HERBIE1

In the article, the mayor stated there seemed to be enough evidence the case should be investigated as a criminal matter, by specialized homicide detectives because it involved the death of a child. Semantics, but at this point it seems to be a death investigation and they will determine if they have enough to proceed with this as a homicide case. Clearly they are still trying to figure out if this will be a criminal or civil matter.

The article also said she was arrested the PREVIOUS DAY on a DUI charge and had her license suspended 6 times. Disturbing. Based on that mug shot of her, I now have a mental image I cannot seem to shake.

The onus is on the prosecutors to determine things such as if the crew's conduct was willful and wanton, did they intentionally cause harm, and did they deviate from the standard of care. Should be very interesting since the crew did not follow procedures for a non transport. No PCR was written, no signed refusal was obtained, no documentation of patient contact with medical control. Homicide? I highly doubt it, but negligence? Sure sounds like it. We are only hearing one side of the story here, but it certainly does not look good for this medic. CYA folks.

Well, we ARE supposed to be professionals, and part of our job includes driving AND listening/talking on the radio, watching a computer terminal for updates and info, AND watching traffic. Just another reason to be hypervigilant behind the wheel. In a perfect world we'd always have someone riding shot gun with us, handling computer and radio duties and assisting with traffic monitoring. Emergency driving is a full time job that I think too many people take lightly- especially when we first start out in the business. They get infatuated with the lights and siren and the privileges we have as an emergency vehicle and too often forget how many bad things can happen if you are not on top of your game. All it takes is to be involved in a good crash(whether you are driving or not) to make you realize how dangerous it is. It's one the the many hazards of the job.

Is the DC system as bad as it seems?

Interesting. I knew that NSAIDs interfere with platelet function, and now this. Just another example of how dangerous OTC meds can be.

The IAFF- and most unions- are not used to answering to anyone but themselves. The difference is, these days, many unions are being demonized because of their greed and inability to compromise. Think UAW and the airline mechanics. The legacy costs alone the employer is responsible for buried many airlines and GM. Many unions are faced with new problems- give backs and renegotiation of their CBA's, but for many businesses, these compromises come too late. Obviously public safety is a scad more important than something like making a new car, and as such should be the last to endure cuts, but the arrogance of the IAFF is a difficult thing to change.

From the article: On Friday, Mayor Adrien Fenty was clear that two medics arrived first. As a result, they have been taken off the street and can no longer have contact with patients. The internal documents obtained exclusively by FOX 5 seem to contradict the city's account. They are the automated time stamps generated by a computer showing the history of the fire units. The documents clearly show Engine 33 with a paramedic on board arrives first at 4:56:45 a.m. on February 10, 2010. Medic 33 arrived at the Southern Avenue address at 4:58:28 a.m., nearly two minutes later, but they were the only ones to go inside. So, what happened during those 2 minutes? Why didn't the medic on the engine go into the house? Why isn't the medic on the engine suspended as well as the ambulance crew? Double standards, folks. Why is the mayor ignoring this? Can you say- union support for his reelection?

And the age old battle continues. This is the usual turf war- nothing more. The medical director is in charge of patient care within an EMS system. If he has questions about the training, skills, or competency of anyone who works under his license, he would be a fool NOT to require them to demonstrate a certain level of competency. The article said that last month, the firefighter medics only had 3 of the 25 calls they needed to be evaluated on. How do you evaluate someone's skills unless they actually get a chance to perform them?

I am looking forward to getting more details on this. Based on the story, we have no idea what happened. What is does show is that this is a veteran, trained as a Tactical Medic, so he should be fully aware of potential hazards. Clearly he was caught totally off guard by whatever happened to him. Despite experience and training, sometimes we can get complacent, so it does serve as notice that we ALWAYS need to be vigilant. RIP to that medic.

That's fine advice, but you better have a spare pair of undies available too. LOL

All good advice. When I started really concentrating on my core, I noticed my back aches were less frequent. The stronger your abs, the stronger your back. Repetitive motion causes wear and tear- no way around it, but as you noted, exercises and targeted strength training are vital- especially with someone who may be slight of build. That said, injuries do happen. I liken our back problems to the heart and lung problems of old time firefighters who started their careers before the advent of the SCBA. It's simply part of the job.

You are probably right. I'm sure we all know of providers who seem to relish the idea of getting someone to agree NOT to be transported. I never understood that mentality. It takes far more time and effort to properly document WHY someone is not being transported than it does to simply give them a ride. Again, with kids, they can compensate well for quite some time, but when they DO crash, it's quick, scary, and NOT a position you want to be in. Why screw around?

First and foremost, my sincere condolences on the passing of your mom. This is one of the most difficult times in anyone's life, and being in the middle of your internship certainly does not make it any easier. I'm not sure how much time has passed, but I know from experience, it's hard. I suggest you talk to someone you trust- family, friend, counselor, clergy, etc to get your head on straight. If you aren't able to focus and concentrate, you need to get help to work through your feelings. Find out why you are having so much trouble-unresolved issues, fear, guilt, anger, denial - it's all a normal part of the grieving process, we all go through these stages, and the timetable varies with each person. Unfortunately, time IS the best healer, but in your position, you have deadlines and commitments you need to be concerned about. I will echo what the others have said- go up the chain of command, have a clear idea of how much time you need, and your date of return. Have them spell out their policy on these things if possible so you know what is possible. You cannot leave something like this open ended- say I need x amount of time to get some help, and would appreciate some consideration. Employers and schools may have various bereavement leave policies, but after that, we need to figure out a way to move on. Have your preceptor and anyone else involved honestly look at your performance, and whether they feel you can work through your problems and still be a good student. Optimal- no, but can you still survive the process? Have them clearly spell out what your options are at this point- stay the course, take some time, do make up work, or start over, etc. I will caution you though- be careful how you handle this and do not burn your bridges- it may come back to haunt you later. I will now say something that you need to consider, and please do not take it the wrong way. In this business, we must deal with the worst society has to offer, we see people at their worst, and regardless of our personal problems, we have a job to do. Patients and families do not care that you are having a bad day, or that you have major personal problems- they need your help, and they need you at your best. You will learn to compartmentalize your feelings- the kids are sick, you had a spat with your spouse, you are having financial problems, but at work, you need to put all that aside. You cannot solve your personal problems at work. I'm not saying ignore how you feel, just stow those feelings and problems away until you can focus your full attention on them after your shift is over. I was told this by a very wise senior person years ago-I was dealing with my own personal issues, and as cold hearted as I felt it was at the time, I later understood what he meant. Best of luck, emtannie and I hope you find some peace and resolution to your problems. Look at it as a test. How committed am I to this field? What am I willing to do to ensure I achieve my goals?

I will be flamed for sure for this, but oh well- I call 'em as I see 'em... As was noted, there ARE physical demands to this job. I spent the 1st 20+ years in this business using 2 man stretchers. My first employer(a private) did not believe in using the stair chair stretcher, and actually would discipline people for using it. I simply did not know better at the time. We also did not have the luxury of having lifting help for most calls unless it was an extremely large patient, and it would be a preplanned situation with 2 crews. Thus, we would find new and creative ways to get the stretcher into tight places, up and down flights of stairs, etc. I was also a young, flexible, and healthy guy so any abuse I put my body through did not show up until later in my career. My biggest problem with lifting was getting the 2 man stretcher into the ambulance from the ground. The initial vertical lift was fine, but the move after the front wheels hit the floor to get the rest of the cot into the rig was where I saw the most trouble. When I worked with women, more often than not, as soon as those front wheels hit the floor of the rig, most of the female partners(and yes, a couple males) would be done. They simply did not have the upper body strength to make that last move to get the cot into the rig and I would be forced to muscle it in essentially by myself. As a result, I believe that wear and tear(and all the other crazy lifts we do) contributed to my current back problems. Now we finally have "1 man" stretchers, which are a godsend, but too little, too late- the damage has been done. You can have the best lifting technique in the world, but there are times when there simply is no substitute for muscle power. Pulling someone out of a car, out of a bathtub, or from under a pile of garbage- there's no "proper technique" or good body mechanics that can help you in those cases. No, not every woman has trouble, and I have worked with women who are strong as oxes, but in general, because women do not have the upper body strength as men, they have caused me the most trouble. That's fine- women can adapt, but too often their partners need to compensate and they can get hurt or sustain chronic injuries. Obviously there are plenty of places where there are 3 man crews, plenty of help, and things like power assisted chairs and cots so any physical differences are certainly minimized in those cases. God bless technology, and it's certainly saved a bunch of EMS careers, but I would strongly encourage people to consider their limitations before choosing ANY career. I am a short guy, which means any basketball aspirations I may have had would have been unrealistic. That's life. It's not right or wrong, fair or unfair, it just IS. Just my nickel's worth and something to consider...

Thanks, brother. I often share your frustrations here, but the "different" personalities are what make any community- virtual or real- thrive. I realize that some people choose to adopt an online persona for the purposes of stirring the pot, playing devils advocate, or simply to be a pain in the arse. That's why I don't put too much stock in the outbursts or pompous displays. I have found that meeting people from other internet forums that the person behind the keyboard is often nothing like their online personality. These online academy awards performances are too much work for me. I am what I am, I call a spade a spade, and I have NEVER been accused of being politically correct. My sense is we are very similar in personalities, and anytime you head up to the Chicago area, the first beer is on me.

Interesting point about support. When we are new providers, we may feel overwhelmed, especially in a system where you may have the highest level of training and are medically responsible for a patient for the first time. I remember the first cardiac arrest I had after I became an officer. I was working with a green and very tentative partner and remember thinking- uh, oh- I need to run the show now. It worked out fine, but it is definitely a shift in your frame of mind. You go from knowing your experienced partner has your back, has probably dealt with most scenarios, to being the one making all the decisions-both medical and procedural. It's a process and a continuum, not some finite goal. We all need mentors-regardless of how much time in the business we have- whether they are instructors, partners, supervisors, family, friends, or even a virtual community. As our confidence and experience grows, we become more assertive and better able to express our opinions and state our case- whether it be on the streets or here in a discussion forum such as this.

Need more information. Who refused the original transport? Why? Often times, the legal issue of who is responsible for the kid is nebulous- Is it a baby sitter, a grandparent, an aunt, an uncle? Maybe there is no official guardian but the parent is MIA for some reason- jail, gone, incompetent, unavailable, etc. What was the child's original signs and symptoms? Like was said, I hope the initial crew's assessment was thorough and their documentation was complete. Personally, I try to encourage transport of all kids- even for a snotty nose. The emotions involved- maybe a new mom, maybe there are other factors- that make easing a parent's mind the best thing you could do for a child- even if all the kid may need is a dose of Tylenol or an OTC decongestant. As we all know, kids are tricky- they can decompensate very quickly. One minute they seem to be OK, and the next they are in big trouble. Let the MD sort it out- that's their job.

Welcome to da hood!

Damn funny, ruff! I hope it's not copyrighted because I'm stealing it for another board...

New one on me...

I KNEW there was a reason I never went to a chiropractor!

I'd be leaning towards an exacerbation of his chronic musculoskeletal issues, but given his age and history, I'd work him up as a cardiac case. I'd look at the 12 lead and proceed from there.

Dwayne's post got me thinking. Instead of derailing his thread, I thought I'd start a new one. After around 30 years in the business- from volunteer to management, to street provider, I was thinking recently about where I am professionally. I am currently on the street, but looking to get back to a management type position. (Long story, but it was mainly a financial decision to return to the streets). I went back to school and received my Masters a few years ago which allows me to teach at the college level in a university setting- at least part time. I felt I needed more intellectual stimulation and this helped me to satisfy that need. It also allowed me to give back to the profession on my terms. I was thinking back to when I first got into this business. I would look at people with the time I now have in the business and wonder- what will I be like when I have put in that much time in EMS. I am now an "old fogey", at least in terms of my students and new hires, so how have I changed since I was an FNG? Well, for one thing, I think the experience I have gives me a better insight into what is really important about this business. Getting an EJ in the back of a moving rig, getting a tube in a dark room, or being able to quickly and efficiently push tons of medications on a sick cardiac or medical patient are all nice skills to have. Problem is, it soon becomes apparent that the most impact we have is NOT our prowess in intubation skills or phlebotomy, but in how we relate to our patients, their family, and the image we project to the public and the other professionals we encounter. To me, that is what will determine the future of this business- NOT how many tubes we get. Alot of what we deal with- fire service animosity, politics, etc- is beyond our control, and despite all the rhetoric and bluster, unless we decide our personal goal is to become politically active, most of us will never be intimately involved in that process. I often wonder what my students and new folks really think of me and how I present myself. I have heard mostly positive feedback, so I must be doing something right. I am pretty stubborn, and have a fairly rigid moral compass. If something is wrong, I say so, and if asked, I have no problem expressing myself- even if it's an unpopular opinion. I do not bend easily to the will of others, and now that I'm an "old timer", like it or not, my opinions and actions DO carry more weight. I feel a responsibility to project a positive image for the profession, as well as to the new folks who are just starting out. I recall seeing too many old timers when I started and thinking- gawd, I hope I never get that way. Yes, our profession has certainly changed over the years, as has the caliber of most of the providers. So what say you, folks? Newcomers and old timers alike. How has your perceptions/opinions/goals in EMS changed over the years? I know you cannot turn back the clock, but do you have regrets, or are there things you would have done differently, knowing what you do about the business?

Well put, Dwayne, and I think your post could even serve as a reminder for those who are not new to the forum. I'm a relative rookie here- lurked occasionally for years but never started posting until a year or so ago. I know we are supposedly educated here- at least to a point past a HS diploma. Yes, some have advanced degrees, some have professional degrees, but you certainly do not need to possess an alphabet soup behind your name to present a coherent opinion or argument. One of the things I like about this forum is that there are literally people from across the planet, with experiences, work environments, and histories much different than my own, yet in some way, we all fall under the EMS umbrella. The only way I would ever be exposed to many of them is on a place like this forum, and I consider myself a richer and more well rounded person for it. Clearly there are hot button issues that can degrade into degrading attacks and insults, but thankfully those incidents seem to be cyclical as well as infrequent. Everyone has their own "deal breaker" opinions on certain topics, and the trick is to be able to see the other point of view in those situations. Not always an easy task, I admit. Again- kudos for the well thought out post.