In the house vs. In the ambulance

[Dustdevil]

To continue your line of thinking "Dust, etal.," There is going to come a time when you don't bring your gear into a call or all of the appropriate gear, and then your gonna hang because you didn't have it....food for thought...Not a Lesson to be Learned firsthand.

That hasn't been a problem for me. There are at least two of us, each with two hands. There is no reason for me to ASSume I won't need the airway/oxygen, med kit, Lifepack or suction unit for any kind of medical run. It all goes in, each and every time, without exception. Only trip back to the ambulance is for the cot. And the fire monkeys usually get that privilege.

The only time in the last ten years of my career I made the patient's side without the equipment I needed for care (excluding immobilization) was the time my partner accidentally left the Lifepak at the ER when restocking after the last run. Yeah... that was not a fun lesson! When you ask for a second ambulance to be dispatched to assist you on a simple "chest pain" run, and you already have FD on scene with you for assistance, the dispatcher tends to ask you over the air why you need a second unit. And I found out that they will not accept "equipment" as your answer. Pretty damn embarrassing to admit to every other medic and scanner listener within six counties that you don't have your damn monitor with you. :shock:

[EMT001]

For a stable patient: If the house is well lit, and relatively insect free, I tend to stay and play a little longer.

For a non-stable patient: ABC's and roll. I have no problem getting everything else done in the ambulance, so why delay arrival at the hospital?

[Dustdevil]

For a non-stable patient: ABC's and roll. I have no problem getting everything else done in the ambulance, so why delay arrival at the hospital?

I think there is a deeper question here. Is it not important to distinguish those patients with instabilities that we can correct from those with instabilities we cannot correct? Our ultimate goal is the improvement of the patient's condition and outcome. Sometimes the only way to achieve that is by rapid transportation to surgery or other definitive resources. But many other times, it is achieved by us in the field through medical intervention. I don't care how "unstable" my patient is, if the cause is something I can correct, then the place to do that is here and now, not later.

Our decision to stay or run should be driven by science, not by adrenaline.

[Ace844]

Our decision to stay or run should be driven by science, not by adrenaline.

Sounds similar to the recurring debate we have been having here for awhile....One can only hope that "the advocacy" will take effect and we won't allow ourselves to be "steamrolled" by other professions with differing goals..

[EMT001]

Our decision to stay or run should be driven by science, not by adrenaline.

Our decison should be getting the patient to a true source of definitive care, the hospital. What if the intervention you thought was going to help the patient failed? Now, you've wasted even more time getting them to a physician. If you load the patient, and then begin your interventions, not only does the patient gain the positive benefits of correct treatment, but also the peace of mind that their access to a more definitive source of care has not been delayed.

Obviously this has its exceptions, i.e. a hypoglycemic emergency, but in most cases, I feel it still applies.

(Disclaimer: If this is not well articulated, I appoligize; I have been flooded with exams and have not slept in awhile. I will reread this tomorrow, and if needed, try to make it flow better.)

[Dustdevil]

Our decison should be getting the patient to a true source of definitive care, the hospital. What if the intervention you thought was going to help the patient failed? Now, you've wasted even more time getting them to a physician.

Doesn't matter. That time would have been wasted by the physician trying the exact same thing anyhow, so in reality, you have lost no time whatsoever. But if you wait five to ten minutes to attempt that intervention because you want to get on the road first, then you HAVE indeed wasted time getting them treatment.

Again, this is regarding those conditions in which we are providing the same therapy that will be given at the ER. I am not referring to any situation where surgical intervention is the immediately required definitive care.

If you load the patient, and then begin your interventions, not only does the patient gain the positive benefits of correct treatment, but also the peace of mind that their access to a more definitive source of care has not been delayed..

Again, you ARE delaying their care if you have the means to provide it, but are not giving it to them in the house.

[PRPGfirerescuetech]

Our decison should be getting the patient to a true source of definitive care, the hospital. What if the intervention you thought was going to help the patient failed? Now, you've wasted even more time getting them to a physician. If you load the patient, and then begin your interventions, not only does the patient gain the positive benefits of correct treatment, but also the peace of mind that their access to a more definitive source of care has not been delayed.

Obviously this has its exceptions, i.e. a hypoglycemic emergency, but in most cases, I feel it still applies.

(Disclaimer: If this is not well articulated, I appoligize; I have been flooded with exams and have not slept in awhile. I will reread this tomorrow, and if needed, try to make it flow better.)

DUST: Decisions should be driven by both, exemplifying speed, accuracy, as well as treatments necessary as exemplified by science.

EMT: This I will say. Under your theory, we need to return to the cadillacs with some "mother juggs and speed" drivers and haul butt to the hospital.

Why are we given interventions if we arent going to use them because they waste time. Sometimes, patients need help now. Sometimes, we can even give that help now....

The only time being wasted is the time your needlessly expelling from patient contact, to stabilizing treatment.

[medic327]

i generally work my pt in the ambulance , but i do bring everything in just in case i need it. i like to do this way because in the ambulance were in our domain and if i need anything else i know were it is.

[Nate]

i generally work my pt in the ambulance , but i do bring everything in just in case i need it. i like to do this way because in the ambulance were in our domain and if i need anything else i know were it is.

Thats how I am.

[Dustdevil]

Ah, okay. So it's not about the patient. It's all about you.

Nice.