EMS Personnel! What Topic Do You Think You Need More Training On?

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Permalink Reply by Jessica Travis on October 22, 2009 at 9:13pm

so i think the next question is " how often do you redo your certs?"

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Permalink Reply by Russ on October 22, 2009 at 10:22pm

unusual situations...the cops arrest a guy in a power wheelchair and asks EMS to transport them to the jail (this happened recently in my area) do you transport or tell the cops to take him without the chair?.....you have a blind patient with a dog, you are gonna transport to the hospital, do you take the dog also? or call animal control...i'd like to have better tools to treat the hearing impared

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Permalink Reply by blair4630 on October 23, 2009 at 9:36am

I remember once we had a drug roundup and one of the dealers was wheelchair bound. He was taken to county lockup by one of our wheelchair vans.

On the issue of service animals (seeing eye dogs, seizure dogs, etc.), you had better be transporting the animals with the pt., that's a law. If you put a service animal in the care of animal control, not only is there potential for the animal to get violent, as they are very, very protective, but you open up your service to fines.

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Permalink Reply by John Crabbe on October 23, 2009 at 3:23pm

On the issue of service animals (seeing eye dogs, seizure dogs, etc.), you had better be transporting the animals with the pt., that's a law. If you put a service animal in the care of animal control, not only is there potential for the animal to get violent, as they are very, very protective, but you open up your service to fines.

I would say it is going to depend upon the patient situation and for the most part having an animal in the back of the ambulance is not an option, whereas animal control has resources to take proper care of an animal, not the hospital, not the EMS provider. Law or not, it would be a hard pressed justification to say that patient care was not done because of the worry about a service dog.

Here is the deal, if the person with a service dog is picked up at home, there is no reason to bring the dog along. If the person is sick or injured while out in public, there is no reason to bring the dog, let the resources of animal control handle it. We do not have kennels, we can't allow a dog to just sit in the hospital because the patient is there.

Very protective they may be, but well trained they are and most animals are trained to ignore their natural aggressions to care for their master. Point being, we had a fatal fire this summer where the victim was wheelchair bound, fell asleep with a cigarette and started the fire. Instead of his service dog looking out for it's own life, the dog was found next to the master. These are service dogs, not police K-9's.

Finally, what matters is the patient care, not the service dog. This isn't a case where the person with the dog is going to the hospital on their own for an appointment where they have control of the dog, this would be cases of an emergency where the master is the patient. At that point the average EMS, or medical person does not have the proper training to handle the dog and as such, should be left in care of Animal Control. This isn't about a bus not allowing the dog on the bus, this isn't about the dog being allowed in a store and so forth. This is about the person being the patient and that we as EMS and hospitals do NOT have the proper resources to handle and care for a service dog while the master is being treated.

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Permalink Reply by blair4630 on October 26, 2009 at 5:35am

Hmm...interesting points. We have always transported service animals in the ambulance with us.

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Permalink Reply by Ralph L. Carr IV on October 28, 2009 at 4:50pm

Blair, we have too. I disagree with my bro John on this one. Yes, an animal control officer would be better suited to transport the critter. Saying that, we should always do waht is right for the patient. Now, if the pt says that his/her cat is a service animal......well......I`d draw the line. I HATE cats ;)~ LOL

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Permalink Reply by John Crabbe on November 2, 2009 at 1:38pm

Actually had a nice conversation with an ADA specialist on this one and even threw them for a loop. Basically boils down to if the patient is conscious and is able to care for the animal, then take it. However, if the pt is unconscious then the animal should be taken care of by police, animal control, etc. Here the PD does the animal control anyway.

As for the wheelchair thing, we never transported a motorized wheelchair.

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Permalink Reply by Ralph L. Carr IV on October 28, 2009 at 4:46pm

Russ, the dog question is on the Nat Reg test........lol......

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Permalink Reply by John Crabbe on October 23, 2009 at 12:25am

As mentioned, getting back to the basics always helps. Something that our training captain has been doing though is ensuring the proper issues are addressed when talking "scene safety".

Anyone ever in an EMT class knows to ensure the scene is safe, they come in for testing or whatever, ask is the scene safe and a proctor says the scene is safe. However, what does that mean? So when told you are coming up to a MVA, such questions are what are you looking for...with an appropiate response, vehcle in a position to block traffic, vest on, check for lines down or hazards, do an outer circle, do an inner, airbags deployed, etc. Domestic disturbance are the cops there first? Stuff like that is a good review.

Another thing we have just done is immobilization of pts in awkward positions, such as a pt who fell head firts down the stairs, leg on the stairs, one under, head down to the wall, torso curled in a ball. So we had to get the pt to a board without compromising C-spine. Definately takes teamwork.

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Permalink Reply by Ralph L. Carr IV on October 28, 2009 at 5:04pm

Jess,

Good topic!

I help the IC`s a lot with the EMT-B classes at work. Once the new basics "hit the streets" the biggest problem we see is lack of knowledge and handling the "toys". Get your hands on EVERYTHING in the truck. Know how it works, what it is used for, why it`s used, why it`s not used. Be comfortable handling the toys...Traction splints, backboards, C collars, suction, KED, cot, controls INSIDE the ambulance, ect..

Take an extrication class and have a general idea of what is going on. Know the hazzards on scene. Know how to be out of the way so the yellow canaries ( fire fighters ;)~ ) can do their job.

SITUATIONAL AWARENESS!!! HEAD ON A SWIVEL AT ALL TIMES ON ALL SCENES......Things can turn to chit in a heartbeat. ALWAYS "have your partner`s back"....I don`t just mean at a MVC scene. A medical call can turn bad fast, diabetics get ornery, OD`s can turn violent, ect. Just KNOW and OBSERVE what is going on around you and have an escape plan ready in your head.

The ABC`s and assessment stuff you should know and understand. It`s not the "bookwork" stuff that "gets EMT`s in trouble" on the streets. It`s the crap that they DON`T teach you that you really need to know. Most of that is learned by having seat time, street time and by asking the older members to be honest and teach you those things.

KNOW where EVERYTHING is in the truck. Know how to USE EVERYTHING in the truck. If you are a basic on an ALS truck and porotcol allows you to hook up the monitor or spike bags.....LEARN HOW.....

ASK QUESTIONS ALL THE TIME.......If you don`t know why something is being done, ask. If it`s a crappy run, ask afterwards.....

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Permalink Reply by blair4630 on October 29, 2009 at 12:43am

KNOW where EVERYTHING is in the truck. Know how to USE EVERYTHING in the truck.

ASK QUESTIONS ALL THE TIME


Excellent

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Permalink Reply by Wade Seely on October 28, 2009 at 5:41pm

I agree with the training on the basics, and relying on those skills and not just the machines. I also believe that a big area that a lot of ems personell could use more training is writing patient care reports. that one time when it may go to court is to late to worry that you have crossed all your t's and dotted your I's. It is something that everyone is told is important, but never really trained on well.

TCSS

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