Small town EMT

[Tyler_EMT]

I live in what many of you would picture when you hear the word Indiana. Corn feilds, more tractors on the road than cars, more corn feilds and you're occasional horse and buggy. Anyway, I'm one of the only EMT's on a very very small volunteer fire department. I'm well known in this town because my family has been here for decades. I get up in the middle of the night and go to residents house with my BLS kit i have in my truck to treat minor injuries that do not require hospital care. The problem is that when i'm called to go treat someone and its not fully controlable by me. A farmer once called me to tell me on of his farm hands had nicked himself. This "nick" turned out to be a deep and very badly bleeding chainsaw accident. I then called 911 and started direct pressure. had to wait for my crew to leave their houses, get to the station and then get out to my location. I love that people trust me but i now strongly urge them to call 911 and let me show up prepared. what other things have you guys been called out to and it was different than described?

[paramatt_]

Happens all the time. The call takers/dispatches can have it pretty tough to try and figure out what is actually happening/and what resources may be actually needed. Sometimes those who put in the calls have no clue or can't describe the problem. Other times people will play things down as they "don't want to be a bother".

Try to get in the habit of keeping an open mind when going out to a job. Some people (myself included) will consider what the worst possible thing may be on the way to a job and work backwards down a list in a means to prepare

Anyways, to answer your question, a couple recent ones that come to mind include "breathing problems" which turned out to be a DOA (dead for 30mins+) and a motorbike vs car ?DOA...turned out to be no car involved and only some very minor superficial injures.

[Kiwiology]

You say you're on the local Fire Department; if somebody calls you as opposed to 911 can you not call it in and get 911 to organise some sort of response; I imagine y'all carry pagers or radios or something ...

Be it your local Fire Department, the State Police, local hick good ole boy drunken Sheriff or somebody paid from two counties you need backup to go to a job

Now by God whatever the bloody hell you do make sure one of the people who rocks up out the sky on the LifeLine helicopter is not a funny talking Kiwi in a black jumpsuit .... and if it happens to be, have the Farmer hog tie him down good y'hear?

Hmm lets see; cornfield 1 o'clock low, hmm, some power lines, looks like they've closed the road off, there, looks like some bloke trapped under a tractor, Fire on scene, clear to ground, Indy, LifeLine descending, call you lifting ....

[island emt]

Tyler : those are the joys of small town EMS. When you personally know a large percentage of the population and they know you, it will happen.

We often get calls at home or have people show up on the doorstep looking for assistance. Many are concerned about the well being of an elderly neighbor , they haven't seen today, or" grandma 's just not right today" kind of worries. other times the knock on the door will be to see if I'll come and pronounce grandpa , cause he's not with us anymore.which turned out to be 92 yo severely dehydrated unconscious unresponsive and resp rate of 6 and full DNR. Called for the truck and ran a couple liters of warm saline in after talking to the Doc at the hospital.

Yep thats rural EMS all the way.

What I do is call dispatch on the radio and let them know that I am responding to xxxxx @ address and will let them know if further assistance is needed.

[Chief1C]

It's the exact same way here. The only time I don't know the patient, usually anyway, is either a wilderness rescue or a vehicle accident on the state road. In this day in age, everyone has cell phones, so I don't even use the home phone. But I leave it connected, because I know every time it rings, someone is avoiding the call to 9-1-1. I handle it just like a dispatched call, I notify the com center where I'm going and what for; they start a card, and I get a refusal (that they didn't require or need an ambulance). If they're in a bad way, I use the medical command option to try and talk them into going. There's places that it takes an hour to get to, so if it sounds bad, I at least want an ambulance on the way. Whether it's just a first aid run, or an inhalator call; or someone needs an oxygen tank filled; I still like to cover my ass.

Some nurses will go out and field suture, I won't go that in depth. I won't apply ointments, etc, if it's bad, I'll drive them in to the urgi care. Have to be very careful, because it's EMS care, not a Good Samaritan act. It's one thing if I'm treating a fellow fireman, or someone shows up at the door. But calling the party line is the same as 9-1-1, it's activating EMS.

But there's a lot of minor first aid stuff. I feel very proud to be trusted enough to be called, but I don't know where the hell these people get my phone number b/c it ain't listed. You could go back to the to do or not to do of treating people "off duty". But I guess I'm always on duty, or on call. I guess the only time I'm off duty is when I go into the tavern for a drink.

Folks around here are poverty stricken, they can't pay, they don't have insurance. They don't call till the last minute, that's taken a lot of lives, for illnesses that can be treated. The protocols support not transporting non-viable patients, eg, no shock on the first try and 15min from an ER. Most of our arrests are an hour from an ER. That is by far the hardest part, because they look at it as if you're giving up.

Edited November 2, 2011 by 2c4

[DFIB]

2c4 You could become a community project to study medic and widen your scope of practice. It seems like a lot of people could benefit. It might even be fun.

We get those weird request in rural areas. I just had a church group ask me to teach the Women’s Mission Auxiliary about HPV and Papanicolau smears. The jury is still out on that one.

I love small town EMS. People need help and I feel like we can really do some good. Any of you guys ever get payed with a chicken, a pie or fresh produce? Pretty cool when folks show appreciation with the simple things they have.

[Chief1C]

They still get billed for transports, as they would anywhere else. But on personal terms, the only thing I've ever accepted was cards and baked goods..

Edited November 2, 2011 by 2c4

[DFIB]

They still get billed for transports, as they would anywhere else. But on personal terms, the only thing I've ever accepted was cards and baked goods..

I have gotten, frying bananas, chickens, tamales, oranges, corn, etc. Sometimes it is “weird” stuff like eatable river worms, baked minnows or roasted grasshoppers. What am I supposed to do with a chicken? It is a little embarrassing to take them but I know that folks really mean it and would be offended if their gift is rejected. The only blessing they might have all day is the blessing of giving. I would not want to take that away.

Probably the funniest is one time I helped a guy neuter a calf, his appreciation was shown by giving me the oysters in a sack.

[Tyler_EMT]

Kiwi, for some reason they will not let me have a radio that i can talk to dispatch with. I only have a side pager that i can hear dispatch calling out runs. But i can't talk to them. I do have a cell phone but i do not get any signal hardly at all in my area. So i can only get help if i have signal. Another reason why i strongly urge people now to just call 911. Most of the time its in the woods or the middle of a feild and a land line phone isn't an option. Most of the time luckily its nothing too serious but i don't want to keep taking a chance of having another situation like the one i described above.

[Kiwiology]

Kiwi, for some reason they will not let me have a radio that i can talk to dispatch with

Crazy Hoosier ambos