Any comments on this one......

[Sasha]

So what did the Medic think was causing the Bradycardia?

Apparently, hypoxia!

 

[CAOX3]

You want to know what s wrong with EMS, you wouldn't have to look much further then the pages in this thread, name calling, degrading comments and unprofessionalism. We all know the state of EMS education to hold someone personally responsible is ridiculous. We like to blame everyone else for the problems in EMS however we create most of them ourselves. Take a look in the mirror, are you doing your part to educate and guide less experienced providers or do you just scan these forums looking for your opportunity to pounce on a inexperienced provider. Its a DBish move and really shines a light on the lack of leadership in this profession.

Everyday I'm faced with questions sometimes I have to ask new providers to repeat because I can't believe the words are coming from their mouth. Sure I could laugh, talk behind their backs to make myself look smarter or I can take the opportunity to educate them. Maybe you should try the latter. No I cant fix all the problems in EMS, I can't increase educational standards, I can't change the protocol mentality or any other of the billion problems that exist in this profession, what I can do maybe educate one provider on what better course of action may have been the maybe when he gets his oppurtunity he does the same.

Blaming others for problems that exist, them not doing your part to change them is weak. Sometimes I want to throw up my hands and walk away, put in my papers and get a little place on the beach but I don't because that just makes me part of the problem. I'm just an emt, nothing special, I got no fancy tools, no magic medications and I don't save lives on a daily basis not do I claim too. What I have is a passion for EMS that I'm happy to share with anyone who is interested.

So yeah I could knock his head off and jump down his throat to prove I'm better but I never have and I never will I choose to take a different path in changing EMS to share what ever I have with anyone who wants it.

Some times I miss the opportunity, I'm not perfect. But nothing bothers me more then then a more experienced provider who belittles a new or less experienced one to make themselves appear superior, I don't care what level you are EMT, medic or whoever you are its unprofessional. I been in this game a long time, I'm not impressed with titles, I'm impressed with actions

 

[Veneficus]

You want to know what s wrong with EMS, you wouldn't have to look much further then the pages in this thread, name calling, degrading comments and unprofessionalism. We all know the state of EMS education to hold someone personally responsible is ridiculous. We like to blame everyone else for the problems in EMS however we create most of them ourselves. Take a look in the mirror, are you doing your part to educate and guide less experienced providers or do you just scan these forums looking for your opportunity to pounce on a inexperienced provider. Its a DBish move and really shines a light on the lack of leadership in this profession.

Everyday I'm faced with questions sometimes I have to ask new providers to repeat because I can't believe the words are coming from their mouth. Sure I could laugh, talk behind their backs to make myself look smarter or I can take the opportunity to educate them. Maybe you should try the latter. No I cant fix all the problems in EMS, I can't increase educational standards, I can't change the protocol mentality or any other of the billion problems that exist in this profession, what I can do maybe educate one provider on what better course of action may have been the maybe when he gets his oppurtunity he does the same.

Blaming others for problems that exist, them not doing your part to change them is weak. Sometimes I want to throw up my hands and walk away, put in my papers and get a little place on the beach but I don't because that just makes me part of the problem. I'm just an emt, nothing special, I got no fancy tools, no magic medications and I don't save lives on a daily basis not do I claim too. What I have is a passion for EMS that I'm happy to share with anyone who is interested.

So yeah I could knock his head off and jump down his throat to prove I'm better but I never have and I never will I choose to take a different path in changing EMS to share what ever I have with anyone who wants it.

Some times I miss the opportunity, I'm not perfect. But nothing bothers me more then then a more experienced provider who belittles a new or less experienced one to make themselves appear superior, I don't care what level you are EMT, medic or whoever you are its unprofessional. I been in this game a long time, I'm not impressed with titles, I'm impressed with actions

I think there is a very important distinction that is being missed.

Every effort is made on this forum to guide and mentor new providers. Some have approaches harder than others.

I do my best to educate the newer people, to share what I have learned.

But when their reception turns into: "the cookbook says" or "following orders" without regard to the thought processes of patient care to simply justify that not thinking, knowing, or wanting to learn because it takes too much effort.

Everyone in EMS claims to want to be more than a taxi driver. Some step up and prove it. Some just recess into excuses and wanting to be considered a hero.

The division between educated professional providers and trained laborers has been going on for ages.

For every one EMS provider who tries to advance the profession, there are 10holding it back with excuses and laziness. You can even see it here on this forum.

I think people are simply choosing their side.

Those who want to learn and be better seem to get more slack for their mistakes here, even if there is a personality clash.

Those that tout following the traditions and dogma of yesterday seem to have a harder time.

I expect that other healthcare fields experienced similar internal struggle when they decided they wanted to be more than the bottom feeders.

 

[18G]

Its exactly what Vene has said. I said they sounded like a bunch of idiots because they really did and the OP was defending them and playing follow the leader. I'm not a condescending person but there does come a time when you have to call it as it is.

 

[emt seeking first job]

In my EMT class, they said always slap on o-2, and monitor the patient, if they refuse, can not tolerate, or have a bad reaction then take them off.

Once again, unless I am told to do something illegal or against the protocols, I will follow.

ALS did not say to take it off.

The ER staff put him on their own o-2 supply.

Maybe I left a critical part out.

Can anyone cite the NYC REMSCO protocl violated in this situation.

And my question was answered, the patient was unfamiliar with EMS protocols and his speciality had been orthopedics anyway.

As far as the comments, I dont care, I am the most thick skinned person you ever met.

 

[usalsfyre]

Three thoughts here.

The ER staff put him on their own o-2 supply.

If I bring a patient in on O2, the ED usually continues it. If I don't they usually don't start it.

Can anyone cite the NYC REMSCO protocl violated in this situation.

As has been noted a dozen time in this thread, just because it's protocol doesn't mean it's not stupid/outdated/assumes your stupid.

And my question was answered, the patient was unfamiliar with EMS protocols and his speciality had been orthopedics anyway.

Depending on where his practice and if there was a specific are of ortho he specialized in, he was very likely extremely familiar with emergency and/or critical care.

 

[94H]

One of the cardinal rules of the public safety professions is if you are the new guy, keep your ears and eyes open and your mouth shut.

Imagine if I had never joined the service. What would have happened any way ?

Thats the problem you need to overcome right now. I am relatively new on an ALS bus (7 months), but I still question my superiors (both rank and seniority) when its necessary.

Like the time I was running with a sup who wanted to give nitro to a pt who had a sys BP of less than 100, before establishing IV access. In that case I was able to convince her to hold off, and IV access was never established, so if we ended up giving the nitro we would have been SOL.

 

[94H]

In my EMT class, they said always slap on o-2, and monitor the patient, if they refuse, can not tolerate, or have a bad reaction then take them off.

Once again, unless I am told to do something illegal or against the protocols, I will follow.

ALS did not say to take it off.

The ER staff put him on their own o-2 supply.

Maybe I left a critical part out.

Can anyone cite the NYC REMSCO protocl violated in this situation.

And my question was answered, the patient was unfamiliar with EMS protocols and his speciality had been orthopedics anyway.

As far as the comments, I dont care, I am the most thick skinned person you ever met.

You didnt do anything wrong, other then perhaps initiating prompt transport when you decided ALS was necessary. As a general rule, wherever I was working (NYC, PA) we didnt sit and play while waiting for ALS (except with the QRS. Its a judgment call though, and its easy to defer to the senior person simply because they are "senior".

What I found though is that many of the "senior" people are still working on the same mentalities they were trained on in the 80s. EMS has come a long way, just like new medics always wear gloves for any type of invasive procedure, and those "senior" ones usually dont.

 

[emt seeking first job]

You didnt do anything wrong, other then perhaps initiating prompt transport when you decided ALS was necessary. As a general rule, wherever I was working (NYC, PA) we didnt sit and play while waiting for ALS (except with the QRS. Its a judgment call though, and its easy to defer to the senior person simply because they are "senior".

What I found though is that many of the "senior" people are still working on the same mentalities they were trained on in the 80s. EMS has come a long way, just like new medics always wear gloves for any type of invasive procedure, and those "senior" ones usually dont.

The explanation given to wait transport is (in our area) ALS i five minutes out and our crew chief wanted a full ALS evaluation before moving him.

(I didnt ask, but the person said that.)

Also, was not said, byt my thinking, there was a very narrow and steep staircase to negotiate and I felt better w/ five pairs of hands on the scoop.

 

[Veneficus]

And my question was answered, the patient was unfamiliar with EMS protocols and his speciality had been orthopedics anyway.

But he is still a doctor and knows more about medicne than any EMS provider ever will.

Also remember that traumatology is originally and still part of orthopaedics. Trauma is one of the most complex parts of medicine, and the molecular and biochemical pathology is the same as any other illness. If he had cardiac insufficency I am sure he was more than aware of what the treatments are, what helps, and what doesn't.

Just because he was unfamiliar with the outdated ineffective medicine practiced by US EMS doesn't make him senile or inept.

If any medical knowledge is lacking in this scenario it is that of the EMS providers. They could have been just as effective waving a dead chicken at him.

 

[Veneficus]

Like the time I was running with a sup who wanted to give nitro to a pt who had a sys BP of less than 100, before establishing IV access. In that case I was able to convince her to hold off, and IV access was never established, so if we ended up giving the nitro we would have been SOL.

If I could just point out...

Nitro tabs or spray lasts about 5 minutes. People self administer it everyday without taking their BP or starting a line.

I know many female patients whos normal BP is less than 100 who are on nitro.

I think you might have been making this more dramatic than it really is.

 

[abckidsmom]

The explanation given to wait transport is (in our area) ALS i five minutes out and our crew chief wanted a full ALS evaluation before moving him.

(I didnt ask, but the person said that.)

Also, was not said, byt my thinking, there was a very narrow and steep staircase to negotiate and I felt better w/ five pairs of hands on the scoop.

You can fit 5 people on a narrow, steep staircase? Swift work. I thought you used the stair chair.

Anyway, on stairs, the safest way to move a person is with the stair chair, bumping down one at a time, with one person on the top (or maybe two, but they need to be able to communicate seemlessly), and one on the bottom.

I wouldn't carry a scoop stretcher down more than 4 or 5 stairs. The angle gets too steep.

 

[usafmedic45]

I know many female patients whos normal BP is less than 100 who are on nitro.

My mother is a perfect example of this.

And my question was answered, the patient was unfamiliar with EMS protocols and his speciality had been orthopedics anyway.

Wow.....talk about misplaced confidence in one's very paltry knowledge and an inflated sense of importance in the world.

 

[emt seeking first job]

Wow.....talk about misplaced confidence in one's very paltry knowledge and an inflated sense of importance in the world.

Please do not be a "forum weenie"....(sigh)

I meant an MD might not be familiar with EMS particulars. The same way a Mechanical Engineer with a PHD defers to an auto mechanic with a tech school certificate to get his dead car to work.

I was just being objective, not putting myself on a higher plane.

Too many people online read into everything........

 

[usafmedic45]

Please do not be a "forum weenie"....

I'll try being more saachrin so you don't get your feelings hurt, when you stop trying to defend you being blatantly rude and extremely disrespectful to someone who probably has forgotten more about medicine than most members of this forum- myself included- will ever know.

I meant an MD might not be familiar with EMS particulars.

Given the "EMS particulars" you're describing, chances are this guy was a junior attending about the time they were developed, so yes, I'm reasonably certain he knew about what you were trying to do and why you were trying to do it.

The same way a Mechanical Engineer with a PHD defers to an auto mechanic with a tech school certificate to get his dead car to work.

The better analogy would be a ASE certified mechanic who works for a Formula One team and the jack*** who learned by tinkering around in his driveway on his Datsun. A doc knows how to get a person working just as well as an EMT does and then some. Get over yourself.

I was just being objective, not putting myself on a higher plane.

I suggest you read the following.....:
http://en.wikipedia.org/wiki/Confirmation_bias
http://en.wikipedia.org/wiki/Attitude_polarization
http://en.wikipedia.org/wiki/Wishful_thinking
http://en.wikipedia.org/wiki/Overconfidence_effect
....before ever trying to argue that you're being objective.

 

[Sasha]

usaf is a loveable forum weenie.

 

[usafmedic45]

usaf is a loveable forum weenie.

Thank you.

Sasha, my dear, even you can see that he was rude and disrespectful to the doc right? I mean, you'd be offended if he assumed you were stupid because you're pretty? How is it any less offensive that he assumed that because the guy's a doc and not an EMT he doesn't know what is going on and that he's senile simply because he is old and does not immediately agree with what is happening?

 

[Sasha]

Are you being condescending to me? Because if you are I'm going to kick you in your shins.

 

[usafmedic45]

Are you being condescending to me? Because if you are I'm going to kick you in your shins.

No ma'am. That was a genuine "thank you" and an honest question.

 

[Sasha]

Yeah, I think it was a jerk move to assume because the patient didnt agree and was old that he was senile. He just wasn't buying the BS and was bullied into taking a treatment that he didn't need.

Patient advocates they were not, and that makes me have a sadface.