fast65
Doogie Howser FP-C
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I did not, that's some you may want to take up with the FD
the 100% directionless thread
- Thread starter KEVD18
- Start date
I did not, that's some you may want to take up with the FD
bigbaldguy
Former medic seven years 911 service in houston
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Parking training?
Great idea, except 95% of the fire trucks I've seen park like 10 feet from the curb. Man I'd love to write that ticket
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NomadicMedic
I know a guy who knows a guy.
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Funny. 90% of the firefighters I know drive f250s or Chevy 2500s, and wouldn't think of driving anything like "a car".
DesertMedic66
Forum Troll
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Same here... And I am included in that list. Gotta have a big truck haha
bigbaldguy
Former medic seven years 911 service in houston
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Great idea, except 95% of the fire trucks I've seen park like 10 feet from the curb. Man I'd love to write that ticket
Duh why do you think they park so far from the curb? Lack of confidence.
bigbaldguy
Former medic seven years 911 service in houston
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Funny, you'd think driving a big red...truck... would instill some serious man-confidence.
Shishkabob
Forum Chief
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Great idea, except 95% of the fire trucks I've seen park like 10 feet from the curb. Man I'd love to write that ticket
Must be nice. The FFs in our area love to park in the only logical spot for an ambulance (ie right infront of the house with easy access for the stretcher to the driveway / walkway) but NOOOOOOO, they need to be 15 feet closer in their big truck.
It's ok, you're the ones rolling the patient out in the uneven terrain while I sit back and snicker.
h34r:Must be nice. The FFs in our area love to park in the only logical spot for an ambulance (ie right infront of the house with easy access for the stretcher to the driveway / walkway) but NOOOOOOO, they need to be 15 feet closer in their big truck.
It's ok, you're the ones rolling the patient out in the uneven terrain while I sit back and snicker.
Good thing I won't have to do that either soon. A couple of years from now I'll be a 2LT in the army. Atleast I'm not scared of jumping out of planes anymore (already dun-it).
I talked with my girlfriend about quantam dynamics a little while ago. My brain hurts.
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Despite what I have said in the past about not stopping at MVAs, I broke my own promise to myself driving down 93 in New Hampshire
Old beater explorer rolled three times, down an embankment, and came to rest on its roof on an abandoned exit ramp 20 feet below the highway. Must of happened like 90 seconds before I came around the curve and saw said vehicle, wheels still spinning. Figuring it unlikely that I would get by traffic considering the traffic jam and that I was not on the highway anymore I decided to stop. There was another EMT who decided to hold C-spine while I checked the car and then the driver (only patient) briefly. Despite the car being crushed down to it's window sills and the driver not wearing a seatbelt, he only had a few lacerations on his back and leg.
All of this is not notable. What bothered me I guess was when the ambulance showed up the first thing the crew did was grab a backboard, apply a collar, and board him. The guy had no complaints of c-spine injuries and no distracting injuries. He freed himself and was walking around on my arrival. But no, the MOI myth still holds true. I don't know what the area's protocols are and I am not second guessing the actions of the crew. I'm just sad that this is still the expectation of many services. See rolled over car, board patient, screw to hospital. I think we can do better.
Old beater explorer rolled three times, down an embankment, and came to rest on its roof on an abandoned exit ramp 20 feet below the highway. Must of happened like 90 seconds before I came around the curve and saw said vehicle, wheels still spinning. Figuring it unlikely that I would get by traffic considering the traffic jam and that I was not on the highway anymore I decided to stop. There was another EMT who decided to hold C-spine while I checked the car and then the driver (only patient) briefly. Despite the car being crushed down to it's window sills and the driver not wearing a seatbelt, he only had a few lacerations on his back and leg.
All of this is not notable. What bothered me I guess was when the ambulance showed up the first thing the crew did was grab a backboard, apply a collar, and board him. The guy had no complaints of c-spine injuries and no distracting injuries. He freed himself and was walking around on my arrival. But no, the MOI myth still holds true. I don't know what the area's protocols are and I am not second guessing the actions of the crew. I'm just sad that this is still the expectation of many services. See rolled over car, board patient, screw to hospital. I think we can do better.
bigbaldguy
Former medic seven years 911 service in houston
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I don't know at least in this case there was a very significant moi. It's when they backboard a fender bender that makes me chuckle.
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I agree but the last time I took a rollover patient into the TC without a board and collar on they were less than pleased with me. Even though the doc agreed with me when I rattled off NEXUS and cleared the patient that way.
I'm wondering how long it'll take for use to catch up with the rest of the world.
EpiEMS
Forum Deputy Chief
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Heard that. Evidence based practice guideline implementation should really speed the heck up.
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It's a tough dilemma. There are two "rights" here. One is the standard of care (full c-spine for significant MOI) and the other is what the research says (MOI is a poor predictor of injury in the absence of other findings). Whatever is best for the patient is what should be done, however I also desire to keep my job and my credibility. I got some funny looks when I suggested that I had little suspicion of c-spine injury that's for sure. It's like I was speaking french or something.
Aidey
Community Leader Emeritus
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What standard of care? Standard of care based on where? I HATE it when people say "oh, well it is the standard of care" because there is a huge variety of "standards" that there is no actual standard.
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There is most certainly a standard in the system or region that one works in. The standard of care is what is expected of you as a provider. This certainly varies from place to place, but we are not at the top of the totem pole. There will be expectations from a higher authority, and we will be expected to meet them, regardless of whether or not it is the best practice or not.
I don't necessarily agree with this, but I'd say this is a fairly universal concept for anyone working under another's license.
I don't necessarily agree with this, but I'd say this is a fairly universal concept for anyone working under another's license.
Aidey
Community Leader Emeritus
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No, there is not necessarily a standard. I work in a county with 7 different ALS agencies, 2 ILS agencies, and 6 BLS agencies with 10 different medical directors (some agencies share). We have neither a spinal clearance protocol or a protocol listing criteria for when we should immobilize someone. There aren't even standards within agencies. Whether or not a patient gets backboarded completely depends on the first agency on scene and what crew happens to be working that day.
Only one agency is consistent, and that is an ALS agency that literally backboards everyone who possibly fell, regardless of complaint or time frame of the fall (fell yesterday? That means backboard). On the other hand, my MD has said we need to stop backboarding isolated head injury patients, including GSWs. There is no general consensus among the MDs or the ED docs and so there are a wide variety of expectations from the "higher authorities".
So yeah, what exactly is the standard of care I'm supposed to be following?
Only one agency is consistent, and that is an ALS agency that literally backboards everyone who possibly fell, regardless of complaint or time frame of the fall (fell yesterday? That means backboard). On the other hand, my MD has said we need to stop backboarding isolated head injury patients, including GSWs. There is no general consensus among the MDs or the ED docs and so there are a wide variety of expectations from the "higher authorities".
So yeah, what exactly is the standard of care I'm supposed to be following?
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The one that cuts you a check I would imagine.
Alternatively perhaps you work at an agency where the QA does not really care that you chose or did not choose to use some sort of intervention if it is a grey area. I guess then the standard of care is your own, backed up by research and acceptance by those that receive your patient. That's a place I'd like to work. In the meantime I'll continue to document the crap out of why I didn't do what was expected of me by my misguided bosses.