Code brown

Smash said:
Hmmm... and still people complain that American EMTs don't get the respect or money that they deserve.
I would present this as evidence that for the most part, they get exactly what they deserve.
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I don't think this attitude is representative of the majority of EMT's, and I know it does not represent me. I treat my patient as if they were a member of my family, and if that means I clean poo, then I clean poo...AS the old, worn out saying goes, that patient is someone's relative.
 
well, the thing about San Francisco, is that it's only 7 miles X 7 miles, with about 12 hospitals, so max transport time is about 10 minutes, not leaving a ton of time for the "fun stuff", I would never object to sticking around and helping the staff of the receiving facility clean up some poo, it's not beneath me, and nothing really grosses me out.
 
We have a pack of baby wipes for this purpose. I clean poop for two reasons: first, it's cruel to make people sit in it, if it's at all avoidable (actual hemodynamic instability is the only reason I'll skip cleaning poop), and second, that crap STINKs and i don't want it in my ambulance making me nauseous if I can help it.
 
emt-mike said:
well, the thing about San Francisco, is that it's only 7 miles X 7 miles, with about 12 hospitals, so max transport time is about 10 minutes, not leaving a ton of time for the "fun stuff", I would never object to sticking around and helping the staff of the receiving facility clean up some poo, it's not beneath me, and nothing really grosses me out.
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The worst thing anyone can say is " it only 5 minutes to ED, so let them do it". That pt may have to sit in it at the ED for another 20 minutes, until they can get to them. What " Fun stuff" do you need to do? I don't care if you are in the parking lot of the ED. Take the time to clean the majority up. Plus, the ED staff won't look at you as an idiot!
 
b2dragun said:
I am 5 minutes from wherever I am dropping off...turn the exhaust fan on and open a window. I am not cleaning anyone up, unless it is a dirty wound I don't clean. If I worried about cleanliness then I would spend all my time cleaning, you have no idea how many of my pt's piss or code brown themselves. The homeless I run on have weeks worth, the drunks have plenty too. If it is a transfer then a couple minutes of being in feces won't kill them, chances are they lay in it for longer while at the facility anyways. When in doubt I am more then willing to refer to my EMT-B and EMT-I books that do not make mention of this.
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You're lucky you're not my partner, 'cause that little comment right there would ensure that you WOULD be cleaning up every one of our patients on your own for a month or two, regardless of who was up.

I don't know who you think you are, but let me make something clear: you are not too good to clean up after your patients. I am not too good to clean up after my patients. NONE of us are too good to clean up after our patients. And unless there's some more pressing issue present, we all SHOULD be cleaning up after our patients.

Medicine is more than just IVs and medications and intubation. It's about being a decent human being and treating people with kindness and compassion. We're there to treat their medical problems, yeah, but that doesn't mean we're not also there to treat their emotional, psychological, and yeah, even social problems as well. Don't have a place to live? Let me make sure the hospital puts you in contact with someone that can help you with that. Need someone to vent to about all the :censored::censored::censored::censored: that made you want to take an overdose? I'm a good listener. Need someone to wipe your ***? Yeah, I'll even do that. And if you ever expect to be taken seriously as a provider or given any measure of respect, you'd better learn that your job doesn't start and stop with the medicine.
 
Bieber said:
You're lucky you're not my partner, 'cause that little comment right there would ensure that you WOULD be cleaning up every one of our patients on your own for a month or two, regardless of who was up.

I don't know who you think you are, but let me make something clear: you are not too good to clean up after your patients. I am not too good to clean up after my patients. NONE of us are too good to clean up after our patients. And unless there's some more pressing issue present, we all SHOULD be cleaning up after our patients.

Medicine is more than just IVs and medications and intubation. It's about being a decent human being and treating people with kindness and compassion. We're there to treat their medical problems, yeah, but that doesn't mean we're not also there to treat their emotional, psychological, and yeah, even social problems as well. Don't have a place to live? Let me make sure the hospital puts you in contact with someone that can help you with that. Need someone to vent to about all the :censored::censored::censored::censored: that made you want to take an overdose? I'm a good listener. Need someone to wipe your ***? Yeah, I'll even do that. And if you ever expect to be taken seriously as a provider or given any measure of respect, you'd better learn that your job doesn't start and stop with the medicine.
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+1

I don't know if anyone could have said it better
 
I'm with Akulahawk on this one. I'll clean up a patient onscene before transport, or allow them to use their own restroom, but if they are chronically incontinent, they should be wearing Depends, and they can wait until they get to the hospital to get cleaned up if they do something in the back of the truck. The back of the truck is no place to be cleaning up patients. Its an uncontrolled environment, and you are bumping around constantly. I work IFT, and many of my elderly patients are overweight, making it a near impossible task anyway for myself to remove necessary seatbelts and roll the patients to clean them up. When working 911, transport is only going to be about 10 minutes for me, and the hospital employs CNAs who are paid and better trained to do this job.
 
Thanks to human physiology, it's completely rare for a person to have a bowel movement in the ambulance. I was talking about in the house or facility. I do not load poop onto the stretcher.
 
I've cleaned plenty of folks in their home, but it wont be happening in the back of a moving vehicle.
 
reaper said:
The worst thing anyone can say is " it only 5 minutes to ED, so let them do it". That pt may have to sit in it at the ED for another 20 minutes, until they can get to them. What " Fun stuff" do you need to do? I don't care if you are in the parking lot of the ED. Take the time to clean the majority up. Plus, the ED staff won't look at you as an idiot!
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"fun stuff" refers to cleaning poo, also I expressly said I would stick around and help, but it's not happening in the back of the ambulance.
 
I should make one thing perfectly clear: It's not that I don't want my patient sitting in poop (because it's very irritating to the skin), it's because of the practicalities of attempting to clean up after a patient once in the back of the ambulance. I've had to do it (yes, more than once), and it's just this side of impossible... but it can be done. Clean 'em up before or after transport. If you can safely do it (and have time to do it safely) en-route, go ahead... hopefully you won't be bounced around into the poo.

While doing IFT or 911, if my patient needed cleaning upon arrival, I'd let the receiving RN know so that they can martial-up the needed supplies (and possibly arrange for a specimen gathering) while they're at it, before I arrive to minimize the amount of poo-sitting time.
 
IMO....If your not to far from the destination....wait till you get them there and clean them up at the facility usually they have a better enviro. for cleaning them up.....
 
I take it on a case by case basis.

If it's a long transport, I will do my best.

If they can help me by turning themselves, or at least holding the side rail to keep themselves turned, I will clean them up.

If I am two minutes from the facility and they're complete dead weight, sorry. I don't have enough room for my partner to come back there and help me roll and clean the patient.

I wont leave them in it, when we get to the facility and get them moved over, I will help change and clean the patient or do it myself if the nurses are taking forever.

I have no problem cleaning a patient. I will put them on a bed pan if they request it, help them get themselves into a urinal, and clean vomit or spit up from their faces, but sometimes it's just not possible to change or clean a patient's bottom in the back.
 
A Word In Defense of the Broken

Let me step out on a limb here.

Did you know that some medics' reality is call after endless call of moving around self-crippled human beings, suffering from all levels of diseases of choice who, given the opportunity to help themselves would much prefer to manipulate the world so that some poor EMS schmuck feels like he HAS to wipe his butt?

I'm talking willful manipulation and maybe poop is just a metaphor.

I've ridden or acted in services literally overdosed with human filth of thought, deed and body; call after call of relentless depravity. This is the Inner City with Many Names and the coldness and evil thoughts and deeds of the medics there are often hidden, even from themselves; perhaps especially from themselves.

YES, there are some locations and some ambulance services where most every moment of every day your patients reflect human beings who have stopped trying; who have essentially lost the will to live. They literally torture medics by being themselves because the medics don't really get to save anyone who really wants to live.

Or worse yet, they CAN'T save those who really do.

Can you imagine that? It's out there and some of your Brothers and Sisters suffer from over-exposure to it.

Self-disclosure: There was a period during my career, when assigned to such a station, I was more than willing to let many of my patients roll in their own. How many times in one day could I get my hands filthy? (Gloved, of course!). A timely transfer saved me from the worst part of myself.

Something else I must say; it is possible that in the course of your career you may experience a string of calls that so deaden, demoralize and chill you that you may find yourself acting cruelly.

Human beings became medics to make some sort of an impact. Some end up in places or situations where they really, truly CANNOT and get a little crazy because of it.

I'm sorry, but it's there, I've seen it and I've seen this kind of exposure first harden and then crumble once stellar medics and decent human beings; I came close myself.

Why would I offer this? Why would I rock this particular boat?

Because there are quite probably people reading this right now who are disturbed by these parts of themselves or these types of experiences.

They would NEVER come forward for fear of judgments that so many have shown here.
 
Bieber said:
You're lucky you're not my partner, 'cause that little comment right there would ensure that you WOULD be cleaning up every one of our patients on your own for a month or two, regardless of who was up.

I don't know who you think you are, but let me make something clear: you are not too good to clean up after your patients. I am not too good to clean up after my patients. NONE of us are too good to clean up after our patients. And unless there's some more pressing issue present, we all SHOULD be cleaning up after our patients.

Medicine is more than just IVs and medications and intubation. It's about being a decent human being and treating people with kindness and compassion. We're there to treat their medical problems, yeah, but that doesn't mean we're not also there to treat their emotional, psychological, and yeah, even social problems as well. Don't have a place to live? Let me make sure the hospital puts you in contact with someone that can help you with that. Need someone to vent to about all the :censored::censored::censored::censored: that made you want to take an overdose? I'm a good listener. Need someone to wipe your ***? Yeah, I'll even do that. And if you ever expect to be taken seriously as a provider or given any measure of respect, you'd better learn that your job doesn't start and stop with the medicine.
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That's my answer to this thread
 
As someone stated earlier, I take it on a case by case basis. If it's an IFT I have the nursing staff help me clean the patient before we even leave. If it happens during transport you get a bedpan and help clean the patient when you've transported them to the new facility. By no means am I or anyone else "too good" to take five extra minutes to keep a patient clean and prevent sepsis.

However, 9-1-1 is a whole different story altogether. Many times your going to find that you just do not have the time to treat and assess a patient AND clean them during transport. If time permits, then by all means I'll do it; but most of the time this isn't the case. In any case EMS is all about patient care and customer service, if you don't clean them in the ambulance at least make sure they get cleaned at the hospital or long-term care facility. Little things like that make all the difference.
 
For all of you who say that you aren't going to clean anyone up, shame on you, you are not a healthcare professional. If my loved one were in the back of your ambulance and you refused to clean them, I would have your job.

As some have said, it's a case-by-case basis. Can the patient turn themselves (even a little)? Are they free of injuries that would complicate maneuvering them to take care of the mess? Then clean them.

If the patient has a broken hip, on the other hand, the cleaning is best left in the hands of RNs and their cool wedge-pillows.

The least you can do is clean the patient when you are in the ER and have more space to maneuver.
 
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