# BLS questions



## LifeSaver (Mar 14, 2011)

1. Is the gurney a hard enough surface to perform CPR? 

2. When transporting code 3 which entrance to the hospital do you use? the emergency entrance or ambulance entrance?


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## Anjel (Mar 14, 2011)

LifeSaver said:


> 1. Is the gurney a hard enough surface to perform CPR?
> 
> 2. When transporting code 3 which entrance to the hospital do you use? the emergency entrance or ambulance entrance?



1. Yes. A backboard underneath is even better. 

2. You always just pull up to the ambulance bay if they have one. I'm pretty sure all hospitals do.


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## usafmedic45 (Mar 14, 2011)

> 2. When transporting code 3 which entrance to the hospital do you use? the emergency entrance or ambulance entrance?



Are you serious?  Who the hell failed to train you or did they simply issue you your card after your check cleared?


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## Anjel (Mar 14, 2011)

usafmedic45 said:


> Are you serious?  Who the hell failed to train you or did they simply issue you your card after your check cleared?



lol that's not nice. Funny. But not nice. 

But yea I kinda wondered the same thing.


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## lightsandsirens5 (Mar 14, 2011)

Yea, the gurney will work. Having them on a LSB is better for movement to and from the gurney and/or the hospital bed.

Yes you use the Amb Entrance. :unsure: Do you have a system that operates differently? In my area, every pt, code green, yellow and red all go through the Anb entrance. If triaged out at the ER, they get wheeled out through the waiting room doors and left there. But we never enter the hospital through the main entrance.


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## LifeSaver (Mar 14, 2011)

usafmedic45 said:


> Are you serious?  Who the hell failed to train you or did they simply issue you your card after your check cleared?



woah calm down man.. I just recently got hired. Starting my orientation next week. I was in the hospital recently and saw two entrance signs. Just an honest question before I get involved 

Thanks for your response Anjel


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## usafmedic45 (Mar 14, 2011)

No need to calm down.  I'm not upset.  I'm just stunned by how clueless you've painted yourself to be.  I don't get upset easily but I also don't hesitate to be blunt.  It's something of a rarity unfortunately because if we stopped coddling marginal students and providers then we probably would have far fewer problems in this trade than we currently face.

Back to your original question:  Riddle me this Batman, but during your clinicals did you ever push the cot with an unstable patient heading for the ED through anything but the ambulance entrance?


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## LifeSaver (Mar 14, 2011)

usafmedic45 said:


> No need to calm down.  I'm not upset.  I'm just stunned by how clueless you've painted yourself to be.  I don't get upset easily but I also don't hesitate to be blunt.  It's something of a rarity unfortunately because if we stopped coddling marginal students and providers then we probably would have far fewer problems in this trade than we currently face.
> 
> Back to your original question:  Riddle me this Batman, but during your clinicals did you ever push the cot with an unstable patient heading for the ED through anything but the ambulance entrance?



There's the problem I did not have clinicals included in my accelerated program.. only one shift of ride along


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## usafmedic45 (Mar 14, 2011)

LifeSaver said:


> There's the problem I did not have clinicals included in my accelerated program.. only one shift of ride along


Like I said....who the hell gave you your credentials as soon as the check cleared?


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## lightsandsirens5 (Mar 14, 2011)

LifeSaver said:


> There's the problem I did not have clinicals included in my accelerated program.. only one shift of ride along



Oh wow....really? That just doesn't sound right? How do they expect you to get pt contact? :unsure:


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## Anjel (Mar 14, 2011)

lightsandsirens5 said:


> Oh wow....really? That just doesn't sound right? How do they expect you to get pt contact? :unsure:



wow. I had to do 60 hours of clinicals for basic. And 120 this semester. 

Did they have tests in this program? Skills? I'm assuming you had to pass practicals? so you must know what you are doing in that aspect. 

No clinicals. Hmm... That does not sound good.


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## MrBrown (Mar 14, 2011)

Transporting a code? The transport of non ROSC primary cardiac arrests is a dangerous practice offering little to no benefit in return for disproportinate risk.

Just sayin ....


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## Shishkabob (Mar 14, 2011)

LifeSaver said:


> my accelerated program..



And theres the issue.   Do yourself and your future patients a favor and do a real school. 


Ps, you said you did a ride along, so usafs question still stands.   Or was it at a station with no calls?


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## usafmedic45 (Mar 14, 2011)

MrBrown said:


> Transporting a code? The transport of non ROSC primary cardiac arrests is a dangerous practice offering little to no benefit in return for disproportinate risk.
> 
> Just sayin ....



Point taken, but here "code 3" is just a way of saying "transporting with lights and sirens".   In many cases, it does not even imply the patient is definitely unstable.


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## lightsandsirens5 (Mar 14, 2011)

Anjel1030 said:


> wow. I had to do 60 hours of clinicals for basic. And 120 this semester.
> 
> Did they have tests in this program? Skills? I'm assuming you had to pass practicals? so you must know what you are doing in that aspect.
> 
> No clinicals. Hmm... That does not sound good.



Yea.....I did 24 hours in the ER, at least 120 on shift with the ambulance. I think we had to have like 20 or 30 pt contacts is what it was....something like that. If you got it done in less time, good for you. If it took more time, (like me) then you put in more time.


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## JPINFV (Mar 14, 2011)

usafmedic45 said:


> Point taken, but here "code 3" is just a way of saying "transporting with lights and sirens".   In many cases, it does not even imply the patient is definitely unstable.



BUT IF WE DON'T GO CODE 3 WE'RE GOING TO MISS RESCUE ME!

See... there are other, more important things going on!


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## traumahawk (Mar 14, 2011)

usafmedic45 said:


> No need to calm down.  I'm not upset.  I'm just stunned by how clueless you've painted yourself to be.  I don't get upset easily but I also don't hesitate to be blunt.  It's something of a rarity unfortunately because if we stopped coddling marginal students and providers then we probably would have far fewer problems in this trade than we currently face.
> 
> Back to your original question:  Riddle me this Batman, but during your clinicals did you ever push the cot with an unstable patient heading for the ED through anything but the ambulance entrance?



 No need to be rude and use a batman joke lol. The lad was just asking a simple question. Now instead of being on a medic power trip, address the real issues. One you can not teach common sense. Two. the BLS system in most states is broken. People come out of EMT school with no real knowlege. In NJ where i work, some EMT classes turn out great EMTs rite off the bat. And some turn out ones who need people to hold their hands.

 Now he only had one ride along. You cant grasp anything in one ride along. Mabye in a busy system but even then, not likely.


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## ffemt8978 (Mar 14, 2011)

This thread has now attracted my attention.







Play nice.


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## Veneficus (Mar 14, 2011)

Linuss said:


> And theres the issue.   Do yourself and your future patients a favor and do a real school.


 
I agree you may be better served by perhaps retaking the course at a more reputable institution.

I would like to point out however, as I stated in another thread, there is considerable education and training in EMS that falls on the shoulders of the employer and requires considerable time to master.

I think this is one of those cases.

It is impossible to turn out knowledgable and proficent providers from a broken system.


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## DesertMedic66 (Mar 14, 2011)

for my EMT class we only had to do 4 shifts of 12 hours. in other words 48 hours. and nothing was ever mentioned about which entrance to use. its just something that they expect you to pick up or know already. if we were running emergency calls then we would use the ambulance entrance regardless of the what the call was for. for BLS/IFT transports we would use the main entrance to the hospital.


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## traumahawk (Mar 14, 2011)

Veneficus said:


> I agree you may be better served by perhaps retaking the course at a more reputable institution.
> 
> I would like to point out however, as I stated in another thread, there is considerable education and training in EMS that falls on the shoulders of the employer and requires considerable time to master.
> 
> ...



I agree. The agency i work for i am one of the persons in charge of Q&A as well as training our new BLS providers and it does take time. It really comes down to the person. Can they learn and are they willing to learn?


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## Anjel (Mar 14, 2011)

firefite said:


> for BLS/IFT transports we would use the main entrance to the hospital.



Really? I don't think so. But maybe it's different where you are. 

I don't wanna take sick grandpa hacking up a lung through the main entrance into the ambulance to take him back to hospice. 

It's a separate entrance for a reason.


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## DesertMedic66 (Mar 14, 2011)

Anjel1030 said:


> Really? I don't think so. But maybe it's different where you are.
> 
> I don't wanna take sick grandpa hacking up a lung through the main entrance into the ambulance to take him back to hospice.
> 
> It's a separate entrance for a reason.



the guy got out of surgery for cancer in his jaw and he also had a stroke. he was in an observation room. we transported him from that hospital to a non-emergency hospital for recovery.


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## JPINFV (Mar 14, 2011)

Anjel1030 said:


> Really? I don't think so. But maybe it's different where you are.
> 
> I don't wanna take sick grandpa hacking up a lung through the main entrance into the ambulance to take him back to hospice.
> 
> It's a separate entrance for a reason.



That's why when one of my local hospital built a new tower, they built a dedicated exit and parking area specifically for discharges. However, that tower, while connected, was not near the ED.

Also, why would I want to take my relatively not sick, but somewhat immunocompromised patient through the ED where they can be exposed to all sorts of critters in patients who haven't had treatment started yet?


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## usafmedic45 (Mar 14, 2011)

> for BLS/IFT transports we would use the main entrance to the hospital.



In 15 years and visits to 100+ hospitals and more states than I care to count (as well as several other countries), I've never encountered that.  We've always gone through the ED ambulance bay or a secondary ambulance specific entrance.


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## Amycus (Mar 15, 2011)

Well, in the OP's defense, and no, I didn't read every post in here...

In this area, a Code 3 is the reverse of what it is to many. A Code 3 is a low-priority, non-life threatening, no lights/sirens transport. The basic BLS/IFT run for grandma who has a fever or such. I've seen hospitals with two entrances, so I can understand the OP's confusion


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## johnmedic (Mar 15, 2011)

firefite said:


> the guy got out of surgery for cancer in his jaw and he also had a stroke. he was in an observation room. we transported him from that hospital to a non-emergency hospital for recovery.



There's your answer. You didn't take him to the ER. In ER's (ED's) you go through the ambulance entrance yes?

Even those patients with toothaches who call 911 because the bus schedule "just doesn't work" for them, we bring them in through the Ambulance Entrance.. then past the doctors nurses & rooms, past the patients, to the clipboard at Triage.


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## DesertMedic66 (Mar 15, 2011)

johnmedic said:


> There's your answer. You didn't take him to the ER. In ER's (ED's) you go through the ambulance entrance yes?
> 
> Even those patients with toothaches who call 911 because the bus schedule "just doesn't work" for them, we bring them in through the Ambulance Entrance.. then past the doctors nurses & rooms, past the patients, to the clipboard at Triage.



Yeah. If they call 911 then it's automatic they go thru the ER. If it's just a basic transport then it depends on where the patient is located in the hospital and the crews decision as to how to exit the hospital.


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## WolfmanHarris (Mar 15, 2011)

Anjel1030 said:


> Really? I don't think so. But maybe it's different where you are.
> 
> I don't wanna take sick grandpa hacking up a lung through the main entrance into the ambulance to take him back to hospice.
> 
> It's a separate entrance for a reason.



Here we're kinda prejudice, only EMS gets to use the Ambulance garages at the hospitals. Since the IFT industry isn't part of EMS (in Ontario; though EMS does some IFT's and quite a lot in some extremely rural or remote areas) and don't do transfers into the ED, they have to park in a separate area and go through the main entrance. With how many stable discharge IFT's that can be going on at one time they could easily tie up the bay at emerg all day.


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## Anjel (Mar 15, 2011)

WolfmanHarris said:


> Here we're kinda prejudice, only EMS gets to use the Ambulance garages at the hospitals. Since the IFT industry isn't part of EMS (in Ontario; though EMS does some IFT's and quite a lot in some extremely rural or remote areas) and don't do transfers into the ED, they have to park in a separate area and go through the main entrance. With how many stable discharge IFT's that can be going on at one time they could easily tie up the bay at emerg all day.



Here we still go through the ER for a transport. Even if they are located on the 90th floor. We may park out of the way. Our ER's don't have garage. But never the less go through the ER. 

I think the OP would been fit greatly from a few more ride a longs. And some better education. Not saying they are stupid, but a lot could of been left out in this "course"


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## exodus (Mar 15, 2011)

Even if they're a candidate for triage, they come into the ER, the admitting RN does a quick AX on them to confirm they're triagable. Then they walk into the waiting room and wait.

And 90% of the time there's some kind of staff entrance you would go through for the hospital for discharge / direct admit... Things like that will be gone over with you on your FTO days.

Btw. I did 10 hours ER, 12 ambulance for basic.


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## MEDIC802 (Mar 15, 2011)

University of Alabama Hospital in Birmingham has several entrances for ambulances, of course there is the ER/ED for 911 or nonemergency calls also can use for IFT if you chose, however you can also pull directly to the building that your IFT is going to, UAB is a large teaching hospital that covers several blocks, My hospital that I normally transport to all pt's 911 or IFT go through the ER/ED.
 I don't remember how many clinical hrs I had to do as a basic, that was way before national registry was thought of.


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## Pittma (Mar 16, 2011)

In the OP's defense, when I took my EMT course, ride time was not required...

...don't worry I still volunteered because I don't want to be the dumbass 

We were all newbies/greenhorns once. Cut him some slack. 

To the OP: As many people already said, some hospitals have different entrances and exits, depending on the type of patient. If you are a new-hire, you may want to request something like a ride-around with the field officer. You can drive from hospital-hospital within your service area, and really learn A) the differing paperwork/protocols/routines in transporting to different hospitals as well as B) learning the area pretty well. A few companies in the metro-Boston area (Cambridge, if I'm not mistaken) require this.

And to reiterate, I think CPR would be more effective on a LSB, think about it, would you want to do CPR in a bouncy palace/ball pit, or a cement floor? Note: CPR should not be needed in a ball pit. Nothing bad happens in a ball pit, and they should be noted as a place of frolicking joy.

-Nick


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## Sasha (Mar 16, 2011)

usafmedic45 said:


> No need to calm down.  I'm not upset.  I'm just stunned by how clueless you've painted yourself to be. * I don't get upset easily* but I also don't hesitate to be blunt.  It's something of a rarity unfortunately because if we stopped coddling marginal students and providers then we probably would have far fewer problems in this trade than we currently face.
> 
> Back to your original question:  Riddle me this Batman, but during your clinicals did you ever push the cot with an unstable patient heading for the ED through anything but the ambulance entrance?



Yes you do. Calm down dear, take your xanax all this anger is going to give you a heart attack. Then who would be the resident curmudgeon? Certainly not me. I'm the resident harpy.

There's a serious problem with emt classes not requiring significant clinical time.


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## Sasha (Mar 16, 2011)

Anjel1030 said:


> Here we still go through the ER for a transport. Even if they are located on the 90th floor. We may park out of the way. Our ER's don't have garage. But never the less go through the ER.
> 
> I think the OP would been fit greatly from a few more ride a longs. And some better education. Not saying they are stupid, but a lot could of been left out in this "course"



We get to go through one of the back hospital entrances. Thank god. It's a long walk from the ER to the staff elevators in some of the hospitals and I'm lazy.


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## usafmedic45 (Mar 16, 2011)

> Yes you do. Calm down dear, take your xanax all this anger is going to give you a heart attack.



There's a difference between being wordy and maybe not polite and be being flat out blood boiling angry or upset.


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## Sasha (Mar 16, 2011)

Ok, but don't say I didn't warn you when you're clutching your chest going 'Sasha, please help me!'


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## usafmedic45 (Mar 16, 2011)

Sasha said:


> Ok, but don't say I didn't warn you when you're clutching your chest going 'Sasha, please help me!'


Eh....it's all the exposure to high fat foods (gotta love having a German heritage and a love for kosher deli meats and being a cheese snob) and family history that are giving me the high likelihood of a coronary related death.


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