Recent content by captaindepth

  1. captaindepth

    Refusal after Narcan administration

    Below is the link to the same article I listed earlier, it is the basis of my argument written by a coworker whom I very much trust and agree with. https://www.emsworld.com/article/12073030/evaluating-patients-decision-making-capacity 0030 GENERAL GUIDELINES: CONSENT General Principles...
  2. captaindepth

    What's your "line" on refusals?

    Below is an excerpt from our protocols regarding this exact scenario. "Transporting Patients Who Have a Psychiatric Complaint A. If a patient has an isolated mental health complaint (e.g. suicidality), and does not have a medical complaint or need specific medical intervention, then that...
  3. captaindepth

    Refusal after Narcan administration

    Being alert and orientated person, place, time, and event does NOT equate to having decision making capacity. I have stated why I believe the patient described in the original scenario does not have decision making capacity. The patient was initially found to be minimally responsive, moved to...
  4. captaindepth

    Refusal after Narcan administration

    Safety is everyones responsibility. Think about the original scenario ("EMS arrives on scene patient is still not very responsive. Loaded onto gurney and halfway through the first set of vitals she wakes up. She presents irate and inconsolable, starts removing all vitals equipment") this is a...
  5. captaindepth

    Refusal after Narcan administration

    Reading the OPs description of the patient and the scene I have hard time believing this patient be capable of rational thought. How can the provider complete a thorough assessment to obtain the necessary information needed to inform the patient of the risks WHILE the pt s actively fighting? How...
  6. captaindepth

    Refusal after Narcan administration

    These are invalid comparisons and lead to more questions than answers. The argument isn't whether or not someone can refuse care/transport following narcan administration, the argument is whether or not the patient in the OPs post is capable of refusing. It states the patient is AAOx 4 but that...
  7. captaindepth

    Refusal after Narcan administration

    This call would have gone so much smoother if the patient hadn't received the IN Narcan prior to EMS arrival. The fact that they did is of no fault of the medic but the subsequent care is their responsibility. There is NO WAY I would let this patient refuse. First of all the pt is...
  8. captaindepth

    BEST EMS Job/Agency in 2019?

    Happy wife, happy life... right? A lot of people are concerned about the cost of living here in the Denver Metro area but its definitely doable. My wife is an elementary school teacher, I'm a medic (and I refuse to work OT due to the work/life balance thing) and we are able to own a home in the...
  9. captaindepth

    BEST EMS Job/Agency in 2019?

    Working off of the list above, Denver Health Paramedics sounds like it would be a great fit AND they are currently recruiting paramedics. The Denver Health Paramedic Division is a hospital based system, 911 only (NO IFTs), 120,000+ calls a year, four 10 hour shifts a week with staggered start...
  10. captaindepth

    Who's fully staffed?

    Have you noticed, since dropping the experience requirement, that the newer paramedics are employed for a shorter time frame before moving onto something else? It seems like if most of the new hires are newer medics they would stay for experience but would then move to bigger systems, FDs...
  11. captaindepth

    Who's fully staffed?

    I think we are somewhere around 6-10 paramedics short of our goal right now, and in the five years I have been part of the paramedic division it seems like we are always just short of our staffing goal. It seems like there are a number of factors that lead to this chronic under par state and...
  12. captaindepth

    Alameda County, CA

    Sounds like you have some pretty strong feelings about your experience there, can you elaborate? Like I said earlier, the only Falck system I have seen is the Aurora CO system and I know for a fact I wouldn't go there for 43/hr. Why is there this theme of their systems being so bad? $50/hr is...
  13. captaindepth

    Alameda County, CA

    Wow, for some reason I never really knew how big Alameda county was. I would imagine with all of those different cities/towns and the geographic divides there would be multiple operations/stations/jurisdictions for ambulance crews (for example, if you're running in Oakland you wouldn't get a...
  14. captaindepth

    Alameda County, CA

    If Berkeley, Piedmont, and Alameda all have their own transport services, where will Falk be responding? Oakland and San Leandro? Is the system going to be 911 only or will there be interfacility transfers as well? Also are the local FDs ALS or BLS departments? Will Falk medics have medical...
  15. captaindepth

    asthma code

    The simplicity of the question and the quick disregard for any further investigation into the arrest indicted by the answers above really bothered me. In the above scenario there is no clinical assessment or interpretation of the arrest etiology. And the answers provided above are in adequate...
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