Any comments on this one......

[Shishkabob]

I know that if I had a messy call, especially a code, that usually entails a lengthy PCR, and if my parter refuses to clean up the back during that time and chooses to "Have a talk" with me, I'll be having a talk right back... and I'll win.



I'll clean up what I can and have no problem cleaning up my mess... but there's common sense there too. If my partner has just been standing around next to the rig the whole time while I handled the transfer of care and did the PCR, that's not right.

 

[JPINFV]

I'll clean up what I can and have no problem cleaning up my mess... but there's common sense there too. If my partner has just been standing around next to the rig the whole time while I handled the transfer of care and did the PCR, that's not right.

...and I'll add that I don't care if the paramedics are with my service or another service. They have a job and I have a job. Parts of that job overlaps, but sometimes not temporally.

 

[emt seeking first job]

You couldn't roll a transfer sheet under him and lift him on the stretcher? Please, please tell me you all moved him to the stretcher and not that the magical paramedics had him "turn and pivot" or walk to the stretcher.

Scoop stretcher.

 

[abckidsmom]

Patient's wife reported gross variations in blood pressure the entire day.

We took six reading, within 10 minutes we had a wide range as well.

If he lasted throughout the day, don't you think you could have moved him to the stretcher at least?

With his potential instability, I'd want to be making movement toward the hospital as soon as possible, especially considering the antiquated mentality your service seems to be bringing to the calls.

People sitting and talking to you don't typically stop being alive just because you slide them over to the stretcher.

I'm with the others, EMT. You've gotta find a real agency to work with before you start thinking this is the standard way to do EMS. The stuff you are learning right now, at the beginning of your career, is the stuff that will last forever. You'll regret having this behavior in your muscle memory if you do go on to actually do some EMS.

It really sounds like your agency is a branch of the Lions club or something. Nice community service, sweet people, but dude, call in the real medics!

 

[emt seeking first job]

It really sounds like your agency is a branch of the Lions club or something. Nice community service, sweet people, but dude, call in the real medics!

I have no doubt in my agency whatsoever.

We have many paid medics, emts, nurses and PA's. Perhaps I left something out of the story ? Me with an emt card less than 1 year old....My agency had a person with 20+ vollie experience, the seconf person had 3 years volley and two years NYC 911 experience.....

I read everyone's input here but I am inclined to follow along in the field..

 

[Shishkabob]

And that's the problem... you're following along blindly.


It's one thing to listen to experience, it's another to believe the experience being shown is the end-all be-all correct experience. You need to be your own provider and need to do what YOU think is best for the patient (so long as science backs it up), even if it's counter-intuitive to what your 'superior' is telling you if they themselves are unable to explain why their way is the right or better way.


I've had my medic for a year now. I work with medics who have had theirs since before I was born. I'll listen to their wisdom, but in the end, it's my license and my patient care, so it's my decision. The only person on this earth who can tell me what to do with my patient is my own medical director... all others are advisors.

 

[abckidsmom]

I have no doubt in my agency whatsoever.

We have many paid medics, emts, nurses and PA's. Perhaps I left something out of the story ? Me with an emt card less than 1 year old....My agency had a person with 20+ vollie experience, the seconf person had 3 years volley and two years NYC 911 experience.....

I read everyone's input here but I am inclined to follow along in the field..

I don't know, man. Seems like something's missing if you decide to leave the patient lying in the bed instead of moving to the truck because his heart might stop if you move him. Where did you learn that? I've not had that lesson....

I'm just saying that you with your EMT card less than 1 year old should be working to acheive competence, and not necessarily venerating these people with their 20+ years vollie experience if these are the kinds of decisions they've been making all these years. The people you learn from are the people you become. Choose carefully.

 

[abckidsmom]

And that's the problem... you're following along blindly.


It's one thing to listen to experience, it's another to believe the experience being shown is the end-all be-all correct experience.


I've had my medic for a year now. I work with medics who have had theirs since before I was born. I'll listen to their wisdom, but in the end, it's my license and my patient care, so it's my decision. The only person on this earth who can tell me what to do with my patient is my own medical director... all others are advisors.

Amen. And even the medical director can be wrong at times. Ours is totally open to receiving well-though-out criticism phrased respectfully. He was completely wrong on a med/legal issue we were talking about last week, and I got the state code, we talked about it, and we all learned a lot from the discussion.

And he's the medical director for the state OEMS!

 

[emt seeking first job]

I don't know, man. Seems like something's missing if you decide to leave the patient lying in the bed instead of moving to the truck because his heart might stop if you move him. Where did you learn that? I've not had that lesson....

I'm just saying that you with your EMT card less than 1 year old should be working to acheive competence, and not necessarily venerating these people with their 20+ years vollie experience if these are the kinds of decisions they've been making all these years. The people you learn from are the people you become. Choose carefully.

Well as I wote, the medics were 5 minutes out. They stayed on scene about five minutes assesing him, we scooped him, carried him carefly down the stairs, keeping him as level as possible, he was brought to the ER in the same condition we found him in.

I appreciate everyone's concern and input.

 

[JPINFV]

We have many paid medics, emts, nurses and PA's. Perhaps I left something out of the story ? Me with an emt card less than 1 year old....My agency had a person with 20+ vollie experience, the seconf person had 3 years volley and two years NYC 911 experience.....

To steal a line from Kelly "Ambulance Driver" Grayson, is that 20 years experience or 1 year experience repeated 20 times?

 

[MrBrown]

To steal a line from Kelly "Ambulance Driver" Grayson, is that 20 years experience or 1 year experience repeated 20 times?

Hey you cant steal that, Brown already stole it before you did!

 

[emt seeking first job]

Thank you everybody for your input.

I have read all the replies and will conisder all of your advices.

 

[EMS49393]

I know that if I had a messy call, especially a code, that usually entails a lengthy PCR, and if my parter refuses to clean up the back during that time and chooses to "Have a talk" with me, I'll be having a talk right back... and I'll win.

I'll clean up what I can and have no problem cleaning up my mess... but there's common sense there too. If my partner has just been standing around next to the rig the whole time while I handled the transfer of care and did the PCR, that's not right.

THIS^

I used to work with a guy that refused to clean anything. He drove to the hospital, we unloaded the patient, and while I transferred care, he ran his mouth at the desk. I'd get finished and have to make the stretcher and drive back to the station. After we got back, he's go back to playing xbox and I'd get to do another hours worth of paperwork.

I'm usually really nice to EMT's but this "I'm not cleaning up after you" crap is starting to tick me off. I never asked anyone to clean up after me, but you can make a stretcher since the only thing you'll be doing back at base is sleeping, eating, playing xbox, or pulling your crank while I get to do my favorite (sarcasm) part of the job - document.

 

[Madmedic780]

IMHO...Patient's always have the right to refuse even if it's going to bad for them in the end. Especially with his education it would have been easy to convince him of the good chance that he was possibly be having a cardiovascular incident and that some 02 might make him feel a bit better.

However that being said I think it was a bit unfair for you to jump to ignorance or senility for his refusal of 02 therapy...as he was obviously not feeling well.

Remember the most important part of the job is being an advocate for the patient, and that includes good clinical skills and judgement rather than just following protocol.

Would I have given 02 given the v/s and history? Yes. 15lpm via NRB? probably not.

 

[emt seeking first job]

THIS^

I used to work with a guy that refused to clean anything. He drove to the hospital, we unloaded the patient, and while I transferred care, he ran his mouth at the desk. I'd get finished and have to make the stretcher and drive back to the station. After we got back, he's go back to playing xbox and I'd get to do another hours worth of paperwork.

I'm usually really nice to EMT's but this "I'm not cleaning up after you" crap is starting to tick me off. I never asked anyone to clean up after me, but you can make a stretcher since the only thing you'll be doing back at base is sleeping, eating, playing xbox, or pulling your crank while I get to do my favorite (sarcasm) part of the job - document.

At my service, the senior person presents to the ER triage nurse, the junior person can listen in, then while the former or the next in line writes the PCR, the later puts the stretcher back and sets everything up for the next call.

The next in line is getting experience in writing PCR's.

One of my shifts is with two very seasoned people, one a full time EMS boss, they are both instructors. The other person with us has about 2 years in, but forgets their glasses. So I jump in and write the PCR. I ask them to dictate, but they force me to make a guess.

I dont mind setting up the bus and I dont mind writing the PCR as I need experience in both.

 

[Sizzlator]

Confused

Perhaps he was just confused because of all the excitement. Or perhaps he did not want to make a big fuss over his situation and thought that O2 would just elevate the situation. Denial perhaps.

 

[reaper]

Perhaps he was just confused because of all the excitement. Or perhaps he did not want to make a big fuss over his situation and thought that O2 would just elevate the situation. Denial perhaps.

Or perhaps he has extensive medical education and knew it was ridiculous to give him O2, when it was not needed or called for.

 

[usalsfyre]

Perhaps he was just confused because of all the excitement. Or perhaps he did not want to make a big fuss over his situation and thought that O2 would just elevate the situation. Denial perhaps.

The misinformation continues...

 

[emt seeking first job]

Or perhaps he has extensive medical education and knew it was ridiculous to give him O2, when it was not needed or called for.

Ok, however, arent the protocols for EMT's written by MD's ????

 

[usalsfyre]

Ok, however, arent the protocols for EMT's written by MD's ????

Written by MDs, but they're often out of date, and assume EMTs aren't educated enough to know when oxygen is indicated.

Ask yourself, do you want to be "that guy" protocols like this are written for.