Hello. So where are you a EMT or medic?

[mobey]

If you want to be considered more than an ambulance driver you have to do more than drive an ambulance.

This has signature written all over it!

I think if I ever start an Ab EMS Association, this will be our motto!

[ERDoc]

I would love to see EMS become more of a PA level curriculum. If it was brought up to that level I think the whole idea of community paramedic would be much more viable. I also think that many more pts can be treated and not transported or told they will need to find other transportation.

As for all pts thinking they have an emergency when they call 911 or go to the ER, this is just not true. Many know it is not an emergency but don't care. They do it out of convenience. There are some that truly think they have an emergency (including the frequent fliers) but there are just as many that don't and when you have been in this field long enough you learn to recognize that. It should not change how you treat people. I treat people the way they treat me. If you show me respect and courtesy, I will bend over backwards and treat you the same. Treat me like a douche and I will do the same. I am not mean to people (even if they are), you'll get treated appropriately but don't expect a smile or anything extra.

[triemal04]

Wow Mike, I don't recall saying every patient needed to go to the ER by ambulance. I stated they deserved dignity and respect. To them it is an emergency, whether or not it is to us.

I have been in the field for a while now, even when you were still a student yourself little grasshopper.. Every patient deserves a complete assessment. We can decide then if it is an emergency. Frequent flyers DO have true emergencies. I've seen it.

The anxiety patient, short of breath every week? Can have a heart attack. You respond as you would any short of breath patient until they are assessed. Even then, you treat them with complete dignity and respect. If you can't treat someone with that, you don't belong in EMS.

You don't quite seem to understand. To many people who call 911 (abuse 911 in various ways), it is not an emergency EVEN TO THEM. They call because they want some free food from the hospital, or a narcotic fix, or a place to sleep (even with an open shelter right down the street), or because they decided they wanted to be seen for the sniffles they've had for the last week and everyone knows if you come in by ambulance you get seen faster...

People no longer call 911 because they think "it's an emergency," they call because they want something, are to lazy, feel entitled, or are not sure what to do. (obviously there are a huge number of exceptions to this and it's not the norm everywhere, more/less depending on where you work).

This doesn't mean that you shouldn't treat these people professionally (if you are a pro and not an amateur hobbyist), it just means that you should realize that, despite the lofty ideals of many people who become EMT's and Paramedics, the reality can be quite different. And the mantra of "they called because it's the worst day of their life and it's an emergency to them!" that every EMT instructor beats into students heads...take it with a grain of salt. It's not true for everyone anymore, and really never was. And while every patient encounter should start out on a neutral basis and in a respectful manner...that does not mean that can't change.

This doesn't mean that you don't assess and treat your patients either...just that you are smart about it. A "complete assessment" for someone who called looking for a place to sleep will be different than a complete assessment for a cyanotic patient with a respiratory rate of 45.

Lofty ideals are great...until you start seeing reality and have to reconcile the two. If you can't...then you won't last.

[MariB]

No, im just saying I've seen a frequent flyer have an actual emergency . You must respond. Do a complete assessment and go from there. I may only be a driver, getting my emt license, but I've seen my fair share.

Handle each call as it can be the potential of something serious, assess and go from there. People do believe their complaint, as minor as it may be to us, is their emergency.

[paramedicmike]

No, im just saying I've seen a frequent flyer have an actual emergency . You must respond. Do a complete assessment and go from there. I may only be a driver, getting my emt license, but I've seen my fair share.

Handle each call as it can be the potential of something serious, assess and go from there. People do believe their complaint, as minor as it may be to us, is their emergency.

This is decidedly different from what you initially argued. Your initial argument was "Every patient, every call should be treated as a true emergency...". Nobody here is taking issue with your comments regarding what we do on a call. Nor is anybody taking issue with the idea that even frequent fliers, on occasion, have a legitimate problem. The issue people have is your position that "...every call should be treated as a true emergency...".

And that's just not the case.

[Kaisu]

Semantics boys semantics. MariB clarified and it sounds like you are in agreement

[MariB]

Semantics boys semantics. MariB clarified and it sounds like you are in agreement

Thank you thank you!

I've heard stories of the frequent fliers who everyone drags their feet, only to be in arrest by the time the crew gets there. It is like the boy who cried wolf.

I did explain in my first post about letting your guard down for it to be a true emergency. But if they want to nit pick, I have thick skin.

[Bernhard]

As an EMT my job is to educate the community.

Really? How come that? How do you do this?

Just wondering if that's really in your "job description" or if I just don't understand something.

BTW: I see my task in EMS to

1. safely get to the scene dispatch already was suspicious enough to assign a valuable resource (my crew & my ambulance) to,
2. assess the situation and
3. decide if it's either an emergency to be treated immedeately, an issue which has to be transported to hospital or a doctor's office, something we "just" need some ambulatory help (and call a doctor for house visits or point to an open doctor's office - they have to provide 24/7 coverage here), another thing we may offer help (lift patient back into rolling chair, call police, ...) or nothing at all (false alarm, ...).
4. Doing whatever my findings in #2/#3 needs.
5. Preparing for next call. Goto #1.

Glad, my system has all those options in #3 and let me decide (if the public or dispatch didn't before). This opens a bunch of possibilities to provide the needed level of care, and yes, you have to be very sure about what you do. Maybe this system is close to this community paramedicine thing mentioned here, just that it's not me who provides that but the regional physicians association.

Oh, to answer the OP's question: I'm neither an EMT nor a medic, technically, since those job titles don't exist in my country. I'm a german Rettungsassistent (2 years education, highest level of non-physician emergency care in Germany, so somehwat compareable to a Paramedic in the U.S.). Living in Germany's most southern state: Upper Bavaria, near citiy of Munich. So much for my excuse for lack of understanding, bad grammar and funny spelling. In english AND german...

[MikeEMT]

Wow Mike, I don't recall saying every patient needed to go to the ER by ambulance. I stated they deserved dignity and respect. To them it is an emergency, whether or not it is to us.

I have been in the field for a while now, even when you were still a student yourself little grasshopper.. Every patient deserves a complete assessment. We can decide then if it is an emergency. Frequent flyers DO have true emergencies. I've seen it.

The anxiety patient, short of breath every week? Can have a heart attack. You respond as you would any short of breath patient until they are assessed. Even then, you treat them with complete dignity and respect. If you can't treat someone with that, you don't belong in EMS.

I was going to elaborate on this but I see others have beat me to it and you now seem to understand the issue judging by your clarification.

I will say this though - don't question my level of experience. You have no clue as to my experience or history.

[MariB]

I was going to elaborate on this but I see others have beat me to it and you now seem to understand the issue judging by your clarification.

I will say this though - don't question my level of experience. You have no clue as to my experience or history.

hey, all I know is when you joined you were a student too. No judgement. None needed.

I understood the whole time, it was spitting (typing) the words out that got me. I think everyone gets that page to the same address and just wants to drag their feet and assume it is the same old thing. My point was, it isn't always the same old thing. You also are pretty new to EMT so the grasshopper comment was a bit uncalled for . I've been in an ambulance for longer than my student status, I just can't be a driver forever.