HERBIE1

I know this is a generalization but I simply don't think most high school students are mature enough to handle the responsibilities of being in charge of someone's life. Hell, many HS kids have enough trouble being responsible for themselves. First responder, basic first aid, CPR or 1st Aid instructor- there are many ways to become involved in EMS until you amass a bit more maturity and life experience. I guess taking the didactic portion would be OK, but actually working as an EMT in HS seems dangerous to me. When I first started as an EMTB, many of the younger folks I worked with- especially the males- were clearly not mature enough for the job, even at 20 or 21. I do realize that in some areas, any warm body is welcomed as an EMS worker, but in general, I think it's a dicey proposition and a potential liability for the company.

Good point. Those printers can get pretty hot if you've printed enough paper, so I suppose those thick lines could result from that.

The only question I would have would be potential interference with ER equipment. Many ER's use wireless transmitting of things like bedside EKG's and vitals to a central monitoring station, as well as wireless phone communications in larger ER's- like the charge nurse and attending Doc phones.

Any paramedic text or basic cardiology book should have examples of 60 cycle interference. Once you see it, you can easily pick it up the next time- it's pretty classic. The problem with the posted strip is that the printer may be slow, the stylus needs adjustment, or the paper was sticking, but if you look close, you can see the classic pattern. The only issue I have is that baseline is also wandering a bit, so that's why I also said it may be a lead problem.

I look at it this way. We are potentially exposed to all types of communicable diseases during the course of our duties. As part of our job, we use PPE and take proper precautions to minimize the risks to ourselves and to our families. I see nothing different about this. I look at the fiasco with the Avian flu and the panic we were exposed to. I refuse to take a shot for something I am not convinced is the best course of action. We now have 2 local hospitals here that are mandating H1N1 vaccines for ALL their employees. If I worked for these facilities, at this point I would probably be looking for another job. Just because we work in the health care field, it should NOT mean we should lose our rights and freedoms. Heavy handed tactics such as this mandate scare the hell out of me.

The care provided was not the issue according to the article. If it was, I can't imagine it would not have been mentioned. This was about WAITING on scene because they needed another ambulance crew to drive their rig. No excuse for that. As for terminating resuscitation, AHA guideline or not, that may not even be an option in their system. Even in the case of an obviously dead child, I ALWAYS transport- even if it's just BLS, unless it is a crime scene. The hospital has the resources, social services, chaplains, etc to deal with a horrible situation. Additionally, if there is any indication that foul play, abuse, or neglect, the child is in a controlled setting where they can figure everything out. Clearly, unless the child is terminally ill, this will be a coroner's case, so you are protecting the rights of that child so that the truth can be discovered. Any cardiac arrest is a traumatic and emotional situation, but when a child is involved, the tension escalates 10 fold.

They are in too much of a hurry to get this out there. They moved the release date up before clinical trials were even over. Think HPV vaccine. They put on the full court press on this, claiming it was safe, etc. Then, even before it was released, more information came out- like it wasn't nearly as effective as we were led to believe. It did not prevent all forms of the disease. Then we find out that there were significant side effects, and girls actually died from receiving the HPV vaccine. Unfortunate, and yes, it does happen with even supposedly "safe" vaccines but why push something like this, especially when it's efficacy and safety is such an issue? I've never received a flu shot before, and I am just getting over the first cold I have had in about 5 years. Are there instances where people NEED these vaccinations-yep. My wife has asthma and before it became well controlled by Advair, even a simple cold had the potential to put her in the hospital. She still gets a flu shot every year- and has the sore arm today to prove it. I'm also of the opinion that we overmedicate ourselves today anyway- our immune systems are wasting away. Medicine is a wonderful thing, but I think we have become overly dependent on popping a pill for every ache, pain, or sniffle. If there is a valid medical reason- an underlying illness, obviously it's a good idea. Unlike the general public, we have the capability to protect ourselves and the patient should the need arise. Mandatory- no friggin way.

Good question. In order to vaccinate so many people, they will have to allow EMT's to do this, in the proper context- ie a clinic or outreach setting. We already give IM, SL, SQ, and IV meds at the advanced levels, so I think all we need to know are possible reactions and contraindications. Medical directors simply need to sign off on this. In disaster situations, many rules are suspended for the sake of mitigating the situation quickly and if we see a pandemic, look for the same thing to happen.

Well, this is the rub. Too many variables. Every area is different. How many other departments use that facility? Is there one dominant organization that does the majority of the transports? Does that facility have an agreement with the EMS providers to allow space for a printer? Do they have an exclusive arrangement with one particular company? Each company may use a different report generating program, which would mean multiple print drivers, cords, docking stations, compatibility issues, etc. Who would be responsible for the upkeep of the printer- toner, repairs, paper, etc? Unless all agencies can agree on the same software/printer set ups, a hospital would need more space for multiple printers- probably not something they would relish. That's why I suggested a portable printer for each ambo.

Exactly my point. As for the liability clause, I'm sure that is the case, but as the inevitable lawsuit will claim, the liability of delaying transport in an emergency situation such as this will trump any silly pissing contest between the EMS provider and the FD. Even an untrained bystander can squeeze an ambu bag on command, and as you say, I'm quite certain these FF's are trained at least to the 1st responder level. Our jobs are all about handling the unexpected, dealing with adversity, and making do with an imperfect situation- it is what we do. This crew needs some serious retraining and reeducation. Unforgiveable. I don't know what the scene time here was, but these are the things you weigh out with a critical patient- it's just as important as the treatment you provide- transport times, need for a helo, need for back up, proper facility to accept the patient- that is part of the job.

WTF? To me, the issue here isn't why a FF could not drive the ambulance (stupid policy, but not the point), but why 1 provider- whatever level they are- could not handle this patient alone, while his partner drove? Both provide initial care and then go. Optimal situation- no, but what happens when a person suddenly arrests when there is only one provider with the patient? Do they stop and wait for help when the hospital is less than a mile away? Without more details, who knows if the patient was viable or not and if the delay made any difference in the outcome, and it is sad that the boy died, BUT- Shame on this crew.

Bingo. In order to demonstrate the maturity of an adult, you need to act like one and start making good choices. If you recognize that you are being put in dangerous situations with your friends, then you really have a few choices- ignore it and take your chances with those kids, or do something about it. You can certainly attempt to be the voice of reason and explain the possible consequences of their reckless behavior to your friends. Problem is, like most teens, they feel bullet proof, immortal, and immune from bad things- that stuff always happens to other people, not them. They hear the stories about horrible accidents, but they think it will never happen to them. You may not be able to change your "friends" but YOU can make a mature decision and take yourself out of a dangerous situation. Throw yourself into school, a hobby, EMS- whatever, and you will find true friends to replace the ones who may very well cost you your life.

Problems like this drive home the point that there is no "one size fits all" solution to problems in our business. A small organization's options may be rather limited, and unless you have a big budget, as was noted, putting a printer in each hospital may be cost prohibitive. One possible solution: A small, portable printer in each unit.

Groan... Early happy hour, Richard? LOL

I haven't seen this since the LP 5's. Classic picture is alot more defined but I agree it's 60cycle interference. A good way to confirm this is to change the leads and see if a better picture emerges. If the problem occurred and then resolved on it's own, you need to ask what changed in the environment. A new piece of equipment was turned on, the telemetry radio, the inverter kicked in, etc. If not, then I would suggest there could be an internal problem with the LP12 itself. I would take that monitor out of service and have it checked out ASAP before it malfunctions in a critical situation. \\Another thought- verify the leads are OK- no breaks in the wires, good contact with the electrodes, etc

This whole situation is no different than any other workplace dispute. Problem is, bickering over a report deadline doesn't have the same impact or consequences as bickering over how to treat a cardiac patient, WHILE THE PATIENT IS LISTENING. As with any situation, some people are not good at interpersonal communication, and in our business, that is a real problem. Some people are power hungry and egocentric, while other prefer to be doormats. You need to strike a happy medium and the best partnerships play off the strengths and weaknesses of each other- a complimentary rather than adversarial situation. I think strong personalities- both good and bad- are attracted to the business because of the autonomy, and this can cause a conflict when those personality types collide. They don't like having someone standing over their shoulder, telling them what to do. You also NEED to have a strong personality to be effective in this profession, but need to channel that in the right direction. When someone is new to EMS, they have the book knowledge but not the experience. If someone shoots down an idea as a newbie, wait until the preceptor or senior person explains themself, and then you need to do an honest assessment of whether or not you were correct. I was always told when I started to keep my eyes open and my mouth shut. It worked well for me. Did I agree with everything I saw or was told- nope. Far from it, but I managed to express my opinions in a nonthreatening way that made it clear I was there to learn, but not to be treated like dog crap. If it was a trivial issue, I would usually drop it, but make a mental note that once I was in charge, I would NEVER repeat whatever action I disagreed with. I guess I was lucky, rarely did I ever get questioned or berated in front of a patient, but when it happened, I always said something like- "We will discuss this AFTER the call", and would occupy myself with something to change the subject and end the incident until later. I was fortunate to have some great role models- and still do. Bottom line- you need to stand up for yourself and your patient when appropriate, but you had damn well better be able to back up what you say or your credibility is gone.

Yeah, but once a pregnant minor has her baby, she goes back to being a minor. She is the legal guardian of her child, but she is still legally a minor. I've spoken to parents on the phone, but playing devil's advocate here, honestly, how do you know if the person you are speaking to is really a parent? I've received "consent" to transport via a phone, but I don't recall ever having a parent refuse transport for their child in this manner. Exception to above- in a school situation where a child has a minor problem, and the parent says they are on their way to pick the child up. The school then takes responsibility for the child until the parent arrives. Medical control has never had a problem in cases like that, but it's also not explicitly spelled out in our policies. Just another one of those grey areas we occasionally need to deal with...

True...it is a common term and I have used it also. Just looking beyond the legal eagles whom try to screw you. Just to help cover, use the term as you stated "apparant ETOH on breath....", but embellish it with other descriptors as 'exhibits slurred speech, blood shot eyes, odor of ETOH on breath and person, etc.' The only thing I meant with AMS would be if the individual was truely intoxicated which in some regions could be viewed as an alteration in their mental state. Again, I do not disagree with you. It just depends on how you see and use it.

I also don't know the legal ins and outs of someone who walks away from us, but as long as they are not obviously impaired or seem dangerous but to me, to chase after them is dangerous. They are not under arrest, you are there to provide them medical care, and if they want no part of it, that is their choice. They also may not care about your protocols for refusals. Most places do have a provision for a "refusal" with no signature, and if you have established patient contact in any meaningful way, then you need to document that encounter to CYA. Like you said, the terminology used on the air is not the same as what you would use on your report. I keep it brief on the radio- no need to tie up the radio with some long winded explanations- save it for the report, PRN. We may use "Pt walked away". "Mistaken caller- nobody on scene wanted EMS", etc.

Sorry folks, but there are plenty of similar stories out there, from all over the country. In a recent safety seminar we saw horrible crashes of fire and EMS vehicles from St. Louis, Chicago, LA, and somewhere on the east coast. All were paid, "professional" departments. The gung ho mentality is not unique to low volume or volunteer groups. There are still plenty of idiots out there who disregard their own safety, the safety of their coworkers, civilians, and those we are supposed to be responding to. It's not nearly as bad as it used to be, but it's still a problem.

Depends on what you had for dinner. Could be ugly...

In most rigs there is a blind spot directly if front of the rig. I have no idea how they receive calls, but clearly they had to be given an address to respond to or how would they know which direction to go once leaving the station?

This is just plain stupid. An entire fire company, EMS crew, and an innocent driver could have died because of stupidity. Firetruck forces ambulance off road on way to Hunterdon County accident Posted on 18 September 2009 HUNTERDON COUNTY, N.J. – A firetruck responding to a car crash call in Hunterdon County illegally passed an ambulance headed to the same wreck, forcing the ambulance into a ditch when the truck swerved to avoid an oncoming car, an ambulance official said. Now the president of the Quakertown Volunteer EMS is calling two members of his squad "heroes" after the accident involving a Quakertown ambulance and a Quakertown Fire Company truck, both of which were responding to a one-car crash on Sidney Road. He credited their training and quick response for preventing the accident from becoming "what could have been a huge disaster." Peter Colby, 27, was driving and Laurie Luster was a passenger in the ambulance shortly after midnight Saturday when "they were illegally passed (by the fire truck) in a no-passing zone on Quakertown Road," president David Evans said. Colby and Luster are employees of the Quakertown squad. "To avoid a head-on collision with an oncoming car, the fire truck forced the… ambulance off the road into a ditch. The oncoming car was also forced off the road," Evans said. It is fortunate that the ambulance landed in the ditch, because it kept the rig from flipping over and prevented it from hitting a nearby utility pole, he said. Kenneth Mandoli, Franklin Township director of public safety, said he couldn't release any information about the accident because it remains under investigation. He said his force is doing a probe, taking statements from about 14 people. Evans said the oncoming car was driven by a Quakertown Fire volunteer, who was driving to the firehouse to respond to the call. Witnessing the accident was a township employee driving behind the ambulance, Evans said. "He saw everything." The ambulance was driven out of the ditch, and Luster and Colby "checked that it was OK," Evans said, before they continued to the Sidney Road accident. Patrolman Tim Wahba and Evans were among the responders to the Sidney Road accident, in which police said Ian Heffernan, 33, of Asbury, lost control of his car. It went off the road and hit several trees. Quakertown EMS took him to Hunterdon Medical Center, where he was then flown to Robert Wood Johnson Medical Center for treatment of "serious injuries," police said. After taking Heffernan to the hospital's helicopter landing pad, Evans and Colby were treated at the hospital's emergency room. Luster suffered a hip injury and Colby an ankle injury. They were released about 2 a.m. With five firefighters in the truck, the two EMS responders in the ambulance and the firefighter in the oncoming car, "There could have been eight fatalities," Evans said. "The first job is to protect yourself, to be safe. We have to be cautious" because failing that "puts the other victim" awaiting help "at risk." "There was no reason to have passed our ambulance," Evans claimed, but there is a reason for the no-passing zone. "It's a blind hill. You can't see over the crest of the road." Quakertown Fire Chief Bradley Patkochis said he was "unable to provide any information or comment" and referred calls to the department's attorney. There's been some hostility between the two volunteer units for more than a year, since the fire company announced plans to initiate a Quick Response Service to answer certain ambulance calls.

Paramedic allegedly shoots two, administers first aid Abington, Mass. – It is not a story one hears every day: a Boston paramedic who allegedly admitted shooting his former work partner’s two brothers, then started to administer first aid on them. “Came outside, there were three men wrestling on the street. Two men were shot, one was shot in the leg, the other guy was shot in the chest. The third guy wrestling around was obviously the shooter. They were wrestling the gun away from him,” said eyewitness Joe LaPointe who lives on Bates Street in Abington. That’s how it ended. It began Saturday night when this man, 41-year-old Boston EMS paramedic Rhys Williams went to a party in Abington after a benefit at the Norwood Elks Lodge in honor of his former work partner, Mark Brinkman, who died in May following a brief illness. Now Williams faces two counts of assault with intent to murder Brinkman’s two brothers. “Mr. Williams immediately stated to the officer, I shot them. They gave me no choice, I shot them both. At this time, he was escorted from the scene and secured. He further stated to the sergeant on scene, I shot them, I had no choice, they made me do it,” said Plymouth County prosecutor Matthew Green. According to Plymouth County prosecutors, after a night of drinking, there was an argument between Rhys Williams and brothers Paul and John Brinkman in this North Avenue home early Sunday morning. The brothers asked him to leave and he did, but when he later returned about 7:30 am Sunday, another altercation started around the corner on Bates Street. “The defendant stated that John Brinkman threatened his life and was attempting to pull him out of the motor vehicle. He stated that it was at that time that he shot John Brinkman in the leg. After shooting John Brinkman in the leg, the defendant stated that Paul Brinkman came towards him at which point in time he shot Paul Brinkman in the chest,” Green said. Prosecutors say witnesses did not hear the Brinkmans threaten Williams. Joe LaPointe was asleep in his home across the street and heard the two shots fired, then saw what he describes as something bizarre. “After the gun was out of the picture, he actually went to the back of his car and pulled out an emergency bag and started doing first aid to his friends. It was bizarre, in the least it was a bizarre situation,” LaPointe said. Rhys Williams, who winced and sobbed through much of his arraignment in Brockton District Court is being held without bail until a dangerousness hearing Thursday. There’s still a lot to be sorted out with this case. Rhys Williams clearly had a relationship with the Brinkmans, he even gave Paul Brinkman a ride to Abington after the benefit. Paul Brinkman remains in a Boston Hospital. John Brinkman was treated at South Shore Hospital and released. Boston EMS said that Williams was on medical leave since July – and has now been placed on administrative leave.

Could his beligerance be onset of AMS? Tough call, probably should have been evaluated due to MOI, but looks like unsure of all the details.