scubanurse

I really think it is time for this to drift off into the archives of the city... it's just gone down hill and emotions seem to be running high.

It was probably moved because it involved education and the disagreeableness of educational resources. I really wouldn't read too much into it or take it offensively...but if that's how you want to take it go for it.

I think it's best if this thread fades off into the distance of the archives of EMTCity

That's a scary call!!! On a different note from DD and causes...make sure you and your partner talk about it either with each other or someone else. Calls like these have a way of catching up to you later with CISM. I know the horse is dead on CISM and how to deal with it, but just keep an eye out for each other as calls like this do have a tendency to still bug you over time.

http://www.emtcity.com/index.php/topic/16768-nbc-cancels-trauma/page__hl__Trauma%20cancelled__fromsearch__1

Probably not in your case but we're not all big hot shot NYC medics. My department in MD placed prevention pretty high on the priority list and thankfully we have enough employees to staff such events. I get that it wouldn't work for you but it does work for us.

I still say an MRI and doctor...seeing things even if they are short and don't hurt or affect vision is a sign of something more serious...

That is a whole new can of worms for a different thread. But the guys who do these programs get paid OT for it or volunteer their time for the greater good of the community.

haha... that sucks dude!!! Go get a brain MRI...

Like I said... we do it on off-duty days.

Yeah ... about the car seats. I know you have to be certified. Our academy certifies FF in properly installing car seats. About the rest of it...I'm done beating a dead horse.

I'm sorry you're too busy to do any sort of prevention. It has always been a priority of the county I worked in to do preventative activities for the community. And we are a busy county in the suburbs of D.C. Even DCFD is doing preventative care. We perhaps aren't as busy as you, but don't you think it might be a good idea to help prevent emergencies? We do it on off-duty days, we have task forces to do car seat checks to make sure they are installed properly. You seemed pretty dismissive of the idea to do preventative care, but that is your prerogative.

Do you actually use padding? Under knees? In between knees? Blanket over the board itself? On EVERYONE? YES. If you have ever been on a backboard and not had padding you will always do this for your patients. Depending on the size I will place a small towel behind the knees, sometimes between the legs for patients with wide-set hips, and also if necessary and won't compromise immobilization, in the small of the back. How do you immobilize head? Do you use head wedges? Cheese blocks. The styrofoam triangles and head pad? Rolled up blankets. Does it depend on patient? We used the yellow head blocks for most adult patients. For peds, you have to adapt to the situation and size of the patient. Do you use backboards always? Or do you have the hard foam boards? We had only recently received the dual purpose scoop stretchers so I have never used them as a backboard, only for a hip or lower extremity injury. We used the plastic x-ray translucent backboards Spider straps? "Box Method"? Straps that click in like an X over chest? Binders? (Pre-ripped sheets that wrap around) Our county uses spider straps. If applied and trained on correctly, I find them easier. They should be applied so the first two straps create a harness affect on the patient and placed through the same hole on the backboard if possible and right up under the armpit. Do you ALWAYS immobilize cervical if immobilizing lower back? Vice-versa? Yes. In EMT-B we played around with this. If you immobilize the head first and the patient needs to be rolled to vomit, it is extremely difficult to hold the body in neutral alignment to prevent further injury. When the body is immobilized first, it is much easier to maintain that alignment as you can just roll as if they aren't on the backboard yet. If you need to immobilize the cervical vertebra, you need to do the thoracic and lumbar as well. So if you are going to immobilize one and not the other what is the point? If you have lower back injury the degree of suspicion goes up for other cord involvement in my mind. Why go half way?? Do you use tape over the neck? Does it go straight across or angled up (perpendicular to the forehead tape). I was taught to use tape. I would attempt to do it in one continuous loop making an X on the sides of the head. So I would start high at the forehead then go low over the chin, then high then low. All the while attempting to overlap my tape so it was always in contact with the board as well as the other tape. This way if one strip would fail because it got wet, hopefully the others would hold well enough. Do you use the arm straps? What do you do for unconscious patient's extremeties. Leave one arm out for IV? All in and you unwrap later for IV access? Most of our spider straps had a strap for the hands to go into. Or use a triangular bandage and a makeshift handcuff technique (hard to explain). For an IV, we would usually take the arm out of strap it into the spider straps in a way that you have access to the AC. Hope this helps.

I am with you completely on that...and I think that's what Vent has been trying to say. By caring for your patient and taking the time to program it and show them how to use it, you have avoided further "abuse." Now if only more people would take the time to educate their patients instead of blow them off as abusing the system...

I agree we shouldn't be social workers...but part of our job is prevention is it not? Do we not help install child safety seats to protect children? Do we not go around and help check smoke detectors (my county started this last year of going door to door and checking every single smoke detector after a string of deaths related to malfunctioning smoke detectors)? Do we not have slogans to buckle up? Or wear a helmet to school aged kids? Part of our jobs is to prevent injury and death. If this also includes service calls to help someone into bed to prevent them from falling and breaking a hip or worse...then so be it. It is part of the job. If you don't like it, work to fix the system instead of complain about it. Work with the patients who call once a day or week to find a better solution. When I was in EMS we had numerous frequent fliers, whenever we did transport the patient, I would make sure the hospital got a social work consult for them. If we didn't transport and it was serious like they were falling or continuously unable to get out of bed on their own or walk to their bed then I would call the elder abuse hot line to get social services involved. Be proactive. We are often the only advocates for these patients. EMS isn't all about the glory and saving that code or running that big trauma. It's often about making a difference in peoples lives sometimes on the most basic of levels. This isn't all to say that there isn't abuse of the system, but unless we do something to educate and solve the problem the abuse is going to continue and probably get worse. WOAH... I just saw this... When is it EVER okay to damage an alarm box for a patient???? It's the Boy Who Cried Wolf Story...and in my eyes as the patient...they have every right to sue those medics! Also, why is it the higher ups job to get them into a nursing home...why not be proactive and take the steps yourself?? Patients always need our respect. Unless you yourself have been disabled and faced what they face you have no right to judge them and treat them with a lack of respect.

Up to the individual company/county/service and their insurance policy. Usually though I have not seen many that look beyond 5 years. I have 0 points and 0 tickets though so I don't really know... Best to check with the individual service though. No DUI's and such is really a good thing... any wrecks? Having an accident which resulted in someone being hurt may hurt you but again up to the company insurance policy on that one. Good luck!

I did not say in this case but in general... misunderstanding. Patient education is also an option here. Instead of going out and joking about it, spend a minute or two with the patient and explain to them that their lifeline is an emergency. And I know of some patients who are blind without their glasses and not being able to find them could result in a serious emergency if they were to walk (not in this particular case) and fall down a flight of stairs.

I agree... I can't stand crochity providers who grumble about the service call to assist a patient. For me, it is their emergency and if I am ever in that situation where I can't get to bed by myself, I would hope caring individuals would come and assist me and not make fun of me or laugh about me behind my back. I get very angry when people assume an elderly individual can't hear them when in fact many have great hearing and hear the derogatory comments made about them. I am 100% with you on this one vent...

It's pretty easy to set up an LLC too, my parents did it for their boat so if they get sued it's only the LLC that gets touched not their personal assets and my inheritance! Would you make it free?? I like the idea and good luck!!!!!

I know!!! I remember this thread... I think i even responded but not sure and too lazy to go through the replies!

+10 for bringing a 3 year + old thread back to life!!!! Welcome to the city!

I was told to clean it every shift in EMT-B, wasn't until EMT-I clinical rotations in a hospital I learned that I should really be cleaning it between every contact. I use an alcohol swab usually or those wipes to wipe down the outside, I do remove the ring on the diaphragm and clean under the diaphragm but only after contact with an infectious patient... too much mess to do between every single patient unless there is a good reason to. I have seen people use those stethoscope condoms but seeing as I'm really allergic to Latex that isn't an option for me

Regards to the stethoscope... I used to clean mine after every interaction with a patient. Something I picked up on during my ICU rotation. Before AND after each patient contact I would wash my hands with the alcohol foam in front of the patient (because when I am the patient, I appreciate seeing the provider cleaning their hands) and I would wipe down my stethoscope...the whole thing not just the diaphragm.

I agree 100%... people keep placing emphasis on age and experience and how young people don't have life experience to yadda yadda yadda... I'm 22 and have gone through more than most 45 year olds. I have been a patient, which I think made me a better provider 10 fold. Age has nothing to do with it. It is the individual and you can't make generalizations when it comes to a topic such as this.

I'm all for the sin tax, but again where do you draw the line. Should women of child bearing age pay a higher premium than a man of equivalent age because prenatal care and child birth are costly? What about me, I have a pre-existing condition, which is quite expensive to manage, should I have to pay for something that was completely out of my control? When you start increasing the costs for one subset it becomes easier for the companies to just increase them arbitrarily across the board. People who choose to speed in their cars are more likely to get into a car accident and that costs money to take care of the injuries long term. People who chose to sky dive or scuba dive are at a higher risk of injury or illness than the couch potato who doesn't leave his/her house.