JakeEMTP

I love those guys!

Yeah, it kinda blows. Not everything we do here makes perfect sense, This is but one of them. I can't remember the exact wording of the document, but it is just stating the patient is unable to sign and that as their EMS provider ( ie Guardian ) I am signing for them.

Umm. no. 8) However, our call volume from nursing homes has increased since the Medical Director refuses to allow BLS transfer services to transport anything to the ED anymore.

Say it's not so. There is a reason we keep Californians on the other side of the mountain you know.

I find it interesting that you don't require the signature of the person you transferred pt. care too. Obviously it isn't a requirement in Alberta. Our Medical Director likes to see it. I personally would feel more comfortable having it, since my report is a legal document and part of the patients medical records. If the pt. can't sign for whatever reason, I can sign as their Guardian. I prefer not to and in actuality, all I need is the pt. to make their mark. There are times however,when this too is unattainable. Luckily, they are few and far between.

With all due respect, what experience have you gained? You should have been observing only which is nothing compared to doing. Without the fundamental education, do you even understand what you witnessed? This is not a slam on you so don't take it that way. It is the opinion of many experienced providers here that you gain little if any experience working BLS and since your function on a medic/basic ambulance is primarily to drive, your exposure is limited to the first few minutes of patient care. Learning to read 3 and 12 leads without knowing what you are looking at is futile. ANYONE can see ST elevation. What about blocks or rhythm interpretation? I commend you for going to medic school. You will get plenty of experience during clinical time AFTER you have the fundamental education to begin to understand what the 12 lead means. As for your partners ludicrous statement, I will refrain from commenting as I don't think it warrants the bandwidth.

I don't know firedoc5. She's had 2 accident's in 3 months, both her fault, or at least partially. I'm not sure how long the probationary period is at Wilson County EMS, but I would think it could possibly be grounds for dismissal. At minimum, she should lose her driving privileges and never, never get behind the wheel of anything larger than a Volkswagen Beetle again.

Sorry Dwayne, I only had to stop and breathe once whilst reading that sentence. Better than some of the posts I've read here that required high flow O2 afterwards. Perhaps the Union this idiots belong to saved there ass temporarily. I foresee 3 squares and cot with daily exercise in their near future.

We use the ePCR here. I agree with Dust that it is a series of check boxes and drop downs. However, occasionally, you are presented with a patient who doesn't fit in to " the box". That is when the particular check box called "other" comes in, in my opinion. After checking "other", there is another box, for you to check and you can explain, in your own words what you are presented with. I use it frequently even if my patient's condition satisfies the other areas, I like to explain what I see. Some of the more experienced medics in my area say I over document. I didn't think that was possible. As always, there is ample room to write a narrative, and there is no maximum words as I've heard of with some electronic programmes. I suppose though, since this is the only programme I have been exposed to thus far in my short career, I am perhaps biased. I believe Dwayne to be correct when he states that reviewing documentation over and over isn't necessarily a bad thing. Eventually some of it will sink in, even if they are chuckleheads. :wink:

Translation, " Sorry, you're a little late. I've been posting that link for a month now in the chatroom." Not that it matters, but those of us that do not frequent the chatroom might want to see it.

Yeah, our system works the same as ncmedic309's does. Once all resuscitation efforts have been exhausted, we can terminate the code. A call to the ME is placed and the deceased is either transported to the morgue or to the funeral home. Not by us though. The ME has their own transportation vehicles as do the funeral homes.

I recently had a call where the patient died en route to the hospital. According to the logic in place here, I should have turned around and taken him back since he was dead. A stretch I know and perhaps uncalled for. I was just trying to illustrate how ridiculous this sounds to me. I will reiterate my earlier comment that once the crew began care of the pt., in fact had him on their ambulance alive, they should have transported or at minimum contacted the ME to have the newly deceased transported to the morgue, hospital, funeral home etc. as stated earlier. To return the patient to the home even if they were on scene still is very bad form and highly inappropriate. Please feel free to correct me, I've got my big boy pants on and can take it, But I always thought DNR meant " Do Not Resuscitate ", not "Do Not Treat ". A " Golden Note " ( DNR's in NC are on Gold paper, no copies please ) in hand is not a free pass to do jack squat.

If they did transport the pt. wouldn't they be in violation of MA state law? I think it is a little bit of a grey area. Did the crew contact Medical Direction for advice? It seems to me, if a person is alive when you begin patient care, then you are obligated to transport if they are loaded into the ambulance. If they are alive when place them in your ambulance, it's pretty weak to take them back into the residence if they then code.

Just wondering, which appendage were you planning to amputate? :shock:

I want to echo AK's sentiments about the job the soldiers are doing, we are all proud of them. I have to ask, how much experience do these medics have with medical complications? I think I can safely say they are kick ass medics in a trauma arena. However, look at the ratio of medical to trauma calls we do. Where I would love to have one of these medics in a MCI scenario, how would they preform in a cardiac emergency involving a 85 y/o pt.? It is my understanding that their training is very cookbook. While the intention is good, in theory I can't see as a step forward and only a further drag on our profession. Has anyone even proposed this to the returning Vets? Maybe they don't want to work EMS. If these medics want to enter the civilian world of EMS, they should have to receive the same education that the rest of us require. To steal a line from Dust, Go big or go home.

I had to do 2 months which equates to 384 hours of being the lead medic on the ambulance under the scrutiny of my partner and one other FTO. Now, that being said, I had worked for this service as an EMT-I whilst finishing medic classes and did most of my clinical time there, so they were familiar with me and my abilities and weaknesses. It is my understanding that other new hires, regardless of experience have to do the same 2 months of ride time with 2 different FTOs. I am sure there is some flexibility in this policy, depending on the individual, but cannot confirm that. In answer to the second part of your question, we as employees have to complete a ALS exam which in all honesty, isn't that difficult. Then there is a 3 stage interview process and of course, the dreaded oral boards with the medical director. Once you have successfully completed this steps, they will do a background check before offering you a position. I will not pretend to know what criteria causes my employer to hire or not hire an individual. Since I have only worked for this one service, I have nothing to compare it to. I don't know whether or not this is adequate. I will say, the majority of the medics I work with are very well educated and competent providers. I only know of 2 that are borderline whackers, the Star of Life decals on their POV with the Paramedic sticker at the top of their rear window ( picture a University sticker ) puts them in this category.

Yeah, just a switch up or down to lower or raise. We've had no problems with ours thus far.

Excellent point Ventmedic, as usual. Yeah, that's what I thought when I read the opening post. Unless the patient coded approx. 1 min out, one would think IV would have at minimum, been established. If in fact the pt. was BLS'd in, another reason to have ALS only service. I have witnessed this " Keystone Cops" version of a code in the ED. It isn't pretty but as mentioned previously, different MD's do things their own way and nobody know WTF their particular role should be. To many cooks spoil the broth, so to speak.

Meh, not impressed. I don't like the idea of being in a ditch or the middle of the road endangering my patient and myself. I have to query as to just how much more storage do we actually need on an ambulance? from the photos provided, there appears to be even less actual room then we currently have, but maybe that's just the angle the pictures are taken from. On the plus side, I do like the harness for the provider. Is it just me or are the new Fords fugly? I did notice this unit was unveiled at the Fire Department Instructors Conference. I'm sure they'll sell well.

Owned and Read. Interesting lecture, but really, what was your point? And, would you work with a medic partner taking antidepressants?

After reviewing their list of apparatus ( 3 fly cars?), did they actually have the gonads to call one piece a F.A.R.T.?

Wendy, Since you explained it so well, I am finding it difficult to come up with something to add. :scratch: You may have single-handedly, killed the thread. j/k Medics can be useful in other calls other than cardiac, contrary to popular belief. In all honesty Mobey, if your co-workers are truly interested in providing the best care for their patients, I am finding it difficult to find one good reason as to why they are fighting this. Unless of course, the reason is in your post which you placed in bold type. I think, as so well explained the our esteemed colleague from CO., the difference is in the critical thinking skills. The reasons why we do things simply cannot be comprehended by someone who has not had a higher level of education. This is not a slam on individuals, however it is a fact and a result of having tiered levels of providers. If everyone was a medic, this wouldn't be an issue. I work in a dual medic system with a few EMT-I's in the process of completing their medic education. This type of argument doesn't exist. Frankly, I'm tired of it.

Yeah, the last Union I belonged to was Teamsters. Dues were 35.00/month and that was in 1982. I have know idea as to what they would be now. Maybe I'm fortunate enough to work in a County based system. We don't have a union, do not desire one either. They take pretty good care of us. The renumeration is decent, benefits are adequate with a low co-pay, State pension and 401 contributions. I really have no idea what a Union could do for us other than create a tension filled work environment. It is my opinion that Unions protect the lazy and incompetent and are more of a hinderance than a blessing.

Foghorn Leghorn was my favorite, or was it Daffy Duck? Close call. Just once I wanted the Coyote ( eatus anythingus) to catch the roadrunner ( speedius maximus). Currently, Stewie from Family Guy cracks me up and I don't really know why .

" People are Strange" - The Doors