the 100% directionless thread

[Handsome Robb]

Are you not using health care trained translators? From my experience with Language Line, I talk to the patient directly and the translator translates exactly what I'm saying. Sometimes I need to think of a different way to word a question if it's not getting me the answer I need, but the same thing is true when patients do speak English anyways.

In my experience with it, no. Unfortunately it is either speaker phone or passing it back and forth. On my 5 the speaker is pretty good so most can hear/understand it but elderly and others with subpar hearing have trouble with it. I've had an instance where I spoke with a Tagalog translator, called back 10 minutes later and they didn't have one available in the 45 minutes I was trying for (call was a logistical nightmare, not medical at all but something that had to be handled).I was going to stay on the phone with the first one but I got like two questions out of him and he hung up the phone.

Very true about having to reword questions in English as well though.

Yes, brand new limited term fire medic, they kept insisting he keep trying for "experience". They had to come to our HQ for replacements since they were out....begrudgingly.

I might have let him try the second one with the very close, watchful eye of myself or my partner over his shoulder but not a chance on the third one. That's just bad patient care. If I was a family member of a patient and watched that happen it wouldn't be pretty either. I'm all for experience and teaching but there is a places draw the line. I guess not much you can do if you're not in charge of the scene though...

 

[Jambi]

Fire medic?

Is it bad that this is the first thing I thought too?

The only IO's I've ever seen missed on the west coast have been from fire medics, and almost always they were placed laterally instead of medially (proximal tibial).

 

[Amberlamps916]

Is it bad that this is the first thing I thought too?

The only IO's I've ever seen missed on the west coast have been from fire medics, and almost always they were placed laterally instead of medially (proximal tibial).

The preferred IO site in San Bernardino County is the Distal Tibia/Medial Malleolus.

 

[Jambi]

The preferred IO site in San Bernardino County is the Distal Tibia/Medial Malleolus.

That's brand new for us weirdos in Riverside County for adult IO.

On a side note: I would trade 4 Ochoa's for one Vaezazizi

 

[Amberlamps916]

That's brand new for us weirdos in Riverside County for adult IO.

On a side note: I would trade 4 Ochoa's for one Vaezazizi

I concur, now if only we can get a excited delirium standing order for Versed that would be great.

 

[Jambi]

I concur, now if only we can get a excited delirium standing order for Versed that would be great.

Ha! We have something you don't? :rofl:

 

[Jambi]

Ativan would be nice too! :rofl:

 

[Amberlamps916]

Ha! We have something you don't? :rofl:

Hahahaha, I think it's because a vast majority of patients from San Bernardino, Fontana, Rialto, Colton, Muscoy, Highland, Del Rosa, Mentone, Victorville, Hesperia, Phelan, El Mirage, Lucerne Valley, Apple Valley, 29 Palms, Yucca Valley, Redlands, Montclair, Crestline, Barstow, Ontario, Baker, Hinkley, Chino, and most definitely Adelanto technically qualify for "excited delirium".....almost everybody would get loaded up on Versed :rofl:

 

[Jim37F]

Please don't tell me your CCT ambulance then had to transfer care to the FD ambulance/engine...

Well we got the patient off our gurney and into the SNF's bed, unhooked our O2, hooked theirs up so as far as our CCT-RN was concerned we had transferred care to the facility before the call was made. So it was the nursing home transferring to fire. We were leaving as FD was pulling up (crowded narrow city street? FD was just happy we cleared a parking spot for them! Lol)

But yeah, patient had a GCS of about a 3, family was still convinced she was still alert, told the facility she was alert who saw the patient with the low GCS, along with some stable tachycardia and the family freaking out about how she'll code, and it was the family wanting 911 to be called. I'm fairly sure this was more of a case of treat the family instead of the patient.

That's la county for you lol. Come to Kern Jim.

I wish. I was looking at Hall Ambulance (based out of Bakersfield I think?) but it's a good 2 hours minimum from where I live. It would just be really tough to commute out there on a regular basis, and unfortunately I have a host of reasons keeping me from moving out there at this time. I'm pretty close to San Bernardino and Riverside counties actually but AMR is the only company I know of worth applying out there and I don't see any openings currently on their website. (Ok I'm also close to OC but they don't count as they somehow make LA Co look sane when it comes to EMS lol)

 

[rmabrey]

Interesting day yesterday. Called out for an assault. Turns out this guy had his electric cut off, so he crashed at his daughters for 3 days. Left his dog locked in the house. When he tried to take the dead dog to the car and take off, a neighbor called the cops.

There was some excessive force used to keep him on scene. In the process, a roof support on another neighbors porch was broken. Cops left a card with a case number and phone number so she could get it repaired (she wasnt home).

An hour later a truck gets sent to that house. Apparently she came home and the roof collapsed on her.

Getting past the animal abuse, and the fact that she was injured (discharged with bumps and bruises), the whole situation is kind of funny (Im twisted)

 

[EMT2B]

Getting past the animal abuse, and the fact that she was injured (discharged with bumps and bruises), the whole situation is kind of funny (Im twisted)

"Other than that Mrs. Lincoln, how did you enjoy the show?"

 

[TRSpeed]

Ativan would be nice too! :rofl:

We have Ativan here in Kern boom! And vallium.

Well we got the patient off our gurney and into the SNF's bed, unhooked our O2, hooked theirs up so as far as our CCT-RN was concerned we had transferred care to the facility before the call was made. So it was the nursing home transferring to fire. We were leaving as FD was pulling up (crowded narrow city street? FD was just happy we cleared a parking spot for them! Lol)

But yeah, patient had a GCS of about a 3, family was still convinced she was still alert, told the facility she was alert who saw the patient with the low GCS, along with some stable tachycardia and the family freaking out about how she'll code, and it was the family wanting 911 to be called. I'm fairly sure this was more of a case of treat the family instead of the patient.






I wish. I was looking at Hall Ambulance (based out of Bakersfield I think?) but it's a good 2 hours minimum from where I live. It would just be really tough to commute out there on a regular basis, and unfortunately I have a host of reasons keeping me from moving out there at this time. I'm pretty close to San Bernardino and Riverside counties actually but AMR is the only company I know of worth applying out there and I don't see any openings currently on their website. (Ok I'm also close to OC but they don't count as they somehow make LA Co look sane when it comes to EMS lol)

Yes it is. I dont live in Bako either just stay there for the 3 nights a week. Its not bad. Alot of employees dont live there.

 

[Jim37F]

Yes it is. I dont live in Bako either just stay there for the 3 nights a week. Its not bad. Alot of employees dont live there.

What's the pay for Basics like? And the cost of a hotel to stay up there? Whats the schedule like?

Plus gas driving back and forth, Google Maps says its roughly 126 miles from Azusa to Bakersfield. I'm already driving 125 miles in the opposite direction once a month to San Diego for my US Army Reserves, about 2 hour drive and almost half a tank one way.

So one of my biggest concerns is getting off work on a Friday night and having to be in San Diego early the next morning lol

 

[Handsome Robb]

So one of my biggest concerns is getting off work on a Friday night and having to be in San Diego early the next morning lol

Welcome to EMS haha.

 

[Jambi]

Well we got the patient off our gurney and into the SNF's bed, unhooked our O2, hooked theirs up so as far as our CCT-RN was concerned we had transferred care to the facility before the call was made. So it was the nursing home transferring to fire. We were leaving as FD was pulling up (crowded narrow city street? FD was just happy we cleared a parking spot for them! Lol)

But yeah, patient had a GCS of about a 3, family was still convinced she was still alert, told the facility she was alert who saw the patient with the low GCS, along with some stable tachycardia and the family freaking out about how she'll code, and it was the family wanting 911 to be called. I'm fairly sure this was more of a case of treat the family instead of the patient.

How is this not abandonment? I know as an EMT on a CCT unit with an RN, you're essentially just along for the ride (a broad generalization, I know), and that it was the CCT RN that made the decision, but even if the receiving person was an RN, that patient was not being transferred to a similar level of care.

If the patient was bad off enough for a 911 activation, your unit should have diverted to the closest appropriate facility. That RN still has to abide by county protocol.

Not trying to bust your chops, but I'd hate to see you get sucked into something because of bad decisions you have no control over.

 

[Jim37F]

Welcome to EMS haha.

Lol yeah well it's one thing working in LA but a 250 mile 4 hour drive once (or worse twice) a month wouldn't be super fun though if the schedulers there can work around monthly drill it does sound like a nice place compared to here

 

[exodus]

How is this not abandonment? I know as an EMT on a CCT unit with an RN, you're essentially just along for the ride (a broad generalization, I know), and that it was the CCT RN that made the decision, but even if the receiving person was an RN, that patient was not being transferred to a similar level of care.

If the patient was bad off enough for a 911 activation, your unit should have diverted to the closest appropriate facility. That RN still has to abide by county protocol.

Not trying to bust your chops, but I'd hate to see you get sucked into something because of bad decisions you have no control over.

Because the patient was fine, the family was the one that requested 911.

 

[Jim37F]

How is this not abandonment? I know as an EMT on a CCT unit with an RN, you're essentially just along for the ride (a broad generalization, I know), and that it was the CCT RN that made the decision, but even if the receiving person was an RN, that patient was not being transferred to a similar level of care.

If the patient was bad off enough for a 911 activation, your unit should have diverted to the closest appropriate facility. That RN still has to abide by county protocol.

Not trying to bust your chops, but I'd hate to see you get sucked into something because of bad decisions you have no control over.

Yeah I was "just" the driver on the call, but from what I saw/overheard and from what my EMT partner and CCT-RN was saying the patient was perfectly fine and stable both at the hospital and while enroute to the nursing facility.

It wasn't until after we transferred the patient to the SNF things went crazy. The patient started to have a little labored breathing, but no where near bad enough for a BVM, she was already getting 6 LPM Vent mask to a trach tube. The RT did a deep suction and then the patient got yacht, pulse in the 120s but her O2 sat was hovering around 95. That's when the family started freaking out, saying they had seen that in the past prior to her crashing. But they've also said they had the patient moved like 5 times in the past two months and as soon as they walked in, before anyone ever mentioned the possibility of 911 they were saying they didn't like that SNF and wanted to know how to transfer her somewhere else, and sounded like they wanted her moved that night, and then shortly thereafter they started talking about 911, so yeah...

But we transferred the patient, had positive contact with the nurse and RT and gave our report and got signatures, before 911 was talked about. We even stayed and hooked up a 4 lead to show that while the heart was beating fast that's all it was doing abnormal, suggested it was quite possibly due to the stress of the transfer, the suction, or the breathing treatment she had just before transfer, but the family wanted 911 so the family got 911.

 

[Jambi]

Because the patient was fine, the family was the one that requested 911.

My bad. Must have missed that part somewhere. Don't you just love families?

 

[DesertMedic66]

My bad. Must have missed that part somewhere. Don't you just love families?

Do we really have to answer that? :unsure: