Dustdevil

Even Cowley himself admitted that the "Golden Hour" was arbitrarily chosen as the time standard, without any real evidence to establish it. That doesn't make it a bad thing. It just tells us two things that remain true: 1. Time is indeed of the essence in critical trauma care. 2. Medical providers -- both in hospital and pre-hospital -- need to remain cognizant of this essence and be encouraged to expedite their assessments and limit their interventions. This leaves us with a dilemma. How do we encourage medical providers to watch their time unless we have a specific figure to give them, like one hour? You can't just tell people to hurry. That means something different to everybody who hears it. You have to establish specific criteria to define the time frame you are trying to achieve. And to do that with any credibility, it must be based upon validated scientific and statistical research. Unfortunately, Dr. Cowley's standard did not do that. And apparently, neither has anybody else. So, do we disregard the Golden Hour concept altogether as invalid, and just tell people to "hurry"? Or do we stick with it because it is all we've currently got? Obviously, simply failing to address it at all because we have no validated standard is not an option.

I'm afraid that is how it is in a great many progressive EMS systems these days. It just makes much more sense on a lot of levels. And so long as they aren't working you longer than twelve hours at a time (and so long as you are getting adequate sleep prior to your shift), it's not such a bad gig. In fact, a great many people prefer it for many reasons. You gotta find ways to stay occupied. I don't know how big your county is, or what kinds of diversions are available to you, but get creative and you'll find something. On day shifts, you can hang out at FD or PD/SO stations in your area and socialise with those blokes. Hang out at the mall or a bowling alley where you can play some pool or video games. At night, you have to try a little harder. Decent size municipal airports (not big international airports) frequently have a pilots lounge (with games, movies, and coffee) and all night attendant who also needs help staying awake. Check that out. If you are stuck in your vehicle or in an area with none of the above facilities, bring books, music, games, a football or Frisbee (I always carried a glow-in-the-dark Frisbee on nights). If you're lucky, your system doesn't mind if you take a nap in the vehicle. So long as you are in a relatively safe, well lit and populated location (in front of a 7-11 or similar), and keep your doors locked and your pager on, you can catch some quality Zs on the squad bench. Fixed stations will continue to become less and less common in EMS in the coming years as leaders finally realise that 24 hour shifts are, in most cases, detrimental to the organisation, its people, and the people they serve. Get used to it.

Specially trained paramedics will join KC police in tactical situations By JOHN SHULTZ The Kansas City Star Specially-trained MAST paramedics will soon be riding into the thick of dangerous situations with Kansas City police tactical teams, the police department and ambulance officials announced Wednesday. The tactical medics — trained by police in, among other things, movement under fire — will roll with police officers in the department's armored vehicles to the front lines of tactical operations. Those operations can run the gamut from stand-offs with barricaded parties to scenarios like April's Ward Parkway Shopping Center shooting. "It's something we've needed to do for a long time," said Sgt. Joe McHale, commander of one of the police department's tactical teams. "It's certainly not a new concept. The idea was designed by the Army during World War II." Having MAST personnel on the front lines of an operation will cut down the time it takes police to get medical attention for an injured party, McHale said. Currently, MAST crews already work tactical operations, but they're stationed at a secure command post several blocks and many minutes away. "This increases our ability to treat casualties in a situation that's unstable," McHale said. One MAST medic, Erik Carlsen, received about 60 hours of police tactical training and has been serving as a one-man pilot project for seven months. He was able to enter Ward Parkway mere minutes after officers stopped shooter David Logsdon. Police and MAST hope to have eight tactical medics — one for each of the city's tactical squads plus two additional alternates — in place by mid-August. The selection process starts with an obstacle course run today, with training to commence in July. Candidates have to pass a police background check and have three years of MAST experience and a clean personnel record with the ambulance service. They'll be outfitted similarly to police with body armor and other equipment, and they will have to undergo continuing training. "We think they'll be MAST's most capable and qualified medics," McHale said.

Agreed. Unless the girl was all but ignoring the elbow injury, I would have to count it under the "distracting injury" criteria. The good news is that the elbow impact probably lessened or eliminated any forces that might have injured the neck. However, that is certainly not a given. And we must remember that it is not so much the force involved that causes SCI, as it is the angle at which it is applied. We've all seen people take one hell of a blow to the head without spinal injury. And, of course, I have seen plenty of SCIs without pain or neuro deficit on the scene, including my own. In all probability -- based upon the info provided here -- I would have immobilised her. But, depending on how well you articulated yourself in your SOAP, I would consider medic discretion to be appropriate in the matter. That better be a thoroughly impressive SOAP though.

Yeah, Modulance (Modular Ambulance Corporation, Grand Prairie, Texas) was the pioneer. I believe they were the first to go full-scale production line with modular style ambulance conversions. First ones to run crash tests. First ones to go with dual alternators. They built the Type I used on "EMERGENCY!" (which was later bought and brought to Fort Worth, Texas, where Dr. Bledsoe worked in it as a paramedic). By the late 1970s, the market was saturated by a lot of other upstarts. By the late 1980s, a lot of those upstarts had become major players, providing a superior product, and Modulance faded with a whimper. Last I saw (a few years ago), the factory was still vacant.

LOL! There are several of those "Trunk Monkey" commercials on YouTube. That's the only medical one I know of, but they are all great! And yes, first time I saw one I immediately thought it was a great idea for EMS videos!

Well, Al, you screwed up by not finishing the protocol. You forgot to mention the "b/l 14g w/o and haul ass to the LZ" part.

LMAO! Just when I thought it had all been said!

Hahaha! Congratulations! With this exchange, you two just qualified this thread for the "Funny Stuff" forum. Everything that Phelps said is what I have been saying all along -- especially the nursing part -- and facing much the same flak as he will receive. SQUINT: Minus five for not quoting your source. Do you have a link to the original article?

That quote is actually two to four years old now, but it is timeless in its relevancy!

You're going to waste the good paper on this caca? You think more highly of it than I do. The IACP and FOP could have written the same thing and made it sound just as impressive (which isn't that much). I'd like to see the national association for water system engineers (there must be one, right?) write a paper on why they are the logical choice to take over fire suppression duties nationwide. They could certainly make a much better argument than the above idiots just made.

:jerk: Just get a Star Of Life tattoo instead. It's cooler, and you don't have to renew it every year.

Definitely. But the lessons are still here to be learned. Number 1: perception is everything. The way this student perceived the situation is how she is going to tell it, right or wrong. And that is how our image is created. One must always ask onesself, "how is this going to look?" Regardless of his intentions, I still think this guy was being stupid. And, of course, I don't think any of us here are naive enough to actually think that this situation, exactly as we suspected it, doesn't occur everyday somewhere. The fact remains that there are indeed a lot of unprofessional, ignorant, and immature people in EMS, and in EMS education. Be alert for these people, because their actions hurt all of us.

Probably the same as they are going to be now. She'd get fired. Then it comes down the the academic discussion of whether it is better to be fired for doing the wrong thing, or for doing nothing at all.

I think by being snippy with the caller, the calltaker bought that negative attention on the agency. Doesn't matter that she was doing her job correctly, within the guidelines she works under. When you cop an attitude, the media smells blood.

Holy fark! :shock: That is the most amazing musicianship by a non-musician that I have ever witnessed! Actually, I bet that's a poor assumption. He MUST be an accomplished musician to even think of this! Minus 5 for posting in the wrong forum, because this is very definitely not funny. In fact, it is downright embarrassing, compared to the things we medics want to call "skills."

It's really just a shame that this has made such a splash in the media. But hiney sight is 20/20. And the more I think about it, the more I think the county should just plop... I mean drop the hole thing. Come down off of their porcelain thrones and turn the other cheek. But who am I kidding? They'll probably sewer.

It's quite cathartic to get this out of our systems. It's not healthy to hold these things in too long.

Blimey! Did Alberta secede? I heard rumours that Ralph was considering it, but I never thought I'd see the day! :shock:

I'm afraid I can't get on board with this suggestion. For us to start digging into this personally reeks of vigilantism. For us to just let it go is negligently apathetic. You are correct, that this is only an accusation at this time. That is why I don't think any discussion of names is appropriate. But the proper bodies to verify the specifics, and to act upon them, is ACP and the school in question. If they are not notified, then there will never be any verification, one way or another. If it never happened, or if this is all just the lunatic rantings of yet another Internet drama queen, then that will be easily determined. But if there is fire beneath this smoke, that too should be addressed by a regulatory body, not by us. I believe our role here in the peanut gallery is nothing more than interested observers. There are SO many lessons to be learned from this scenario. Whether it happened as we have been told or not is irrelevant. This is still a very educational professional discussion. By the way, the thread is -- as I predicted -- gone again, at the request of the original poster. Not sure I can really blame her, as it must be pretty embarrassing as she realises how inappropriate this scenario really was. Did anybody take my advice and copy/paste or screen capture the original post for us?

I'd really rather we did not get into names on this topic. Who was involved is really irrelevant to this forum. It is the professional issues involved that are the important topic of discussion. Naming names is just going to get this topic closed, and rightfully so.

As backed up as the courts are, this case could linger in the bowels of the justice system forever.

IT'S BACK!!! One of the moderators put the thread back up, but no telling how long it will stay, so read it while you can! I have no way to save it on this computer, so if somebody can copy/paste it to MS Word or screen capture it, I would appreciate it.

It is rarely seen in this business. After all, most people with considerable common sense would never choose EMS as a profession in the first place.

Minus 10 for overquoting. We only need to read these posts once, Mack. Please edit out or delete all those quotes (the stuff framed in white) from your replies. You're killing our bandwidth.