So you're saying a trauma center is a trauma center is a trauma center right? Wrong. There are (or can be, definetly should be everywhere in my book) multiple different levels. Here it's 4. There will be a huge difference between a local hospital that can produce an ER Doc, 2RN's, has a surgeon in house and everyone else on call and a regional hospital that can produce multiple ER Docs, RN's of various types,RT's, anesthisiologists, neurosurgeons, surgeons, and chaplains in just a couple of minutes. Just because a hospital get's itself classified as a trauma center doesn't always make it the best choice; I don't know how Minnasota does it, but maybe you should look into that. Not to mention the fact that a trauma center is definetly not always a burn center; often they can be two different things entirely. That kid needed a burn center, not a trauma hospital. So unless it happened to be both...straight to the bird with him.
Spanked By ER Doc!
- Thread starter Gbro
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Arkymedic
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Well let me tell ya'll this if you can just go to a trauma center consider yourself very lucky. We have one level I trauma center in Little Rock at the University of Arkansas Medical Services (UAMS) about 3.5 hours from here, a burn center at Arkansas Childrens Hospital same place, and very few other level trauma centers scattered throughout Arkansas. There are also trauma and burn centers in Memphis, TN, Tulsa and OKC, OK, Springfield, MO, and Shreveport, LA. Consider yourself very very fortunate to have that option. We are also one of the few states that has a designated trauma system. I consider myself fortunate to have the choice between two good hospitals that are progressive. http://www.bizjournals.com/memphis/stories/2007/03/26/daily11.html?b=1174881600%5E1438099
Ridryder911
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There are multiple levels of trauma center designations. The most common is accredited by the American College of Surgeons (ACS) Level I and Level II. The main differential is sponsorship and participation in research and residency and publications. There of course is much more.. I was on the ACS acreditation and review, when I worked as a Trauma Systems Specialist. Most of the criteria is chart review and surgical intervention and rehabilatation. Not as much in regards to the true physical building nor the ones in the center.
Level III and Level IV are usually state appointed (albeit some states certify all levels) and these can be varied in requirements. Such as some states do not even require a physician to be present .. Yes in a trauma center (level IV). So, just because one advertises or announces that they have a trauma center does not impress me or convince me that they are capable of providing the required care.
There is as well differential in Burn Centers and Burn Units. Burn centers are usually accredited through the American Burn Association (ABA) and have to meet strignet requirements set forth by their accreditation committee.
Technically, the ACS does not regard burns as trauma rather as enviromental injuries.
R/r 911
Level III and Level IV are usually state appointed (albeit some states certify all levels) and these can be varied in requirements. Such as some states do not even require a physician to be present .. Yes in a trauma center (level IV). So, just because one advertises or announces that they have a trauma center does not impress me or convince me that they are capable of providing the required care.
There is as well differential in Burn Centers and Burn Units. Burn centers are usually accredited through the American Burn Association (ABA) and have to meet strignet requirements set forth by their accreditation committee.
Technically, the ACS does not regard burns as trauma rather as enviromental injuries.
R/r 911
EMTmetzger
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id probobly do the same thing, i'v been know to mach attitude w/ attitude (mostly to the realy cocky teachers)
spanked by er doc
You are not alone when it comes to arse chewing. I'll give you my scenario- we were called for a difficult breather (which is an als dispatch protocol in my area) on arrival my findings were actually minor injurys from a domestic with no difficult breathing- I immediatedly canceled the als unit . obtained pt.vitals and assessed to find pt.admitted to drinking a bottle of wine and taking her dose of anti-depressants for evening. pt. presented as being under influence -slurring, could not focus , and in a state of anger at times . Law enforcement on scene sorted thru mess of he said she said . During course of pt. interview pt. stated that we didn't have to worry she wasn't going to committ suicide that nite (?)In any case pt agreed to be transported to er for evaluation and pt. insisted on ambulating to stretcher outside of her door once we reached stretcher pt.claimed to have panic attack and in a matter of seconds appeared to go unconscious , I tried to verbally arouse pt. w no response while maintaining airway , a sternum rub also did not prompt any response so I asked for ALS to be dispatched (as per protocol ) for an unknown loc , pt regained consciousness within 1 minute and als was within 30 seconds of our location. Oh boy were they angry and questioned why they were "bothered with this call " after they were initially canceled. I responded that protocol dictated their dispatch and pt. status had changed -- Now get this 1 medic confronted pt. with anger and neither medic of the 2 even listened to my report. The only assessment they provide was a check from outside of rig of pt.current a+o which was 3 at that time . Pt. became infuriated unbuckled and jumped from rig where she was again confronted by mighty medic #1 , hence pt.was placed under arrest by pd the omighty duo left scene and later spouted that I never should have "bothered them " sorry my advocacy is for my pt. not the sleep of 2 medics !
You are not alone when it comes to arse chewing. I'll give you my scenario- we were called for a difficult breather (which is an als dispatch protocol in my area) on arrival my findings were actually minor injurys from a domestic with no difficult breathing- I immediatedly canceled the als unit . obtained pt.vitals and assessed to find pt.admitted to drinking a bottle of wine and taking her dose of anti-depressants for evening. pt. presented as being under influence -slurring, could not focus , and in a state of anger at times . Law enforcement on scene sorted thru mess of he said she said . During course of pt. interview pt. stated that we didn't have to worry she wasn't going to committ suicide that nite (?)In any case pt agreed to be transported to er for evaluation and pt. insisted on ambulating to stretcher outside of her door once we reached stretcher pt.claimed to have panic attack and in a matter of seconds appeared to go unconscious , I tried to verbally arouse pt. w no response while maintaining airway , a sternum rub also did not prompt any response so I asked for ALS to be dispatched (as per protocol ) for an unknown loc , pt regained consciousness within 1 minute and als was within 30 seconds of our location. Oh boy were they angry and questioned why they were "bothered with this call " after they were initially canceled. I responded that protocol dictated their dispatch and pt. status had changed -- Now get this 1 medic confronted pt. with anger and neither medic of the 2 even listened to my report. The only assessment they provide was a check from outside of rig of pt.current a+o which was 3 at that time . Pt. became infuriated unbuckled and jumped from rig where she was again confronted by mighty medic #1 , hence pt.was placed under arrest by pd the omighty duo left scene and later spouted that I never should have "bothered them " sorry my advocacy is for my pt. not the sleep of 2 medics !
What you did/went through/deal with in a metro setting that screens calls ALS vs BLS, has to be a frustrating thing. One would doubt his service/self much more than a BLS in my setting.
We get everything. And we request ALS when its needed/and by guide lines.
Our rig transports the PT. and through it all we are still part of every call.
EXCEPT 1.
The sister of one of the EMT-P's from a nearby ALS system requested that service for her husband. It was in our PSA and the dispatch properly dispatched that unit, but also dispatched us. Of course we were on scene much sooner, and got to here all about how wonderful her brother was and how she would only trust her husband with the service he was with.
It was quite the seen!, How glad we were to have them come through the door.
They did deserver each other! LOL
We get everything. And we request ALS when its needed/and by guide lines.
Our rig transports the PT. and through it all we are still part of every call.
EXCEPT 1.
The sister of one of the EMT-P's from a nearby ALS system requested that service for her husband. It was in our PSA and the dispatch properly dispatched that unit, but also dispatched us. Of course we were on scene much sooner, and got to here all about how wonderful her brother was and how she would only trust her husband with the service he was with.
It was quite the seen!, How glad we were to have them come through the door.
They did deserver each other! LOL
Trouble with a smile
Call for a 10-52 Motorcycle VS Deer, 2
1st responders gave us a update, 2 pt's one uncon/unrep. head injury, other back pain, good CMS.
We did a load -N- Go with the head injury, but left one attendant on scene.
Radioed to responding ALS unit that we would grab a medic off there unit and they could continue and one of our attendants was still on scene.
We did the intercept and all, BUT the ALS unit only had one medic on-board. the driver was EMT-B, just like us.
So here is an ALS unit on a scene with 2 Basics with it.
When we arrived at the ER, the supervisor of the ALS unit thought he was going to give me a chewing over this.
The smile never left my face!, The Pt's were my focus, We did our job. all the rest is just nit-pic parade.
"I am smiling now"
.
Call for a 10-52 Motorcycle VS Deer, 2
1st responders gave us a update, 2 pt's one uncon/unrep. head injury, other back pain, good CMS.
We did a load -N- Go with the head injury, but left one attendant on scene.
Radioed to responding ALS unit that we would grab a medic off there unit and they could continue and one of our attendants was still on scene.
We did the intercept and all, BUT the ALS unit only had one medic on-board. the driver was EMT-B, just like us.
So here is an ALS unit on a scene with 2 Basics with it.
When we arrived at the ER, the supervisor of the ALS unit thought he was going to give me a chewing over this.
The smile never left my face!, The Pt's were my focus, We did our job. all the rest is just nit-pic parade.
"I am smiling now"
.
Corl-Grove
Forum Ride Along
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Water Gel is awesome
Whether or not your state appoved the use of water Gel from a burned patient perspective this :censored::censored::censored::censored: is great...
My brother had a truck that was overheating and he was attempting to remove the radiator cap when it blew off covering his chest and neck with screaming hot antifreeze/water. My truck responded to the call and found him screaming (wimpy Paramedic b.t.w.) we took him to the local ER which of course prescribed silvadeen (sorry not sure of spelling) and it did nothing for him. I aquired some Water Gel from the volunteer squad I ran with and told him to try it. Because of the Lidocaine his pain quickly subsided. I truly believe that as a tx for burns this needs to be investigated thoroughly.
Take care, and Be Safe
Whether or not your state appoved the use of water Gel from a burned patient perspective this :censored::censored::censored::censored: is great...
My brother had a truck that was overheating and he was attempting to remove the radiator cap when it blew off covering his chest and neck with screaming hot antifreeze/water. My truck responded to the call and found him screaming (wimpy Paramedic b.t.w.) we took him to the local ER which of course prescribed silvadeen (sorry not sure of spelling) and it did nothing for him. I aquired some Water Gel from the volunteer squad I ran with and told him to try it. Because of the Lidocaine his pain quickly subsided. I truly believe that as a tx for burns this needs to be investigated thoroughly.
Take care, and Be Safe
Silvadene is a sulfa medicine used to prevent and treat bacterial or fungus infections. It is not a pain killer but can prevent serious complications from infection.