new cots

We have ordered 8 new cots to replace our oldest ones. The cots that we are replacing are being serviced and stored for MCI's. They will have an MCI sticker on them to distinguished them from front line cots.

Congratulations Pat GIfford

Pat Gifford was honor last night at the Sherwood Chamber of Commerce Banquet as the 2009 EMT of the year. Congratulations Pat!!

This accident was July 4 2000. The girl in the story was pinned under the car. Though a mutual family friend Jeff Tabor has been keeping up with her since the accident, and was invited to be a part of her lecture Monday night.

link to story

Bariatric cot system

MEMS has purchased a bariatric cot system that includes a Stryker cot that is rated up to 1600 lbs in the low position and 850 in a raised position. Our system also includes the Transafe brand of ramps and winch. This equipment will be carried in two of our retired wheelchair vans. One is located in Conway with the other at station one. Every type 3 unit is in the process of having the necessary hardware installed to receive the ramp and winch.

How it is dispatched
If we know that a particular call has need of this equipment, it will be dispatched with the unit. The vans currently do not have emergency lighting, so it will take a little longer than the unit to get on scene. The transporting crew can begin patient care, until the equipment arrives. The van crew will begin the process of installing the ramps and winch in the transporting unit. In addition they will help load the patient, and carry the units normal cot to the destination.

In the event of an emergency call where you realize you have need of the equipment when you get on scene, you will simply notify communications, who will dispatch the cot and ramps to you. Remember the vans currently do not have emergency lighting, so it will take a little longer to get to you.

How are they staffed?
The van will not be staffed each day with a ready crew, so Oscar, floating medic or office staff etc... will be used to bring the van to the scene.

Check out the video on the web at metroems.org looking under the education and training tab and then to updates.

We will be issuing more information as this project matures.

MS Package Changes

Due to a change from our manufacture, there has been a change in the packaging of our Morphine. Instead of 10mg/10ml we now have gone to 10mg/1ml. This is in a carpi-jet just like the Valium. Please take a look at the video at the following link, to make yourself fame lure of this change.

Greg


A Note: we have added a tab to our website for updates. (metroems.org) This will hold training videos.

Link

Do you treat your patients or do you care for them?

Have a little think for a moment then read on and see if you still think the same way by the end of the post.

Here’s a little bit of a back story as to what got me thinking about it….

I was working with a new member of staff a little while ago. We were sent to an elderly male who had fallen outside of a bar after he had been spending the evening with some of his friends. He was intoxicated but not drunk as such, and he was my favourite type of drunk….The happy singing drunk.

Anyway, he had a small laceration to the back of his head which had stopped bleeding and probably only needed a little bit of glue to close it up. He also had a small haematoma surrounding the wound. There was no known loss of consciousness, although there was no witness to the fall. He had no neck or back pain and appeared alert and orientated. All of his primary observations were well within normal limits.

It all pointed to a simple mechanical fall after tripping on a lose pavement stone resulting in a minor head injury.

With these sorts of cases it is up to me to decide if it is suitable for my colleague, an ECSW (Emergency Care Support Worker) to go in the back with the patient to the hospital. When this happens and an ECSW ‘observes’ the patient on the way to the hospital, I am still totally responsible, clinically for the patient, even though I am in the front and driving the vehicle.

[An ECSW is trained to be able to assist the paramedic in his/her interventions and care. They can complete all clinical measurements that the paramedic can, and they have a basic understanding of A+P and various clinical and trauma conditions. They are trained to ‘observe’ suitable patients in the back of the ambulance on the way to A&E after the paramedic has completed a full assessment – Maybe this is the same sort of thing as an EMT-B?}

It goes without saying, that there has to be an element of trust between the paramedic and the ECSW for this to work. As the senior clinician, I need to know that if there is any change in the condition of the patient, then the ECSW in the back will inform me immediately so that I can decide whether I need to swap into the back and take over care of the patient.

But, there always has to be a first time to start to develop the trust, and this was that moment.

Once I had completed my assessment and decided that the patient was suitable for an ECSW to care for them en route to A&E, we set off up to the hospital.

On the way, I kept looking into the rear view mirror so I could see the patient and my colleague. It was all very quiet back there. I could hear no chit chat and no questioning for demographic and personal details. As I looked back, I could see the patient asleep in the chair.

I started to get a little nervous…

“Julie……Can you please check that Bobby is just sleeping and not actually suffering from a decreased level of consciousness?”

A quick shout over to him saw him wake up and acknowledge Julie, he then stated that he was just tired and then shuffled in his seat and closed his eyes again.

“He is okay, just a bit tired!”

I decided to keep driving but keep a very close eye on the rear view mirror. I know that the chances of anything bad happening to Bobby were very small, but I just wasn’t happy.

A few minutes later, I still don’t hear any conversation, so I look back and see Julie, writing on the patient report form, but not looking up and checking on Bobby.

Something is nagging away at me so I pull over and ask Julie to finish the drive to hospital. I get the expected dirty look, but now is not the time to discuss why I have pulled her out of the back.

The rest of the journey goes without a hitch. I engage Bobby in a conversation about his time in the Air force in the 1950s (always good for checking someone’s level of consciousness) and I hand him over to the hospital team where he gets cleaned up and sent off home in a taxi with a head injury card.

All well and good, yes?

No, not really, and here is my point.

In these days of ‘respond not convey’. If you are taking a patient to hospital, it is because you have a legitimate concern about them. If there was absolutely nothing wrong with them, then they wouldn’t be going to hospital would they?

Therefore, if you have a patient in the back of the ambulance, they need constant re-assessment. They are in your care and they are your responsibility. You don’t have to take constant blood pressures and ECGs for the vast majority of patients. It doesn’t mean that you have to be actively assessing them throughout the journey, but it does mean that you at least need to engage in some form of regular conversation or interaction with them.

‘Treating’ your patient is performing the interventions that are required by your protocols and guidelines in specific response to a clinical presentation. ‘Caring’ for your patients is to provide much more than an intervention. It is to show concern, empathy, understanding, and interest in them and their lives.

If you care for your patient then in return they feel cared for. They feel as though you actually want to be there and you want to be looking after them. They don’t feel as though they are troubling you and they open up far more than what they would if you are just treating them.

Virtually anyone can treat a patient…Give someone a list of signs and symptoms, then give them the interventions that are required to treat those signs and symptoms and the vast majority of people could do that adequately.

You can’t teach someone to be truly caring, it has to come from within, and if you find yourself in any of the health professions, I would assume that you are one of those people.

However, there are some of us out there who are not carers, and sometimes it is blatantly obvious to see.

More from this writer

BENSALEM, Pa. - March 8, 2010 (WPVI) -- At 7:00 p.m. Sunday, a 911 came in reporting an emotionally disturbed man on the 2600 block of Knights Road.


"The medics arrived first and were approached by the person and as a result, the medic was injured at the scene," Andrew Aninsman of the Bensalem Police said.

Investigators say the man then ran. One paramedic followed. When his partner caught up to the two, the medic was on the ground. He had visible signs of injury, but police say they still don't know the cause of death.

The medic has been identified as 39-year-old Daniel McIntosh.

McIntosh, a 13-year veteran paramedic for the Bensalem Rescue Squad, leaves behind his wife and two daughters, ages 1 and 5. He was also a Tactical Medic for the Bucks County South SWAT Team and was recently hired as a part-time police officer for Hulmeville Boro.

"We are treating it like we would any other investigation; our detectives have been called in and we're just basically trying to find out why it happened and what caused this tragic incident tonight," Aninsman said.

As police combed the area for clues, medics at the Bensalem Emergency Medical Services building placed a bunting on the front facade.

The suspect's name is being withheld. Police say he has a history of mental illness. The suspect is in custody and being evaluated at a local hospital.

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