paramedicmike

I agree there is more to this story. I'll withhold any decision until more details come to life. Ace: I'm going to play devil's advocate with some of what you posted. Not necessarily because I disagree, mind you. Simply for furthering a discussion on ethics and exploring the topic a bit. Don't you think there's a big difference between an MCI situation where you triage a patient, realize that there's nothing that can be done and moving on versus triaging a patient, realizing that nothing can be done, and actively taking a roll in terminating that life? It's one thing to withhold treatment in an MCI situation while moving on to someone you really can help. It's quite another to actively take a roll in eliminating the need for further treatment despite the circumstances. If it had been an issue of batteries dying and equipment failing leading to these deaths that would be one thing. But active euthanasia is quite a different story (if that is, in fact, what happened here. Like I said, I'm withholding any decision on this particular topic until all the facts are known.). Overall, I understand the point that you're making. It was a tough situation. Events demanded an atypical response. There was no sense in thinking outside the box as this situation provided no box in which to think. By all accounts, the environment was horrible. This lead to a situation where decisions that shouldn't have to be made were needed. And Dust, you now have the high esteem of being regarded in the same company as Shakespeare. You were both right... "The first thing we do, let's kill all the lawyers". -be safe.

Well, what do you want to do? Do you want to work in EMS? Or do you want to be a firefighter? If you want to be a firefighter, then go do it. If the department wants you to be an EMT they'll provide the training. At the very least they'll help you get it. If you go EMS as a foot in the door to becoming a firefighter, then you're doing yourself and any patient with whom you come into contact a disservice in that you're not really interested in what you're doing. And no patient deserves that. I mean no disrespect with this post. But there are too many people out there who think this is nothing more than a foot in the door to becoming a FF. If you want to fight fire, go do it. If you want to work in EMS, go do that. But please, pick one or the other. If you do a search in these forums of fire vs ems you'll find many long drawn out discussions. There are varying opinions. But in the end it'll provide you with more food for thought than you can digest in one sitting. I suggest you try that first. Good luck to you in whichever career path you choose to follow. -be safe.

Why would it be slamming? Don't you think it would be good to know that a service has a refusal rate pushing 50%? Don't you think that maybe there's a greater issue here if a service has a refusal rate that high? Don't you think that getting this information out would be doing a public service to people who live in that area? If this is, indeed, factual information (which, by the way, you haven't been able to prove) then there is no slamming a service to post the info. And if you're concerned about it being behind their back, then use your name! Nope, nope again, and nope a third time. And you must be a republican for your innate ability to throw numbers around with no proof of what you're talking about. Then, when questioned as to the source and accuracy of the numbers your providing, cry "foul!" and question the intelligence and motivation of the others in the discussion. If you post numbers, *YOU* are the one who needs to support them. I shouldn't then have to do research to verify the info you mention. That's your responsibility. Any basic high school debate, or writing class will teach you to reference your sources. You did go to school, didn't you? I'm not questioning your right to post. I'm questioning your motivation, information source and debate skills by calling you on unsubstantiated numbers. My full time job has less than a 1% refusal rate. When I started there I asked about the refusal process for paperwork purposes. The reply I got was, "Gee, I'm not sure. Talk to so and so. He had the last refusal. That was what? Two...three years ago?" Granted, this is a hospital based flight service. But I don't know that the type of agency applies. Any patient can refuse whether you're 911 or interfacility. My two part time jobs (both strictly 911) are between 3% and 5%. Both part time jobs are in a heavily populated urban area in a neighboring county to a major east coast metropolitan area. You're not contributing either. Not until you provide proof as to the numbers you referenced regarding a 50% refusal rate. And I'm willing to bet that you can't do it. If you can provide proof that "many 911 systems have non-transport rates >50% (usually urban)" then this will all dissolve and go back to a conversation regarding refusal rates. But until you can do that you will continued to be called on the source and accuracy of your information. And I still maintain that if your service has providers who, for several months, see a greater than 30% refusal rate there is something inherently wrong with either your system or your providers. And that does nothing but contribute to the greater issues EMS has with being considered a respectable profession.

Prove it. Stop talking out your...well..if you're going to cite numbers you need proof that you can place out in front of everyone for review. As far as a 36% refusal rate...if you have a medic who has that high a refusal rate of a one month period then management had damned well better be looking into why this person has such a high rate. Could just be the nature of the calls that month. Could be the number of calls during that months. Could be, and what would worry me most, a lazy medic who just doesn't want to transport a patient. Once more GA, your fingers are flying over that keyboard but you're not saying anything. Either back up what you're saying with something we all can reference or stop stirring the pot.

If the greater issue is professionalism then, as AZCEP noted, you have to paint with such a broad stroke that you're setting everyone, including yourself, up to fail. Is watching a movie at the station unprofessional? No more so than it would be to watch the same thing at home. But why stop there? Smoking presents an unprofessional image. As does swearing. As does being a fat slob. As does wearing an untucked shirt, rolled up flight suit sleeves, messy hair after taking off a helmet after a 40 minute flight in an 110 degree cockpit (damned air conditioning). If you're going to address whether or not something is professional you can't stop with one, for the most part unseen, issue. I think the point that you're trying to get at relates more to a hostile work environment which can include, but is not limited to, sexual harassment. If you find something offensive at work you need to try and work it out with the person/people immediately involved. If that doesn't work, then you go to the boss and file a complaint. An investigation will ensue and the results will either see you vindicated or ostracized or both. Not that it shouldn't be done. Just be prepared for the results whether they work in your favor or not. Why should your rights trample mine, indeed! Don't like it? Leave the room. Turn it off. I'm sure those shiny federals could use an extra buff or two. But as has been mentioned, you have yet cut to the chase. Others have brought up greater issues regarding professionalism and you ignore it and head back to the movie issue. Why? What happened that has you stuck on this particular issue. Someone else mentioned that EMS is a tough field. I get spit on, vomited on, cursed at, sworn to, threatened and worse pretty much every day I go to work. And then I have to deal with my coworkers. If I can handle that then pretty much anything my coworkers dish out is cake (preferably cheese cake...to make sure my belly hangs out from under my untucked shirt :roll: ). So come clean there, sparky. What's your deal? -be safe.

Fair enough. But how many patients can realistically remember the split second events of an accident even though they don't lose consciousness? Ever been in an accident yourself? I have. Didn't lose consciousness either. But I had the cops looking for a third vehicle involved because I swore up and down there was a third vehicle. This is where a thorough, complete and detailed assessment of not only the patient but the vehicles and the situation would come into play. This will be developed over time as you work the street. See my comments about getting your officers to partner you with someone very senior/experienced to help guide you in the right direction. (Again, not saying she didn't hit her head. Just that an assessment and the info posted here don't indicated as much.) Again, ever been in an accident? Ever been so freaked out that you don't want people to touch you? To the point that you'll forcefully pull away? (I have. Left some pretty nasty bruises on the people who didn't listen to me, too. But I was hardly combative.) If you haven't, you'll see this type behaviour in some patients. More experience will help you differentiate true combativeness versus scared $hitless. So you called for a helicopter and your chief was ok with this? Sounds like he could use more experience, too. Tell you what, where's the closest MSP aviation unit to you? This might be a great opportunity for you to set up a con-ed program. Get them to fly out to you and help you with a presentation on trauma. Then you could also tie in the fire side by having a presentation on LZ safety, security, hazards etc.... Invite neighboring squads. Turn it into a weekend event! Have a barbecue, inter-squad competitions (e.g. tug of war etc...). Because it sounds increasingly like very few people in your area know when it's appropriate to call MSP (crass sweeping generalization, I know. Only going on what's here.). Again, find a seasoned partner who can help mold you into a better street provider. You'll be better off in the long run. -be safe.

So, just so I understand this, you became argumentative, obstinate and obtuse and now you're going to say that it was all simply for the sake of sparking debate? Come on. We deserve better than that! Is that the best you can do? :shock: -be safe. :wink:

You don't need new construction. Just put a conveyor system with cots so that each exam room can hold 5 or more patients. When you need to see a particular patient you just hit the button on the wall and wait for that cot to rotate around to the front (kinda' like at the dry cleaners). More people, less construction, more money, right? :roll: -be safe

Patty: (And Dust, this should help you in your concern with this thread, too.) I suggest you re-read your Maryland Statewide Protocols. In fact, if you follow the trauma decision tree (it's page 128 in my copy), it says "CONSIDER helicopter transport". You are under no obligation what-so-ever to call for a helicopter simply based on MOI. Further, by stating that you had to call for it based on MOI tells me that not only are you unsure of the protocols, you didn't even really assess the patient or the situation appropriately. I'm glad someone mentioned (sorry, I forget who) that airbags can star a windshield. They can and they will do just that. From everything that has been posted it doesn't sound like the patient hit her head. It sounds like the airbag cracked the windshield. What you included here regarding your assessment should've led you down that line, too. You said she had no tenderness or lacerations on her head. Don't you think that hitting a windshield at the speeds you mentioned might have caused some damage? Don't you think that maybe her agitation might have something to do with being annoyed/scared/freaked out at having just been involved in an accident? Now, I'm not saying she didn't hit her head...simply that the information posted doesn't lead me to think that's what happened. As was mentioned previously, the patient was well within her right to refuse. Explain the refusal process, get her to sign the form, get the witness signature(s) and then document the hell out of this call. Sure, it can be tough when the person actually needs help. But what are you gonna do? Kidnapping *isn't* an option. Do the best you can and document accordingly. You sound like you're relatively new to EMS. Looking for feedback from your peers in an attempt to learn and improve your ability to work in the field shows promise. However, hiding behind protocols doesn't. And since you're hiding behind the "my protocol says I have to do this" line it tells me you really don't need to be out on the street by yourself yet (never mind that you've just demonstrated to all of us that you don't even know what the protocol says). Maybe a discussion with the officers at your station to have you teamed with a seasoned provider who can help keep a better eye on what you're doing will better prepare you for life in EMS. Good luck to you. -be safe.

I have two. Manual of Emergency Airway Management by Ron M Walls, Robert C Luten, Michael F Murphy, Robert E Schneider Paperback: 368 pages Publisher: Lippincott Williams & Wilkins; 2nd edition (May 1, 2004) Language: English ISBN: 0781747643 This is a great airway book! It offers excellent review of anatomy, pharmacology and methods for everything from simple to difficult airways. Assessment methods are also discussed to help identify those potentially problematic airways. The downside is that it's aimed more towards physician/in hospital airway management. However, the same methods and assessments that apply in hospital work prehospitally as well. If you're looking for an airway book this is it. On a lighter note: Stiff By Mary Roach Paperback: 304 pages Publisher: W. W. Norton & Company; Reprint edition (May 2004) Language: English ISBN: 0393324826 Ever wonder what happens to bodies? Ever wonder how bodies get to be where they are? This is a history and informational look at death and what happens to the physical self afterwards. Everything from dissection to research to common burial practices are discussed. Mary Roach provides insight along with a touch of humour in what is otherwise a heavy and somewhat depressing topic. I never was good at writing book reports. -be safe.

You mentioned Idaho...look here: http://www.adaparamedics.org/ And they're hiring, too! Get your butt in gear and apply! I've conversed electronically with a guy who works there. From what it sounds like it's a great place to work. Not to mention it's Idaho. So if you're into outdoorsy type stuff you'd be in heaven. Good luck. -be safe.

I'm going to regret asking this because this thread will now start a horrible downward spiral towards lockedthread-dom, but here it goes.... Just what, exactly, does the above statement mean? And how do you figure? No one has ever been able to answer this question. And please, this question was asked out of sheer curiosity and respect for other's beliefs. No bashing, tormenting, name calling or other untoward behaviour, please. -be safe.

Don't forget Bush broke the law through illegal wiretapping, through illegal detentions, for ignoring legal treaties to which the US is a signatory...and that's just what we know about. Where's the talk of impeachment now? Sure, lying under oath about getting a blow job in the oval office is morally reprehensible, ethically indefensible and perjury. But I'm not sure how you can make the comparison between the two, though. Clinton may be a wimp. But Bush 43 is nothing more than Dick Cheney's puppet and an out and out criminal. At least the SCOTUS was able to manage the Constitutionally mandated checks and balances and keep them intact as Congress seems to enjoy taking it in the rear. You want to go after who was responsible for 9/11? Try the Taliban. Try all those crazy Al Quedans hiding in Afghanistan. There are DIRECT links between those people and what happened in NYC and WDC that day. So why is it that the bulk of resources are being directed at a country with no solid links between Al Queda and 9/11? Why, as soon as the invasion of Iraq started, were monies, troops and support diverted from the actual problem groups and thrown someplace else? I'll leave out the inherent problems created by us now having to figure out how we deal with both Iran and North Korea. Can't really sustain four wars now, can we? -be safe.

AMEN!! AMEN!!! AMEN!!!! Can I hear another? AMEN!!!!! -be safe.

Simply because it's a way for employers to claim ALS level service while screwing their community out of real ALS service at the paramedic level. Plus, they don't have to pay these providers as much as they'd have to pay a paramedic so they're saving money in the long run. Who loses? The community and the providers. Who wins? The owners of the ambulance companies. Shouldn't the community be the winner here? The latest JEMS salary survey doesn't really show a salary benefit to becoming an Intermediate level provider. You, and your patients, would be better served to go straight to paramedic. -be safe.

No, they just attacked and sank our shipping interests. Never mind these ships were sailing under the flag of a then neutral nation. The ships were torpedoed anyway. So, you can look at it and say that Germany never came to the US and bombed or invaded us in either world war. Or you can look at what really happened and see the hundreds of thousands of tons of shipping lying now on the bottom of the ocean (along with their American crews) care of the German U-boat fleet. An attack on shipping interests is still an attack on America. -be safe.

Agree with PRPG. There is no evidence Iraq was involved in 9/11. If there was, FoxNews would still be spouting it from their highest tower with their loudest bullhorn. There was an interesting news piece on Frontline (PBS) recently about the story behind how the US went into Iraq. I suggest, if you're interested in expanding your knowledge base to help form a more informed opinion, people take a look. Keep in mind this has nothing to do with the soldiers/airmen/sailors/marines involved. They were given a job to do and they're doing that job. Gripes stop with the politicians. Praise starts with the troops. -be safe.

Who's feathers are ruffled? Not mine. So, if you're not computer illiterate it shouldn't be a problem. Or did you mean you were weren't computer literate? You are absolutely right. Forgive my poor manners. :oops: Despite above postings it's nice to see newcomers here. Welcome! However, you set yourself up for it, dude. It's all pretty clearly labeled. And when you create your account you have to indicate that you've read the terms and conditions of the site. It's all there. But I think this is a case of lesson learned for both. You learned that researching is good and will save you some very direct posts in reply. I learned that I need to pay more attention when people say they're new here. Hope to see more of you around here! -be safe.

Just to take this a little further off course...sorry everyone... Please tell me you're not comparing Saddam Hussein to Hitler. There's little or no comparison to be made. The rest of the world appeased Hitler to no end. The rest of the world pretty much stood by and did nothing while Hitler started his roll over Europe. By the time they had the guts to stand up and militarily say "STOP!" it was much too late. Hussein headed an army that was at one point the fourth largest in the world. He was funded by many countries, including the USA, for many years. This funding included both arms, training, and yes, chemical weapons. Don't believe it? Ask current US Secretary of Defense Donald Rumsfeld about his trips to Baghdad in 1983. As soon as Hussein stepped out of line by invading Kuwait the rest of the world jumped to not only contain him but sanctioned him and his government for almost 15 years after the fact (ok...they jumped at the request of the Saudi's, who not only are on top of the largest crude oil reserves on the planet, but were afraid that they were next. The rest of the world, dependent on that oil, of course had to rush in and help!). As a further side not, the majority of the Arab world wasn't upset that Hussein invaded Kuwait. They were upset he did it without telling them first. Kuwait is not well regarded in the Arab world. But back to this particular point. There are little to no similarities between the two. Yes, they both were just a tad megalomaniacal. Yes, they both wore a goofy mustache (Hussein wears his better than Hitler). Yes they killed untold numbers of people. But even here there's no comparison between the tens of millions Hitler killed and the hundreds of thousands Hussein killed. Oh! And the reference to Lindbergh is quite funny. Do you know why he was opposed to the war against the Nazis? Because he was a Nazi sympathizer and agreed with their politics! The wartime government refused to let him join the military to fight due to his outspoken position in favor of Nazi Germany. Although, they did let him work as a civilian employee in the Pacific Theater (they didn't want him in Europe.). There's little comparison between the two. Now, as to using ambulances as a transport truck for mercenaries for the purpose of ambushes... YIPE! Although, it doesn't surprise me much. I had a boss who, the story goes, allowed the local swat team to use an ambulance in serving a high risk warrant. Providers refused to enter that neighborhood for a long time after that. Just a thought. -be safe.

Obviously, you haven't really been reading otherwise you would have come across this poor, beaten horse in more than one place. Plus, you would've been here: http://www.emtcity.com/phpBB2/siterules.php Please take note of the area that mentions just how good a friend Google can be to you. ppl? What is ppl? Do you mean "people"? Yes, this is the internet. But we have enough stupid people running around in the profession as it is. Please take the time to properly spell out what it is you'd like to say. Aren't sure how to spell? Please see the above reference to Google and just how good a friend it can be. Further, there's even a spell check feature that will review what you've written and offer suggestions for correction. Bonus! Is this a question? Punctuation helps. By the way, what do morals and confidence have in common with having a handle on good basic skills? Search the forums. You'll be amazed at what you find. No feathers ruffled here. But, what do you mean by "keep it save"? Save what from whom? Altogether, -20. -be safe.

I hope you realize this, but I think it's safe to say that more than half of everything you run into on the street won't have been covered in your book. That's one of the inherent problems and biggest dangers in basic EMT training. If you want to hear more on that idea then search the forums. You'll find tons of info there. As to the idea of the pencil in the cheek, you've got half the pencil outside the body. The other half inside the mouth...potentially between the teeth...which can still bite down...and sever a pencil...creating what? Think about potential here, not about the specific injury itself. Sure, bleeding out is bad. But what comes before that in your assessment? -be safe.

Mon Dieu! I guess maybe the French aren't all *that* bad.

Gotta offer the green stuff (no no...the paper green stuff the Treasury puts out...not *that* green stuff!). Signing bonuses, retention bonuses after set amounts of time, vacation/holiday time etc... If you pay them well, people will come. Good luck. -be safe.

Not a stupid post or a stupid question. I think a better way to look at this would be why you think it's an odd answer. I knew the answer before I finished reading the post. And I knew why it was correct even before reading the rationale you provided. So why do you think it's an odd answer? Maybe we can start there and then see how we can help you. But it's not a stupid post or question. -be safe.

Sounds like he's still new in the job. Keep in mind that as the new guy, with bottom of the bucket seniority, he'll probably get hit with holidays for a while. As he works his way up in the department and builds some seniority he'll be better able to work some time at the holidays so he can spend it with you and the kids. Another thing you may see, I know this happens in places I've worked, that for some of the big holidays (Thanksgiving, Christmas etc...) the single folks are a little more willing to switch shifts or adjust their times (e.g. come in early or stay a little late) so that the folks with families can stay with their kids/spouses for a couple extra hours. At least, I've done it for guys who have families. I know some others who've done it, too. That may be an option at his department as well. Like madmedic said, too, sometimes you just reschedule the holiday for the day before or the day after. There are certainly some unique challenges that face not only those of us who work in this job but also our families. It's not always easy for all involved. The job can be very rewarding. But so can a family. If you can strike a balance that's a good thing. But there has to be some give and take on both sides. Good luck. Enjoy the fireworks. Can you meet him at the station and watch them from there? -be safe.