A call to arms! EMT-B's defend yourself!

[Lone Star]

Until the paragods can be 'bothered' to descend from the mount, and start taking nursing home calls, and the 'routine transport calls', there will ALWAYS be a need for the EMT-B. Any private carrier will show that statistically, the BLS calls outnumber the ALS calls, therefore in your non municipal settings, the higher BLS call volume will therefore generate the revenue to allow the company to be able to 'reward' the EMT-P with the higher wages for the higher training.

That being said, there are the 'misfits' at ALL license levels. You know the 'type' that I'm referring to; the ones that can only 'regurgitate' facts printed in a book, as opposed to being able to JUSTIFY why they performed a speciffic treatment, and the expected result of that treatment option.

In 1996, I was driving home from working EMS in Detroit. I was still in My uniform, and suffered from vertigo, left sided hemiperesis and occluded field of vision bilaterally. To be honest, I thought I was having a stroke!

In addition to the above mentioned complaints, there was also decreased tactile sensations on the affected side as well. Luckilly, I had a CB radio in my truck and was able to call for help.

The responding unit was an ALS unit. On arrival, I was A&Ox4, and explained my 'situation' to the medics. The first thing they did was to make me get out of the truck UNASSISTED!

Once I stumbled to the cot, and was put into the semi-Fowlers position, the medics moved me from the median to the shoulder of the freeway. Before loading the cot into the rig, the attending paramedic 'took a blood pressure reading' through 4 layers of clothing (two layers of coat, a long sleeved uniform shirt and a long sleeved turtle neck shirt). He stated that he had 'heard' a blood pressure of 172/150.

The rest of the 10 mile trip to the hospital (code 1) was spent filling out the pt care report. In the spaces provided to list the vital signs, he simply wrote 'WNL' for the unstated 'Within Normal Limits' abbreviation. No other vital signs were checked! (Pulse, eyes, lung sounds, respirations, etc).

Upon arrival at the local ED, an ER Tech took my blood pressure PROPERLY, after assisting with the removal of the 4 layers of clothing mentioned above. Not surprizingly, the B/P was then entered into my chart at a 'reasonable' 118/80. The ER tech also started an Vv of NS @ KVO, utilizing an 'IV block'. (for multiple IV access if necessary).

The attending physician walked up, took one look at Me and within 30 seconds of introducing himself and asking a couple questions, was ordering a trip to radiology for a CT scan.

I later asked the doc how he came to the decision about sending me to radiology so quickly, stated that 'one look at the eyes' was all he needed (in addition to listening to the chief complaints).

After spending 8 days in ICU, I was released to 'rest and recuperate' at home, while waiting for the surgery date that was in 3 weeks.

Just because my body didn't work like it should, didn't mean my mind was gone too. I made a call to the local Paramedic Instructor/Co-ordinator in my area and started asking questions about the paramedic protocols for a suspected CVA pt. I stated that had I been MY pt, as a medic, I would have performed the following procedures.

1. Properly assess ALL vital signs

2. Start an IV (N/S @ KVO)

3. High flow O2 via NRB

4. 5 lead monitoring with a 'test strip' for records

5. RAPID transport to the closest appropriate facility.

6. monitor the pt for any changes in condition/status

7. be prepared to step in with chemical intervention (if necessary)

I was told by the Paramedic I/C that my treatments were correct and accurate. Now if I, as a 'lowly Basic' can figure this out....then the paragod that showed up on scene should have known this as well! (so much for the 'superior training' theory!)

Needless to say, this medic no longer holds a license in the State of Michigan because of this!

Ultimately, it boils down to this: Basics DO have a 'place in the field', we DO serve more of a purpose than to 'step and fetch' for the medics and we ARE healthcare providers in our own right. Granted, our scope of practice is much more limited than that of the paramedic, and thats why we don't command as high of a wage for what we do. But, realistically, not every call is going to require ALS intervention, so why tie up an ALS rig on the bullschit calls?

[medicare-emr]

Three cheers to the BLS crews. wooooohooooo ata boy, nicely put lone star,

I too have had situations in my runs, the one time i arrived on a scene to find the ambulance crews outside packing the vehicle, and this was after the cops asked me to assist them with a stabbed chest. i asked the crew what the situation was and they said to me the guy was dead.

i asked them if i could take a quick look and proceeded to have a squiz, and my gut said to me to check for a pulse. apon checking i discovered a weak thready pulse and proceeded to resus the pt., i called for help and it took the crew 10 mins to come and assist me, the pt. was aspirated in his own blood, they did not do the basics, did not have an ECG to declare, no suction, i had to stop CPR to show the senior crew member ILS how to do a proper C-grip while ventilating coz she was pumping air into his stomach, while the BLS was attempting to put up an IV that was not in his scope of practice.

after resusing the pt. 6 times, we lost the pt. the damage done was to late. this was due to the first crew on scene not performing the basics ABC's, and to top it off their attitude towards their job stank - it was clear, in it for the money and not the passion for life.

i bit my tongue and kept quite about the situation, because i was launching a new dedicated service to the community and did not want to crap on my own doorstep. the amount of politics in SA is unbearable, to the point where i no longer can further my studies locally in Cape Town, i have to go to Johannesburg to do it. there is just too much politics in this industry, you always have to be careful what you say and who you say it to coz you might just be pissing on someone's battery in power. i suppose its a lot easier in a first world country.

back to old school i say, not for the money, for me its a way of life, i live by it and will die by it!

do it for the right reasons and keep your integrity

regards

DaMadMedic

[brentoli]

Three cheers to the BLS crews. wooooohooooo ata boy, nicely put lone star,

It's posts like this that make me hesitant to declare that I am a BLS provider... heh...

[spenac]

BLS only sucks. OOPs should have put that on another post. But really BLS is great if backed up with ALS.

[PRPGfirerescuetech]

But again, the only people on the crew of an EMS ambulance should be highly educated medical professionals. EMTs simply do not even come close to meeting that definition. But, if it makes you feel any better, neither do most paramedics in the U.S. Yet. And that is what we are trying to change. That change will never happen if you can still be one of us with a 3 week first aid course.

[marq=down:b89b252688]Amen-ah[/font:b89b252688][/marq:b89b252688]

[flight-lp]

I stated that had I been MY pt, as a medic, I would have performed the following procedures.

1. Properly assess ALL vital signs

2. Start an IV (N/S @ KVO)

3. High flow O2 via NRB

4. 5 lead monitoring with a 'test strip' for records

5. RAPID transport to the closest appropriate facility.

6. monitor the pt for any changes in condition/status

7. be prepared to step in with chemical intervention (if necessary)

And you would have potentially killed your patient thus further proving our point.................

High flow O2 in a stroke pt. is contraindicated due to cerebral vasoconstriction potentially increasing the infarct and further occluding cerebral blood flow. In fact, most stroke pts. require NO OXYGEN!

So tell me again why your EMT basic class qualifies you to treat pts. in an emergency response environment????

[medicare-emr]

to the great spenac, how long have you been a paramedic?, and where did you start?, at the bottom, where will you end? at the bottom of a 6ft pit

what goes up...must come down!

go eat some humble pie, we all start some where, don't ever forget the journey along the way, its what makes us and it seems that your journey was an easy one, one that was paid for by mommy and daddy, not one that was a constant struggle to getting to your goals. it really shows in your attitude towards people who you think are less of value.

so in essence the only thing that sucks is your attitude

mr brentoli, as for you, the only thing you can declare is.......

as taken from sloganizer << 3,2,1....Brentoli is an ass>>

[brentoli]

I will refrain from making any personal attacks.

Why can we not come together as basic's and realize we are not the be all-end all of emergency care? Patients can be much better serviced by higher levels of care on a 911 truck. It is what they expect.

If you want to be an ambulance driver, then so be it. Rural/Metro does all kinds of inter-facility transports. They would love to take anyone aboard.

Don't bring the rest of this profession down by refusing to realize there are people with more knowledge, education, skills, and experience then you. That is what I meant by being ashamed. I don't want to be put in the same category as yayhoo ricky rescue who thinks that he is the best EMT-B to ever get his card in the mail.

[spenac]

to the great spenac, how long have you been a paramedic?, and where did you start?, at the bottom, where will you end? at the bottom of a 6ft pit

what goes up...must come down!

go eat some humble pie, we all start some where, don't ever forget the journey along the way, its what makes us and it seems that your journey was an easy one, one that was paid for by mommy and daddy, not one that was a constant struggle to getting to your goals. it really shows in your attitude towards people who you think are less of value.

so in essence the only thing that sucks is your attitude

mr brentoli, as for you, the only thing you can declare is.......

as taken from sloganizer << 3,2,1....Brentoli is an ass>>

Ouch dude. As stated BLS is great with an ALS backup. BLS is better than nothing, but is not a replacement for ALS. I have stated many times I think we need BLS. To me it is like in nursing you have nurses aids, LVN's, and RN's. Each has it's place and the value of each needs to be realized. But it is accepted that the RN's are able to do much more. Remember those of us in ALS also do BLS, then do ALS. Only the bad ALS provider forgets to take care of abc's first.

[spenac]

I will refrain from making any personal attacks.

Why can we not come together as basic's and realize we are not the be all-end all of emergency care? Patients can be much better serviced by higher levels of care on a 911 truck. It is what they expect.

If you want to be an ambulance driver, then so be it. Rural/Metro does all kinds of inter-facility transports. They would love to take anyone aboard.

Don't bring the rest of this profession down by refusing to realize there are people with more knowledge, education, skills, and experience then you. That is what I meant by being ashamed. I don't want to be put in the same category as yayhoo ricky rescue who thinks that he is the best EMT-B to ever get his card in the mail.

Good dispatch Brentoli, very professional response.