Do you really run, or just walk?

Melclin

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I've been wondering for a this for a while now and this seems a good place to ask.

I'm a paramedic student in Australia, and we get taught never to run once we're on scene. That we should conduct ourselves calmly and that walking to a scene is important in maintaining control of the situation and staying calm. Out and about on work placements, this is seems true. Paramedics never never seem too run and to good effect. They seem too command the respect and attention of everyone at a scene.

In American movies and TV paramedics always run. They are always in a hurry, always keen to put the patient on the stretcher and get them in the ambulance often before even thinking about treatment.

My question is: to what extent is this true. Do you guys really run? And what is your obsession with getting patients on stretchers and into ambulances. Is it anything to do with the whole EMT-B/EMT-I/EMT-P thing (we're all ALS and above in Australia)?
 

akflightmedic

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No, it has everything to do with drama and television and keeping folks such as yourself captivated for whatever reason.

Obviously it is working since our TV shows seem to cross the vast seas and catch the attention of other nations who seem to think everything they see on TV is real when it is in regards to Americans and American lifestyles.
 

DT4EMS

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As a medic I didn't run on scenes. The only time I run at work (PD) is if the bad guy runs first...... then all I gotta do is get within 21 feet....... then the running comes to sudden stop, thanks to Taser International :)
 

Veneficus

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As a medic I didn't run on scenes. The only time I run at work (PD) is if the bad guy runs first...... then all I gotta do is get within 21 feet....... then the running comes to sudden stop, thanks to Taser International :)

DT,

Do you take your own taser darts out?

No emergency provider should ever run on scene.

It can inspire panic, increases the chance of an injury, and if you are running, your ability to get and keep a full view of what is going on.
(Just like shooting with both eyes open,to maintan some level of situational awareness.)

Pay no attention to how actors portraying healthcare or emergency workers do anything on TV from drive, to run, and especially not procedures.
 

JPINFV

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I don't run. It's bad form to show up being more short of breath than the patient.
 
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Melclin

Melclin

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No, it has everything to do with drama and television and keeping folks such as yourself captivated for whatever reason.

Obviously it is working since our TV shows seem to cross the vast seas and catch the attention of other nations who seem to think everything they see on TV is real when it is in regards to Americans and American lifestyles.

And the rest of you.

I'm glad to hear it. HAHA. I'd love to actually come and visit your country. It would be so intensely interesting to challenge all these things I think I know about America. As it happens I think your TV shows are corny, unrealistic and poorly written for the most part, but oddly addictive. I'd love to get an idea of how wrong they are. I think America might be a good deal better than TV lets on.

On a slightly different note, the "getting them on the stretcher and in the ambulance" thing isn't from fictional TV shows. It's based on case studies and real life videos of American paramedics or EMT's or whatever. One of my lecturers spent some time in LA and said they don't like to stay and play much, amongst other things. Is there a strong emphasis on getting them to hospital, rather than treating them yourself?
 

Veneficus

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And the rest of you.

I'm glad to hear it. HAHA. I'd love to actually come and visit your country. It would be so intensely interesting to challenge all these things I think I know about America. As it happens I think your TV shows are corny, unrealistic and poorly written for the most part, but oddly addictive. I'd love to get an idea of how wrong they are. I think America might be a good deal better than TV lets on.

On a slightly different note, the "getting them on the stretcher and in the ambulance" thing isn't from fictional TV shows. It's based on case studies and real life videos of American paramedics or EMT's or whatever. One of my lecturers spent some time in LA and said they don't like to stay and play much, amongst other things. Is there a strong emphasis on getting them to hospital, rather than treating them yourself?

Depends on the individual, service culture, or even condition of the patient.

Most fire based services feel their job is not patient care, but to deliver the pt to the hospital. (I know there are some private and 3rd services with the same philosophy, I spent way too much of my life with them, but largely it is a FD culture)

Some of the providers who feel EMS is "common sense," were trained instead of educated, or "stuck" in the job also feel that way. I have even met one provider who was very educated claim that it was not his job to "practice medicine" but to strictly follow protocols and hospital was the #1 goal, so choosing between moving towards such and initiating treatment, turning wheels was always preferred.

US EMS providers can't even agree on what the role is unfortnately. Some don't ever want what they do now to change. As the world always changes, it is wishful thinking.

It is so fragmented, you could look at an EMS agency in area x and in theneighboring area Y it can be completely different. Sometimes there are completely different services within the same region.
 
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Melclin

Melclin

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Depends on the individual, service culture, or even condition of the patient.

Most fire based services feel their job is not patient care, but to deliver the pt to the hospital. (I know there are some private and 3rd services with the same philosophy, I spent way too much of my life with them, but largely it is a FD culture)

Some of the providers who feel EMS is "common sense," were trained instead of educated, or "stuck" in the job also feel that way. I have even met one provider who was very educated claim that it was not his job to "practice medicine" but to strictly follow protocols and hospital was the #1 goal, so choosing between moving towards such and initiating treatment, turning wheels was always preferred.

US EMS providers can't even agree on what the role is unfortnately. Some don't ever want what they do now to change. As the world always changes, it is wishful thinking.

It is so fragmented, you could look at an EMS agency in area x and in theneighboring area Y it can be completely different. Sometimes there are completely different services within the same region.

That resistance from the 'old school' is something we are trying to fight. I'm glad that there are medics like you fighting the same fight (not just against the old school but against any stakeholders espousing a derogatory position on 'EMS' as, I suppose, you would call it. I'm surprised and overwhelmingly happy to know that the same struggle is happening elsewhere.

Just the other day, I was at a symposium held by the Australian College of Ambulance Professionals, and Dr. Angus McDonnel spoke on the subject breaking away from strictly defined protocols. In fact Australian paramedics are not bound by them (protocols), so much as they are directed by by guidelines. As one of my clinical instructors put it, "you can do anything you want, as long as you can justify what you've done". There is a very strong move, here, towards paramedic practice being a unique field, utilizing a unique body of knowledge.

To be honest, your whole system disgusts me. As I understand it (I'm quite open to being proven wrong, and I hope I can be) the American paramedical system is based largely on privately run companies and Fire Departments with some low level paramedical training. It seems a horrible concept to me that peoples lives rely on the whims of a mishmash of private companies and poorly (BLS) trained fire fighters. It feels strange (to me) that you say US EMS providers (emphasized plural, like there are many and varied types), because, here, there is an excellent state provided ambulance services and nothing else. It just seems to me that when peoples lives are at stake, private companies (who's principal interest is, and should be, the private shareholder) shouldn't be in control. Thoughts?
 

AnthonyM83

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Do the television shows and movies in Australia really show you all walking?
It's not that American EMS runs, rather it's that TELEVISION EMS runs.

There have been EXTREMELY few situations where I've ran...I can't even think of one right now...and even then it was probably a jog.
 
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Melclin

Melclin

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Do the television shows and movies in Australia really show you all walking?
It's not that American EMS runs, rather it's that TELEVISION EMS runs.

There have been EXTREMELY few situations where I've ran...I can't even think of one right now...and even then it was probably a jog.

No the TV doesn't show us walking mostly because there isn't much Australian TV watch, in the way of medically themed teli. The TV that is there does tend to be fairly accurate so I was wondering if your TV was also accurate. I was basing my assertion that we (Australians) walk, on experience, not on TV.
 

JPINFV

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because, here, there is an excellent state provided ambulance services and nothing else. It just seems to me that when peoples lives are at stake, private companies (who's principal interest is, and should be, the private shareholder) shouldn't be in control. Thoughts?
You can level the same claim over any private health care or private critical industry. Private power companies hold the lives of some people (e.g. vent dependent patients) and the livelihood of most people in their hands. Same with private trash companies (public health concerns/sanitation). The problem isn't about the difference between public and private (heck, Washington, DC [capital of the USA]) has what is widely regarded as one of the worse EMS systems in the US. It's a public run (fire based EMS) system providing paramedic level care (not just basic care).

The problem is about oversight and proper funding not 'who's on first.'
 

DT4EMS

Kip Teitsort, Founder
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DT,

Do you take your own taser darts out?

No emergency provider should ever run on scene.

It can inspire panic, increases the chance of an injury, and if you are running, your ability to get and keep a full view of what is going on.
(Just like shooting with both eyes open,to maintan some level of situational awareness.)

Pay no attention to how actors portraying healthcare or emergency workers do anything on TV from drive, to run, and especially not procedures.

Yes, we remove them unless a sensitive area (groin/breast). We still have to have them evaluated by EMS......... usually because of the fall.
 

triemal04

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The problem is about oversight and proper funding not 'who's on first.'
Which may be hard to see, or even understand if you're looking in from a country that does things differently and basing things off of Hollywood's interpretation of EMS.

The US is not Australia in regards to EMS in any regard. While the majority (still think it's slanted that way) of EMS is provided by public agencies (fire departments) it's not provided by a separate, fully funded state run agency that focuses soley on EMS, and a lot is still done by for-profit privates out to make a buck (which is getting harder and harder to do).

Here there is no single body that effectively runs EMS nationally. The closest thing to that is the NREMT, but, they don't have real enforcement power, except over their own certification, which is not mandatory, depending on where you work.

The way paramedics are taught, certified, and recognized is a bit...different...as well. Despite what NREMT has done and is doing, there is still really no national standard for paramedic education that has to be followed; each state is not required to abide by NREMT's rules and, if they want, can teach their paramedic's what they want. So, depending on where in the US you are, a paramedic from 1 area is not the same as a paramedic in another, both is education, knowledge, abilities, and scope.

The standards for education are much laxer than what I know of Aussieland...while there are some bachelor's programs out there, the standard is still not even an Associates degree. This unfortunately goes back to there not being anyone really in charge of determining and enforcing what a US paramedic is.

In a nutshell, don't believe what you see on TV, but be aware that there are huge differences between Australian EMS and US EMS.
 

Ridryder911

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To the original posts, I have stated this before but let me restate this. I was on filmed for a t.v. show long time ago called Rescue 911. It was a show about emergencies and and they would re-create it.

During the filming the producer wanted us to "run to the EMS unit"... and we refused to do so. After repeated requests, he asked if we would at least "jog" .. My partner & I still refused.. so our entry to our unit was limited film time and basically focused on us in the truck and at the scene.

One of the other areas I do want to clarify is there IS U.S. National Standards for EMS training. NREMT has NO training or educational standards as long as it meets the NHTSA national standards. Many become confused of this.

I do agree our education system is horribly flawed at this time. It will become better and there will be an increasing number of arguments and fights as things change; as change always produces.

R/r911
 

Veneficus

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That resistance from the 'old school' is something we are trying to fight. I'm glad that there are medics like you fighting the same fight (not just against the old school but against any stakeholders espousing a derogatory position on 'EMS' as, I suppose, you would call it. I'm surprised and overwhelmingly happy to know that the same struggle is happening elsewhere.

Truthfully, I see my days fighting this good fight are numbered. I got in to help patients, the more I try to help providers the more resistance I get, so I am at the point where it is time to keep with the original plan of being the best provider i can be.

Just the other day, I was at a symposium held by the Australian College of Ambulance Professionals, and Dr. Angus McDonnel spoke on the subject breaking away from strictly defined protocols. In fact Australian paramedics are not bound by them (protocols), so much as they are directed by by guidelines. As one of my clinical instructors put it, "you can do anything you want, as long as you can justify what you've done". There is a very strong move, here, towards paramedic practice being a unique field, utilizing a unique body of knowledge.

That was my ideal as well, but I found the only realistic way to achieve it is being a MD. In the US, such a goal is beyond my lifetime. Of course, I have no intention of doing EM and in my home state, only such can be a medical director, so aside from teaching my EMS contact will obviously decline substantially.

To be honest, your whole system disgusts me. As I understand it (I'm quite open to being proven wrong, and I hope I can be) the American paramedical system is based largely on privately run companies and Fire Departments with some low level paramedical training. It seems a horrible concept to me that peoples lives rely on the whims of a mishmash of private companies and poorly (BLS) trained fire fighters.

Some private companies are superior to even 3rd service EMS services. Some private companies are the worst EMS in the States. It is really hit or miss, but certainly not factual to say all private companies are bad.

The fire service is it's own monster. Most Fire service EMS I have encountered is aweful. I know there are a few good places, but that is not the norm.

Unfortunately in the US BLS and ALS is divided by a few skills, like starting an IV, not bad any level of measurable educational standards. For example, a BLS provider can take a class to get certified to start IVs or give certain meds when they see X. You should see on this forum some of the statements about how "advanced" those prviders are.


It feels strange (to me) that you say US EMS providers (emphasized plural, like there are many and varied types), because, here, there is an excellent state provided ambulance services and nothing else. It just seems to me that when peoples lives are at stake, private companies (who's principal interest is, and should be, the private shareholder) shouldn't be in control. Thoughts?


It is strange, but it is was it is. I agree most private companies are in EMS for the wrong reasons, especially many of the airmed ones, companies that want to provide the best service for the money do exist.They get contracts based on the level they provide.
 

Hockey

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I've ran before

A few times actually


I've also ran after shutting the garage door and found a patch of ice.

It all depends really. 99.99% of the time I walk.

When they are looking at me like HEY I'M RIGHT HERE (when I'm 20 feet away) and its for a typical BS call, I tend to walk slower.

I run when the Krispy Kreme truck pulls up.

But yeah, no running for me. I do enough of it at the other job it seems
 

guardian528

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On a slightly different note, the "getting them on the stretcher and in the ambulance" thing isn't from fictional TV shows. It's based on case studies and real life videos of American paramedics or EMT's or whatever. One of my lecturers spent some time in LA and said they don't like to stay and play much, amongst other things. Is there a strong emphasis on getting them to hospital, rather than treating them yourself?

As my instructor said, "some folks just need a good dose of diesel therapy." meaning toss em in the ambulance and hit the gas asap. but besides those, it seems like most calls around here are stay and play, the medics like to get all their info and hook them up before they start bounding down the road, unless of course it's actually an emergency
 

Ridryder911

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As my instructor said, "some folks just need a good dose of diesel therapy." meaning toss em in the ambulance and hit the gas asap.

It appears that your instructor needs to return to school to learn how to treat patients. There is NEVER such thing as diesel therapy. Expediting yes due to injuries, but to emphasize fast transport? Never.

R/r 911
 
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guardian528

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It appears that your instructor needs to return to school to learn how to treat patients. There is NEVER such thing as diesel therapy.

R/r 911

i think you misunderstood. 'diesel therapy' simply means load and go as opposed to stay and play
 

Ridryder911

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i think you misunderstood. 'diesel therapy' simply means load and go as opposed to stay and play

Okay. better put. I get sensitive because of that type of emphasis of even meaning for assessment and care.

R/r 911
 
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