Nate

The first thing I do I actually do is extend a hand to shake theirs, then slide into a checking of the pulse while I ask them what seems to the problem today. I've seen to many people who just start touching a patient and don't bother to tell them who they are or ask what their name is.

The debate now is are we doing any good? I kind of believe that we should focus on helping the parents coupe right their until someone who is trained better can arrive to help them. Maybe training a few police officers are EMS supervisors in dealing with SIDS would be good to free up the crew to return to service.

I was called out to a patient last Monday who was reported to be c/o chest pain that felt just like her prior MI in Feb. 2003. Patient rated the pain a 10, raidating to the left arm, was a sharp pain, nothing made it better/worse, and she had taken 3 nitro with no effect. She refused to go to the local ER (which can handle an MI just fine), instead wanting to go to St. Luke's (Texas Medical Center area, also the Texas Heart Inst.) because that is where her doctors are. I tried to get her to go to local ER (CYA), but she refused AMA (no problem). Turns out she had a minor MI (I had to argue with the staff to get a doctor to read the EKG and he saw the MI that I was seeing) and was in the ICU until Thursday. Well Sunday morning (two hours before we were to get off) she calls again saying she is having CP. Put her on the monitor, same thing she wants to go back to the ER at St. Luke's. So off we go. I ended up getting jumped on by a supervisor for taking her there. So when I got back to the station I spend 30 minutes explaining what an MI is, how to treat it, the proper treatment upon arrival at the hospital, the benefits of St. Luke's vs. local ER (who on the weekends can get a team together in 30 minutes to 3 hours), and patient rights. He shut up, then again this is the same man who gets V-Tach and Sinus Tach confused. :shock:

Proper patient assessment should tell you the answers you need to know. If the patient just has a little bit of the hives, however has good PMS/Vitals/ETC..and has asthma...I would be more concerned with making sure they stayed calm so they don't have an asthma attack. Remember the goal of EMS isn't to push a drug every time you turn a wheel, it is to provide the best appropriate care to the patient. So if you had a patient that was having an allergic reaction you might want to ask them, "have you ever had any reactions to benadryl?" and "have you ever taken benadryl before?" If you do feel that the patient should need it, then you can always start low with 25mg and work your way up to 50mg should the patient need it. Remember you can always add, but you can't subtract drugs from the patient.

If you have reason to believe that blood sugar might be a factor then check it. Your glucometer is a tool, so use it (just don't treat it and not your patient). I know that if I start an IV I'll get a BGL off of the blood in the flash chamber (granted I have to remember to use the glucometer that is calibrated for this). We draw a lot of blood, it is expected by the ER that we have blood for anyone who isn't going to the waiting room. As far as trauma goes (Dustdevil said something about the guy breaking his leg on a bike) I would check it because you don't know if he blacked out due to a low blood sugar and that is why he hit a tree or car.

I was kind of wondering the same, I've never seen any of the ambulances around here use it.

Something similar is the theory of working a SIDS baby even though it is clear they are dead to help the parents "deal" with the loss.

:shock:

This is a never ending battle. I'll sum it up like this. It will take someone of importance turning up dead in each small town to get people to change to paid staff.

I see most services go through a few stages of volunteer to paid. The first one is when they are a volunteer service, then they start paying paramedics only, and then they go to paid fully. I still find it hard to believe that the vast majority of American services can't pay for at least ONE paramedic to staff the truck. Worst case the paramedic responds to a call with the ambulance and a volunteer meets them at the scene to drive or a police officer drives the rig. Jsut a thought... Nate

I agree with the above statement. Generally with a pysch patient, we have not "released care" until the nurse sings off on our run report and is physically with the patient. Granted in Texas they are considered the hospital's problem the minute you walk through the door, the jury won't see it that way if something was to happen to the patient (and you can bet the hospital is going to push this off on you).

WTF, they weren't even hosted on the EMTCity server. Since the admin **REMOVED** you can check them out over on FOOPS. http://www.foops.org/forum/showthread.php?t=2333 [web:dcd7b00426]http://www.foops.org/forum/showthread.php?t=2333[/web:dcd7b00426]

This video is 123mb, most email accounts won't allow it. I have the video that didn't make it on the news. :twisted:

How about this one; "Is Dustdevil going to make fun of me when I talk about this on the message board?"

"How long until my paramedic gets here?" That was a joke for those of you who can't tell.

Fire only responds to major MVA's with us, they don't first respond to medical calls, and they don't even come out on CPR calls. If we need lift assistance they will come, but we can usually get some strong guys at the scene to help us. We don't go to their fires unless it is a working structure fire. If I worked for a department that was fire/EMS then I'd do what ever they paid me to do (although I'd rather perfer to do EMS).

Yeah, what they said.

They were, the video shows them using water.....they waited to use foam once the fire was out. :roll: In the last picture you can see the engine arriving on scene.

I present to you some pictures of a Pearl Ambulance on fire. The ambulance was running hot to a nursing home and rear ended a car, then caught on fire. They are not the primary 911 service for any city/county. PICS REMOVED. PLEASE POST PICS IN THE PHOTO GALLERY AND PLACE A LINK IN YOUR POST TO THEM. ADMIN I have the video, but it is 123mb and you can see when the fire hits the protable oxygen tanks and the main tank.

I hope one of their requriements is that a paramedic must have another job or something. If this was your only job, I can't imagine you being to good at your skills after a few years of never really using them. Kind of like a school nurse, most of them couldn't start an IV when they went through the last ACLS class that I was in. They simply didn't do them, so they lost the ability.

They are probably looking at it from the stand point that you should have told them sooner incase something would have came up. However, at my station we carry a spare set of gear for the paramedic (including an LP10 :? ) I think they have gone off the deep end though.

OMG, I love to freeze the Girl Scout Thin Mints and eat them when they are super cold. Those are the best cookies. We saw some girl walking down the street with her mom one day who had a cart full of them. We got on the PA and were like "hey little girl, give us some cookies!"

We had a lot of people who were moaning about them, they wanted to see a pay raise instead. Then management threw down the numbers and showed how much had been spent on back injuries directly related to the use of the regular cots and showed how these cots would have been paid for in two months. They are worth it IMHO as they will prolong one's career in EMS. However, the best thing about them (and I still want to point this out) is that you can get the cot level with the height of most cars/trucks. This is great for placing the backboard on the cot, pulling it up to the patient, and using the KED to move them out with no "drop" from the seat to the cot. I love the new Styrker stair chair with the tracks on it. Going down three flights of stairs is now simple.

Yeah, code summery is nice....helps in making sure your times are correct. The only thing is that if you want to use the other features of it (such as printing what drug at what time) then you have to have someone sit there and do it. Plus, cleaning blood out of that knob is a PITA. I prefer to use a dry erase board and a marker for that. If the marker gets to much blood on it, we just throw it away. I've carried my LP12 with charging base up 10 stories, it is heavy but what is the point of having it if you plan on taking an AED with you.

I used a KED's to remove 32 teenagers from a bus. They were probably okay, but I don't have x-ray vision and they haven't figured out how to get a CT machine to fit in our ambulances yet, so I'd rather be safe then sorry. From the comments you have made, you might want to look into driving a tow truck, delivering pizza, or some other mindless job since it is clear you don't care to much for your patients.