uglyEMT

Ok are the on lookers family / friends? Can they help tell us anything prior to the 911 call? Is the patient breathing? Pulse? Pupils? History of siezures? Epilepsy? What kind of meds is the patient currently on? Possibly OD? History of recreational drug use / abuse? Vitals?

One thing our local hospital did was install a key fob system. The linen locker would only open when the fob as swiped so they had a record of who took what. They gave key fobs to allt he local 911 EMS agaencies the regularly used their ED. That way they were almost certain to get thier stuff back. Yes ocasionally when we transported to a different ED we would leave it their but they would put it in bags and store it in the gear locker in the bay. When we sent someone back to retreive our things from the locker they would pick up the sheets as well and we would drop them back off at the other ED. For cold weather we do use heavy wool blankets but they never come in contact directly with the patient, we always use our ED linens first then put it on top of them that way they stay as clean as possible. After the call we would wash them at the station. Each rig carried 2 wool blankets and we kept four in our station to swap out used ones. For hypothermia patients we had these mummy bags that were like sleeping bags but disposable. They even had pockets for warming packs to be inserted. I will try and find a link to them, I know they came from our equipment company so I don't know if they are available online or through them directly.

Yea what kind of scene are we talking about here? PD on scene? Local residence, field, park, ect? Whats the environment? Any chemical spills or confined spaces? More then one patient not "acting right"? Hell I'll go crazy... possible NCB attack?

As a person who works in an area that flys patients quite often I have to agree with island here. Waiting 30 min for the bird vs 15 ground transport to a higher care facility was wrong. Get the kids to the ER and if it was necessary for a more specialized care then the medivac could be done from the hospital. Why risk the pedi crashing for the additional 15 minutes wait time if they were in such a condition that required medivac. As a note as per the article, the flight medic and nurse both stated the second child needed medivac as well and requested a second bird. So somewhere along the line the pedi's condition or injuries made them make the same call. So either their condition was worse then stated by the news article or the news article is being biased against the responding medic for whatever reason. Without us being there we only have one side of the story. I still agree though waiting was a wrong decision as ground transport was a faster option to higher level of care.

http://worldnews.nbcnews.com/_news/2013/09/17/20538372-austria-cops-besiege-farmhouse-after-suspected-poacher-shoots-dead-3-cops-medic?lite So far just have what's in the article. He apparently waited for the Medic to arrive to assist the officers then was fired upon himself. Scene Safety Reminder everyone. My condolences and prayers to all the families involved.

This is why I love hearing from members in other countries. I am in an area that flys patients alot (we actually have a helo on standby at our local airport and three maintained LZ in town) so I can equate but the bikes what I wouldn't give for that kind of escort during rush hour.

PD- The Finest FD- The Bravest SD- The Strongest EMS- The Forgotten I know what you mean by the lack of respect we usually get. I think it comes from ignorance mostly, thinking all EMS is fire based.

Hi Tim. Welcome to the City! Pull up a chair and enjoy.

On my recent recert class we talked alot about why we do the interventions we do instead of what we do. I know it helped some students out to understand why we do things, some of the more seasoned folks learned those things in the field so it helped the newer EMTs or those that just do IFTs. We did have one session of case studies with difficult extrications or environments. Car overturned into a small creek, farmer unresponsive in a silo, machineist caught up in a lathe, electrician unresponsive up on a pole. I will give you a personal case that I told the class and the instructor wrote down for further use and study. Very heavy snowfall (2+ feet) outside with drifts to chest height, home set back from the road 100 feet, unshoveled walk ways. 56yr old male post CABAGE complaining of pain in his left arm radiating to his chest. You and your partner arrive (both EMTs) ALS is in route but due to the conditions and the roads is likely 30 minutes away. A) How do you get to the patient. How do you get the patient to the rig. What we did was basically swim to the front door through the drifts. Left the cot at the rig and used the backboard as kind of a sled. Patient was allowed to sit up for comfort on the board but for safety we strapped his legs down and slid him (partner behind the board for stability and pushing, used two spider straps attached to the front and over my shoulders to pull it) to the cot where we transfered him to the cot and off the board. Met ALS in route to the hospital yada yada yada. Hopefully your class will get into scenario based labs and use real world examples that work your mind vs fulfilling a check list. Hope this helps. If you have any other questions I would be glad to help. Especially with some real world cases of some pretty unlikely stuff. Its amazing what you get to see in rural EMS vs the big city type stuff.

Captain at the recent EMS convention around here they had a presentation about just that. L&S vs None in non critical patients and they found the same thing it only saved an average of a few seconds but ADDED a large amount of risk vs reward. http://www.njmedics.com/assets/presentations/LightsAndSirens.pdf Again I have to agree that its the perception of doing everything we can.

All I can do is follow what is outlined in our protocol. In which it is written that.. When we are on the highway we use the siren a bit more but if it is late at night we are the only vehicle on the road usually. At the one hospital we go to it is an actual policy that no sirens be used within two blocks of the place. The surrounding residents got the town council to draw that one up. Although I do see where there is the need to have both on and in some places it is required I also see the flip side in where in a rural area with low traffic volume the use of both is sometimes not required. Yes at any and all intersections it should be used regardless. If I see someone coming from a driveway I usually give the a blow of the air horn to grab their attention more so then the siren. For some reason it seems (to me anyway)that they can hear it better and know which direction I am coming from faster. Intersection get it all, lights siren and horns.

Sitting here in my work trailer looking out the window at the New York Skyline listening to the names being read in the back ground and remembering what happened 12 years ago. Today is always a hard day for me and I know for countless others as well. Just wanted to thank everyone for their service. Sometimes we forget how we touch lives and just what our actions can do for people. Even if not directly acting upon someone we touch lives. Be it seeing a smile on a face that adds a glimmer of sunshine to someones cloudy day, a shoulder for someone to cry on, or just an ear to bend. We all touch lives. Please remember those that perished and those that were left behind to hold the burden. Stay safe everyone.

I would say in this instance Lights Yes but no siren. I would actually use my air horns when necessary. In bad traffic with little to no speed I don't see the need for the siren if nobody can get out of the way. Intersections get the siren because I trust noone LOL In my area I have to agree with jwiley40, I always use my lights to respond TO the call but sirens stay off until needed. Late at night the only thing I need to move off the road are the bears and deer so very rare to hear sirens in the wee hours. As per our protocols all calls are responded to with Lights (siren when needed). The only time we respond without lights are for lift assists and transports (usually scheduled ahead of time). After clearing the scene its up to the crew how we transport to the hospital.

Welcome to the City!! Congrats on becoming an EMT as well. Yes Captain means an actual officer. Most Tactical guys are officers first, not saying in your area its is that way but more likely than not. I know the one or two I have spoken with all said their respective departments don't look outside of the dept for their medics. They want them to be good officers first in the heat of the situation then be good medics if necessary. Like I said, that what was told to me. Keep your dreams alive though and ask around. Sometimes you have to kick the door open vs waiting on a knock. Did a ride along with our Flight crew once, you can have it LOL too many parts flying around in an organized fashion for me LOL but a word of advice on getting one, be the squeaky wheel. I had to ask everyday for almost a year before the Captain finally said it was a go to just get me to stop calling. Became good friends with the Captain and the crew since then actually from that experience. Again welcome to the City. Hope to see you around the threads. Ask questions alot, none are stupid or dumb, we will respond and give our knowlege but be prepared we are honest here and you might not like the response but don't let it discourage you. My biggest asset when I first started as an EMT was this place and the honesty really helped me see my mistakes and learn from them. I had to own the mistake thats for sure but it made me a better EMT because of it and it benifits my patients.

It works Ruff. Awsome Pics!! Some of that Steampunk stuff was out of this world. Still can't understand standing in the desert for days, but thats just me, I hate the heat.

Without a doubt one of the best comments on this site! I have tried to instill this in all my partners. If they see something say something. Sometimes its not even the senior thing. Hey we all get tired and might overlook something even obvious.

No but I did have a partner once that had Another One Bites The Dust as a ring tone that did go off during a CPR. Talk about

Wow it was there yesterday during the day. Sorry about that. Let me try again.... http://www.emtcity.com/gallery/image/874-3am/ always expect the unexpected

Always expect the unexpected

Thanks for bringing this back up LOL You all got me in trouble at work for spending so much time rereading it from page one. Was well worth the stroll down memory lane.

Congrats! Welcome to the field. Mike hit the nail on the head. One thing I will add is don't be too hard on yourself during Basic class in the begining. You're new and don't have the muscle memory to get it right off the bat. Practice, practice, practice. You will get it eventually. When you start doing your blood pressures practice on everyone and in all different settings. Start with dead quiet and progressively get to louder and more chaotic environments. Your friends and family will get sick of you taking their BP but later on your partner and patients will appreciate it. Come here and ask questions. None are dumb or pointless. The wealth of knowlege and experience on this site is second to none and most are willing to help in any way we can. One thing I will warn you of we are brutally honest here. We don't sugar coat or coddle you for sake of making you feel good. We tell it like it is and will call you on a mistake. Don't take it the wrong way though, learn from it. The biggest thing I learned from this site is to own your mistakes. Learn from them and you will grow into a provider that will be the best you can be for your patients. Again congrats and welcome to the ranks and the City.

Certain things you do get used too. I remember when I first started every call got my blood pumping, you hear the tones and Randy Rescue comes alive. Even for the 3am stubbed toe calls. Then as you do the job longer you start realizing not every call is huge. You begin to find your own place and learn how to calm down and run the call. Its not that you stop caring or become unsympathetic to your patients it's that you learn how to center yourself and become the provider of care. You become the shoulder to cry on, the lighthouse amongst the gail. Then just when you finally "get it" you get hit with a call that turns your world upside down be it a submerged vehicle (Capt I can't even begin to imagine that call) or a 20yr old OD on Thanksgiving or something else you didn't expect to get you. The death,dying, and suffering part comes with our job, some are easier to rationalize in your mind, others are not and those are the ones that suck. During the call you will be steadfast and be what everyone expects of you, somehow our brains get wired to just do it, its after the call that it hits you. Be it at the ER after handing off the PCR, in the equipment room grabbing something left from a previous call, just outside the doors or the long quiet ride back to the station that it hits. Its at this point where we can give examples of what we have done to cope but in all actuallity we don't know how you will cope. We are all different mentally. In my experiences I have seen things from anger and screaming at walls, someone needing to go to the chapel, puking, crying, all the way to unstopable laughter. We all deal with it differently. What hopefully you get in place is a way to deal with it both in the near term (right after the call) to the long term (the days and longer after the call). That's what will help keep you from burning out too quickly. I'm glad to see you stuck around. Shows me personally that you do want to be part of this. Your honesty to yourself that you know the OCD might get in the way and are currently seeking treatment for it shows me that you take an honest look at yourself and know your limitations. I hope everything works out for you and we do get to see you become an EMT.

Good job Seth. Hopefully once you do that you do find a place in this field. And if / once you do remember he are all here for you to ask questions, discuss stress and burnout, and anything else you want to bounce off us. As for cumulative stress. It affects us all differently so it can be kind of hard to say how any one individual will be and to what extent. What we can say is that it happens to us all and depending on coping mechanisms put in place to help and or prevent critical chronic buildup happens sooner then later. Before you start find something that makes you forget everything (please don't self medicate with ETOH or illicit pharmacuticals) and clears your mind and body. For me that would be scuba diving. Once I am in the water everything seems to melt away to an almost zen like state, everything from EMS all the way down to "did I put the laundry in?". I come out of the water feeling so relaxed and care free. Something like that will help you too (not saying scuba diving but anything that you can emerse yourself in). Keep up the good work Seth.

Yes triemal there are outdate protocols but if they are your protocols you follow them (ie the back board and C spine, my service and Med Dir state in the protocols that we must do it so I do.) But gloves for patient use, come on. Yes they should be used at all times. Look at it from a different perspective they also protect the patient from US. What if we have some nasties on us that you comprimise our patient? gloves are a way of stoping that. Now back to the OP he had non intact skin so he should have been gloved up no matter what. Why risk contaminating a patient? At the end of the day I am the most important person right? We are number one priority right? So why not take that one second (as you stated) and glove up? What is the harm in wearing the gloves? Its a nonivasive preventative measure to insure both parties (you and the patient) are safe. You asked about full PPE (mask gloves googles ect) if I have a trauma in the back you betcha. I dont want fluids in my eyes, mouth, ears, hair ect. Hell I even wear eye protection with drunks and EDPs. If they are spitters I will actually put a mask on them to insure my crews safety. Documented of course. Why not take the precaution? Is it now taboo to take PPE seriously for every patient? Like I asked OP about cleaning the cot and straps between calls. Is that not needed either? An ounce of prevention I say. In my personal life outside EMS. Yes I try to be hygenic as much as possible. Sure I am not walking around in a biosuit but I try and avoid contamination as much as possible (Yes I will and do put gloves on when treating even my own wife and family for a cut. Again don't want to give them something I might have on my person) Washing frequently is always advised. I stay away from antibacterials and stick with plain old soap and water. We do have good bacteria so I try and not kill them. I don't understand how this thread has turned into a PPE bashing thread. Are our soap boxes so high that the lack of oxygen has made us loonie?