Dustdevil

I don't know the answer to that trivia question, but believe it or not, I do remember that episode of "Get Smart" and can tell you why the robot's name was Hymie! Yeah... I'm old. :?

I have definitely known some real a-hole paramedics. Guys who want to do ALL the driving and won't attend on any patient that is not ALS. They crap on their partners. That's BS, but it happens. Some of them aren't quite as bad, but will still make their EMT attend all non-emergency patients and not let them attend any emergencies. It has always been my policy to alternate after each and every run. If I attend on this run, I drive on the next one and you attend. It's only fair. The medic will still end up getting screwed since he gets not only every other patient, but also every ALS patient. But I refuse to stick my partner with all the crap runs simply because I am the senior medic. And if my partner is a rookie, I am going to try and give him or her every possible opportunity to use his/her skills.

It's not a "feeling." It's a fact. Besides, there is usually going to be a senior person on a crew of two EMTs too. There's always a pecking order, regardless of training levels. It's not about egos. It's about what is best for our patients. What extra training would they need? No they wouldn't. Triage is triage. Medical priorities don't change according to the level of training of the responders. The only difference would be that they would no longer have to spend that extra time trying to decide which level of responder to send. And it would totally eliminate the need for sending two units, or intercepts. You may have a point there. What is the breakdown? How many ALS vs. BLS units on the road at any given time? With some of the highest taxes in the nation, they should be able to find the money to protect their citizens. I bet you can think of quite a few things the city could pull money out of in order to fund EMS. WHY ARE YOU SHOUTING??

Two medics is a luxury in most systems. Most ALS systems run 1 basic/1 medic teams. I never found it that much easier to work a code with another medic than with a good EMT who knew how to hang an IV. Once the tube is in, there's only one ALS job anyhow. I certainly wouldn't say it was something I "need." As far as I know, there is only one tiered system in Texas with both basic and ALS units instead of all ALS. That's Austin. Somehow they make it work well enough to get good reviews by the experts, but they still have a lot of problems with it. Seems to me that if EMTs never work with medics, their professional growth is severely limited. Also seems like it would cause a deep divide between the two levels and increase the whole "just a basic" vs. "paragod" animosity.

Hmmm... I can see some sense in that. I certainly prefer a 2-medic truck when possible. But in a city that size, I would think it is better to give everybody one medic than to give half the people two medics. What do you think, Richard? How often are BLS trucks ending up with ALS patients? And do they call for an ALS unit in that case, or do they just load and go?

No doubt about it. I've seen them panic themselves into distress if they couldn't find their inhaler, even if they weren't having any problems before.

I believe that has been established. The question is, why not? There must be some logic they are following. Do you know what it is?

I'm surprised they don't do it. It makes sense to double the number of ALS units you have by simply rearranging personnel. Most agencies would do this. Tiered response is an archaic concept. I can't really think of why NYC would choose to stay in the dark ages of "tradition." Maybe they just can't afford the extra defibrillators? :?

You don't even start work for three more days, and you're already burned out? :shock: That's gotta be some kind of record! :?

A good salesman makes all the difference. Seems like most ambulance salesmen haven't a clue about EMS though, and sold used cars or widgets before ending up at their current job. I know the last time I ordered from Wheeled Coach, the salesman was really cooperative and wrote up the order just like I wanted it. But then when I took delivery, it had completely different lights, siren, cot mount and captains chair from what I ordered. Yep... they put in the "standard" off the rack stuff instead. When I asked, "WTF?" they tried to tell me how much better the stuff they put on there was and that I should keep it. :roll: They fixed it relatively quick, but it was still a disappointing hassle. At least I got a free trip to Florida out of it to pick it up!

Ooooh! I like this analogy! It's the difference between being a cook and being a chef! Thanks for the inspiration! :wink:

I've never worked in a Braun, although the service in my hometown had them for many years. Knowing many of the medics there, I heard mixed reviews of them. They were the slope-sided models, and most of the medics wish they had the extra room of a full box. Brauns seemed to have fewer workmanship problems, such as things falling apart in the box and cab. But electrically, they didn't have any less problems than any other ambulance. They ate alternators for breakfast and a/c units That's just life in Texas though. No ambulance is built to handle summers here. http://www.braunambulances.com/ I've worked in a lot of Wheeed Coaches. Like every other ambulance I have ever worked in, they had electrical and a/c problems. There were always little annoyances like pieces of cabinet trim falling off, and things rattling that you could never pin down. And -- although this was quite awhile back and they may have improved -- dealing with their salespeople was a pain in the ass. Buying a Wheeled Coach ambulance was like buying a Motorola radio system. Instead of asking you what you want, and then making it for you, they want to sell you what they already have. Really very much like buying any new car! They want to crank a bunch of clone ambulances off the assembly line and just paint them differently for each customer. If you want anything custom or non-standard, they act like a kid working at McDonalds when you tell them you don't want secret sauce on your Big Mac. They can't seem to understand the concept of "have it your way." Excellance was very much the same way. On the good side, Wheeled Coach service and support after the sale have always been excellent. They don't mind coming in and saying, "Yeah, we screwed up. But we'll fix it fast!" And they do. http://www.wheeledcoach.com/

EMS for the money? Anybody who thinks they are going to make good money in EMS should be rejected outright. Obviously, they lack the necessary intellect (and self-esteem) to be a good medic! Anyhow, I seriously disagree with any belief that EMT experience is somehow an important pre-requisite for paramedic. I'm all for schools that take you from zero-to-hero without any intervals. Wham bam, thank you ma'am. Time spent as a basic is usually just time spent picking up bad habits. Get to medic school as fast as possible. But to stay on-topic, yeah... two years should be the minimum education for a medic.

ooops. :roll:

I agree. a simple folding stretcher with wheels and an elevating head is more than adequate, and a LOT more reasonably priced than an ambulance cot, which you really probably have no use for. And it will be a LOT easier to get up, down, and around an industrial plant too. Especially since you are probably going to be the only one on scene who knows how to work that stretcher. You wouldn't want bystanders attempting to raise and lower your patient with you. You could get one of those stretchers, a scoop stretcher, a stair chair, and a tonne of other goodies for your clinic for the same money you'd pay for a Ferno or Stryker ambulance cot. Remember, in most cases you are going to be carrying somebody simply to the clinic to recover and return to work or go home. I am guessing that you would not be transporting. And those patients who require immobilization and transportation would usually be transported by EMS directly from the scene, not from the clinic, so an elaborate cot just shouldn't be required.

Wow, that was WORTH bringing back up! :shock: If that info was posted here three weeks before it happened, then the mayor of N.O. and the governor of LA better come up with a much better excuse for being wholly unprepared than they are currently offering! :roll:

It depends. When did he "admit" it? Before or after he was caught? And by he "admits taking the medication," do you mean he admitted the theft, or simply admitted to using the medication? Personally, I have as much tolerance for substance abuse as I have for child abuse. Rehab is unreliable for both, and both are crimes of moral turpitude which seriously diminish or entirely shatter my confidence in the employee's reliability and integrity. I've never understood why there is all this special sympathy for substance abusers in the first place, other than a bunch of liberal drivel from the APA and ACLU. In medicine and nursing they are lenient because of the shortage. We have no shortage of EMTs. Of course, what you do -- or even can do -- about it depends a lot on where you are. In union and civil service systems, you are extremely limited in how you can deal with the situation. But if it is up to me -- and so long as my legal advisors concur -- I am putting the employee on special duty away from patient care pending the legal outcome of his case. If found guilty, then I am firing them. It's not my responsibility to get them out of the pickle they got themselves into, and there are plenty more rookie EMTs out there more than happy to take his spot.

I am a huge supporter of the Explorer program, and of Scouting in general. So really, I hate to even bring this up. But man... it seems that you can't hardly open the newspaper anymore without reading about sexual misconduct between fire/police/EMS officials and the Explorers entrusted to them. Every few years, either a Fort Worth cop or Paramedic gets busted for it. When this happens, it is a HUGE publicity blow to the agency involved. And every time, everybody involved acts like they absolutely could not have conceived of such a thing happening. Again, I support Exploring fully. But for the sake of your agency's and your own personal integrity, keep your mind and your eyes wide open to the potential for misconduct. Do some research through the Scouting council regarding the subject, as they are just as concerned about it as you are. But also do some independent research on the net and through talking to other agencies who currently or previously had Exploring programs. It would probably be helpful to seek out agencies that experienced problems and ask for their advice too, because I am sure that in retrospect, most of them have some good advice of things to do and to look for.

Haha! Only in NYC does a drunk call turn into an MCI!

Ahhh! Now there is some information that actually offers something useful! I always applaud efforts to identify and serve those patients who typically get overlooked by the system. Especially when it takes nothing more than a little outside-the-box thinking to do so. Thanks for the update, SA!

Agreed, Kev. They seem to be suggesting that silent MI's are somehow more pathological than symptomatic MI's, which the study doesn't seem to prove or even address. This reminds me of the study that revealed that patients who arrived at the ER by ambulance suffered higher mortality rates than those who arrived by private conveyance. Well DUH! Those who arrive by ambulance are statistically more likely to be sicker or more seriously injured than those who arrive by conveyance! Yet everyone was quick to cite the study as if it somehow proved that medics were killing people, which was not even addressed by the study. Can you tell that I am not too quick to trust all these "studies" that come out everyday? :roll: It seems that very few of them present a useful conclusion, and are simply presenting statistics for the sake of statistics... and for federal grant money, of course. As Kev says, what is the solution? Do we go house to house and give everybody a 12 lead and cardiac enzyme profile just in case they are having a silent MI? Does everybody who comes into the ER with nausea get the same? Or is the statistic irrelevant to medical practice, and simply suggest the unfortunate fact of life that if you don't know you are sick, you can't seek help?

HIPPA would be the least of your concerns in that case. It is federal copyright laws you would need to be worried about. I am pretty sure that "Paramedics" is copyrighted and probably not really open to their work being used without permission.

Almost any vehicle will provide you the room you need, since you're not transporting or doing heavy rescue. Since you have a specific need for all-terrain capability, then obviously sedans are out. Panel trucks or squads are overkill, unless you want to be a rescue or MCI capable unit. Same thing with Excursions or Suburbans. Tahoe's are great, but suck gas something fierce. Grand Cherokees are my personal favourite, as they provide more than adequate room on a tough but comfortably riding 4wd chassis that gets better mileage than a larger vehicle. Dodge and Ford both make similarly sized SUV's that would fit into this category. Although unspeakable back in the days of cheap gas, the possibility of going with a foreign made SUV can no longer be discounted. The Xterra, the Mistubishi Monterro, and other import SUV's may offer you the best combination of features and economy. If so, it would be foolish to not seriously consider them. Can you tell us more about your plan? Is this response force to be a free-standing "rescue squad," or associated with a currently existing agency? Do you have community and governmental support, both theoretically and financially?

Nope. I'm adult enough to admit my mistakes, take my licks, learn from the experience and move on. And I did all that before this system had to be implemented. Amazing how I figured the system out in only a week, when the average learning curve seems to be six months. I don't believe I am so much better than anybody else on this board that I ought to demand special treatment. Even though I am a Sophomore and you're just a Freshman. :wink:

I find it amazing that you believe that is a prerequisite for having a voice here. After all, this is a public board, not a private club. She did ask for comments. If she only wanted comments that agreed with hers, she should have stated so. It is painfully obvious that even those who are complaing want moderation. They just don't want themselves to be moderated.