mikeymedic1984

Check out teaching universities that accept "donated bodies", also contact your local organ donation company (like Lifelink) to see if they will allow, but as others have stated, stiff cadavers are not much better than the manequins you practice on. Successful intubation is more about confidence than skill, so practice often and you will be fine (pour a can of soup in Fred the Head and intubate him).

Kiwi and Oz, do you guys really have REAL traffic to deal with, seriously I have no idea what your traffic is like, but I doubt it rivals any major american city. And as far as big ford ambulances traveling at high speeds; they are mostly diesels (although there are some gas burners out there now), so high speed is not really realistic. But I agree, more training is always a good thing, and no one under age 25 should be allowed to "drive" an ambulance (the children can "tech calls")

Bieber, here is a suggestion: Someone in your group knows your average number of transports and collection numbers those transports average. If you are like most 911 services, your transport rate is probably around 50-60%. Have that numbers person run the numbers of what revenue would be produced if you transported 5% more patients this year, then ask for a cut of that across the board (in a Christmas bonus)if you achieve the goal. For instance, you run 2000 calls per month and average $300.00 per call in collections received -- not billed out (including the good and the bad), but you only transport 1100 which nets you $330k per month. If you were to change that to 1300 transports per month, it increases your revenues another $60k per month (raising your yearly from 3.9 million to 4.68 million or $720k per year). Split the difference between the department and the employees, giving the employees $360k to split. *** Bieber responded on page 1 of this thread

Go to your local OBGYN/nursery and get some skull caps, the head is where most heat is lost, and it is the most likely part to be left exposed. If they do not have any, go to the ER and get the cloth sheeth the put around a fractured extremity prior to casting, twist/tie on end into a little pig-tail.

I would always confirm, only takes a a few seconds more. It seems that at least twice per year I read a story where some live person has woken up in a morgue, after some healthcare provider determined they were dead. Its kind of like the "never point a gun at yourself while cleaning it, even though you know all bullets are removed".

If they have no delivery equipment at all, then it would be a bad decision to take any pregnant patient there, regardless of complaint, you never know when a complication would set in, so I would write it as all go to the distant facilities that are most appropriate (whichever their OB doc practices at), you would only stop at the local if the mother or baby is in arrest (or a severe complication - Low heart rate). Might be time to ask the hospital for a little financial contribution to both ambulance services so that you can stock up with more neonatal equipment.

I agree with arctikat in that there will be other opportunities in the future, so this may not be the time to take on a new job. But if I may suggest something, it sounds like it is time for a family meeting (the whole extended family), to discuss everyone's role and responsibility in these situations. If you want to help any of the kids/grandkids that is fine, but you should not be obligated too. As I read it, all of their problems were caused by their poor decisions and I am guessing this is not the first time they have been in trouble; if they continue to not have to pay the price for those consequences, the cycle will never stop. Where are your brothers, sisters, uncles, aunts, your other children that are grown ? Meet with them and ask them to share the burden. If that fails, consider moving everyone into one big house somewhere, so that if the kids/grandkids cannot find work, they can atleast help with the healthcare and chores around the house. Remember that counseling is not a bad thing, and there may be support groups out there that can help you. But if you choose to bail everyone out, I would set a date specific for when it ends, and say, "I will help your for "x" months, after that, I need to get back to living my life". There is treatment for drug addiction if they want it, and the house may take years to sell, you could be on the hook for years if you do not handle this right. Remember, you do have a life, and you do not know how many years you have left. What would they do if you were not here ? Sorry all this has happened to you, will put you in my prayers, good luck.

Being in Canada does throw a monkey wrench in it. In the US, the EMTALA laws were created because of incidents like these, where the hospital staff would put the patient back in the car and say go to hospital ABC, we dont do "babies" here. Therefore, all US hospitals/ERs have to provide a medical screening exam / emergency treatment, and then arrange an appropriate transfer. I guess the question is, does your hospital have the capability to deliver babies, but just cannot take care of high risk deliveries ? The problem you are going to run into is that most of these patients will be complaining of back pain, abdominal pain, or bleeding/spotting; regardless of trimester it would be hard for medics to know the level of stress the infant is in, but on the other hand, if you take the patient to a hospital that you know does not have OB, and then the baby dies, you have the same risk as if you bypassed the closest hospital for a further one. One suggestion would be to ask the local hospital if they would allow you to stop in, have them check FHTs, and then let you go among your merry way ?

I would convene a meeting between the local hospital with no capability, the closest hospital with capability, and the two ambulance services. To me, it should be no different than stoke, AMI, and Trauma, the patient should go to the most appropriate. The problem is that without clearly defined responsibilities and an agreed to protocol from each side, you will get the following: 1. Non provider hospital may abuse and no longer accept ANY pregnant patient. An 18 year old pregnant woman, in her first trimester, with the flu could go to the non-providing facility. 2. The hospital that does provide may get pissed now that they are getting every pregnant woman from that county (or area), and what if their doctor practices at another hospital (the patient should go where their Dr. delivers) ? 3. I would like to hear the rationale for "we can only go to the closest". Is it because they are a small service with limited units (if so, maybe an agreement can be made with your service or another local private service to be dispatched along with them on all OBGYN and let the other service transport). Is it because they are just lazy and want to get back to the station for TV time (then they have to step up to their responsibilities). Or is it because they are a private, and they want to get the secondary hospital to hospital transport (it is wrong but it happens). You can write the best protocol in the world, but without input from each steakholder it is doomed from the start.

What do you or your employer do to keep morale up at work ?

Good for you ! A car is a car, gets you from point a to point b. I am guessing I blew about $33-38,000 on cars in my 20s until I got smart; sure wished i bought a clunker and put that money in my 401k instead of looking cool.

Are you sure your injury is not job related ? Could it be that you have weakened your back at work, but it popped somewhere else ? You might want to talk to a work comp attorney, just to make sure you have no claim. I am not suggesting you scam your company, but you have to wonder if lifting fat ass patients did not contribute to your injury ? I know my back is going to give me lots of trouble in my golden years from all the years of lifting two-man stretchers in the truck, but those companies I worked for are long gone, so there is nothing I can do about it (for the rookies in the room, we used to have to lift the stretcher from the ground into the back of the truck - one of us on each side). I would definitely start taking instructor classes and work your way towards teaching. You are kind of in the Peyton Manning situation; most teams will not take the risk of hiring you, and then you have to ask yourself "if someone does hire me, is getting back on a truck" the best thing for me ? Or this may be your chance for a do-over. Many times in my life, changes occured in my job because of my choice or other's choice that seemed to be the end of the world or at least a big set-back, but if I had stayed at my first "real job" all these years, there would be a lot of people and experiences I would not have ever encountered. So you have to ask, is EMS (on the truck) the job I really love ? If so, look for teaching, ER, industrial, prison, or other EMS related jobs to keep you involved. If not, it is the perfect time to maybe do that thing you really wanted to do, but did not for whatever reason. Do not let fear trap you in your current industry.

You will be fine, just remember that no matter how bad the call is, YOU did not cause the injury or illness, you are just there to do the best you can, and many times, doing the best you can will not be enough. Also remember that a "code" may be one of the most critical calls you will run, but they are already dead -- hard to make "dead" worse no matter what you do or fail to do. I hope that your service will put you with a preceptor or strong medic until you get your confidence up. If not, I would strongly suggest transporting a higher percentage of your patients than the traditional medic would, for the first few months. Refusals and drunks will bite you in the butt more than the typical code ever could.

Get with your local big departments who have done it, take a tour learn from their mistakes and successes. The last one I did was right after 9/11 and there was little info on the web on such things, I imagine it has changed. Check out FEMA information and see if your state version has suggestions. Look to see if there is any more grant money, if you already have grant money, make sure there are not stipulations and strings of what you must buy. Then do a complete threat assessment of disasters that have actually happened in your area, or what has happened the most and make sure you cover that. Everyone is worried about a dirty bomb or nuclear device, but you are probably way more likely to have a weather, transportation, or industrial incident. I would also recommend that you buy as big as you can, as you will be stuck with this thing for probably another 20 years, so it has to be able to meet your communities needs in the future (unless that takes away from buying necessary gear). Look at your fire stations and schools that were built 20 years ago, have they kept up ? Finally for the trailor itself: Make sure you have something that can tow that weight, it would be nice to have exterior electrical plugs, exterior lighting, an office area in the nose with desk, cabinets, dryerase boards, pencils, pens, paper, a laptop with wireless internet connection (so you can function indoors if needed for weather), a generator or two.

Could someone make the argument that it is a germ thing (shared pillow) and not a laziness thing ?

I would wait a few weeks and get a feel for the job. What you will need will vary with the area you work in, call volume, and other variables. Most rookies spend way too much, and buy way more than they need, so give it some time, and you don't want to be "that rookie" that has everything on his belt including a KED. PPE is always good and usually necessary, so you cant go wrong with that, but everything else can wait (watch the veterans on calls).

http://www.eventemsllc.com/ this service handles alot of big venue events in atlanta (practically all), you might call or email to see what formula or rationale they use. One of the services that I worked for usually staffed one ambulance, and then called the local 911 service for transport (unless it was a cardiac arrest or something critical). But kiwi is probably right, it will probably be all about price.

I have noticed a trend over the years regarding pillows and ambulances ? Most 911 services never have a pillow on the cot, most IFT services have a pillow on their cot. When I have asked 911 medics about it, they are quite indignant about having a pillow on the cot, usually saying something like "this is not the Ritz Carlton, if you need a pillow you do not need 911". So to all you 911 medics, are you "burned out" or "less compassionate" if you are not concerned about patient comfort ? If you are one of the ardent ones that are against pillows, can you tell me why ? And what if you work for one of those alphabet services that do both 911 and IFT, what do you do then ? P.S. I said "most" not all, I realize that there will be services who fall on both sides of issues, regardless of which type you work for. I am just curious if there is a cultural difference between the types of services, or if it is between types of medics ?

I am not aware of "documented standards" but it seems I remember 1 ALS ambulance for every 8k people. I doubt you will find a documented standard.

Cmon guys !!! You are really so homophobic that you would go without or rather have IO than PR ???????? Get over yourselves. There was this one time at bandcamp .....................................................

Do you get a happy ending with that massage ?

The best boots I ever owned were regular military combat boots, they lasted alot longer than any others I have owned.

Fired if caught texting and driving. We ask that they not use the cellphone for calls while driving, but it is not as big of a sin as texting. The first $500.00 (our insurance deductible) or the cost of the damage if it is less than that, is payroll deductible if you are at-fault in an accident.

Who is it hurting ? Probably only female CEOs who could afford to join if they wanted to, as there are other places they could go join, and they can play golf there on the course, they just cannot be an official member, so it just would not be as prestigious for them. But if women do not want to join or have not tried, why would you need the "rule" ? Much like asys says, we tend to congregate where we want to with our own kind, so I am not sure that if they opened it up to women that they would get 1000s of applications.

Too many to list, but will list my favorites: 1. 1965 Ford F100 (bought in 90s as an antique daily driver) 2. 1978 Chevy Camaro Z-28 4speed with 4 barrel carb as a teen, can't believe that car did not kill me.Favorite my parents owned while growing up: Red 60's model Ponitac Fire Chief convertible, and early 70s model Corvette.