JPINFV

Half hour from the hospital!=volunteer BLS squad? If anything, having a longer transport time is a reason for a professional paramedic first response service.

¿The feminine version of a hippo?

Good point. I've seen plenty of crews from companies that have them (the majority of the ambulances at my company didn't have them) just bend over in plain sight and hit the button. It's not exactly hard to figure out what they're doing when they next get into the ambulance. To be honest, this would be a better reason for having 2 keys than having an auto-open button.

It always seems that crews aren't exactly attempting to hide their super secret switches, so it isn't exactly hard for someone observing a crew to find it. [hr:de177ae3ec] Want to see: Hospital with security controlled access to the ambulance bay. It seems that most ambulance bays that I've seen are directly connected to a public parking lot or road, if not a part of said parking lot or road. Edited due to stupidity

Well, to be fair, are we talking about replacing the entire trach or just the inner lumen?

I would argue that she should be suspended with pay (full or reduced) or used in some other capacity (e.g. QA) until her condition is stabilized and make being compliant with medications a condition of employment. While, yes, having her job terminated would be bad, it would be worse if her actions secondary to her illness causes her patients or her partner harm. Hopefully she works for a company that will be willing to work with her and are not completely for the bottom line.

So, basically, if your on home rest you can't, say, go grocery shopping?

In Boston it's 2.00 a trip with free transfers (you don't even leave the paid area to switch from one line to another) and $60 a month for unlimited bus and subway use. Of course the Massachusetts Bay Transit Authority (MBTA) is in extreme debt.

It appears that RAL stands for "ride-a-long." Point of interest, the proper way to introduce a non-standard acronym would be by adding it after the first use of the word, in a manner such as "ride-a-long (RAL)."

Yea, I pretty much take the subway everyplace I go now. The closest stop is about 1/3 of a mile from my apartment.

Gas prices? I was plesently surprised when I first moved to Boston that gas was still under $3/gallon. It never dawned on me that I might also go 4 months without buying gas.

1. HR should handle any complaints about a hostile workplace [it, quite humerous, was actually a query asked during my exit interview]. 2. If you feel that it is an honest hostile work enviroment, my suggestion would be to stop working there. Given the amount of time in a week that an average EMS provider spends at work (especially with 24 hour shifts), it simply isn't worth the stress if you can find another job.

^ Damn it, someone stole my saying from me

So you try to stay away from Bellflower Medical Center and PIH? At least Bellflower's staff is nice and understand that they only have 3 gurneys in their ER. PIH on the other hand... :evil: :x :evil4:

Working interfacility, I could honestly not care less which hospital the patient requests to go to (within reason, of course, and 20 minutes is more than reasonable. The patient I was talking about was transported to their hospital of choice). To be honest, you can cover a good amount of ground and reach a lot of hospitals in 20 minutes from most places. The 20 minutes is just an estimate, not really a hard limit. Thus it's more up to the paramedic than anything else.

Meh, I've heard stories through the grape vine about basics arriving to a 911 call and finding their patient sitting on the curb with a paramedic PCR taped to their chest.

I have never worked for a 911 company. I was in the second ambulance that responded to the call and the one that actually transported the patient. From what we were told by a staff member and family member on scene was the medics cleared the patient for BLS and told the staff that, 'since they didn't like their private ambulance crew leaving the area [note: the Orange County in this area is essentially one contiguous suburban city and the prefered destination was not 20 minutes away] , the patient either goes to the nearest hospital or they need to call someone else.' The company that provides 911 ambulance service to that city, ironically enough, also does IFT transports. By protocol, patients have the right to determine their own transport destination provided it isn't too far (20 minutes) AND they are stable enough to go the extra distance. Whether the patient is being transported by basics or medics is irrelevant.

The fire department is dispatched to every 911 call. To the best of my knowledge, there is no way to cancel them, and with short response times, they often beat the BLS ambulance to the scene anyways. On the other hand, anyone can call an interfacility transport company for ambulance transport. Since there is no regulation in OC or LA for chief complaints that must be refereed to 911 (Riverside County has an entire list of chief complaints that IFT companies are not allowed to transport and instead must direct to AMR for paramedic transport), a BLS ambulance will be dispatched and it is up to the basics on board to determine if paramedics are needed, and if so, if the nearest hospital is closer transport time wise than a paramedic response.

Well, with 110 hours of training, do you expect to not be on the bottom of the totem pole? I've worked for 2 years in OC for an IFT company and have dealt with hospital providers that ranged from wanting me to essentially recite the patient's entire packet to just wanted a chief complaint. The simple fact is that doctors and nurses are going to be doing their own assessment, regardless of who gives them report. They aren't going to be saying "Well, the EMT (B or P) told me that the lungs were clear, so I guess I don't have to listen to them." To be honest, the problem with Southern California EMS is as simple as it's fire based. Fire fighters who do not want to be involved with EMS at all are forced to become medics and, simply put, no one can put forth a proper effort if they are uninterested in the job. I've ended up running transports following calls where the fire department refused to let their private ambulance crew transport a patient to a hospital outside of the closest. They [the fire medic] was going to BLS the patient anyways, so there was no medical need to go to the nearest receiving. This situation, especially in Orange County, especially hits the basics because they do transport patients that should be ALS every day. This is, in large part, because there are no private paramedics. So, it is either a 911 call or it is a BLS transport. This means that a patient with a confirmed electrolyte imbalance gets transported BLS, with all the risks associated with it (lack of care if anything does happen). Furthermore, with 18 hospitals [soon to be 19 with Kaiser Irvine], most transports are well under 10 minutes. This means that acutely ill patients who do need paramedic care do end up being transported by basics. Of course this does tend to leave a bad taste in a bunch of emergency room staff's mouth (I'm looking at you, Huntington Beach and St. Joseph's). Of course the basics get the short end because they don't choose who the nursing home calls to transport. As far as the basic v paramedic terminology, personally I have changed to how I refer to the levels (I generally try to not call basics "EMT"s), but that is really neither here nor there. As long as 110 hours is considered enough to provider emergency care and, as is the situation in OC, paramedics are restricted to the fire department, the situation will not, nor could it, change. As far as the fire department basics responding on an engine, what exactly are they going to do? If you have the scene under control, the fire department basics should be assisting you with you, the ambulance basic, in charge of patient care until the paramedics arrive. It's your ambulance and your patient. You, the ambulance basic, should be in charge regardless of the amount of brass some fire officer has on his uniform (I'd have no problem telling a fire chief that was a basic where to sit and spin if he tried to give me any medical direction on a medical patient).

No worries... you didn't mess up the forum, its just that it's happened before. Besides, I fixed my link [it took me a few edits to get it] while you were posting the article.

To get the link to work I cut down the URl to just the story ID http://www.kmiz.com/news/story.php?id=10546 and used the link button to format how it looks in the post. All of the extra stuff in the link is what is messing up the link.

link (fixed) It's generally better to just post the link instead of embedding the page. I only embed if I can't directly link an image [and then it's only the image]. There have been problems in the past, especially if the page is a .pdf, with too many embedded pages breaking a thread. After watching the video, I thank god that I've always lived in a place with professional fire suppression with automatic mutual aid (my understanding is that fire units in Orange County, CA are dispatched without regard to city limits) I don't buy the liability argument, especially since fires are not that common to begin with. Just because the fire company's actions were correct doesn't make it right.

If you're in the back unbuckled, especially on a non-emergency transport, then you're most likely doing something wrong [exceptions would be actively getting something out of a cabinet, moving from one seat to another (sue me, I prefer to sit in the jump seat and not on the bench). Taking vital signs is not included].

15[s:2e7a25c728]miles[/s:2e7a25c728](1[s:2e7a25c728]hour[/s:2e7a25c728]/65[s:2e7a25c728]miles[/s:2e7a25c728])(60minutes/1[s:2e7a25c728]hour[/s:2e7a25c728])=13.8 minutes 15[s:2e7a25c728]miles[/s:2e7a25c728](1[s:2e7a25c728]hour[/s:2e7a25c728]/100[s:2e7a25c728]miles[/s:2e7a25c728])(60minutes/1[s:2e7a25c728]hour[/s:2e7a25c728])=9 minutes 13.8-9=4.8 4.8 minutes saved assuming those speeds are maintained for the entire 15 mile trip (unlikely). You aren't exactly saving an insane amount of time there. Especially since 4.8-(time delayed due to accident/blow out/etc)=vastly negative number. Now, I'll admit that I've reached some stupid speeds in an ambulance [never broke 100 though, but these were well maintained freeways with more than plenty of following time]. That doesn't make it right and it took my company cracking down [read actually monitoring the speeds] before I stopped. Especially since, in the end, you really have to travel a good distance before you actually save time.

Smoking, the job, or both?