tskstorm

Intoxication rules out the ability to Refuse Medical Aid/Attention. Especially if they are college students under the age of 21... If they refuse to go to the hospital, police should be involved. When in doubt call Med control. If you want to reduce OOS (out of service) times, transport multiple patients at once. Problem with you signing them to a sober friend is... if something does go wrong the sober friend will say to the judge "but the EMT's evaluated him and i trusted their opinion based on their assessment that he didn't need to go to the hospital and would be okay if he just went to sleep" as the sober friend has no medical training they have nothing to go off of, except your opinion. On a note about your general demeanor, you should never have "rule out intoxication" as a primary presumptive diagnosis. You should never assume alcohol is involved despite obvious trends, and obvious 'evidence.' You need to rule out many other things... AEIOU TIPS A - alcohol, anoxia(more hypoxia than anoxia) E - epilepsy I - insulin (diabetes) O - overdose U - uremia, under dose of Rx Med T- trauma I - infection P - psychiatric S - stroke (cardiovascular) Just to name a few.

Oh yea by the way dust you owe me one from a good post a few days ago !

CSL = cross street location = place to nap ... erm rather place to post. I don't think texting while my partner was subconscious risked anyones well being, or affected patient care.

Who said there was a risk ? sitting at my CSL warrants no attention and no risk.

Not that I know of, but everything causes interference with something else .... Reguardless doesn't change nothing in your personal life should effect your patient care on the job ... but if you can do things without interferring with pt care what's the big deal ...

No one has mentioned bluetooth or hands free devices.... Im texting this on my phone while driving the ambulance

Isn't a stable something you store horses in?! ](*,) ](*,) ](*,) ](*,)

I'm always excited to get a thumbs up from dust ... I must have done something right this time around ... don't forget it next time i mess up!

My opinion on the matter is simply this, Reason EMS providers do not release the leg straps is because 'there is no need to' they improperly apply the KED. When they move the patient on the LB they are perfectly supine instead of being in a so called 'seated position.' This of course is just my humble opinion.

I use my phone while driving all the time and its pretty standard practice around here ... I've even had SGT's riding in the back of the ambulance as an escort write me a fake summons for talking on my cell (to a supervisor regarding a mandate) It really is a big joke around here.... We all know new york is a different animal ... Although I agree there are risks with talking on a cell and driving I don't think its as serious and as cut and dry as you guys are make it sound ... Ive worked with supervisors who talk on the phone and smoke with a patient in the back who's on oxygen .... Now chew me up ... spit me out .... and repeat a few dozen times .... I love you all:)

I agree with Dust's interpretation in what you are asking, clockwise vs counterclockwise. I also agree immobilization is a subjective skill, if you accomplish your goal without doing harm, you did it right. To answer I believe under the leg up the medial side would be the proper way This is being based on the way the strap is angled on the device which is a poor assumption on my part As pictured below the straps look like they should come forward not off to the side as you would need to in the first method you described (over the top of the leg, down the medial aspect, then under the leg) [web:246a53f3a6]http://upload.wikimedia.org/wikipedia/commons/0/07/KED.jpg[/web:246a53f3a6]

Richard gave you the exact rundown of the policies and procedures of our system. Bottom line is it becomes a judgment call. Legal protection = Best interest of the Patient. If you're doing whats in the best interest of the patient you're doing something right!

I've spoken with NYPD on matters similar to this dozen's of times. It goes like this .... IF PD OR FD are on scene, and it is an EMS call, or there is a patient as the primary concern (there's no fire or PD matter going on) EMS has full and complete control to direct, and instruct PD and FD for the best interest of the patient. IF PD wants a reason to take a combative patient into custody, remind them suicide is a crime and if this patient doesn't get the appropriate treatment they could die. In protocols around here we are allowed to restrain a patient in three situations, 1 protect the patient from themselves, 2 protect ourselves from the patient, 3 if PD directs us too/asks for our assistance.

Dust I would come down just to hang out with you! but alas, I am still in medic school and the schedule doesn't work : Sorry man have fun, take notes and send them my way

http://www.jems.com/news_and_articles/news...r_fondling.html Prison for Ore. Paramedic Who Fondled Patients * The Associated Press * 2008 Aug 5 PORTLAND, Ore. -- A Multnomah County judge sentenced a former paramedic to five years in prison for inappropriately touching female patients during ambulance trips. Judge Leslie Roberts also sentenced Lannie Lee Haszard to five years of probation and ordered him to register as a sex offender following his release. Haszard, 62, pleaded guilty to attempted first-degree sexual abuse. The abuse became public after a 28-year-old single mother of three reported what Haszard had done to her last December. The woman said she passed out in her Portland home and one of her children called for help. She said Haszard fondled her as she lay in a semiconscious state. "I wasn't all the way awake, but I was aware of what was happening around me," the woman said. "That's what bothers me the most. It was like watching somebody do something to me and I couldn't do anything." Once at the hospital, the woman remembers waking and screaming when Haszard entered her room. Hospital staff told her she imagined what happened, but she demanded that police be called. "He was the first to believe me," she said of the Portland police officer. After the woman's story hit the news, several other victims came forward to report abuse by Haszard. They ranged from 28 to 73 years old. Three of the them attended Monday's hearing with family sitting by their sides. "The one thing they all had in common was they're all in the back of the ambulance with Lannie Haszard," Deputy district attorney Donald Rees said. Haszard, who lost his job with American Medical Response and his professional certification, did not speak at the hearing. The single mother and two other victims are suing Haszard and AMR, The Oregonian newspaper reported.

yes same here paper form and fisdap ... but my instructor is all about research ...

MY emtb class required one 8 hour ride along no paperwork random crew.. medic class ... one word ... fisdap ... www.fisdap.net for more information ...

yourwelcome good luck

The third involved here, from the original story seems to have been a conditions boss ... but it doesn't seem likely.

the question would be, were their cfr's(firefighters, pd) on scene? if so one could assume it was them ...

Best they could do is a needle Cric

I work in the area, I know people involved, I don't work for FDNY or OLM however. 1. I have yet to have been to a call in the north Bronx where ALS pulls up with L&S where a bls crew is already there. 2. Just because the report says the dispatcher gave a 1 minute ETA doesn't state the crew heard or understood that. 3. Just because a newspaper crew who probably heard it over a scanner or who listened to the tape heard it doesn't say anything about the crew hearing it or understanding it. Side note, I work for the privates. The crew everyone has rivalries with, and have no reason to back up any crew or have a defensive tone or justify myself. I know the reality of the system I work in as I am certain you know yours. Perhaps in your 10 years as ems you've turned rogue, but I rely on my protocols to cover my ass, as this crew did, because if they didn't do proper CPR "by the book" they would have their asses handed to them in court.

Do you have an AHA CPR card? Are you required to have one to maintain your EMT certification? If you answered yes to either of these questions, you need to re-read the standards for FBAO in an unresponsive pt. No one freaked out, and there was a supervisor on scene, and the supervisor probably did tell them to haul ass! Not hearing a bang on the back of the bus, not seeing lights, misunderstanding the radio, this is freaking out? Oh, and for the record, the standard is CPR this is a combination of compressions and ventilations, better to push the ball into a lung lobe and have the lobe removed then for the alternative, death.

2 persons in back are doing cpr on a 4 year old, and the driver is trying to get the ambulance going calling in the notification, putting in the signals. who's looking behind the ambulance? This is all speculation, and wont get us far.

As stated before FDNY has auto-locking doors, and any crew who works the north bronx knows you lock everything, every time. Ambulances are broken into weekly if not more often with door locks, leaving them open is just asking for trouble .. Standard practice on lights and sirens calls, is all lights on, sirens as necessary, approaching intersections or to make people move again as necessary. Its not policy, its not even good practice, but it is what is done regularly. Probability is, they pulled up with lights on, no siren. I work with a few paramedics from our lady of mercy regularly and I haven't asked what happened with this but I will next chance I get. See if they can shed some light on it. EDITED for punctuation.