Richard B the EMT

Marty the Scaramedic makes a very good point. If telling these stories, make sure to not mention specific locations, dates, and especially not names of the patients, or your crew-mates. Oh, the story I mentioned? It was a long time ago, in a galaxy far away...

Securing a handcuffed patient to a backboard smacks severely to the "Bellevue Sandwich." The patient is on the backboard, and the front of the patient is on the scoop. The patient vomits, and, due to the board and scoop, is not noticed to be asperating, and you have a dead patient when you get to the hospital, instead of one who might need a 72 hour hold to determine if the reason they are AMS is medical, chemical, or psychological. I am 34 years in this "Biz", and the Bellevue Sandwich has been illegal in both city and state of New York for almost that entire time. If it is not in your area, presume it soon to be, if you are in a progressive system, as I believe most of you to be.

Dustdevil said: Bravo, my man. Everybody knows different things, and two viewpoints bolstering each other, from different areas, can only help the patient care. Think outside EMS. I play regular guitar, and my buddy plays bass guitar. Each alone is good, but together, we're awesome!

Hey, riskynremtp: Bang, Boom! You have now been slammed. Now that THAT is out of the way, let's move on. LOL

NYPD LEOs don't like leaving their cuffs on someone when the someone is being transported by FDNY EMS. If the patient is cuffed, either as being under arrest, or in protective custody, a LEO rides the back with patient and EMT. There are specific times when we can request a LEO to ride along, even when the patient is not cuffed, but I'm not going there at this time.

I plead ignorance. Who is Neal Boortz?

A reminder, people. If a posting is answered with "I believe you to be wrong because of the following specifics", and then lists them, it is one thing. However, if the response is "I believe you to be wrong because you are the south end of a northbound horse," that is counterproductive, unwarranted, and simply mean! Let's try to keep it civil, and professional. Hey, I have been wrong, and actually saw wherein lay my errors when they were pointed out to me, but an outright attack, I'll remember the attack, not the lesson.

I think we should keep away from phrases like "country bumpkin". Those from farming areas have specific knowledge on their areas that a mountaineer wouldn't, and both have knowledge I lack, as a so called "City Boy". I admit this is generalized, but everyone knows something someone else doesn't, or wouldn't, know.

Speaking of the Nassau County (NY) PD, when a call for an ambulance is received, a patrol car and a Paramedic-driven ambulance respond to the location. The Paramedic then does most of the patient care, and the LEO becomes the driver for the ambulance. Admittedly, this works better with the 2 man cars, otherwise the ambulance has to return the cop back to the scene to pick up the police cruiser; with 2 man, the cruiser picks up the ambulance driving cop at the hospital. The Paramedic then drives the ambulance back to it's staging point. It seems to work for them, but I admit my own uncertainty if it could or would work in another jurisdiction, or with other specific situations that can, and do, crop up.

Could, or would, there be local protocols that would allow ALS to turn back patient care to BLS? Say, a patient that is stable enough, IN THE OPINION OF THE PARAMEDIC(S), to have BLS transport, and make the ALS available for another call? I admit the system is NOT foolproof, but I have had ALS turn care back to me on my BLS ambulance many times, without any consequences. I further admit I could have had a long streak of good luck in this regard.

Could someone clarify a specific, here? I thought the USMC had no medics or corpsmen, they "borrow" one from the United States Navy, and assign the person to a Marines unit.

New York City EMS, pre FDNY merger, had a response to a "Diffbr", a difficulty breathing, that was supposed to be asthma related. No one answered the door. The BLS ambulance crew had the dispatcher call back, heard the phone ring in the apartment, and heard the dispatcher leave a message. The upshot was the patient had probably left prior to EMS arrival. 18 hours later, there was another call to 9-1-1, from a family member with a key. The patient had been so far gone with the asthma, the crew had been unable to hear him struggling to get to the door, and the family member had found him on the floor, dead. There was a lawsuit for EMS having "allowed" the death. I don't recall the lawsuit outcome. New policy implemented: If no response at the door, crew requests "additional resources for access". PD will respond, FD if available (or PD Rescue) to "take" the door". PD will make entry to determine if there is anybody home, and an officer will remain on the scene to "secure" it, until repair can be made on the door. If a patient is found, as described, the crew will take the patient. I always find it interesting that we have had so many concerned family members at the door without a key, FD using fire ax and 10 pound sledgehammer, pounding to force the door, and just as they open it, the person we are all there for, suddenly shows up at the door, confused as to what is happening, from a "deep sleep". How the hell deep is that sleep that they don't hear 2 EMTs, 2 Paramedics, an EMS Lieutenant, 4 LEOs, their sargent, and a 5 man FD crew hammering the hell out of the door, as everyone else on the floor comes to their doors to find out what the commotion is, for 10 minutes?

Please clarify: did you mean medical, medicine, or other word? Thank you.

medic_girl_chas, you say "I'm currently taking a sports medican class." I am unfamiliar with the word "medican". Unless this is a misspelling, what were you saying? And don't worry too much, even with the spellcheck being available, misspellings still get through. Case in point, the spellcheck program did not recognize the word "spellcheck" just now!

Addemdum to my previous posting: During the time mentioned, due to no particular reason, I came in an hour early. The lieutenant advised me I was already mandated. I questioned this, as, obviously, with only some of the tour 3 crews, on a citywide basis, having started their shifts, I knew he had not had a chance to publicize on the department intranet (not the internet, this is a departmental internal system), or the vehicle radio computer linkup via the Computer Assisted Dispatch system. He said, "Don't have to, conditions already exist for it". Yup, I worked my tour, 1630 to 0030, and then the overtime through to 0630, as did my partner. They made us leave our regular ambulance for the regular tour one relief, and put us into a spare truck, too. (Our relief, I heard, also was mandated into the "daylight tour" of 0830 to 1630, although they just worked the mandated 6 hours, to 1430.)

While this is written partly in jest, just remember, a politician's job, after job one of getting reelected, is to legislate using the smallest amount of money for the maximum effect. Witness back in 1998, the FDNY activated a large number of additional units, but rather than hiring new personnel, mandated overtime of everybody to put butts on the ambulance seats. Figure we normally work an 8 hour day, and then get forced to work an additional 6. Pick up the kids after work? Can't, you gotta work. Forget that doctor's appointment, or your marriage rehearsal dinner (can't leave to pick up her folks coming into JFK, either). I actually had several weeks where I, and everybody else in EMS Bureau would work a non-requested 6 hours of overtime, 4 of our 5 days on. (Yeah, I hear the 12 hour and 24 hour tour folks laughing at me, mandated after a measly 8 hour tour? They tried to mandate, by phone, personnel on their days off!) After a union demonstration in front of FDNY Headquarters, and threat of legal action by the union, they took the new units off line, until after they hired new personnel to "man" them.

Oh, yeah, "But I'm not dead yet!"

I have been working the ambulances, 9-1-1 type Volunteer, paid non 9-1-1 ambulance services, hospital based and fire service based 9-1-1 responders (the EMS in NYC used to be under NYC Health and Hospitals Corporation, until the Mayor decided to force it into a merger with the FDNY, who now manages it), for 34 years. In each of them, I have met good people, and bad people. I have met people who, for the life of me, I cannot figure out how they got certified as either EMTs or Paramedics, or got New York State to grant them a driver's licence. I have met people who I think could teach the classes better than those who were the teachers. Figure it this way: in EMS, as in the rest of your life, you will meet both the best and the worst of society. Final thinking point: Remember, to the other guy, YOU are the other guy. How are you being viewed?

Jake, whatever the Youtube posting was, they had removed it for an unspecified violation of the tube's rules.

One of my associates insists on writing all his call reports with a specific shade of blue ink. This shade, apparently, doesn't show up on photocopies, and is supposedly used by newspaper editors. This way, if called to court, his comments on paper can only be confirmed by having the actual call report in front of him, as it seems he doesn't trust photocopies of his paperwork.

Someone mentioned medevac helos have GPS. I would trust those better than one in a ground vehicle, as an aviation GPS will help the pilot avoid large objects like mountains. It would kind of hurt someone, if a chopper ran into one at high speed at night. Yes, I am being flippant, but that is how I feel. Ground vehicle GPS is improving, however.

Gee, NREMT-Basic, why not tell us how you really feel? On your point #2, no one under 21? Some tasks, like driving an emergency vehicle, will be regulated by the insurance carrier. With my VAS, that was why I couldn't drive my first 2 years, as I joined when I was 19. However, what about "Youth Squads" and/or "Junior Corps"? Some of them, in drills and competition, do better than "Adult" teams. If a committee of the senior squad personnel feel, on a case by case basis, to allow juniors to ride, most I am aware of have policies that no juniors are even to be in the squad building, either during school hours, overnight, or without a senior member in the "House", preferably a supervisory level officer (this can also be for juniors in general, not just those allowed to ride). You mentioned curfews. As I already mentioned, no overnighters for juniors, but, just as a mention, my own New York City, a town of 8 million residents, and perhaps 2 million transients each 24 hours, there is still a law on the books, never rescinded, that NYC has a 10 PM curfew for everyone! Somehow I don't think it will, or even can, be enforced.

I quote an instructor/coordinator from a refresher I had, a long time before I became municipal-employed: "While you are in my classroom, you are employed to get refreshed in your EMT certification, not to respond to calls. Therefore, ALL Plectrons*, scanners, and 2 way radios are to be turned off NOW, or you can leave without being recertified, and I don't give class refunds". *Plectrons were a first generation VFD/VAS used pager system, from back in the late 1960s to the late 1970s, when Plectron went out of business. Their influence was so big, pagers were known for years, even if a different brand, as a "Plectron". Long-timers like me still slip and call pagers by that name.

How about... VAS crew, first time together, all green and on the road for the first time. Car Accident, car versus concrete elevated train track support. Municipal ambulance already had one aboard, and let us take the second. C-Collared, longboarded, sandbags taped into proper position (a time before the KED, KODE, or IDEA), we got the patient to the hospital. Then... As we were still so green, whoever had the release lever on the streacher forgot to let go, so we went up and down a few times before we figured it out. Once we got the patient inside, after a quick evaluation by the ED doctor, we were instructed to remove the patient from the longboard. The longboard was still on the streacher, and we had undone only the streacher straps, not the longboard. We nearly choked the poor woman. Then, we decided, just undo all the straps, and we attempted do slide the longboard out from under the patient. This went OK, if you don't take into account that in doing so, we pulled off the woman's wig! We got a lot of weird looks from the ED crew, but managed to maintain our composure until we got back outside to the corridor, then we were almost rolling on the floor laughing at ourselves, just in time to be seen doing so by a characteristically no-humor Highway Patrol Cop, who was doing a followup on the accident. His dour attitude towards our laughter made us laugh all the more!

I am of the belief that it will be the workers, not the managers, who will respond to the string, and it, unfortunately, will be, of majority, opinion. This is not to say that some manager(s) won't respond to it with policies being quoted.