A different scenario for you.

[Scaramedic]

Here's the scenario for you.

A 76 yo Female has pushed her LifeLine Personal Alert, LifeLine called her son who rushed to her house (she refused to have Lifeline call 911). He found her sitting on the toilet, complaining of shortness of breath. He calls 911 and you arrive on scene.

You find her pale, diaphoretic, able to speak in full sentences but very weak. A&OX3, no LOC, no C/O CP, dyspnea has subsided.

BP is 72/34, RR 24, HR 38, Sinus Brady without ectopy on the monitor, SaO2 98 on room air. LS Clr Bil, No neuro deficits. Finger stick Glucose was 133. Rest of assessment is unremarkable. Hx NIDDM, A-Fib, CLL, and HTN. Pt is on Glucophage, Coumadin, Atenolol and Lusinopril. NKDA.

You start the usual IV 20g R AC NS TKO, O2 NC, Monitor. You do not do any further interventions. :shock:

The question is this.

Do you...

A. Pick up all the trash you created and dispose of it in the unit.

B. Pick up all the trash and throw in the patients garbage.

C. Throw the garbage on the floor of the patients bathroom, kitchen and living room and leave it for the family to pick up later.

Hah, you thought this was going to be a vagal thing didn't you?

Well obviously it was, her Atenolol was causing too low of HR, and the BM caused a vagal response that dropped it even lower. The patient was my mom, I was the son who got called. She is fine and at home resting. They changed her Atenolol dose and D/C'd her after all the standard tests came back negative.

The issue I have is that my family was irritated at the house being trashed, and they asked me if it is normal for an EMS crew to leave garbage everywhere. My answer was that I always tried to pick up trash that we created on scene. I understand maybe on a critical call leaving the occasional bit of garbage when treating the patient. This was not a critical call by far, I won't even start on the lack of treatment, that is another issue. My family does not know there were several things the crew could have done for my mom, they just know the crew trashed my mom's house.

So the question is this; do you pick up after yourself when on scene? I am not talking an arrest or a load & go scenario, I'm talking your typical non-critical medical call.

I would love to hear your opinions on this.

Peace,

Marty

:thumbleft:

[medic53226]

I have always mad it a point to pickup my trash because as your family pointed out, even if you don't think they notice they do, and we carry a big blue trauma bag that seconds as a big blue trash bag. Now I left trash before but it was critical that the pt get to the hospital. As, for your mom, I think they dropped the ball a little.

[Asysin2leads]

I try and take all trash with me, but if I really want to throw something in the trash, I'll ask the patient first. Good manners is a hallmark of good EMS.

[Dustdevil]

I try and take all trash with me, but if I really want to throw something in the trash, I'll ask the patient first. Good manners is a hallmark of good EMS.

Agreed. You've got big, fat cargo pockets on those wanker pants. Use them.

If you don't go throwing trash around like a madman, it isn't hard at all to grab it all up in seconds and stuff it in your pocket.

If working out of an ALS box or bag, I will usually use the box or bag as my trash container. Then my partner cleans it out as he restocks, while I am doing my paperwork. If you do it that way, it takes NO extra time or effort on the scene, so there is really no excuse for not doing it. Except for laziness, stupidity, or bad manners.

[aussiephil]

With the exception of sharpes, i will usually ask the patient or family member if i can use the bin, or i will tell them that i will clean up when i colllect the rest of my gear, they usually tell u its ok & they will do it.

[SSG G-man]

Most of the time I will take my trash with me, especially if I am in a home. IF it is a bad trauma (especially MVA) I may leave some trash. On the MVAs the fire guys will be cleaning up debris anyway. Even though as a basic I do not have much call for sharps (finger sticks), they are always properly taken care of. I even keep a portable sharps in my personal first aid kit, just in case.

[Acosell]

If I make garbage I make an effort to dump it into one of those giant pockets on my pants, then dispose of it at the hospital once care has been transferred. In the back of the truck though, I'll just toss stuff everywhere so I won't have to get up and lean waaay over my patient or anything. If it's a VSA, then well those BVM bags make good trash cans.

[medik8]

I always clean up after myself in a patient's home!! I do not see there to be any other way, or any excuse, not to. If the patient is an arrest situation, then yeah...I may leave something behind, but I apologize on the way out. I've never had anyone complain in that situation.

I use a side pocket on my jump bag, and I also have an area where I keep a few small trash bags stashed, so if necessary, I throw everything in one of those and carry it out that way. Then, if anything is slimy, it doesn't get on the rest of your equipment or contaminate anything in your bag.

I think one of the factors here...is...and this sounds silly, but it's true... How long have you been in EMS? New or easily excited providers tend to go haywire and things go flying in all directions. You can just as easily tear the side off of a 4X4 gently and drop the paper at your knees as to rip into it like a dog after a beef steak with the paper flying over your head and landing on their couch. :roll: There's no reason to be a maniac... Your mess should all be contained in one area, for the most part, and easily able to be scooped up. If there's a bloody situation and you have lots of soaked gauze, as I accumulate a pile in ONE spot...when I am finished...I will scoop it ALL up in my gloved hand and then peel the glove off inside out leaving all the contaminated pieces inside the glove. That solves that. Then, grab a new glove from your wanker pants pocket (which you should always have extras...I feel...) and replace it with a clean one.

Bottom line...there's many ways to do things, and different things work for different people. We all have tips and tricks...but the one fact remains. Don't be a slob. It reflects on you as a person, you as a provider, your service and the community you represent. Respect people, their feelings, their vulnerable moments, and their home. It's a package deal. There's no reason any link should be left out.

xoxo :wink:

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[Ridryder 911]

It all depends on the situation, if it is a code from hell.. no. I will try although I can't promise it though. Most of the time, there is no trash for me to pick up. I carry a saline lock and a couple of Jelco's and a small roll of tape in my side pocket. If I start a line inside the house, which is becoming less often.

Unless, the patient is a very ill most of my procedures now are performed in the back of the unit, and even then I prefer the trash to be picked up.

R/r 911

[medik8]

...And that's a very good point and a ditto for me, as well. Something I forgot to mention...

I rarely work anything in the patient's home unless totally necessary. I do most of my stuff in the back or en-route mostly. I don't like spending much time on scene. So, yeah...most of my trash is in the ambulance, and then we can pick it up at the end of our call. But...if the mess is made at the house...refer to my post above.

xoxo

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