To Carry, or Not to Carry, that is the question???

[spenac]

No way I carry a perfectly healthy taxi fare. It is stupid to risk injury. All of us know that probably less than 10% of all 911 calls actually are true emergencys. Just because the idiot thinks his stubbed toe is a reason to dial 911 is no reason for me to risk injury for myself or partner.

I think next stubbed toe I get I will tell them walk to ambulance. Then as they get close pull the ambulance forward. Stop holler sorry and do it again and again till they actually get to hospital. :twisted: Sad part some idiot would probably fall for it.

[captainstandup]

Fatasses have overwhelmed us! Run up the surrender flag and staff each ambulance with three or four personnel. Volunteer First Responders aren't going to help with repeat offenders and why would they? Contrary to misguided assertions in this thread, the patient’s wellbeing is SECONDARY to our own. Destroying your lower back or trashing your rotator cuff is just as career ending as getting badly burned, stabbed or shot (assuming you survive the latter).

We must consider patient size and location as a logistical challenge that has to be managed safely. If the patient cannot be safely be evacuated with two personnel then they should be treated in place, until adequate resources can be mustered. This must be adhered to regardless of patient acuity. If this means someone dies while waiting on adequate resources, then so be it! We will do the best we can with available resources and in my opinion the remaining responsibility rests on the patients and the community's shoulders.

Perhaps people will someday understand that the impact of improperly staffing EMS and Fire agencies. Patients must understand that it may not be the best option for a 500 pound person to live in a third floor apartment with stairs and narrow halls. Regardless of the level of public or patient understanding, EMT's and Paramedics simply do not bear responsibility for bad life choices by patients or poor political funding decisions by the "powers that be"

Just remember, at the end of the day, we must return home in the condition in which we left in.

[JPINFV]

Uhh...I walk backwards all the time, whenever the ground's not completely flat....they probably had a lot of gurney's tipping over (I'm reminded of the YouTube video of either coroners or EMS tipping an MVA DOA over onto the freeway on news camera). Obviously, the law's overdoing it...but I bet they had a problem that led to it....

I'm not trying to give the impression that walking backwards never happens, but I doubt that the tip over rate for walking through the flat and level hallways of the ER is very high.

Can you find that video? If the gurney was being rolled sideways when it happened then it was a case of stupidity where the "two hands" rule would not have helped. After all, there's a great idea. Train providers (or teach them physics) not to do stupid things and you won't need to write stupid blanket rules.

[CBEMT]

I find there's not a lot of reasons to have the stretcher ALL the way up ALL the time anyway. I've had inexperienced partners almost tip a few stretchers on me, so I'm much more aware now of how high the center of gravity really is.

[AnthonyM83]

Looks like coroner, but then again they don't have as much reason to be as careful with most of their "patients" . . . http://youtube.com/watch?v=YYQpLmxy4Lw

Obviously that law cited over does it, but it's not like walking backwards is uncommon in the least...in fact the opposite. For almost all calls, there's a portion of it that I walk backwards or sideways (two hands) for....driveways, grass on sidewalk, any uneven pavement, the roadway because of the slope. I also hate carrying gurney over more than one step, for stability reasons.

I also prefer it lowered one 'click' from the top setting, but almost never do it b/c it's extra work and it throws partners off.

[JPINFV]

As I said earlier, it's not about walking backwards vs not walking backwards. I'm sure that 99% of ambulance calls involve some walking backwards. As you said, it all depends on the type of ground being covered. I do believe, though, that that represents a minority of the actual time that the gurney is being moved.

As far as the video, a few things came to mind. First off the wheel's on the coroner's gurney do not look like they're really made for use outside.

Second, and probably the most important, the coroner isn't watching the gurney. Having two hands on it would have done nothing if he was still looking as something else. He actually did have both hands on it before it fully tipped over. The gurney snagged on something and started to tip. This is when he put both of his hands back on the gurney. When the gurney came free of the snag, it was almost perfectly perpendicular to the direction of movement, which is when a gurney is most at risk for flipping.

When I was working, the gurney was always moved at full height outside of special cases [patient's weight in a few cases, stairs [dropping it down a few clicks makes clearance easier when needed]]. I have nothing wrong with it being done other ways due to provider preference, but I find it being mandated one way or another to be stupid.

[AnthonyM83]

I think the accident might have been prevented by having to hands on it. It forces you face the gurney moreso and thus pay more attention to it. Also, once he felt the gurney was falling, he spent a split second getting ahold of it with both hands. If both hands were on, he could have uses that split second tense his core and put his body weight into it to offset the fall (I'm sure most have had a near miss or scare where they had to do that).

We're both in agreement that it's stupid to mandate it by law, though.

PS I just realized what your avatar was off....all this time it always threw me off...haven't watched the show itself, but had a few people play me or sing me the songs on car rides

[mstovall]

I guess I am lucky. We are allowed to walk at our own discretion, hence many of the runs we make on ky gold cards that are not life threatening are walked. Like a previous person stated, we have to transport a person to the hospital regardless of neccessity or ability to pay if the patient requests it. A prime example of this is the lady that had an uncontrollable nose bleed, sent to respond priority 1 for uncontrolled bleeding (new dispatcher) to find the lady sitting on the curb waiting for us. She jumps in the ambulance as we are trying to get to her apartment. Wondering what this lady is doing, my partner asks whats up. She says she needs a ride to the ER for her nose bleeds. She had the bleeding controlled and still wanted to go because she had no vehicle and no primary care physician (by the way, her disability she had was alcoholism and she was on medicare and medicaid, our tax dollars at work).

Our volunteer FD's are more help than the paid crews. We are lucky that they will do anything they can to help and turn out in numbers no matter time of day or night. It is not uncommon for them to have a line established, path cleared, primary strip ran, and ready for meds if needed upon our arrival.

I think that until the government dedicates another form of medical service to those who have no transportation means or limited means, we will forever have those bs runs. There simply is no accountability.

Likewise on these runs, it is up to our on judgement as to whether we ambulate or carry. I try to treat everyone like it is a true emergency for the simple fact that the little boy who called wolf too many times wasn't fibbing in the end. I don't want to be the one bringing in a person, assuming it is another bs run, only to find a lifethreatening issue was overlooked.

[captainstandup]

Perhaps mstovall is right! Until the government (another way of saying open your wallet and bend over!) provides alternatives for the poorest, oldest, substance addicted, illegal (man that one angers me), uninsured, and more often that not lazy criminal looser segments of society, EMS will continue to represent little more than a glorified garbage service. Our mission is often little more than ferrying the trash from one point to another and back again. This isn't to imply that everyone we care for is trash.

[Richard B the EMT]

Someone posted that patient care is secondary to your own health and safety.

A former partner of mine posited: "Look out for your self, your partner, your vehicle, and then the patient, in that order, and everything will be all right."

Good idea, but she also posited, and, over 22 years later, I don't know if she was joking or not: "Sleeping is a Commie Pinko plot!"