Friday, February 27, 2009

Pedro the Paramedic Presents- Rules of the Road

This is the first in the series- and it's not just for EMS personnel- it's for everyone.

The other day we responded for a two car crash that occurred in an intersection controlled by a traffic signal- you may have seen them- they are those red, yellow, green things that hang down over the intersection...
Our patients vehicle had been T-boned in the drivers door- she definitely had the green, but after talking with her it became apparent that she was also aware that there was still traffic flying through the intersection from the left.

So, our rule of the road today is in a few parts but still pretty simple...
  1. Look before you enter any intersection
  2. Yes, even if you have the greenie
  3. Do not enter the intersection, irregardless of the color of the traffic signal, if entering will cause your vehicle to be hit by another

Contrary to popular belief, following these simple rules will not cause your genitals to fall off- nope, they'll be just fine- and so will you... and you won't have to deal with Pedro the Paramedic and his little EMS friends...

Tuesday, February 24, 2009

Hey, You Could Put an Eye Out...

... or as we like to call it around here- Lesson 1, EMS Management 102-

I've been informed by a certified EMS "oldtimer"- one of those guys that ran with the funeral home based services in a Caddy hearse rig- that in the olden days, the officer in question would have received an immediate, life changing assbeating...
My, my- how times have changed...

Legal disclaimer- Pedro the Paramedic in no way, shape, or form encourages or approves of any act of assbeating or other violence against anyone, anywhere at any time. Don't hit!

Monday, February 23, 2009

Yet Another Quote of the Day

"Fear is that little darkroom where negatives are developed." 

Saturday, February 21, 2009

Article- "The Failure of EMS"

Here is a link to an article entitled "The Failure of EMS"- it's interesting reading and food for thought- even if, like me, you don't necessarily agree with everything written...

Friday, February 20, 2009

Some Random Dispatches...

... and the calls that came out of them...
I've somehow ended up with a couple scheduled days off- after doing the 16 on/ 8 off cycle and a 48 hour overtime shift- here is just a brief selection of the fun we had:
  • 4 year old girl who ate dirt from a flower pot- mom is hysterical. Eventually Command clears the little girl and we transport mom
  • Homeless man who claims "the devils coming at me with sheets of glass"
  • Mini van vs. Harley- my partner walked up and down the road picking up toes while I treated the patient
  • MVC with refusals- Driver "A" is pissed because he had to shut off ignition and put vehicle in park
  • 80 year old with bright red rash all over- overheard ER nurses saying- "I'm not touching her, we don't know what the hell that is"
  • Dispatched for a 20 year old who "collapsed"- true enough- after getting shot. Lived to fight another day- in fact he started with us en route to the trauma center
  • 16 year old with a fondness for Tylenol- downed 38 for an after school snack
  • A couple "I can't pee" calls
  • Teenager with a loose tooth
  • Cardiac arrest that went well for everyone but the patient
  • Mutual aid into community two towns away- big house fire- they didn't have an ambulance on duty this shift
  • And of course the normal collection of two week old symptoms that get called in right at shift change- how do people know?
Stay safe, Pedro the Paramedic loves you...

Tuesday, February 17, 2009

Just Another Call in the Big City

...2217- Angry mob on the corner, guy got beat up in a fight with a drug dealer... went to put a C-Collar on him, he starts bobbing his head up and down and back and forth, he's yelling "Ain't nothin' wrong wif my neck motherf*****!"... Cop yells back at him "You can't even sue now you dumb asshole"... The patients grandpap is out, waving a baseball bat and the fat activist ladies are everywhere- yelling at the police for not doing anything, yelling at us for being part of the system I guess.
The patient just sat there- he didn't see anything...

Photo by Ireina
Creative Commons License

Monday, February 16, 2009

EMS Management 101- Extra Credit Lesson

In 1960 Douglas McGregor developed a view of working mankind- Theory X and Theory Y-

The really quick summery goes like this:

Theory X- workers are dumb, lazy, hate their jobs, can't be trusted and can only be motivated by constant oversite, threats, coersion, and punishment

Theory Y- people like to work and are inventive, creative and self directed when committed to the "objective". The role of management would be to define the objective and provide a system of reward (wages, benifits, working conditions etc)

So, for ten extra credit points and an instant pass into EMS management 102- which of the above do you believe is the norm for EMS agencies today and is your service an X or a Y?

Saturday, February 14, 2009

Paramedic Reality TV

The part of the video shot in the ambulance is excruciating...

For your daily dose of real life:

Saturday, February 7, 2009

Mommy, What is Mutual Aid?

Well Pee Wee, back in the olden age of EMS, Mutual Aid agreements were a way of assuring coverage to your EMS service area during those times when demand suddenly exceeded supply. Kind of a You watch my back and I'll watch Yours thing. Today- well today a lot of services abuse the mutual aid concept by using it to cover their area- period. It's a way for the chiefs to hold onto their fiefdoms, a way for these miserable hell- hole services to stay operative after they have run off their own paid staff.

Some examples from my immediate area:
  • The busy service to our east has no staff most days between 1800 and 0600- none, nobody
  • The volunteer fire department run EMS service to our south-east regularly shuts down week- end nights. Lights out kids- don't get sick till morning...
  • The service to our north "holds" calls- today they sat on a diabetic emergency for 37 minutes
  • My agency routinely responds through two other service areas to take calls in third- that can't or won't staff their ambulances
So what's the reason for this? Bottom line it's bad management. Pardon, you in the back... the paramedic shortage... you're asking if this isn't caused by the paramedic shortage? Could be, but the paramedic shortage is due to poor management... Right?

The video very briefly illustrates what bad EMS management looks like...

Thursday, February 5, 2009

Priority Dispatch and You...

... we all know that in theory the priority dispatch system is a fine idea. Calls are assigned a number and hence a priority based on the information gathered by the 911 call-taker. Around here an E0 would be a call with immediate life threats, down to an E4 which would include lift assists etc.

Often a caller will utter certain keywords that move a relatively minor call all the way up the dispatch ladder into E- zero heaven.

Here are a couple recent examples:

Dispatched E0 for a 38 year old female in respiratory distress...
What we found- an active, agitated female with a "cold the past two days", who told the call taker she "stopped breathing" yesterday because the "air can't go through my nose"
... yes, we wanted to yell "Breathe through your mouth and blow your nose"- but we did not. 

Dispatched E0 for a 2 year old struck by a car...
What we found- a healthy, happy toddler being held by his frantic mum- the child, being carried by his mother, bumped his head on the open hatch of a parked car as mom squeezed past it and another parked car. The thump was apparently percussive enough that mom, now thoroughly upset, told 911 "Send someone to check my baby. Please hurry, he just got hit with the car"

To quote the old man on the corner, " Damn right the thing's broke boy- but it's the only one I got."

Monday, February 2, 2009

What the ALS Response Truck is For...

Finishing up 12 on the Responce truck, always an interesting detail...

We used to use our ALS response vehicles to provide Paramedic medical back-up to our ALS crews and as an occasional public service to the EMS agencies on our borders who sometimes ended up short- staffed.
We used to...

Now we use it to:
  • Buy time so the public doesn't learn all their ALS ambulances are out on BLS inter-facility transports
  • As the night time and weekend source of ALS for the smaller services on our border who have managed to scare away most of their own paramedics
  • For the Manager and/ or supervisors to get breakfast, lunch and dinner under the pretence of "picking up the mail"