island emt

On this call we are equipped with the oldest scanning tool known to EMS: The mark 1 eyeball. What do you see when you walk up to the scene? Was he in a full harness or sitting on a bosuns chair? Makes a big difference. How big a drop till the safety life stopped it? Pulse: regular or thready? Respirations? Skin color: face, arms,torso, legs circulation to above? pulses to extremities? I'll reserve tx till we get some more info

In Maine : Mandated reporter statute covers us as Healthcare providers ,firefighters, law enforcement officers , teachers & school administrators : It means we have to report our suspicions to the receiving hospital ER Doctor personally and file a report over the phone to either the child protective services office for children or the Elder services office of DHS. The system does work and I have made use of it in the past. Both have a 24/7 hotline and will have a caseworker in touch with you within an hour to get a full report and followup.

I would definitely file a report as a mandated reporter under state statute. Let the powers that are above my pay grade figure out how to handle the case. We do not have to witness an incident to make a report, we only need a reasonable suspicion of wrongdoing. I would also be talking to a friendly LEO over a cup of coffee. My job is to be the patients advocate, especially with a minor

It's an easy solution if the tax base can support a full time paid service based on a record 160 calls. If you figure a "normal year average of 150 calls. Small town of 2000 population in a rural environment::: probably not going to happen full time coverage would cost around 250k with a possible 75-90 k in revenue from billing. Awful big tax increase to make up the difference.

I'd turn in a complaint with the state attorney generals office. They have a fraud division and what happened to you constitutes fraud and malpractice.

Your right Chris : late posting ,was writing from old memory banks. The AK platform uses the 762x 39 which is a .308 caliber often used for deer hunting the 762x63 is the cartridge used in the M-60 machine gun. Both are weapons systems designed to kill human beings. The point being : An assault weapon is a gun designed for military use to kill human beings with large capacity magazines . The NRA solution is to put weapons in the hands of school administration staff and armed guards in every school. Whats next? the old retired cop posing as a janitor patrolling the doors? That goes down a whole different line of thought about becoming a police type state or the wild wild west. Yes there are resource officers in some schools in largely urban settings now. The question that nobody is addressing at the national level is how to keep someone with a mental defect or illness from getting their hands on a weapon of any kind. How about banning all the electronic role player killing games that give kids the thinking process of it's ok to kill people, & then hit the reset button? What is the breaking point for American sensibilities in innocent deaths? Time to open the discussion on these topics.

On some sites that would get you neutered !

The two most common "assault weapons in the world are the russian designed AK-47 and all it's variants [ produced in a dozen different communist bloc countries. and made by the millions], firing the 7.62x63 cartridge; this round is a heavy bullet that travels at a subsonic rate and carries a good knockdown punch with a fragmentation slug. And the U.S. designed M-16 and all it's variants such as the bushmaster , Colt AR-15 and a couple other custom gunsmiths that are producing specialty versions, using the .223 cartridge. The civilian versions of these are semi automatic action , which means a trigger pull for each round fired. They are available with 20 round standard , 30 round , 50 round & even 100 round extended magazines. These can be emptied as fast as you can pull the trigger repeatedly. The 223 is a high speed supersonic round with a projectile that is designed to penetrate and tumble around in the body to do maximum damage along with the shock wave effect on tissues. It was designed to maximize the killing capability of our military troops in the police action called Vietnam.

Have seen the same problems with our work computers and a software upgrade to the electronic run reporting software. Damn cursor jumps around like it has palsy. Glad the laptop is touch screen. Windoes sucks.

Here We are mandatory reporters in cases of suspected abuse , sexual assault and cases of neglect to children and the elderly. State statute is very clear on the requirements for us to file a report to the hospital receiving the patient AND the state hotline. I would write up everything you can remember from the beginning of the call to the time you handed over care at the second receiving hospital. DOCUMENT everything seen and heard. Make copies and file one away at home in a sealed dated & timestamped envelope for safe keeping. File one through your services normal chain and send one to the state or province CPS. Be prepared to go to court to testify. Good on you for coming here to vent and get other experienced providers opinions. This is a call that has no good outcome for the young girl, don't let her down by doing nothing.

Gotta love those farm raised pharmaceuticals.

I was dead serious when i made my post. Find someone who is on the way to the federal penitentiary for medicaid fraud and offer large bags of unmarked cash. In Pennsylvania , this is a very regular occurance. buying an already running service is a lot easier than starting from scratch. Just change the name & go out and get into business defrauding the government. Thats why most of the foreigners are in the ambulance business. Don't forget you need a medical director to sign your waivers and file for your DEA paperwork.

On what basis are you making that statement? Are you counting the tens of thousands of people that have been disposed of by the taliban? Or basing that statement on the count provided by the evening news? Any war torn country has a death rate many times higher than what is reported. Look to bosnia , Iraq, Lebanon , syria,any one of the west african nations where hundreds of thousands just disappear, or Mexico where the estimates are 4-5 thousand murders per month by the drug war cartels.

There are some places that a handgun for personal protection is a necessity . I've had places I worked in the past that we had a CC permit to carry while at work,[major industrialized northeast city]. The criminal element there came out after dark and robberies car jackings and muggings were skyrocketing in the 80's. Murders happened daily. We lived in a small city north of there that had slowly deteriorated and become a place where I did keep a pistol within hands reach of my bed at night, due to all the break ins. That was the point when my wife & I decided to move North and get away from the senseless violence & crime. Here the occasional kid stealing change or laptops knows that the odds are high that he will encounter a homeowner that is armed and not afraid to let the lead fly. It does cut down on the crime rate to an extent. Now back to the original topic:: I have never seen a hunter in the fields or woods carrying a semi automatic assault rifle. Been around guns all my life. My Father was a salesman for a major sporting arms manufacturer based in New England till he retired as president of the company in the mid 80's. I grew up target shooting and hunting for food & sport.. Had a rifle range in the back yard. There is no need for assault weapons to be in the hands of folks with mental impairment or even the average Joe gun enthusiast.

Can you imagine a scenario where a bunch of billy bob rednecks got all budweisered up, and grabbed their AK -47' & bushmaster assault rifles from the gun racks in their pickups, jumped on their 4 wheelers and raced off into the woods to hunt down the elusive bambi? Now you see how stupid this scenario is. ? Of course they don't carry an assault rifle through the woods looking for bambi, They are designed for killing human beings! Period........... If you have a legitimate reason to own an weapon that is capable of firing hundreds of rounds per minute , I'd be interested in knowing what it is. For all you constitutionalist I do not believe anyone needs to possess a semi automatic assault rifle , who's primary desisn & intent is to kill human beings. I've never seen anyone hunting animals for food with one, or walking though the woods with one for sporting purposes. They are designed for ONE thing only . To take human lives. It is not the intent of the second amendment to possess military assault weapons, no matter what spin the NRA puts on the discussion. We were on a call recently where the homeowner had dozens of weapons in the home and thousands of rounds of ammunition. He doesn't even hunt, he is a prepper with dehydrated rations by the case , steel bars for his windows & doors and is preparing for the apocalypse. Or when the men in white suits come to take him away to the funny farm.

Get three duffle bags of unmarked $100 bills a million $$ line of credit and 5000 pages of paperwork to fill out. Or take the bags of cash and buy out an existing service owned by a foreigner thats has been indicted for medicare fraud and is heading to the federal penitentiary. You have to go to the commonwealth and file for a certificate of need then apply for licensing through the various state offices.

Giving these deranged individuals their moment of glory is what lets all the other squirrels loose. they seek the fame and bask in the moment. Combat war corespondents used to travel in a "press pool"until the Vietnam era. now they are often embedded with the troops on the line. This gives a different perspective to the mayhem. Same thing with the active shooter psych cases. they know the press will be there to cover their moment of fame/shame as a world event.

Kat is always looking for the elusive pericarditis case. :-} How big of a ravine? 10 feet or 100 feet? steering wheel bent or deformed?windshield intact? LOC? Rib cage intact. lung sounds equal?quick set of vitals. What does her presentation show as to history. recent problems beside back pain, co-morbitities, Medications prescribed?

i've heard of places out west , where the billing starts at over a thousand for a bls truck just to turn a wheel. Think there was one commercial contract in the news recently where it started at over $1400.00 in this area a bls run starts @ $300.00, ALS @ $400 Our service doesn't charge here. we are ALS transport 911

Women have been birthing babies for centuries without assistance from EMS, fire ,or the police. EMT's clean up the mess in the back of the truck.

Ahh young Jedi: in your future , I see crappy diapers and baby spit. Less sleep than you've ever gotten and lots of years of wondering why didn't I wrap that rascal. The fire service will not go away as there is still a need for them on occasion , There will be cutbacks and maybe the dinosaur knuckle dragger mentality will go away. It just takes a top down decision to do prehospital care properly as the primary mission , followed by the occasional fire call. Look for more combined services as cities and towns consolidate their budgets. The michigan public safety model will reappear in many places due to budget cuts. The on scene treatment and no transport will all depend on convincing the big health care systems it will not cost them too much revenue, and the insurance companies will have to figure out that they are saving $$$$$ by paying for field services. It is nice to have a dream

ResQ: There is an old saying TABBOMA. I have been in the business for over 4 decades, worked for private mom & pops, 3 rd service ,corporate EMS ,large urban and rural systems & I'm currently head of a fire service based EMS system.I do know what I'm talking about. If the fire service there was really into providing proper care , they would require a higher level of traing than EMR. It is the equivalent amount of training as given to red cross first aiders or boy scouts for a merit badge. Actually the last group of boy scouts I taught were required to have 60 hours of wilderness first aid training .

"All they care is that they are taught and pass the exams. " what else would you expect from the fire service. They don't really care if they know how to provide proper care as long as they pass the test. I can say this as a two hatter.

We had a big push for us to purchase Lactate monitors last year from the state EMS office. A lot of services did bite the bullet and spent serious money for them. Well guess what? The company that sold the monitors is no longer producing them for sale and will only have strips available for a couple of years. I didn't buy one for our ambulance , as I couldn't see where it was going to affect our treatment or transport decisions based on a given reading. glad I didn't waste that money! Now giving us the ability to get a tropinin level in the field would make a difference on decision making of where to transport when used with other data from the 12 lead and history taking.

Have fun in the showers biotch.