Lone Star

Obviously, if you roll up on a scene where the pt has harmed one of your family members, I would think that you would be too 'close' to the call. Some might (note the key word 'might' used here), be willing to provide less than 'adequate' care to this pt. I don't see a problem of having your partner attend. The cause of the family members death is irrelevant. If the pt was found to be the cause of the death, some would be tempted to exact some form of revenge, be it either poor care, gross negligence, or pt abuses (making the required treatments as painful or uncomfortable as possible). In some cases, you may not have the luxury of being able to pass the pt off to your partner, or someone of equal or higher licensure. In these cases, you have but one option available to you. Detach yourself from the situation, treat the pt, and do your job.

Say whatever you want to...I've never claimed to be above it all, nor did I put myself in any speciffic category!

.... and they wonder why we call them 'dumb criminals'......

Intelligent minds discuss ideas Narrow minds discuss 'events' Small minds discuss people

What a crock of schit! To single ANYONE out based on habits, personal vices (as long as they're not illegal), sexual preference or lifestyle, and denying them the same opportunities as 'everyone else' is ILLEGAL, and is DISCRIMINATORY! We cannot base employment on race, color, creed or religion...nor can we base housing, education or other basic rights. To single out a speciffic group of people is segregationistic and has been declared by LAW to be a 'no- no'!

VIVA LA COLOMBIA!!!

Having worked EMS in metro Detroit, I can say this...first off, you'll probably be relegated to doing alot of non emergency transfers, which will give you a good chance to hone your basic skills, and bedside manor. You'll get your 'trauma junkie calls' but they wont be as many as the 'routine transfers'. Depending on the company you work for, you may be able to pick up open shifts, (the company I worked for used to page out the open shifts as soon as they were open) Having said that, I have to honestly admit that working in Detroit taught me alot of things, not only as a health care provider, but things in general. I don't see a 'problem' with your plans to work and go to school to advance in your license level, just dont try to do too much all at once...burnout is a bitch! Never stop striving to learn, as you will never 'know it all' in EMS! Good luck in your travels in the EMS world!

Welcome to Earth, the third rock from the sun!

What happens in 'outer space', stays in 'outer space'? I have to agree with what whit said th ough....if the Basic can't recognize that the pt care reqired is out of the Basic scope of practice, then it's time to call in the big medic guns and let them do what needs to be done. If the Basic is too 'gung ho', egotistical, or just plain stupid to realize that the pts condition is more than they can handle, then they need to be removed from that position. They are doing nothing more than contributing to the degredation of pt condition.

Not all 'routine calls' are as you describe. Point still remains...EMT-B's have a place in the EMS system, and until the Paramedics can take that 3am call for 'pain management' or patient transport, dialysis, etc ...there will ALWAYS be EMT-B's around to be the 'whipping post' for arrogant medics! At the end of the day, its not an 'US against THEM' scenario. It's two different niches being filled by those that are able to do the job!

IF my assessment and treatment suggestion were so grossly detrimental to the pt's well being, then tell me why the Instructor/Co-ordinator told me they were correct? IF the medic did such a good job, then why did they end up LOSING THEIR LICENSE after I made a call to the Medical Control Board? I can only hope that since you've decided to tell this 'lowly basic' how WRONG he was...then please explain these answers in 'little words' so I can understand! Also, let's keep in mind that I didn't supply that information for you to use to tell me how little I know as a Basic, those were the FACTS as they pertained to the situation at the time! At the end of the day, it STILL boils down to the fact that EMT-B's have their place in the 'EMS Food Chain', and our narrow little scope of practice only means that we're the thinnest spot in the line between life and dead!

Gotta LOVE 'revenge by protocol'!!

THE PARAGOD HAS SPOKEN (those that do not have 'paragod' status, bow down NOW!!! :wink:

Until the paragods can be 'bothered' to descend from the mount, and start taking nursing home calls, and the 'routine transport calls', there will ALWAYS be a need for the EMT-B. Any private carrier will show that statistically, the BLS calls outnumber the ALS calls, therefore in your non municipal settings, the higher BLS call volume will therefore generate the revenue to allow the company to be able to 'reward' the EMT-P with the higher wages for the higher training. That being said, there are the 'misfits' at ALL license levels. You know the 'type' that I'm referring to; the ones that can only 'regurgitate' facts printed in a book, as opposed to being able to JUSTIFY why they performed a speciffic treatment, and the expected result of that treatment option. In 1996, I was driving home from working EMS in Detroit. I was still in My uniform, and suffered from vertigo, left sided hemiperesis and occluded field of vision bilaterally. To be honest, I thought I was having a stroke! In addition to the above mentioned complaints, there was also decreased tactile sensations on the affected side as well. Luckilly, I had a CB radio in my truck and was able to call for help. The responding unit was an ALS unit. On arrival, I was A&Ox4, and explained my 'situation' to the medics. The first thing they did was to make me get out of the truck UNASSISTED! Once I stumbled to the cot, and was put into the semi-Fowlers position, the medics moved me from the median to the shoulder of the freeway. Before loading the cot into the rig, the attending paramedic 'took a blood pressure reading' through 4 layers of clothing (two layers of coat, a long sleeved uniform shirt and a long sleeved turtle neck shirt). He stated that he had 'heard' a blood pressure of 172/150. The rest of the 10 mile trip to the hospital (code 1) was spent filling out the pt care report. In the spaces provided to list the vital signs, he simply wrote 'WNL' for the unstated 'Within Normal Limits' abbreviation. No other vital signs were checked! (Pulse, eyes, lung sounds, respirations, etc). Upon arrival at the local ED, an ER Tech took my blood pressure PROPERLY, after assisting with the removal of the 4 layers of clothing mentioned above. Not surprizingly, the B/P was then entered into my chart at a 'reasonable' 118/80. The ER tech also started an Vv of NS @ KVO, utilizing an 'IV block'. (for multiple IV access if necessary). The attending physician walked up, took one look at Me and within 30 seconds of introducing himself and asking a couple questions, was ordering a trip to radiology for a CT scan. I later asked the doc how he came to the decision about sending me to radiology so quickly, stated that 'one look at the eyes' was all he needed (in addition to listening to the chief complaints). After spending 8 days in ICU, I was released to 'rest and recuperate' at home, while waiting for the surgery date that was in 3 weeks. Just because my body didn't work like it should, didn't mean my mind was gone too. I made a call to the local Paramedic Instructor/Co-ordinator in my area and started asking questions about the paramedic protocols for a suspected CVA pt. I stated that had I been MY pt, as a medic, I would have performed the following procedures. 1. Properly assess ALL vital signs 2. Start an IV (N/S @ KVO) 3. High flow O2 via NRB 4. 5 lead monitoring with a 'test strip' for records 5. RAPID transport to the closest appropriate facility. 6. monitor the pt for any changes in condition/status 7. be prepared to step in with chemical intervention (if necessary) I was told by the Paramedic I/C that my treatments were correct and accurate. Now if I, as a 'lowly Basic' can figure this out....then the paragod that showed up on scene should have known this as well! (so much for the 'superior training' theory!) Needless to say, this medic no longer holds a license in the State of Michigan because of this! Ultimately, it boils down to this: Basics DO have a 'place in the field', we DO serve more of a purpose than to 'step and fetch' for the medics and we ARE healthcare providers in our own right. Granted, our scope of practice is much more limited than that of the paramedic, and thats why we don't command as high of a wage for what we do. But, realistically, not every call is going to require ALS intervention, so why tie up an ALS rig on the bullschit calls?

I ended up with a whopping 3%! I own a scanner that isn't plugged in (it was my fathers, who had it mounted in his truck), and a couple of EMS shirts that were gifts.

In a nutshell, I hope you ain't lookin to get rich working EMS, no matter how you 'look at it' to ease the painful truth!

Hey, I got no problem admitting that I'm wrong about things. I live in Genesee county and worked in Oakland and Wayne counties (primarily), so you can see the confusion about local protocols. The problem here is that there are too many different local protocols to try to remember, especially when in direct conflict with each other. I am thoroughly chastised, and for that, I retract my original statement.

Are you referring to the Genesee County protocols?

Remember, what you're seeing is GROSS wages....or your 'before taxes' wages. Depending on your filing status, you'll find your NET wages ('take home pay') less satisfying.

Slightly different scenario, but still to the point of this whole thing: I was called to the private residence of a 68 YOM (year old male) who was unresponsive. On scene, I determined the guy was in a diabetic emergency. Since we were only transporting 3-5 minutes tops (priority 1[code 3]), there was no time for ALS intervention. Strictly P.U.H.A. (Pick Up, Haul Ass) When I notified the dispatcher that we were transporting priority 1, I was questioned on the 'grounds' of why I chose to transport in this manner. I don't know about you, but I dont have time in this type of situation to debate the findings with an untrained dispatcher over the air, patient care trumps all that! On clearing from that call, I went back to the main station, and filed a formal complaint agianst said dispatcher. How can she make a determination of transport priority when first of all, she's not even trained as an EMT, and second, she's not on my scene?

CBEMT, Not only is this service incompetent, but unprofessional as well. I for one would be documenting things as best as I can, and then making an 'anonymous' call to the county med control, or the state. I mean, what can that service do to you? I know all about unions, as I grew up in a GM (General Motors) town. My father worked for them for 30 years. I was even a UAW member for a while.

When I was in EMT-B class, we were taught that there was additional padding placed under the 3 straps across the torso as well as in the groin area. I almost got failed in my state practical testing, because the 'partner' they put me with for the KED station REFUSED to pad the sternum/torso straps. He stated, "The patient don't have tits, they don't need any extra padding!". I immediately stepped away from the scenario, stating my objections to the proctor. The proctor asked me how I would do things 'differently', to which I stated the process that I had been taught in class. Needless to say, I passed the station, where my 'partner' (although I had 'coached' him as much as I possibly could) didn't. I didn't feel any remorse, as we had sat through the same class night after night, and he knew better! My instructor was great, and because of him, I walked out of the State practical exams (done to NR standards) with a 92%. I guess he wasn't kidding when he said on the first day of class: "Compared to the State test, mine is gonna be a BITCH!"

Damn! Since when does union negotation supercede State protocols? I believe that we as PROFESSIONAL EMS workers, have a committment to patient care that outweighs any obligation to another service, even if we are 'on the same side'! If the hospital isn't going to report these half-assed EMTs ( and I use the term loosely here), then it should be the responsibility of the witnesses to make a stand. These knuckleheads need to have their licenses removed PERMANTENTLY!

The closest I get to buying any woman tampons, is thread and cotton balls, ------the 'roll your own' brand of tampons!