Guest guest Posted February 27, 2005 Report Share Posted February 27, 2005 That's why Dr. has us request id and specialization from the doctor, call med control for the ok, have the doc accompany the patient AND fill out the run form with legible signatures. Eddie > > " How do I tell who is going to be helpful, and who is going to be a > hinderance? > > >> > magnetass sends " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 27, 2005 Report Share Posted February 27, 2005 That's why Dr. has us request id and specialization from the doctor, call med control for the ok, have the doc accompany the patient AND fill out the run form with legible signatures. Eddie > > " How do I tell who is going to be helpful, and who is going to be a > hinderance? > > >> > magnetass sends " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 28, 2005 Report Share Posted February 28, 2005 God bless you, and those like you Dr. . McGee, EMT-I Larry wrote: Yes, I make runs with my paramedics so that I can understand the problems and help with the solutions. Yes, I wear my Yellow Patch when I make scheduled runs. When I come upon an accident beside the road, I make it easy by showing my medical director¹s badge. I fully understand and have protocols for private physicians showing up at the scene not knowing what they are doing or trying to make my medics do something that is not in our protocol or in their training. Nevertheless, there are hundreds of ER doctors and military Doctors with combat experience driving around the roads that could offer great help in certain situations. These are the same doctors you call for ³on-line medical control². Now they are ³on-scene medical control². I hate to place restrictions on them when they do offer a higher level of care. Again the question comes down to what if this were you or your mother lying in the ditch in dire straights. Would you want (or expect) me to stop and see if the medics treating you need any help, or would you prefer that I just drive on home and watch it on the 5 o¹clock news? We do have a choice. This is not necessarily something that ER doctors want to do, but often feel is a civic (humanitarian) duty. Thanks for your support. Best regards, Larry > Are you wearing your yellow EMS Medical Director patch? <grin> > > Mike > > > >> > >> > Let me ask you all this question. >> > >> > If you were at the scene of a critically ill or injured patient that you >> > were having difficulty stabilizing and I showed up at the scene to help. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 28, 2005 Report Share Posted February 28, 2005 God bless you, and those like you Dr. . McGee, EMT-I Larry wrote: Yes, I make runs with my paramedics so that I can understand the problems and help with the solutions. Yes, I wear my Yellow Patch when I make scheduled runs. When I come upon an accident beside the road, I make it easy by showing my medical director¹s badge. I fully understand and have protocols for private physicians showing up at the scene not knowing what they are doing or trying to make my medics do something that is not in our protocol or in their training. Nevertheless, there are hundreds of ER doctors and military Doctors with combat experience driving around the roads that could offer great help in certain situations. These are the same doctors you call for ³on-line medical control². Now they are ³on-scene medical control². I hate to place restrictions on them when they do offer a higher level of care. Again the question comes down to what if this were you or your mother lying in the ditch in dire straights. Would you want (or expect) me to stop and see if the medics treating you need any help, or would you prefer that I just drive on home and watch it on the 5 o¹clock news? We do have a choice. This is not necessarily something that ER doctors want to do, but often feel is a civic (humanitarian) duty. Thanks for your support. Best regards, Larry > Are you wearing your yellow EMS Medical Director patch? <grin> > > Mike > > > >> > >> > Let me ask you all this question. >> > >> > If you were at the scene of a critically ill or injured patient that you >> > were having difficulty stabilizing and I showed up at the scene to help. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 28, 2005 Report Share Posted February 28, 2005 God bless you, and those like you Dr. . McGee, EMT-I Larry wrote: Yes, I make runs with my paramedics so that I can understand the problems and help with the solutions. Yes, I wear my Yellow Patch when I make scheduled runs. When I come upon an accident beside the road, I make it easy by showing my medical director¹s badge. I fully understand and have protocols for private physicians showing up at the scene not knowing what they are doing or trying to make my medics do something that is not in our protocol or in their training. Nevertheless, there are hundreds of ER doctors and military Doctors with combat experience driving around the roads that could offer great help in certain situations. These are the same doctors you call for ³on-line medical control². Now they are ³on-scene medical control². I hate to place restrictions on them when they do offer a higher level of care. Again the question comes down to what if this were you or your mother lying in the ditch in dire straights. Would you want (or expect) me to stop and see if the medics treating you need any help, or would you prefer that I just drive on home and watch it on the 5 o¹clock news? We do have a choice. This is not necessarily something that ER doctors want to do, but often feel is a civic (humanitarian) duty. Thanks for your support. Best regards, Larry > Are you wearing your yellow EMS Medical Director patch? <grin> > > Mike > > > >> > >> > Let me ask you all this question. >> > >> > If you were at the scene of a critically ill or injured patient that you >> > were having difficulty stabilizing and I showed up at the scene to help. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2005 Report Share Posted March 27, 2005 I'd LOVE to have you at my scenes, but it rarely works out that way. What I get are radiologists or podiatrists......geez I even had a opthamologist in my face one night telling me to administer calcium chloride first on a code at a resturaunt, then loudly telling everybody within earshot that I'd " killed " the guy. sigh..... How do I tell who is going to be helpful, and who is going to be a hinderance? I worked the first night " Minute Maid " park opened and a guy up in the stands had some chest pain. It was a disaster, because apparently he was sitting in the AMA section 'cause there were literally hoardes of doctors there climbing over each other and me trying to see the EKG and arguing with each other about what I should do and where I should take him. Where were you, LOL! I really could have used you that nite. If you showed up at a scene of mine, look at it from my perspective. This guy stalks up who you don't know and announces that he's Doctor so and so, a board certified emergency physician. What do you do? Where does he fit in? Do you just assign him a patient, hoping that he's not some crackpot....'cause we get those sometimes. It's not a matter of if it's proper to allow you to assist...because it would be, but rather a matter of that I don't have the time to run a vetting process for everybody who wants to help out at a scene, even though I'd really like the help sometimes. You know we do this to each other, right? When people walk on to a scene of mine and say " I'm a paramedic with _________ " I say, " Great, could you go stand over there please " and point to the crowd. Unless I know you, there's no way in hell I'm letting you near a patient. Couple of years back I'm at a convention for one of my hobbies in VA beach, eating at Hooters. Several of the guys I'm with are fire/EMS professionals, incl. an assistant cheif from a department in upstate NY, a senior medic with Phoenix FD, a medic supervisor with Atlanta FD and a guy with the Toronto fire dept. There's hundreds of years of experience at this table. I witnessed a bad MVA at the intersection involving a van with downs syndrome kids and a car with a gaggle of teenagers in it. It was a MESS. Kids all over the intersection running around, 4 fairly seriously injured people and 1 trapped, small fire under the hood of the car....a pretty bad scene. So we all ran out there and by the time VA Beach FD got there, we had the fire under the hood of the car out with a portable extinguisher that somebody had, all the kids rounded up, the entire scene triaged and seperated and all bleeding and c-spine being managed. We were on FIRE, and I've rarely seen a smoother scene. The guy from VBFD hops out and I went up to him and said " Ok, here's what you got....there's a........ " and he says " Thats great sir, could I get you to go stand over there for me " and points at the crowd. " But...but, I'm a paramed....... " " Great sir, I appreciate it, now if I could get you to go stand right over there " I just had to laugh, 'cause I knew exactly what that guy was thinking. magnetass sends Re: Re: Health Care Providers Let me ask you all this question. If you were at the scene of a critically ill or injured patient that you were having difficulty stabilizing and I showed up at the scene to help. (I am a board certified emergency physician. I have treated over 120,000 patients in my career and have been EMS medical director for more than 25 years. I currently have more than 200 EMT¹s working under my license. There are dozens of such doctors driving the streets of Texas and are able and willing to stop and help). So the question is: Even if I were not your medical director, would it be proper for me to stop and help? Would it be proper for you to accept my assistance? What about the Good Samaritan Law obligating me to stop and render aid? Think about that when you write your protocols. In the end, the right answer is always what is in the best interest of the patient. Best regards, Larry MD > > I understand what you are saying, but we have some rather unique > protocols. We have been on scenes and while we were working the pts > per our protocol, and we had to almost stop and explain or " justify " > what we were doing. For example, trying to explain why we perform > chest-abdominal counter compressions, obtain either IV or IO access, > administer Aminophylline, , and intubate prior to defibrillation (at > 360 joules) for someone who is in V-fib with a down time greater > than 4 minutes is rather difficult. Once the call is over, we can > offer loads of literature that backs our protocols, but most > physicians want complete control of the scene and per our medical > director...that won't happen. It causes conflict and the pt is the > one who will suffer. > > D. Stone > > >>> > > >>> > > Ours states to not take advice from an on-scene physician. >>> > > Therefore, I would interpret that as including PAs or NPs. >>> > > >>> > > D. Stone >>> > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2005 Report Share Posted March 27, 2005 I'd LOVE to have you at my scenes, but it rarely works out that way. What I get are radiologists or podiatrists......geez I even had a opthamologist in my face one night telling me to administer calcium chloride first on a code at a resturaunt, then loudly telling everybody within earshot that I'd " killed " the guy. sigh..... How do I tell who is going to be helpful, and who is going to be a hinderance? I worked the first night " Minute Maid " park opened and a guy up in the stands had some chest pain. It was a disaster, because apparently he was sitting in the AMA section 'cause there were literally hoardes of doctors there climbing over each other and me trying to see the EKG and arguing with each other about what I should do and where I should take him. Where were you, LOL! I really could have used you that nite. If you showed up at a scene of mine, look at it from my perspective. This guy stalks up who you don't know and announces that he's Doctor so and so, a board certified emergency physician. What do you do? Where does he fit in? Do you just assign him a patient, hoping that he's not some crackpot....'cause we get those sometimes. It's not a matter of if it's proper to allow you to assist...because it would be, but rather a matter of that I don't have the time to run a vetting process for everybody who wants to help out at a scene, even though I'd really like the help sometimes. You know we do this to each other, right? When people walk on to a scene of mine and say " I'm a paramedic with _________ " I say, " Great, could you go stand over there please " and point to the crowd. Unless I know you, there's no way in hell I'm letting you near a patient. Couple of years back I'm at a convention for one of my hobbies in VA beach, eating at Hooters. Several of the guys I'm with are fire/EMS professionals, incl. an assistant cheif from a department in upstate NY, a senior medic with Phoenix FD, a medic supervisor with Atlanta FD and a guy with the Toronto fire dept. There's hundreds of years of experience at this table. I witnessed a bad MVA at the intersection involving a van with downs syndrome kids and a car with a gaggle of teenagers in it. It was a MESS. Kids all over the intersection running around, 4 fairly seriously injured people and 1 trapped, small fire under the hood of the car....a pretty bad scene. So we all ran out there and by the time VA Beach FD got there, we had the fire under the hood of the car out with a portable extinguisher that somebody had, all the kids rounded up, the entire scene triaged and seperated and all bleeding and c-spine being managed. We were on FIRE, and I've rarely seen a smoother scene. The guy from VBFD hops out and I went up to him and said " Ok, here's what you got....there's a........ " and he says " Thats great sir, could I get you to go stand over there for me " and points at the crowd. " But...but, I'm a paramed....... " " Great sir, I appreciate it, now if I could get you to go stand right over there " I just had to laugh, 'cause I knew exactly what that guy was thinking. magnetass sends Re: Re: Health Care Providers Let me ask you all this question. If you were at the scene of a critically ill or injured patient that you were having difficulty stabilizing and I showed up at the scene to help. (I am a board certified emergency physician. I have treated over 120,000 patients in my career and have been EMS medical director for more than 25 years. I currently have more than 200 EMT¹s working under my license. There are dozens of such doctors driving the streets of Texas and are able and willing to stop and help). So the question is: Even if I were not your medical director, would it be proper for me to stop and help? Would it be proper for you to accept my assistance? What about the Good Samaritan Law obligating me to stop and render aid? Think about that when you write your protocols. In the end, the right answer is always what is in the best interest of the patient. Best regards, Larry MD > > I understand what you are saying, but we have some rather unique > protocols. We have been on scenes and while we were working the pts > per our protocol, and we had to almost stop and explain or " justify " > what we were doing. For example, trying to explain why we perform > chest-abdominal counter compressions, obtain either IV or IO access, > administer Aminophylline, , and intubate prior to defibrillation (at > 360 joules) for someone who is in V-fib with a down time greater > than 4 minutes is rather difficult. Once the call is over, we can > offer loads of literature that backs our protocols, but most > physicians want complete control of the scene and per our medical > director...that won't happen. It causes conflict and the pt is the > one who will suffer. > > D. Stone > > >>> > > >>> > > Ours states to not take advice from an on-scene physician. >>> > > Therefore, I would interpret that as including PAs or NPs. >>> > > >>> > > D. Stone >>> > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2005 Report Share Posted March 27, 2005 I'd LOVE to have you at my scenes, but it rarely works out that way. What I get are radiologists or podiatrists......geez I even had a opthamologist in my face one night telling me to administer calcium chloride first on a code at a resturaunt, then loudly telling everybody within earshot that I'd " killed " the guy. sigh..... How do I tell who is going to be helpful, and who is going to be a hinderance? I worked the first night " Minute Maid " park opened and a guy up in the stands had some chest pain. It was a disaster, because apparently he was sitting in the AMA section 'cause there were literally hoardes of doctors there climbing over each other and me trying to see the EKG and arguing with each other about what I should do and where I should take him. Where were you, LOL! I really could have used you that nite. If you showed up at a scene of mine, look at it from my perspective. This guy stalks up who you don't know and announces that he's Doctor so and so, a board certified emergency physician. What do you do? Where does he fit in? Do you just assign him a patient, hoping that he's not some crackpot....'cause we get those sometimes. It's not a matter of if it's proper to allow you to assist...because it would be, but rather a matter of that I don't have the time to run a vetting process for everybody who wants to help out at a scene, even though I'd really like the help sometimes. You know we do this to each other, right? When people walk on to a scene of mine and say " I'm a paramedic with _________ " I say, " Great, could you go stand over there please " and point to the crowd. Unless I know you, there's no way in hell I'm letting you near a patient. Couple of years back I'm at a convention for one of my hobbies in VA beach, eating at Hooters. Several of the guys I'm with are fire/EMS professionals, incl. an assistant cheif from a department in upstate NY, a senior medic with Phoenix FD, a medic supervisor with Atlanta FD and a guy with the Toronto fire dept. There's hundreds of years of experience at this table. I witnessed a bad MVA at the intersection involving a van with downs syndrome kids and a car with a gaggle of teenagers in it. It was a MESS. Kids all over the intersection running around, 4 fairly seriously injured people and 1 trapped, small fire under the hood of the car....a pretty bad scene. So we all ran out there and by the time VA Beach FD got there, we had the fire under the hood of the car out with a portable extinguisher that somebody had, all the kids rounded up, the entire scene triaged and seperated and all bleeding and c-spine being managed. We were on FIRE, and I've rarely seen a smoother scene. The guy from VBFD hops out and I went up to him and said " Ok, here's what you got....there's a........ " and he says " Thats great sir, could I get you to go stand over there for me " and points at the crowd. " But...but, I'm a paramed....... " " Great sir, I appreciate it, now if I could get you to go stand right over there " I just had to laugh, 'cause I knew exactly what that guy was thinking. magnetass sends Re: Re: Health Care Providers Let me ask you all this question. If you were at the scene of a critically ill or injured patient that you were having difficulty stabilizing and I showed up at the scene to help. (I am a board certified emergency physician. I have treated over 120,000 patients in my career and have been EMS medical director for more than 25 years. I currently have more than 200 EMT¹s working under my license. There are dozens of such doctors driving the streets of Texas and are able and willing to stop and help). So the question is: Even if I were not your medical director, would it be proper for me to stop and help? Would it be proper for you to accept my assistance? What about the Good Samaritan Law obligating me to stop and render aid? Think about that when you write your protocols. In the end, the right answer is always what is in the best interest of the patient. Best regards, Larry MD > > I understand what you are saying, but we have some rather unique > protocols. We have been on scenes and while we were working the pts > per our protocol, and we had to almost stop and explain or " justify " > what we were doing. For example, trying to explain why we perform > chest-abdominal counter compressions, obtain either IV or IO access, > administer Aminophylline, , and intubate prior to defibrillation (at > 360 joules) for someone who is in V-fib with a down time greater > than 4 minutes is rather difficult. Once the call is over, we can > offer loads of literature that backs our protocols, but most > physicians want complete control of the scene and per our medical > director...that won't happen. It causes conflict and the pt is the > one who will suffer. > > D. Stone > > >>> > > >>> > > Ours states to not take advice from an on-scene physician. >>> > > Therefore, I would interpret that as including PAs or NPs. >>> > > >>> > > D. Stone >>> > > > > > > > Quote Link to comment Share on other sites More sharing options...
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