# Do not ever bring the stretcher up more than one or two steps.



## abckidsmom (Oct 19, 2011)

Use some other means of carrying the patient down to the stretcher.  That is all.

Do you have an always or never statement that applies to EMS?


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## dixie_flatline (Oct 19, 2011)

abckidsmom said:


> Use some other means of carrying the patient down to the stretcher.  That is all.
> 
> Do you have an always or never statement that applies to EMS?



Never drop a baby, but if you do, always fake a seizure.


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## JeffDHMC (Oct 19, 2011)

^^^ Best advice ever.


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## JPINFV (Oct 19, 2011)

Edit:

Ok... always remember to disconnect the O2 from the ambulance before removing the patient.


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## Sasha (Oct 19, 2011)

Always make sure the jp drains arent open BEFORE you move the patient.

NEVER forget to burp the colostomy before helping to change it. 

Sent from LuLu using Tapatalk


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## MasterIntubator (Oct 19, 2011)

Never 'assume' your truck is good to go when you arrive after someones shift.


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## Anjel (Oct 19, 2011)

Never say Never


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## Handsome Robb (Oct 19, 2011)

MasterIntubator said:


> Never 'assume' your truck is good to go when you arrive after someones shift.



I'm spoiled. VSTs stock our trucks. Everything is checked and all compartments are snap-tied shut by them, if the tie is broken they know they need to check and restock the compartment  They are really, really good at what they do.

Our bags are our responsibility, though.


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## Jon (Oct 19, 2011)

Anjel1030 said:


> Never say Never



Too true.

I disagree with the first comment. Especially if additional hands are available, there's nothing wrong with carrying 4,5,6 steps. Depends on the situation. It's easier with an old-school litter, rather than one of these fancy power ones.


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## Handsome Robb (Oct 19, 2011)

Jon said:


> Too true.
> 
> I disagree with the first comment. Especially if additional hands are available, there's nothing wrong with carrying 4,5,6 steps. Depends on the situation. It's easier with an old-school litter, rather than one of these fancy power ones.



Agreed on situation dependent comment. We have the Stryker power pros, I love 'em but they are heavy. If its only 5-6 steps and fire is with us we usually bring the stretcher. If it's just my partner and myself anything more than 3 usually gets a stair chair, unless they are a small patient.

Stryker stair chair with the tracks


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## Sasha (Oct 19, 2011)

NVRob said:


> Agreed on situation dependent comment. We have the Stryker power pros, I love 'em but they are heavy. If its only 5-6 steps and fire is with us we usually bring the stretcher. If it's just my partner and myself anything more than 3 usually gets a stair chair, unless they are a small patient.
> 
> Stryker stair chair with the tracks



So much jealousy right now. 

Sent from LuLu using Tapatalk


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## Sasha (Oct 19, 2011)

Whoops wrong thread 

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## Handsome Robb (Oct 19, 2011)

Sasha said:


> So much jealousy right now.
> 
> Sent from LuLu using Tapatalk



It's nice being able to hold a 300+ pound patient mid way down the stairs by myself just by tipping the chair back a bit.


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## Anjel (Oct 19, 2011)

I love our stryker stair chairs. 

I have taken the regular stryker stretchers up and down ten stairs. 

The guy was a vegetable and on a portable vent. The stairs were like 3ft wide. It was our only choice.


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## Handsome Robb (Oct 19, 2011)

Anjel1030 said:


> I love our stryker stair chairs.
> 
> I have taken the regular stryker stretchers up and down ten stairs.
> 
> The guy was a vegetable and on a portable vent. The stairs were like 3ft wide. It was our only choice.



Scoop stretcher?


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## Sasha (Oct 19, 2011)

NVRob said:


> Scoop stretcher?



You can't really rest a scoop stretcher on the stairs if one of you needs a second. 

Sent from LuLu using Tapatalk


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## Handsome Robb (Oct 19, 2011)

Sasha said:


> You can't really rest a scoop stretcher on the stairs if one of you needs a second.
> 
> Sent from LuLu using Tapatalk



True, but it's better than carrying the entire gurney, manual or powered.


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## Sasha (Oct 19, 2011)

I'd rather take the stretcher. Yeah its heavier but like I said if I need to take a second I could put it down half way through rather than possibly losing my grip or hurting myself. I have also seen people use the power stretches to kind if "climb" the stairs. Wore out the battery but it worked.

Sent from LuLu using Tapatalk


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## Handsome Robb (Oct 19, 2011)

Sasha said:


> I'd rather take the stretcher. Yeah its heavier but like I said if I need to take a second I could put it down half way through rather than possibly losing my grip or hurting myself. I have also seen people use the power stretches to kind if "climb" the stairs. Wore out the battery but it worked.
> 
> Sent from LuLu using Tapatalk



Touche saleswoman.


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## fast65 (Oct 19, 2011)

You guys are so lucky to have the Stryker stair chairs, half of our stair chairs are broken, and aren't really helpful anyways 


Sent from my iPhone using Tapatalk


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## mycrofft (Oct 19, 2011)

*"Always remember, and never forget..."*








...to take the BP cuff off the arm before you use that side for an IV.
...not to leave the scalpel behind in a house full of drunks and kids after a field OB delivery.
...turning off the lights with the engine shut off on-scene.
...check LPM on any full-face O2 mask, especially from a convalescent home.
...never use Armor-All on a bench seat.


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## Tigger (Oct 19, 2011)

Shouldn't have to be said, but always wear your seat belt.


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## Handsome Robb (Oct 19, 2011)

mycrofft said:


> ...to take the BP cuff off the arm before you use that side for an IV.



I'll argue this one. I definitely have left the BP cuff in place, inflated it, used it as a tourniquet to get an IV then removed it and placed it on the other arm. Does the same thing and distributes the pressure over a greater area which makes it more comfortable to the patient. 

I made the mistake of using Armor-All on my steering wheel once in my jeep. :facepalm:


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## Shishkabob (Oct 19, 2011)

My last partner would always try to bring the stretcher in to the house, regardless of the amount of stairs or how skinny the hallway.  I had to eventually tell him just leave the stretcher outside so we can actually MAKE it to the patient in a reasonable amount of time, so we can then decide how best to get them out, either by walking, backboard, stairchair or whatever.





Make sure you take the tourniquet OFF a patient before cursing at the IV for not flowing and DCing the IV...


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## Anjel (Oct 19, 2011)

NVRob said:


> Scoop stretcher?



we don't have those. We have a pole stretcher. But there wouldn't of been a place for the vent.


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## Handsome Robb (Oct 19, 2011)

You don't have scoops!?


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## Epi-do (Oct 19, 2011)

Linuss said:


> Make sure you take the tourniquet OFF a patient before cursing at the IV for not flowing and DCing the IV...



Reminds me of a recent run.  We had this guy in the back of the truck, and while I was getting the 12-lead hooked up, the other medic on scene started an IV.  He finishes up, we run the 12-lead and head off to the hospital.  My personal preference is to take BPs in the opposite arm as the IV, when possible.  I also like to put the pulse ox monitor on a finger on the arm that does not have the BP cuff, just because I don't want to hear the monitor beep at me for "poor perfusion" everytime I get a BP.  Well, I wasn't running any fluids at the time, so I didn't notice a problem with the line not flowing.  However, no matter how much I messed with the pulse ox, I couldn't get it to get a good reading.  I finally just put it up since we were almost to the ER and he seemed to be perfusing well.  We get to the ER, and as we are pulling the patient out of the back of the ambulance, I notice the tourniquet is still on the guy's arm.  No wonder I couldn't get the pulse ox to work.  I bet his hand was incredibly numb, but he never complained.  I popped it as soon as I noticed it, so we didn't go rolling in with it still on his arm, to be found by the nurses.

So, always double check that you removed the tourniquet after starting the IV.


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## mycrofft (Oct 19, 2011)

*Yes, NV, but you DID remove the BP cuff before USING it.*

Starting: good.
Using: bad.
Effect is sort of like an old fashioned alcohol thermometer like in front of the general store...red stripe keeps rising, and rising, and rising...


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## Handsome Robb (Oct 19, 2011)

I can't quote your topic line. I was saying get a BP, reinflate, start the line, deflate then switch to opposite arm.

I agree about BPs on the same arm as the IV from the sense of don't do it.


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## Anjel (Oct 19, 2011)

NVRob said:


> You don't have scoops!?



Nope. I really can't think of why we would need it. 

Between the pole, manual stretcher, and stair chair. We are usually good. When all else fails we blanket carry.


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## Fish (Oct 20, 2011)

dixie_flatline said:


> Never drop a baby, but if you do, always fake a seizure.



hahahahahahaha


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## 46Young (Oct 20, 2011)

Make sure the first thing you check is the O2/BVM bag and the monitor. Everything else can be faked if necessary.

(tongue in cheek, but true nonetheless...)


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## Tigger (Oct 20, 2011)

dixie_flatline said:


> Never drop a baby, but if you do, always fake a seizure.



The first thing my basic instructor told us, maybe even before introducing himself, "If you drop the baby, pick it up!"


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## DrParasite (Oct 20, 2011)

46Young said:


> Make sure the first thing you check is the O2/BVM bag and the monitor. Everything else can be faked if necessary.
> 
> (tongue in cheek, but true nonetheless...)


better add suction and backboards to the list... well that and fuel....


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## Jon (Oct 20, 2011)

Anjel1030 said:


> we don't have those. We have a pole stretcher. But there wouldn't of been a place for the vent.



Like a foldable canvas stretcher, al la M*A*S*H?


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## 46Young (Oct 20, 2011)

DrParasite said:


> better add suction and backboards to the list... well that and fuel....



"The pt wouldn't tolerate the backboard/lying flat/was combative" is how you would document. As for fuel, my position would be that the gauge was showing just under a half before we pulled out. 

I've been in several units already that have fluctuating fuel gauges, and that was actually the truth.


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## NomadicMedic (Oct 20, 2011)

*Never* pass up an opportunity to pee.


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## 46Young (Oct 20, 2011)

Always strap down or secure in brackets everything in the back. A flying IV tray, O2 bottle, pt's walker, etc. is not cool.


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## Anjel (Oct 20, 2011)

Jon said:


> Like a foldable canvas stretcher, al la M*A*S*H?



Lol yup. I love that thing.


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## Trauma_Junkie (Oct 20, 2011)

n7lxi said:


> *Never* pass up an opportunity to pee.



My medic instructor told us that the first day of class. ^_^


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## 46Young (Oct 20, 2011)

One more thing, whenever you have any kind of issue that could potentially fall back on you, make sure you advise the proper people on a taped line. For example, they want you to drive a vehicle that you report to be unsafe. Running a call when you advise missing equipment. When they give you a call when you walk in the door and don't give you time to check your vehicle. For that last one, a radio or phone advisory (not nextel) stating "document unchecked vehicle" will cover you if something's missing, and throws the onus back to the prior crew or the agency.


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## klfire (Oct 20, 2011)

good info


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## EMTswag (Oct 20, 2011)

JPINFV said:


> Edit:
> 
> Ok... always remember to disconnect the O2 from the ambulance before removing the patient.



omg i almost forgot that the other day at work. But we can translate this into "dont forget to unplug the shoreline before you peel out" also


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## mycrofft (Oct 20, 2011)

*This is like the "Murphy's Laws of EMS" we had a couple years ago.*


...Always take two slices of bread and a paper towel with a meal on duty, you might get rang (toned) out. (I finished a couple dinners on the tailboard that way). Two slices of pizza equals that.
...Never assume an obtunded or non-English patient said/means "Yes" or No". Ask again but requiring a negative or specific response. ("DO you hurt?"  "No". "Where do you hurt?" "No".) :unsure: 
...Don't ever release the catch AND the frame of the ambulance litter without giving it a little shake while still supporting the weight.
...Don't ever start action on your co-worker's direction before the sentence is over. (Lot of difference between "Pull the release catch ..." and "Pull the release catch, _*when I say 'three'  "*_h34r.


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## Sasha (Oct 20, 2011)

n7lxi said:


> *Never* pass up an opportunity to pee.



Always make an opportunity to pee before your long distance transport.

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## abckidsmom (Oct 20, 2011)

46Young said:


> One more thing, whenever you have any kind of issue that could potentially fall back on you, make sure you advise the proper people on a taped line. For example, they want you to drive a vehicle that you report to be unsafe. Running a call when you advise missing equipment. When they give you a call when you walk in the door and don't give you time to check your vehicle. For that last one, a radio or phone advisory (not nextel) stating "document unchecked vehicle" will cover you if something's missing, and throws the onus back to the prior crew or the agency.



Always follow up with an email when you have an official conversation with a boss.  Paper trail, very important.


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## 46Young (Oct 20, 2011)

abckidsmom said:


> Always follow up with an email when you have an official conversation with a boss.  Paper trail, very important.



Copy that!


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## abckidsmom (Oct 20, 2011)

46Young said:


> Copy that!



Right, I wasn't saying it to you, your post just reminded me.


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## Shishkabob (Oct 20, 2011)

abckidsmom said:


> Always follow up with an email when you have an official conversation with a boss.  Paper trail, very important.



Dealing with that from my previous provider as of now.  I didn't print a hard copy of my email that I no longer have access to, so that's going to bite me in the rear if I look for a new job...


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## STXmedic (Oct 20, 2011)

All patients lie.

*mumbles* stupid :censored::censored::censored::censored::censored:...


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## Nerd13 (Oct 20, 2011)

n7lxi said:


> *Never* pass up an opportunity to pee.



Winner! I know this rule and I still did it today... 

NEVER give ANY medication without asking for allergies. (okay, that was kind of a gimmie)

NEVER assume that your can correctly inform you of their medical history. 
I.E. Have you ever had any heart problems? "No!" Until they tell you about their stents when you ask about surgeries.


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## usalsfyre (Oct 20, 2011)

Nerd13 said:


> NEVER give ANY medication without asking for allergies. (okay, that was kind of a gimmie)


Errrr, I've done this often. Midaz for seizures and psychotic breaks, naloxone to opiate overdoses, fentanyl, etomidate and rocc or suxs for unconscious RSIs, ACLS drugs to every cardiac arrest I've ever run, calcium for hyperkalemia...the list is long. Not really a good "never".


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## Handsome Robb (Oct 20, 2011)

Linuss said:


> Dealing with that from my previous provider as of now.  I didn't print a hard copy of my email that I no longer have access to, so that's going to bite me in the rear if I look for a new job...



Just a thought, my agency's IT department saves email records for 7 years from the work email accounts. Might be worth a shot to ask?


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## Shishkabob (Oct 20, 2011)

NVRob said:


> Just a thought, my agency's IT department saves email records for 7 years from the work email accounts. Might be worth a shot to ask?



Not if they refuse to let you get the email as to 'prove' their side.


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## Handsome Robb (Oct 20, 2011)

Linuss said:


> Not if they refuse to let you get the email as to 'prove' their side.



Yea, I thought about that after I posted it and was too lazy to edit :unsure:

I mean worst case scenario if it did come back to bite you, you could look to the legal system for a court order but thats an extreme. 

Adding on to the never pass up an opportunity to pee. Never pass up an opportunity to snag a cup of coffee. Adding on to that, never come to work without a travel cup, it keeps the heat in 

All of the above only apply if your a coffee drinker haha


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## Fish (Oct 20, 2011)

Never decide now is a good time to take a stinky load, when you are the only Ambulance Available in the City


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## para344 (Oct 21, 2011)

Always be polite to the dispatcher...

Always remember that "Our Lady of Assumption" is the mother of all fcuk-ups...

Never forget that you haven't seen it all...  yet


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## firetender (Oct 21, 2011)

NEVER cut the umbilical cord of the baby you just delivered until AFTER you've placed one clamp, squeezed blood out of the umbilicus, and then clamped again an inch or so away. 

If you forget that, just get in to the habit of slicing the umbilical cord pointed toward your partner.


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## STXmedic (Oct 21, 2011)

firetender said:


> If you forget that, just get in to the habit of slicing the umbilical cord pointed toward your partner.


I'm more likely to remember this part...


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## EMSrush (Oct 21, 2011)

NEVER believe the code status (Full Code/DNR) of a Pt as provided to you by a nurse at the sending facility. Always check the paperwork yourself!!


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## Nerd13 (Oct 21, 2011)

usalsfyre said:


> Errrr, I've done this often. Midaz for seizures and psychotic breaks, naloxone to opiate overdoses, fentanyl, etomidate and rocc or suxs for unconscious RSIs, ACLS drugs to every cardiac arrest I've ever run, calcium for hyperkalemia...the list is long. Not really a good "never".



Of course there are patients that are unable to answer you but in general if they can answer it's a really fantastic idea to ask.


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## the_negro_puppy (Oct 21, 2011)

If you have to go number 2's always do so before clearing hospital. Otherwise Murphies law states you will get a a code 1 (code 3?) while you are dropping the kids off at the pool.


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## wandering_idiot (Oct 22, 2011)

the_negro_puppy said:


> If you have to go number 2's always do so before clearing hospital. Otherwise Murphies law states you will get a a code 1 (code 3?) while you are dropping the kids off at the pool.



SEVEN Pages and NOW someone decides to mention Murphy?  WTF is wrong with you people?  He should have been mentioned back around posting #3...


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## MSDeltaFlt (Oct 23, 2011)

Never say Never.  Never say always.

Never get caught with your pants down.  (Be prepared for anything and everything)


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## mycrofft (Oct 23, 2011)

*Ahem, WanderingIdiot, see reply #44. Where were you, Charlie?*

In fact, see my statistics for threads stated back in 2009 or so...


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## MSDeltaFlt (Oct 23, 2011)

Invest in yourself. Sleep when you can. Eat when you can. Pee when you can. And, yes, poop when you can. Because there will be moments when you can't. Noone wants to be stuck tired (about to pass out from shear exhaustion), hungry (low blood sugar), doing the pee pee dance, and/or prairie dogging.


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## DigDugDude (Oct 26, 2011)

*never*

take a set of vitals given to you by a nurse/cna/doctor. take your own ALWAYS even if they say they took them 20 seconds prior to you getting there. 

heres an exchange =

nurse : PT is hypertensive i took BP before you got here BP is 180/90
me : i took BP just now and i got 120/60 on left arm and right arm 2X
nurse : take PT to hospital they are hypertensive
me : no they arent i just took BP they are normal and AnO X3 and dont want to go.
nurse : no they are hypertensive take to hospital
me : no.

rinse and repeat.


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## Handsome Robb (Oct 26, 2011)

Alright I have to interject here.

Never trust a BP of 120/80 unless you or someone you have worked with and trust took it.


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## DigDugDude (Oct 26, 2011)

NVRob said:


> Alright I have to interject here.
> 
> Never trust a BP of 120/80 unless you or someone you have worked with and trust took it.



my opinion is if your being handed off a patient from someone else you take your own vitals period because at the end of the day its your responsibility. partners that you know and trust are one thing but if your being handed  a patient from a hospital/nursing home/another unit my point was never take their vitals as the word take your own. thats how things are in my district.


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## Handsome Robb (Oct 26, 2011)

DigDugDude said:


> my opinion is if your being handed off a patient from someone else you take your own vitals period because at the end of the day its your responsibility. partners that you know and trust are one thing but if your being handed  a patient from a hospital/nursing home/another unit my point was never take their vitals as the word take your own. thats how things are in my district.



Thats a given...we have a lot of students in our system, myself included when I'm not wearing my Intermediate pants. We also interact a lot with fire seeing as they are with us on any priority 1 or 2 call.

I'm pretty sure we are agreeing if I'm not mistaken. I won't lie, I've told more than a few EMT students to take the pressure again if they spit out 120/80 at me if its an ILS/BLS patient and I'm the attending. If the student is competent I'll let them run the show for the most part, until myself or the medic see something they miss then we will bump them in the right direction.


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## Hellsbells (Feb 18, 2012)

> Never 'assume' your truck is good to go when you arrive after someones shift.



Very good one. On one occasion, I few years back I came on for a night shift. The days crew said "no need to check the truck, we didn't have any calls today." Like an idiot I took him at his word, went inside to eat supper, get called out of town for a man with chest pain, I open the doors to collect the strecher for my partner, but the strecher is not there. 

It turns out they did transfer a neonate in an isolete to the airport, but had to take out our strecher, because the hospital had thier own that fit with their equipment, then they forgot to pick it up again later.


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## NomadicMedic (Feb 18, 2012)

Never revive a thread that's been dead for months...


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## the_negro_puppy (Feb 18, 2012)




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## Anonymous (Feb 18, 2012)

dixie_flatline said:


> Never drop a baby, but if you do, always fake a seizure.



:rofl:


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## Tigger (Feb 18, 2012)

Hellsbells said:


> Very good one. On one occasion, I few years back I came on for a night shift. The days crew said "no need to check the truck, we didn't have any calls today." Like an idiot I took him at his word, went inside to eat supper, get called out of town for a man with chest pain, I open the doors to collect the strecher for my partner, but the strecher is not there.
> 
> It turns out they did transfer a neonate in an isolete to the airport, but had to take out our strecher, because the hospital had thier own that fit with their equipment, then they forgot to pick it up again later.



So then the question is, what did you do next?

A similar thing happened last month, an offgoing dispatcher onsited an MVC a block from the base. He called 911 and then called our dispatch and asked them to send one of our trucks out given the location. Another dispatcher and an oncoming EMT grabbed a truck at random out of the garage and took off, failing to note that the stretcher was left next to the truck after some preventative maintenance. They were a little embarrassed when the city showed up and asked why they didn't just transport.


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## Hellsbells (Feb 18, 2012)

We were luckly, I don;t remember what the pts specific problem was, but we were able to walk him to the ambulance and have him sit in the airway chair. When we arrived at the hospital our strecher was sitting in the bay where the previous crew left it. 

Needless to say I never neglect a complete unit check anymore.


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## Handsome Robb (Feb 18, 2012)

the_negro_puppy said:


>



I love it.


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## JPINFV (Feb 18, 2012)

Disregard. This is what I get for thinking that captioned pictures only belong in the directionless thread.


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## Commonsavage (Feb 19, 2012)

Always listen respectfully to your patient.  Never believe what they say.


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## Tigger (Feb 19, 2012)

Hellsbells said:


> We were luckly, I don;t remember what the pts specific problem was, but we were able to walk him to the ambulance and have him sit in the airway chair. When we arrived at the hospital our strecher was sitting in the bay where the previous crew left it.
> 
> Needless to say I never neglect a complete unit check anymore.



I'm sure there were some red faces too.


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