There was no thinking involved, if they talked about your momma, you hit them. Now at age 30, if someone you do not know talks about your momma, I hope you have the intelligence and maturity to not take an automatic swing at someone. The trivial stuff you are talking about is the same thing -- YOU ARE CHOOSING TO LET IT BOTHER YOU. And by doing so, you are giving the losers control over your life for some portion of each day. Dont give them that power. I used to be that way: 7:00 Shift change time, let's check the truck. 7:01 Truck not washed -- B/P 140/90 7:02 Trash can full -- B/P 150/98 7:03 Jump bag rearranged B/P 160/98 7:04 Sheet on stretcher dirty B/P 170/100 But i learned, just because they pull your string, doesnt mean you have to dance like a puppet. Stop dancing.

A little advice from an old man. You cant control what you cant control. You need to stop letting the other stuff bother you. You have to ask yourself, when i am 99 years old, on my deathbed, is this the memory that will flash before my eyes ? If the answer is no, you are putting way too much emphasis on something trivial. Do your job, take care of your patients, and go home. No matter where you go, in any profession, you will find much the same thing. We do hold on to subpar employees too long in this profession, but the worse news is that if you fired them all tomorrow, they would rehire the exact same type of people to fill their spot. Its like 500lb patients or drug-seekers, as soon as one dies off, there is another to take their place. Quit playing the role of "victim", and try to find happiness in your opinion of yourself, not what your supervisor or peers think of you.

i agree with anthony --- if psych issues were years ago, and they have a steady work history since then, i wouldnt worry about it (unless they are on a psych-med that does not allow the operation of a motor vehicle). If psych issues were last year, not so fast. Most employers do have some sort of psych or personality test they administer these days.

I am not aware of any advocacy groups, but the best advice I can give is to not let your non-fire based EMS system become unprofitable. It is painful to say, much like telling a 3-pack a day smoker that he could avoid lung cancer if he would just quit smoking. We in EMS have to swallow the bitter medicine and realize that: Transporting about 50% of your patients is not good enough, unless you reduce man-hours proportionally. You should take over the non-emergent market in your area, which can prevent takeover from Fire or the private service who is currently handling non-emergencies. You dont need more chiefs than you need indians -- you have to keep administrative overhead low. You need a billing department that bills your calls as if their job depends on it --- most county 911 providers are very lax about collections.

arent we holier than thou ? Because someone doesnt speak english you will report them. Why not report all black people as they are obviously dealing drugs or committing some crime ? What about the white executive that confides in you that he had chest pain while having sex with his mistress -- do you call the wife ? What about all the redneck women in trailer parks, no doubt they probably do prostitution on the side. How about your partner for his/her various sins they have confided to you or you have witnessed ? How about you ? Did you ever drive drunk ? Ever steal something as a kid ? Ever cheat on your taxes ? Ever lie about being sick when you called in at work, when you werent ? Ever take a peak at a patients privates ? People in glass ambulances shouldnt throw stones !!