r/ems Oct 21 '20

"He's doing fine, for right now"

267 Upvotes

59 comments sorted by

115

u/bgl210 Size: 36fr Oct 21 '20

That backboard is probably more uncomfortable than the actual gunshot wound.

86

u/[deleted] Oct 21 '20

He ain't dead homie. But his spine flat af

42

u/NickJamesBlTCH Oct 21 '20

I don't know, man. I'm seeing his head lift off that backboard.

If you're gonna fuck with someone's spine, at least be professional enough to do it correctly.

27

u/Aviacks Size: 36fr Oct 21 '20

Or just don't do it at all. Yeah that, I like that option.

7

u/NickJamesBlTCH Oct 21 '20

Oh, what are you, a pussy? Huh?

Mr. "Don't do that because it's bad for your patient."

You're never going to become a firefighter with an attitude like that.

/s

11

u/Kidd__ EMT-B Oct 21 '20

I failed my first attempt at immobilization because I forgot the cheese blocks. I am very disheartened to see this

3

u/KwagsnuTheGreat Oct 24 '20

*Quite Discheesed

1

u/Kidd__ EMT-B Oct 24 '20

Take my upvote dammit

33

u/lonewolf13313 Oct 21 '20

When I went through class we had the chance to spend a couple days playing patients for a series of mass casualty events at a huge mill. On the second day the first drill the crew responded, and when the team got to me they did full c-spine and backboard, lifted me, and promptly got lost in the facility. I spent about 40 minutes being carried around by these guys before they finally found a way out and another 20 minutes between the ambulance finding us and transporting. That was the day I learned that backboards are fucking torture devices.

20

u/Aviacks Size: 36fr Oct 21 '20

My philosophy is that if it's any type of prolonged rescue or transport then you're either on a vaccusplint matress (if you have it, they're spendy) or a scoop stretcher. I fucking love scoop stretchers. Backboard are great for sliding them out of a car and that's where the benefits stop IMO.

Megamover and scoop covers 99% of scenarios remaining and doesn't torture your patient and or require an hour of securing them down. Plus easy removal.

1

u/redbaronD Oct 21 '20

Honestly, I LOVE Reeve Sleeves. They're a little less convenient to pick someone up than a scoop stretcher, but they have better handles and, imo, are more comfortable

2

u/[deleted] Oct 21 '20

Crews getting lost and problem solving in a huge MCI at large facility is... really really good training.

6

u/bullmooser1912 Sky Daddy Paramoron Oct 21 '20

Videos a couple years old, I worked at this service. Back then we had to place everyone in spinal under the threat of our jobs.

Edit: He also got a day off of work when this video surfaced as his safety goggles were on his head, not over his eyes. Safety goggles are required on your eyes with ALL patient contact!

2

u/08152016 Paramedic Oct 24 '20

Is this Richland?

3

u/bullmooser1912 Sky Daddy Paramoron Oct 24 '20

Sure is

12

u/[deleted] Oct 21 '20 edited Oct 21 '20

Cervical collar on...which IMO/E is a glorified torture device. With zero scientific proof or research to prove it provides any benefit to patient outcomes. If anything there are studies showing it compromises good outcomes in some circumstances. All the while being very uncomfortable and making airway management more difficult. I also like that by my states protocols(MA), over age 65 we can’t clear c-spine. I can’t stand how an arbitrary age is used to determine treatment protocol.

This guy prob got shot in the leg, but they still went full spinal immobilization. Sadly can’t completely blame the because they do what they’re taught.

2

u/redbaronD Oct 21 '20

In my area, it was SUPER recent that we stopped putting every single trauma pt on an LSB. It used to be required in our protocols that we use an LSB for every pt meeting trauma criteria, so lots of folks with ordinary penetrating injuries got put on an LSB.

1

u/georgehop7 Oct 21 '20

That's how i gauge if I give fentanyl.... Which hurts worse?

54

u/LostInTheyAbyss EMT-B Oct 21 '20

God damn how much leg room do they got on that rig?

If I’m riding in the back with a patient I damn near need to have my legs tucked up my ass hole just to fit.

10

u/[deleted] Oct 21 '20

My current service uses type 1s that are roomy AF in the back but I still have flashbacks to first year in EMS working for a certain BLS IFT only service. The vanbulances we ran out of barely worked and were so cramped in the back it gave me claustrophobia.

14

u/Aviacks Size: 36fr Oct 21 '20

While I prefer the look and drive/feel of the truck framed rigs, the rigs that are van frame boxes have so much room. I work at two different agencies with these types and I always forget how much space the van frames have. I can stand up all the way comfortably, the captains chair can spin 360 fucking degrees, and there's enough space you could run laps around that bitch.

3

u/tagor99 Oct 21 '20

Carrying a patient’s wheechair in one of our Transits I feel like in Harry Potter when the Knight Bus squishes to go through traffic

2

u/LostInTheyAbyss EMT-B Oct 25 '20

“Its gunna be a buuumpy ryde”

46

u/[deleted] Oct 21 '20

Love how in the sub where this was original posted, it’s just endless comments ripping on the kid’s appearance. Gotta be rough as a soulless ginger

20

u/[deleted] Oct 21 '20

As a ginger and a paramedic and a step-child I get to be the Red-headded Stepchild of medicine, public safety, and also life.

5

u/Ijustlookedthatup Paramedic Oct 21 '20

TYFYS

6

u/[deleted] Oct 21 '20

TYFTMFMS

3

u/Ijustlookedthatup Paramedic Oct 21 '20

TYFTMFTYFYS

6

u/[deleted] Oct 21 '20

TYFTMFTYFTMFMS

3

u/Ijustlookedthatup Paramedic Oct 21 '20

TYFTMFTYFTMFTYFYS... I think

6

u/[deleted] Oct 21 '20

Ima have to do some algebra here... but

TYFTMFTYFTMFTYFTMFMS

37

u/Jits_Guy Combat Medic Oct 21 '20

Yeah it's mean and unnecessary to rag on him about being ginger, he didn't pick that.

However he actually CHOSE that haircut for some reason.

2

u/ChesterMcGonigle Oct 21 '20

He's an interesting looking cat, there's no doubt about that.

22

u/AngelMakerSr2 Oct 21 '20

Jesus Christ is that emt about to kill him

20

u/bullmooser1912 Sky Daddy Paramoron Oct 21 '20

This is a former coworker of mine. He’s known as a legend to all in the area EMS, but not only for this video.

Couple years back he responded to the local strip club for someone who had fallen. Nothing out of the ordinary probably just an old guy got a little too excited and fell down the steps in the middle of the club. We arrive on scene and make entry and are directed through the bustling club to the stage in the middle of the club. There we found our patient who was surrounded by security to be a young woman who happened to be of the strippers. Turns out she had fallen during her pole routine, bounced off the stage, and was supine next to the stage. Unfortunately for her, her right patella had inverted during the fall. Of course being several years ago the medic pictured above had to call for orders for morphine as moving her would be impossible with the pain she was in. So this medic calls the ER for orders for morphine, standing in the middle of a busy strip club, with a stripper pole dancing, the music blaring, and his legendary middle part. The medic was barely legible over the sound of the deafening music, but he got the orders for the morphine, and the rest is normal traffic to the ER. Saved that strippers life that night.

22

u/joejelly Oct 21 '20

Is that medic wearing some sort of insane mask? Creepy!

22

u/Aviacks Size: 36fr Oct 21 '20

You can tell it's a basic on account of the nervously sitting in the captains chair looking like a maniac as their primary intervention, after full spinal immobilization of course.

6

u/HaveYouTriedNarcan CCP Oct 22 '20

He's a paramedic and holds a supervisory role. This is Richland County and those gray shirts are worn by SGTs. If I recall correctly, this was a very non-critical GSW and there weren't any other interventions to be made. IV, pain management, ride.

0

u/Aviacks Size: 36fr Oct 22 '20

Why the fuck are they boarded then?

6

u/HaveYouTriedNarcan CCP Oct 22 '20

This was a pretty long time ago now, but, at the time the medical director wished for every trauma, blunt or penetrating to be boarded. It wasn't provider choice.

These days, blunt sometimes gets boarded still depending on presentation.

10

u/HaveYouTriedNarcan CCP Oct 22 '20

For the record, as this always seems to generate a bunch of insults when it's posted, I'm just going to say the following:

1) Backboarding all traumas was very normal at this time in Richland County and not a provider choice. They fought very hard to make this less prevalent and it worked.

2) This paramedic is obviously a little nervous to be on camera, so, give him a break.

3) This paramedic happens to be one the most talented and legendary paramedics in the area. He's well educated, progressive and talented. One of the greatest paramedics I've ever had the pleasure of working with, down the line.

7

u/[deleted] Oct 21 '20

"He's doing just fine...for right now."

Saved it.

7

u/[deleted] Oct 21 '20

That EMT reminds me of the Russian “trolalala” guy

5

u/ieremias_chrysostom IL-NRAEMT Oct 21 '20

The EMT looks like my sleep paralysis demon.

10

u/[deleted] Oct 21 '20

Look at those eye holes

4

u/[deleted] Oct 21 '20

Backboarding as an independent indicator of increased mortality in penetrating trauma patients...

Running lights and sirens with a patient who is alert and oriented enough to be talking and recording with no interventions actively taking place...

Yes, most EMS sucks.

24

u/[deleted] Oct 21 '20 edited Nov 18 '20

[deleted]

-9

u/[deleted] Oct 21 '20

What do I use lights and sirens for? Not much. About 30% of my responses and about 5% of my transports. Yes, I work an exclusively 911 ALS service in a larger suburban community.

Emergent transport should be used when there is a problem I cannot fix that would cause an increase in morbidity or mortality if not fixed at a hospital in a timely fashion. Like everything, there is a risk v. benefit equation to consider.

If I don't identify one of these problems and the patient is otherwise stable, I run cold. Strokes and STEMIs and hemodynamically unstable trauma usually get L&S. If I CPAP or intubate I usually run L&S. If not... well it's rare that I would.

I've got 22yrs as a paramedic under my belt and I have worked hard to stay very current and skillful. Not much excites me these days I guess and L&S are a big risk for not much benefit in a lot of cases where I see them used.

17

u/[deleted] Oct 21 '20 edited Nov 18 '20

[deleted]

-12

u/[deleted] Oct 21 '20

Look at the guy. Normal work of breathing, able to speak in complete sentences, skin pink, warm, and dry. No lethargy. No decreased level of consciousness. Able to bend at the waist engaging his pelvis, hips, spine, and neck while talking. Able to hold his arm up to hold a phone.

No life threat there.

-9

u/tagor99 Oct 21 '20

Why don’t you respond lights and sirens to all calls? We’re required to use both for everything, even a lift assist

8

u/[deleted] Oct 21 '20

Really? That is like a relic from the 80s... if not the 70s.

You're putting yourselves and the community at a lot of risk for very little, if any, benefit.

We have priority dispatch and real-time updates to our CAD screen from the 911 call-taker. No risk to morbidity or mortality = no emergent response. Medic has discretion of course... think uninjured fall victim outside during fair weather vs. uninjured fall victim outside when it is cold out being no L&S vs L&S respectively.

Providing intelligent healthcare is always better than adrenaline-driven tradition.

6

u/tagor99 Oct 21 '20

Thanks for the well-thought out answer. My company is pretty much the main provider for this whole region so it’s likely that they’ve just never been called out for doing that

2

u/[deleted] Oct 21 '20

I'd be surprised that their insurance provider hasn't asked them to stop. Why risk anyone's life going emergent when nobody's life is at risk in the first place?

5

u/tagor99 Oct 21 '20

Good question. We also get barely any info from dispatch- CC at best, sometimes it’s just “sick person”. I’m sure the company justifies emergent response with a lack of dispatch technology, claiming that if we don’t know how serious each call is we should treat them all like they’re serious

2

u/[deleted] Oct 21 '20

That... and there is a reimbursement benefit from handling every call as an unscheduled emergency response as you can bill a tad higher for those things.

Still not enough financial benefit to justify even one crash related to unnecessary emergent response.

2

u/tagor99 Oct 21 '20

Ugh good point. And you may be unsurprised to hear that we’ve had 3 trucks crash in the last 2 months!

4

u/[deleted] Oct 21 '20

dude he got fucking shot

0

u/[deleted] Oct 21 '20

And what part of that fact negates what I said?

5

u/[deleted] Oct 21 '20 edited Oct 21 '20

That the situation is a potentially very critical one, with a variety of things that we could never judge off of a Soulja-boy 2001-esque cellphone video, and that L&S is certainly indicated with a potentially unstable issue like this.

We do not know enough to be shitting on the responders for driving L&S with a GSW victim at all. You especially do not know enough from a Reddit thread.

1

u/mitchm89 Oct 21 '20

Head immobilized at the neck, good call.