Just Plain Ruff Posted May 22, 2007 Posted May 22, 2007 give me a break nifty don't get your heart rate up it's bad on your psyche - I meant no offense. But you gotta agree, saying you will haul ass with this patient gives the impression that you would not be so careful. Here is what you wrote "Haul ass to LZ, wait for Medstar 10-97 (arrival), transfer pt, call the hospital, and clean up for the next one" so you are saying that you would haul ass to the landing zone to wait for the helicopter. I'd like to know why you would drive to a landing zone while hauling ass when part of that time driving to the landing zone could be spent driving to the two hospitals that could deal with the patient. Tell me how far you would drive to get to a landing zone? Can you justify driving a certain amount of time to the landing zone, waiting for the helicopter arrival and then the time it takes for the helicopter to fly to the hospital that will take the patient. Wouldn't waiting for the helicopter and your drive time to get there be offset by going on to one of those two hospitals. Second, does this patient really get a choice on what hospital to take her to? what if she says, take me to xyz hospital where you know they cannot treat her, do you take her there cause it's her choice? or do you make a determination that hospital xy or yz are the two that can take care of her and bypass her decision? Even though it's a figure of speech, using it makes you sound like you would be careless. I've had medics and emt's who would drive like bat's out of hell and nearly wreck when I told them to haul ass to the hospital. Yeah, "haul ass" is a figure of speech but too many people take it literally. By the way, how do you know I don't have a phd? Just because its not in my profile doesn't mean I don't have one. Oh wait, that was a figure of speech too. You know Nifty, I respect you quite a bit. I didn't mean for you to take offense at my comments but too many people are careless and when you use a "figure of speech" some of us take it literally, not figuratively. but take it however you want. No need to get your Knickers all bunched up (another figure of speech) we could go on and on.
AnthonyM83 Posted May 22, 2007 Posted May 22, 2007 #4) I am looking out for the safety of the myself, my partner, and my pt.I wonder what that stats would say about this...
Niftymedi911 Posted May 22, 2007 Posted May 22, 2007 Hey Ruff, I get your point about the figurative speech thing, I might say something off the wall but I usually mean something else a habit of mine I really need to stop. I also respect you Ruff!! But from talking with you before I kinda saw where you came from, but never the less I shouldn't of generalized ya. My mistake! I just get so damn sick and tired of everyone ripping my posts apart as if I'm nothing but an idot. I might be new, but I am not an idot. Bout the pt choice thing, I give them their choices based upon their signs and symptoms. If they want to go XYZ but XYZ has no cardiac, I'll name the 3 hospitals that can handle cardiac and if they don't want to go to either of these, I have to inform the pt, call that hospital, and if they refuse to take her then, she's got no luck to go there. That usually summs it up to the point of I give the 3 choices again and then she chooses. I cannot take her to a facility AGAINST her wishes, it's called Kidnapping in the USA. If it's a priority 1 they really have no choice. Priority 1's usually go right to the closest facility. But here in Lee County each of the 6 hospitals specialize in only one thing, they don't all take in everything. So if it's a AMI pt they go to nearest cardiac hospital, CVA goes to the stroke hospital, Trauma goes to the Trauma center and minor crap goes to the hospitals with small 9 and 10 bed ER's. The LZ topic, Medstar has usually a 10 min response time anywhere in our county. From the time I call for them to the time they get on scene is roughly 12 minutes. FD usually lands them on scene but if there' no place to land they find one within a certain distance. I get what you say I could be driving already by the time they land. But to be honest, by the time I do my definitve Tx on scene and get the pt loaded and ready to fly, MedStar's already at the LZ waiting for me. The key is to have the assessment skills to know when you'll need MedStar within the first few minutes of arriving on scene. As any medic knows. From the time I arrive at the LZ to the time they're usually lifting off is under 4-5 minutes.
Just Plain Ruff Posted May 22, 2007 Posted May 22, 2007 Nifty this is why I like you so much. YOu are very articulate and your answer to my questions and statements give you kudos in my book. +10 for that explanation +10 for not getting pissed off at whatever I say. I certainly understand the LZ thing and the drive time thing. We need to get together and chat sometime. drop me a pm.
Dustdevil Posted May 22, 2007 Posted May 22, 2007 Dust, there's no need for that. - 5 for you I agree with Ruff. Plus 5 for not getting all bent out of shape over what did indeed look to be a personal shot at you. It was not. I wasn't addressing you specifically at all. But yeah, I can very definitely see why you or others might have taken it that way, and I apologise. Your reply was mature and respectable. Now, that said, after reading all of your rationale, I'm afraid I still don't see it. I am with Ruff, in that the numbers just don't add up to a helo trip for this girl. She's at school, not in the middle of the Everglades. And despite all their super duper, top secret critical care training, your ALS unit should be every bit as prepared and capable of handling her as the flight crew who are, despite all the extra letters I am sure they use behind their names, still just paramedics. I doubt their defibrillator has any better success rate than yours does. And she's not an immediate candidate for any pump regulated drips, so again, you should be handling this. Without freaking out. I do have to agree though, if you and your partner are freaking out and feel incapable of handling this patient, then yes... she probably is safer going by some other means. But it also means you guys aren't ready for the streets. While you are piddling around with all sorts of protocol monkeying around (as outlined in your posted treatment plan), p3medic and I already got her back to a normal rhythm. Now she is stable and half way to the hospital -- without hauling arse -- while you are still waiting for your magic helicopter. I'm driving. P3 is in back, admiring her breasts until the Versed wears off. It's a tough job, but somebody's gotta do it!
ERDoc Posted May 22, 2007 Posted May 22, 2007 I would have to agree about the helicopter. With hospitals only 20 miles away, it really seems unnecassary. You have just as much to treat this girl with as they will in the helicopter and in the ER.
p3medic Posted May 22, 2007 Posted May 22, 2007 [ While you are piddling around with all sorts of protocol monkeying around (as outlined in your posted treatment plan), p3medic and I already got her back to a normal rhythm. Now she is stable and half way to the hospital -- without hauling arse -- while you are still waiting for your magic helicopter. I'm driving. P3 is in back, admiring her breasts until the Versed wears off. It's a tough job, but somebody's gotta do it! yeah, life sucks...next time you get to ride in back...
akflightmedic Posted May 22, 2007 Posted May 22, 2007 That post you referenced Dust reminds me of the Hindenburg recording. OH THE HUMANITY A little overdramatic methinks. Sorry, I cant resist, but in FL, we say.....OH, THE HUGE MANATEE
CBEMT Posted May 22, 2007 Posted May 22, 2007 I believe that I have been trained and have learned my standard of care, and more than adequate to provide this to the public. If I did not have the confidence in myself, and present that confidence, I can not expect the patients confidence in me. I think the point is that if all you can think to give a patient in regards to oxygen is either 6 liters per minute or fifteen, you may want to pack a lunch while waiting for other providers to have confidence in you.
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