Re: Duct Tape

[Guest guest]

Ok, ladies and gentlemen of the greater EMS community. I have used duct tape for

immobilization only on the forehead and possibly under the chin to help the

patient understand not to move their head. I was not aware we are using this

instead of straping our patients to the backboard with standard quick clip

straps or standard straps.

Please tell me what I have been seeing is not in relation to my last statement.

" Crosby, E " wrote:

Mr. Molino, I was apparently very wrong. The duct tape issue

does seem to start some sticky arguments. I stand properly chastised

and will now take 10 minutes to reevaluate my life, flog myself with

duct tape and hide my young before they are eaten.

Crosby

EMT-B

PS: I will still use duct tape for quick and easy auto, home repair and

minor veterinary needs....

PPS: I hope you had a very enjoyable Thanksgiving after your shift was

up (or maybe during?).

Re: Duct Tape

Salvador,

It is nice that you step up to the plate to explain what Alfonso was

saying;

.... that you and he worked for a service that considered a patient's

ability to pay or a class of individuals' ability to pay to

establish how you treated those you encountered. Exactly how long

did it take either of you to have that epiphany?

[Crosby, E] Snipped for brevity

________________________________________________________________________________\

_____

This email and its attachments, if any, are intended for the personal use of the

named recipient(s) and may contain confidential, privileged, or proprietary

information. If you are not a named recipient, or an agent responsible for

delivering it to a named recipient, you have received this email in error. In

that event, please (a) immediately notify me by reply email, ( do not review,

copy, save, forward, or print this email or any of its attachments, and ©

immediately delete and/or destroy this email and its attachments and all

electronic and physical copies thereof. Thank you.

________________________________________________________________________________\

_____

[Guest guest]

Ok, ladies and gentlemen of the greater EMS community. I have used duct tape for

immobilization only on the forehead and possibly under the chin to help the

patient understand not to move their head. I was not aware we are using this

instead of straping our patients to the backboard with standard quick clip

straps or standard straps.

Please tell me what I have been seeing is not in relation to my last statement.

" Crosby, E " wrote:

Mr. Molino, I was apparently very wrong. The duct tape issue

does seem to start some sticky arguments. I stand properly chastised

and will now take 10 minutes to reevaluate my life, flog myself with

duct tape and hide my young before they are eaten.

Crosby

EMT-B

PS: I will still use duct tape for quick and easy auto, home repair and

minor veterinary needs....

PPS: I hope you had a very enjoyable Thanksgiving after your shift was

up (or maybe during?).

Re: Duct Tape

Salvador,

It is nice that you step up to the plate to explain what Alfonso was

saying;

.... that you and he worked for a service that considered a patient's

ability to pay or a class of individuals' ability to pay to

establish how you treated those you encountered. Exactly how long

did it take either of you to have that epiphany?

[Crosby, E] Snipped for brevity

________________________________________________________________________________\

_____

This email and its attachments, if any, are intended for the personal use of the

named recipient(s) and may contain confidential, privileged, or proprietary

information. If you are not a named recipient, or an agent responsible for

delivering it to a named recipient, you have received this email in error. In

that event, please (a) immediately notify me by reply email, ( do not review,

copy, save, forward, or print this email or any of its attachments, and ©

immediately delete and/or destroy this email and its attachments and all

electronic and physical copies thereof. Thank you.

________________________________________________________________________________\

_____

[Guest guest]

Danny;

Speaking for myself, I was metaphorically shaking my head in

disbelief on how the thread went and I was commenting on the fact in a

tongue in cheek way to Mr. Molina in reference to a comment he made

about an argument getting started (again). Please forgive my taking the

liberty if it caused you any distress. In reference to your use of duct

tape, it pretty much parallels mine. Unfortunately, some folks have

taken the use of it to include trying to fully immobilize a patient with

it, going so far as to include a comment about a patient of large size

being suspended on a backboard above a hapless medic waiting to get

squished when the tape gives. I said in my first post on the 'issue'

yesterday that it was a " useful tool to help " . I never said that it

would do the job all by itself, but there are always folks who want to

go off on tangents and have spin off arguments. Some seem to protect

their pieces of the briar patch(see my earlier comments on the

bureaucrat mentality), some folks just seem to like to argue either to

show what they know, or just form the sake of argument itself (which can

be kinda therapeutic I guess if you think about it).

Anyway, please forgive my ramble, and know that while I don't

know if any of this is in direct relation to you last comment, I would

be glad to take an extra duct tape flogging on your behalf while I'm at

it.

Crosby

EMT-B

RE: Re: Duct Tape

Ok, ladies and gentlemen of the greater EMS community. I have used duct

tape for immobilization only on the forehead and possibly under the chin

to help the patient understand not to move their head. I was not aware

we are using this instead of straping our patients to the backboard with

standard quick clip straps or standard straps.

Please tell me what I have been seeing is not in relation to my last

statement.

" Crosby, E " wrote:

Mr. Molino, I was apparently very wrong. The duct tape issue

does seem to start some sticky arguments. I stand properly chastised

and will now take 10 minutes to reevaluate my life, flog myself with

duct tape and hide my young before they are eaten.

Crosby

EMT-B

PS: I will still use duct tape for quick and easy auto, home repair and

minor veterinary needs....

PPS: I hope you had a very enjoyable Thanksgiving after your shift was

up (or maybe during?).

________________________________________________________________________________\

_____

This email and its attachments, if any, are intended for the personal use of the

named recipient(s) and may contain confidential, privileged, or proprietary

information. If you are not a named recipient, or an agent responsible for

delivering it to a named recipient, you have received this email in error. In

that event, please (a) immediately notify me by reply email, ( do not review,

copy, save, forward, or print this email or any of its attachments, and ©

immediately delete and/or destroy this email and its attachments and all

electronic and physical copies thereof. Thank you.

________________________________________________________________________________\

_____

[Guest guest]

Danny;

Speaking for myself, I was metaphorically shaking my head in

disbelief on how the thread went and I was commenting on the fact in a

tongue in cheek way to Mr. Molina in reference to a comment he made

about an argument getting started (again). Please forgive my taking the

liberty if it caused you any distress. In reference to your use of duct

tape, it pretty much parallels mine. Unfortunately, some folks have

taken the use of it to include trying to fully immobilize a patient with

it, going so far as to include a comment about a patient of large size

being suspended on a backboard above a hapless medic waiting to get

squished when the tape gives. I said in my first post on the 'issue'

yesterday that it was a " useful tool to help " . I never said that it

would do the job all by itself, but there are always folks who want to

go off on tangents and have spin off arguments. Some seem to protect

their pieces of the briar patch(see my earlier comments on the

bureaucrat mentality), some folks just seem to like to argue either to

show what they know, or just form the sake of argument itself (which can

be kinda therapeutic I guess if you think about it).

Anyway, please forgive my ramble, and know that while I don't

know if any of this is in direct relation to you last comment, I would

be glad to take an extra duct tape flogging on your behalf while I'm at

it.

Crosby

EMT-B

RE: Re: Duct Tape

Ok, ladies and gentlemen of the greater EMS community. I have used duct

tape for immobilization only on the forehead and possibly under the chin

to help the patient understand not to move their head. I was not aware

we are using this instead of straping our patients to the backboard with

standard quick clip straps or standard straps.

Please tell me what I have been seeing is not in relation to my last

statement.

" Crosby, E " wrote:

Mr. Molino, I was apparently very wrong. The duct tape issue

does seem to start some sticky arguments. I stand properly chastised

and will now take 10 minutes to reevaluate my life, flog myself with

duct tape and hide my young before they are eaten.

Crosby

EMT-B

PS: I will still use duct tape for quick and easy auto, home repair and

minor veterinary needs....

PPS: I hope you had a very enjoyable Thanksgiving after your shift was

up (or maybe during?).

________________________________________________________________________________\

_____

This email and its attachments, if any, are intended for the personal use of the

named recipient(s) and may contain confidential, privileged, or proprietary

information. If you are not a named recipient, or an agent responsible for

delivering it to a named recipient, you have received this email in error. In

that event, please (a) immediately notify me by reply email, ( do not review,

copy, save, forward, or print this email or any of its attachments, and ©

immediately delete and/or destroy this email and its attachments and all

electronic and physical copies thereof. Thank you.

________________________________________________________________________________\

_____

[Guest guest]

Along with the duct tape? Remember, you will only be supergluing the

skin to the board; you still need to keep the head from wagging and

sliding around in there. Don't forget to use the superglue in a well

ventilated area or you might end up doing something silly when the fumes

get to you.

Crosby

EMT-B

________________________________

From: [mailto: ] On

Behalf Of txguy001@...

Sent: Friday, November 25, 2005 4:54 PM

To:

Subject: Re: Re: Duct Tape

Why can't we just use super glue?

________________________________________________________________________________\

_____

This email and its attachments, if any, are intended for the personal use of the

named recipient(s) and may contain confidential, privileged, or proprietary

information. If you are not a named recipient, or an agent responsible for

delivering it to a named recipient, you have received this email in error. In

that event, please (a) immediately notify me by reply email, ( do not review,

copy, save, forward, or print this email or any of its attachments, and ©

immediately delete and/or destroy this email and its attachments and all

electronic and physical copies thereof. Thank you.

________________________________________________________________________________\

_____

[Guest guest]

Along with the duct tape? Remember, you will only be supergluing the

skin to the board; you still need to keep the head from wagging and

sliding around in there. Don't forget to use the superglue in a well

ventilated area or you might end up doing something silly when the fumes

get to you.

Crosby

EMT-B

________________________________

From: [mailto: ] On

Behalf Of txguy001@...

Sent: Friday, November 25, 2005 4:54 PM

To:

Subject: Re: Re: Duct Tape

Why can't we just use super glue?

________________________________________________________________________________\

_____

This email and its attachments, if any, are intended for the personal use of the

named recipient(s) and may contain confidential, privileged, or proprietary

information. If you are not a named recipient, or an agent responsible for

delivering it to a named recipient, you have received this email in error. In

that event, please (a) immediately notify me by reply email, ( do not review,

copy, save, forward, or print this email or any of its attachments, and ©

immediately delete and/or destroy this email and its attachments and all

electronic and physical copies thereof. Thank you.

________________________________________________________________________________\

_____

[Guest guest]

Along with the duct tape? Remember, you will only be supergluing the

skin to the board; you still need to keep the head from wagging and

sliding around in there. Don't forget to use the superglue in a well

ventilated area or you might end up doing something silly when the fumes

get to you.

Crosby

EMT-B

________________________________

From: [mailto: ] On

Behalf Of txguy001@...

Sent: Friday, November 25, 2005 4:54 PM

To:

Subject: Re: Re: Duct Tape

Why can't we just use super glue?

________________________________________________________________________________\

_____

This email and its attachments, if any, are intended for the personal use of the

named recipient(s) and may contain confidential, privileged, or proprietary

information. If you are not a named recipient, or an agent responsible for

delivering it to a named recipient, you have received this email in error. In

that event, please (a) immediately notify me by reply email, ( do not review,

copy, save, forward, or print this email or any of its attachments, and ©

immediately delete and/or destroy this email and its attachments and all

electronic and physical copies thereof. Thank you.

________________________________________________________________________________\

_____

[Guest guest]

Wait wait wait, I got it... Expanding foam!!!!!!! With duct tape!

Crosby

EMT-B

Re: Re: Duct Tape

Hold up. I'm sure we could find a way to super glue the head to the

board.

If super glue doesn't work, maybe hot glue would work.

[Guest guest]

Wait wait wait, I got it... Expanding foam!!!!!!! With duct tape!

Crosby

EMT-B

Re: Re: Duct Tape

Hold up. I'm sure we could find a way to super glue the head to the

board.

If super glue doesn't work, maybe hot glue would work.

[Guest guest]

Wait wait wait, I got it... Expanding foam!!!!!!! With duct tape!

Crosby

EMT-B

Re: Re: Duct Tape

Hold up. I'm sure we could find a way to super glue the head to the

board.

If super glue doesn't work, maybe hot glue would work.

[Guest guest]

I may be getting weird now, but now that I think about what

I just wrote, I wonder if something like that might not be a bad idea.

A non-toxic expanding foam. I need to think on that some more, but the

expanding foam that we use where I work of does harden quite well, and

it does so quickly. I think I need to bring this up to some chemistry

hobbyist I know.

Crosby

EMT-B

________________________________

From: [mailto: ] On

Behalf Of Crosby, E

Sent: Friday, November 25, 2005 5:39 PM

To:

Subject: RE: Re: Duct Tape

Wait wait wait, I got it... Expanding foam!!!!!!! With duct tape!

Crosby

EMT-B

Re: Re: Duct Tape

Hold up. I'm sure we could find a way to super glue the head to the

board.

If super glue doesn't work, maybe hot glue would work.

[Guest guest]

I may be getting weird now, but now that I think about what

I just wrote, I wonder if something like that might not be a bad idea.

A non-toxic expanding foam. I need to think on that some more, but the

expanding foam that we use where I work of does harden quite well, and

it does so quickly. I think I need to bring this up to some chemistry

hobbyist I know.

Crosby

EMT-B

________________________________

From: [mailto: ] On

Behalf Of Crosby, E

Sent: Friday, November 25, 2005 5:39 PM

To:

Subject: RE: Re: Duct Tape

Wait wait wait, I got it... Expanding foam!!!!!!! With duct tape!

Crosby

EMT-B

Re: Re: Duct Tape

Hold up. I'm sure we could find a way to super glue the head to the

board.

If super glue doesn't work, maybe hot glue would work.

[Guest guest]

" Crosby, E " wrote: A non-toxic expanding

foam. I need to think on that some more, but the expanding foam that we use

where I work of does harden quite well, and it does so quickly.

Don't most of those fast forming foams have an exothermic reaction? I would be

concerned about possibly burning the patient. .. Primum non nocere!

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

" Crosby, E " wrote: A non-toxic expanding

foam. I need to think on that some more, but the expanding foam that we use

where I work of does harden quite well, and it does so quickly.

Don't most of those fast forming foams have an exothermic reaction? I would be

concerned about possibly burning the patient. .. Primum non nocere!

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

" Crosby, E " wrote: A non-toxic expanding

foam. I need to think on that some more, but the expanding foam that we use

where I work of does harden quite well, and it does so quickly.

Don't most of those fast forming foams have an exothermic reaction? I would be

concerned about possibly burning the patient. .. Primum non nocere!

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Actually, they type we use doesn't. I have personally used it to fill some

mouse holes in the place we used to live, and I have gotten it on my hands.

It felt like shaving cream till it got hard (in about 10 seconds or so).

Took forever to get off, but no heat or chemical burns at all.

Crosby

EMT-B

RE: Re: Duct Tape

> " Crosby, E " wrote: A non-toxic

> expanding foam. I need to think on that some more, but the expanding foam

> that we use where I work of does harden quite well, and it does so

> quickly.

> Don't most of those fast forming foams have an exothermic reaction? I

> would be concerned about possibly burning the patient. .. Primum non

> nocere!

>

>

>

>

> ---------------------------------

> Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

>

>

[Guest guest]

Actually, they type we use doesn't. I have personally used it to fill some

mouse holes in the place we used to live, and I have gotten it on my hands.

It felt like shaving cream till it got hard (in about 10 seconds or so).

Took forever to get off, but no heat or chemical burns at all.

Crosby

EMT-B

RE: Re: Duct Tape

> " Crosby, E " wrote: A non-toxic

> expanding foam. I need to think on that some more, but the expanding foam

> that we use where I work of does harden quite well, and it does so

> quickly.

> Don't most of those fast forming foams have an exothermic reaction? I

> would be concerned about possibly burning the patient. .. Primum non

> nocere!

>

>

>

>

> ---------------------------------

> Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

>

>

[Guest guest]

Is it just me or is this turning into the Tim thread? LOL

-Wes

RE: Re: Duct Tape

" Crosby, E " wrote: A non-toxic

expanding

foam. I need to think on that some more, but the expanding foam that

we use

where I work of does harden quite well, and it does so quickly.

Don't most of those fast forming foams have an exothermic reaction? I

would be

concerned about possibly burning the patient. .. Primum non nocere!

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Is it just me or is this turning into the Tim thread? LOL

-Wes

RE: Re: Duct Tape

" Crosby, E " wrote: A non-toxic

expanding

foam. I need to think on that some more, but the expanding foam that

we use

where I work of does harden quite well, and it does so quickly.

Don't most of those fast forming foams have an exothermic reaction? I

would be

concerned about possibly burning the patient. .. Primum non nocere!

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Is it just me or is this turning into the Tim thread? LOL

-Wes

RE: Re: Duct Tape

" Crosby, E " wrote: A non-toxic

expanding

foam. I need to think on that some more, but the expanding foam that

we use

where I work of does harden quite well, and it does so quickly.

Don't most of those fast forming foams have an exothermic reaction? I

would be

concerned about possibly burning the patient. .. Primum non nocere!

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Sylvester Stallone actually. Something about the foam had tickled a memory

with me, and it took me a little bit to nail it down. Stallone did a movie

called 'Demolition Man' where he was a cop that got put in a cryoprison and

was defrosted years later. Near the end of the movie he crashed a police

car. As the car was crashing, the passenger area filled with foam that

padded him from the crash and held him in place. I seem to remember

something from either Popular Science or Popular Mechanics where such a

restraint system was tossed around, kinda collecting ideas for development.

Like I said, something to think on (the ultimate one size fits all C

collar). Maybe after I gather some good info I'll take this up in the EMS

Research group.

Crosby

EMT-B

" We just need more power!!!! "

RE: Re: Duct Tape

>

> " Crosby, E " wrote: A non-toxic

> expanding

> foam. I need to think on that some more, but the expanding foam that

> we use

> where I work of does harden quite well, and it does so quickly.

> Don't most of those fast forming foams have an exothermic reaction? I

> would be

> concerned about possibly burning the patient. .. Primum non nocere!

>

>

>

>

> ---------------------------------

> Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

>

>

[Guest guest]

Actually the medical director had no clue what was

going on. We were instructed to increase our

transports immediatley because our refusal rate was

way up. So sometimes even though it was a very minor

fender bender we would tell the pt that we could not

guarantee they had no c-spine fx. Their old protocol

was basically to SMR everyone period and did not leave

much room for a medic to make his own decision. Their

new one basically is geared towards the PHTLS

protocol. But I bet they still push transports even

if it is without SMR and sitting on the bench. I

remember once I transported like 6 pts in one unit,

all walking.

Salvador Capuchino

EMT-Paramedic

--- britton_waldron wrote:

> Salvador,

>

> It is nice that you step up to the plate to explain

> what Alfonso was

> saying;

> ... that you and he worked for a service that

> considered a patient's

> ability to pay or a class of individuals' ability to

> pay to

> establish how you treated those you encountered.

> Exactly how long

> did it take either of you to have that epiphany?

>

> Are you announcing that your Medical Director was so

> intimately

> involved in the billing process that his/her medical

> treatment

> protocols were established on EMS reimbursement

> rules.

>

> Or were you saying that your Medical Director had no

> clue and that

> the Director of the Service set the Standing

> Delegated Orders for

> the medics to follow?

>

> Or are you saying the Director and the Medical

> Director had so

> little confidence in the judgment skills of the

> Medics to

> consistently do the right things they would not

> consider allowing a

> selective spinal immobilization protocol to be

> implemented knowing

> the staff would not evaluate the patient properly to

> come to the

> reasonable conclusion of a low probability of spinal

> injury?

>

> Were you saying that you and Alfonso worked at the

> same place during

> a time when the " standard of care " in Texas

> prehospital treatment

> was to c-collar and c-spine everybody that had some

> sort of bump or

> fall?

>

> Exactly what were are you saying?

>

> I asked Alfonso to explain his comment, your attempt

> did not answer

> the question.

>

> We know some well financed EMS systems, both public

> and private,

> that continues to raise the bar for treatment

> standards. I am

> reasonably certain that for every good action from a

> publicly funded

> agency one will find the same or similar from a

> private agency. The

> same will likely hold true for private agencies

> doing a bad action

> will be duplicated by a publicly funded service.

>

> I am not trying to start an argument, but trying to

> exploit how

> thoughtless and unsubstantiated comments, such as

> those that

> Alfonso made, are not beneficial nor do they support

> the position.

> They are more likely to be perceived as an assault

> on a class or

> group. Our society has recognized those types of

> verbal

> generalizations as a bad thing.

>

> A blanket assault on Public, Private, Hospital

> Based, Third Service,

> P.U.M, ESD, FD, Not for Profit, For Profit,

> Volunteer (please

> forgive me if I failed to mention a group) is not

> necessary and will

> pretty much always leave one with the taste of a

> foot in the mouth.

>

> My thoughts, yours may vary.

>

> bkw

>

>

> >

> > >

> > > --------------- In Reply To:

> > >

> >

>

----------------------------------------------------------------

> > >

> > > Yes, Dr. B, but that makes too much sense. Tell

> > > that to the private

> > > providers who depend on this service for their

> > > cash-flow. :-)

> > >

> > > --------------- End of Quote

> > >

> >

>

--------------------------------------------------------------

> > >

> > >

> > >

> > >

> > > I really try to stay quiet around here, but

> afraid

> > > that it's not going to work this time.

> > >

> > > No wonder I've recently read here that EMS

> appears

> > > to " eat its own " . As a whole, we scream, yell,

> and

> > > pound fists on the table to demand recognition

> from

> > > the world as unified medical professionals: EMS.

>

> > > And yet in the same room, we find ourselves

> > > separated simply by the type of service we work

> for.

> > >

> > >

> > > We are all certified to at least a statewide

> > > standard of education and skills, no matter what

> > > service employs us... city, private, fire, or

> > > volunteer. No one with a heart and a humble ego

> > > immobilizes anyone for their own selfish

> pleasure or

> > > to gain from insurance. And as I've easily found

> by

> > > a simple web search, CMS does not reimburse for

> > > immobilization no matter what service you work

> for.

> > > For reference, please see

> > >

> >

>

http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

> > >

> > >

> >

>

(www.trailblazerhealth.com/notices.asp?action=detail & id=1798).

> > > I truncated the very extensive list to just the

> > > immobilization procedures below:

> > >

> > > From CMS carrier Trailblazer Health:

> > > > " The following supplies are considered part of

> the

> > > transport and a separate charge is not

> reimbursable

> > > by Medicare and not billable to the patient.

> > > >>> Back board.

> > > >>> CID (cervical immobilization device,

> C-collar,

> > > cervical collar).

> > > >>> Inflatable arm or leg splint.

> > > >>> Minor extrication.

> > > >>> Neck board (neck brace). "

> > >

> > >

> > > Please pass the Real Tree camo-colored duct

> tape,

> > > and I'll try to sit here quiet and camoflaged a

> > > while more. ;-)

> > >

> > > K. Pelletier

> > >

> > >

> > >

> > >

> > >

> > > [Non-text portions of this message have been

>

=== message truncated ===

__________________________________

Yahoo! Mail - PC Magazine Editors' Choice 2005

http://mail.yahoo.com

[Guest guest]

Actually the medical director had no clue what was

going on. We were instructed to increase our

transports immediatley because our refusal rate was

way up. So sometimes even though it was a very minor

fender bender we would tell the pt that we could not

guarantee they had no c-spine fx. Their old protocol

was basically to SMR everyone period and did not leave

much room for a medic to make his own decision. Their

new one basically is geared towards the PHTLS

protocol. But I bet they still push transports even

if it is without SMR and sitting on the bench. I

remember once I transported like 6 pts in one unit,

all walking.

Salvador Capuchino

EMT-Paramedic

--- britton_waldron wrote:

> Salvador,

>

> It is nice that you step up to the plate to explain

> what Alfonso was

> saying;

> ... that you and he worked for a service that

> considered a patient's

> ability to pay or a class of individuals' ability to

> pay to

> establish how you treated those you encountered.

> Exactly how long

> did it take either of you to have that epiphany?

>

> Are you announcing that your Medical Director was so

> intimately

> involved in the billing process that his/her medical

> treatment

> protocols were established on EMS reimbursement

> rules.

>

> Or were you saying that your Medical Director had no

> clue and that

> the Director of the Service set the Standing

> Delegated Orders for

> the medics to follow?

>

> Or are you saying the Director and the Medical

> Director had so

> little confidence in the judgment skills of the

> Medics to

> consistently do the right things they would not

> consider allowing a

> selective spinal immobilization protocol to be

> implemented knowing

> the staff would not evaluate the patient properly to

> come to the

> reasonable conclusion of a low probability of spinal

> injury?

>

> Were you saying that you and Alfonso worked at the

> same place during

> a time when the " standard of care " in Texas

> prehospital treatment

> was to c-collar and c-spine everybody that had some

> sort of bump or

> fall?

>

> Exactly what were are you saying?

>

> I asked Alfonso to explain his comment, your attempt

> did not answer

> the question.

>

> We know some well financed EMS systems, both public

> and private,

> that continues to raise the bar for treatment

> standards. I am

> reasonably certain that for every good action from a

> publicly funded

> agency one will find the same or similar from a

> private agency. The

> same will likely hold true for private agencies

> doing a bad action

> will be duplicated by a publicly funded service.

>

> I am not trying to start an argument, but trying to

> exploit how

> thoughtless and unsubstantiated comments, such as

> those that

> Alfonso made, are not beneficial nor do they support

> the position.

> They are more likely to be perceived as an assault

> on a class or

> group. Our society has recognized those types of

> verbal

> generalizations as a bad thing.

>

> A blanket assault on Public, Private, Hospital

> Based, Third Service,

> P.U.M, ESD, FD, Not for Profit, For Profit,

> Volunteer (please

> forgive me if I failed to mention a group) is not

> necessary and will

> pretty much always leave one with the taste of a

> foot in the mouth.

>

> My thoughts, yours may vary.

>

> bkw

>

>

> >

> > >

> > > --------------- In Reply To:

> > >

> >

>

----------------------------------------------------------------

> > >

> > > Yes, Dr. B, but that makes too much sense. Tell

> > > that to the private

> > > providers who depend on this service for their

> > > cash-flow. :-)

> > >

> > > --------------- End of Quote

> > >

> >

>

--------------------------------------------------------------

> > >

> > >

> > >

> > >

> > > I really try to stay quiet around here, but

> afraid

> > > that it's not going to work this time.

> > >

> > > No wonder I've recently read here that EMS

> appears

> > > to " eat its own " . As a whole, we scream, yell,

> and

> > > pound fists on the table to demand recognition

> from

> > > the world as unified medical professionals: EMS.

>

> > > And yet in the same room, we find ourselves

> > > separated simply by the type of service we work

> for.

> > >

> > >

> > > We are all certified to at least a statewide

> > > standard of education and skills, no matter what

> > > service employs us... city, private, fire, or

> > > volunteer. No one with a heart and a humble ego

> > > immobilizes anyone for their own selfish

> pleasure or

> > > to gain from insurance. And as I've easily found

> by

> > > a simple web search, CMS does not reimburse for

> > > immobilization no matter what service you work

> for.

> > > For reference, please see

> > >

> >

>

http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

> > >

> > >

> >

>

(www.trailblazerhealth.com/notices.asp?action=detail & id=1798).

> > > I truncated the very extensive list to just the

> > > immobilization procedures below:

> > >

> > > From CMS carrier Trailblazer Health:

> > > > " The following supplies are considered part of

> the

> > > transport and a separate charge is not

> reimbursable

> > > by Medicare and not billable to the patient.

> > > >>> Back board.

> > > >>> CID (cervical immobilization device,

> C-collar,

> > > cervical collar).

> > > >>> Inflatable arm or leg splint.

> > > >>> Minor extrication.

> > > >>> Neck board (neck brace). "

> > >

> > >

> > > Please pass the Real Tree camo-colored duct

> tape,

> > > and I'll try to sit here quiet and camoflaged a

> > > while more. ;-)

> > >

> > > K. Pelletier

> > >

> > >

> > >

> > >

> > >

> > > [Non-text portions of this message have been

>

=== message truncated ===

__________________________________

Yahoo! Mail - PC Magazine Editors' Choice 2005

http://mail.yahoo.com

[Guest guest]

Actually the medical director had no clue what was

going on. We were instructed to increase our

transports immediatley because our refusal rate was

way up. So sometimes even though it was a very minor

fender bender we would tell the pt that we could not

guarantee they had no c-spine fx. Their old protocol

was basically to SMR everyone period and did not leave

much room for a medic to make his own decision. Their

new one basically is geared towards the PHTLS

protocol. But I bet they still push transports even

if it is without SMR and sitting on the bench. I

remember once I transported like 6 pts in one unit,

all walking.

Salvador Capuchino

EMT-Paramedic

--- britton_waldron wrote:

> Salvador,

>

> It is nice that you step up to the plate to explain

> what Alfonso was

> saying;

> ... that you and he worked for a service that

> considered a patient's

> ability to pay or a class of individuals' ability to

> pay to

> establish how you treated those you encountered.

> Exactly how long

> did it take either of you to have that epiphany?

>

> Are you announcing that your Medical Director was so

> intimately

> involved in the billing process that his/her medical

> treatment

> protocols were established on EMS reimbursement

> rules.

>

> Or were you saying that your Medical Director had no

> clue and that

> the Director of the Service set the Standing

> Delegated Orders for

> the medics to follow?

>

> Or are you saying the Director and the Medical

> Director had so

> little confidence in the judgment skills of the

> Medics to

> consistently do the right things they would not

> consider allowing a

> selective spinal immobilization protocol to be

> implemented knowing

> the staff would not evaluate the patient properly to

> come to the

> reasonable conclusion of a low probability of spinal

> injury?

>

> Were you saying that you and Alfonso worked at the

> same place during

> a time when the " standard of care " in Texas

> prehospital treatment

> was to c-collar and c-spine everybody that had some

> sort of bump or

> fall?

>

> Exactly what were are you saying?

>

> I asked Alfonso to explain his comment, your attempt

> did not answer

> the question.

>

> We know some well financed EMS systems, both public

> and private,

> that continues to raise the bar for treatment

> standards. I am

> reasonably certain that for every good action from a

> publicly funded

> agency one will find the same or similar from a

> private agency. The

> same will likely hold true for private agencies

> doing a bad action

> will be duplicated by a publicly funded service.

>

> I am not trying to start an argument, but trying to

> exploit how

> thoughtless and unsubstantiated comments, such as

> those that

> Alfonso made, are not beneficial nor do they support

> the position.

> They are more likely to be perceived as an assault

> on a class or

> group. Our society has recognized those types of

> verbal

> generalizations as a bad thing.

>

> A blanket assault on Public, Private, Hospital

> Based, Third Service,

> P.U.M, ESD, FD, Not for Profit, For Profit,

> Volunteer (please

> forgive me if I failed to mention a group) is not

> necessary and will

> pretty much always leave one with the taste of a

> foot in the mouth.

>

> My thoughts, yours may vary.

>

> bkw

>

>

> >

> > >

> > > --------------- In Reply To:

> > >

> >

>

----------------------------------------------------------------

> > >

> > > Yes, Dr. B, but that makes too much sense. Tell

> > > that to the private

> > > providers who depend on this service for their

> > > cash-flow. :-)

> > >

> > > --------------- End of Quote

> > >

> >

>

--------------------------------------------------------------

> > >

> > >

> > >

> > >

> > > I really try to stay quiet around here, but

> afraid

> > > that it's not going to work this time.

> > >

> > > No wonder I've recently read here that EMS

> appears

> > > to " eat its own " . As a whole, we scream, yell,

> and

> > > pound fists on the table to demand recognition

> from

> > > the world as unified medical professionals: EMS.

>

> > > And yet in the same room, we find ourselves

> > > separated simply by the type of service we work

> for.

> > >

> > >

> > > We are all certified to at least a statewide

> > > standard of education and skills, no matter what

> > > service employs us... city, private, fire, or

> > > volunteer. No one with a heart and a humble ego

> > > immobilizes anyone for their own selfish

> pleasure or

> > > to gain from insurance. And as I've easily found

> by

> > > a simple web search, CMS does not reimburse for

> > > immobilization no matter what service you work

> for.

> > > For reference, please see

> > >

> >

>

http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

> > >

> > >

> >

>

(www.trailblazerhealth.com/notices.asp?action=detail & id=1798).

> > > I truncated the very extensive list to just the

> > > immobilization procedures below:

> > >

> > > From CMS carrier Trailblazer Health:

> > > > " The following supplies are considered part of

> the

> > > transport and a separate charge is not

> reimbursable

> > > by Medicare and not billable to the patient.

> > > >>> Back board.

> > > >>> CID (cervical immobilization device,

> C-collar,

> > > cervical collar).

> > > >>> Inflatable arm or leg splint.

> > > >>> Minor extrication.

> > > >>> Neck board (neck brace). "

> > >

> > >

> > > Please pass the Real Tree camo-colored duct

> tape,

> > > and I'll try to sit here quiet and camoflaged a

> > > while more. ;-)

> > >

> > > K. Pelletier

> > >

> > >

> > >

> > >

> > >

> > > [Non-text portions of this message have been

>

=== message truncated ===

__________________________________

Yahoo! Mail - PC Magazine Editors' Choice 2005

http://mail.yahoo.com

[Guest guest]

Tape or straps, neither totally keeps a pt from

moving. They both have the same effect. We were not

allowed to use the duct tape on the forehead. It was

considered a little cruel.

Salvador Capuchino

EMT-Paramedic

--- Danny wrote:

> Ok, ladies and gentlemen of the greater EMS

> community. I have used duct tape for immobilization

> only on the forehead and possibly under the chin to

> help the patient understand not to move their head.

> I was not aware we are using this instead of

> straping our patients to the backboard with standard

> quick clip straps or standard straps.

>

> Please tell me what I have been seeing is not in

> relation to my last statement.

>

>

>

> " Crosby, E "

> wrote:

> Mr. Molino, I was apparently very wrong. The duct

> tape issue

> does seem to start some sticky arguments. I stand

> properly chastised

> and will now take 10 minutes to reevaluate my life,

> flog myself with

> duct tape and hide my young before they are eaten.

>

> Crosby

> EMT-B

>

> PS: I will still use duct tape for quick and easy

> auto, home repair and

> minor veterinary needs....

>

> PPS: I hope you had a very enjoyable Thanksgiving

> after your shift was

> up (or maybe during?).

>

> Re: Duct Tape

>

> Salvador,

>

> It is nice that you step up to the plate to explain

> what Alfonso was

> saying;

> ... that you and he worked for a service that

> considered a patient's

> ability to pay or a class of individuals' ability to

> pay to

> establish how you treated those you encountered.

> Exactly how long

> did it take either of you to have that epiphany?

>

> [Crosby, E] Snipped for brevity

>

________________________________________________________________________________\

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