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

[Lone Star]

The "routine transport calls" such as dialysis, doctors office, wound care, discharges, etc don't require an ambulance. Those generally require nothing more than an oxygen tank, a gurney, and a van (like wheel chair vans).

Most nursing home calls actually require an ALS assessment. Afterall, why is it that any SNF patient with a history of cardiac problems gets a monitored bed regardless of the complaint (side note: most ER beds where I live have a monitor, but they aren't always used on all patients for monitoring cardiac activity)? Furthermore, what could seem like a routine BS call to transport a patient to an emergency room could easily require an ALS assessment. Just because the pager says that the complaint is "pain all over" doesn't mean that is what you are going to find.

Not all 'routine calls' are as you describe. Point still remains...EMT-B's have a place in the EMS system, and until the Paramedics can take that 3am call for 'pain management' or patient transport, dialysis, etc ...there will ALWAYS be EMT-B's around to be the 'whipping post' for arrogant medics!

At the end of the day, its not an 'US against THEM' scenario. It's two different niches being filled by those that are able to do the job!

[medicare-emr]

At the end of the day, its not an 'US against THEM' scenario. It's two different niches being filled by those that are able to do the job!

and those who are willing to do the job!!

[sassy_emt]

JPINFV wrote:The "routine transport calls" such as dialysis, doctors office, wound care, discharges, etc don't require an ambulance. Those generally require nothing more than an oxygen tank, a gurney, and a van (like wheel chair vans).

My comment to this dear is that these "routine tansport calls" in wheel cair vans happen to also in clude dementia patients, dialysis patients with histories of MIA, diabetic complications, and various unknown mental health issues. I know I worked on a wheel chair van for a while......loved my patients but I never knew when a dementia patient I was transporting would flip out or if one of my dialysis patints woul have a diabetic episode or if chest pains would begin in the middle of transport....as an EMTB all I had on my van was a basic jump kit and an average ALS response time of about 15min at best.......I know my training so to be honest I knew I could stablize until someone came or be able to get to a medical facility quickly if the clearance was given and my transport time was less than the response time of an ALS crew.

[brentoli]

JPINFV wrote:The "routine transport calls" such as dialysis, doctors office, wound care, discharges, etc don't require an ambulance. Those generally require nothing more than an oxygen tank, a gurney, and a van (like wheel chair vans).

My comment to this dear is that these "routine tansport calls" in wheel cair vans happen to also in clude dementia patients, dialysis patients with histories of MIA, diabetic complications, and various unknown mental health issues. I know I worked on a wheel chair van for a while......loved my patients but I never knew when a dementia patient I was transporting would flip out or if one of my dialysis patints woul have a diabetic episode or if chest pains would begin in the middle of transport....as an EMTB all I had on my van was a basic jump kit and an average ALS response time of about 15min at best.......I know my training so to be honest I knew I could stablize until someone came or be able to get to a medical facility quickly if the clearance was given and my transport time was less than the response time of an ALS crew.

And that is the point of having an EMT delegated to that role. You have the tools and knowledge to stabalize the situation. You have the capability of transporting to the ER, or awaiting an ALS ambulance. That is exactly the point trying to be made. Basics are better served in the non emergent transport field.

[flight-lp]

IF my assessment and treatment suggestion were so grossly detrimental to the pt's well being, then tell me why the Instructor/Co-ordinator told me they were correct? IF the medic did such a good job, then why did they end up LOSING THEIR LICENSE after I made a call to the Medical Control Board?

I can only hope that since you've decided to tell this 'lowly basic' how WRONG he was...then please explain these answers in 'little words' so I can understand!

Also, let's keep in mind that I didn't supply that information for you to use to tell me how little I know as a Basic, those were the FACTS as they pertained to the situation at the time!

At the end of the day, it STILL boils down to the fact that EMT-B's have their place in the 'EMS Food Chain', and our narrow little scope of practice only means that we're the thinnest spot in the line between life and dead!

I'm sorry, I can't speak intelligently about why your local educator gave you false information. I feel I did present it in a manner that would be easily interpretated by EMS professionals, however should you really not understand it, I'd be happy to break it down for you.

As far as your care as a patient goes, yes absolutely the Medic should have obtained appropriate vitals and completed a thorough assessment. However, your 10 minute trip, as you describe, did not constitute an emergency response to the ER. Also, I am interested in the "chemical" intervention that you mentioned. Could you clarify?

I'm not going to get into a pissing match with you. I run the 3 a.m. bullshit just like the next medic, I deal with the drunks, and I deal with the stupid, emphasis on the latter. Each pt. I encounter deserves the level of assessment, treatment, and transport that I provide in conjunction with my partner. Even the B.S. deserves at least an initial ALS assessment. If after that it is deemed to not require a Paramedic, then the care can be delegated at that time.

On my final note as the more I type, the more I realize that this is going nowhere, please understand that the dialysis calls, Dr. appointments, and hospital discharges are NOT EMS calls. They are transportation calls that do not usually require any level of care. Show me a professional EMS agency that offers these services based on the belief that they are truly MEDICALLY needed vs. an easy way to supplement their agencies income, then the first beer is on me.....................

[Dustdevil]

yes reputation is important, but not as important as integrity. so i challenge you Dustdevil and old bush wacker from oz to get out your cozy situations of having 1st world country EMS systems and come join me in the no1 Trauma Capital in the World, South Africa, and come see what we have to deal with on a daily basis. the lack of resources, having six patients crammed into an ambulance and receiving a priority one call and having to do a response with them in the back of an ambulance and trying to do a resus in a crowed ambulance, blood everywhere.

First of all, I am thousands of miles from the nearest "1st world country." All the blood, screaming, and shooting you see in the rest of your pseudo career is not likely to match what I have seen in the last year.

Second of all, my family left South Africa because it was shyte. Apparently, yours is not quite as smart.

Third of all, when I realised that my BLS training was very nearly useless in the grand scheme of EMS, I furthered my education rather than sitting around and whining about "politics." There are an awful lot of medics (real medics. Not EMRs who call themselves medics) in SA who manage to obtain higher education despite the politics. I guess you're simply not as good or smart as them, eh?

Fourth of all, when I decided to be an EMS professional, I went to school and got a job in EMS. I didn't slap some lights on my POV and call myself a "company" to go wankering about as a hobby.

You're throwing around a lot of accusations about people you know nothing about. And sadly, it appears you know as little about yourself as you know about us.

[sassy_emt]

And that is the point of having an EMT delegated to that role. You have the tools and knowledge to stabalize the situation. You have the capability of transporting to the ER, or awaiting an ALS ambulance. That is exactly the point trying to be made. Basics are better served in the non emergent transport field.

As an Emtb i disagree that we should only be used in a nonemergency transport field.....

I have been the first ems personel on the scene when an austic child was injured and unable to comunicate with even the care giver there......this child was so emotionally overloaded that a totally emotional "shut down " was apparent.....I was the only one who could reach this child and had to be there with ALS so they could transport the child.......the medic on duty had experience working with children but not with an autistic child......I have worked with autistic children( and their numbers are gowing), I have three boys who all have Aspbergers Syndrom which is a for of autism, two autistic nephews and a close friend with and autistic son. As a basic provider I feel that if I have this kind of knowledge and experience not only have I shared it with my employer but also my fellow ems providers then I want and need to be allowed on the truck to be there for these cases and any other cases I may be able to assist with.

I have posted earlier some of the experiences I have had over an 18year time span befor becomming a Basic....I have been a Basic for two years.......I have still relied on my experince from those past years when working with my patients. I am one who will fight for Basics to have a chance to back up a Medic and be there to be that person who has just the right comforing tone in my voice for a rape victim or a victim of domestic violance....I want to be there to have that special silly smile for the youngster who is so scared all they want to do is curl up and hide even when it shurts so bad all they can do is cry......I want to be that one special voice of compassion who is able to reach that elderly patient who just is too tired to care weather they fight or not........I want to be the voice of sincere honest understaning for the suicidal patient who can't find a reason to go on....and the sound steady voice of hope for the family membr of a patient in anaphlaxic shock who isn't sure if they did the right steps proir to us gettting there.....

These are just a few of the reasons I went through the training for my basics and now am looking into training for my Medics........I am proud of the fact I am a Basic...I will nver forget my training and one day hope that I am lucky enough to have a basic partner who is as passionate about this field as I feel.....

[Just Plain Ruff]

Medicare, wow the anger and insults from you keep coming.

You apparantly don't have any clue where Dustdevil is. Maybe you should be reading some of his previous posts and then maybe look at his photo album.

The force is strong in you.

and yes you did call Brentoli an ass and that my friend is what they call an insult.

[Dustdevil]

Empathetic communications is an elusive skill that is extremely important to our field. This does indeed make you valuable. Sometimes. But it doesn't make you as an EMT valuable. Unless this skill is something you and every other student was taught in your EMT school, then it is a personal skill, not an EMT skill. And I don't need a special EMT on my ambulance just for that once every 20 years autistic patient. I'd rather have a paramedic who could do the very same thing.

[Dustdevil]

Medicare, wow the anger and insults from you keep coming.

The force is strong in you.

Don't you mean "the farce?"