PCP

Dwayne, I always enjoy reading your posts and what you have to share. I think that is bullshit that a worker needs to see their supervisor before going to seek medical attention. What training does a super. have on first aid scenarios? I hope that the workers think the same way, and decide that if they need to seek medical attention that they do so without their supervisor's permission! I will always try to teach and help out any new medic we have on site, until I get tired of their bullshit and there lazyness. I feel to be a first aid attendant you need to have the drive and passion for the job and always want to learn and practice your skills, as you never know when you are going to be put to the test! It is true we do tons of sitting around waiting, but there are things to keep us busy. All I ask is that hopefully my next partner has the same passion for the job as I do, as my cross shift now is leaving in two weeks time after only working at the mine site for 3 weeks. I wish I could unplug my phone Happiness, but being the back up attendant this is not allowed. Only one more block of 4 days left and then she is gone and lucky me gets to train another newbie

I work for a first aid company at a mine site and have now for four years. We have gone through many first aid attendants with that time good and bad. I am not sure if it is just me and if am anal or what, but it seems that the last 4 or 5 attendants we have had just don't seem to get the job. I am tired of training these new people on what we do on a day to day bases and then have them not do the job or even attempt to do what is asked of them by the owner of the company. I am tired of listening how tired they are and how boring the job is. IF you don't like it find another job! Don't waste my time or my bosses time and while you are working at least do your job and practice your skills and go through the ambulance and fire truck. I am tired of being woken after working a night shift, to come back down to the first aid office to deal with your first aid patient cause you are not sure what you should do. I have tried to help you teach you how to take a BP, blood glucose, splint an arm or leg, and help by going through practice scenarios. Sure I get over time when I come down to the office and help and then sit at the office until the on duty attendant transports the patient to town and back, but seriously it should not take almost six hours to treat your patient and take them to town, when town is only an hour away! It burns me when the new attendants say they know there stuff, but when you ask them questions they can't answer the questions or just guess. If you say you know your shit, then don't ask what OPQRST is used for then and when I try to help you, don't brush it off like I am being a dick and Mr. know it all. Sure I have only been working as a medic for three year, and a first aid attendant for four years and ya I don't know it all, but I do have some experience and smarts that I am willing to share with anybody who is new and willing to listen. I just don't get it, when you try to help these people and they say they don't need to practice or they know they shit, but when it comes down to doing a call, even a simple report for a sprianed ankle or sore back, I get a phone call and come down and find the patient still sitting in the treatment chair and no questions have been asked or no patient comfort has been done! That really pisses me off! Okay I am done and I am sorry for venting, but I have PASSION for my job even if it is just being a first aid attendant, but I care about my job and the people I am responsible for treating when they are injured. Everybody have a great day and stay safe! Brian

Hey UGLYEMT, I never thought of when we respond to a fire that it could be helpful as to letting the fire guys know we are coming and to leave room for our car, as well as give us updates as to if there are any patients needing medical aid. I always like to be prepared when I respond to a scene as to what we are possibly dealing with. As lots of times we get dispatched out for one thing and it turns out to be something different. At least this way fire or our us, can give each other updates. We just have to remember to turn on our radios when responding. I am sure this combined events channel thing will take time getting use to, but for the most part it sounds like a great idea!

Happiness, they are talking about using the combined events channel with our volunteer fire departments that surround Port Alberni, we will see how well that works out. I feel it is nice to have this channel to use with the full time Fire as they do respond to certain calls and I think it will be great to get updates as to the pt condition or if there is a certain way that we have to enter into the house. We have an okay relationship with the full time fire crews. I know I have never had any problems with them, but some crew members do. We will see how it works I guess. I feel it is alway nice to have extra hands on a call, even if it is only for a lift assisst or to carry our gear back to our car. P.S. where did you say you are located again? I think I work with a lady who was at your station for about 10 years. Her name is Sonja. Ring any bells?

We are doing a trial run by using a combined events channel with our local fire department. We have selected a certain channel on our portable radio that we are to use when responding to a delta or echo call. We are to let fire know we are responding and say the road name and that is it. Fire is to the same and we are let each other know of our arrival on scene. As well as who ever arrives first is to give an update of the situation. Do any of you do this within your service or know of any other agency that does this and how it works for them? As mentioned this is something new to us as of April 1, 2011 and so far it has not worked very well, as either fire or the duty crew that is on forgets to turn on the portable radio and alert fire that we are rolling. I think it can work for giving each other updates on what is going on at the scene before arrival. Either a confirmed arrest or we can let them know if we require an auto extrication to get our patients out. Anybody have any thoughts on this good or bad Brian

We do not have nurses riding with us to keep their certification, but just last week there was a sign up sheet for any paramedic who is okay with allowing nursing students to come out and ride with us for a shift. I think it is a great idea, so that they can see what we do at a call before we bring the patient to the hospital. Sometimes I feel some of the nurses that have been working at the hospital for a while need to come out and ride with us, as there have been times when they question us as to why are the clothes cut off or question why a certain procedure was not done by the time we arrive at the hospital. I feel they don't understand that there are times we are very busy on a call and the transport time is short to the hospital, so we may not get all the things done we would like to before arriving or we need to cut the clothes to do our assessment properly. Hopefully by the nursing students coming out for a ride along, they will understand and not forget that the patient may be presenting differentley on our arrival then when we arrive at the hospital and not question what I tell them in my report. Sorry I got off topic, but just wanted to add a few things. Brian

At my station we have female partners working together all the time and they never have problems lifting patients and for that to be a rule for a company is just WRONG! Nothing wrong with calling for a lift assist, as I have done this multiple times evern while working with another male partner, due to the patient being over weight or because we have multiple flights of stairs do go down, or because we have lots going on at the call that we feel having those extra set of hands on a call very helpful.

I am sorry that your first experience on car was not very good at all. Hopefully next time you have a better expereince and more calls!

My 16 month old twins are still in a rear facing car seat and they don't mind it at all. I Went by the fire hall a month ago, and the guy I spoke to, said he would change the car seats so they would face forward, but they are much safer while the car seat is facing the back of the vehicle. I plan on leaving my kids that way until they are about 18 months to 2 years old. Depending on much they grow over the next few months!

I do not see your foot pain being a problem, as we are never standing for three hours at a time. There might be some people who should not be doing the job due to lacking personality. I feel anybody can do the job if they put their heart into the job and really care about helping people. I find a few people I have worked with or met have lost the drive for the job and may not do a proper assessment of a pt. and just want to load and go. This might be due to them being a paramedic for a long time and they are burnt out or like mentioned above have lost the drive for the job. If you are going to be in EMS I feel one needs to love the job, have passion for what they do, and really care about the patient. Always remember that we may not feel it is a emergency, but to them it is and that is why they call. A big part of our job is being able to talk with the pt. and have compassion. So yes there are some people that should not do the job, but everybody can do the job, just depends on how well they do the job! It is true the pay is not the best, but it could be worse. Like mentioned above, most people get into EMS because they are interested in EMS and enjoy helping people and not for the money! Some of us have two jobs to make ends meet, so be prepared to work two jobs when you start. Good luck!

Welcome to the city!

Hapiness I agree with you 100% I love the Golden slipper for transfering patients from our cot to the hospital bed or from a chair to our cot. As well as the clam shell (scoop to some people) is by far one of the best pieces of equipment we use on car. I find that many paramedics I work with forget about the Golden slipper and just use the blankets when moving the patient. Golden slipper is sooo much easier on your back

HERBIE1 that is a great question. I am not sure what the company's policy is if a patient declines transport and treatment by the first aid attendant on duty, but gets taken in by a coworker. The person who was injured is a staff member and as mentioned is the acting Mine manager for this week. I am going to bring that question up with the head of the safety department this afternoon when I see him. The company I work for is not part of the mine or the union. We are contracted out by the mine site, and I know if we transport a patient to the hospital via ambulance and I need to wake up my cross shift to cover the first aid office while I am gone, my boss sends a invoice to the mine and if it is another contractor that is being taken out by ambulance he sends the invoice to the injured works company. Thanks for bringing that issue to my attention, I will bring it up with the safety department.

Any time I have to code X a call or while on duty as a first aid attendant and my patient refuses treatment I Document everything. I tend to do more writting on my PCR when the patient refuses to go with me then when I do a regular call where we end up transporting the patient.

Sounds like it is one of those calls that just can't be explained I am probably thinking the same thing as you mentioned in your post. It was probably fractured, but not a complete break and all it took was that final move or bump on the road, but just guessing here. I don't think you failed at all, it is just one of those calls that you think to yourself By reading your post it sounds like you did a good assessment and if I remember correctly did you not say a week prior she had X-Rays done on her hip and at that time they did not detect anything wrong? Only thing you can learn from this call, as I am learning as well is go with your gut feeling.

Hey guys, thanks for all your comments and suggestions. I am going to do a little reading today on Oxygen, as I feel after reading some of your posts, I did not get a full understanding of the effects of Oxygen and its use. I did feel this patient could benefit from some oxygen, as he had just suffered a event that caused a few injuries, as well as having to climb up a side of a bank roughly 60 feet up in the snow. As mentioned I am going to do some reading today about Oxygen and its use. I am still going to stick to my guns and say that my patient would have been better off by being transported by our ambulance with me in the back. I received a phone call from the person who transported my patient to the hospital and told me that when they explained to the nurse what happened, she asked " how come he does not have a hard collar on and why is he not on a back board?" As well as the Dr. questioned them as well and attempted to put a collar on him, but he refused again at the hospital. Makes me feel good that, at least I was not the only one who could not put a collar on this guy and that I was correct, by wanting to board this guy and put a collar on him as well. He is back to work today, so I will be popping over to his office and checking in him to find out the final outcome. Thanks again for all your suggestions, questions, and comments. Brian

Okay, I see what your saying, I am trying not to put to much information on this website about my call as it is a site that is open for the genral public. My patient did have two 4 to 5 inch lacerations to the back of his head with moderate bleeding as well. I just feel when a patient complains of a sore neck that he should be put on a back board with a collar and transported by ambulance. I may not be able to detect a underlying injury, but at least I can monitor the ABC while enroute and I can fix those if needed, make sure the bleeding stays and make sure the bleeding is under control. I wish I had a X-Ray machine and was able to determine that he does not have a spinal fracture or any underlying injuries that would make my job sooo much easier. I understand what you are saying about the non verbal clues as well and ya, this guy did not have any non verbal clues that I was concered about. I just would have felt better taking him in my self.

His SP02 stats where 93% and when he was put on high flow O2 they went up to 96 %. Patient was a heavy smoker, so 93% for him was acceptable to me. I feel that the O2 would just have helped him calm down a little and bring his SP02 stats up while being transfered. He may not have needed it, but at least I could have put a nasal cannuel on him. NOt going to hurt anything. He did not ask for pain control, but I could have offered it to him again while in transport, if I felt that the chest discomfort he was feeling was due to him being a heavy smoker and had just finished climbing back up a side of a bank about 20 to 30 meters. Not saying I would give it to him, but at least I have on my ambulance if needed. I can not do 12 leads, but I do have a AED with 3 lead capability so I could monitor him that way. I was not concerned about his chest as I questioned him about the soreness in his chest and it was not pointing towards cardiac. I should have mentioned I did hook up our three lead and he had a normal sinus rythm. To be honest I was not really concerned about any underlying problems that may have developed, but more so about his pain in his neck. He did take a pretty big fall. My feeling is if something did happen like, decreased LOC, sudden abdominal pain, the injuries to his head bleed through my dressings. AT least I can deal with that when we are in the ambulance and not in some personal vehicle. I could have started an IV on him, even though there was really no indication for one. I just feel the best place for a patient who has suffered trauma is in the back of my ambulance rather than a coworkers vehicle where nothing can be done at ALL!! Do you not agree that a patient like that should be in the back of the ambulance? I just don't see why not give a patient oxygen, sure they may not need it, but if it helps them feel comfortable, or help with nausea, bring there SPO2 stats up. I was taught that any trauma patient gets a non rebreather. So that is what I did, then I down graded to a nasal at 3 LPM.

I explained to him that there may be underlying injuries that I can't see or may develop while being driven to the hospital that could not be treated due to being driven by a coworker in a personal vehicle, but that did not work. It is hard to talk a patient to go to the hospital in the ambulance when the patient is the acting mine manager this week. I was hoping one of the other staff members might have spoken up and helped me talk him into being taken in by ambulance, but that did not happen. I guess I could have kept trying, but I felt he needed to be seen by a dr. sooner than later. All and all it turned out okay, from what I was told. Only a few stiches in both wounds and no damage to the spine. Main thing is the guy is okay and was able to go home without any major complications. I did have a third party sign my form as a witness. The same as I do when I am working on car for the BC Ambulance. I documented everything that happened, as I enjoy working as a first aid attendant and do not want to be brought down in flames due to a patient refusal form.

I am very lucky where I work, we have a fully equiped ambulance on site. Same as what you would find in any ambulance service. I have access to everything I would normally have while working for the BC Ambulance service, plus a few extras like wooden splints and a few other wound care supplies. It is just hard for me to allow a coworker to transport a patient of mine who I feel needs to be monitored while being transported, not to mention higher care for the patient.

So, I had a worker today come to into my first aid office with head trauma from a fall. I treated the worker for his injuries to his head. The worker complained of a stiff neck, which is to be expected after being thrown off a snowmobile and falling down an embankment about 20 to 30 meters. The patient refused a hard collar and did want to be taken to the hospital by our onsite ambulance, but wanted a coworker to drive him to the hospital. I told the injured worker and the other workers that came over to check on their fellow worker that I did not agree with him being taken to the hospital in a work vehicle due to the lacerations on his head and tightness in his chest. The worker still refused and managment backed him up on it. My question is, how far does one go to try to talk the patient into being transported to the hospital by our onsite ambulance, rather than a personal vehicle? The hospital is an hour away from the work site. I feel that the patient should have been transported by our ambulance where I could have monitored his vitals, gave him O2, been able to give the worker Entonox if wanted, as well as monitor the tightness in his chest, along with the injuries he sustained on his head. I just don't understand sometimes!!!

Hawk eye welcome to the city!! Those are some great questions and as mentioned great answers! Feel free to ask questions and check out posts from other members as you will find some great information being posted on this site. Brian