the 100% directionless thread

[CCCSD]

Ageed. Does make me curious as to why California thinks they have jurisdiction on federal property, though.

Newsome et al.

 

[Tigger]

Not the same but somewhat interesting, DOD is also telling our local installations that they need to follow some sort of nationwide DOD set of guidelines. Fort Carson really set the standard for awesome guidelines in our region so it would be a shame to see that happen. Also the private companies that the Air Force contracts with would have to use these instead of our (much better) and universal county guidelines.

 

[VentMonkey]

Shout out to all my fellow dad’s out there. Happy Pappy’s Day.

 

[NomadicMedic]

Shout out to all my fellow dad’s out there. Happy Pappy’s Day.

Back atcha.

 

[fm_emt]

Ageed. Does make me curious as to why California thinks they have jurisdiction on federal property, though.

They're splitting hairs with it. It's about using an off-facility resource (a local hospital) as medical control. The LEMSA is saying that the second an ambulance or provider leaves the wire, they have to be under *their* protocols and credentialing and so on. There's a whole list of reasons why I think it's unnecessary and is causing more problems than it's solving. Unfortunately, it's been like this for a long time and nobody has ever looked into why it is this way, only accepting the fact that it "has always been this way." even though it shouldn't be.

 

[ffemt8978]

Note to self: when fishing in Florida Everglades, don't forget the sunscreen and a chair. Lol

Other than that, 90 minutes of fishing without a single catch still beat working 10 hours.

 

[Jim37F]

 

[fm_emt]

Not the same but somewhat interesting, DOD is also telling our local installations that they need to follow some sort of nationwide DOD set of guidelines. Fort Carson really set the standard for awesome guidelines in our region so it would be a shame to see that happen. Also the private companies that the Air Force contracts with would have to use these instead of our (much better) and universal county guidelines.

woah, this is actually *very* interesting to me and may be really helpful helpful. Could you please PM me more info?

 

[CCCSD]

Not the same but somewhat interesting, DOD is also telling our local installations that they need to follow some sort of nationwide DOD set of guidelines. Fort Carson really set the standard for awesome guidelines in our region so it would be a shame to see that happen. Also the private companies that the Air Force contracts with would have to use these instead of our (much better) and universal county guidelines.

I’m confused. FT Carson has awesome guidelines and yet yours are better?

 

[Tigger]

I’m confused. FT Carson has awesome guidelines and yet yours are better?

Fort Carson has great guidelines, better than the county. The Air Force contractors currently use our county guidelines which are still quite good and of greater scope than what the DOD is pushing.

 

[luke_31]

Fort Carson has great guidelines, better than the county. The Air Force contractors currently use our county guidelines which are still quite good and of greater scope than what the DOD is pushing.

The protocols being pushed by DOD were poorly written and made by docs who didn’t understand what paramedics especially do, are trained in, or how a prehospital response is. I actually know one of the paramedic advisors for the protocols and he raised lots of issues but was struck down in pretty much all of them. It’s another case of the ARMY flight medics thinking they know more than what their civilian counterparts know and then selling themselves as better to the docs who wrote the protocols. It’s very entertaining reading the protocols as it basically puts paramedics who aren’t critical care paramedics as almost a functional equivalent to advanced EMTs just with more drugs to utilize. Our medical director has us continuing to use our protocols since the new ones put out don’t make much sense and are too limiting in his opinion.

 

[Tigger]

The protocols being pushed by DOD were poorly written and made by docs who didn’t understand what paramedics especially do, are trained in, or how a prehospital response is. I actually know one of the paramedic advisors for the protocols and he raised lots of issues but was struck down in pretty much all of them. It’s another case of the ARMY flight medics thinking they know more than what their civilian counterparts know and then selling themselves as better to the docs who wrote the protocols. It’s very entertaining reading the protocols as it basically puts paramedics who aren’t critical care paramedics as almost a functional equivalent to advanced EMTs just with more drugs to utilize. Our medical director has us continuing to use our protocols since the new ones put out don’t make much sense and are too limiting in his opinion.

I appreciate the background. The local military hospital’s medical director was quite disappointed but she didn’t have time for the full backstory.

 

[luke_31]

I appreciate the background. The local military hospital’s medical director was quite disappointed but she didn’t have time for the full backstory.

You’re welcome.

 

[Akulahawk]

Are any of you *very* familiar with California's Title 22? Specifically, how it relates to Federal properties?

Interesting situation. A friend at a DoD facility said that they want to use DoD protocols but the local LEMSA is telling them that they cannot, and they have to use *their* protocols instead. This is confusing, and I have been unable to find solid answers as to how a local county agency can tell a Federal installation that they have to use local protocols.

That Federal Installation may have an agreement in place with the LEMSA that extends the local EMS policies/protocols onto that installation. That establishes a "concurrent jurisdiction" that allows this to occur. In the absence of such an agreement, if transport is initiated on the installation, with a destination somewhere outside the installation, it should be treated exactly as if transport was initiated in one LEMSA area with a destination in another... the crew follows the protocols/policies where the transport was initiated. Same happens for those rare transports across state lines because the closest appropriate facility is literally in another state. Now should an EMS unit be brought onto the installation for transport, they'd follow their protocols and not DoD, as it's effectively a mutual aid situation.

 

[Akulahawk]

Newsom et al.

That explains a lot... including things beyond EMS wrt California's issues...

 

[RocketMedic]

The protocols being pushed by DOD were poorly written and made by docs who didn’t understand what paramedics especially do, are trained in, or how a prehospital response is. I actually know one of the paramedic advisors for the protocols and he raised lots of issues but was struck down in pretty much all of them. It’s another case of the ARMY flight medics thinking they know more than what their civilian counterparts know and then selling themselves as better to the docs who wrote the protocols. It’s very entertaining reading the protocols as it basically puts paramedics who aren’t critical care paramedics as almost a functional equivalent to advanced EMTs just with more drugs to utilize. Our medical director has us continuing to use our protocols since the new ones put out don’t make much sense and are too limiting in his opinion.

As I foresaw when the Army and DoD started this “everyone important should be a critical care flight paramedic” monster off 10+ years ago, without ensuring any sort of relevant prehospital experience or adjusting for contextual factors…

It’s frustrating because these look to be the product of an exclusive little enclave of smart people trying to apply specialized lessons learned to an environment and situation that has very little to do with what they are familiar with, but lacking the humility and self-awareness to understand that. Obvious issues with scale, sustainment and application were probably blunted with a CA-inspired “just take it away from them”, to the detriment of patients.

Here’s a link I found, but I’d be interested in the official thing:

https://jts.health.mil/assets/docs/cpgs/Standard_Medical_Operating_Guidelines_(SMOG)_for_Critical_Care_Flight_Paramedics_2022.pdf

 

[luke_31]

As I foresaw when the Army and DoD started this “everyone important should be a critical care flight paramedic” monster off 10+ years ago, without ensuring any sort of relevant prehospital experience or adjusting for contextual factors…

It’s frustrating because these look to be the product of an exclusive little enclave of smart people trying to apply specialized lessons learned to an environment and situation that has very little to do with what they are familiar with, but lacking the humility and self-awareness to understand that. Obvious issues with scale, sustainment and application were probably blunted with a CA-inspired “just take it away from them”, to the detriment of patients.

Here’s a link I found, but I’d be interested in the official thing:

https://jts.health.mil/assets/docs/cpgs/Standard_Medical_Operating_Guidelines_(SMOG)_for_Critical_Care_Flight_Paramedics_2022.pdf

Yup and reading all the names of the ones who wrote the protocols it was entertaining to see how much the Air Force dominated the project.

 

[Jim37F]

Waking up on my off day, open FB amd see the local news posting a story about a "Police Investigation" on a street in my Station's first in area... and the picture showing multiple SWAT trucks parked and fire and EMS units staged...

Guess the guys tomorrow morning are gonna have a good story to tell!

 

[CCCSD]

Waking up on my off day, open FB amd see the local news posting a story about a "Police Investigation" on a street in my Station's first in area... and the picture showing multiple SWAT trucks parked and fire and EMS units staged...

Guess the guys tomorrow morning are gonna have a good story to tell!

Or…that promotion is YOURS!

Believe!!

 

[fm_emt]

That Federal Installation may have an agreement in place with the LEMSA that extends the local EMS policies/protocols onto that installation. That establishes a "concurrent jurisdiction" that allows this to occur. In the absence of such an agreement, if transport is initiated on the installation, with a destination somewhere outside the installation, it should be treated exactly as if transport was initiated in one LEMSA area with a destination in another... the crew follows the protocols/policies where the transport was initiated. Same happens for those rare transports across state lines because the closest appropriate facility is literally in another state. Now should an EMS unit be brought onto the installation for transport, they'd follow their protocols and not DoD, as it's effectively a mutual aid situation.

I think that's how we're trying to get them to treat us, and what you said makes sense. No state line issues at this one, fortunately, just a couple different receiving hospitals. Apparently someone at the LEMSA was trying to say that the hospitals will refuse to accept patients from here unless we followed their (LEMSA) rules, which makes no sense at all. (The hospital staff also said no, that's not the case either, and they take patients from anywhere.)