Hi everyone! Most of you are already familiar with me but for those who are visiting for the first time, please allow me to introduce myself. I am a Firefighter/Medic with training and experience in the following areas; HCP-CPR, Advanced Cardiac Life Support, Prehospital Trauma Life Support, Pediatric Advanced Life Support, Firefighting Operations, Hazardous Materials, Technical Rescue, Water Rescue, Emergency Vehicle Operations, Prehospital Pharmacology, and Medical Terminology. I am here to provide technical support for those seeking to broaden their knowledge of Firefighting and Emergency Medical Services. This board has a wealth of resources to answer any and all questions that may come it's way, so if you need to know, ask and we will help in any way we can!
Changing Shifts
by Linda C.
What would happen if a station received a call at the same time they are changing shifts? Who would go? What if one half of the paramedic team has not yet arrived? Does the previous shift wait to leave until their replacements arrive? Thanks.
Can't speak for everywhere but we run EMT driver and EMT-P. Like changes for like. If the new crew is there and the the call is within 15 minutes of shift change, they take it. Otherwise, if the new driver is in, the old can leave. Same for the medics. Sometimes though, someone is running real late. In this case, a chief officer can ok going out of service. In the case we depend on mutual aid or one of our other stations.
PS. Small operation. 3 stations, one in each of the 3 townships we serve. One ALS unit per station is the norm.
Where I work, most people come in 20-30 min early to beat the commute traffic (shift change at 0700). If we get a call (like at 0650 hrs) when the new crew is there, it's common courtesy for the next shift to take it, especially if it's for the ambulance. BTW, in my county, two medics is the norm on ambulances.
Thanks for the info. I'm still not clear on one point, and I'm afraid it's crucial for my story. What if a call is received right at the shift change, and one paramedic on the new shift has not yet arrived? Would the previous shift take the call? Are there any believable circumstances in which the old and new shifts would somehow both respond? In other words, is there a way I can have Roy respond to a call with a paramedic from the previous shift because Johnny has not yet arrived? Sorry to be so picky!
Yes, it is completely plausible to have Roy respond with another medic if Johnny has not yet arrived. However, if you are looking for two "Squads" to respond to the same incident, that won't happen. One of the medics from the previous shift would respond with Roy.
Most departments have a tone notification over the alarm system at shift change. The departments that I a familiar with have an "alarm systems test" at or near shift change. The tones going off is recognized as official shift change, so it is the responsibility of the previous shift if the tones have not sounded, and the next shift if they have. If that occurs right at shift change, the official determination is made by the dispacher, whether or not he/she has done the tones for the morning.
Additionally, because shift change, at least in my area, is very early in the morning, the call volume at that time is generally the lowest of the entire day.
The actual practice is different though. For example, there was a structure fire, which are rare, at shift change, so firefighters from both shifts went.
I hope this helps with your story. Let me know if I can be of additional assistance
That sounds pretty much like what could happen in Pulaski Co, ArK
by
It's funny, as much "EMERGENCY!" as I watch, and as much as I visit my real-life hose-jockey friends at Station 12. I feel like an official/unoffical member of the LRFD. I learn a lot about fires. However, when I visit in the morning. Their tones go off roughly around 8:00, for roll call, but it's not like on "E!"
what they do is call out if all the Engines and Trucks are available at that time. Some engine companies have been out on a run @ roll call, and couldn't respond, like, they'll call out Engine 12, and the FF
who drives the engine responds Engine 12, and then their radio, is 12A. They don't have HT's. Although I call their portables HTs,they call them portable radios. It's bad when FFs can't hear the dispatch, I have good ears, so I listen for them. The C shift crew got a run while my dog and I were there, so I we left, but we saw them off before walking home. I could tell that the call was for them.
Oh, and if you wonder why Fire Depts. don't have mascots, I've been told by Captain Floyd that mascots are a liability- like they could bite a visitor. Dalmations do not have the best dispositions, so I've been told, and they are prone to deafness. That's just what I've learned about Dalmations.
I am in school now for emt-basic at the fire training academy in charlotte and i want to go through the paramedic course how do i get started . I can't seem to get the web sight for cmc.HELP!!!!
It depends on the state that you are currently in. Each of the 50 states has a slightly different set up.
Offhand, if I were you, what I'd do, is get in contact with the best friend you have right now in EMS... your EMT instructor. EMT insturctors generally have a good and wide range of experiences, and also, a pretty good knowledge of your state's procedures for obtaining Paramedic level training.
Another piece of advice... It's great to want to undergo paramedic training, and I encourage it in every way... BUT... that said... I have to suggest that you concentrate right now, on your EMT level training... it's the very basic fundamentals that you will need, in order to go on to become a paramedic.
Also, don't rush through EMT training and then after you get your certification, rush right into paramedic training. Get out there on an amubulance service... and get some experience under your belt. Work with EMS personnel with greater experience than yourself. This will help you grow in the number one trait that ANY emergency responder must have... and that's judgement.
Every emergency you go to, will be different than the last. It takes a special mix of training, AND experience, and mature growth under the eyes of seasoned people, to make a successful emergency responder of ANY kind.
When you take the time to get that experience, and learn... (An EMT certificate, which is an accomplishment to obtain... is STILL nothing more, than a license to BEGIN to learn how to be a better responder in the field.)
The EMT certification, is JUST a beginning. No new certified EMT, is "ready", to just jump on the squad when the tones go off and lead the crew through an emergency response. Trust me on that one... I know from personal experience... It wasn't until I had a few years under my belt, that I was really ready to even run on the squad as an EMT in charge... let ALONE, consider attempting to get into paramedic training, which in my state, is a good 2 years worth of schooling, interning, etc, under seasoned paramedics and ER doctors.*grinning*
BUT... Keep that desire to BE a paramedic!! Get the experience... strive to learn something new at every class, on every drill, and yes, on every run... and YES... even in conversation with others in the EMS community! Then... when you've done your homework... and prepared yourself well, and become a sound EMT that just gets better with time... only THEN... make the move toward upgrading your certified level of care.*s*
Your patients, and your peers, will more than appreciate your dedication for doing so... and you'll have an exciting and challenging and REWARDING career ahead of you.
Paul, that was great. Thank you for your insight. I am in EMT-B training myself at the moment, and finding it quite challenging. I think I may go on to the intermediate level, but probably not until I get that experience you're talking about. As for paramedic, I have doubts. But I'll cross that bridge later! Thanks again.
I think every one of us that watched Emergency!, thought it would be really cool to do the things that Roy and Johnny did.
What strikes me, looking now at the episodes, and back on my training, is how much EMS has changed since the LACoFD began the paramedic program.
The knowledge I was given, in the late 80's, is far superior, in many ways, to what Roy and Johnny were. At least on the basic level. Remember that they didn't even HAVE the Heimlich maneuver back when Emergency first aired.*s*
Now, here we are today... and what you are learning, is superior to the training that I underwent. (We never used anything for airways, but the old oral airways... anything else, was a Paramedic level skill... and the Automated Defibrillators, we just barely coming into existance, and EMTs were generally not permitted to use them in my state. Now... they're all over the place)
I think you're going to have a lot of fun. And yes, I think you're going to have days where you look up and say, "Damn... why in the heck did I get into this profession! It sucks!"
All that comes with the territory. There's some sad calls, calls that just don't go right at all, calls that your first instinct, is to run away from... all part of the game. (And yes, some of those calls, where that 'flight' instinct pops up, you're GOING to run, and probably be glad you did.)
Is it possible to be one without being the other?
In Lake Charles, we have FF/EMTs, which is a must, and then we have our separate ambulance services with EMTs and Paramedics, also in Arkansas, it was set up that way. Me, I hate fire, and I hate heights, so I wouldn't want to be a firefighter. I just was wondering, because I'm writing a story about that, where I become a civilian EMT-B, nothing more. I just help J & R out, and when they get there, they take over, and I just bring them up to speed on what went down and all that, and they take it from there."
Does that sound about what an EMT-B would do?
I agree with Pat. In my rescue company, we are required to run at least 15 "aidman" calls after EMT-B (thats basic in MD)training. This means that in addition to assisting the aidman on calls in general, you need to actually comand 15 calls, under supervision, sucessfully, before you are granted full aidman status. This allows you to really get a feel for the different calls that can happen. We also have to run as medic assists (on the ALS units) a certain amount of times and then, take an aidman trauma scenario test. After this, we are granted the rank of PRIVATE, and are fully capable of running and commanding calls.
That's what my plans were - to go from an EMT-B to an EMT-Paramedic - but after reading your letter, I decided to wait and get ALOT more experience in the field as a basic. The limitations put on a EMT - Basic or even an EMT - Intermediate are frustrating because you want to do everything you can for your patient. But like you said - judgement is the number one trait needed to effectively treat patients. THANKS!
Iknow that Julie London died, My real-life firefighter friends at Station 12, told me, It was Captain Mark Hillman who told me, at first, I thought it was Bob Fuller who passed away, but it turned out to be Julie London, so I went to Harvest Foods, by where I live.
(I live right behind Tanglewood Shopping Ctr. in Tanglewood Apts. in LR AR), and got a PEOPLE Magazine, and turned to passages, There was Julie London's picture, and coincidentally she died on what would've been Bobby's 82nd b-day. She wanted to be with him in heaven. What a way to honor her beloved late hubby.
They're 4/ever together in heaven, along with Jack Webb,and Julie and Jack's daughter,Lisa, I think it was, who passed away, they had two girls together, Stacy and Lisa Webb.
Would Viral Cardio-myopathy been detectable by doctors in the 1970's? Could they have heard something distinct in a valce with a 12 leed ekg
that would cause them to look further physically even after the patient was brouhjt in on a suicide attempt? Could this heart condition be treated sometimes then? Thanks Alice
Try Columbia House. They have a collection of old television series available. Adam-12, Dragnet and Emergency are just a few of them.
On AOL type in Columbia House and their link will come up.
I'm looking for the story the Roy get hurt and and Chris blames johney for keeping roy safe. and roy tell chris to help johnny w/ the chores he doesn't/the end boys go near a river???
2
there is site that has a secondary site to it...
it has several stories on it..one of the stories that i read is that the crew go on cruise and johnny and the people get sick on aboard where it ...???
can any tell me who can do some adam 12 tapeing
or has a collection I can buy
Vitals for a 55 y/o male that suffered grand mal seizures
by
Good question...
Let's take this from another direction...
Arrive on scene after dispatch to a report of someone in grand mal seizures...
Find a 55 y/o man, that's coming out of grand mal seizures... figure someone else is there to call the ambulance... perhaps his wife, or another relative...
Grand mal seizures, involve normally, a major exertion of the body... meaning... when they are in the seizures... the body exerts itself heavily.
Respirations are going to be up there...
Pulse is going to be up there, and the B/P is likely going to have a high reading...
This is IF you arrive JUST after the seizures cease.
If you arrive 5-10 minutes after... they are liable to be back to what one would consider normal, depending on how quickly the patient recovers their breath etc... (If you ran around the block full blast a few times... you'd take a little bit to catch your breath, etc, afterward)
This is what I'd find at the routine seizure call.
The patient would feel fatigued... probably a bit embarassed too, because for those who suffer seizures due to epilepsy... such things are not something that really takes them by complete surprise... in fact, it's just 'expected' from time to time.
Standard treatment for this case, would be a simple patient interview, asking what medications they are on for it and have they been taking it according to its prescription... how have they been eating... how have they been feeling lately... has this happened before... is this the only seizure you've had today...
Questions like that... during this time, vitals would be checked WITH the patient's permission... (The patient does not HAVE to permit you to lay a hand on them, and you can't force it on them, if they are conscious and coherent.)
In the end, while in my EMS system, we always asked the patient if they wanted to go to the hospital, the answer was usually no, and they'd sign the refusal line on the report form, and we'd depart, advising them to contact their physician and advise him/her of the occurance, so the doctor can continue to monitor the progress of their treatment plan.*s*
The non-typical case, might be a first-time seizure patient... If they say it's never happened before... they are usually frightened enough by it... that they want to go to the hospital. Most care is supportive... so chances are, they'll be interviewed, vitals checked and recorded on arrival and every five to ten minutes thereafter, and we'd just monitor and talk with them on the way to the hospital.
If the patient seizes AGAIN after the squad arrives... the whole ballgame changes... because something's going on that's not 'under control'...
In my EMS system, I was an EMT... and we had a paramedic team dispatched with us on such calls...
In the cases of the epilepsy patient, or the first timer that did NOT seize... we'd tell the paramedics to cancel and go back to their station... HOWEVER... in the case of the patient that seized prior to our arrival and continued to seize... or had another episode while we were on scene... we'd tell the paramedics to continue to our location... and we'd just move objects that could hurt the seizing patient out of his way... and just let him seize away without intervention.
We'd have to watch, of course, for respiratiory or circulatory distress or arrest... and take action if he developed difficulty breathing or cardiac arrest...
The paramedics would arrive and then take whatever actions deemed by their protocols and by the doctor.
In a nutshell... vitals ARE important... however... they are just one tiny PART of the entire picture... Respiration, BP, and pulse, are important... but MORE important... are the signs and symptoms the patient exhibits... A sign, is something that you can see... such as profuse sweating, or cool clammy skin, or paleness... a symptom, is something the patient tells you or complains of... like, 'My arm hurts... or I feel like crap.. or I'm tired...'
Something else that's extremely important... is the patient's past medical history... and does that patient have any kind of Medic alert identification.
If I roll up and that 55 year old man has a medic alert bracelet that says, "Epilepsy"... then I already know... he's under treatment... and has likely been prescribed dilantin... which is a standard medication to control seizures... If he's otherwise okay after the seizure... and he doesn't immediately go into seizure again... I'm going to probably wind up with a signed refusal of transport to the hospital... and just get back in the squad and go on home, after a few minutes of discussion with him.
If I don't see anything like that... or if the patient seizes again, or doesn't stop seizing... then all I can really do, is let the paramedics do their assessment, and follow their procedures to stablize the patient for transport WITH them on board.*s*
For Roy and Johnny... that run would likely be a cakewalk... without them even having to do much more than speak with him... MAYBE check his vitals IF he permitted... and then they'd say, "Be sure to get with your doctor sir... he might want to do an evaluation to see if your dilantin dosage needs adjustment... and if you seize again, call us and we'll run you to Rampart to get checked out."
Seizures... especially grand mal seizures, appear suddenly and to the person that's not seen them before... they appear dramatic and cause for great alarm... and it's true... there are times that seizures ARE a signal that something is not right... and needs immediate medical care... BUT... those times... are exceptions... most seizure calls, are NOT life threatening... they're usually more scary and dangerous looking, than they really are.
Hello! Two quick questions so I can finish my story. One: What would be the vitals of an accident victim who is suffering from hypovolemic shock? Two: What would be the treatment of the same victim at the hospital? He has a lacerated femoral artery and a hairline fracture of the pelvis. Thank you!
First let me address the question on the vital signs. Hypovolemic shock is caused by loss of blood (large amounts),blood pressure would be low..top number around 70 or 80, pulse rate high..120 or higher, breathing also fast. The skin will be pale, cool to touch and wet.
Treatment would be oxygen by mask @10 to 15 liters per minute, full spinal precautions, 2iv lines (1 in each arm) running wide open.
You would also keep pressure on the arterial bleeding, monitor vitals and rapid transport to a trauma center.
At the hospital I believe x-rays and blood word would be ordered, and depending on the results go to surgery, if internal bleeding was found.
As for the hairline fracture I don't think it would require surgery.
Thanks so much, Mike. I need to clarify something. Would the IVs be Ringers Lactate? Also, do you know how the lacerated artery would be repaired? Something like vascular surgery? I don't need huge amounts of detail, just enough to indicate the treatment in my story. I'm not a doctor, and I don't play one on the internet!
Here in Los Angeles County paramedics only carry normal saline (ringers and D5W use by paramedics was discontinued in this County several years ago)
so the IV's would be saline.
As for the repair of the artery I would think it would be repaired surgically
One more quick question. What would be considered fast for respirations? Would 25 be too fast for the scene I have described above? Not fast enough? Just right? Thanks!
The normal adult respiratory rate is 12-20 respirations per minute, although of course normal variations exist. However, most caregivers time the respiratory rate for 15 seconds and then multiple by 4, so you would not normally hear someone report a rate of 25 (it needs to be a mulitple of 4). In this case, I think something in the range of 32 to 40 would be good. Hope this helps.
I would call and ask some of the ambulance services in your area if they have, or know of any explorer posts for people interested in emergency medical services.
I also remember watching a documentary a few years ago about a volunteer ambulance service that had mostly teenagers working as EMT's, along with an adult medic or EMT supervising them.
I ould be wrong but I think the name was Teanaulk (not sure of spelling)ambulance or rescue squad, and they were located in New Jersey
Here in Calif., you need to be 18 years old to get EMT-1 (EMT-Basic) certification. I was 18 when I took the course (many years ago) and had been 19 for only a few weeks before I finished the course and got my card from the county. The Exploring program, through the Boy Scouts of America has a minimum age requirement of 15 years old, or completion of the eighth grade. Max. age is 22nd birthday. The program is co-ed. Explorers learn and practice their vocational skills under the close supervision of their Advisors (adult leaders). An Explorer is never supposed to be a replacement for a professional (or fully-trained adult volunteer) position in a certain occupation. The current Exploring program is what grew from the original Sea Scouts. Explorer Posts cater to a variety of career interests, from firefighting to law enforcement to other occupational skills.