HERBIE1

There is no quicker way to a loss of your sanity than to look for justifications for the actions of people- especially in our business. Not our place to ask those "why's". Why does it seem that too often, in a confrontation between a LEO and a bad guy, the LEO dies and the dirt bag lives? Why does it seem that we so often "save" an elderly, contracted, nursing home patient who is in a vegetative state yet may be unable to save an infant SIDS victim? Why would someone stab their own brother to death at the dinner table because they took the last pork chop? Why would someone sexually abuse and then murder their own infant child? Why would someone leave 6 children all under the age of 6 alone in an apartment so they could go out and score some dope and cigarettes, only to return after all those kids were killed in a fire? and, more globally... Why would someone justify killing innocent men, women, and children in the name of some religion? In your situation, like you said, clearly someone had come to the end of their rope- and for whatever reason, they could no longer cope with their problems. Unfortunately their "solution" did not work out as they planned it and they and their family must deal with the aftermath. Suicide- a permanent solution to an almost always temporary problem. When I first met my wife, I would relate some of the funnier events I would see, and for a long time, she would ask "why" would someone do what they did. I told her there is no "why"- it just IS. When I first started out in the business, I realized the best way to "understand" someone's rationale in insane situations was to say that there is a subset of people who look at life, morals, and right and wrong from a POV 180 degrees off mine. Their "right" was my "wrong", and nothing I could say or do would change that. We do the best we can- regardless of how futile or crazy it may seem- and let a "higher authority" decide on the outcome. Ultimately, there needs to be an internal drive to do our jobs to the best of our abilities- we cannot operate on immediate positive feedback or recognition, - we'd never last a week in this business. We do this because every so often, we get a thank you. We get an appreciative nod, hug, handshake, or occasionally a note from someone who's life we have touched in some way- be it a patient or a family member. Hang in there, Kaisu. I know it's frustrating at times.

Sounds like you need a change of venue, but depending on the severity of your back problems(sprain, strain, or something worse?) I do not see how you would ever be hired by a fire department or other EMS agency if they did a background check because of your preexisting condition. Look to another area- better opportunities/pay/conditions- or in a related medical field. Go back to school, get an education, train for nursing, ultrasound tech, RT, etc.

I honestly have no idea how many ETI's I had this year. Guessing around 25-30? Funny thing is, the last 3 saves we had with ROSC, all walking out of the hospital with no deficits- were WITHOUT ETI's- only used a BVM and an oral airway at most. I think I missed 2-3, and my partner got those. I'm not nearly as enamored with ET's as I used to be as a new medic, or even just a few years ago. As long as you are properly ventilating the patient, for short term, in my experience ET's are overrated. If you have ROSC, then protecting the airway means ET, but good BLS ventilations and aggressive ACLS is the key to good outcomes.

An oldie but a goodie... LMAO

I hope this FF is OK, but it doesn't sound good. Need more details before condemning the dispatcher. What did the caller say when requesting EMS? Problem is, when there is a 2 tiered dispatch/ response, these things CAN happen- even in the best system, with the best protocols. Anyone out there have more info on this?

Of all the reasons someone sees doctor for, how many do you think are urgent enough to warrant an IMMEDIATE appointment?

Oh my gawd. Is that real or photoshopped?

LMAO

Mateo, we are on the same page here. I do not LIE to patients. I explain to them the possible consequences of their decisions and the limitations of what we can tell them about their conditions and current situation based on our level of training and knowledge. If someone has a laceration they prefer not getting sutured, I do not tell them they will die if they do not allow transport. I DO tell them about time limits on suturing wounds and the potential for infections, but that's the extend of my "coercion" in such cases. On the other hand, if I have a 60 year old who has a sudden syncopal episode who is refusing, I do include the possibility they may have had some unknown cardiac event that caused their problem. Here's another story. Had a recent call for an elderly 80 year old gentleman-end stage renal failure, CHF, CAD, diabetic- very weak and frail looking. He just returned from Florida, and was mildly SOB- the reason we were called. We were also informed he was a doctor. Uh oh... We evaluated him- EKG, pulse ox, glucose, etc. He had a sick heart, PVC's, slight basilar rales, pedal edema, glucose and V/S were OK. He said he felt no different than he has for the last several months, and that it was not his idea that we were called. We gave him some O2, and he said he felt better. His family was panicked and wanted him evaluated- at their own hospital 20 miles away, which we could not oblige him with. This gentleman was very nice, quiet, seemingly immune to the frantic family members who surrounded him, and said he simply wanted to go to "his" hospital where he would be most comfortable, and where he was the recently retired chief of the medical staff. My take- he took his final vacation, said his good byes to his extended family, and simply wanted to go home to die. I felt foolish explaining the consequences of his refusal to him as I explained what may happen, as if he did not know - but he was very understanding and patient. He admitted he knew there was a possibility he may not make it to his own hospital, but that he was OK with that. I asked him about his family and the impact that would have on them- they were scared and worried. He said he understood, he appreciated their concerns and did not want to cause them undue worry but they were also in denial about his condition. He was tired of being sick and tired and had enough of endless tests, procedures, medications, dialysis, hospital stays, and no longer wanted to put up with them. He was ready to go, he had a good life, he wanted to die with dignity and on his terms, and his family needed to accept that fact. He also said he almost wished he had died in Florida and avoided all this hoopla. We called medical control, and after much discussion, they were finally OK with the refusal. We told the family to call us back if he changed his mind enroute, or if something happened, and even explained to their limo driver where the closest ER's were along their route. The doctor was very thankful, said he appreciated our efforts, and even apologized for "wasting our time." We shook hands and the family pushed him away in a wheelchair. Did we feel guilty about this- no. I was more concerned about the impact on the family members, but I respected the doctor's wishes and completely understood and agreed with his reasons. A couple days later, I read a glowing obit about him, praising his long career, his contributions to medicine(he was well published) and that he died in his hospital, surrounded by his family and friends.

Itku2er- Thanks to you, that image has been seared onto my retinas and I am forwarding the bill to you for my opthamologist visit. I can never look at a plate of Hooters wings the same way again... \\Shudders...

Well, I would say there are 2 different scenarios. As a responder, I have no problem trying to "guilt" someone into going to an ER. Tell them the worst case scenario, tell them they may die (if appropriate for their condition), tell them their family is worried they may lose them. If all that fails, and they meet the criteria for a refusal of transport, then you've done all you can, and you need to respect their wishes. Yes, it seems our society has become far more likely to know what's best for someone else- regardless of their expressed wishes or their refusal to comply with seemingly common sense advice/treatment/care. Like you alluded to, since when did making your own decisions become a bad thing? As a family member of someone who may not be doing what you feel is in their best interests, well, like you said, give them the straight dope, make them understand the possible consequences of their decisions, and then support and love them unconditionally. Is it hard- of course. Nobody wants to see a loved one hasten their demise or live a quality of life you feel is not adequate, but ultimately it's not YOUR decision, it's THEIRS. As long as that person is of sound mind and body, you must respect their wishes. That is what love is all about- doing what THEY want. I'm sure that most people struggle long and hard with their decisions to forgo treatment or care and don't come to these conclusions easily. They accept their situation, understand the probable outcome, and are OK with it. We've all had patients who completely frustrate their families(and us) by refusing care, being noncompliant with their medications, or simply do not take care of themselves as we think they should. They made a choice, and we must accept that choice- as unpleasant as it may be.

Most people cannot afford extra fees on top of their insurance premiums to retain the services of a favored doctor, or one that limits their practice to those willing to pony up for their elite fee. It is a very specialized niche that some doctors are willing to fill, but it simply does not affect most people. I wouldn't say we are moving towards concierge medicine- it has always been, and will always be there. It's like a very specialized subspecialty of medicine that most people will never take advantage of. Regardless of the type of health care system we end up with, there will ALWAYS be special privileges for those with power and money- one of them being able to get any doctor, at any time, if you have enough money. Ethical? Right? Wrong? We can debate those points forever, but it won't change anything. The vast majority of doctors will be stuck- just like we will be- with whatever system our government decides is best for us. (Just don't think for a moment that John Q Public has anything to say about it unless we are willing to remove every current lawmaker from office and start over with them, too)

Anyone who has seen an incident they've been involved in make the news, knows the media often does not get the story right. Countless times I've read media accounts of incidents and wondered if I was really there at all. Sometimes it's because the police or our agencies do not give out all the details, while other times the reporter or editor decides that a witness's account has more punch than the official version. Other times it's merely a matter of wording and bias to convey a more exciting story. Regardless, this is a tragic situation and clearly more than that EMT could handle.

Need more details- like the original call, how many victims were there initially, what were the signs and symptoms, etc, but, based on the passage... I hate to say it, but if they knew or even suspected the patients they had were CO poisoning victims, these medics DID screw up- at least in a procedural sense. Anyone else in that hotel(or at least in the immediate area) were potential victims as well and that place needed to be swept for CO. That hotel should have been evacuated. This was a hazardous materials incident and needed to be treated as such.

Will this be a show featuring your area/service, or will it be more general than that? Will it be chronological (ie a day in the life of one person) or snippets of several people and their experiences? Will this be focusing on strictly an urban or rural area, 3rd service, private, hospital based, fire based, etc - or are you planning to take perspectives from several types of agencies? I guess if you are looking at the personal perspective, it really does not matter where they work, though. I like the idea of showing the personal impact of our business. I think we've all heard statements like "I could never do your job!", so I think most folks realize it's a difficult profession, but few understand the personal toll it can take on you- health, family, emotional, financial, etc. Good luck and keep us updated.

Damn shame all the way around, but I saw this one coming when I initially read the article. If the guy was so unstable as to bring a gun to a funeral and shoot his partner's brothers, you had to know nothing good would happen.

I thought that was what folks said about Scotland?

I like that quote, but I learned something today. I always thought it was from Thomas Jefferson, but was actually from Gerald Ford, of all people, back in the 70's. Still totally accurate. Here's something Jefferson actually said, and is also appropriate in this context: "The natural progress of things is for liberty to yield,[1] and government to gain ground." - Thomas Jefferson to Edward Carrington, Paris, 27 May 1788[2] So, does that mean that our current march towards socialism is inevitable? I certainly hope not.

LMAO Yep. Working in the ER, I had a running gag with one of the trauma surgeons. When we had someone who was stabbed multiple times, broken up, or shot and going down the tubes, I would look at this doc and tell her- "Time to do that doctor stuff!" which meant getting the person to the OR and under the knife ASAP. She would look at me and just laugh.

Does the fact that you are paying a "retainer" for your MD mean you will be getting better care? No, it simply means your doctor will be always available and you can call him/her in the middle of the night for an ear ache, you will not wait weeks for a visit, or he will always be the one visiting you in the ER and the hospital if you are admitted. Look, this is no different than some well heeled person who donates millions to a hospital or is a celebrity who gets the royal treatment when admitted to a hospital. Many places do have special wings where they have top of the line rooms, silver water pitchers instead of plastic, special menus, nice furniture, art work, and nearly one on one treatment from nurses and aids. They get the VIP room, they see nothing but attendings (no students or residents). One hospital I deal with calls them their gold card patients. They actually have a special card that designates their priority status- quicker admissions, no wait in an ER, etc. Is this wrong- maybe, but like I said, there is always 2 sets of rules. Health care reform will NOT change this. Bottom line- do these VIP's get better medical care? No, but they THINK they do, they pay for that perceived advantage, and that's what matters to them.

For the vast majority of illnesses and problems, a PA or NP is more than adequate for their needs. Does someone need a Harvard educated doctor to swab their throat and give them antibiotics for their strep? What about treating someone for a yeast infection? Does that need a world famous OB/GYN specialist? We know when a patient presents with a problem beyond our capabilities to handle, and so do NP's and PA's. How many times have you had a well to do patient who has a lac to their arm and demands to see a plastic surgeon to sew up their injury because they feel an ER doc cannot do the job to their satisfaction? This is a matter of perception, and most people have no idea how easy or difficult their problems are to handle.

I suggest that even with an ALS provider, this is an issue that needs an MD ASAP. The only thing an ALS provider could do at this point is work the code after the patient crashes but I think the outcome would not be good.

Back at ya crochity. And to all, enjoy the time with family, friends, and to those of us who will spend the holiday at work, be safe and enjoy the day with your coworkers- your extended family. We all have many things to be thankful for- jobs, family, a roof over our heads, and food in our bellies. Let's also remember those who have passed in the last year, be thankful for the time we spent with them and strive to be a better person in the coming year.

These elitist doctors are not the vast majority, Lone Star- even now. I submit that you will get your wish if we get heath care reform in the manner the far left wants. I also submit that in the coming years, we will also see the results of that reform when the best and brightest minds turn to professions other than medicine because altruism is nice, but it also does not pay the mortgage and the medical school debt.

Those are some classics! I could probably add a few dozen more to that list. Such as: I didn't do no drugs- just a little weed, cocaine and heroin... I don't drink no alcohol- just a little wine and Crown Royal... There is no way in the world I can be pregnant- as the baby's head is crowning... I woke up unconscious... I can't be pregnant- I wasn't having my period when we had sex...