# Ideal number for a code



## ffemt8978 (Jan 10, 2005)

A comment in another thread got me thinking about this.  If you could control how many people assisted you working a full code, how many would you choose?  They can be any level of EMT's, but I'm curiious as to how you would break them down.

For me, the ideal number is four: 
1. doing compressions, 
2. using the BVM and O2 
3. to intubate/IV access/Defibrillate, 
4. and one for data recording/communications.  

(I'm restricting my answer to the level of service provided by my agency, and hope you do too.)


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## MMiz (Jan 10, 2005)

I also believe the ideal number is four.  My company also believes the ideal number is four.

An ALS call is dispatched with a minimum of 3 Paramedics (One ALS rig and a Paramedic First Responder), but may be dispatched with four (One ALS and one BLS rig).

I've never worked a cardiac call, so I can't break it down the same way, but what you described is what I've heard happens in the field.


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## PArescueEMT (Jan 10, 2005)

I say 3. 1 to pump, 1 to blow, and 1 to drive. I follow the KISS method.


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## cbdemt (Jan 10, 2005)

> _Originally posted by ffemt8978_@Jan 10 2005, 01:43 AM
> * A comment in another thread got me thinking about this.  If you could control how many people assisted you working a full code, how many would you choose?  They can be any level of EMT's, but I'm curiious as to how you would break them down.
> 
> For me, the ideal number is four:
> ...


 I agree, but just add a driver.


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## coloradoemt (Jan 10, 2005)

> _Originally posted by cbdemt_@Jan 10 2005, 08:26 AM
> *
> I agree, but just add a driver. *


 Yes this is in fact very important!!  :lol:


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## Wingnut (Jan 10, 2005)

My first code was 2 months ago and we had our usual, a medic and EMT (all our ambulances here are ALS) the medic pushed drugs, did EKG & shock, the EMT drove, I did compressions, and one of the FF's onscene rode with us and did BVM. It went very smoothly. There were probably 7 or 8 people on scene and frankly it was too much...


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## rescuecpt (Jan 10, 2005)

From my experience, I like 4 in the back, but 3 can work just as well if you combine persons 3 & 4.

1. Pump (EMT)
2. Blow (EMT)
3. Tube & Drugs (ALS)
4. IV & Monitor (ALS)

So far, that has worked the best for me.  That way, when I prepare to tube or start an IV, I have both my hands free to do that.


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## emtbuff (Jan 10, 2005)

The last code that I ran we had 3 EMTs 1 First Responder/ Driver and 1 that was a driver trainee.

We cordinated our Block to the hospital by:
1:Bagging (EMT)
2:Compressions (EMT)
3:Hooking up Defib (EMT)
4: Was the Driver and Called in report by what the EMT's were telling (First Responder)

So I like to have at least 3 in back and 1 up front.


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## Jon (Jan 10, 2005)

> _Originally posted by emtbuff_@Jan 10 2005, 03:29 PM
> * The last code that I ran we had 3 EMTs 1 First Responder/ Driver and 1 that was a driver trainee.
> 
> We cordinated our Block to the hospital by:
> ...


 I think that 3 people is the MINIMUM possible to work a code - one to pump, one to Blow, one to drive. - ALS is one of the 2 in the back - get everything done onscene. Even better, put the patent on the autovent for transport and the the ALS dosen't have to pump, too.


Ideally you should have 4 big guys on an engine Co to carry the patient to the bus from the third floor / basement - I've been part of one of these arguments before   - it is nice to have the extra manpower, but 15 or 20 folks sanding around with thumbs in *** is a bad thing.

Jon


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## Luno (Jan 11, 2005)

> *it is nice to have the extra manpower, but 15 or 20 folks sanding around with thumbs in *** is a bad thing.
> *


Wait, I thought that was how firefighters justify their salary/pension...... hehehe, professional bystanders.


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## rescuecpt (Jan 11, 2005)

> _Originally posted by Luno_@Jan 11 2005, 01:09 AM
> *
> 
> 
> ...


 Yeah, until your girly arse is trapped in a fiery house and they come drag your sorry squealing self out...


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## cbdemt (Jan 11, 2005)

> _Originally posted by rescuecpt+Jan 11 2005, 10:31 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (rescuecpt @ Jan 11 2005, 10:31 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Luno_@Jan 11 2005, 01:09 AM
> *
> 
> 
> ...


Yeah, until your girly arse is trapped in a fiery house and they come drag your sorry squealing self out... [/b][/quote]
 Ooh daaaaamn!!!! :lol:


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## coloradoemt (Jan 11, 2005)

> _Originally posted by cbdemt+Jan 11 2005, 10:43 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (cbdemt @ Jan 11 2005, 10:43 AM)</td></tr><tr><td id='QUOTE'>
> 
> 
> 
> ...


Ooh daaaaamn!!!! :lol: [/b][/quote]
 That had to hurt!!  :lol: Well maybe sting a bit...


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## Luno (Jan 11, 2005)

Ooooooooooooooohhhhhhhhhhhhh, somebody take the whip away from the little blond FF before she hurts herself  <_<  but it's not that I have a problem running away from fire, I just have a problem running towards it from a safe position.     nahnahnahnahnah naaaaaaaaaaaaaaaaaaaaaaah


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## rescuecpt (Jan 11, 2005)

Just like people who hide in the closet because it's "safe".


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## PArescueEMT (Jan 11, 2005)

Hey luke... a donut roll is NOT a new teat at Dunkin' Donuts. You may want to tread lightly with the firefighter bashing b4 we make you the trapped victem in the burn tower.

We'll save you! :lol:


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## Luno (Jan 11, 2005)

Erika, don't make me kick this door open, and *come out of the closet*, oh, wait, hey, you tricked me.

PA Dunkin' donuts?  I am most definately not a cop, but I can see how smoke effects logic.....     Actually, I'm kind of a risk junky, so I may take you up on that one, I've always wanted to see a flash over, or whatever they're called, but I don't see myself making a career out of it.  Besides, I get to the point where I just don't get the thrill anymore, so I have to look for it somewhere else.


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## cbdemt (Jan 12, 2005)

> _Originally posted by Luno_@Jan 11 2005, 11:20 PM
> * ...I've always wanted to see a flash over, or whatever they're called... *


 The first one you see will be your last!


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## rescuecpt (Jan 12, 2005)

> _Originally posted by PArescueEMT_@Jan 11 2005, 10:20 PM
> * Hey luke... a donut roll is NOT a new teat at Dunkin' Donuts. *


 I didn't know they sold TEATS at Dunkin Donuts!!!


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## rescuecpt (Jan 12, 2005)

> _Originally posted by cbdemt+Jan 12 2005, 09:27 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (cbdemt @ Jan 12 2005, 09:27 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Luno_@Jan 11 2005, 11:20 PM
> * ...I've always wanted to see a flash over, or whatever they're called... *


The first one you see will be your last! [/b][/quote]
 I've been in a flashover.  Pretty neat.  I'm not afraid to admit it was damn scary too... "crispy fried firefighters", a phrase one of my academy instructors always said, was running through my mind...

I've seen medical flashovers too.  NOT GOOD... one minute lungs clear bi-lat, next minute rales in all four lobes with expiratory wheezes.  Oops.


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## cbdemt (Jan 12, 2005)

> _Originally posted by rescuecpt+Jan 12 2005, 11:00 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (rescuecpt @ Jan 12 2005, 11:00 AM)</td></tr><tr><td id='QUOTE'>
> 
> 
> 
> ...


I've been in a flashover.  Pretty neat.  I'm not afraid to admit it was damn scary too... "crispy fried firefighters", a phrase one of my academy instructors always said, was running through my mind...

I've seen medical flashovers too.  NOT GOOD... one minute lungs clear bi-lat, next minute rales in all four lobes with expiratory wheezes.  Oops. [/b][/quote]
 So it's possible to live through a flashover?  We were told in FF1 training that if a room flashes over you're pretty much screwed.  They showed us pictures of a melted and charred pile of goo (formerly turnout gear) that was in a flashover... gives me the heebie jeebies!!!


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## Luno (Jan 12, 2005)

> *So it's possible to live through a flashover? We were told in FF1 training that if a room flashes over you're pretty much screwed. They showed us pictures of a melted and charred pile of goo (formerly turnout gear) that was in a flashover... gives me the heebie jeebies!!!*


Yeah, but think of the adrenaline dump!  I think I remember one of my FF friends (yes, I have FF friends, hence my "right" to bust on them) said they could/did duplicate that in training, but certain gear may melt.


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## MedicPrincess (Jan 12, 2005)

I was always taught at our dept. and in our FF1 classes, if a Flashover occurs everything reaches ignitions temp at the same time...even the FF who happens to be in the room...thus a flaming FF is a BAAAAAAAAAAAD thing.

Now a Rollover...now that is a whole different thing.  Often time people say they have lived through a "flashover" when in reality it was Rollover (you know, when the fire goes up the walls, across the ceiling, down the other wall, effectively surrounding you with fire).  Cool to see...scary as crap to have happen the first time....and yes, can cause some equipment to melt.

Luno- I would say what your FF friends are recreating is Rollover...not a flash.


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## tricam (Jan 12, 2005)

Luno's in the closet for an entirely different reason  h34r:


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## rescuecpt (Jan 12, 2005)

> _Originally posted by EMTPrincess_@Jan 12 2005, 02:34 PM
> * I was always taught at our dept. and in our FF1 classes, if a Flashover occurs everything reaches ignitions temp at the same time...even the FF who happens to be in the room...thus a flaming FF is a BAAAAAAAAAAAD thing.
> 
> Now a Rollover...now that is a whole different thing.  Often time people say they have lived through a "flashover" when in reality it was Rollover (you know, when the fire goes up the walls, across the ceiling, down the other wall, effectively surrounding you with fire).  Cool to see...scary as crap to have happen the first time....and yes, can cause some equipment to melt.
> ...


 Yeah, we call rollovers flashovers here... what you described as a flashover is called an "oh ****".


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## cbdemt (Jan 12, 2005)

> _Originally posted by rescuecpt+Jan 12 2005, 03:02 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (rescuecpt @ Jan 12 2005, 03:02 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-EMTPrincess_@Jan 12 2005, 02:34 PM
> * I was always taught at our dept. and in our FF1 classes, if a Flashover occurs everything reaches ignitions temp at the same time...even the FF who happens to be in the room...thus a flaming FF is a BAAAAAAAAAAAD thing.
> 
> Now a Rollover...now that is a whole different thing. Often time people say they have lived through a "flashover" when in reality it was Rollover (you know, when the fire goes up the walls, across the ceiling, down the other wall, effectively surrounding you with fire). Cool to see...scary as crap to have happen the first time....and yes, can cause some equipment to melt.
> ...


Yeah, we call rollovers flashovers here... what you described as a flashover is called an "oh ****". [/b][/quote]
 ahhhh ok... that I'll buy. 

At our last training house burn, they took those of us who had not been in a fire before into the house first.  They lit the first fire and let us watch the smoke & fire behavior.  They let it rollover, and then sent in the first attack line.  Pretty cool... little scary... quite a first experience with firefighting!


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## Wingnut (Jan 12, 2005)

You know, I have to go through the fire academy to work for our EMS system...

I was already nervous about doing that, now...I'm scared lol


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## Jon (Jan 12, 2005)

> _Originally posted by cbdemt+Jan 12 2005, 09:27 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (cbdemt @ Jan 12 2005, 09:27 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Luno_@Jan 11 2005, 11:20 PM
> * ...I've always wanted to see a flash over, or whatever they're called... *


The first one you see will be your last! [/b][/quote]
 Once, I went to a Mardi-Gras Party and there was flashing all over - is that at all similar??


Jon


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## rescuecpt (Jan 12, 2005)

> _Originally posted by cbdemt_@Jan 12 2005, 05:05 PM
> * At our last training house burn, they took those of us who had not been in a fire before into the house first.  They lit the first fire and let us watch the smoke & fire behavior.  They let it rollover, and then sent in the first attack line.  Pretty cool... little scary... quite a first experience with firefighting! *


 You didn't have to do that at the fire academy?


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## rescuecpt (Jan 12, 2005)

> _Originally posted by MedicStudentJon_@Jan 12 2005, 08:16 PM
> * Once, I went to a Mardi-Gras Party and there was flashing all over - is that at all similar?? *


 This one time, at band camp...


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## cbdemt (Jan 13, 2005)

> _Originally posted by rescuecpt+Jan 12 2005, 09:33 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (rescuecpt @ Jan 12 2005, 09:33 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-cbdemt_@Jan 12 2005, 05:05 PM
> * At our last training house burn, they took those of us who had not been in a fire before into the house first. They lit the first fire and let us watch the smoke & fire behavior. They let it rollover, and then sent in the first attack line. Pretty cool... little scary... quite a first experience with firefighting! *


You didn't have to do that at the fire academy? [/b][/quote]
 I didn’t get my FF1 through the academy; our county has a 2-day "fire school" in the summer.  Instructors from the academy come and teach Essentials of Firefighting, Smoke Behavior, Advanced Smoke & SCBA, Bus Extrication... and other stuff that I cant remember off the top of my head.  They told us from the start that we would not see ANY smoke or fire in the essentials class. (Insert your opinion here) We learned important stuff (basic SCBA, ladders, different hose lay) but I felt like something was missing.... LIKE THE FIRE! :blink:


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## rescuecpt (Jan 13, 2005)

> _Originally posted by cbdemt+Jan 13 2005, 09:32 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (cbdemt @ Jan 13 2005, 09:32 AM)</td></tr><tr><td id='QUOTE'>
> 
> 
> 
> ...


I didn’t get my FF1 through the academy; our county has a 2-day "fire school" in the summer.  Instructors from the academy come and teach Essentials of Firefighting, Smoke Behavior, Advanced Smoke & SCBA, Bus Extrication... and other stuff that I cant remember off the top of my head.  They told us from the start that we would not see ANY smoke or fire in the essentials class. (Insert your opinion here) We learned important stuff (basic SCBA, ladders, different hose lay) but I felt like something was missing.... LIKE THE FIRE! :blink: [/b][/quote]
 Y'think???


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## MedicPrincess (Jan 13, 2005)

A 2 day essentials class??? ??? ???  Wow.  We did 160 hours for our FF1, and that covered the Essentials of FF book (well most of it).

And we did get to see fire...it was part of the course.

Even still...2 days....that is really a "just the facts ma'am" kind of class, wouldn't you think?  I don't think...know I KNOW I would not have felt comfy operating ANY of the equipment after a class like that.  I would have been comfy identifying it...but operating it....nope nope.

Our ladders class alone, at our FD, is minmum 8 hours total.   Extrication classe, they are all day.  

Wow...


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## cbdemt (Jan 13, 2005)

> _Originally posted by EMTPrincess_@Jan 13 2005, 04:44 PM
> * A 2 day essentials class??? ??? ???  Wow.  We did 160 hours for our FF1, and that covered the Essentials of FF book (well most of it).
> 
> And we did get to see fire...it was part of the course.
> ...


 I agree 100%.  I DON'T feel prepared at all.  I learned a lot at our training burn, and we have monthly training that is specific to our equipment and needs.  That’s where I've gained most of my knowledge.  The 2-day essentials class is most definitely "just the facts."  Someone from our dept described it by saying "they teach you just enough to keep yourself from getting killed," and even that I'm not so sure of...:unsure:


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## Luno (Jan 13, 2005)

Hey Tricam, I wondered when you were going to post, you "silent professional" congrats on passing, I got your e-mail, I nominate you for the "Ego Sniper" award.  Anyway, congrats, and have fun with the blood and guts... I'm trying to get enough guys together to have a class with Dr. Brown, probably covering TEMS stuff inc. fluid replacement, prophylactic antibiotics, etc... in the seattle area.  He's a good guy, of course he denies it all   .  Take care of the little one, and you know the private sector awaits for pros like you.  I'm probably also going back to ITG in March for the HRE class.  

Luke


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## DFDEMS (Jan 14, 2005)

As many as I can find and they don’t even have to know what they are doing.

Just worked one, here we run 2 guys and that’s it. Handed the clipboard to the family to fill out the information while we shocked the pt, Intubated, cpr etc. My partner continues on with cpr, etc. I go get a board, load the guy up.....Have the family or bystander’s carry out some of the equipment if possible. Get in the truck; hook up the thumper and then and only then do I feel like we are actually doing something like the rest of the modern world.

The thumper is like two people who never get tired, one for compressions, one to ventilate. They say we can even log roll some one properly with only two people....


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## rescuecpt (Jan 14, 2005)

Our FF1 in Suffolk County includes:

Sessions: 19 Classroom sessions, and 8 Hands-on sessions (57 classroom hours, 24 hours hands-on, 26 hours home study, totaling 107 hours)  

This course is designed for the "recruit" firefighter. It follows the basic objectives set forth in NFPA 1001 and NFPA 1910. The program is primarily a lecture style presentation with 8 hands-on sessions. 

Subject material is presented in 3-hour segments. This 19-session course provides approximately 57 hours of classroom instruction, 24 hours of hands-on training along with 26 hours of home study totaling 107 hours of training. These lectures incorporate PowerPoint presentations and videos, and where practical, actual firefighting equipment is demonstrated. The following classes are conducted during this course. 

Session  Topic  Session  Topic  
1  Safety, FD Organization, EMS Rehabilitation  
2  PPE/SCBA    
3  Building Construction
4  Ventilation
5  Fire Behavior, Extinguishers 
6  Forcible Entry, Search, Rescue    
7  Ladders, Sprinklers, Fire Alarms
8  Hose Appliances/Fire Streams        
9  Ropes, Knots, Salvage
10  Fire Control, Arson Awareness
11  HazMat Operations 1
12  HazMat Operations 2  
13  HazMat Operations 3  
14  HazMat Operations 4
15  HazMat Operations 5  
16  CPR
17  CPR
18  CPR
19  Final Exam

Hands-On Sessions must be completed before exam. Pre-registration is required. 

1  Maze  5  Tools  
2  SCBA Emergencies  
3  Smoke Discipline  
4  Ladders 
5  Tools
6  Hose Handling
7  Extinguishers/Vehicle Fires
8  Knots/Victim Removal

NOTE: Prior to taking hands-on sessions, probationary firefighters must be certified by the Chief of the Department in the following areas: 1) is qualified on the Department's SCBA equipment and 2) is physically and medically fit to undertake the training and passed the Department's required physical examination. 

Proper PPE & SCBA are required for all 8 hands-on sessions.


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## shorthairedpunk (Feb 17, 2005)

It all depends on the crew.

We are an Advanced ILS agency (essentially we are the old ALS)

for reference, my whole family is in EMS- Dad FF/EMT-B, Mom Instructor/EMT-P, Sister EMT-P/FF, Sister EMT-B, Babys Momma EMT-B Candidate, Neice EMT-B Candidate, Newborn son- he will be, Me EMT-I

My sister and I(the paramedic) worked a code a few weeks back and a FF drove in. For that particualr call 2 was the perfect number. We were in such close proximity to the ER that we did not get much done prehospital, she took over airway, and I did compressions and handled the radio(i do one handed compressions).  This was a DRT, but family was present so it became a practice run.  ETT wasnt an option, so we stuck a combitube in, and we could have paced in lieu of my compressions if IV access were an option (in this case it wasnt, they went central in the ER). so for basic medical arrests, 2 is a great number, 3 for sport, more than that then everone is just in each others way.

Now traumatic arrest on the other hand, 4 plus is the number. We had an MVA head on car vs. motorcyle, another DRT, but medical control advised to bring it in. pt hips were at a 90 to the body but her legs were 180 to the hips, blood bubbling from the ear with every ventilation/compression.

My dad was running suction, (this was a mess) pt had a combitube again (oropharanx was inexplainably mishapen when I attempted ETT, essentiall, the roof of the mouth was in the back of her throat) My mom had airway, a fireman was doing compressions, and I started the 2 IVs and cut clothes/radio call in. That call went smooth with the 4 and a driver, considering the circumstances...a note, the patient turned out to be a local EMT

So its all dependant on the crew how many you need, with a good partner, 2 is perfect on the medical arrest, but we also have a girl who all she does in a code is work on the IV, including trying to delay transport, so that instance requires 3.


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## ffemt8978 (Feb 17, 2005)

> _Originally posted by shorthairedpunk_@Feb 17 2005, 02:18 PM
> * ...a note, the patient turned out to be a local EMT
> *


 That sucks... :huh:


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## rescuecpt (Feb 17, 2005)

Wow, shorthairedpunk's whole family is involved in EMS, cool... is the name of your town Whackerville?

(that's a joke incase you haven't seen it elsewhere on the site)


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## ffemt8978 (Feb 17, 2005)

> _Originally posted by rescuecpt_@Feb 17 2005, 04:14 PM
> * Wow, shorthairedpunk's whole family is involved in EMS, cool... is the name of your town Whackerville?
> 
> (that's a joke incase you haven't seen it elsewhere on the site) *


 Can't you just imagine the conversation around the dinner table?


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## Jon (Feb 17, 2005)

> _Originally posted by rescuecpt_@Feb 17 2005, 06:14 PM
> * Wow, shorthairedpunk's whole family is involved in EMS, cool... is the name of your town Whackerville?
> 
> (that's a joke incase you haven't seen it elsewhere on the site) *


 No. He doesn't live near Zak and myself


Jon


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## Phridae (Feb 18, 2005)

Im going with 4.  This way its not too crowded. But, thats usually not the case around here.  If it comes over the radio as a full code, 20 people show up. Some I've never met!  Then it gets crazy. 5 people are all trying to do the same thing and it just doesnt work.  The last code we worked we had 5. 3 medics, and 2 emts. That was nice. I think we could have done with one less medic. Oh well.


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## Margaritaville (Feb 18, 2005)

Because we have had to manage so long with minimal help - my # is low.

1 to drive
1 for CPR
1 for Airway management
1 for drugs and Monitor

2 crews is all we are alloted, and it seems to work for us. In my volly area, there are many hands that have good intentions, but less personnel is easier for the Paramedics around here to manage.


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## rescuecpt (Feb 18, 2005)

> _Originally posted by Phridae_@Feb 18 2005, 04:24 PM
> * Im going with 4.  This way its not too crowded. But, thats usually not the case around here.  If it comes over the radio as a full code, 20 people show up. Some I've never met!  Then it gets crazy. 5 people are all trying to do the same thing and it just doesnt work.  The last code we worked we had 5. 3 medics, and 2 emts. That was nice. I think we could have done with one less medic. Oh well. *


 Lol, when I first read your post I saw "5.3 medics"... took me a second... hehe - gotta get to sleep, shift at 7am.


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## ffemt8978 (Feb 19, 2005)

> _Originally posted by rescuecpt+Feb 18 2005, 08:36 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (rescuecpt @ Feb 18 2005, 08:36 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Phridae_@Feb 18 2005, 04:24 PM
> * Im going with 4. This way its not too crowded. But, thats usually not the case around here. If it comes over the radio as a full code, 20 people show up. Some I've never met! Then it gets crazy. 5 people are all trying to do the same thing and it just doesnt work. The last code we worked we had 5. 3 medics, and 2 emts. That was nice. I think we could have done with one less medic. Oh well. *


Lol, when I first read your post I saw "5.3 medics"... took me a second... hehe - gotta get to sleep, shift at 7am.    [/b][/quote]
 Maybe one of them was pregnant?  First tri-mester, if it's 5.3    

Must also get sleep, but looking for #6000 first.


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