# What makes you mad on scene?



## sksmedic (Jul 19, 2007)

Just wondering what makes you guys mad on scene. Family members, bystandrs, supposed doctors, RN's, first responders? Any of these people do anything to really piss you off. If so, I'd love to hear.

For example:
I work in Great Falls MT. We are fairly rural with a population of 70,000 and several very small, back woods, communities that surround us. My service covers 911 for all of it.

I get dispatched to SUV vs. Train with extrication needed in the county. This means that we will have a ton of volunteers running around like chickens with their heads cut off. En route we get an update that the occupant is pinned with the steering wheel crushing his chest. Also that he is choking on his own blood. This all being relayed through dispatch from a passer by on scene. Also that Mercy Flight is out of the area. 
We get on scene to find one smashed up RAV 4, one pinned driver, and 30 volunteers. As I approach the vehicle I got my helmet and eyes on. I entered the vehicle through the passenger front door and began working on this poor guy that was cold, pale, and didn't have any radial pulses.The next thing I know is that I am now outside the vehicle. Someone has grabbed me by my belt and pulled me out of the vehicle. I am now officially PISSED. I turn to find a 45 yo woman with frizzy blonde hair telling me to get out of her way so she can get at the patient. This woman is a first responder volunteer that is the wife of the volunteer fire chief. I am the only paramedic on scene and this dumbass thinks that she has something to offer. I very elouently asked her to move so I could treat my patient. She refused stating that her husband is in command and he wants her in the vehicle. Normally I would have raised my voice but i didn't have too. Several cops on scene saw this and came over to assist me. She was escorted away from the vehicle. After an hour of cutting on this vehicle, we mannaged to free this guy and get him boarded. I walked over to my rig to find none other than Mrs Fire Chief herself sitting on the bench seat. She procalimed that she was riding in with me. Now that we are face to face I think I have figured out the problem. She is a mean drunk. Yes, DRUNK!!!! :wacko: My cop buddies were close by and ended up getting her for DUI. Her ems license is under state review. I managed to find a picture of this crazy scene too, Mrs FireChief will be the crazy blonde standing next to the passenger door.


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## Asclepius (Jul 19, 2007)

That's unique. What did Mr. Fire Chief have to say? I assume that you didn't work under Mr. Fire Chief!?

Been doing this a long time and it seems that there is one on every call of significance.  I love the RN's that work in some out of the area department of the hospital running up and identifying themselves and then proclaiming that they out rank us, by virtue of their training, and that they are going to help. If you're really lucky, you'll get a doctor to do this to you sometime. Of course, all you have to do is start talking trauma protocol or ACLS or something like that and they realize that you may know something more about this setting than they do.


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## sksmedic (Jul 19, 2007)

Oh gosh no, To be honest this was the first time i had ever even seen her. She has no affiliation with the ambulance company. It was understood by everyone on scene but her that I was in charge. Those first responders are in charge until ALS gets there, then they turn the scene over.


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## Asclepius (Jul 19, 2007)

That's the way it is supposed to be in every system. I just wondered why Mr. Fire Chief didn't do something to get her out of the way. I'm glad for you, that you enjoy such a good relationship with your law enforcement officials. It could have wasted very precious time otherwise. How did your patient turn out, anyway?


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## sksmedic (Jul 19, 2007)

This was a 30 y/o male, neg prior medical hx. BP on scene of 60 systolic rr 32 and shallow, sinus tach 120 w/ moderate st elavation O2 sat 82% ra.. Extrication was prolonged lasting just over an hour. Radial pulses present by the time we hit the ER doors with a bp of 88/52 rr 20 st 120 with O2 sat 96% 15L NRB. I was happy with it considering.  He stayed concious and able to protect his own airway during extrication and transport. Head and neck were clear, Surprisingly no hemo, pneumo, or cardiac tamp. He did have a liver lac. He had an open L humerus fx which was repaired without incident. He had a pelvic fx with a L hip dislocation. He also had an open L tib/fib. All surgical repairs were made without incident. After a 2 day stay in ICU he was moved to a less acute unit where he is recovering. I am blown away that this guy even survived. I have never seen that much intrusion into a cab and pull something other than a corpse out. I was expecting to needle and intubate based on the dispatch info. The steering wheel was burried in his chest. It was impressive. This wasn't a train crossing incident either. This guy was doing hwy speeds when he lost control and went head on into the train that was going full speed. He must have had guardian angels looking out for him.


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## Ridryder911 (Jul 20, 2007)

Control the scene, don't let the scene control you. I realize you were trying to be politically correct and cordial, but after the refusal then I would had her either escorted out of the scene or arrested. Sorry, the feces can hit the fan later... as well, I doubt the Chief would like everyone to know about his public drunk spouse interfering with emergency services. 

This is part of the problem I have with so called volunteering services. The "good old boys"  mentality, when other members should had stopped and not allowed her to even be on the scene. Unfortunately, it is occurrences that gives the good ones a black eye. 

R/r 911


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## MMiz (Jul 20, 2007)

I hate to say it, but I wouldn't have seen this when I worked in suburban EMS with a clear command structure.  I can *definitely* see it happening where I am now, with multiple volunteer agencies responding.  It seems like everyone around here wears a white helmet and is related to the chief.


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## MtJerry (Jul 20, 2007)

I listened to all of this on my portable radio.  Sounded like you did a great job.  From the vitals you posted It appears that you did an outstanding job.  From the conversations I've had with others who were there (fire), you and others deserve a big pat on the back for saving that young man's life.

Good job !

I am a QRU in the Stockett area. 

I'd really be intersted to know what department Mrs. Chief is related to.  Sounds like she deserved to have her license yanked.


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## MtJerry (Jul 20, 2007)

Wow ... machine-gun post ... sorry :unsure:


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## firecoins (Jul 20, 2007)

MMiz said:


> I hate to say it, but I wouldn't have seen this when I worked in suburban EMS with a clear command structure.  I can *definitely* see it happening where I am now, with multiple volunteer agencies responding.  It seems like everyone around here wears a white helmet and is related to the chief.



On an EMS call, what does being related to the Chief mean?


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## Rattletrap (Jul 20, 2007)

Giving Ms Chief the boot is nothing. I gave my chief the boot from the back of the bus X2. He might have been chief and in charge of the scene but I had the higher card and was in charge of the patient.


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## bstone (Jul 20, 2007)

Hmm...I once was on a camping trip and it turned out this guy OD'd on opiate pain relievers. I always carry a BLS bag with me so I ran over when I heard people screaming for help. When I got there I saw a guy laying supine, ashen grey and agonal resps. As I gloved up and prepared to put in an OPA and bag him some guy kneeling over him looks up at me and says "I checked him out. He's fine. Just sleeping. You don't need to be here." I screamed for him to move away and the cops who showed up deferred to me as it was clear I knew what I was doing (and I had a hat on that said "EMT). 

That's pretty much my only experience with interference.

Oh, once time a cop tried to PREVENT me from treating people who had been banged up in an automobile accident. They had hit his car and he was pretty steamed up about it. I guess cops can be the best of friends and the worst of friends.


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## BossyCow (Jul 20, 2007)

bstone said:


> some guy kneeling over him looks up at me and says "I checked him out. He's fine. Just sleeping. You don't need to be here."




Was this guy the one who gave him the meds?  I had to ask.....


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## Anomalous (Jul 20, 2007)

Ridryder911 said:


> This is part of the problem I have with so called volunteering services. The "good old boys"  mentality, when other members should had stopped and not allowed her to even be on the scene. Unfortunately, it is occurrences that gives the good ones a black eye.
> 
> R/r 911



It really has nothing to do with being a volunteer, but more to do with being a professional.  We are volunteer and if you have anything to drink you may not respond to a call, be on a scene, handle equipment or _breath_ on a patient, etc.   Actually, you're not really very welcome even at the station.


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## sksmedic (Jul 20, 2007)

Anyone ever had a doctor on scene try to throw their weight around? How did you handle it and what was the outcome?


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## BAMAMEDIC (Jul 20, 2007)

Stupid people !!!!!!!!!!:wacko:


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## Ridryder911 (Jul 21, 2007)

sksmedic said:


> Anyone ever had a doctor on scene try to throw their weight around? How did you handle it and what was the outcome?



I have seen very few physicians ever really attempt to "throw their weight around". Usually, the smarter they are, the more they tend not to even get involved. (which EMT's have yet to learn)

One of the services I worked for, had a business card we handed out to them; stating : 

_If you are a physician, you can assume care for the patient by the following: 

Provide proper I.D. and credentials ( must be current state licensed) out of state(s) does not count

Must discuss with on-line medical control

* Must* assume all liability and potential liability as well as the  responsibility of all patient care. 

*Must *travel with patient to hospital with patient and * document* event for EMS and Hospital. 

If the above is not given, then the EMS crew can have such party escorted and possibly arrested for interfering in emergency services, if hindrance occurs._

If they agree, then yes they can participate. and play. otherwise, they are nothing more than by-standers. Usually, when I inform them we have it under control, they never become involved. I have only had one physician in 30 years ever attempt to "be in charge", he quickly declined after I informed him, hw would to enter the auto during the extrication. 

Now, I have had a couple of non-medical doctors (chiropractor/dentists, even a PhD in music) etc. attempt, but were excused off the scene.

R/r 911


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## sksmedic (Jul 21, 2007)

How about nurses? Anyone had a pain in the butt RN on scene?


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## emtkelley (Jul 21, 2007)

Yes, I have had a certain ER nurse appear mysteriously on alot of calls that I have been on. She used to be on the same dept I was on but couldn't hack the field stuff so she quit. She used to try to control the scene until I had a a little  talk with the director who spoke with her and relieved her of her "duties".


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## Ridryder911 (Jul 21, 2007)

I've not had seen a "nurse" on a scene in some time. Usually the newer ones are not as interested in stopping or realize that EMS will do their job. If I do see them, it is usually the non-emergency type(s). 

Very few nurses I know of want to be involved on their days off. They have had enough providing care while on duty. Besides, there is nothing more they can do (or anyone else for that matters) than any other first responder other than perform first-aid. 

R/r 911


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## Asclepius (Jul 21, 2007)

I've had RN's and an LPN stop a couple of different times. Although, they just asked if we needed help. In other words, they were very pleasant and went about their business once they saw the situation was well under control. 

I don't think I have experienced any scanner chaser's. At least none that I know of.


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## RescueShirts.com (Jul 22, 2007)

It can be summed up in one sentence...

*Please treat the patient up to the level of your training... don't just "sit" on scene and wait for the ALS ambulance.*

I work in an area that has a lot of rural fire departments and long response times to these areas.

If the patient needs c-spine... place them in c-spine!

If the patient has a broken arm, wrist, leg, ankle, etc... please SPLINT the extremity!

I trust your description of the laceration... feel free to BANDAGE the laceration... don't leave it alone so I can inspect it. (i.e. "I didn't do anything to the wrist lacerations so you could see them for yourself...")


I have NEVER complained about a first responder's treatment of the patient. Heck... even if they do something wrong, I am simply grateful that they are doing something... and "trying" to provide patient care.

Lack of care... and simply sitting on scene waiting for ALS (when there are things you can do)... on the other hand, is very annoying.


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## MMiz (Jul 22, 2007)

firecoins said:


> On an EMS call, what does being related to the Chief mean?


I just recently moved to a small town, and will soon be moving away from that town.  As I told my boss (non-EMS) one day at work, I have never in my life seen a community so fixated on one's status within the community.

When I worked in a suburban environment, a person was seen as who they were.  I didn't give a second thought as to whether or not their family was prominent in the community.  No one ever played the "Do you know who I am?" card.  Around here it happens daily.

A scene should be worked as a team by the most qualified people.  Every action taken should be in the best interest of the patient.


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## Jon (Jul 22, 2007)

Medical Doctors (MDs/DOs) are usually good about staying out of the way.

Healthcare providers from non-critical specilties seem to be the ones who stop: "I'm a Doctor (Chropractor/Dentist/Psychologist)" or "I'm a Nurse (and when you question them, they are a Nurse's Aide at a SNF)".

Around here, I know of a few Medical Command docs that WILL show up to assist their service if the call sounds cool and/or they are nearby when it comes in... and they show up, offer help, and are willing to write it up and ride it in if need be.


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## randyb (Jul 23, 2007)

Mine is going to the scene and having people pull out in front of you, or refuse to give the right of way.  Makes me want to install a cow catcher and video  dash cam......

I also hate having to move furniture to get someone out of the house and having folks get upset about it.


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## Airwaygoddess (Jul 23, 2007)

Under the influence family members that call for the ambulance and then try to tell you how to do YOUR job........... Sigh :wacko:


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## BossyCow (Jul 23, 2007)

How about the armchair quarterback who heard the call on the radio and wants to second guess what you did based only on what the call sounded like to him.


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## Airwaygoddess (Jul 23, 2007)

Hence the name "Laz-Boy!" ^_^


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## firetender (Jul 23, 2007)

Little Mexican Cha-who-a-who-a's who come flying out from under a crevice somewhere in the house, shrill-yapping to high heaven and then they wrap their slobbering jaws on your ankle in a death-grip!

Swear to all that's Holy, those are the only dogs I ever had trouble with, and it happened so often, as to be ridiculous!


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## sksmedic (Jul 23, 2007)

I love going to a nursing home and finding that they have placed a non rebreather on someone at 3lpm.


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## firecoins (Jul 23, 2007)

sksmedic said:


> I love going to a nursing home and finding that they have placed a non rebreather on someone at 3lpm.


lol yeah. I hate that too. And they wonder why the patient has difficulty breathing.


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## bstone (Jul 23, 2007)

sksmedic said:


> I love going to a nursing home and finding that they have placed a non rebreather on someone at 3lpm.



Or a NC at 15lpm. Riiiiight.


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## Pablo the Pirate (Jul 25, 2007)

nursing homes are the best.  My dad who is also a paramedic was over the other day when the pager went off for a NONemergency transport from nursing home for trouble breathing.  He was like let me strangle one of them til they have trouble breathing and then they can tell me it's a god D@%n nonemergency.  Or my favorite one is pt fell about an hour ago pt needs to be evaluated.  Show up and pt has major Q sign goin on and asystole in 3 leads.  brilliant people brilliant


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## hitechredneckemt (Aug 23, 2007)

RNs are my biggest pet peeve onscene. As far as nursing homes they are just rescues from stupid nurses.


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## mtmedic (Aug 25, 2007)

sksmedic said:


> Just wondering what makes you guys mad on scene. Family members, bystandrs, supposed doctors, RN's, first responders? Any of these people do anything to really piss you off. If so, I'd love to hear.
> 
> For example:
> I work in Great Falls MT. We are fairly rural with a population of 70,000 and several very small, back woods, communities that surround us. My service covers 911 for all of it.
> ...



Hey thanks for mentioning your good buddy stopped by on his way home from the archery range and unloaded some of the ALS duties from those shoulders...  It really was a crazy scene...  Extrication took too long but thats how it goes.  I too expected a much worse scenario when I walked up on this.  But anyway your welcome...


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## seanm028 (Sep 19, 2007)

sksmedic said:


> I love going to a nursing home and finding that they have placed a non rebreather on someone at 3lpm.



My EMT school instructor told us about a code he ran on to a nursing home.  When they got there, the orderly/RN/whatever said "Thank goodness you guys are here, I've been bagging this guy for 5 minutes now."  He had put a NRB on the pt and was squeezing the bag, waiting for it to fill back up, then squeezing it again.


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