# First Code 3 call



## 350chevy (Dec 8, 2010)

So we're in class last night when the tones drop and LAS (the agency I'm taking my class thru) gets paged out for a motorcycle 10-50 2 miles west of town. This is only the 4th night of class so none of us were expecting to get to do anything. Right now we're working on checking vitals and pt assessment. Instructor figured it would be a good chance to get hands on in the field. We load up in one rig and 2 medics and 1 intermed go in the first due rig. We get there and rescue 1 with the medics clears the scene and gets access to the pt. We students (theres only 4 of us) pile out and take notes on what's going on. Pt is unresponsive to painful stimuli, severley intoxicated, and laying 100 feet down the road from where the motorcycle is laying in the ditch. Medics get c-spine, board, o2, load and get ready to go. Instructor picked me and 1 other kid to go with them. It was cramped to say the least. Went code 3 to the ER and made the report, cleaned out, stocked up, and headed back. Spent 2 hours talking about the call and discussing what we learned.


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## Veneficus (Dec 8, 2010)

350chevy said:


> So we're in class last night when the tones drop and LAS (the agency I'm taking my class thru) gets paged out for a motorcycle 10-50 2 miles west of town. This is only the 4th night of class so none of us were expecting to get to do anything. Right now we're working on checking vitals and pt assessment. Instructor figured it would be a good chance to get hands on in the field. We load up in one rig and 2 medics and 1 intermed go in the first due rig. We get there and rescue 1 with the medics clears the scene and gets access to the pt. We students (theres only 4 of us) pile out and take notes on what's going on. Pt is unresponsive to painful stimuli, severley intoxicated, and laying 100 feet down the road from where the motorcycle is laying in the ditch. Medics get c-spine, board, o2, load and get ready to go. Instructor picked me and 1 other kid to go with them. It was cramped to say the least. Went code 3 to the ER and made the report, cleaned out, stocked up, and headed back. Spent 2 hours talking about the call and discussing what we learned.



Was not using radio codes part of the discussion?


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## Shishkabob (Dec 8, 2010)

So, with him being unresponsive, how could you tell he was "severely intoxicated"?


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## fast65 (Dec 8, 2010)

Linuss said:


> So, with him being unresponsive, how could you tell he was "severely intoxicated"?



My thoughts exactly...btw, I wouldn't make it a habit of saying that.


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## jjesusfreak01 (Dec 8, 2010)

Linuss said:


> So, with him being unresponsive, how could you tell he was "severely intoxicated"?



Smell of alcohol on his breath, because there is nothing else that can cause that. /sarcasm


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## jrm818 (Dec 8, 2010)

It's easy to tell if you do a proper assessment.  I'm sure he looked like this:


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## GoatMan165 (Dec 8, 2010)

Veneficus said:


> Was not using radio codes part of the discussion?



But the more numbers you use, the cooler you are.  I tried speaking in binary once, but it was too overwhelming for all the people around me.


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## Chimpie (Dec 8, 2010)

*Let's keep it polite and on topic please.*


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## amberdt03 (Dec 8, 2010)

jjesusfreak01 said:


> Smell of alcohol on his breath, because there is nothing else that can cause that. /sarcasm



Have you not learned about Diabetes yet?


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## amberdt03 (Dec 8, 2010)

amberdt03 said:


> Have you not learned about Diabetes yet?



Opps sorry, just realized you put the sarcasm at the end


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## jjesusfreak01 (Dec 8, 2010)

amberdt03 said:


> Opps sorry, just realized you put the sarcasm at the end



Thats how I roll...

Ontopic...lucky the motorcycle driver wasn't worse off, those can be really nasty.


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## Shishkabob (Dec 8, 2010)

jjesusfreak01 said:


> Thats how I roll...
> 
> Ontopic...lucky the motorcycle driver wasn't worse off, those can be really nasty.




Hey now, it's not "motorcycle driver".  They are professional organ donors.


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## Bullets (Dec 8, 2010)

Apparently, some places still use radio codes? i thought that was phased out like 10 years ago?

Unless the guy had a liter of vodka in his pocket, dont be quick to make every MVC cause ETOH, i know you said you just started, but keep that in mind when you get to Diabetic Emergencies


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## Veneficus (Dec 8, 2010)

Bullets said:


> Apparently, some places still use radio codes? i thought that was phased out like 10 years ago?



Some people just never catch on.

Some have never had a large enough emergency with multiple agencies or providers from all over or different backgrounds trying to commnicate effectively either.


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## firetender (Dec 8, 2010)

Welcome to EMTlife where, green as they come, you can share your first calls and feel comfortable because you know everyone understands what it meant to be an FNG and enthused about actually experiencing something and strives to be supportive at every level!

That's on topic, ain't it?


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## reaper (Dec 8, 2010)

> Apparently, some places still use radio codes? i thought that was phased out like 10 years ago?
> 
> Unless the guy had a liter of vodka in his pocket, dont be quick to make every MVC cause ETOH, i know you said you just started, but keep that in mind when you get to Diabetic Emergencies



Don't be quick to make them intoxicated, just because they have a liter of vodka in their pocket!


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## 350chevy (Dec 8, 2010)

We are being taught ot use ten codes and the agencies around here use specialized ems codes for the type of call. And there were beer cans all around the scene and the smell was god awful. When he woke up in the rig en route to the ED he was slurring speech excessively, uncoordinated, and blew double drunk on a breathalizer at the hospital. Also one of our instructors declared him to be so.


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## Veneficus (Dec 8, 2010)

350chevy said:


> We are being taught ot use ten codes and the agencies around here use specialized ems codes for the type of call.



Maybe your instructors should spend more time looking at the FEMA and other disaster/mass casualty experiences and recommendations than what they have always done.

We need to better regulate who can be EMS instructors.


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## reaper (Dec 8, 2010)

Come on Vene, the ones that can't do, have to be able to teach! What else would they have to talk about.


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## lampnyter (Dec 8, 2010)

I thought diabetic was a fruity smelling breath.


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## Veneficus (Dec 8, 2010)

lampnyter said:


> I thought diabetic was a fruity smelling breath.



DKA is.

Hyperosmolar nonketotic coma is not.


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## GoatMan165 (Dec 8, 2010)

Did the guy crash into a pile of beer cans, or was he carrying around his empties on his bike to recycle later?


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## fast65 (Dec 8, 2010)

GoatMan165 said:


> Did the guy crash into a pile of beer cans, or was he carrying around his empties on his bike to recycle later?



My thoughts exactly, the guy was just carrying around all his empties on a motorcycle?

Either way, we DO NOT state that someone is intoxicated, it's called slander.


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## CAOX3 (Dec 8, 2010)

Well I like to jump to conclusions, so if he looks drunk, acts drunk, smells drunk, then usually their drunk.

Drunks and diabetics in me experience have a completely different smell and it should take you about 20 seconds to determine one from the other.

If the two medics and ten other people on scene are assuming he is drunk them I'm going to give them the benefit of the doubt and go with he s drunk.


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## Bullets (Dec 8, 2010)

Veneficus said:


> DKA is.
> 
> Hyperosmolar nonketotic coma is not.



Is that similar to hyperosmolar hyperglycemic nonketotic coma, Im assuming its just adding an extra word? we always use HHNKCon our charts and with nurses...


If people work in a rural system, then i guess i understand using 10 codes or whatever people use. We still use 1001 for a pronouncement, people are still funny about saying someone is dead clear text over the radio

And isnt everyone required to have ICS 100 to complete the Basic course?


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## Veneficus (Dec 8, 2010)

Bullets said:


> Is that similar to hyperosmolar hyperglycemic nonketotic coma, Im assuming its just adding an extra word? we always use HHNKCon our charts and with nurses...



It's the same, there are 3 or 4 different named and abbreviations. That is why I wrote it out.


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## the_negro_puppy (Dec 8, 2010)

CAOX3 said:


> Well I like to jump to conclusions, so if he looks drunk, acts drunk, smells drunk, then usually their drunk.
> 
> Drunks and diabetics in me experience have a completely different smell and it should take you about 20 seconds to determine one from the other.
> 
> If the two medics and ten other people on scene are assuming he is drunk them I'm going to give them the benefit of the doubt and go with he s drunk.



This. Alot of people are getting very upset that the OP stated patient was intoxicated. Not hard to determine really.


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## Shishkabob (Dec 8, 2010)

the_negro_puppy said:


> This. Alot of people are getting very upset that the OP stated patient was intoxicated. Not hard to determine really.



Until you get your *** handed to you in a court of law for documenting as such.


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## bstone (Dec 8, 2010)

What does 10-50 mean?


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## Shishkabob (Dec 8, 2010)

bstone said:


> What does 10-50 mean?



Accident, I believe.


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## abckidsmom (Dec 8, 2010)

350chevy said:


> So we're in class last night when the tones drop and LAS (the agency I'm taking my class thru) gets paged out for a motorcycle 10-50 2 miles west of town. This is only the 4th night of class so none of us were expecting to get to do anything. Right now we're working on checking vitals and pt assessment. Instructor figured it would be a good chance to get hands on in the field. We load up in one rig and 2 medics and 1 intermed go in the first due rig. We get there and rescue 1 with the medics clears the scene and gets access to the pt. We students (theres only 4 of us) pile out and take notes on what's going on. Pt is unresponsive to painful stimuli, severley intoxicated, and laying 100 feet down the road from where the motorcycle is laying in the ditch. Medics get c-spine, board, o2, load and get ready to go. Instructor picked me and 1 other kid to go with them. It was cramped to say the least. Went code 3 to the ER and made the report, cleaned out, stocked up, and headed back. Spent 2 hours talking about the call and discussing what we learned.



Congratulations on your first EMS high.  All these people have experienced the same thing, and have said stuff that wasn't correct, were over-the-top enthusiastic, and were flat out squirrelly in their time.  Don't let them trick ya, man.

Don't run away from the criticism, just note it and move on.  There are plenty more mistakes waiting for you to make them.  You will, and you should let them hit you square so you can learn the most from them.


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## firecoins (Dec 8, 2010)

Veneficus said:


> Maybe your instructors should spend more time looking at the FEMA and other disaster/mass casualty experiences and recommendations than what they have always done.
> 
> We need to better regulate who can be EMS instructors.



I can think of more important qualifications than whether they follow FEMA guidelines on using 10 codes as apart of an EMT class.


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## jjesusfreak01 (Dec 8, 2010)

firecoins said:


> I can think of more important qualifications than whether they follow FEMA guidelines on using 10 codes as apart of an EMT class.



I remember my EMS instructor explicitly telling us that we aren't supposed to use 10-codes anymore, or say stupid phrases on the radio like, "Be advised...". I heard both on my first ride-along.


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## EMT11KDL (Dec 9, 2010)

jjesusfreak01 said:


> I remember my EMS instructor explicitly telling us that we aren't supposed to use 10-codes anymore, or say stupid phrases on the radio like, "Be advised...". I heard both on my first ride-along.



our county still uses 10 codes...


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## Handsome Robb (Dec 9, 2010)

Company I did my rides with uses 10-4, 10-8, and Status 99. That is it tho the rest is all verbage.


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## fast65 (Dec 9, 2010)

The only codes that my area uses (that I can think of at least) are for their responses, i.e. alpha, bravo, charlie, delta, or echo.


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## usalsfyre (Dec 9, 2010)

CAOX3 said:


> Well I like to jump to conclusions, so if he looks drunk, acts drunk, smells drunk, then usually their drunk.
> 
> Drunks and diabetics in me experience have a completely different smell and it should take you about 20 seconds to determine one from the other.
> 
> If the two medics and ten other people on scene are assuming he is drunk them I'm going to give them the benefit of the doubt and go with he s drunk.



Ask the medics who took care of David Rosenbaum how easy it is.


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## 350chevy (Dec 9, 2010)

bstone said:


> What does 10-50 mean?



10-50 is a motor vehicle collision. 10-50 PI is persons injured, 10-50 PD is property damage. We share a freq with the county sheriff so we have to use codes that keep both agencies informed and on the same page. We're a real rural agency so we don't deal alot with urban emergencies and rarely do IFT.


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## Veneficus (Dec 9, 2010)

firecoins said:


> I can think of more important qualifications than whether they follow FEMA guidelines on using 10 codes as apart of an EMT class.



So can I, however no matter who they are, they should be aware of the current recommendations and best practices that allow interagency operations.


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## Sasha (Dec 9, 2010)

> Don't be quick to make them intoxicated, just because they have a liter of vodka in their pocket!



If he's still got a liter of vodka in his pocket he's not drunk.  Although he must have some big pockets to be carrying around a liter in them.

I find the trunk of my scooter is a great place to store my empty beer cans.


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## Sasha (Dec 9, 2010)

> 10-50 is a motor vehicle collision. 10-50 PI is persons injured, 10-50 PD is property damage. *We share a freq with the county sheriff so we have to use codes that keep both agencies informed and on the same page.* We're a real rural agency so we don't deal alot with urban emergencies and rarely do IFT.



Nothing will keep you guys on the same page like plain english radio transmissions will!


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## Sasha (Dec 9, 2010)

> All these people have experienced the same thing, and have said stuff that wasn't correct, were over-the-top enthusiastic, and were flat out squirrelly in their time



I still get squirrelly sometimes. With my last student I got to show him what a AAA felt like on our hospice patient. I nearly peed myself with excitement at that opprotunity.


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## firecoins (Dec 9, 2010)

Veneficus said:


> So can I, however no matter who they are, they should be aware of the current recommendations and best practices that allow interagency operations.



yes they should be aware of it.  Since NY state requires taking NIMS classes, they will be aware. 

Than the city of NY, in their infinite wisdom, keeps using 10 codes. I am not defending it. Of course the events of 9/11 in NYC were the cause of the FEMA recommendations.  But I digress.


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## Jay (Dec 10, 2010)

350chevy,

Congrats on what will hopefully be your first of many Code-3's, this call probably made your week as it's all new to you but was really just about average when it comes to interesting calls. I personally will pick a medical call over a trauma call any day and love having to try to figure out the why's. Some advice, first don't let these guys get to you, they are just really into EMS, that's why we are here. Second, NEVER (yes, I used CAPS) jump to conclusion on ETOH because it could be diabetic amongst other things and if you're wrong and it states that in your report, the guy can be screwed in court for no reason unless the docs in the ER got a chem test which is iffy as some docs do and some wont. Third, always try to factor in secondary issues and causes, for example, what if your Pt was hypoglycemic which caused his accident, so now he is both medical and truama... I have seen cases where a Pt had a heart attack or stroke behind the wheel and everything has to get taken into consideration. Just a few thoughts. If you have any questions, hit me up, I am always willing to help and give advice when I find time to. Good luck with your course and again a hearty congrats!!!


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