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According to the AAOS Sixth Edition - MCI is defined as: An emergency

situation that can place great demand on the equipment or personnel

of the EMS system or has the potential to overwhelm your available

resources. We should all know and understand this type of situation.

Lets trust the judgement of the paramedics that were on the scene and

support them.

> More from the " oopsie " incident. Looks like the SAFD PR efforts

are improving, albeit slightly.

>

> -Wes Ogilvie, MPA, JD, LP

> -Austin, Texas

>

> Â

> Controversy over woman left for dead

>

> Web Posted: 12/19/2007 01:02 AM CST

>

> Chasnoff and Lomi Kriel

> Express-News

>

> The injury looked grave.

> Part of the front-seat passenger's skull had caved in after a head-

on collision on Loop 410. McLaughlin, a truck driver who said

he witnessed the wreck and rushed to the aid of its victims, crouched

beside the mangled Honda Accord and talked to the injured woman, 23-

year-old a , until a police officer arrived.

>

> had been moaning, McLaughlin said.

>

> " I said, 'Sir, that girl in the front seat is messed up bad. She

needs help,' " he recalled.

>

> Yet it was precisely that injury  coupled with an apparent

lack of a pulse  that led paramedics to abandon ,

believing her dead, and instead rush two other victims with non-life-

threatening injuries to Army Medical Center, Fire Chief

Hood said on Tuesday.

>

> was actually alive  a detail discovered more than an

hour later by a medical examiner's investigator called to the scene

to examine her body. Paramedics again were called, and was

taken to Army Medical Center, on Sunday, more than two hours

after the early morning wreck. She died at the hospital Monday

afternoon.

>

> The paramedics' decision to abandon in the wreckage in near

freezing temperatures  compounded by Hood's refusal to

apologize for the incident at a news conference Monday  has

stoked outrage among some. Tuesday, in an interview with the Express-

News editorial board, Hood said he regretted not saying he was " sorry

for the family. "

>

> Although he conceded that Sunday's misdiagnosis " could possibly

have been a mistake, " Hood defended the judgment of the four

paramedics who abandoned after checking her pulse. Cold weather

can mask vital signs, he said, and victims can continue breathing

after they are brain dead.

>

> " The body is designed, basically, to function without a brain, " he

said. " Bodies make noises, bodies move, bodies will sit up on you.

>

> Gordon, a professor of medicine at the University of Texas

Health Science Center at San , said up to 60 percent of

patients who gasp are not alive. Typically, he said, the gasp is the

result of a spinal reflex.

>

> Hood and Gordon, who has authorized the standard medical operating

procedure for the city's Fire Department for more than two decades,

said medical privacy laws constrained them from detailing what

exactly led paramedics to believe was dead.

>

> But Gordon said national standards prevent medical providers from

resuscitating patients if they meet criteria classifying them as

an " obvious death on arrival. "

>

> And on Tuesday, Hood said publicly for the first time that, " by all

intents and purposes, (the paramedics) thought () was dead. "

>

> " She presented as deceased to them, " Hood said, adding that

paramedics, " when they checked, she had no pulse. "

>

> According to the current operating procedure, which Gordon updated

last year, patients fall into the category of " obvious death on

arrival " if they have " no measurable vital signs, " such as a heart

beat or pulse, and meet one of four criteria: rigor mortis; when the

blood pools to the lowest level of gravity; decapitation,

incineration or visual massive trauma; or if the body is decomposed.

>

> " Visual massive trauma " refers to injuries severe enough for a

layperson to think they might cause death, such as " part of a V-6

engine sitting in the middle of your chest, " Gordon said.

>

> According to McLaughlin, suffered a major head injury.

>

> " I knew that if she didn't get help right away, she might not make

it, " he said, adding, " My opinion, I think they should have paid more

attention to her. "

>

> A police officer familiar with the incident said he told paramedics

at least twice that was still breathing.

>

> " They kept telling everybody, 'No, she's not. ... She'll die in a

few minutes,' " said the officer, who requested anonymity because he

is not authorized to speak about the case.

>

> If there's any question about whether a patient meets the required

criteria for resuscitation, paramedics are required to call their

medical director for an opinion. Gordon, who is the medical director

for the city's Fire Department, declined to say whether he was called

in 's accident.

>

> But typically, he offers such opinions on a daily basis, he said.

>

> It is very rare for someone to be classified as an " obvious DOA "

and then return to life, he said, but it has happened. Over the past

20 years, San has recorded two other such incidents, Hood

said Tuesday.

>

> The four paramedics involved in Sunday's incident have been with

the department for several years, with the least experienced having

worked as a medic for nearly six years. Officials declined to release

their names on Tuesday, but said the other three have served in their

roles for six years, seven years and 12 years. None was disciplined

for the incident and each is expected to return to work this week,

Hood said.

>

> Still, the incident remains under investigation, he said, and will

force the department to review its policies.

>

> " We need to figure out what to do to avoid this, " he

said. " Customers in San need to have faith in their

department. "

>

> was one of three people inside the Accord when a Pontiac G5

veered into an oncoming lane on Loop 410, striking the Accordshortly

before 4 a.m. The driver of the Pontiac, Ann Ybarra, 28, was

taken to a hospital after complaining of back pain. She has been

charged with intoxication manslaughter and her bond set at $50,000. A

jail official said she had posted bail, but was awaiting an ankle

monitor so that she could be released.

>

> 's friends  Shaner, 22, the Accord's driver,

and back seat passenger Amber , 22 suffered serious but

non-life-threatening injuries.

>

> __________________________________________________________

> More new features than ever. Check out the new AOL Mail ! -

http://webmail.aol.com <http://webmail.aol.com>

>

>

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A two vehicle collision with 4 total patients is not an MCI...they acted like

they had 50 injuries and had to do a rapid triage and declare her " Expectant "

which would be the right decision...it was not the right decision in a two

vehicle collision..Bill

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Any incident in which there are more patients than the responding

units can handle is an MCI. How many MICU's responded with how many medics?

Dick

Celina Fire Department

At 10:16 PM 12/20/2007, you wrote:

>A two vehicle collision with 4 total patients is not an MCI...they

>acted like they had 50 injuries and had to do a rapid triage and

>declare her " Expectant " which would be the right decision...it was

>not the right decision in a two vehicle collision..Bill

>

>

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In a message dated 12/22/2007 12:58:23 P.M. Central Standard Time,

kenneth.navarro@... writes:

Have a (choose one)

() Merry Christmas

() Happy Chanukah

() Krazy Kwanza

() Terrific Tet

() Inconspicious Id al-Adha

() Super Solstice

Kenny Navarro

Dallas

I don't care who you are that's funny

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

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(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

**************************************See AOL's top rated recipes

(http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004)

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Man...this just keeps hanging on and hanging on...but I think I have a

solution...

Lets all meet at the Cowboy's parking lot at the corner if Loop 410 and IH-35

say Tuesday morning around 0900.? Everybody bring your pick-ups, clubs,

pitchforks, and torches.? We will then depart from there and converge on the 4

or 5 fire stations that may have responded to this incident and just beat the

living crap out of every DSHS certified personnel we can find....that will

definitely solve the problem and prevent it from re-occurring...plus then we can

all feel a little better about ourselves knowing we spent our Christmas solving

a real problem for the EMS community.

Geesh...I have never seen anyone out for blood like this in ages.? To everyone

who is angry, upset and pissed off...WHAT do we need to do to help you get over

this?? I have withheld posting on this topic up till now, but the the exception

of Henry and a couple of others...this is getting a little out of control.

In the last?7 days, how many people on here have done any or all of the

following:

1.? Reviewed the protocols you work under to make sure you are intimately

familiar with your agency's definition of obvious death, cessation of

resuscitation, and MCI's?

2.? Discussed this call with other health care professionals in a constructive,

NON-HINDSIGHT TEMPLE MOUNT position to not only talk about how this could have

happened, but when faced with similar circumstance, how you can make sure it

doesn't happen to you?

3.? Talked with your Medical Director about this incident to see his/her

thoughts.

4.? Talked with an ED physician regarding the end of life and examples he/she

may have where incidents surrounding the end of life?could happen in the ED and

if seen by others, be totally misconstrued?

5.? Spent some quiet moments before drifting off to sleep reviewing many of the

calls you have responded to where potentially questionable decisions were made

in the blink of an eye that afterwards, in the dark recesses where we don't like

to look, you secretly question whether or not the right decision was made.

6.? Run an MVC and made double sure you knew who and where all the patient's

were...as well as their status?

7.? Received a report from a first responder and then double-checked and

verified that what you had been told was true?

8.? Gave a report to your transport provider and then didn't get upset when they

double checked what you had told them?

This is not the first time this has happened...it won't be the last.? It does

disturb me that the San area is the only area of the state or nation

where mistakes occur.? I would like to hire some of the folks on this list to

come into town and educate myself and my folks on how to obtain perfection in

every high-pressure, no-looking back scenario we face on our multiple calls a

day we respond to.? Because, I realize our agency is ONE call away from this or

one very similar scenario...and when that occurs, I can't wait to have to face

the hostile citizens, family members, media and potentially city

officials...knowing that when I get home and pull up my AOL mail for some

leisurely reading, I will get to read every second-guessing, hind-sight looking,

slack-jawed yokel who wants to tell me how they would have done it better than

my guys and wouldn't have made such horrendous mistakes that obviously only

stupid, cro-magnon paramedics who didn't give a rat's butt about human beings

would make.

I mean, how did these imbecile paramedics?function prior to this call that day

without us criticizing the way they played with the febrile baby to stop the

crying, or worked their butt off resuscitating the elderly patient while their

family sobbed in the living room, or held the old ladies hand while their

partner tried desperately to get the IV into one of her spider veins so they

could relieve her pain from the fractured hip...no, I am sure they came into the

station 20 hours prior to this call just saying, man I can't wait for the 0300

call so we can leave some poor coed out in the cold to die...that will really

make our day!!!!

Really now...I would echo many of the other sane voices I have heard on this

list over the last few days...back off, work YOUR calls to the best of YOUR

ability, and make sure that you do everything possible to avoid getting your

hind end in gun sights of those who like to second guess...because my 22+ years

in this business have taught me one thing...if it hasn't happened yet, it surely

could the next time the alarm rings.?

Be safe and have a joyous Christmas!!!

Dudley

(Now that's a soapbox!)

Re: Re: The latest from San ....

okay okay... man I have heard something bad here... MCI...shem-ci. This is San

Fire/EMS we are talking about here. A department with multiple resources

and manpower that could have been brought to them with the simple press of a

radio button, to assist in such event as an " MCI " . whether you want to define it

as 2 or 4+patients. Yes, the definition of an MCI is

" An emergency situation that can place great demand on the equipment or

personnel of the EMS system or has the potential to overwhelm your available

resources. "

I could see this if it were in a rural community, out in the sticks somewhere,

or in a city where the emergency medical services are somewhat slim pickens, San

does not have this issue here. This department deals with accidents with

2 and more patients nearly every day, and as far as one discussion was saying is

that they were short of manpower etc etc... San could have called for

additional resources like they have in the past to other agencies if it was a

tremendously bad " MCI " sorry, but I just can't tag this call as a true MCI,

because this accident would not have " overwhelmed " the resources available to

them. (besides that this accident took place at one of the lowest call times of

the day. for just about any service. There is ABSOLUTELY no excuse for what took

place. They made a bad judgement call, plain and simple.

I'm sorry that this may tick a few people off, but I feel passionately about

this. I have been in this field for a very long time, and even though you may

not see it posted here, there are quite a few other people who feel the way I

do. Granted, I do not have all the details about what happened, so I am going by

what I have, and what I have, is what I am ranting against.

I will step down now. must go take my bloodpressure meds now.

A.Dempsey EMT-I/FF

Supply/Maintenance Supervisor

Acadian Ambulance Service

Austin Texas, 78721

kdempseyjr@...

office

*pager*

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AMEN, DUDLEY... marry christmas, ya'll ht

THEDUDMAN@... wrote:

Man...this just keeps hanging on and hanging on...but I think I have a

solution...

Lets all meet at the Cowboy's parking lot at the corner if Loop 410 and IH-35

say Tuesday morning around 0900.? Everybody bring your pick-ups, clubs,

pitchforks, and torches.? We will then depart from there and converge on the 4

or 5 fire stations that may have responded to this incident and just beat the

living crap out of every DSHS certified personnel we can find....that will

definitely solve the problem and prevent it from re-occurring...plus then we can

all feel a little better about ourselves knowing we spent our Christmas solving

a real problem for the EMS community.

Geesh...I have never seen anyone out for blood like this in ages.? To everyone

who is angry, upset and pissed off...WHAT do we need to do to help you get over

this?? I have withheld posting on this topic up till now, but the the exception

of Henry and a couple of others...this is getting a little out of control.

In the last?7 days, how many people on here have done any or all of the

following:

1.? Reviewed the protocols you work under to make sure you are intimately

familiar with your agency's definition of obvious death, cessation of

resuscitation, and MCI's?

2.? Discussed this call with other health care professionals in a constructive,

NON-HINDSIGHT TEMPLE MOUNT position to not only talk about how this could have

happened, but when faced with similar circumstance, how you can make sure it

doesn't happen to you?

3.? Talked with your Medical Director about this incident to see his/her

thoughts.

4.? Talked with an ED physician regarding the end of life and examples he/she

may have where incidents surrounding the end of life?could happen in the ED and

if seen by others, be totally misconstrued?

5.? Spent some quiet moments before drifting off to sleep reviewing many of the

calls you have responded to where potentially questionable decisions were made

in the blink of an eye that afterwards, in the dark recesses where we don't like

to look, you secretly question whether or not the right decision was made.

6.? Run an MVC and made double sure you knew who and where all the patient's

were...as well as their status?

7.? Received a report from a first responder and then double-checked and

verified that what you had been told was true?

8.? Gave a report to your transport provider and then didn't get upset when

they double checked what you had told them?

This is not the first time this has happened...it won't be the last.? It does

disturb me that the San area is the only area of the state or nation

where mistakes occur.? I would like to hire some of the folks on this list to

come into town and educate myself and my folks on how to obtain perfection in

every high-pressure, no-looking back scenario we face on our multiple calls a

day we respond to.? Because, I realize our agency is ONE call away from this or

one very similar scenario...and when that occurs, I can't wait to have to face

the hostile citizens, family members, media and potentially city

officials...knowing that when I get home and pull up my AOL mail for some

leisurely reading, I will get to read every second-guessing, hind-sight looking,

slack-jawed yokel who wants to tell me how they would have done it better than

my guys and wouldn't have made such horrendous mistakes that obviously only

stupid, cro-magnon paramedics who didn't give a rat's butt about

human beings would make.

I mean, how did these imbecile paramedics?function prior to this call that day

without us criticizing the way they played with the febrile baby to stop the

crying, or worked their butt off resuscitating the elderly patient while their

family sobbed in the living room, or held the old ladies hand while their

partner tried desperately to get the IV into one of her spider veins so they

could relieve her pain from the fractured hip...no, I am sure they came into the

station 20 hours prior to this call just saying, man I can't wait for the 0300

call so we can leave some poor coed out in the cold to die...that will really

make our day!!!!

Really now...I would echo many of the other sane voices I have heard on this

list over the last few days...back off, work YOUR calls to the best of YOUR

ability, and make sure that you do everything possible to avoid getting your

hind end in gun sights of those who like to second guess...because my 22+ years

in this business have taught me one thing...if it hasn't happened yet, it surely

could the next time the alarm rings.?

Be safe and have a joyous Christmas!!!

Dudley

(Now that's a soapbox!)

Re: Re: The latest from San ....

okay okay... man I have heard something bad here... MCI...shem-ci. This is San

Fire/EMS we are talking about here. A department with multiple resources

and manpower that could have been brought to them with the simple press of a

radio button, to assist in such event as an " MCI " . whether you want to define it

as 2 or 4+patients. Yes, the definition of an MCI is

" An emergency situation that can place great demand on the equipment or

personnel of the EMS system or has the potential to overwhelm your available

resources. "

I could see this if it were in a rural community, out in the sticks somewhere,

or in a city where the emergency medical services are somewhat slim pickens, San

does not have this issue here. This department deals with accidents with

2 and more patients nearly every day, and as far as one discussion was saying is

that they were short of manpower etc etc... San could have called for

additional resources like they have in the past to other agencies if it was a

tremendously bad " MCI " sorry, but I just can't tag this call as a true MCI,

because this accident would not have " overwhelmed " the resources available to

them. (besides that this accident took place at one of the lowest call times of

the day. for just about any service. There is ABSOLUTELY no excuse for what took

place. They made a bad judgement call, plain and simple.

I'm sorry that this may tick a few people off, but I feel passionately about

this. I have been in this field for a very long time, and even though you may

not see it posted here, there are quite a few other people who feel the way I

do. Granted, I do not have all the details about what happened, so I am going by

what I have, and what I have, is what I am ranting against.

I will step down now. must go take my bloodpressure meds now.

A.Dempsey EMT-I/FF

Supply/Maintenance Supervisor

Acadian Ambulance Service

Austin Texas, 78721

kdempseyjr@...

office

*pager*

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

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>>> . . . when I get home and pull up my AOL mail for some leisurely

reading, I will get to read every second-guessing, hind-sight

looking, slack-jawed yokel who wants to tell me how they would have

done it better . . . <<<

Dudley, now you are just insulting slack-jawed yokels!

>>> (Now that's a soapbox!) <<<

I'm impressed!

Have a (choose one)

() Merry Christmas

() Happy Chanukah

() Krazy Kwanza

() Terrific Tet

() Inconspicious Id al-Adha

() Super Solstice

Kenny Navarro

Dallas

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Share on other sites

Finally someone who has expressed the thoughts of many. You know Dudley the

interesting thing about all this is that the charge has been led by two

attorneys and an ex TDH regional guy....can anyone say " Due Process "

>>> 12/22/07 11:45 AM >>>

Man...this just keeps hanging on and hanging on...but I think I have a

solution...

Lets all meet at the Cowboy's parking lot at the corner if Loop 410 and IH-35

say Tuesday morning around 0900.? Everybody bring your pick-ups, clubs,

pitchforks, and torches.? We will then depart from there and converge on the 4

or 5 fire stations that may have responded to this incident and just beat the

living crap out of every DSHS certified personnel we can find....that will

definitely solve the problem and prevent it from re-occurring...plus then we can

all feel a little better about ourselves knowing we spent our Christmas solving

a real problem for the EMS community.

Geesh...I have never seen anyone out for blood like this in ages.? To everyone

who is angry, upset and pissed off...WHAT do we need to do to help you get over

this?? I have withheld posting on this topic up till now, but the the exception

of Henry and a couple of others...this is getting a little out of control.

In the last?7 days, how many people on here have done any or all of the

following:

1.? Reviewed the protocols you work under to make sure you are intimately

familiar with your agency's definition of obvious death, cessation of

resuscitation, and MCI's?

2.? Discussed this call with other health care professionals in a constructive,

NON-HINDSIGHT TEMPLE MOUNT position to not only talk about how this could have

happened, but when faced with similar circumstance, how you can make sure it

doesn't happen to you?

3.? Talked with your Medical Director about this incident to see his/her

thoughts.

4.? Talked with an ED physician regarding the end of life and examples he/she

may have where incidents surrounding the end of life?could happen in the ED and

if seen by others, be totally misconstrued?

5.? Spent some quiet moments before drifting off to sleep reviewing many of the

calls you have responded to where potentially questionable decisions were made

in the blink of an eye that afterwards, in the dark recesses where we don't like

to look, you secretly question whether or not the right decision was made.

6.? Run an MVC and made double sure you knew who and where all the patient's

were...as well as their status?

7.? Received a report from a first responder and then double-checked and

verified that what you had been told was true?

8.? Gave a report to your transport provider and then didn't get upset when they

double checked what you had told them?

This is not the first time this has happened...it won't be the last.? It does

disturb me that the San area is the only area of the state or nation

where mistakes occur.? I would like to hire some of the folks on this list to

come into town and educate myself and my folks on how to obtain perfection in

every high-pressure, no-looking back scenario we face on our multiple calls a

day we respond to.? Because, I realize our agency is ONE call away from this or

one very similar scenario...and when that occurs, I can't wait to have to face

the hostile citizens, family members, media and potentially city

officials...knowing that when I get home and pull up my AOL mail for some

leisurely reading, I will get to read every second-guessing, hind-sight looking,

slack-jawed yokel who wants to tell me how they would have done it better than

my guys and wouldn't have made such horrendous mistakes that obviously only

stupid, cro-magnon paramedics who didn't give a rat's butt about hu

man beings would make.

I mean, how did these imbecile paramedics?function prior to this call that day

without us criticizing the way they played with the febrile baby to stop the

crying, or worked their butt off resuscitating the elderly patient while their

family sobbed in the living room, or held the old ladies hand while their

partner tried desperately to get the IV into one of her spider veins so they

could relieve her pain from the fractured hip...no, I am sure they came into the

station 20 hours prior to this call just saying, man I can't wait for the 0300

call so we can leave some poor coed out in the cold to die...that will really

make our day!!!!

Really now...I would echo many of the other sane voices I have heard on this

list over the last few days...back off, work YOUR calls to the best of YOUR

ability, and make sure that you do everything possible to avoid getting your

hind end in gun sights of those who like to second guess...because my 22+ years

in this business have taught me one thing...if it hasn't happened yet, it surely

could the next time the alarm rings.?

Be safe and have a joyous Christmas!!!

Dudley

(Now that's a soapbox!)

Re: Re: The latest from San ....

okay okay... man I have heard something bad here... MCI...shem-ci. This is San

Fire/EMS we are talking about here. A department with multiple resources

and manpower that could have been brought to them with the simple press of a

radio button, to assist in such event as an " MCI " . whether you want to define it

as 2 or 4+patients. Yes, the definition of an MCI is

" An emergency situation that can place great demand on the equipment or

personnel of the EMS system or has the potential to overwhelm your available

resources. "

I could see this if it were in a rural community, out in the sticks somewhere,

or in a city where the emergency medical services are somewhat slim pickens, San

does not have this issue here. This department deals with accidents with

2 and more patients nearly every day, and as far as one discussion was saying is

that they were short of manpower etc etc... San could have called for

additional resources like they have in the past to other agencies if it was a

tremendously bad " MCI " sorry, but I just can't tag this call as a true MCI,

because this accident would not have " overwhelmed " the resources available to

them. (besides that this accident took place at one of the lowest call times of

the day. for just about any service. There is ABSOLUTELY no excuse for what took

place. They made a bad judgement call, plain and simple.

I'm sorry that this may tick a few people off, but I feel passionately about

this. I have been in this field for a very long time, and even though you may

not see it posted here, there are quite a few other people who feel the way I

do. Granted, I do not have all the details about what happened, so I am going by

what I have, and what I have, is what I am ranting against.

I will step down now. must go take my bloodpressure meds now.

A.Dempsey EMT-I/FF

Supply/Maintenance Supervisor

Acadian Ambulance Service

Austin Texas, 78721

kdempseyjr@...

office

*pager*

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

Never miss a thing. Make Yahoo your homepage.

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Dudley,

Couldn't have said it better myself, and lord knows I tried!

Rick

________________________________

From: texasems-l [mailto:texasems-l ] On

Behalf Of Rinard

Sent: Saturday, December 22, 2007 3:11 PM

To: texasems-l

Subject: Re: Re: The latest from San ....

Finally someone who has expressed the thoughts of many. You know Dudley

the interesting thing about all this is that the charge has been led by

two attorneys and an ex TDH regional guy....can anyone say " Due Process "

>>> <THEDUDMAN@... <mailto:THEDUDMAN%40aol.com> > 12/22/07 11:45 AM

>>>

Man...this just keeps hanging on and hanging on...but I think I have a

solution...

Lets all meet at the Cowboy's parking lot at the corner if Loop 410 and

IH-35 say Tuesday morning around 0900.? Everybody bring your pick-ups,

clubs, pitchforks, and torches.? We will then depart from there and

converge on the 4 or 5 fire stations that may have responded to this

incident and just beat the living crap out of every DSHS certified

personnel we can find....that will definitely solve the problem and

prevent it from re-occurring...plus then we can all feel a little better

about ourselves knowing we spent our Christmas solving a real problem

for the EMS community.

Geesh...I have never seen anyone out for blood like this in ages.? To

everyone who is angry, upset and pissed off...WHAT do we need to do to

help you get over this?? I have withheld posting on this topic up till

now, but the the exception of Henry and a couple of others...this is

getting a little out of control.

In the last?7 days, how many people on here have done any or all of the

following:

1.? Reviewed the protocols you work under to make sure you are

intimately familiar with your agency's definition of obvious death,

cessation of resuscitation, and MCI's?

2.? Discussed this call with other health care professionals in a

constructive, NON-HINDSIGHT TEMPLE MOUNT position to not only talk about

how this could have happened, but when faced with similar circumstance,

how you can make sure it doesn't happen to you?

3.? Talked with your Medical Director about this incident to see his/her

thoughts.

4.? Talked with an ED physician regarding the end of life and examples

he/she may have where incidents surrounding the end of life?could happen

in the ED and if seen by others, be totally misconstrued?

5.? Spent some quiet moments before drifting off to sleep reviewing many

of the calls you have responded to where potentially questionable

decisions were made in the blink of an eye that afterwards, in the dark

recesses where we don't like to look, you secretly question whether or

not the right decision was made.

6.? Run an MVC and made double sure you knew who and where all the

patient's were...as well as their status?

7.? Received a report from a first responder and then double-checked and

verified that what you had been told was true?

8.? Gave a report to your transport provider and then didn't get upset

when they double checked what you had told them?

This is not the first time this has happened...it won't be the last.? It

does disturb me that the San area is the only area of the state

or nation where mistakes occur.? I would like to hire some of the folks

on this list to come into town and educate myself and my folks on how to

obtain perfection in every high-pressure, no-looking back scenario we

face on our multiple calls a day we respond to.? Because, I realize our

agency is ONE call away from this or one very similar scenario...and

when that occurs, I can't wait to have to face the hostile citizens,

family members, media and potentially city officials...knowing that when

I get home and pull up my AOL mail for some leisurely reading, I will

get to read every second-guessing, hind-sight looking, slack-jawed yokel

who wants to tell me how they would have done it better than my guys and

wouldn't have made such horrendous mistakes that obviously only stupid,

cro-magnon paramedics who didn't give a rat's butt about hu

man beings would make.

I mean, how did these imbecile paramedics?function prior to this call

that day without us criticizing the way they played with the febrile

baby to stop the crying, or worked their butt off resuscitating the

elderly patient while their family sobbed in the living room, or held

the old ladies hand while their partner tried desperately to get the IV

into one of her spider veins so they could relieve her pain from the

fractured hip...no, I am sure they came into the station 20 hours prior

to this call just saying, man I can't wait for the 0300 call so we can

leave some poor coed out in the cold to die...that will really make our

day!!!!

Really now...I would echo many of the other sane voices I have heard on

this list over the last few days...back off, work YOUR calls to the best

of YOUR ability, and make sure that you do everything possible to avoid

getting your hind end in gun sights of those who like to second

guess...because my 22+ years in this business have taught me one

thing...if it hasn't happened yet, it surely could the next time the

alarm rings.?

Be safe and have a joyous Christmas!!!

Dudley

(Now that's a soapbox!)

Re: Re: The latest from San ....

okay okay... man I have heard something bad here... MCI...shem-ci. This

is San Fire/EMS we are talking about here. A department with

multiple resources and manpower that could have been brought to them

with the simple press of a radio button, to assist in such event as an

" MCI " . whether you want to define it as 2 or 4+patients. Yes, the

definition of an MCI is

" An emergency situation that can place great demand on the equipment or

personnel of the EMS system or has the potential to overwhelm your

available resources. "

I could see this if it were in a rural community, out in the sticks

somewhere, or in a city where the emergency medical services are

somewhat slim pickens, San does not have this issue here. This

department deals with accidents with 2 and more patients nearly every

day, and as far as one discussion was saying is that they were short of

manpower etc etc... San could have called for additional

resources like they have in the past to other agencies if it was a

tremendously bad " MCI " sorry, but I just can't tag this call as a true

MCI, because this accident would not have " overwhelmed " the resources

available to them. (besides that this accident took place at one of the

lowest call times of the day. for just about any service. There is

ABSOLUTELY no excuse for what took place. They made a bad judgement

call, plain and simple.

I'm sorry that this may tick a few people off, but I feel passionately

about this. I have been in this field for a very long time, and even

though you may not see it posted here, there are quite a few other

people who feel the way I do. Granted, I do not have all the details

about what happened, so I am going by what I have, and what I have, is

what I am ranting against.

I will step down now. must go take my bloodpressure meds now.

A.Dempsey EMT-I/FF

Supply/Maintenance Supervisor

Acadian Ambulance Service

Austin Texas, 78721

kdempseyjr@... <mailto:kdempseyjr%40yahoo.com>

office

*pager*

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

Never miss a thing. Make Yahoo your homepage.

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Share on other sites

Well, I can tell you book and page about due process. I do happen to

understand it. Been there, done that, got the T, the gimmie cap, the pen, the

notepad, plaque, and the mug, and the tattoo, long before most of y'all were

even

aware of what the term meant. Yes, I'm OLD. I took the course in law

school, and I have read the cases.

I have litigated due process. I have been a champion for due process all my

life. I KNOW what due process is, and I fiercely advocate for it.

We're generally expressing OPINION on this list. Last I heard, we don't

have the power to convict, discipline, or sanction anybody. We do have the

power to discuss things that happen and talk about whether or not they're good

or

bad. We try to learn from things that happen.

Apparently few actually read what I write. If you'll review my emails on

this subject, I made a point of saying that we oughtn't place blame until the

investigation is complete. I also recommended an independent investigation

from both DSHS and form the IAFC.

Then I stated, in an OPINION, that whatever happened, it's ultimately a

management/medical director problem, and those are the folks that ought to be

held

responsible, not the poor medics who are the ones who will probably get the

blame if there is any.

Now, we've got the same folks who were quick to pillory me for my opinions

about the SA incident wanting to pillory the folks who forgot to tell everybody

that the " helo down " call was a training exercise.

Heh. Shit happens, doesn't it?

Well, let's remember that what we read in the papers ain't necessarily so.

And let's remember that REAL PEOPLE LIKE US make the mistakes that we

condemn.

How more direct can I be than that?

The real problems are not connected with things that well meaning,

overworked, unappreciated, and sometimes clueless troops do. The real problems

arise

from the non-systems that we have in EMS, from the terrible lapses in

management that allow these incidents to happen, and our failures to cure the

sores

that we have.

When something goes wrong, we want to convict the troops, but we seldom ask

just who it was that allowed the troops to make the mistakes that they made,

who ignored the signs that the troops were not up to the challenges, who had the

power to make the changes, but who played the political games to make

themselves look good while throwing the field troops to the lions. And we also

fail

to ask what the salaries are of the " suits " versus the " troops. "

Why do the " suits " make 6 times what a medic makes? (I'm talking about the

private services here, of course.) Well, maybe sometimes not.

I would say that in the situation of the botched " helo down " exercise, the

responsibility lies at the very top of the heap. How often does the guy or gal

at the top get the licks? Not often, friends.

I say again. The San incident is a failure of command. At what

level remains to be seen. But it is a failure of command. At the

administrative level, which may be as low as a Lieutenant, or a Captain, or a

Batt Chief,

or maybe higher.

The question that's not asked often enough is this: What's the

responsibility of the off-line medical director for incidents like this?

This question WILL be asked in court one day. The answer will depend upon a

number of issues.

I'll attempt to list some of them here, but others will undoubtedly have

their additions to the list.

1. How much POWER does the off-line medical director actually have to

influence behaviours in the field? If he cannot take a medic off the rig

because

of union or civil service rules, then what good it he?

2. How much POWER does the off-line medical director actually have to deal

with incidents in the field that resulted in " unfortunate patient outcomes. "

Most medical directors lack actual power. Most of them serve under a

contract that was written by somebody they don't know, a contract that they have

never had a lawyer interpret, and one that probably makes them liable for a lot

of stuff they oughtn't be liable for.

3. How involved in everyday operations is the off-line medical director?

Does she or he ever make scene calls? Is she or he accessible to field

medics by cellular or radio?

4. How liable is the off-line medical director for the mistakes that are

made by the troops she or he supposedly supervises?

5. Is it reasonable to think that a medical director should do something to

get to know the people she or he supervises? To actually talk to them? To

listen to their questions about protocols? To answer those questions and to

do the research necessary to answer those questions?

6. Is it reasonable to think that a service's medical director would be an

advocate for EMS, would be actively involved in understanding and improving

EMS?

In the USA, some states are more liberal than others in allowing

physicians to delegate practices to medics.

In the states who allow liberal physician delegation, how liable is the

physician for the actions of his or her medics?

IN the states with rigid SOPs, could the state and its' EMS regulators

be held liable for failure to adopt an intervention that might be proved as

standard of care elsewhere? Sooner or later some lawyer will figure out that

that person can be challenged. So get ready for it.

And lastly, and this is meant to be tongue in cheek, who in his or her

right mind would become an EMS medical director?

Gene G.

>

> Dudley,

> Couldn't have said it better myself, and lord knows I tried!

> Rick

>

> ____________ ________ ________ _

>

> From: texasems-l@yahoogrotexasem [mailto:texasems-l@yahoogrotexasem] On

> Behalf Of Rinard

> Sent: Saturday, December 22, 2007 3:11 PM

> To: texasems-l@yahoogrotexasem

> Subject: Re: Re: The latest from San ....

>

> Finally someone who has expressed the thoughts of many. You know Dudley

> the interesting thing about all this is that the charge has been led by

> two attorneys and an ex TDH regional guy....can anyone say " Due Process "

>

>

> >>> <THEDUDMAN@... <mailto:THEDUDMAN%mailto:TH> > 12/22/07 11:45 AM

> >>>

>

> Man...this just keeps hanging on and hanging on...but I think I have a

> solution...

>

> Lets all meet at the Cowboy's parking lot at the corner if Loop 410 and

> IH-35 say Tuesday morning around 0900.? Everybody bring your pick-ups,

> clubs, pitchforks, and torches.? We will then depart from there and

> converge on the 4 or 5 fire stations that may have responded to this

> incident and just beat the living crap out of every DSHS certified

> personnel we can find....that will definitely solve the problem and

> prevent it from re-occurring. prevent it from re-occurring.<wbr>..plus t

> about ourselves knowing we spent our Christmas solving a real problem

> for the EMS community.

>

> Geesh...I have never seen anyone out for blood like this in ages.? To

> everyone who is angry, upset and pissed off...WHAT do we need to do to

> help you get over this?? I have withheld posting on this topic up till

> now, but the the exception of Henry and a couple of others...this is

> getting a little out of control.

>

> In the last?7 days, how many people on here have done any or all of the

> following:

> 1.? Reviewed the protocols you work under to make sure you are

> intimately familiar with your agency's definition of obvious death,

> cessation of resuscitation, and MCI's?

> 2.? Discussed this call with other health care professionals in a

> constructive, NON-HINDSIGHT TEMPLE MOUNT position to not only talk about

> how this could have happened, but when faced with similar circumstance,

> how you can make sure it doesn't happen to you?

> 3.? Talked with your Medical Director about this incident to see his/her

> thoughts.

> 4.? Talked with an ED physician regarding the end of life and examples

> he/she may have where incidents surrounding the end of life?could happen

> in the ED and if seen by others, be totally misconstrued?

> 5.? Spent some quiet moments before drifting off to sleep reviewing many

> of the calls you have responded to where potentially questionable

> decisions were made in the blink of an eye that afterwards, in the dark

> recesses where we don't like to look, you secretly question whether or

> not the right decision was made.

> 6.? Run an MVC and made double sure you knew who and where all the

> patient's were...as well as their status?

> 7.? Received a report from a first responder and then double-checked and

> verified that what you had been told was true?

> 8.? Gave a report to your transport provider and then didn't get upset

> when they double checked what you had told them?

>

> This is not the first time this has happened...it won't be the last.? It

> does disturb me that the San area is the only area of the state

> or nation where mistakes occur.? I would like to hire some of the folks

> on this list to come into town and educate myself and my folks on how to

> obtain perfection in every high-pressure, no-looking back scenario we

> face on our multiple calls a day we respond to.? Because, I realize our

> agency is ONE call away from this or one very similar scenario...and

> when that occurs, I can't wait to have to face the hostile citizens,

> family members, media and potentially city officials... family members,

> I get home and pull up my AOL mail for some leisurely reading, I will

> get to read every second-guessing, hind-sight looking, slack-jawed yokel

> who wants to tell me how they would have done it better than my guys and

> wouldn't have made such horrendous mistakes that obviously only stupid,

> cro-magnon paramedics who didn't give a rat's butt about hu

> man beings would make.

>

> I mean, how did these imbecile paramedics?function prior to this call

> that day without us criticizing the way they played with the febrile

> baby to stop the crying, or worked their butt off resuscitating the

> elderly patient while their family sobbed in the living room, or held

> the old ladies hand while their partner tried desperately to get the IV

> into one of her spider veins so they could relieve her pain from the

> fractured hip...no, I am sure they came into the station 20 hours prior

> to this call just saying, man I can't wait for the 0300 call so we can

> leave some poor coed out in the cold to die...that will really make our

> day!!!!

>

> Really now...I would echo many of the other sane voices I have heard on

> this list over the last few days...back off, work YOUR calls to the best

> of YOUR ability, and make sure that you do everything possible to avoid

> getting your hind end in gun sights of those who like to second

> guess...because my 22+ years in this business have taught me one

> thing...if it hasn't happened yet, it surely could the next time the

> alarm rings.?

>

> Be safe and have a joyous Christmas!!!

>

> Dudley

> (Now that's a soapbox!)

>

> Re: Re: The latest from San ....

>

> okay okay... man I have heard something bad here... MCI...shem-ci. This

> is San Fire/EMS we are talking about here. A department with

> multiple resources and manpower that could have been brought to them

> with the simple press of a radio button, to assist in such event as an

> " MCI " . whether you want to define it as 2 or 4+patients. Yes, the

> definition of an MCI is

>

> " An emergency situation that can place great demand on the equipment or

> personnel of the EMS system or has the potential to overwhelm your

> available resources. "

>

> I could see this if it were in a rural community, out in the sticks

> somewhere, or in a city where the emergency medical services are

> somewhat slim pickens, San does not have this issue here. This

> department deals with accidents with 2 and more patients nearly every

> day, and as far as one discussion was saying is that they were short of

> manpower etc etc... San could have called for additional

> resources like they have in the past to other agencies if it was a

> tremendously bad " MCI " sorry, but I just can't tag this call as a true

> MCI, because this accident would not have " overwhelmed " the resources

> available to them. (besides that this accident took place at one of the

> lowest call times of the day. for just about any service. There is

> ABSOLUTELY no excuse for what took place. They made a bad judgement

> call, plain and simple.

>

> I'm sorry that this may tick a few people off, but I feel passionately

> about this. I have been in this field for a very long time, and even

> though you may not see it posted here, there are quite a few other

> people who feel the way I do. Granted, I do not have all the details

> about what happened, so I am going by what I have, and what I have, is

> what I am ranting against.

> I will step down now. must go take my bloodpressure meds now.

>

> A.Dempsey EMT-I/FF

> Supply/Maintenance Supervisor

> Acadian Ambulance Service

> Austin Texas, 78721

> kdempseyjr@... <mailto:kdempseyjr%mailto:kdem>

> office

> *pager*

>

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

> Never miss a thing. Make Yahoo your homepage.

>

>

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So just how do you feel about due process Gene? (tongue in cheek of course)

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

**************************************See AOL's top rated recipes

(http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004)

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In a message dated 12/27/2007 10:48:48 A.M. Central Standard Time,

ExLngHrn@... writes:

Should medical directors be required to have operational training in EMS,

particularly if they're making scene responses?

Well from an anecdotal perspective and in my OPINION the ones that do tend

to make the better Medical Directors both from the Providers and the

Administrators standpoint having been on both sides of that fence. When they

understand both the clinical and operational capabilities of the Service that

they are

working with then they tend to do a better job.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

**************************************See AOL's top rated recipes

(http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004)

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Gene,

Well said------- KUDOS to you, sir !

wegandy1938@... wrote:

Well, I can tell you book and page about due process. I do happen to

understand it. Been there, done that, got the T, the gimmie cap, the pen, the

notepad, plaque, and the mug, and the tattoo, long before most of y'all were

even

aware of what the term meant. Yes, I'm OLD. I took the course in law

school, and I have read the cases.

I have litigated due process. I have been a champion for due process all my

life. I KNOW what due process is, and I fiercely advocate for it.

We're generally expressing OPINION on this list. Last I heard, we don't

have the power to convict, discipline, or sanction anybody. We do have the

power to discuss things that happen and talk about whether or not they're good

or

bad. We try to learn from things that happen.

Apparently few actually read what I write. If you'll review my emails on

this subject, I made a point of saying that we oughtn't place blame until the

investigation is complete. I also recommended an independent investigation

from both DSHS and form the IAFC.

Then I stated, in an OPINION, that whatever happened, it's ultimately a

management/medical director problem, and those are the folks that ought to be

held

responsible, not the poor medics who are the ones who will probably get the

blame if there is any.

Now, we've got the same folks who were quick to pillory me for my opinions

about the SA incident wanting to pillory the folks who forgot to tell everybody

that the " helo down " call was a training exercise.

Heh. Shit happens, doesn't it?

Well, let's remember that what we read in the papers ain't necessarily so.

And let's remember that REAL PEOPLE LIKE US make the mistakes that we

condemn.

How more direct can I be than that?

The real problems are not connected with things that well meaning,

overworked, unappreciated, and sometimes clueless troops do. The real problems

arise

from the non-systems that we have in EMS, from the terrible lapses in

management that allow these incidents to happen, and our failures to cure the

sores

that we have.

When something goes wrong, we want to convict the troops, but we seldom ask

just who it was that allowed the troops to make the mistakes that they made,

who ignored the signs that the troops were not up to the challenges, who had the

power to make the changes, but who played the political games to make

themselves look good while throwing the field troops to the lions. And we also

fail

to ask what the salaries are of the " suits " versus the " troops. "

Why do the " suits " make 6 times what a medic makes? (I'm talking about the

private services here, of course.) Well, maybe sometimes not.

I would say that in the situation of the botched " helo down " exercise, the

responsibility lies at the very top of the heap. How often does the guy or gal

at the top get the licks? Not often, friends.

I say again. The San incident is a failure of command. At what

level remains to be seen. But it is a failure of command. At the

administrative level, which may be as low as a Lieutenant, or a Captain, or a

Batt Chief,

or maybe higher.

The question that's not asked often enough is this: What's the

responsibility of the off-line medical director for incidents like this?

This question WILL be asked in court one day. The answer will depend upon a

number of issues.

I'll attempt to list some of them here, but others will undoubtedly have

their additions to the list.

1. How much POWER does the off-line medical director actually have to

influence behaviours in the field? If he cannot take a medic off the rig because

of union or civil service rules, then what good it he?

2. How much POWER does the off-line medical director actually have to deal

with incidents in the field that resulted in " unfortunate patient outcomes. "

Most medical directors lack actual power. Most of them serve under a

contract that was written by somebody they don't know, a contract that they have

never had a lawyer interpret, and one that probably makes them liable for a lot

of stuff they oughtn't be liable for.

3. How involved in everyday operations is the off-line medical director?

Does she or he ever make scene calls? Is she or he accessible to field

medics by cellular or radio?

4. How liable is the off-line medical director for the mistakes that are

made by the troops she or he supposedly supervises?

5. Is it reasonable to think that a medical director should do something to

get to know the people she or he supervises? To actually talk to them? To

listen to their questions about protocols? To answer those questions and to

do the research necessary to answer those questions?

6. Is it reasonable to think that a service's medical director would be an

advocate for EMS, would be actively involved in understanding and improving

EMS?

In the USA, some states are more liberal than others in allowing

physicians to delegate practices to medics.

In the states who allow liberal physician delegation, how liable is the

physician for the actions of his or her medics?

IN the states with rigid SOPs, could the state and its' EMS regulators

be held liable for failure to adopt an intervention that might be proved as

standard of care elsewhere? Sooner or later some lawyer will figure out that

that person can be challenged. So get ready for it.

And lastly, and this is meant to be tongue in cheek, who in his or her

right mind would become an EMS medical director?

Gene G.

>

> Dudley,

> Couldn't have said it better myself, and lord knows I tried!

> Rick

>

> ____________ ________ ________ _

>

> From: texasems-l@yahoogrotexasem [mailto:texasems-l@yahoogrotexasem] On

> Behalf Of Rinard

> Sent: Saturday, December 22, 2007 3:11 PM

> To: texasems-l@yahoogrotexasem

> Subject: Re: Re: The latest from San ....

>

> Finally someone who has expressed the thoughts of many. You know Dudley

> the interesting thing about all this is that the charge has been led by

> two attorneys and an ex TDH regional guy....can anyone say " Due Process "

>

>

> >>> <THEDUDMAN@... <mailto:THEDUDMAN%mailto:TH> > 12/22/07 11:45 AM

> >>>

>

> Man...this just keeps hanging on and hanging on...but I think I have a

> solution...

>

> Lets all meet at the Cowboy's parking lot at the corner if Loop 410 and

> IH-35 say Tuesday morning around 0900.? Everybody bring your pick-ups,

> clubs, pitchforks, and torches.? We will then depart from there and

> converge on the 4 or 5 fire stations that may have responded to this

> incident and just beat the living crap out of every DSHS certified

> personnel we can find....that will definitely solve the problem and

> prevent it from re-occurring. prevent it from re-occurring.<wbr>..plus t

> about ourselves knowing we spent our Christmas solving a real problem

> for the EMS community.

>

> Geesh...I have never seen anyone out for blood like this in ages.? To

> everyone who is angry, upset and pissed off...WHAT do we need to do to

> help you get over this?? I have withheld posting on this topic up till

> now, but the the exception of Henry and a couple of others...this is

> getting a little out of control.

>

> In the last?7 days, how many people on here have done any or all of the

> following:

> 1.? Reviewed the protocols you work under to make sure you are

> intimately familiar with your agency's definition of obvious death,

> cessation of resuscitation, and MCI's?

> 2.? Discussed this call with other health care professionals in a

> constructive, NON-HINDSIGHT TEMPLE MOUNT position to not only talk about

> how this could have happened, but when faced with similar circumstance,

> how you can make sure it doesn't happen to you?

> 3.? Talked with your Medical Director about this incident to see his/her

> thoughts.

> 4.? Talked with an ED physician regarding the end of life and examples

> he/she may have where incidents surrounding the end of life?could happen

> in the ED and if seen by others, be totally misconstrued?

> 5.? Spent some quiet moments before drifting off to sleep reviewing many

> of the calls you have responded to where potentially questionable

> decisions were made in the blink of an eye that afterwards, in the dark

> recesses where we don't like to look, you secretly question whether or

> not the right decision was made.

> 6.? Run an MVC and made double sure you knew who and where all the

> patient's were...as well as their status?

> 7.? Received a report from a first responder and then double-checked and

> verified that what you had been told was true?

> 8.? Gave a report to your transport provider and then didn't get upset

> when they double checked what you had told them?

>

> This is not the first time this has happened...it won't be the last.? It

> does disturb me that the San area is the only area of the state

> or nation where mistakes occur.? I would like to hire some of the folks

> on this list to come into town and educate myself and my folks on how to

> obtain perfection in every high-pressure, no-looking back scenario we

> face on our multiple calls a day we respond to.? Because, I realize our

> agency is ONE call away from this or one very similar scenario...and

> when that occurs, I can't wait to have to face the hostile citizens,

> family members, media and potentially city officials... family members,

> I get home and pull up my AOL mail for some leisurely reading, I will

> get to read every second-guessing, hind-sight looking, slack-jawed yokel

> who wants to tell me how they would have done it better than my guys and

> wouldn't have made such horrendous mistakes that obviously only stupid,

> cro-magnon paramedics who didn't give a rat's butt about hu

> man beings would make.

>

> I mean, how did these imbecile paramedics?function prior to this call

> that day without us criticizing the way they played with the febrile

> baby to stop the crying, or worked their butt off resuscitating the

> elderly patient while their family sobbed in the living room, or held

> the old ladies hand while their partner tried desperately to get the IV

> into one of her spider veins so they could relieve her pain from the

> fractured hip...no, I am sure they came into the station 20 hours prior

> to this call just saying, man I can't wait for the 0300 call so we can

> leave some poor coed out in the cold to die...that will really make our

> day!!!!

>

> Really now...I would echo many of the other sane voices I have heard on

> this list over the last few days...back off, work YOUR calls to the best

> of YOUR ability, and make sure that you do everything possible to avoid

> getting your hind end in gun sights of those who like to second

> guess...because my 22+ years in this business have taught me one

> thing...if it hasn't happened yet, it surely could the next time the

> alarm rings.?

>

> Be safe and have a joyous Christmas!!!

>

> Dudley

> (Now that's a soapbox!)

>

> Re: Re: The latest from San ....

>

> okay okay... man I have heard something bad here... MCI...shem-ci. This

> is San Fire/EMS we are talking about here. A department with

> multiple resources and manpower that could have been brought to them

> with the simple press of a radio button, to assist in such event as an

> " MCI " . whether you want to define it as 2 or 4+patients. Yes, the

> definition of an MCI is

>

> " An emergency situation that can place great demand on the equipment or

> personnel of the EMS system or has the potential to overwhelm your

> available resources. "

>

> I could see this if it were in a rural community, out in the sticks

> somewhere, or in a city where the emergency medical services are

> somewhat slim pickens, San does not have this issue here. This

> department deals with accidents with 2 and more patients nearly every

> day, and as far as one discussion was saying is that they were short of

> manpower etc etc... San could have called for additional

> resources like they have in the past to other agencies if it was a

> tremendously bad " MCI " sorry, but I just can't tag this call as a true

> MCI, because this accident would not have " overwhelmed " the resources

> available to them. (besides that this accident took place at one of the

> lowest call times of the day. for just about any service. There is

> ABSOLUTELY no excuse for what took place. They made a bad judgement

> call, plain and simple.

>

> I'm sorry that this may tick a few people off, but I feel passionately

> about this. I have been in this field for a very long time, and even

> though you may not see it posted here, there are quite a few other

> people who feel the way I do. Granted, I do not have all the details

> about what happened, so I am going by what I have, and what I have, is

> what I am ranting against.

> I will step down now. must go take my bloodpressure meds now.

>

> A.Dempsey EMT-I/FF

> Supply/Maintenance Supervisor

> Acadian Ambulance Service

> Austin Texas, 78721

> kdempseyjr@... <mailto:kdempseyjr%mailto:kdem>

> office

> *pager*

>

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

> Never miss a thing. Make Yahoo your homepage.

>

>

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Let me try to redirect the conversation here...

How many medical directors are actively involved in their EMS systems?? What

level of involvement is appropriate??

Should medical directors be required to have operational training in EMS,

particularly if they're making scene responses?

-Wes Ogilvie, MPA, JD, LP

-Attorney/Licensed Paramedic

-Austin, Texas

Re: Re: The latest from San ....

>

> okay okay... man I have heard something bad here... MCI...shem-ci. This

> is San Fire/EMS we are talking about here. A department with

> multiple resources and manpower that could have been brought to them

> with the simple press of a radio button, to assist in such event as an

> " MCI " . whether you want to define it as 2 or 4+patients. Yes, the

> definition of an MCI is

>

> " An emergency situation that can place great demand on the equipment or

> personnel of the EMS system or has the potential to overwhelm your

> available resources. "

>

> I could see this if it were in a rural community, out in the sticks

> somewhere, or in a city where the emergency medical services are

> somewhat slim pickens, San does not have this issue here. This

> department deals with accidents with 2 and more patients nearly every

> day, and as far as one discussion was saying is that they were short of

> manpower etc etc... San could have called for additional

> resources like they have in the past to other agencies if it was a

> tremendously bad " MCI " sorry, but I just can't tag this call as a true

> MCI, because this accident would not have " overwhelmed " the resources

> available to them. (besides that this accident took place at one of the

> lowest call times of the day. for just about any service. There is

> ABSOLUTELY no excuse for what took place. They made a bad judgement

> call, plain and simple.

>

> I'm sorry that this may tick a few people off, but I feel passionately

> about this. I have been in this field for a very long time, and even

> though you may not see it posted here, there are quite a few other

> people who feel the way I do. Granted, I do not have all the details

> about what happened, so I am going by what I have, and what I have, is

> what I am ranting against.

> I will step down now. must go take my bloodpressure meds now.

>

> A.Dempsey EMT-I/FF

> Supply/Maintenance Supervisor

> Acadian Ambulance Service

> Austin Texas, 78721

> kdempseyjr@... <mailto:kdempseyjr%mailto:kdem>;

> office

> *pager*

>

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

> Never miss a thing. Make Yahoo your homepage.

>

>

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