holding the wall

[Tigger]

Yep, furthermore, I'd argue that giving NYC's system a pass is disingenuous. Either the 911 provider can provide the service needed, or they can't. Why is it OK when the primary 911 provider in NYC goes outside of FDNY, but not elsewhere?

More importantly, what sort of disservice is a primary 911 provider doing to their citizens when they say, "Out sandbox. Only we can play here, even if we can't provide enough ambulances to cover the call volume."

Couldn't agree more. If a city doesn't have someone doing backup, then what happens? If every truck is tied up on a call turnarounds are going to be slow since the hospitals are also likely to be busy (hey back on thread topic!).

So then what, do people just wait and wait despite the fact that there are in fact available ambulances capable of providing the same service as the municipality? That seems like more than just a disservice, it seems stupid. Say what you will about private EMS and about how they know nothing about "working the streets," I'd rather have a crappy crew take me to the hospital than wait at home for the 911 super ambulance to come whisk me away.

No service can cover 100% of its call volume and still stay within acceptable response times 100% of the time. An overflow plan needs to be in place, which doesn't necessarily need to include private EMS, but it in many cases it will be the cheapest for the municipality.

 

[Joe]

Hey, OP, still there?

Yea still here. Just got a bag of popcorn. I enjoy the discussion. Hahaha. That pic that was posted with all the ambulances in line is what it looks like here on a weekend. I will get a pic tomorrow. Usually we don't hit true level zero. If we do another private company that usually does ift is called and they cover. They seem to like it.

 

[DrParasite]

Well let's see I work in such a system in the city of Boston. So I would say it exists. It's a very similar system to NYC from what I gather, we don't have hospital based EMS here we have private companies. If FDNY runs out of ambulances or has an extended eta they give the call to a voluntary provider right? That's what's done in Boston too.

Boston may do that, I don't know. I always thought Boston EMS handled all EMS in Boston, I never knew they handled overflow.

and you are wrong about FDNY. completely wrong. FDNY covers parts of the city, the voluntary ambulances cover other parts. it's not a case of if FDNY is tied up, they call for help. Plus, both FDNY and the voluntary ambulances use the same medical command and have the same protocols, and only certain companies are permitted to participate in the FDNY system. there are quite a few IFT companies in NYC that don't do 911, don't get dispatched to 911 jobs, and will never be part of the EMS system (outside of an MCI situation like 9/11 when every available ambulance will be called).

and FDNY is far from a high quality well run and well managed EMS system. very far from it.

 

[JPINFV]

I'm starting to realize that while the protocols and scope might suck, the system design and system policies for So. Cal. tend to be much better than a lot of other places. I can't imagine a system saying, "Sorry, but you're going to have to wait simply because we don't want to ask for help from one of the many ambulance services in the local area by developing backup contracts and mutual aid." Heck, even many of the fire departments have gone to a common dispatch center where the closest units are sent, even if it's technically the next city over. Granted, it's one continuous suburb our here instead of distinct cities, but still...

 

[DrParasite]

I'm starting to realize that while the protocols and scope might suck, the system design and system policies for So. Cal. tend to be much better than a lot of other places.

judging from some of the horror stories I have heard on here, and the reason for the limited protocol and scope, I would probably disagree.

I can't imagine a system saying, "Sorry, but you're going to have to wait simply because we don't want to ask for help from one of the many ambulance services in the local area by developing backup contracts and mutual aid."

I can, and I can also see the reasons not being what you are thinking. Aside from the whole "staff enough units to handle the routine call volume" argument that i have been making for years.

If only 1 department runs EMS, than you have control over the system. you know everyone has the same training level, same protocols,and same equipment. you know everyone passed the same competancy tests to be on the ambulance. an agency knows everyone has valid certificates, were trained in house the same way (regarding city operations and navigating the city, etc). Once you start involving agencies where you DON'T have control over what equipment they are bringing in, or what training they have, the host agency and citizen can expect one level of service, and get something vastly different. heck, can the private companies even communicate directly with dispatch, or do they need to go through the IFT dispatcher or call 911?

If we are calling any local ambulance service, you don't know who you are getting. Can you imagine sending Jack and Jill, two EMTs who typically do dialysis runs, and send them into a double shooting?

Heck, even many of the fire departments have gone to a common dispatch center where the closest units are sent, even if it's technically the next city over. Granted, it's one continuous suburb our here instead of distinct cities, but still...

and you don't see them calling private fire trucks when the 1st due areas are tied up right? ever wonder why? and there are career FDs that will call other stations in their department from further away before they call their neighbor department for a fire. happens all the time.

 

[JPINFV]

judging from some of the horror stories I have heard on here, and the reason for the limited protocol and scope, I would probably disagree.

To clarify, there's a difference between medical protocols ("treat this by A, B, and C") and system policies (e.g. licensed emergency departments must be capable of treating peds (OC does, LA doesn't), DNR policy, requiring a workable mutual aid policy, etc).

I can, and I can also see the reasons not being what you are thinking. Aside from the whole "staff enough units to handle the routine call volume" argument that i have been making for years.

If only 1 department runs EMS, than you have control over the system. you know everyone has the same training level, same protocols,and same equipment. you know everyone passed the same competancy tests to be on the ambulance. an agency knows everyone has valid certificates, were trained in house the same way (regarding city operations and navigating the city, etc). Once you start involving agencies where you DON'T have control over what equipment they are bringing in, or what training they have, the host agency and citizen can expect one level of service, and get something vastly different. heck, can the private companies even communicate directly with dispatch, or do they need to go through the IFT dispatcher or call 911?

Everyone in urban California systems have the same protocols and the same minimum training level. If you're working at an IFT company in LA, you have the same basic protocol as if you're working at the 911 services. There are a few variations between companies, but none that can be said as being uniquely present at the 911 services.

You aren't going to see non-EMTs or paramedics responding to medical emergencies because of a lack of people. As far as valid certification, if they're responding on an ambulance, then they are supposed to be licensed by the state as an EMT or paramedic. The fact that some services might skirt the rules regarding this isn't restricted from occurring at fire departments. For example, it wasn't just the private services involved in the MA CE scandal a few years back.

Furthermore, if city X is contracting with service 1 to provide primary ambulance service and service 2 for backup service, then the contracts for both can specify what ever is deemed mutually agreeable, hence giving control to the city over what systems responds to emergencies in their territory.

If we are calling any local ambulance service, you don't know who you are getting. Can you imagine sending Jack and Jill, two EMTs who typically do dialysis runs, and send them into a double shooting?

Since many services out here run both primary 911 and IFT, then Jack and Jill may very well be sent anyways by the primary 911 system. It definitely can't be worse than the low volume volly systems where you can have the same "OMG, what do I do" in experience reaction. Additionally, and for better or worse, out here many of the IFT EMTs are better than the 911 EMTs at handling medical calls because we aren't reliant on the fire medic umbilical cord to make decisions.

Personally, would I feel comfortable running a double shooting? Probably. Would I feel comfortable running a multicar TC? At this point no. Let me run a few as a primary unit, though, and I imagine I'd get it down pretty quickly. On the other hand, let me throw the average 911 EMT who's reliant on the fire medic into a nursing home with a strange DNR situation or the pulmonary edema patient who's been sitting in distress for a half an hour before anyone was even called and watch them try to make a coherent decision on whether to transport or call for paramedics and I'm willing to bet they aren't nearly as smooth as I was in those calls after I got a minimal amount of experience.

Of course, if all the ambulance crew does is freak out and transport, it's better than having the patient sit on scene because no one is available. At least the patient will, relatively quickly out here, reach the ED where an appropriate level of care can finally be established. I'm not a huge fan of the proverbial "diesel bolus," but it's better than nothing. Nothing is what the overloaded EMS system who refuses to ask for help is offering them.

and you don't see them calling private fire trucks when the 1st due areas are tied up right? ever wonder why? and there are career FDs that will call other stations in their department from further away before they call their neighbor department for a fire. happens all the time.

If you want to make all 911 EMS municipal, then that's a separate argument than this. Private, non-industrial fire departments are rare, and in the places that have them I hope to God that the municipal services won't think twice about enlisting their help when they need them.

Municipal services who would rather risk their citizen's lives than call for the fire department next door is insane, stupid, and dangerous. Granted, the urban situation in So. Cal. is somewhat unique compared to other areas. There are 8 cities in this map screen (Tustin, Santa Ana, Garden Grove, Huntington Beach, Costa Mesa, Westminister, Irvine, Fountain Valley) which makes up the north half of the county I grew up in. The cities range from geographically small (60k people, 9 sq miles) to several hundred thousand people. Try to draw the political boundaries.

I use this to show that often the only way to tell you left one city and entered another is a little sign saying, "Welcome to ____." There's no reason not to pool resources. There's no reason for the city of 60k to have an air/light unit, USAR team, technical rescue team, etc when mutual aid can easily cover for these units. Similarly, if a neighboring city needs additional fire units for a structure fire, the closest unit will be sent regardless of agency. This isn't because the home agency is out of units, but because it's the height of lunacy to ignore the unit 2 miles away and call for the one 6 miles away simply because of a geographical border.

Of course maybe So. Cal. realizes that it's about the citizens and not agency pride. I happy I've never been in an area so politically malignant that they would put their pride over the health and safety of their citizens. Sure, we have our fun out here between "Drop Me in the Pacific," the "Care Bears," "Another Moron Responds," and "The Lynch Squad," but I'll be damned if I don't access the resources I need for my patient because those resources may come in a different colored ambulance and wearing a different color uniform.

 

[Tigger]

Boston may do that, I don't know. I always thought Boston EMS handled all EMS in Boston, I never knew they handled overflow.

and you are wrong about FDNY. completely wrong. FDNY covers parts of the city, the voluntary ambulances cover other parts. it's not a case of if FDNY is tied up, they call for help. Plus, both FDNY and the voluntary ambulances use the same medical command and have the same protocols, and only certain companies are permitted to participate in the FDNY system. there are quite a few IFT companies in NYC that don't do 911, don't get dispatched to 911 jobs, and will never be part of the EMS system (outside of an MCI situation like 9/11 when every available ambulance will be called).

and FDNY is far from a high quality well run and well managed EMS system. very far from it.

I assure you that this is how the Boston system works. I am not conjecturing, I work in it. If that's how the FDNY system works then I agree with your assessment of how well run the system is. That seems absurd that FDNY refuses to even make an effort to cover parts of the city. It's not like people living in areas served by the hospitals don't pay taxes or something right?

judging from some of the horror stories I have heard on here, and the reason for the limited protocol and scope, I would probably disagree. I can, and I can also see the reasons not being what you are thinking. Aside from the whole "staff enough units to handle the routine call volume" argument that i have been making for years.

I imagine the same horror stories exist in all 50 states, CA just seems to have a disproportionately loud (and negative) voice, especially on this site.

If only 1 department runs EMS, than you have control over the system. you know everyone has the same training level, same protocols,and same equipment. you know everyone passed the same competancy tests to be on the ambulance. an agency knows everyone has valid certificates, were trained in house the same way (regarding city operations and navigating the city, etc). Once you start involving agencies where you DON'T have control over what equipment they are bringing in, or what training they have, the host agency and citizen can expect one level of service, and get something vastly different. heck, can the private companies even communicate directly with dispatch, or do they need to go through the IFT dispatcher or call 911?

I'm not sure I understand, the state (at least here) mandates that everyone pass the same minimum training standard and that all ambulances carry the same minimum equipment. On paper, there is no difference in getting a private BLS ambulance and a city BLS ambulance.

Here in Boston we can communicate directly with Boston EMS if need be, all of our radios have Boston Ambulance Mutual Aid (BAMA) channel on them, and our dispatch has a dedicated BAMA radio. Generally though we have no need to talk to Boston EMS dispatch. If all the city trucks are busy Boston EMS requests an ambulance over the BAMA channel, and the private dispatcher will dispatch his unit to the call and notify Boston EMS dispatch. This is done for both ALS and BLS calls. At that point, it's now a private ambulance call and if additional help is needed (lift assist or ALS), it usually comes from the company that took the call. If the company has no medics available, their dispatcher can request Boston EMS ALS.

If we are calling any local ambulance service, you don't know who you are getting. Can you imagine sending Jack and Jill, two EMTs who typically do dialysis runs, and send them into a double shooting?
and you don't see them calling private fire trucks when the 1st due areas are tied up right? ever wonder why? and there are career FDs that will call other stations in their department from further away before they call their neighbor department for a fire. happens all the time.

You don't see fire departments requesting private fire departments for mutual aid because they don't exist in a significant quantity. The privatized fire service is tiny compared to private EMS.

At the company I work at I do mostly non-emergent stuff. It's not my favorite but I appreciate a paycheck every now and again. And though a generous 15% of my runs are "emergencies," that doesn't mean I can't handle myself, and most of my coworkers are in the same boat. Our uniforms and trucks might not be as cool as Boston EMS's and we sure don't carry handcuffs, but at the end of the day being an EMT is just not that difficult of a job. Everyone's scope is so limited that if I ran on a double shooting I'd be doing the same thing that any "911" EMT does, taking the patient to the hospital without delay. You act like somehow private EMS have no idea how EMS on the streets work, which is absurd. Everyone knows the goal is to get the patient to the hospital, it doesn't take being a grizzled veteran to know that.

Of course, if all the ambulance crew does is freak out and transport, it's better than having the patient sit on scene because no one is available. At least the patient will, relatively quickly out here, reach the ED where an appropriate level of care can finally be established. I'm not a huge fan of the proverbial "diesel bolus," but it's better than nothing. Nothing is what the overloaded EMS system who refuses to ask for help is offering them.

This is the crux my argument. There are not that many ways for a BLS crew to completely screw up a call, but even if they do the patient is still getting to the hospital.

 

[Bullets]

I can't imagine a system saying, "Sorry, but you're going to have to wait simply because we don't want to ask for help from one of the many ambulance services in the local area by developing backup contracts and mutual aid."

Because not everyone has the same standard of care or staffing requirements. Woodbridge EMS covers 100k people and runs about 10-12k jobs a year. They dont call mutual aid, they page their volunteers who respond and take one of their 8 bls units. Unless its and MCI, they can handle their town.

You also have to understand that not everyone is the same. NJ doesnt have a required ammount of EMT's on a truck. My home squad was getting mutual aid from an adjacent town, we require 2 EMT's as a township rule, but our mutual aid squad, Unbenkownst to us, would send a truck with a driver and a EMT or a driver and a First Responder, or even just 2 guys who know CPR and nothing else. That ended quickly


Question for those talking about hospitals going on bypass...What happens if you ignore the bypass and bring your patient in anyway? They cant refuse treatment, i would have rolled that CPR in and told them tough, start compressions

That seems absurd that FDNY refuses to even make an effort to cover parts of the city. It's not like people living in areas served by the hospitals don't pay taxes or something right?

You also have to understand the geography of NYC. in parts of brooklyn and queens they are so far from a FDNY post or house that responding a EMS unit is not cost effective or practical for the volume of calls generated in that area. There are still volunteer FD in NYC, some are even officially called VFDNY and cover the Rockaways and Breezy Point out past JFK airport

 

[JPINFV]

Because not everyone has the same standard of care or staffing requirements. Woodbridge EMS covers 100k people and runs about 10-12k jobs a year. They dont call mutual aid, they page their volunteers who respond and take one of their 8 bls units. Unless its and MCI, they can handle their town.

You also have to understand that not everyone is the same. NJ doesnt have a required ammount of EMT's on a truck. My home squad was getting mutual aid from an adjacent town, we require 2 EMT's as a township rule, but our mutual aid squad, Unbenkownst to us, would send a truck with a driver and a EMT or a driver and a First Responder, or even just 2 guys who know CPR and nothing else. That ended quickly

1. In the rest of the civilized world that doesn't kowtow to the First Aid [grade?] Council, sending an ambulance to an emergency call without appropriate staffing is unthinkable. In any place of any sort of actual population, sending an ambulance without at least 2 EMTs (or higher) is unthinkable. You aren't, for example, going to find an ambulance in Boston without 2 EMTs. You aren't, for example, going to find an ambulance in Southern California without at least 2 EMTs. Extrapolating the inability of NJ to require appropriate staffing levels to other states is like extrapolating the level of intelligence and ability of the average paramedic in California.

2. As you said, there's a reason you don't have that mutual aid contract anymore.

Question for those talking about hospitals going on bypass...What happens if you ignore the bypass and bring your patient in anyway? They cant refuse treatment, i would have rolled that CPR in and told them tough, start compressions

How many times do you do that before you start facing licensing issues? Sure, the hospital can't refuse care under EMTALA, but that isn't going to stop the state EMS office/authority from yanking your EMS license. So I guess the question is, how much is your job worth?

You also have to understand the geography of NYC. in parts of brooklyn and queens they are so far from a FDNY post or house that responding a EMS unit is not cost effective or practical for the volume of calls generated in that area. There are still volunteer FD in NYC, some are even officially called VFDNY and cover the Rockaways and Breezy Point out past JFK airport

I hope the people in those areas that FDNY considers "too hard" to provide services for don't pay taxes to support the FDNY.

 

[Veneficus]

How many times do you do that before you start facing licensing issues? Sure, the hospital can't refuse care under EMTALA, but that isn't going to stop the state EMS office/authority from yanking your EMS license. So I guess the question is, how much is your job worth?

The question is:

"why are you doing that at all?"

CPR in a truck is not only minimally if effective at all, it is exceedingky dangerous for the benefit of a corpse.

The hospital divert is a complex issue. Beyond the scope of EMS to influence.

There simply are not enough hospitals to meet America's healthcare needs. Nor enough providers.

So in commercial interest, it is kept that way by a variety of self serving forces who masquerade as being benevolent that simply are not.

The people in the hospital I know usually have to fight admin for divert status. They don't do it to skip out on work, they do it because they can no longer provide effective care to those they have. (by that time optimal care fell by the wayside some time ago)

When you ignore the welfare of many patients over excitement genrated over a corpse or on a good day, one unstable patient, you are not demonstating the ability and knowledge of a professional.

If you cannot manage 1 patient in any condition to the next available resource, then your ability is insufficent.

What if said "nearest" hospital was closed for another reason? Would you go anyway?

Divert is the hospital term for: We can't help, go somewhere who can. (in the interest of all patients, including yours)

If that is too much for people at your agency, then, your agency sucks.

I hope the people in those areas that FDNY considers "too hard" to provide services for don't pay taxes to support the FDNY.

The power of state monopoly and propaganda. Amazing isn't it?

 

[DrParasite]

How many times do you do that before you start facing licensing issues? Sure, the hospital can't refuse care under EMTALA, but that isn't going to stop the state EMS office/authority from yanking your EMS license. So I guess the question is, how much is your job worth?

I've taken patients to hospitals on divert before. usually it's because the patient is insisting on going there. But I have brought a cardiac arrest to the closest hospital, or the closest ALS provider, because they were sick and needed an ER and not a field provider.

Never once did I have to worry about my license being yanked, nor would I ever worry about losing my job for doing it.

 

[JPINFV]

Most diversion policies that I've seen have allowed a patient to override the diversion for home hospital requests since, generally, the patient would find their way there when all is said and done anyways. Additionally, there's a difference between an isolated occurance and a pattern. I imagine if EMTs and paramedics started just blatantly ignoring diversion status, then bad things would start to happen.

 

[Handsome Robb]

We have certain parameters that allow to ignore them divert or bypass status unless it's divert because of internal hospital disaster.

-Pt choice
-Trauma
-Cardiac arrest if they arrest en route unless its traumatic in origin.
-Inability to obtain an airway/Airway obstruction.
-Severe shock
-Imminent delivery with abnormal presentation.
-Uncontrolled hemorrhage

 

[Outbac1]

The longest I've waited is 4 - 5 hrs at the big hosp. in the city(2hrs away). At our local hosp. the worst was 1 hr. usually only a few minutes. It all depends on the triage score of the patient and how busy they are. Some of the city medics have spent their entire shifts in line with low priorty pts. Sometimes pts will get handed off to other crews who will look after two or three pts in line. This allows other crews to go back out, get another pt and come back to get in line again.
Of course when the city gets busy it then pulls crews in from other nearby areas to cover the shortfall of avalible crews. In our system which covers the whole province any empty unit is an available unit. So it doesn't matter that I am based out of a town 2hrs away. If I have dropped off my transfer pt and don't have one to take back I'm considered an avalible unit. If the city is busy I get held for coverage. This we lovingly refer to as "getting sucked into the vortex". Once in it can be hard to get out. The dispatchers do try to get you out if they can but "Murphy" is always present.
Like Sun about 02:45 we were just on the edge of the city on our way home and calls started dropping one after the other. We got sucked in. Ended with us doing a 2 pt MVC on the other side of the city as we were the closest unit. Cleared the hosp at 5am. Shift end was at 6am so got an hr of OT.
Whoopee livin the dream.

 

[Tigger]

You also have to understand the geography of NYC. in parts of brooklyn and queens they are so far from a FDNY post or house that responding a EMS unit is not cost effective or practical for the volume of calls generated in that area. There are still volunteer FD in NYC, some are even officially called VFDNY and cover the Rockaways and Breezy Point out past JFK airport

Nonetheless, FDNY is still the primary EMS provider even in areas served by volunteer companies. My understanding of the volunteer EMS outfits is that they are no longer dispatched by FDNY and buff calls. Event though these neighborhoods are far from FDNY units, they are still served by FDNY.

I'm thinking more about neighborhoods served by hospital based EMS. If FDNY is not covering those areas period, those neighborhoods should be getting a tax break (in theory) as the the municipality is failing to provide a service. In this case it has nothing to do with call volume, as clearly there is enough population to justify the existence of a hospital.

 

[DesertMedic66]

Had a new experience today while "holding the wall".

We got the patient a room. However there were no beds left. So we were inside the room with the patient on our gurney as the doctor walks in and starts doing his assessment on the patient. Then X-ray comes and does the X-ray while the patient is still on the gurney.

 

[Joe]

Hahaha that sucks! Atleast they are putting the pt first but still sucks for you guys

 

[DrParasite]

Most diversion policies that I've seen have allowed a patient to override the diversion for home hospital requests since, generally, the patient would find their way there when all is said and done anyways. Additionally, there's a difference between an isolated occurance and a pattern. I imagine if EMTs and paramedics started just blatantly ignoring diversion status, then bad things would start to happen.

you would imagine wrong, but that's ok. diverts are a courtesy that EMS is trying to provide to the hospital; it doesn't HAVE to be followed.

We have certain parameters that allow to ignore them divert or bypass status unless it's divert because of internal hospital disaster.

-Pt choice
-Trauma
-Cardiac arrest if they arrest en route unless its traumatic in origin.
-Inability to obtain an airway/Airway obstruction.
-Severe shock
-Imminent delivery with abnormal presentation.
-Uncontrolled hemorrhage

although we don't have it written down, those are pretty much the reasons we can go to a hospital on divert (the most common being patient choice).

Had a new experience today while "holding the wall".

We got the patient a room. However there were no beds left. So we were inside the room with the patient on our gurney as the doctor walks in and starts doing his assessment on the patient. Then X-ray comes and does the X-ray while the patient is still on the gurney.

We brought in a diabetic once with no ALS avail and a BGL of around 14. the ER nurse started the IV, pushed d50, and started pushing flush after flush to try to get the patient to wake up while still on our cot. after the 3rd flush, he said to put the patient in a bed (the patient also accidentally overdosed on their narcotic pain meds). a little narcan later, and the patient was awake and talking. I was told later that the ER was not able to do anything while the patient is on our cot, but I wasn't going to argue if it helped out patient and preventing his him going into cardiac arrest from hypoglycemia.

taking the x-ray, on the other hand, would have gotten me to call the charge nurse and get a bed, because that seems a little absurd.

 

[JPINFV]

you would imagine wrong, but that's ok. diverts are a courtesy that EMS is trying to provide to the hospital; it doesn't HAVE to be followed.

The same could be said with everything else in the policy and protocol book, which makes any discussion of policies outright asinine. However, please post policies that says, "Hey guys, this entire thing? Yea, it's just a request. Feel free to ignore it just because, you know, you don't want to drive to another hospital." Hell, a DNR is just a request, why not just ignore every DNR that meets criteria because, hey, it's just a request no one is going to physically stop you.

although we don't have it written down, those are pretty much the reasons we can go to a hospital on divert (the most common being patient choice).

Didn't you just say it's just a request? Why even have reasons to begin with. If it's just a request, couldn't you just say, "We came here because we wanted to. You know... save the company gas money and put less miles on the ambulance."

I was told later that the ER was not able to do anything while the patient is on our cot, but I wasn't going to argue if it helped out patient and preventing his him going into cardiac arrest from hypoglycemia.

What are you going to do to stop the hospital from treating someone on your gurney anyways?

taking the x-ray, on the other hand, would have gotten me to call the charge nurse and get a bed, because that seems a little absurd.

Why draw the line there? So they don't have a bed ready now, everything else gets delayed instead of getting imaging studies and labs cooking?

 

[Handsome Robb]

Had a new experience today while "holding the wall".

We got the patient a room. However there were no beds left. So we were inside the room with the patient on our gurney as the doctor walks in and starts doing his assessment on the patient. Then X-ray comes and does the X-ray while the patient is still on the gurney.

That's pretty much what happened with our narcan guy I was talking about. We ended up in a room on our cot using the hospital's meds, however my partner and I were still providing care not hospital staff.

"oh there's a crash cart here...hey there's narcan in it!"

After they took over care while we were getting ready to leave. "oh btw that crash cart needs two bristojets of narcan replaced... "

Charge nurse "really guys?!?"