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The Off-Duty Paramedic FAK

Discussion in 'First Aid Station' started by towheadedmule, Sep 8, 2008.

  1. StealthChaser13

    StealthChaser13 Loaded Pockets

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    seriously? some of you who are certified EMT's, or Paramedics are unwilling to help others when they are in need, simply because of that one in a million chance that you will get sued...

    I recently took my EMT course and got certified as an EMT-B here in NYS (Though I am not part of the local Ambulance yet). I have built a FAK that rides in my vehicle. Its not to the point of the trauma kits that alot of EMT's around here carry, but it could handle some pretty serious stuff. I would certainly stop and help someone if they needed it, and local EMS had yet to arrive.

    Seriously, more people would be angered if they had an emergency, and later found out you refused to help, than if they had an emergency and you did help.

    Besides, if you are not on the Ambulance that arrives, your name doesn't go on the PCR (pre-hospital care report). About the only way your name could be on record is if your the one to call 911, then your listed as the reporter.
     
  2. towheadedmule

    towheadedmule Loaded Pockets

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    As a paramedic FTO for the company that I work for (with 18 years experiance) there is very little I can not handle with a pair of gloves only that is truly life threatening, cardiac arrest, stroke, Major trauma and seizures included in that list. Notice I left out allergic reaction, that I need a little more, but the state board restricts me from carrying Epi, solumedrol, benedryl and the IV needle needed for that treatment. SO You wanna hump a large bag full of crap you rarely use go ahead, but do not accuse me of refusing help to those in need. In fact, why not go on to paramedic school and find out the consequences of helping those when you are out of your jurisdiction, sometimes you are protected by good samaritan laws, other times you are not.

    And BTW, I am not worries about my name on the PCR, its the license plate on my truck, my face, on the police report or bystanders memory that gets you.
     
  3. Rich

    Rich Loaded Pockets

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    StealthChaser,

    Yes, seriously.

    I believe that all/almost all of the public safety folks on this forums got started with their hearts in the same place that yours is: the right place. What you will realize as you see more and more is that the most important thing that you can bring into any situation/scene is your mind and the desire to make a positive out of a negative. How you do that when you are by yourself warrants serious contemplation.

    Protecting yourself should always be your first consideration, it's not just a good idea, it's a standard of care. Good EMTs and Paramedics practice good Scene Management and it doesn't just benefit you, it benefits the patient(s). Think about placing traffic control devices and preventing an "accessory" accident as an example. Now think about placing yourself off the scene to avoid becoming a statistic/making things worse for the crew that's responding.

    After Scene comes Airway Management with Spinal Immobilization. I won an award for stopping at an accident off duty in 2004, I never made it past the A in my ABCs and used exactly one piece of equipment: gloves. The patient was pinned in with diesel fuel leaking onto her (and me) from the truck her car was was pinned under. I would have liked to have fully immobilized her, suctioned her airway, intubated her, assisted her irregular ventilations, listened to her lung sounds for a pneumothorax, covered her open wrist fracture with some sort of dressing, et cetera. But guess what: when I performed a jaw thrust on her, I gave her a patent airway I was able to maintain until she was extricated and maintained her spinal immobilization to boot. You cannot save the world alone when you're dealing with blunt trauma. To safely do ANYTHING else for that patient I would have needed my crew (trained hands, not just more hands). The first crew that showed up rightly prioritized her extrication which left me holding a manual jaw thrust/c-spine for over a half an hour in the diesel and she lived.

    In my old house there was a sign up that read (and I'm paraphrasing): Remember - When people call 911, they DON'T say "send me a couple dumb@$$ firefighters in a pickup truck." They want 4 brain surgeon, rocket scientist, decathletes to magically appear and solve all their problems.
    I think that as your number of patient contacts approaches 27,371 your outlook on EMS will have changed a bit. The vast majority of the incidents we deal with are not as dramatic as the one I've described. In the vast majority of accidents without real injury you are ONLY exposing yourself to liability and you are NOT benefiting anyone.
     
  4. StealthChaser13

    StealthChaser13 Loaded Pockets

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    I'm not saying that I would stop at an accident scene expecting to save every person involved. I'm saying that I would stop, and I would help to the best of my ability based on the situation. Thats more that most here are saying that they would do. Also, I'm not saying that I would instantly go to my vehicles FAK (which is not large in size). On my person I carry a breathing barrier; Once I find a good way to, I will also carry a pair of gloves...

    to be honest, various members of my family to alot of stupid stuff. That is the primary reason I have a FAK in my vehicle. But if I were to end up helping somebody out, then good.
     
  5. Travis

    Travis Loaded Pockets

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    I'm not saying I won't stop what I'm saying is that very rarely will I identify as a paramedic normally I'll offer to help and call on-duty crews and advise what's going on. I may do some spinal immobilization or other basic care but off duty as a medic I use basic BLS skills since it would be very rare that I have the supplies to do ALS plus I'm not covered under protocol.

    Hope that makes some sense.
     
  6. firemedic183

    firemedic183 Loaded Pockets

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    YOU KNOW THATS RIGHT!!!!!!! I make DANG good and sure that I always have gloves close at hand!!! No pun intended. It is nice to see another member of EMS on here!!!
     
  7. firemedic183

    firemedic183 Loaded Pockets

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    Those STAT packs are AMAZING. We carry them on our fire trucks at my fire department. VERY dependable, and endless organization possibilities.
     
  8. firemedic183

    firemedic183 Loaded Pockets

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    Rich,

    I have been in EMS for 12 years officially and for 3 years before that with explorer scouting. Your whole statement was VERY well written, and I will be passing it on to my colleagues. I LOVE the sign that was up at your house. That is hillarious!!!!
     
  9. StealthChaser13

    StealthChaser13 Loaded Pockets

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    exactly!!! Perfect sense!!!
     
  10. cap6888
    • In Omnia Paratus

    cap6888 Loaded Pockets

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    Rich-

    I too am in Public Safety. Going on 22 years in the fire service 17 volunteer, 5 career and 7 years as a cop(I finally scored the extra 10 points). Your post was dam near perfect. And the sign you all had in your house is not only funny, but perfectly on point.

    I think many people on here who talk about getting FAKs who have little to no training envision pulling up on the grisly MVCs with hair, teeth, and eyeballs everywhere, and just want to jump into action. Although their intentions are great, they don't understand the infrequency of said crashes. Yes these accidents happen everyday, but their frequency is spread across the whole nation. In one of my old houses we would end up doing about one serious auto extrication a week. But you could never say when or where it would be. Luckily in all my years, I have never been in the situation where I have come across a gruesome accident. My initial reaction now would be that I don't plan on stopping (because I don't want to subject my family to anything, moreso than a liability issue). The true answer is I don't know what I would do unless I was in that situation.

    Truth be told (and fellow medics correct me if I am wrong) it seems that most FAKs on here concentrate on all sorts of trauma dressings, blood stoppers, etc. In all my years, there are not many cases where anything more than some 4x4s and kling won't fix. When I was in Iraq, there were large open wounds, but we are talking from heavy weapons fire, explosives, and the like. That has been the proving ground for so many of these new, fancy dressings that many people want for their FAKs.

    While I also have a small FAK that I keep with me most of the time, it is very simple. The only "advanced" items I carry are some tegaderms (make a nice waterproof dressing) and a saline flush (if for some reason I don't have water to flush a cut out). I actually don't even carry gloves with that since my intention is to only use that kit for my famiy or friends.
     
  11. weeneldo

    weeneldo Empty Pockets

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    What if their wound gets infected from your hands? For some organisms only gloves will stop them - alcohol hand gel wont (eg. C Difficile) What if your family member/friend has a blood borne condition that they don't even know about (1 in 3 people with HIV don't know they have it...)? What if they're allergic to something that's you've touched? What if someone you didn't know was bleeding to death? You wouldn't help them? Not carrying gloves is just daft. They cost next to nothing, take up almost no space, can save you or your patient's life and are a lot quicker to use than the 7-stage handwashing technique.
     
  12. cap6888
    • In Omnia Paratus

    cap6888 Loaded Pockets

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    "I actually don't even carry gloves with that" as in with my FAK. I don't have gloves in my FAK because it is meant for use for family and friends. In a nutshell, myy FAK only has bandaids and commonly needed OTC meds. I carry gloves in my EDC and in my car if for some reason I do have to help someone I don't know. As far as HIV, it is a blood borne pathogen. If I got blood infected with HIV on my INTACT skin, I would not be at risk of getting it. If I had an open cut, then I risk infection. Without sounding "daft", do you put on gloves everytime you put a bandaid on one of your family member's wounds? How often have you treated a wound that has needed anything more than a bandaid, or maybe one 4x4 to cover it? And just because you wear gloves doesn't mean you don't wash your hands. The common rule in the medical field where I work is this......if you touch a patient (with gloves, since when I am at work, I don't know anyone) and there is no contact with bodily fluids, sanitizer is sufficient after removing your gloves. If you touch a patient, and there is contact with bodily fluid, then you wash your hands after you remove your gloves. Knowledge, training, and common sense all go a long way when it comes to first aid.
     
  13. TK66

    TK66 Empty Pockets

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    I agree, knowledge, training and common sense is all you have to fall back on. As for gloves in my line of work , USE THEM!!! Like cap6888 my FAK is intended for family and friends.
     
  14. stevem174

    stevem174 Loaded Pockets

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    I have a few different FAK that I carry depending on what I am doing. The most common things that I carry are gloves, 4x4, tape and the most commonly used item...band-aids.
    When I come up on an accident I will think about M.O.I., ETA for EMS etc. If it looks like there is a high risk of injury then I will stop. But I have transported enough people for P.L.P. (Pre lawsuit Physical) to know that I don't want to be a part of every wreck that sets off an airbag. I got into EMS in 88 and became a Medic in 91.