Paramedic sits up front on transfer, patient dies

[mobey]

Just today I did a 45 min transfer of a patient for a CT quering reocurring subdural hematoma. I did vitals and physical before we left the hospital, got him settled and planted my butt in the airway seat and buckled up. About half way I moved back to the bench, reapeated vitals, did a quick neuro and headed back to the airway seat. The whole trip i could see my patient moving around. Not to mention i think I would notice if he lost all muscle tone and slumped over in the cot.

So by the above posters standards I was acting as a poor attendant?

[JPINFV]

At your very young age, and hence, few years in this field, do you really have a right to go off half-cocked and accuse providers of neglect simply because they prefer the idea of going home to their family should you inadvertently crash the ambulance they are in?

Well, to be fair, how many traits and little customs are there in EMS that exist simply because someone passed on some hearsay and the person adopted it because it was the first thing they heard? It's, unfortunately, the EMS way where any little difference is wrong and the only right way to do things is how each provider sees it individually. I bet that if someone were to start a poll right now on the number of people who use a seat belt in the back that the majority of people would reply that they did not. This is regardless of if the trip is 30 minutes or 5, critical or non-emergent (be it scheduled or unscheduled). Afterall, EVERYONE knows that you can't care for a patient with a seatbelt on [/rhetorical statement].

[EMS49393]

Valid point, JP. I dare to say it often takes a tragedy to change a person. When I started in EMS, I never thought about securing items in the back, including myself. After all, I was young, and we all know ambulances never crash. Sort of like how police cars never crash. :? Well, about six years ago, a colleague was killed by a flying oxygen cylinder in the back of an ambulance that had crashed. From that moment on I made the conscious decision to secure items, secure myself, and pray the person driving had enough sleep before their shift.

I know a lot of medics that never secure anything. I preach until my head turns red, and it doesn't change how individual providers carry on day to day. All I can hope is that I reach the next generation, and that they be a safer, and better educated generation.

[JPINFV]

Talking about things flying, this brings up a question. The company that I worked for had custom mounts that mounted the monitor to the gurney for CCT calls. They were great because the monitor never had to leave the gurney to transfer the patient to the gurney. (Link to picture) Thus, I've never actually used the more common table style mount used by CCT crews.pic How secure are those things in the end?

[Dustdevil]

I bet that if someone were to start a poll right now on the number of people who use a seat belt in the back that the majority of people would reply that they did not. This is regardless of if the trip is 30 minutes or 5, critical or non-emergent (be it scheduled or unscheduled). Afterall, EVERYONE knows that you can't care for a patient with a seatbelt on [/rhetorical statement].

I used to be one of them for over a decade, right up until the day I broke my farking neck -- literally -- by going head first into the front bulkhead at 70mph. But that was almost twenty years ago. The dark ages. No more. It's the captain's chair for this captain. This is the twenty-first century, and we know better today. Anybody who doesn't know better has to face the fact that their school sucks.

[EMS49393]

Looks a lot like the old pac-racks we had for the ferno cots. How secure? Not very. So NOT secure, we eventually did away with them entirely for safety concerns. As for the stryker version, I wouldn't bet my meager paycheck on is safety.

How old do I have to be when I can start telling people their school sucks?

(I actually did tell someone their school sucked tonight at dinner. They told me they didn't have to have any pre-requisite A&P. She felt she got all the A&P she needed in the first week of paramedic school. I actually put down my sushi, turned to her and said...

"No A&P? Your school sucks." My friends know I never put down my sushi.)

[mobey]

They told me they didn't have to have any pre-requisite A&P. She felt she got all the A&P she needed in the first week of paramedic school. I actually put down my sushi, turned to her and said...

"No A&P? Your school sucks." My friends know I never put down my sushi.)

That amazes me. I had to have A&P before PCP (EMT) school. :roll:

[JPINFV]

(I actually did tell someone their school sucked tonight at dinner. They told me they didn't have to have any pre-requisite A&P. She felt she got all the A&P she needed in the first week of paramedic school. I actually put down my sushi, turned to her and said...

"No A&P? Your school sucks." My friends know I never put down my sushi.)

Based off of some of the replies on another board (half the people were trying to say that Albuterol dilated the lungs, and that this was the reason why Albuterol was bad for CHF patients), I'm beginning to think that any program that doesn't require histology, as either a pre-req or as a part of the program, sucks. To be honest, I don't think that A/P should be a pre-req, but instead should be integrated into the program. Of course this doesn't exactly works if the program is going for the minimum required hours.

[Dustdevil]

How old do I have to be when I can start telling people their school sucks?

By the authority granted me by the National Registry of Emergency Medical Technicians, I hereby prounounce you qualified to tell people their school sucks.

You'd think that people would take that positively. After all, it's a lot better than being told that you personally suck!

But seriously, I do hold the schools responsible for this. In addition to JP's observation of the monkey-see-monkey-do culture in EMS, there is a real tendency for EMT schools to give only minimal lip service to the concept of personal safety. They're all real big on having their students verbalise "scene safety" in their practical scenarios. But way too few of them actually teach their students what that actually means. I am constantly amazed by how clueless EMTs are about safety. It's as if the only thing they were told about safety was to stage on shooting runs and verbalise it for the NR exam.

Pretty ironic that people with so little clue about even their own personal safety want to call themselves "public safety" professionals, don't you think?

[Scaramedic]

You know we need to scrap the whole "scene safety" crap anyway. It's antiquated and counterproductive. We should be, like the rest of the modern world, be thinking in terms of job safety.

The idea of job safety requires us to think beyond one situation and consider the safety risks in all aspects of our job. We tend to worry about the scenes that involve violence yet the records show more EMS personnel die from traffic injuries than anything else. EMS needs to be taught to look at all dangers not just the ones on scene. It is like the Medic who concentrates on a leg bleed when the patient is dying from a head injury. We are looking at the small picture and are missing the larger picture.

We should be concerned with safety from the moment we clock in till we clock out. Not just worry about safety when we are on a call. The scene safety/BSI crap they teach in school is getting people killed.

Examples.

How many of your schools taught you how to park the unit on a busy highway?

How many taught you to look in the side mirror before you open the door?

How many taught you which side of a vehicle to approach when on the highway?

How many schools taught you to lock the doors when your in quarters?

How many taught you to look up and back when going up stairs for dangers?

I could go on forever.