All the bells and whistles...REALLY?

[Sasha]

I'd settle for a visible ID. Seriously, it's identification. It only works if people read it. If you're that worried about the patient learning your name, something's amiss.

But then they know who to complain about!

 

[Melclin]

1. There was a time, recently, when I responded to a medical call at an event, went out with my partner, O2, jump bag, AED, etc. Pt was pulseless, apneic, and cyanotic. Laid the pt out and began CPR. Well, after one cycle of compressions my (new) partner was still assembling the BVM while she radioed for the other crew on scene and their AED, and suddenly I really, REALLY wished that I had the pocket mask I had to buy for training. So you know what I did that night? I put it on my belt, right next to the Leatherman and the Surefire, both of which I've also had to use on calls. That way, the next time I'm in that position I don't have to choose between giving air and a mouthful of puke, which as a CPR instructor I can tell you is no choice at all. (Pt recovered, btw).

2. I will always, always believe that EMS needs to become a paramilitary style organization in training, operations, and organization, the details of which I can save for another thread, but since we're talking about "whacker-dom" I can point out that the military issues load-bearing vests that allow soldiers to carry the majority of their gear ON THEIR PERSON so that it is accessible in a crisis. That logic holds true when you are plunging into service at an MCI. No, it doesn't happen everyday, but i prefer to Be Prepared and not have to go running back to the bag. So carrying your scope, shears, your penlight, some 4x4s in the cargo pocket, whatever, is only going to make you a more effective practitioner of EMS, and efficiency is priority #1. It's certainly not going to make you WORSE. All the training in the world is useless if you don't have your equipment, and all the gear in the world isn't going to save you if you don't take your job seriously and study up. If you just want to wear straight officer-style slacks and your duty shirt and keep all the other gear in the bag and the truck, by all means. Just don't criticize someone for wanting to equip themselves appropriately for the unexpected.

3. The public, and the patient, DOES take into account the image that you convey. I worked for a company before that handed out EMS badges, and you know what? People actually responded to them, respected them. Little anecdote, my girlfriend and I recently passed an accident scene driving through NJ, and climbing out of a squad car was an officer in khaki cargos, a green button up & ballcap, with a thigh holster for his sidearm and a webbed belt for his gear (This was a traffic light, we had a minute to take it all in). You know what her reaction was? "Wow, that guy looks really good. He looks like he knows what he is doing." Before you think that she's easily impressed, she's not, or that she's saying it for my benefit, she rarely if ever sees me at work. The man was just... Impressive.

I know that is only one example, but the fact is that what you look like has everything to do with how you are perceived by people, and being that EMS deals largely with strangers, making that impression is key to making them feel safe. Just conduct yourself with the confidence that you can appropriately manage the situation and put the patient at ease. Whether you roll onto a scene with a 5.11 vest stuffed with gear or you wear ****ies and a polo to work, just look and act like you take your role in medicine seriously. Lazy-a** transport company culture has infected EMS, and it really has to stop if this profession is going to take the quantum leap forward that it's capable of. The inter-EMS judgments, scorn, and mocking really undermine what we, as a service, are trying to do.

1. I don't see it being an issue to just go to the bag. I have to say, I don't agree with the rush rush rush type thinking you seem to have. Very few things can't wait to reach into a bag. Additionally you must get pretty tired carrying all that stuff around. I don't have anything against people who wanna wear a few bits and pieces. I just worry that in some the need to be "tac'd out" is indicative of a provider who is more interested in a sort of paramilitary aesthetic than being a well educated provider.

2. The kind of MCI where you need buckets of 4x4 and things like not just rare, they almost never happen. To constantly wear a vest carrying all that stuff would surely be counter productive. It would get in way, get caught on stuff. I just have this picture of apologising to Nanna Chest Pain after you knocked her favourite vase over when it caught on you EMS stormtrooper gear.

3. Uniform is important. No doubt about that. It adds a certain authority which is useful in two ways. 1. When you need to tell people to piss off/move back/do this/do that, it works better in uniform. 2. It makes people feel like they're being looked after by someone who is reasonably professional. Just like Drs wear reasonably formal cloths. Can you imagine telling a mother that her son is dead wearing a cradle of filth hoody. I would never wear a uniform polo shirt for example, and I don't like the look of the new cargo pants we have. We need to look professional and formal, not imposing and "cool" in a military sense.

 

[FirstInTac'dOut]

EMT-DAN 1. About the mask, pt taken. You're right, the updated protocols do maintain that there is enough tidal volume to just begin another cycle of compressions in that sense. At the same time, it doesn't hurt to give the breaths too. Again, though, you're right, the next ventilations given with BVM+O2 did the trick anyway.

 

[FirstInTac'dOut]

Mr. Conspiracy-
Neat and squared away is certainly one thing, but there you can look that way and look like any highway patrol officer in the world. There was another quality that uniform had: The officer DIDN'T look like a typical neat, pressed, creased, belted officer- he looked like he was actually ready for anything, not just morning inspection. Maybe it's irrelevant to an EMS discussion, but I was trying to convey the difference in impressions. Sometimes being neat is one thing, looking prepared is another.

 

[FirstInTac'dOut]

Melclin-
EMS stormtrooper- that made me laugh. Good natured ribbing I can take. You're right about the almost-never nature of an MCI. But I like to prepare for any possibility, not just the probability. That doesn't mean that I go see NannaChestPain like that, just that the equipment is available to be a more effective provider if we DO come upon a scene like that.
It's not a rush-rush nature that I have, just a desire to move quickly to identify and solve problems in a quick algorithmic pattern. Efficient patient care. Had a state EMS inspector show up on scene (MCI, yes) and compliment our team on it a few weeks ago, for what that's worth.
On the other hand, you're absolutely right. The kind of provider who spends more time in the lights&sirens section of the Galls website than they did/do in their textbooks/personal con-ed research is probably trying to hide their lack of knowledge with shiny stuff. That happens in every profession, to be sure, but like I said, you start with the knowledge and then try and give yourself all the tools to be both competent AND capable of providing treatment.

 

[FirstInTac'dOut]

Melclin-
EMS stormtrooper- that made me laugh. Good natured ribbing I can take. You're right about the almost-never nature of an MCI. But I like to prepare for any possibility, not just the probability. That doesn't mean that I go see NannaChestPain like that, just that the equipment is available to be a more effective provider if we DO come upon a scene like that.
It's not a rush-rush nature that I have, just a desire to move quickly to identify and solve problems in a quick algorithmic pattern. Efficient patient care. Had a state EMS inspector show up on scene (MCI, yes) and compliment our team on it a few weeks ago, for what that's worth.
On the other hand, you're absolutely right. The kind of provider who spends more time in the lights&sirens section of the Galls website than they did/do in their textbooks/personal con-ed research is probably trying to hide their lack of knowledge with shiny stuff. That happens in every profession, to be sure, but like I said, you start with the knowledge and then try and give yourself all the tools to be both competent AND capable of providing treatment.

 

[bstone]

I gutted my car last night looking for a stethoscope. I found a lot of tools, but no EMS gear. I failed the wacker test.