# Things told to me yesterday.



## NomadicMedic (Jun 20, 2016)

These items were all presented to me as actual and factual...

While I was getting a refusal...

"It's a law that if someone calls us we have to take them to the hospital."


While I was staring a line to give some pain management. 

"We don't really do that here."


While setting up CPAP...

"We need to get moving, it's our job to take people to the hospital, they need the hospital."


And my favorite, as I was getting out the Zofran...

"Let her puke. We're only 10 minutes from the hospital".


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## Gurby (Jun 20, 2016)

You must have felt pretty silly when you realized you've been doing it wrong all this time.


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## TrueNorthMedic (Jun 20, 2016)

Drives me crazy when people use the close proximity of the hospital as an excuse for not treating their patient properly. Sounds like we work with some of the same people, haha.


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## chaz90 (Jun 20, 2016)

Man. All we can do is fight the same battle time after time. It's tough to make progress against these people. 


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## NomadicMedic (Jun 20, 2016)

I was incredulous. I was also working with a paramedic who was proud to tell me he's been doing the job for 27 years.


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## chaz90 (Jun 20, 2016)

At least that means retirement is soon.

"Thanks for your service buddy. Let me show you where the pasture is."


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## Summit (Jun 20, 2016)

DEmedic said:


> I was incredulous. I was also working with a paramedic who was proud to tell me he's been doing the job for 27 years.



Someone should congratulate him on being a crappy medic for 27 years...

At least your practice is  your own... assuming management doesn't see it strictly his way.

Is it just this one medic or is it the organizational culture of practice? How does your medical director feel about that attitude? If they are on your side, you might  be able to change the culture?


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## Underoath87 (Jun 20, 2016)

Did you just start working at a different service or something?


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## StCEMT (Jun 20, 2016)

Gurby said:


> You must have felt pretty silly when you realized you've been doing it wrong all this time.


I feel pretty silly knowing I've been learning it wrong all this time. This past year has all been a lie.


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## NomadicMedic (Jun 20, 2016)

Underoath87 said:


> Did you just start working at a different service or something?



Yeah, a per diem thing, with a guy I'd never worked with before. 



Summit said:


> Is it just this one medic or is it the organizational culture of practice? How does your medical director feel about that attitude? If they are on your side, you might  be able to change the culture?



It's not the whole department, but it's certainly not a high speed, low drag kind of place.


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## ERDoc (Jun 20, 2016)

Summit said:


> Someone should congratulate him on being a crappy medic for 27 years...



Probably more like 24 years.  He was probably a superstar those first 3 years and then forgot to keep up with medicine after that.  DE, if you ever work a code with him, ask him where the bretylium is.


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## Akulahawk (Jun 21, 2016)

ERDoc said:


> Probably more like 24 years.  He was probably a superstar those first 3 years and then forgot to keep up with medicine after that.  DE, if you ever work a code with him, ask him where the bretylium is.


Careful with that one... because you may induce a stroke in your partner and then you'll have to deal with 2 patients.


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## ERDoc (Jun 21, 2016)

Akulahawk said:


> Careful with that one... because you may induce a stroke in your partner and then you'll have to deal with 2 patients.



That would be a perfect teaching moment.  You could then have a discussion on the evidence for and against tPA, assuming your partner knows what that is.


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## Akulahawk (Jun 21, 2016)

ERDoc said:


> That would be a perfect teaching moment.  You could then have a discussion on the evidence for and against tPA, assuming your partner knows what that is.


Perhaps during the lucid interval... assuming herniation didn't happen within 30 seconds.


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## ERDoc (Jun 21, 2016)

If we are talking herniation then we are talking a hemorrhagic stroke, which would be an absolute contraindication.  So again we can turn it into a teaching moment, even if it is a very brief moment before loss of consciousness.


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## jteeters (Jun 21, 2016)

DEmedic said:


> These items were all presented to me as actual and factual...
> 
> While I was getting a refusal...
> 
> ...




I certainly hope that not ALL of the medics at this service are this way.  If they were, I'd run like hell.  Far and fast.  WOW!


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## NomadicMedic (Jun 21, 2016)

jteeters said:


> I certainly hope that not ALL of the medics at this service are this way.  If they were, I'd run like hell.  Far and fast.  WOW!



They're not.


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## Tigger (Jun 21, 2016)

Topics of yesterday's shift/why I love where I am:

An hour long discussion debating the pros and cons to everyone's method for differentiating between Vtach and SVT with abberant conduction.
Nicardipine and how/why its mechanism makes it excellent for hypertensive stroke patients. 
When lidocaine might be superior to amiodarone and when it might not me. 
And pretty much the best pharm math teaching ever..took a big chunk of p school and made it waaaaay simpler.


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## Gurby (Jun 21, 2016)

Relevant to the OP:



> But the paramedics did not treat Bray for nearly 25 minutes, according to court records and witness statements. At one point, one of the paramedics suggested that Bray’s son take her to the hospital in his personal vehicle, according to court records.
> 
> The medics did not check her vital signs, connect her to an electrocardiogram machine or follow procedures for someone showing signs of cardiac arrest, Bray’s attorneys said.
> 
> ...



http://www.ems1.com/ems-management/...2-million-for-medics-delay-in-treating-woman/


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## RocketMedic (Jun 22, 2016)

Gurby said:


> Relevant to the OP:
> 
> 
> 
> http://www.ems1.com/ems-management/...2-million-for-medics-delay-in-treating-woman/



Ah, the "she's faking being blue and not breathing" patient....these medics were both incompetent and lazy. 

Too bad they're fire


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## mgr22 (Jun 22, 2016)

Tigger said:


> Topics of yesterday's shift/why I love where I am:
> 
> An hour long discussion debating the pros and cons to everyone's method for differentiating between Vtach and SVT with abberant conduction.
> Nicardipine and how/why its mechanism makes it excellent for hypertensive stroke patients.
> ...



I've worked at two places like that. There was so much less stress not having to deal with being ridiculed for trying to do the right thing.


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## NomadicMedic (Jul 3, 2016)

Jesus. It just happened again. 

"we don't work codes on scene here. It's much better to put them in the truck and drive hot to the hospital."

All of the other medics were nodding at this sage wisdom. 

I have to quit.


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## chaz90 (Jul 3, 2016)

DEmedic said:


> Jesus. It just happened again.
> 
> "we don't work codes on scene here. It's much better to put them in the truck and drive hot to the hospital."
> 
> ...


Didn't you get ROSC on that patient too? How dare you give a pulseless patient a perfusing rhythm rather than just a taxi ride to the actual medical professionals?


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## NomadicMedic (Jul 3, 2016)

chaz90 said:


> Didn't you get ROSC on that patient too? How dare you give a pulseless patient a perfusing rhythm rather than just a taxi ride to the actual medical professionals?



It's ridiculous. I'm screaming on the inside.

But, it's a cultural/situational thing.


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## EpiEMS (Jul 3, 2016)

DEmedic said:


> It's ridiculous. I'm screaming on the inside.
> 
> But, it's a cultural/situational thing.



Sounds like a place full of one year 20 times over folks...


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## Tigger (Jul 4, 2016)

When you're responding to a call and another ambulance that's transporting their own patient answers the tone and requests mutual aid.

Grrrrr I can handle my own calls Mr. "when there is no supervisor on duty I like to play one."


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## RocketMedic (Jul 5, 2016)

DEmedic....wow. That is literally the dumbest thing I've heard all week.


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