Any other skydiving EMT's/Paramedics?

[WeakMindedFool 0]

Quote

No where in you post does it say you can provide ALS care outside of Sac. County. Look in the State H & S code.

Quote

Edited to add: I do conceed that permission is required to carry drugs. If they are there...you can use them...

If you do carry drugs and use them without the ability to contact a base station you are diagnosing and prescribing, both functions allowed by a Physician only. What besides Narcan and Dextrose for unconscious unknown do protocols allow you to administer before contact?

So if you send out a strike team your paramedic becomes an EMT-1. No your paramedic operates under the protocols of your county. As for drugs I can give...the ony drug I need to make contact for is Dopemine. I know down there in so cal you have extremely restrictive protocols. Not so in the rest of the country. We are on mostly automatic orders in nor cal.
As for diagnosing and prescribing... semantics and you should know it! We assess and stabilize, let me give you a hypothetical:
You have been in a car accident. You are entrapped and injured, who would you rather have come take care of you:
a: An MD
b: A Paramedic
c: A copy of title 22

Now with all that time on the street I'll assume you have had the odd Physician show up on scene. With the best of intentions they generally haven't a clue what to do with themselves. It's out of their arena of training in most cases. You can always tell the ER MD's, they are the ones that won't assume patient care from you at gun point.

Faith in a holy cause is to a considerable extent a substitute for lost faith in ourselves.
-Eric Hoffer -
Check out these Videos

[Casquito 0]

Quote

You have been in a car accident. You are entrapped and injured, who would you rather have come take care of you:
a: An MD
b: A Paramedic
c: A copy of title 22

Not sure of your point there...
It would depend on the MD. A pathologist- no.
An ABEM certified EM MD who does USAR in addition to working at a trauma center... Not a bad choice.

Quote

Now with all that time on the street I'll assume you have had the odd Physician show up on scene. With the best of intentions they generally haven't a clue what to do with themselves. It's out of their arena of training in most cases.

Again, depends on the MD. It's always a hoot when one shows up and tries to take control, and when you ask them what they do, they sheepishly reply "pediatrics" or "gastroenterology."
Though most would realize their limitations and stay out of the way. But I would venture that most EM MDs would not be "out of their arena of training." Most have significant EMS experience (part of most EM training programs) as well as contact with EMS on a daily basis (runs, base station, and administrative- who do you think writes and approves EMS protocols?). Knowing what happens before patients arrive in the ED as well as what needs to happen when they are there would provide a big picture perspective on what needs to get done when.

Quote

You can always tell the ER MD's, they are the ones that won't assume patient care from you at gun point.

It's a mutual respect thing. Everyone has their area of expertise and if you do it for a while you know where they overlap and where the hard line is.

This thread is getting a bit acrimonious.
Just remember we all want to help and have different skills we bring with us. Do what you can and feel comfortable doing, but always remember you can do more harm than good. The middle of grassy field is no place to provide definitive care for severe injuries. We just need to support them and prevent further injury until they get to somewhere where they can get that care.

[packerboy 3]

How about you do whatever it is you know how to do to make the situation more survivable for the patient (your friend), with whatever supplies you have available. Fuck protocols if your friend is dying. You obviously wont/don't do anything you are not trained or know how to do at work. Why the hell would you? I don't know about sue happy America, but here in Canada you will not get in trouble for doing what you know how to do to help. Any judge who gives you hell for doing what you've been trained to do to help a trauma victim before on-duty help arrives needs to grow some balls. As for losing your licence, if you are carrying shit you STOLE from work... maybe that's something to think about, but if you happen to be in posession of something that you have procured legally and is not a controlled substance... WTF use it if it'll help?

My g/f is a Paramedic, and I have heard stories of MD's on scenes... not good ones. She has had to tell an MD that if he doesn't f*&^ off that he will have to assume care and responsibilty of the patient and be in care for transport as well. He backed off.

She has collared and spinal boarded a jumper while off duty at the DZ, and transported with him in the ambulance. He was extremely gratefull. If she had not taken charge of the situation (along with a military search and rescue tech), he may not be with us anymore (pelvis,femur,spinal fractures).

I would hope that anyone with the necessary training would step up to the plate and not stand back and worry about legal ramifications. That's bullshit.

--------------------------------------------------
In matters of style, swim with the current; in matters of principle, stand like a rock. ~ Thomas Jefferson

[WeakMindedFool 0]

You misunderstand. I'm not trying to be difficult, rather I'm trying to exchange ideas with you kids from other areas in the country. I'm not slighting MD's and by the way, thanks for letting me know where protocols come from (ROFL). If you think being an er doc prepares you for field medicine, I have to disagree. The reason most MD's wont take over care in the field has nothing to do with "mutual respect" it's more of a liability thing. That's why the AMA distributes those cards that tell MD's to back off or assume all liability for the whole scene.

Faith in a holy cause is to a considerable extent a substitute for lost faith in ourselves.
-Eric Hoffer -
Check out these Videos

[mjosparky 3]

Quote

So if you send out a strike team your paramedic becomes an EMT-1.

Things may be different in No. Cal. But I have never heard of a PM unit being sent on a strike team. It is to valuable a resource to loose for an indeterminate time. And if the Unit I do assign to a strike team has a PM on the crew, without his equipment he is an EMT.

Quote

You have been in a car accident. You are entrapped and injured, who would you rather have come take care of you:
a: An MD
b: A Paramedic
c: A copy of title 22

A PM would be nice, but an off duty PM without his equipment is still just an EMT.

Quote

As for drugs I can give...the ony drug I need to make contact for is Dopemine.

And what drugs can you carry in your personal vehicle, outside of inventory control, and administer without violation protocols. Not to mention state and federal drug laws?

Just a question, what kind of inventory control does your dept. have if all the off duty PM are running around with a car load of ALS supplies "acquired" from the station?

I think you are assuming more latitude than the State H&S Code allows.

PARAMEDIC DISCIPLINE STATUTE

Pursuant to California Health & Safety Code Section 1798.200, the EMS Authority may deny, revoke, suspend, or place on probation a paramedic’s license for the following acts or omissions

Functioning outside the supervision of medical control in the field care
system operating at the local level, except as authorized by any other
license or certification.

You might want to do a little research and reconsider your position on this matter.

My idea of a fair fight is clubbing baby seals

[WeakMindedFool 0]

Quote

Things may be different in No. Cal. But I have never heard of a PM unit being sent on a strike team. It is to valuable a resource to loose for an indeterminate time. And if the Unit I do assign to a strike team has a PM on the crew, without his equipment he is an EMT.

AAhh...things are differen't. We do cross county lines and send ALS units out on strike teams as ALS units.

Quote

And what drugs can you carry in your personal vehicle, outside of inventory control, and administer without violation protocols. Not to mention state and federal drug laws?

Just a question, what kind of inventory control does your dept. have if all the off duty PM are running around with a car load of ALS supplies "acquired" from the station?

This is not what I am saying! To carry meds is through your employers approval only. Yes they would be inventoried and no, I don't carry supplies with me because I have very little need. I am fortunate to jump in an area where EMS is close. One of the places has an aero medical helicopter at the same airport. If however I jumped where the fastest respose would be 30+ min...I would be prepared...with both equipment and medical control (were talking about a cell phone here!) and I would do it with the full approval of my agency, or I would make altenate arrangements through another provider, perhaps as a volunteer.
Now outside of control, If I find myself in a situation where someone requires intervention and I have the equipment and the training to use it, I will every time. I would also report the situation to my employer and medical control.

Faith in a holy cause is to a considerable extent a substitute for lost faith in ourselves.
-Eric Hoffer -
Check out these Videos

[Lindsey 0]

Paramedics are hot :)

linz

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[mjosparky 3]

Quote

Now outside of control, If I find myself in a situation where someone requires intervention and I have the equipment and the training to use it, I will every time.

I wish you luck and hope you don't run into some young prosecutor looking to make a name for himself. You will not just be looking at losing your cert. you could be looking at criminal charges.

My idea of a fair fight is clubbing baby seals

[skybeergodd 0]

I've been a FF/EMTP for over 15 years professionally(currently a captain on an ALS engine). I've taught the EMT and EMTP courses and evaluate on a state level. I also teach ACLS/PALS and PHTLS.I have read all thess posts and have dumb founded by people thinking that starting an IV is actually a life saving measure. It is a life line to give drugs and to hang blood but fluid itself does not carry oxygen and at best is a very poor blood expander.In current standards the old methods of raising the blood pressure by giving masses of fluid is out the door. Current standard says to just try to maintain a pressure of around 80 to 90 systolic. Let the body shunt and tampanode blood naturally instead of thinning it to a point that it can not clot on it's own. I have treated many of my friends who have been hurt doing what they do. The best thing you can do is do GOOD ABC's(get an airway and maintain it), control bleeding and CPR if needed. Prevent other injury and do a good primary and secondary survey. Having that done prior to EMS arrival expedites them off the scene and gets our friends to hospitals and trauma surgeons faster(and in critical trauma blood, an airway with O2 and an OR is what saves lives).I have a great working relationship with our local EMS service and once they arrive I assist them with what ever they want..starting IV's for med. pushes, intubating ect. I have even gone with them as an extra pair of hands on several occations.
After all that being said I do applaud the DZ's that do have spinal equipment and splinting materials available.Having the patient packaged does make for a quick turn around time on the scene and makes that golden hour or as new thinks says the Platinum 10 minutes a reality.That is what saves lives.

[dropdeded 0]

Reply to the the original post.

EMT/Bambulance driver

Working on the Paramedic thing.

Got some BLS crap in the trunk that I hope to leave there.

Someone needs medical help at the dz, I will of course do what I can until an ambulance arrives, as Im sure everyone else would do.


dropdeded

------------------------------------------
The Dude Abides.
-

[mjosparky 3]

I agree with you entirely. As I posted earlier, make sure 911 is called to start EMS wheels rolling. Stabilize using basic BLS methods, assess and assist when ALS arrives.

I spent 30 years on the job and retired as a Capt. The use of common sense on scene has remained the same I am sure.

My idea of a fair fight is clubbing baby seals

[skymedic 0]

firefighter/paramedic here. My 13yrs as a paramedic has taught me that I won't risk my future on going to extreme's when I am not on duty. I WILL help as much as i can i.e. BLS stuff. but ALS stuff is reserved for work. There are people that I know of in both IL and MO that have lost there paramedic licenses for doing ALS care off duty without medical orders.

Marc
otherwise known as Mr.Fallinwoman....

[hjumper33 0]

I was an EMT for a while, now a med student. I think the experience will help me really see both sides of the coin as far as emergency care goes. From what I hear around the area, Cahill really knows his shit. If im in a place where I dont know the rules, such as when I was in a train station in barcelona this summer and a guy had a heart attack, I will hesitate to act, but if im at the DZ and its my buddy, im going to call for a rig and do the best I can until they get there.

[mjosparky 3]

Quote

From what I hear around the area, Cahill really knows his shit.

There should only be two kinds of Medics, those that know their shit and those that used to be medics.

My idea of a fair fight is clubbing baby seals

[jdthomas 0]

I carry a bls bag to the dz, I also rock climb and hunt. I find myself in very remote locations and sometimes cell phones just don't work.
I usually try to travel in a group, so at least one person can go for help, at that point in time I would not hesitate to provide bls care.
I have helped on the dz a few times and I would encourage all dz's to have at least one full time staff person or very regular jumper at least take a first responder course if not the emt-b class.
having a spine board, collar and airway on hand can help tremendously.
I understand the liabilities of it all as well and know that each time that I may be doing something i am at risk, either at the dz or while at work.
but I have choose this path and I will follow it no matter.
if my friend is down then i will do what I can, I just care more about friends then I do my job.
Joe

www.greenboxphotography.com

[skydiverbry 0]

Yep me, I was a ground,Flight medic until I got injured in 2003 At Methodist Hospital And Wishard Hospital in Indianapolis,Id

--------------------------------------------------
Growing old is mandatory.Growing up is optional!!

D.S.#13(Dudeist Skdiver)

[angryelf 0]

I just recently passed Registry and finished my Paramedic license. I've been on scene w/ two patients who hooked in low and impacted hard. The first patient was badly injured. As a Paramedic sudent, w/ a Parmedic (my instuctor at the time) I did an assessment and maintained the patient's airway, directed the control of C-spine and controlled obvious external hemorhage. Once the on duty medic arrived we assisted as needed. The second patient was myself- after a really good example of how not to pilot a canopy I landed w/ cracked ribs and a dislocated hip. I did more advanced stuff (beyond the scope of a registered Medic), but I was working on myself. In allmost all scenarios encountered in parachuting injuries-3 things happen: 1The patient is totally compromised. 2The patient has many life threatening injuries. 3The patient has localized injuries that are uncomfortable. In all cases BLS manuevers are the most important. Air way open, Patient breathing or being ventilated, Circulatory insults reduced and bleeding controlled. Will an IV save a patient-prolly not, people bleeding need blood not NS to flush what little perfusing fluid left in them out. Does intubation secure the airway-yes, but a Combitube will do the same job and not get you killed in court. The ALS stuff is deff way cooler, but at what cost? Per NREMT-BLS manuevers are cool, if you step outside of Basic skills (ie IV therapy, intubation or ALS drugs, etc), however, you are practicing medicine w/o the blessing of a doc. The Paramedic License (and I'm fairly certain the Intermediate's as well) only cover your ass if you are working under direction of a MD. I'm all for helping out at the DZ if someone is misfortunate enough to get hurt. C-Spine gear, O2/BLS airway stuff, trauma dressings and splints are great tools and should be used by any one w/ appropriate training. Just remember guys, Medics don't save bad traumas-they just prolong death untill deffinitive treatment is reached-Cold Steel and Bright Lights. But hey, what do I know-I'm only 20!

"Sometimes you eat the bar,
and well-sometimes the bar eats you..."