Secouriste

Hey, I'm pondering the idea of getting on of those for my service http://www.physio-control.com/TrueCPR/ any thought about such device?

Thanks for the info Mike and Craig

Hey, thank you for you answer, I'll give it a look!

Hello everyone! I'm currently looking for restrains when we transport a child that does not fit in our stretcher's restrains. We use vacuum splints to secure babies but we don't have any good solution for bigger kids. Is there a solution you've been using for a while, and you're happy with? Thanks!

Before those bikes were bought we had a real problem for this kind of situation where it's too far to walk and yes not easily accessible with an ambulance. This is the case during big public events in Paris, such as a marathon. The bikes allow us to quickly have a pair on EMTs on scene and determine if the pt: needs immediate care, can go to the rescue post alone or doesn't need further assistance. The bikes are also very very good for our image. The public but also the organizer likes those stuff, mainly because they see them pass around many times and they can see we're really here, close to the event (which is their #1 concern). We use them like 5 or 6 times a year, which is not much. We could use them for the EMS but so far they refused, even if they're experimenting their own bikes. EMS bikes in France go cycle: idea => trial => official use => end of bikes => idea => trial => official use => end of bikes...

The question of pain treatment is very interesting. Here is France we have no paramedics (it's either "EMT-Basic" or a doctor that arrives on scene) so if you have a limb injury without immediate vital threat you can be sure you'll get an EMT-B crew. Such crew doesn't do any kind of pain treatment. The only question I ask myself when I respond this kind of call is: "Can I take this person to the hospital without him/her screaming in pain?" If yes, then go, if I cannot move the pt because of the pain => Call EMS to get a Mobile Hospital Unit. There are two problems here: - Our advanced units aren't meant to perform "just" an IV to treat pain, so it really takes a serious situation (or a good negotiation) to get one "just" for the pain. - Pain treatment in (non-vital) traumas in an issue that arose very late in France, where doctors are only starting to be told it shouldn't be overlooked. The solution would be to: - Allow nurses to respond call on their own, following protocols or even the doctor's instruction via phone. - "Upgrade" the EMT-B to be able to perform some basic IV (only on the doctor's order). But this is not going to happen anytime soon... About the "ambulance abuse", I'll give you an evocative example: Call: > Wounded person > Female 27 > Burn located on the right hand. Ok, we arrive on scene to discover the women has been cooking and had received a tiny drop of boiling oil on her right hand. She had a blister no bigger than the smaller coin u can find... In other word, nothing. We were pissed, really, why not calling an ambulance next time I hit my foot against a piece of furniture. We asked her why she'd called and she said "I didn't know what to do." See? People here have no first aid education whatsoever... We try our best to train people and have them come and take our first aid lessons but we're not helped at all. The other issue here is why on earth the dispatcher sent us? Maybe because we've come to a time when people aren't responsible and worst than that, will try to blame others when things go wrong. So our dispatchers would rather send an ambulance to "make sure there is nothing" rather than making the headlines the following days.

Today one of our crew met a fellow EMT of the Mexican Red Cross in Paris, near the Eiffel tower!

On duty: - Shears - Gloves - Eye-lamp - Torch LED light (P7 by LedLenser) - ear-plugs Off duty: - pocket mask Not a single EMT in France carries any kind of weapon or restraining equipment. If the situation isn't safe, we don't go and wait for the actual Police to come. Working in the most dangerous places in Paris I never had any trouble handling any kind of victim. I have to mention we're 5 in the ambulance here, so it can help taking control over the situation, but not as much as thinking and not doing stupid things (relying on any kind of weapon).

Given the little (if no) information we have when we answer a call, we always use lights and siren, but keeping in mind that having priority isn't a good reason to die with it. If it's an "orange" call, it means the situation can be quite serious so we try to be as fast as we reasonably can. If the pt needs a very quick transport, it's either the helicopter that will come, or 2 police bikes will open the way for the ambulance. I can tell you I've crossed paris at 65 mph and never stopped, thanks to the bikes.

Our protocol for a snakebite is to apply pressure (same as bleeding) , then immobilize the limb with a splint. Then we call dispatch and they call the anti-poison center. Richard: The black mamba has the reputation of having the quickest and most lethal venom. The movie Kill Bill refers to it in the end of the 2nd movie

Yes, we all learn pretty soon, that not only the uniform doesn't really matters, but also that being here to help doesn't change much either... to certain people. As was said in the EMTs' declarations, it is one thing to be threatened or attacked by someone drunk or under drugs, it's another thing when the person has no mental alteration. On our side we think the situation was handled as well as possible, given the man's temper. And even if, let's say it, no real harm was done, we pressed charges in the name of all EMTs and firefighters, because the public service of emergency rescue is something so important it cannot suffer and must not suffer the tiniest offense. The trial will be held in september, the man face serious penalties.

Chbare: Yes. I think that if you really want to decrease gun violence you have to ban guns from civil society. Of course there should be exceptions, but owning a loaded lethal weapon shouldn't be allowed. Background checks wouldn't change anything really. When one wants to acquire a gun, one finds ways. A "background check" would be easily bypassed. Moreover, no offense but I'd never trust the american administration to set up such a big system and run it efficiently. And who to pay for it? If you allow only a certain caliber with a certain amount of ammo per charger, and if you limit the overall number of ammo's one can own you automatically decrease the potential damages. Moreover, if the state were to perform regular controls, it would generate money and free equipment for the police. Well, I'm quite aware this is never going to happen. Thus my position is quite simple: ban every automatic or semi-auto weapon. Only the police and the army should own such guns. There is absolutely no reason for a random civilian to own a war weapon. Or maybe I'm missing something...

I'm sorry I should have put in some comment with the link. Anyway, it was about a 5-yo kid who killed his little sister with his own rifle. Yes, his own "kid" rifle which is something I find unbelievable. Beside the problem that "guns for kids" exist I think there is something missing here. People say "a gun doesn't kill people, people kill people". Right, if u put a gun on a table, it won't kill anyone. It's a tool. YET, it's a tool designed to make a lot of damages, in a very short amount of time and quite easily. Minimum effort => maximum damages. So a gun isn't just an item like any other. If guns were regular tools, soldiers would use hammers and nails to fight. Guns can give small acts huge consequences. Of course, one can always kill or wound with about anything. But it will take more effort to the criminal and offers more chances to the targets. I told you about that event in China, when a crazy man attacked a school with a knife. Result : 2 kids wounded. Had he used a machine-gun, what toll could haven been expected? I understand people saying: "I have a gun, I'm not crazy, I'm not stupid, why would you take away my gun?" I agree, there are people who are no danger with a gun. But if you want to have your gun, it means you allow everybody else to own one, thus allowing all the events that make big news. You can't have your cake and eat it. Now, if you like the beauty of guns: buy collectible empty guns. If you like to shoot things: register at a shooting club with sport weapons. If you like to shoot living things with friends: get a non-automatic hunting rifle If you want to defend yourself: get a teargaz can. I mean it's not the government alone that will change things. Only people can change things. If people can still believe what says the NRA clips, we're not anywhere close to seing any change. In my humble opinion, the abstract "freedom to bear arms" cannot balance the gruesome, actual, sound, death of innocent kids.

Link deleted by Dwayne Brother that link didn't provide any new information. I'm not sure what it was supposed to do. But if you'd like to repost it, with comments as to why you believed that it is relevant to this conversation, I'd be happy to leave it alone next time. Dwayne

In France, we still teach people to perform a 30/2 CPR... The Lucas CPR devices are used by some EMS here, especially the SAMU who are 2 or 3 and had to handle a full procedure on scene... alone. Those are also quite handy if an emergency transport is needed (for instance, if the person cannot be stabilized on scene). In big cities they're not used, you'll mostly find them in the rural areas. The EMT-B aren't using them.

Sorry, it was a metaphor, but maybe it doesn't translate so well in english. I just mean that, the same way no one should ever target an ambulance (that's the principle of the red cross), an EMT should never be assaulted in any way or for any reason. Of course, the same can be said about anyone, but in France (because I don't know how that works in the US) any criminal action taken against someone on public service duty will be more severely punished. There is a basic respect people have to observe toward people working for the general interest. I'm not talking of the problem of drunk or drugged or psych patients. In the situation described in the original post, the person, sober and with no obvious psych issue, decided to hurt a fellow EMT with his car (which I deemed as weapon). There is no forgiving for such thing. But that's my point of view. I hope it's clearer.

For whoever wears it. ... if that makes sense.

Anyone can go crazy, shout and insult for some reason, but this guy pushed it too far. It is only logical that such attack sould be punished. The EMT uniform is a sanctuary.

A well-done clip: http://www.dailymotion.com/video/xz3fbq_petition-pour-renforcer-la-loi-sur-les-armes-a-feu_news

Hey, Last week a man was arrested and put into custody for threatening and then riding down an EMT who was standing on a parking spot. At 2:30 pm a crew of the Civil Protection was returning from the Paris marathon and found the Civil Protection reserved parking spots occupied illegally by third party vehicles. Meaning to park their vehicle elsewhere, the EMTs located another spot in a nearby "one way" street. One of them got off the vehicle to keep the paring spot while the rest was driving around the block. A few seconds before the Civil Protection vehicle arrived, another car turned in the same street and arriving at the level of the "guarded" spot the door opened and the driver got out, violently protesting. The EMTs, who arrived just then, got out of their vehicle and tried to calm the man down but before long he started to call out threats. The EMTs wore their uniform and the vehicle they meant to park was marked as well. Police was called but before they arrived, the driver got back in his car and reversed into the parking spot where an EMT was still standing. The car hit the EMT's leg just when his colleagues pull him off the way. There is no doubt about the will of the driver to hit the EMT with his car. When the police arrived, the description of the offender (wearing the staff shirt of his working place) allowed a quick identification and arrestation. The three EMTs threatened and the one hurt pressed charges against the man who was put into custody and brought to the general attorney the following day. Fortunately and thanks to his colleagues reaction, the EMT hit by the car got only a minor knee injury resulting in 8 days off work. The offender now awaits his trial next week for threats of violence and death and physical armed assault on a person on public service duty. It is crazy what we can see these days...

The french emergency medical services send their thoughts and prayers for all people involved, shocked, hurt, killed and all those who fought to save lives and relieve the wounded.

That reminds me of a colleague who worked in the french Sécurité Civile (part of the army specialized in heavy disaster relief, fire fighting...) who went to Haïti then. As someone trained in medical emergencies, he was given a role much more advanced than he had in France. He wasn't a physician nor a nurse, yet he was trained to help with a lot of medical procedures given the context. Interesting to see that people's qualifications depend not only on their actual skills or studies but also a lot on the context...

Well, that will be an option if I fail in France. To be honest, remaining in France allow me to avoid a lot of administrative issues and also to immediately start the medical studies. The french studies are also very very good even if going through the first year is a real nightmare. I have investigated the UK, the US, Canada, Belgium, Romania... If I cannot become a doctor, I'll consider another career in health.

In France too we have a very high level of education for our advanced responders who are actual physicians and nurses, and even surgeons now that we have the mobile ECMO unit The job of the dispatcher is to assess the situation and send the required response. The problem of the seriousness of the calls isn't really an issue for the advanced response so much as it is for the first responders. The problem is that the dispatchers are now more and more afraid of prosecutions if they deny an ambulance. I know the SAMU dispatchers are keen on sending an ambulance only if really needed (otherwise they call a "city doctor" who will attend the patient's home within the hour). The Fire Dept. dispatcher are the opposite. They will deny he response only if there is really nothing relevant (eg: "My heating system stopped this morning"). I give you a blatant example: last week I attended a young woman who got her hand "burnt" by squirt of boiling oil. There was absolutely nothing to be seen. She had put her hand under tap water and called us. When we asked why she called, she said "Because I didn't know what to do..." Obviously she did because she had put her hand under water... We reminded her of our real missions and then we wondered how the hell the dispatcher could send us on something like that... So you see, the problem is more related to the EMT's rather than the advanced response. Why? Because to have a straight advanced unit, the situation has to be very clear and serious. Otherwise we get there first and we ask for the doc. And we better be right in our judgement, otherwise the doc will have no qualm about reminding us why he should come, or rather not come. But of course it sometime happens that the advanced unit is called even if not really needed, because there is such a huge gap between the EMT and the physicians. For instance, a basic-LS ambulance of the fire dept. cannot transport a patient who's got an IV (from a doctor already on scene...) ... They have to call an advanced unit for transportation alone! Why? Because EMT's aren't meant to perform such gesture so they can't manage the patient once he's received the treatment. We don't have such rules at the Civil Protection, but you see the issue. In Germany, the EMT-B of volunteer units are trained to operate the Lifepack (ECG...) and the respirator. They can do it only on request (from a physician) and they cannot decide of any setting, BUT they're trusted to have the equipment (and not to use it outside the authorized situation) and operate it. In France, that could never happen. The day you put a respirator in a french BLS ambulance, you'll have a mob of angry nurses and physicians with pikes and torches at your doorstep. Fab: The medical studies in France are quite special. Many student do what is called a "P0" ("year 0") during their last year of highschool, to get in touch with the subject they'll study the next year. It's a training that comes on top of your "baccalauréat" year. They do not do 1 or 2 year of "classe préparatoire" (preparatory course) like you would to get in an engineer school. Basically all you need to get into mad school is the Bac, whatever the section (S, L, ES). YET at the end of the year you'll have an exam with a numerus closus that will allow only 10 to 20% of the student to pass on the next year. You can try twice, then you're done with med school. The working conditions and the competition between the student make it very very hard for someone without strong wit to get through that dreaded first year. I have tried to register for some med school in the UK but I'm afraid by academic background isn't good enough yet...

The responsibility isn't mine. Is shitstorm there was, it would strike well above my little EMT's head! If I arrive on scene with a pt declared dead by a physician, I keep my bag on my back and wait for the authorization to leave. I will of course recors the whole situation in my mandatory "call report".