What's the point of dual medic?

[firecoins]

I prefer dual medic. while I get an I've he can draw meds or call med control. I like having 2 sets of hands on serious calls. am not there to babysit bad medics.

 

[DrParasite]

DBP = death by powerpoint?

Dirty Button Pusher, assigned to communications.

I know your sarcasm by now, but I also know you either worked for, in or with NYC at some point. (I think?) You know what goes on here...

Mind you this partner is 3x my senior.

actually, I have never worked in NYC. I was offered a position with a hospital in NYC, but when I heard the crews complaining the got slammed when they did 6 calls in 8 hours (did that in 6, and still had 6 more hours of work ahead of me), I decided that it wasn't for me. Plus the tolls and the pay cut weren't worth it for me.

But I know quite a few FDNYers, work with several former FDNY medics (they crossed the Hudson for better pay), as well as have worked with some NYCers who work part time in NJ for better pay. In fact, many NJ people go to NYC for their medic training (since it's 10 months in NY, and 2 years in NJ), and many NYC people come to NJ because they want to make more money, and find working 12 hours vs 8 hours make better financial sense.

and I've dealt with my share of bad EMTs (from NY and NJ), as well as some paramedics that waste time setting up camp or that can't assess and figure out a definitive treatment plan. It's really scary, but I know there are some EMTs and Paramedics that can run circles around me as well. It all depends on the person, and sometimes the popular EMTs and Paramedics aren't as good as people think they are, but they are well liked or in the clique

Side note: as an EMT in NJ, the only times I will wait on scene for ALS is for a known diabetic whose sugar has dropped, or on a cardiac arrest. Other than that, I can do almost every intervention in my toolbox (as well as most of my secondary assessment) while enroute to the ER, meeting ALS on the way or notifying the ER of what I have and let definitive care manage the patient, instead of delaying that care by waiting for the MICU to assess, start their IV, push some meds, and then transport to that same definitive care (in my urban and suburban experience, I never worked rural EMS in the sticks).

 

[NYMedic828]

I prefer dual medic. while I get an I've he can draw meds or call med control. I like having 2 sets of hands on serious calls. am not there to babysit bad medics.

Thats the other issue... in NYC, as you know, calling medcom can be quite a long ordeal.

 

[nocoderob]

I know I'm not a paramedic, but my little EMT brain (which is a DBP brain more than EMT nowadays) never knew that excessive vomiting was a sign of an allergic reaction, esp when you eat sketchy fish.

But then again, I'm not a paramedic, so apparently I am pretty useless in an emergency until I get my P card, right?

Not to pick on you but, this type of attitude is common among EMT's. You do not have a "little EMT brain" but, come on, are you truly in a place to make a judgement on how many medic's may or may not be needed on a call?

An EMT has virtually no responsibility when working with a medic. Maybe it's different where you are. Where I am at, the medic has to perform a full assessment on every pt before he can turn over care. And the pts the EMT can take are very limited. The medic also has to do the initial portion of the run ticket and has to audit said paperwork as well. And if anything detrimental occur's enroute to the pt, the medic is on the hook. The medic is responsible for the rig check out, monitor tests, glucometer testing, and narcotics log.

As far as being useless on a call, you are not. But, to even suggest that an EMT is anything more than a supportive role and extra set of hands is ridiculous. When you get a "P" card you will see thing's in a whole new light.

 

[bahnrokt]

How many of these calls where a 2nd medic is beneficial do we see daily vs normal ish calls that are BLS or fine with 1 medic? 1%? .5%?

Hell, let's staff every rig with 2 ER docs. Even better for the pt. This would make sense if all our calls were emergencies. But we deal with a lot of BlS calls that are taxi rides and there is no reason to spend the money on dual medics.

 

[NYMedic828]

Not to pick on you but, this type of attitude is common among EMT's. You do not have a "little EMT brain" but, come on, are you truly in a place to make a judgement on how many medic's may or may not be needed on a call?

An EMT has virtually no responsibility when working with a medic. Maybe it's different where you are. Where I am at, the medic has to perform a full assessment on every pt before he can turn over care. And the pts the EMT can take are very limited. The medic also has to do the initial portion of the run ticket and has to audit said paperwork as well. And if anything detrimental occur's enroute to the pt, the medic is on the hook. The medic is responsible for the rig check out, monitor tests, glucometer testing, and narcotics log.

As far as being useless on a call, you are not. But, to even suggest that an EMT is anything more than a supportive role and extra set of hands is ridiculous. When you get a "P" card you will see thing's in a whole new light.

Well you certainly are a humble one aren't you. Why don't you join the rest of us at ground level and get off that pedestal.

EMT is meant to be a supportive role in the presence of a higher certified person capable of delegating duties, that doesn't make them otherwise worthless as you make it out to be. Technically we are all in a supportive role. We support the wishes of the medical director.

If you want to see things in a different light, take it even further.

 

[nocoderob]

How many of these calls where a 2nd medic is beneficial do we see daily vs normal ish calls that are BLS or fine with 1 medic? 1%? .5%?

Hell, let's staff every rig with 2 ER docs. Even better for the pt. This would make sense if all our calls were emergencies. But we deal with a lot of BlS calls that are taxi rides and there is no reason to spend the money on dual medics.

Take the emotion out of it. By your way of thinking, why have ALS at all?
Why have EMT's? Have two driver's that can give O2 and that are CPR cert'd. This entire job is based on small percentage's. The number's of actual emergencies is small. No different than having PD or FD. The actual percentage that you may actually need either is small but, you do feel them necessary do you not?

 

[nocoderob]

Well you certainly are a humble one aren't you? Why don't you join the rest of us at ground level and get off that pedestal.

EMT is meant to be a supportive role in the presence of a higher certified person capable of delegating duties. It is not only a supportive position.

Ha, no pedestal. Not my intention. The point being made is that a BLS provider should not be one to say how many ALS provider's are necessary.

 

[NYMedic828]

Ha, no pedestal. Not my intention. The point being made is that a BLS provider should not be one to say how many ALS provider's are necessary.

There happen to be quite a few EMTs on this forum who are more knowledgeable than a large handful of the medics I know. Just because I don't have a card that says I know something, doesn't mean I don't.

Not to knock the service, but the most common denominator of paramedics are usually not that knowledgeable... or accurate in their knowledge anyway.

 

[Hockey]

I never used to understand the double medic thing until I started working in an area with it.

I absolutely love it. Not only does it help me out drastically on calls (hands not as full), I feel it gives the patient better care. If I can't get an IV, my partner can (vice versa). Less likely to make mistakes. One person isn't "swamped" with all the calls all day and won't be as tired or what not.

I work in another area that allows us to run EMT/Medic for ALS. When I work there, I feel "dirty" and anxious on calls for some reason. Like I have to hold my partners hand sometimes.

Medic/Medic is where its at

 

[bahnrokt]

Take the emotion out of it. By your way of thinking, why have ALS at all?
Why have EMT's? Have two driver's that can give O2 and that are CPR cert'd. This entire job is based on small percentage's. The number's of actual emergencies is small. No different than having PD or FD. The actual percentage that you may actually need either is small but, you do feel them necessary do you not?

Necessary, yes. But there is a cost benefit that starts to slide off where pumping more money into advanced providers only nets a minimal increase in the care. Putting more police on the street and having all of them SWAT trained with AR15s and full body armor would slow down an active shooter like in Colorado. But it is not cost effective. In a world of limited budgets and resources it is not feasible to staff everything for the worst call possible.

What is better for a city?

A) 10 dual medic rigs running their balls off to keep up with call volume.
or
B) 12 medic/emt rigs that have some breathing room.

 

[the_negro_puppy]

You do raise the excellent point that I left out of the issue with NOT being dual medic. The other half can't be left alone...

I had a patient the other day who ate fish at a sketchy Jamaican restaurant and 30 minutes later was vomiting to no end. Patient was hyperventilating, and complained of "itching." She was obviously experiencing an anxiety exacerbation along with presumed food poisoning. My random partner for the day began to draw up benadryl... Story ends with giving the patient 4mg of zofran and everything started to feel better. A good example of checks and balances, and at the same time, a good example why single medic probably would fail.

If the patient had suspected food poisoning would it not be beneficial for the patient to be vomiting? Unless the patient had already vomited up their stomach contents and was retching/producing bile?

Itching and vomiting could also be a sign of G.I disturbance/allergic reaction however i'm guessing the patient didn't have any urticaria or other symptoms?

 

[nocoderob]

There happen to be quite a few EMTs on this forum who are more knowledgeable than a large handful of the medics I know. Just because I don't have a card that says I know something, doesn't mean I don't.

Not to knock the service, but the most common denominator of paramedics are usually not that knowledgeable... or accurate in their knowledge anyway.

I am sure you do. But, how does this translate to their job? They still only have the ability to do what their classification allow's.

The bolded is funny. Seemingly by your argument, paramedic's are usually less knowledgeable than many EMT's?

 

[NYMedic828]

If the patient had suspected food poisoning would it not be beneficial for the patient to be vomiting? Unless the patient had already vomited up their stomach contents and was retching/producing bile?

Itching and vomiting could also be a sign of G.I disturbance/allergic reaction however i'm guessing the patient didn't have any urticaria or other symptoms?

I figured it would be more beneficial for her to vomit up the substance causing the disturbance, but she was mostly dry heaving at this point. She vomited a substantial amount prior to our arrival and was just feeling extremely nauseous.

When I asked her if the "itching" felt more like a bug bite or pins and needles, she said the latter. My assumption was paresthesia 2nd to hyperventilation/anxiety.

I am sure you do. But, how does this translate to their job? They still only have the ability to do what their classification allow's.

The bolded is funny. Seemingly by your argument, paramedic's are usually less knowledgeable than many EMT's?

I think you merely think too highly of your abilities, or anyone's abilities for that matter as a paramedic. Sure, an EMT can do even less but we can't really do all that much either in the grand scheme of things.

Not sure how you translated my statement into EMTs are more knowledgeable than paramedics. I stated many paramedics aren't as knowledgeable as their god complex makes them think they are. That would usually imply EMTs being less knowledgeable. I said a small amount of EMTs can best a handful of paramedics. Hardly substantial numbers.

 

[bahnrokt]

I am sure you do. But, how does this translate to their job? They still only have the ability to do what their classification allow's.

The bolded is funny. Seemingly by your argument, paramedic's are usually less knowledgeable than many EMT's?

I believe his point was that having a "P" on your card does not automatically mean you know more than every "B" on earth.

 

[nocoderob]

Necessary, yes. But there is a cost benefit that starts to slide off where pumping more money into advanced providers only nets a minimal increase in the care. Putting more police on the street and having all of them SWAT trained with AR15s and full body armor would slow down an active shooter like in Colorado. But it is not cost effective. In a world of limited budgets and resources it is not feasible to staff everything for the worst call possible.

What is better for a city? 10 dual medic rigs on duty or 12 medic/emt rigs?

So now it's a money thing? I thought this discussion was "why have dual medic units?" Many have stated supportive facts/thoughts/opinions and yet you try and argue against it for financial sense.

What is better for a city? Well, if you have 10 dual medic unit's and 10 BLS unit's roaming the streets, in the case of disaster you could split the dual's with the BLS and have 20 medic/emt unit's.

 

[nocoderob]

I believe his point was that having a "P" on your card does not automatically mean you know more than every "B" on earth.

I got his point. Mine is that knowing a lot does not translate to being able to do a lot. My wife is a RN and know's much more than I do but, I can do more than she can. If that make's sense.

 

[NYMedic828]

I got his point. Mine is that knowing a lot does not translate to being able to do a lot. My wife is a RN and know's much more than I do but, I can do more than she can. If that make's sense.

Which is completely *** backwards and in such lies a major problem with EMS.

 

[bahnrokt]

So now it's a money thing? I thought this discussion was "why have dual medic units?" Many have stated supportive facts/thoughts/opinions and yet you try and argue against it for financial sense.

What is better for a city? Well, if you have 10 dual medic unit's and 10 BLS unit's roaming the streets, in the case of disaster you could split the dual's with the BLS and have 20 medic/emt unit's.

Because it is a fiscal issue in most cities and towns. Go ask your ops director this question and the first word from their mouth is money. Most agencies I know would love to run dual medics on beautiful type 3 rigs but can only afford BLS vans and ALS fly cars.
I'm not questioning the fact that 2 medics are better than one.

 

[nocoderob]

Which is completely *** backwards and in such lies a major problem with EMS.

I'm not questioning the fact that 2 medics are better than one.

Agreed.