Rural Scene Times

[Just Plain Ruff]

The worst that can happen is they code, I really really fail to see that humor. If they code something happened that you more than likely failed to catch.

I wouldn't be surprised that you waited to see if your NEAT drugs did the trick. Had you not have waited to see if your neat drugs did the trick, you would have been all that much closer to the hospital and had something else in the pipeline waiting for you to try.

Or were you just obtuse and you left out that part.

You sound a tad bit dangerous. But since it's your first time here I don't know you from adam so I'll withhold judgement a little longer till I get to know you and your posting style here a little better.

[runswithneedles]

Coding is some bad juju.

I agree on taking a pharmacology class. The box may say it does this, but the patient may be taking other medications or have medical conditions that can cause paradoxical or catastrophic affects. Or might not do a single thing. For example. Atropine is said to block/ reduce parasympathetic tone which according to the drug company will increase HR if the SA node is conducting impulses properly. However in a pt with a heart transplant, The heart may not respond to it. Or if Atropine is pushed too slow it can actually slow down the heart.

[medicmafiaemt]

i have worked rural ems all of my career and in my opinion if possible with pts stay and play now depending on how aggressive your protocols are and what your allowed to do you can do almost everything to a person that the ER will with the exception of a cath or other surgical procedure i know fibronilytics are making their presence known in EMS even in a area like MS where we are always behind the times and in CVA and STEMI calls these can be very very useful and can actually have a pt ready where when you get to the hospital they can roll straight into the cath lab or wherever. In my personal opinion and if it was me in rural EMS or urban EMS i would stay and play if possible. the bed habit has came into EMS that if a hospital is not far then it is ok to not treat your pt too many times have i seen pts roll in with nothing done because the crew was "just around the corner" this is no excuse, treat your pts and treat them right or find another job quit trying to come to work and do nothing to get paid if your incompetent brush up on your skills if your just lazy then fix the problem or get out you make us all look bad. off my soapbox now lol anyways yes i agree the stay and play method in rural EMS is the better choice if possible

[paramedicmike]

First of all, welcome.

Second of all spelling, grammar and punctuation are your friend. Proper use of the three will help us understand just what it is, exactly, you're trying to say.

Thank you for your consideration.

[cwilliams17]

i have worked rural ems all of my career and in my opinion if possible with pts stay and play now depending on how aggressive your protocols are and what your allowed to do you can do almost everything to a person that the ER will with the exception of a cath or other surgical procedure i know fibronilytics are making their presence known in EMS even in a area like MS where we are always behind the times and in CVA and STEMI calls these can be very very useful and can actually have a pt ready where when you get to the hospital they can roll straight into the cath lab or wherever. In my personal opinion and if it was me in rural EMS or urban EMS i would stay and play if possible. the bed habit has came into EMS that if a hospital is not far then it is ok to not treat your pt too many times have i seen pts roll in with nothing done because the crew was "just around the corner" this is no excuse, treat your pts and treat them right or find another job quit trying to come to work and do nothing to get paid if your incompetent brush up on your skills if your just lazy then fix the problem or get out you make us all look bad. off my soapbox now lol anyways yes i agree the stay and play method in rural EMS is the better choice if possible

Stay and play? I can't stand that term! What are we playing, doctors? If they want to go to the hospital, then great. I can assess and treat in the ambulance. The shorter the on scene time the better for me.

[Richard B the EMT]

Stay and play?

Someone tried making a phrase that sounded like a bit of memorable poetry. Like it or hate it, you remember it.

[MedicAsh]

Scene times here are a tricky situation. We live in a very rural area. Our boss has it in the policies that 20 minutes is MAX. Does this always happen? In the majority of cases yes we are very good about our scene times. There are cases that we have longer scene times. Living in Northern Wisconsin, we could have many things that keep us from having good scene times. Distance comes into play, if we know we have a longer transport time, we may do more while enroute. if we have a shorter transport we may do more on scene. There are so many variables that can play into scene times. I think we do well here but there are times where we can't. This goes for both rural and urban EMS.

[mobey]

I didn't re-read this whole thread, so I am not sure if this has been said before, but I treat my patients to the max of my protocol/knowledge even if it means extended scene times because I KNOW I proide the best Emergency care in this area. To race off to the rural/remote local clinic so the family medicine doctor can take my critical cardiac pulmonary edema patient into x-ray, then fill them full of lasix and "wait and see" is borderline negligence on my part.

Arrogant or not, I do not apologize and I'll do the same for you when you are visiting.

[Richard B the EMT]

Mobey, as I believe we've established, here, we are all using some varient of CUPS status to determine appropriate scene time. For those who don't know CUPS, that is Cardiac Arrest (or Critical), Unstable, Potentially Unstable, and Stable, which should be used to determine staying on scene to treat, or taking the show on the road, what I've been irreverently calling "Load and Go" versus "Stay and Play".

[Just Plain Ruff]

I didn't re-read this whole thread, so I am not sure if this has been said before, but I treat my patients to the max of my protocol/knowledge even if it means extended scene times because I KNOW I proide the best Emergency care in this area. To race off to the rural/remote local clinic so the family medicine doctor can take my critical cardiac pulmonary edema patient into x-ray, then fill them full of lasix and "wait and see" is borderline negligence on my part.

Arrogant or not, I do not apologize and I'll do the same for you when you are visiting.

I don't doubt that you will treat my pulmonary edema better than many remote doctors would. I expect no less from the Great mobes. (no sarcasm at all there).

But I hope to not need your treatment ever, nor anyone elses treatments. But if I do, let's hope it's provided by competent medics who know what they are doing. That's all I or anyone out there want. Just don't make me worse. If you do and I die, I'm coming back to haunt you and it won't be pretty.