Things told to me yesterday.

NomadicMedic

NomadicMedic

I know a guy who knows a guy.
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These items were all presented to me as actual and factual...

While I was getting a refusal...

"It's a law that if someone calls us we have to take them to the hospital."


While I was staring a line to give some pain management.

"We don't really do that here."


While setting up CPAP...

"We need to get moving, it's our job to take people to the hospital, they need the hospital."


And my favorite, as I was getting out the Zofran...

"Let her puke. We're only 10 minutes from the hospital".
 
Drives me crazy when people use the close proximity of the hospital as an excuse for not treating their patient properly. Sounds like we work with some of the same people, haha.
 
Man. All we can do is fight the same battle time after time. It's tough to make progress against these people.


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I was incredulous. I was also working with a paramedic who was proud to tell me he's been doing the job for 27 years.
 
At least that means retirement is soon.

"Thanks for your service buddy. Let me show you where the pasture is."


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DEmedic said:
I was incredulous. I was also working with a paramedic who was proud to tell me he's been doing the job for 27 years.
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Someone should congratulate him on being a crappy medic for 27 years...

At least your practice is your own... assuming management doesn't see it strictly his way.

Is it just this one medic or is it the organizational culture of practice? How does your medical director feel about that attitude? If they are on your side, you might be able to change the culture?
 
Gurby said:
You must have felt pretty silly when you realized you've been doing it wrong all this time.
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I feel pretty silly knowing I've been learning it wrong all this time. This past year has all been a lie.
 
Underoath87 said:
Did you just start working at a different service or something?
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Yeah, a per diem thing, with a guy I'd never worked with before.

Summit said:
Is it just this one medic or is it the organizational culture of practice? How does your medical director feel about that attitude? If they are on your side, you might be able to change the culture?
Click to expand...

It's not the whole department, but it's certainly not a high speed, low drag kind of place.
 
Summit said:
Someone should congratulate him on being a crappy medic for 27 years...
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Probably more like 24 years. He was probably a superstar those first 3 years and then forgot to keep up with medicine after that. DE, if you ever work a code with him, ask him where the bretylium is.
 
ERDoc said:
Probably more like 24 years. He was probably a superstar those first 3 years and then forgot to keep up with medicine after that. DE, if you ever work a code with him, ask him where the bretylium is.
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Careful with that one... because you may induce a stroke in your partner and then you'll have to deal with 2 patients. ;)
 
Akulahawk said:
Careful with that one... because you may induce a stroke in your partner and then you'll have to deal with 2 patients. ;)
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That would be a perfect teaching moment. You could then have a discussion on the evidence for and against tPA, assuming your partner knows what that is.
 
ERDoc said:
That would be a perfect teaching moment. You could then have a discussion on the evidence for and against tPA, assuming your partner knows what that is.
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Perhaps during the lucid interval... assuming herniation didn't happen within 30 seconds. ;)
 
If we are talking herniation then we are talking a hemorrhagic stroke, which would be an absolute contraindication. So again we can turn it into a teaching moment, even if it is a very brief moment before loss of consciousness.
 
DEmedic said:
These items were all presented to me as actual and factual...

While I was getting a refusal...

"It's a law that if someone calls us we have to take them to the hospital."


While I was staring a line to give some pain management.

"We don't really do that here."


While setting up CPAP...

"We need to get moving, it's our job to take people to the hospital, they need the hospital."


And my favorite, as I was getting out the Zofran...

"Let her puke. We're only 10 minutes from the hospital".
Click to expand...


I certainly hope that not ALL of the medics at this service are this way. If they were, I'd run like hell. Far and fast. WOW!
 
Topics of yesterday's shift/why I love where I am:

An hour long discussion debating the pros and cons to everyone's method for differentiating between Vtach and SVT with abberant conduction.
Nicardipine and how/why its mechanism makes it excellent for hypertensive stroke patients.
When lidocaine might be superior to amiodarone and when it might not me.
And pretty much the best pharm math teaching ever..took a big chunk of p school and made it waaaaay simpler.
 
Relevant to the OP:

But the paramedics did not treat Bray for nearly 25 minutes, according to court records and witness statements. At one point, one of the paramedics suggested that Bray’s son take her to the hospital in his personal vehicle, according to court records.

The medics did not check her vital signs, connect her to an electrocardiogram machine or follow procedures for someone showing signs of cardiac arrest, Bray’s attorneys said.

At one point, the paramedics started discussing the pot roast being prepared at their fire station for dinner that night, according to court records and witnesses.

After 26 minutes with Bray, Hingst and Amick took her to the hospital. Inside the medic unit, Bray slumped over and became unconscious.

The men performed CPR on Bray and kept her alive until they got to the hospital. Bray survived for a few days but the lack of blood flow and oxygen to her brain during the cardiac arrest proved fatal, her attorneys said.

The city hired Amick, 66, in 1996. Hingst, 57, was hired in 1987.
Click to expand...

http://www.ems1.com/ems-management/...2-million-for-medics-delay-in-treating-woman/
 
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