what would you do in this situation as a EMT-B

[MAGICFITZPATRICK]

NYC protocols...2 breaths and start yer CPR......call for back up it's going to be a long night.

[dahlio]

None, but really, what is there to ask for at the BLS level? Not knowing local procedures is not a reason to pass things up to medical control. If the patient is critical enough to warrent a base hospital consult then BLS should be doing 1 of 2 things, calling for medics or transporting.

Well JPINFV, that's not all that accurate. What about JEMS 2 in New Jersey, you know, when you call the hospital five minutes out? If you really needed a doctor, I'm sure the receiving hospital would try and get someone to assist but to say there's none?

True, all medications the EMT-B in NJ are standing orders, but they are still technically under the supervision of a doctor.

[brentoli]

THat is the dumbest thing I have ever heard. You can't call medical control? I would be looking for a new job really fast.

Almost verbatim from my protocols:

DNR present at scene signed by paitents regular physician

A Medic may assume a DNR notation in nursing home or home health care record is a valid medical order. the EMT-B must defer to the medic to validate complete DNR order in extended care facilities only

Unanimous statement from the pt family that a DNR exists but can not be located. CPR may be with held 2-3min while rapid confirmation from the pt's physician is sought.

Unanimous statement from pt family the pt has a terminal illness and expressed a desire for DNR. You may delay efforts 2 -3 min while contacting medical control for orders. Medical control at their discretion may issue a DNR order

An awake alert and competene pt may refuse life saving mesaures or recind their DNR at any time. An impaired, demented or suicidal pt can not refuse resuscitation

If the paramedic or EMT-B is unsure of the validity or unable to confirm or obtain a DNR then begin efforts in accordance with the appropriate protocol

I made it shorter took out some legalize but did not change the meaning.

Once again though, if you do not have online medical control, I would be finding a new job.

[EMT4455]

Protocols say for us say start CPR. But I would have done the same thing as you. He was there to die. With conformation from med. director then don't. It could have been very painful for the family to go through watching and knowing that he was there to die. DNR's are a pain in the ... when they are not done correctly. I wasn't there but it sounded like you did the right thing. He went peacefully and at home with is family. What more could they or the pt. have asked for. Good job.

[JPINFV]

THat is the dumbest thing I have ever heard. You can't call medical control? I would be looking for a new job really fast.

Once again though, if you do not have online medical control, I would be finding a new job.

That would mean taking a job in a different county and I'm not sure if any of the surrounding counties have online med control at the BLS level. I want to say that LA county doesn't offer it to BLS and I refuse to drive an hour to work for $10/hr [give or take a few dollars].

[AnthonyM83]

Realistically, I've never needed medical control. Medics respond to every call (we can't cancel them) and are usually there within 3 minutes of our arrival. If it's a rapid transport situation, they're usually arriving as we're loading the patient. Only time I can think of calling medical control is if we had a patient crash or we transported before medics arrived, but it would mainly be to inform them of an incoming critical patient, not for online orders. I've contacted once by cell phone to inform of an incoming. Transport times are short here and there's not much we can do in LA as EMTs...

[Dustdevil]

I want to say that LA county doesn't offer it to BLS and I refuse to drive an hour to work for $10/hr [give or take a few dollars].

Can you really drive anywhere in LA County in quicker than one hour? :?

[JPINFV]

Can you really drive anywhere in LA County in quicker than one hour? :?

Ahh, but I don't live in LA county, I live in Orange County. Strangely enough, a LOT of people at my company live somewhere in Riverside county, anywhere from 45-90 minutes away from base depending on traffic.

[Dustdevil]

Ahh, but I don't live in LA county, I live in Orange County. Strangely enough, a LOT of people at my company live somewhere in Riverside county, anywhere from 45-90 minutes away from base depending on traffic.

Riverside County is well worth the drive.

The women is hott there! 8)

[JPINFV]

Tell me about it. I've found an entire website with pictures of them.