Lone Star

The service I used to work for in Detroit, their 'motto' is: 'The Provider of Choice' .... although among the road crews, the unofficial 'motto' was 'There is NO 'unity' in 'Community'!'

Rid, Ultimately, the key words are as follows: If we do everything possible in the field that our license lvel allows, we are 'saved' from any and all liability incurred during treatment in the field. In short, all Im saying is that the ER doc is sthe one to actally call it a 'save' or not. Just becasue we bring the pt back to spontaneous respirations, or even a steady pulse, or NSR....is it really a 'save'? As long as we render the best pt care that we can, with the restriction sof our license levels.... as long as we have done everything humanly possible under the scope and protocols of our license levels...then and ONLY then are we 'protected'. IF (and I stress the word 'IF' the EMT (?) screws up, neglects the pt or does not render proper care under the scope of their license level)...then by all means, hang them from the nearest tree! I take great pride in the fact that I have maintained My license for 11 years with NO disciplinary actions EVER taken against Me. I know that Im not the only EMT out there that can brag about that, and thats how it should be..... We've all studied, trained and tested hard to get where we are (regardless of licensure level). We all need to realize that life is fragile, and no matter how hard we try to 'save' that life......when God (or whatever higher power you belive) decides that its time for that person to go 'home'.....no matter what we do in the field, or in the hospital settings....we WILL fail. It's a fact of life...that all life will cease at one time or another. We have no control over that..... but as long as we continue to render the best patient care...thats all we can really do. Sometimes that thin (very thin) line between life and death will be broken, no matter what we do....

two simple words.....: Respondeat Superior...Let the Master Respond. The E/D phsician/medical control director must make the call after the EMT(?) brings the pt into the Emergency Department and transfers care to the E/D. If we do everything possible in the field that our license lvel allows, we are 'saved' from any and all liability incurred during treatment in the field.

Under Michigan State protocols, once patient care has been effectively transferred to the recieving facility, the responsibility of chasing down a 'runner' ( as in this case), rests SQUARELY on the reciveing facilities staff. We're EMS personnel, not security, or law enforcement. As far as the 'Pharmaceutic-ally gifted'......ahh yes, better life through chemical enhancement. I just wish they didn't enjoy the 'enhancement' quite so much!

I use a Sprague, and do well with it. The main reason I don't spend all that extra money on the bigger names is because in this field, the 'scopes tend to get bashed around alot....and I don't see the sense in spending that kind of money to watch in horror as it gets thrown around the back of a rig...or worse. I've been able to hear things with a Sprague that some medics cant hear in the back...even with their top dollar 'scopes.

I took a pt in to a psych facility from a local E/R. The hospital staff had already had her restrained. While moving her from the bed to the cot, she became extremely violent. Needless to say...she couldn't move during transport. On arrival, the nurse at the recieving facility DEMANDED that we remove the restraints. We informed her that the hospital ordered them, and that the pt was already violent. We were told that she didn't give a damn about the pt's behavior prior to arrival. I handed the nurse the keys to the restraints. Once the leather restraints had been removed, the nurse got punched right in the face. It's amazing how fast the nurse asked for our help at that point. I thought seriously about telling her that I really didnt give a damn about the pts behavior since the care had been transferred to the recieving facility!

Whit, Thats exactly my point! I'm a member of a part paid on call fire department, and have been for 14 years. I've also been in EMS for 11 years on top of that. I do what I do because the'res a need for it, and not everybody has the grit to do it. Those that sit and 'forget' where they've come from (ie: rookie status, or vollie...whatever) make it rough for those that are getting into these fields! It's discouraging at best. These fields need all the professionals that they can get. If a person sticks with it long enough to make it a 'career' ..then hats off to them! There's no sense in all the 'bashing' that goes on, and as a note to anyone that is interested in these fields, I can only suggest that you let the bullshit bashing go in one ear and out the other, and follow your dream...and become the most professional EMT, Firefighter or whatever you can be!

In April 2001, My father passed away from an acute M/I. He was attended to by THREE (3) full time PAID paramedics (Two were with a service, and the other was employed by the county Sherriffs department, which respsonds to all tier 1 medical calls). I'm thinking that the 'extra practice' in this case didn't make 'perfect' (as sthe old adage goes). I could go on about how paid paramedics didn't provide adequate care, and in at least one case, did LESS than what a Basic would have done! In fact, in one case the pt was a Basic IN UNIFORM! (The attending PARAMEDIC no longer has a license in this state.) I'm guessing that this whole 'Basics vs Medics, and paragods rule' stuff is getting out of hand. We're all on the same team here, whether we make $20,000 (or more) a year or not. The bottom line in this is that the vast majority of us in this field are in it to help those that need our service. Granted, there are those in the field that would probably 'run hot' to every call that was ever dispatched....the majority in this field are competent, trained PROFESSIONALS. I personally am getting tired of watching one license level trash another just to make themselves feel better. It's no different than the cops bashing security officers for being 'hobby cops' and active duty military bashing the National Guard as 'weekend warriors'.... I would guess that as long as there's a license level above us, no one would amount to a steaming pile of what we should have scraped off the bottom of our boots, unless we all were Doctors!

I personally disagree with this practice. Working a wheelchair service as an EMT does NOT get the EMT's working in their field of training. In the State of Michigan, there are certain exemptions to the motor vehicle code that are afforded to police, fire, and EMS. For example, the EMT is not required to have a chauffers license in order to transport people as an EMT. If your state has this exemption as well, the EMT that works the non emergency transportation division is in violation of the local motor vehicle code, simply by working on a vehicle that transports other people for hire. All the wheel chair van is, is a taxi cab that is designed for the ability to move the wheelchair with the person in it. Taxi drivers are required to have a chauffers license, and so are the wheelchair van drivers. Both transport people 'for hire' (they charge money for transportation services). If the wheel chair bound customer (they should not be considered patients because they are not being transported in an ambulance, nor are they receiving medical attention by qualified medical services provider), is in such poor health, they should be transported by ambulance, and attended to by EMT's. In the event that an emergency does arise with the wheelchair bound customer, the EMT chauffer is completely unprepared and unequipped to deal with it. Keep the EMT's in the ambulances, and leave the wheelchair transport to the chauffers!

Hey Dust, First keep your head down, and be safe! You'll be in my prayers. We may not see eye to eye on some things, but I for one want to see you back here! Good luck and Godspeed

The State of Michigan recognizes the MFR (Medical First Responder), They are trained to the EMT-B level, but I think they only hold a certification as opposed to licensure. Michigan also now requires the new EMT's to be NR tested as a requirement to become state licensed. All EMT veterans are 'grandfathered' for this requirement, but must meet the new criteria for relicensure. (part of these new requirements include not only 30 Continuing Education Units, but also 6 'hands on' or practical CEU's. There has been talk for the last several years about eliminating the Specialist license, ( equal to the Intermediate level) and increasing the EMT-B scope to include IV applications. Currently, the EMT-B cannot perform invasive proceedures, including glucometers. We can, however, use AEDs and Combitubes. (requires special certifications for these applications)

The State of Michigan recognizes the MFR (Medical First Responder), They are trained to the EMT-B level, but I think they only hold a certification as opposed to licensure. Michigan also now requires the new EMT's to be NR tested as a requirement to become state licensed. All EMT veterans are 'grandfathered' for this requirement, but must meet the new criteria for relicensure. (part of these new requirements include not only 30 Continuing Education Units, but also 6 'hands on' or practical CEU's. There has been talk for the last several years about eliminating the Specialist license, and increasing the EMT-B scope to include IV applications. Currently, the EMT-B cannot perform invasive proceedures, including glucometers. We can, however, use AEDs and Combitubes. (requires special certifications for these applications)

The question at hand here is whether or not this individual is at a 'disadvantage' for getting hired, as opposed to taking defensive driving courses that may not even be offered or required in their state. As for getting hired, I dont think you'll find you have any more difficulty getting hired than any other 'fresh emt'. By that, I mean any other EMT that has gone through the course, passed it...and then has to drive the rig for the first time. I don't think they offer a driving course for the EMT on how to handle the rigs. Just remember, depending on the type of vehicle your service has....each vehicle has its own set of 'weird properties' that is inherent by the vehicle design. For example, if your service drives the van style vehicles, they're topheavy and can roll over if you take curves and turns too sharply. I hope that I don't have to mention that although quick response is good, you MUST drive with due caution and due reguard for those on the street, and for you and your partner. By the time you get the call.....the emergency is over, now its your job as an EMT to respond and deal with the results of that emergency. I was told that in EMS driving...theres a ranking order that could be used as a guide for safety (and can apply to driving emergency vehicles): In order of importance .... you should consider safety for: 1. you 2. your partner 3. your patient 4. everybody else Good luck, and be safe!

I only carried that window punch until it ripped a hole in the car seat!...as far as the 'scope....it came off the mirror during a panic stop and gave My passenger a concussion.....*sighs* The person below me is arachnophobic

I've got to throw Mmy two cents in here now! Paragods are those medics that have forgotten that they themselves were once 'lowly basics' like the rest of us, and hence spend their time talking down to those of us Basics that actually want to LEARN something, (if they even deign the 'lowly basic' WORTHY enough to be spoken to at all!) They seem to have forgotten that BAISIC care ALWAYS preceeds advanced care, and are always flaunting their education and certificates. They make it clear that anyone who is not a PARAMEDIC should be eliminated from the medical field, and refuse to give any creedence to the necessity and need for BLS and LLS providers. They're 'above' routine transfers that the lower levels have to suffer through, (which by the way allows the company the resources to pay their 'god wages'. Arrogance, attitude and self induced 'superiority' are NOT qualities that provide good pt care, and are contraindicated for good working conditions. Paragods need to drop their attitudes, and realize that even though they are part of the PARAMEDIC 'class'....they still put their boots on just like the Intermediates and Basics. And believe it or not.....they're nothing more than mortal humans with a mobidly obese ego (from all the time spent patting themselves on the back) :shock: I think that less time should be devoted to the whole 'I'm better than you, because Im a PARAMEDIC!' b/s needs to be dropped and more time spent on learning to practice better medicine, and better pt care. They ARE the reason we do what we do! Just the thoughts from one of the 'lowly Basics'

Having been involved in the emergency services for a number of years, (14 years Fire/11 years EMS), I can say this: You can't MAKE them understand. The lines of communication have to be open, and the best you can really do is try to explain your passion for the job that you do. We don't get into EMS, (or any of the emergency services for that matter) for the money. We don't do it for the glory, and we don't do it really do it for any other reason than we have answered a calling that not many people can fill. From what I've gleaned from the posts so far, this boils down to nothing more than a bad case of petty jealousy. This is HIS problem, not yours. It sounds like you've done what you can to explain things to him about your passion for the job, the desire to help those that need it, and to give something to a generally unappreciative community. This is something that he has to accept, and learn to deal with. You can be supportive, and even try to help him understand by keeping those lines of communication open, but it's something that he has to accept. If he loves you, he'll accept it for what it is. Just out of curiosity, what is his 'dream job'? Why couldn't he take the steps necessary to achieve this goal? I mean, most of us have gone to school, and held a job as we took the steps necessary to get where we are.... why can't he do the same thing? Keep us posted on the progress, and I hope my two cents have helped in some way.

I am Mongo Hornblower of Waymoot. Pleased to make your acquaintance. Among the elves, I am known as Oropher of Nargothrond.

Does it count if your partner is the one that says the most incredibly stupid thing you've ever heard? On a call to the home of a hospice pt. (terminal ca), we arrived to find a woman in her mid to late 40's lying in bed. She's obviously in extreme pain. (otherwise, why would we be there to transport for pain management?) As we're getting her ready to move the pt from her bed to the stretcher, my partner climbs on the bed behind her, looks down at her and says: "So tell me honey, how's it feel to have a strange man in your bed?" If looks could kill......

*whispers to wendy* Catcher's Mitt would refer to the reciever of good old fashioned prison 'tough love'..... :shock:

*hangs head* I just can't get a break no matter how hard I try! My screen name comes up with B.F. Goodlick.....and My given name comes up with Man Hole..... Guess I should change my favorite song to 'Whistle While You Walk'! :shock:

Just gotta love the 'ingenuity of the totally smashed!

When I did my clinicals at the local ER, I too was ignored by most of the staff... I overheard a couple of the nurses talking about 'another EMS student that they had to deal with'...'I'll be glad when they stop sending students in here' and things like that. Luckily, I found a nurse that was willing to 'take me under her wing' and taught me alot while I was there. I ended up assisting ortho set a tib/fib fx, a gastric lavage on a 2 year old, and quite a few other things that day. I even ended up having to have a chat with the attending doc on duty, which resulted in Child Protective Services being called in....(what a mess that was!) All in all, even though you had the bad experience during that clinical rotation, you did learn something valuable...what NOT to do when approached by an EMT student, ... and you'll remember the hunger for knowledge that you had, and when you're approached by a newbie, or a student thats doing ride time with you....you'll be more willing to help that student learn the 'tricks of the trade', how to develop a good bedside manner, and ultimately, you'll be able to teach that student what to do, as opposed to what not to do. Good luck in your endeavors, and always remember......as long as stupid people do stupid things, we'll always have job security! (chuckles)

I came close, but as they say....no cigar! Got called as a Firefighter to a private residence, for a woman who had been dead for about 10 days in 90°F + heat. She had no face, due to the hungry little maggots running all around. She was stuck to the sofa, and obviously had started to bloat. We were instructed to place a body bag over her, then roll her forward into it. When I picked up her feet, it was like moving a water balloon....and when I set them back down on the floor (before pulling up the body bag) I noticed a small air bubble moving up from her ankle to he dorsal aspect of her foot. Actually had to peel her off the cushions of the couch. when we rolled her forward into the body bag, I happened to look at the couch where she'd been sitting, and noticed that the skin from the back of her legs, arms, neck and the back of her scalp were still firmly attached to the couch cushions....and was moving. (I'm sure you can figure out what was doing the moving) Even in a SCBA, you could actually taste the decomposition. Gawd, just thinking about it makes my stomach turn! Another call involved having to use a shovel to pry a body loose from the carpet (thick shag carpet that melted in the heat of a full blown structure fire.) Guess you could say that one was just a little over done!

You were a firefighter, hey sparky? I guess then by your own judgement that Firefighters are too incompetent to render quality care, I guess that means you're just as guilty as the rest of us smoke eaters. After all, you did that for 2 whole years!!! You're too busy puffing up your chest and then beating it with your 'credentials', to actually pay attention to the real issues at hand. (Issues that your own mindless babbling has brought to the forefront.) I guess you're trying to compensate for other 'short comings'

Sadly, this has nothing to do with having a sense of humor or not, nor about the biggest diploma...it has to do with insulting the intelligence, and the ethics of Firefighters that practice emergency medicine. Not only are we capable of rendering quality patient care, since we are bound by the same governing body that the rig jockeys are...its REQUIRED of us. I for one, am sick of all this Basic Bashing going on by you 'paragods' who seem to think that anyone that isn't a medic, should go back to 'putting band aids on boo-boos'. Just remember this: if it weren't for the Basics and Intermediates taking all the 'routine transfers' in a private company, you parageeks wouldn't be living quite so high on the hog (regardless of your big diplomas) As far as my sense of humor goes, it's working just fine there sparky. But before you start bashing a profession that you know very little about, or the personnel that perform those tasks, maybe you should try walking the proverbial mile in their bunker boots first.