# Divert?



## Summit (Jun 12, 2005)

10-50 3pts in rig.
"Let's go that clinic A" (15 miles, closer to trauma center, 80 miles)
"No, they are closed on weekends."
"Great! Then the other one" (15 miles, opposite direction from trauma center)

Radio:
"Clinic B, Ambulance, blah blah inbound with 3pts, details" (1red 2 green)
"Ambulance, negative, we have 2pts at the clinic, divert to clinic C" (50 miles away, opposite direction of trauma center)
"Clinic, I don't think so. You have five beds and we will be there in ten minutes, ambulance out."


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## Chimpie (Jun 13, 2005)

LOL


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## rescuecpt (Jun 13, 2005)

Um, what is this clinic thing of which you speak, and where so that I may avoid being in an area that doesn't have hospitals....


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## MedicPrincess (Jun 13, 2005)

CLINIC??? Tell me can't just drop patients off at the nearest "clinic"?

'Round here, it has to be an Emergency Room for an ambulance to drop off at.  Even if they pass 5 Urgent Cares/2 Redi-Meds, and umpteen Dr Offices/Clinics on they way.


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## TTLWHKR (Jun 13, 2005)

The town I grew up in had a doc in the box (urgent care). They would accept ambulance reports over the CB radio, I always tapped in. Now this was extreme rural Montana, so it was nothing odd. When the treated the patient, if they didn't die first, the US Forest Service would airlift them to a Trauma Center somewhere near Missoula. 

The thing was, the area was only popular four or five months out of the year. So the DITB was only open May-Sept.


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## rescuecpt (Jun 13, 2005)

I hate the Doc-in-the-boxes around here.  They're putzes.  We pick up a lot of people from there, and expect the doc to be able to give us history and interventions - nooooo it's always "um, i think she's having a heart attack, no, i don't know her history.  no, i didn't do anything for her."  Sheesh.


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## Jon (Jun 13, 2005)

> _Originally posted by rescuecpt_@Jun 13 2005, 05:23 PM
> * I hate the Doc-in-the-boxes around here.  They're putzes.  We pick up a lot of people from there, and expect the doc to be able to give us history and interventions - nooooo it's always "um, i think she's having a heart attack, no, i don't know her history.  no, i didn't do anything for her."  Sheesh. *


 Ummm... isn't "MONA" taught in medical school too? At least the ASA and O2 part?


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## Summit (Jun 13, 2005)

the clinics are our usual destination. they call themselves "medical centers" with "EDs" (usually 2-3 beds, x-ray, insta-lab (tox, treponin, hematocrit), 1 family practice DO or a rentaMD, 1-2 RNs, a tech). they are the infamous "trauma level IV" whatever the heck that means (no OR no surgeons, not even an emergency medicine doctor)

the nearest "real" hospital would be that trauma center 70-80 miles away.


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## vtemti (Jun 18, 2005)

> _Originally posted by Summit_@Jun 13 2005, 07:33 PM
> * they call themselves "medical centers" *


 We never tx to the local "Family Medical Center". They always call us when the s*@t hits the fan and they can't handle the situation.


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## CodeSurfer (Jun 19, 2005)

Yeah, the call where they have the PT on NRB at 3 LPM because their protocol is they cant give more than 3 lpm to any patient. :angry:


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## usafmedic45 (Jun 19, 2005)

I worked as a respiratory therapist what I would classify as a Level IV Trauma Center when I was doing temporary medical staffing. They were technically supposed to (and I repeat) SUPPOSED to have a doctor in house, but often times the ER doc (actually an FP doc) could found at the same hotel I was staying at, asleep unless there was a patient that "urgently" needed his attention.  The docs would be there for shift change, then leave after an hour if there weren't any patients and go back to sleep.  We would have to call them and tell to come in if something bad was coming in.  Of course, if you ask the hospital there's a doctor on the premises 24-7.  Yeah, right.  :lol:   Heck, I slept most of the nights I worked, all night, on the bed in the "trauma" room.

The nursing staff was made up almost entirely of 'travelers' (temporary staffing agency personnel like myself) so no one was real familiar with the hospital, the only RNs that worked technically directly for the hospital were the house supervisors and maybe a couple others out of the entire hospital.

On at least four occasions during the month I worked there (boy was I glad to get out of there) we had patients crash and/or code and we called the doc in and even after they arrived they just let me (as the RT) run things because they couldn't remember ACLS protocols, etc.     :blink:   Same went for when we had a patient who needed to be intubated or vented- "Hey Dr. -------, what do you want for vent settings?"  Response: "Why are you asking me? You're the RT, you tell me what they need."  

One night one of the docs told the RN's before he left (and I quote) "If anything bad happens, listen to him until I get here" (points at me).  Of course then we had a code come in (a drive up nonetheless) so I got to play ER doc- reminds me again why I want to become a dentist and not an MD- until the doc finally got back to the hospital about 30 minutes later.  By this time, the patient had received at least 6 or 7 rounds of epi, was maxed out on lidocaine, had received amiodarone, had been defibrillated at least 5 times and was in an agonal rhythm- for which we gave two doses of atropine and were trying to pace.  Doc walks in, looks at me, goes "How's he doing?"  :blink:  :unsure: "Great doc."  I told him what we had done and that we had seen no improvement, so he goes, "Well then why are you still working on him? Why haven't you pronounced him?"  Apparently he didn't realize that none of us could legally do that.


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## vtemti (Jun 19, 2005)

> _Originally posted by CodeSurfer_@Jun 19 2005, 01:05 AM
> * Yeah, the call where they have the PT on NRB at 3 LPM because their protocol is they cant give more than 3 lpm to any patient. :angry: *


 They are lucky if they get that. Many times the patient gets O2 because they came with thier own.


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## Jon (Jun 19, 2005)

> _Originally posted by CodeSurfer_@Jun 19 2005, 01:05 AM
> * Yeah, the call where they have the PT on NRB at 3 LPM because their protocol is they cant give more than 3 lpm to any patient. :angry: *


 Isn't that a nursing home thing???


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## Jon (Jun 19, 2005)

> _Originally posted by usafmedic45_@Jun 19 2005, 01:32 AM
> * On at least four occasions during the month I worked there (boy was I glad to get out of there) we had patients crash and/or code and we called the doc in and even after they arrived they just let me (as the RT) run things because they couldn't remember ACLS protocols, etc.     :blink:   Same went for when we had a patient who needed to be intubated or vented- "Hey Dr. -------, what do you want for vent settings?"  Response: "Why are you asking me? You're the RT, you tell me what they need."
> *


 I've had some situations like this in my clinicals..... Watching interns try to talk a 3rd year medical student through a rapid trauma assessment..... In the trauma bay... with someone that was obviously trauma-alert criteria....

Jon


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## TTLWHKR (Jun 19, 2005)

> _Originally posted by MedicStudentJon_@Jun 19 2005, 11:20 AM
> *
> I've had some situations like this in my clinicals..... Watching interns try to talk a 3rd year medical student through a rapid trauma assessment..... In the trauma bay... with someone that was obviously trauma-alert criteria....
> 
> Jon *


 It's like putting together a toy.

Connect tube A to tube B, put tube C into tube D, Put tube E into Hole one... etc etc.  :blink:


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## CodeSurfer (Jun 20, 2005)

> _Originally posted by vtemti+Jun 19 2005, 10:06 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (vtemti @ Jun 19 2005, 10:06 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-CodeSurfer_@Jun 19 2005, 01:05 AM
> * Yeah, the call where they have the PT on NRB at 3 LPM because their protocol is they cant give more than 3 lpm to any patient. :angry: *


They are lucky if they get that. Many times the patient gets O2 because they came with thier own. [/b][/quote]
 Yeah. I got one today and I really wish I had an O2 sat. Because I bet she was sat'ing at 75 max, it would be nice to know what it actually was.  But, treat the patient, not the machine (esp. if you dont have it). Put her up to 5Lpm's and she seemed to pink up a bit.


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## CodeSurfer (Jun 20, 2005)

via N/C just so you dont think I'm completely incompetent


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## vtemti (Jun 20, 2005)

> _Originally posted by CodeSurfer_@Jun 20 2005, 01:43 AM
> * via N/C just so you dont think I'm completely incompetent *


 Nah............Would we think that? 

We might though, pick up on it and run.  :lol:


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## PArescueEMT (Jun 21, 2005)

> _Originally posted by vtemti+Jun 20 2005, 12:03 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (vtemti @ Jun 20 2005, 12:03 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-CodeSurfer_@Jun 20 2005, 01:43 AM
> * via N/C just so you dont think I'm completely incompetent *


Nah............Would we think that? 

We might though, pick up on it and run.  :lol: [/b][/quote]
 but then again... we might just run with this...


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## TTLWHKR (Jun 21, 2005)

> _Originally posted by PArescueEMT+Jun 21 2005, 03:16 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (PArescueEMT @ Jun 21 2005, 03:16 AM)</td></tr><tr><td id='QUOTE'>
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but then again... we might just run with this... [/b][/quote]
 I knew a woman once who would put trauma patients on 25LPM via Nasal Cannula; so she didn't have to return to base for restocking.. i.e. if she didn't have any masks, etc.


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## CodeSurfer (Jun 22, 2005)

> _Originally posted by TTLWHKR+Jun 21 2005, 12:03 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (TTLWHKR @ Jun 21 2005, 12:03 PM)</td></tr><tr><td id='QUOTE'>
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I knew a woman once who would put trauma patients on 25LPM via Nasal Cannula; so she didn't have to return to base for restocking.. i.e. if she didn't have any masks, etc. [/b][/quote]
 Haha, I wonder what it feels like to be on 25lmp N/C?

Lets try it out on someone...


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## MedicPrincess (Jun 22, 2005)

I vote for Jon to be our Test Pig...


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## Jon (Jun 22, 2005)

Hey!


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## MedicPrincess (Jun 22, 2005)

OH...OOOPSS!! I meant for that to say  GUINNEA PIG!!


HAHA  :lol:   :lol:  :lol:  :lol:  :lol:


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## Jon (Jun 22, 2005)

Still!


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## MedicPrincess (Jun 22, 2005)

Would you rather be the test Chicken??  At least Guinnea Pigs are all squishy and loveable and cute....


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## TTLWHKR (Jun 22, 2005)

> _Originally posted by EMTPrincess_@Jun 22 2005, 03:05 PM
> * Would you rather be the test Chicken?? At least Guinnea Pigs are all squishy and loveable and cute.... *


I quote "Don't squeeze the charmin"


DON'T SQUEEZE THE BABY MEDIC!

You may break him.. Baby medics are *nearly extinct.

Too many FOG medics are taking on the career.

FOG: Pronoun: Fvcking Old Guy.


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## PArescueEMT (Jun 23, 2005)

> _Originally posted by EMTPrincess_@Jun 22 2005, 10:10 AM
> * I vote for Jon to be our Test Pig... *


 I second the Emotion... erm... i mean motion


All in favor say "Aye"

All opposed say "Nay"


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## TTLWHKR (Jun 23, 2005)

> _Originally posted by EMTPrincess_@Jun 22 2005, 03:01 PM
> * OH...OOOPSS!! I meant for that to say  GUINNEA PIG!!
> 
> 
> HAHA  :lol:   :lol:  :lol:  :lol:  :lol: *


 I picture him as more of a rabbit, than a pig.


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## PArescueEMT (Jun 23, 2005)

whkr... you were supposed to vote here...


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## TTLWHKR (Jun 23, 2005)

> _Originally posted by PArescueEMT_@Jun 23 2005, 06:13 PM
> * whkr... you were supposed to vote here... *


 Oh, I missed that.

Nay.


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## usafmedic45 (Jun 24, 2005)

> _Originally posted by EMTPrincess_@Jun 22 2005, 03:05 PM
> * Would you rather be the test Chicken??  At least Guinnea Pigs are all squishy and loveable and cute.... *


 Introducing Jon's new hit single:
http://www.albinoblacksheep.com/flash/guineapig


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## TTLWHKR (Jun 24, 2005)

> _Originally posted by usafmedic45+Jun 24 2005, 12:41 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (usafmedic45 @ Jun 24 2005, 12:41 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-EMTPrincess_@Jun 22 2005, 03:05 PM
> * Would you rather be the test Chicken?? At least Guinnea Pigs are all squishy and loveable and cute.... *


Introducing Jon's new hit single:
http://www.albinoblacksheep.com/flash/guineapig [/b][/quote]
 Doesn't look like him.  :blink:


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## vtemti (Jun 24, 2005)

> _Originally posted by EMTPrincess_@Jun 22 2005, 04:05 PM
> * Would you rather be the test Chicken??  At least Guinnea Pigs are all squishy and loveable and cute.... *


 and bigger nostrils. It would be hard to get an NC into a chicken. Besides, I can imagine that 25 LPM up there would feel like the shuttle was taking off. So Jon needs the biggest possible.


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## CodeSurfer (Jun 24, 2005)

> _Originally posted by vtemti+Jun 24 2005, 12:01 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (vtemti @ Jun 24 2005, 12:01 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-EMTPrincess_@Jun 22 2005, 04:05 PM
> * Would you rather be the test Chicken?? At least Guinnea Pigs are all squishy and loveable and cute.... *


and bigger nostrils. It would be hard to get an NC into a chicken. Besides, I can imagine that 25 LPM up there would feel like the shuttle was taking off. So Jon needs the biggest possible. [/b][/quote]
 Or we could use him as is... human I assume.


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## vtemti (Jun 25, 2005)

> _Originally posted by CodeSurfer+Jun 24 2005, 06:16 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (CodeSurfer @ Jun 24 2005, 06:16 PM)</td></tr><tr><td id='QUOTE'>
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Or we could use him as is... human I assume.  [/b][/quote]
 Haven't quite figured that one out!!!!!! :unsure:


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## Jon (Jun 25, 2005)

> _Originally posted by TTLWHKR+Jun 23 2005, 01:42 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (TTLWHKR @ Jun 23 2005, 01:42 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-EMTPrincess_@Jun 22 2005, 03:01 PM
> * OH...OOOPSS!! I meant for that to say GUINNEA PIG!!
> 
> 
> HAHA :lol:  :lol: :lol: :lol: :lol: *


I picture him as more of a rabbit, than a pig. [/b][/quote]
 Yeah..... I could be Thumper, from Bambi.... A "Real" CPR Thumper...

(Ok... So it was Steve Berry's line.... Sorry)


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## PArescueEMT (Jun 25, 2005)

> _Originally posted by MedicStudentJon_@Jun 25 2005, 11:25 AM
> * Yeah..... I could be Thumper, from Bambi.... A "Real" CPR Thumper...
> 
> (Ok... So it was Steve Berry's line.... Sorry) *


 wow... is there anything he doesn't tie steve berry into?

now i think everybody except jon needs practice with the defib... I go first... h34r:


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## PArescueEMT (Jun 25, 2005)

> _Originally posted by TTLWHKR+Jun 24 2005, 12:00 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (TTLWHKR @ Jun 24 2005, 12:00 PM)</td></tr><tr><td id='QUOTE'>
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Doesn't look like him.  :blink: [/b][/quote]
yeah... not enough hair or...

but the other male dimention is too large from what i've heard.


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## CodeSurfer (Jun 26, 2005)

> _Originally posted by PArescueEMT+Jun 25 2005, 10:51 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (PArescueEMT @ Jun 25 2005, 10:51 AM)</td></tr><tr><td id='QUOTE'>
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yeah... not enough hair or...

but the other male dimention is too large from what i've heard. [/b][/quote]
 that was a homo-statement.


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## ipscscott (Jul 2, 2005)

> _Originally posted by usafmedic45_@Jun 24 2005, 12:41 AM
> *Introducing Jon's new hit single:
> http://www.albinoblacksheep.com/flash/guineapig*


Ok, not to rehash here, but am I the *ONLY* one who found that *TRULY*  disturbing???  
I've seen some scary things, but that tops just about all.  
I think I'm going to have nightmares.  

Wait, a minute, none of you were bothered by that.  Maybe THAT is the scary part! :blink:


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## usafmedic45 (Jul 3, 2005)

It bothered me.....that's why I posted it.  :lol:


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## Jon (Jul 5, 2005)

oh... that is disturbing.


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## Wingnut (Jul 5, 2005)

> _Originally posted by usafmedic45_@Jun 24 2005, 12:41 AM
> *
> Introducing Jon's new hit single:
> http://www.albinoblacksheep.com/flash/guineapig *


 WTF was that!?


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