Prehospital command hierarchy, fitting it in with the regular medical community

ZootownMedic

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To be fair, there's a difference between the docs who regularly engage in prehospital emergency care, and those who don't.

Haha exactly. When was the last time a regular doc started a 20 gauge IV, bagged, and intubated on a little baby whos mom is screaming in your face? But because they are a Doc they can do anything right? gimme a break.....
 

usalsfyre

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Haha exactly. When was the last time a regular doc started a 20 gauge IV, bagged, and intubated on a little baby whos mom is screaming in your face? But because they are a Doc they can do anything right? gimme a break.....

Just because someone's a medic makes them somehow suited to this?

Someone's been listening to their medic school instructors too much, your more arrogant and conceited than I am...and that's an achievement.
 

Handsome Robb

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Haha. Yeah since they know where everything on the ambulance is......but hey its your life

Doesn't really matter if you don't know where stuff is in the truck if someone who does is riding in the back with you...

My question is why didn't the doc let the medic try and get the tube, and if they really couldn't get it why didn't this guy get a crike?

I sure hope the medic documented the living :censored: :censored: :censored: :censored: outta the call, it's his truck and his responsibility.
 

ZootownMedic

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"It is better to know some of the questions than all of the answers."- James Thurber

Its probably also better to know where the equipment youll need is to perform a life saving intervention before the patient is dead.....just saying.....plus Doc's don't do pre-hospital interventions very often. Some interventions maybe but not some of the ones that count.
 

ZootownMedic

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Doesn't really matter if you don't know where stuff is in the truck if someone who does is riding in the back with you...

My question is why didn't the doc let the medic try and get the tube, and if they really couldn't get it why didn't this guy get a crike?

I sure hope the medic documented the living :censored: :censored: :censored: :censored: outta the call, it's his truck and his responsibility.

The Doc sunk a combitube on the guy after the failed ETI.....The doc assumed patient care and wanted to do it. The Paramedic on that bus is one of my training advisors...shes a great medic. I don't know about the documentation but Im sure she did........
 

ZootownMedic

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Just because someone's a medic makes them somehow suited to this?

Someone's been listening to their medic school instructors too much, your more arrogant and conceited than I am...and that's an achievement.

haha what do you mean more suited to this? I know in some parts of our city its a weekly event! So yeah, practice makes perfect
 

usafmedic45

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Its probably also better to know where the equipment youll need is to perform a life saving intervention before the patient is dead.....just saying.....plus Doc's don't do pre-hospital interventions very often. Some interventions maybe but not some of the ones that count.

It was more of a general statement about some of the comments that have been made by a couple of the parties involved in this discussion than about the post that was inadvertently quoted.
 

usalsfyre

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Its probably also better to know where the equipment youll need is to perform a life saving intervention before the patient is dead.....just saying.....plus Doc's don't do pre-hospital interventions very often. Some interventions maybe but not some of the ones that count.

So your saying your average ED physician doesn't do airway control, place lines or administer medication very often?
 

ZootownMedic

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Doesn't really matter if you don't know where stuff is in the truck if someone who does is riding in the back with you...

My question is why didn't the doc let the medic try and get the tube, and if they really couldn't get it why didn't this guy get a crike?

I sure hope the medic documented the living :censored: :censored: :censored: :censored: outta the call, it's his truck and his responsibility.

And it's not the medics responsibility anymore if a licensed and practicing MD takes pt care and rides in with the pt.....as far as I know at least....
 

usafmedic45

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Just because someone's a medic makes them somehow suited to this?

Someone's been listening to their medic school instructors too much, your more arrogant and conceited than I am...and that's an achievement.

This is what I was referring to but I am trying to be a little more civil than I normally am.
 

ZootownMedic

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So your saying your average ED physician doesn't do airway control, place lines or administer medication very often?

you said a BASIC Doctor...not a ED physician. I'd take a ED physician over a average medic anyday....not a regular MD though that practices a different type of medicine
 

Handsome Robb

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Doesn't have to be pretty to work.

The part of the story that makes me wonder is why this 'great' ER doc said vitals were stable at that BP with signs of a tension pnuemo...sounds fishy to me, no offense. I truly am sorry about what happened to your friend.

So your saying your average ED physician doesn't do airway control, place lines or administer medication very often?

I'll bite, at the level II here not too often for the airway and line placement.

RRTs and techs or nurses are so plentiful there's usually one around to take care of both tasks, respectively. Not saying they don't do it but more often than not it's someone else, in my limited experience in the ER.
 

usalsfyre

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you said a BASIC Doctor...not a ED physician. I'd take a ED physician over a average medic anyday....not a regular MD though that practices a different type of medicine
You do know I was referring to the prehospital physicians in the UK when I said a BASIC doc right?
 

ZootownMedic

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For whatever reason civility hasn't been on my agenda the past couple of days...

Its all good guys....this discussion has kinda gone in a argumentative direction. I'm not trying to sound arrogant I am just confident in the people I work with.
 

usafmedic45

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For whatever reason civility hasn't been on my agenda the past couple of days...

Having the girlfriend around has tended to improve my mood significantly. Take that as you will. :p
 

Handsome Robb

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And it's not the medics responsibility anymore if a licensed and practicing MD takes pt care and rides in with the pt.....as far as I know at least....

It's still the medic's truck, and if not documented properly can turn around and bite you in the ***. Albeit the MD will go down too but the medic very well could be dragged down with them, from my understanding. Just like an EMT-B partner can get screwed by not speaking up when his Medic partner was being negligent.
 

ZootownMedic

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Doesn't have to be pretty to work.

The part of the story that makes me wonder is why this 'great' ER doc said vitals were stable at that BP with signs of a tension pnuemo...sounds fishy to me, no offense. I truly am sorry about what happened to your friend.



I'll bite, at the level II here not too often for the airway and line placement.

RRTs and techs or nurses are so plentiful there's usually one around to take care of both tasks, respectively. Not saying they don't do it but more often than not it's someone else, in my limited experience in the ER.

THANK YOU. Since ER Doctors do IV's ALL The time. haha what a joke! And I don't know about the vitals. From what i gathered I think that the ER Doc was kinda scared to do surgical interventions in the field......again just out of her element.
 

usalsfyre

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THANK YOU. Since ER Doctors do IV's ALL The time. haha what a joke! And I don't know about the vitals. From what i gathered I think that the ER Doc was kinda scared to do surgical interventions in the field......again just out of her element.
Ever seen a central line initiated? Not too far from an IV...
 
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