Home Forums Hunting & Shooting Hunter's Campfire Unreal. Heart Attacks in NY not to be brought to ERs

I ever keel over from a heart attack or serious trauma I’d rather have a king county medic working on me to start then an er doc every time. Of course I would still want to end up in an er but the medic units here have hundreds of medications on them, their life pack is no different then the ones in the er, ive seen them perform in field operations and I’ve been in tons of situations where doctors happened to be on scene and it was a cluster. To be fair there have been a couple times when drs were on scene of something and did a fantastic job, just the far less common example. I also think that not all medics are created equal in general but certainly in different parts of the country. Far different levels of training and equipment available. I would love to hear what airway interventions an er can do for a code that a medic unit here can’t.

I should also I suppose say that not all er’s are created equal in my mind and I can think of one where every trauma doc I’ve encountered has been amazing. Several other local hospitals I’d be fine going to and feel confident in the care I would receive, but the smaller they get and less major stuff they see the less I’d want to go there if I was really having a bad day.

Okay. You are splitting hairs here.
Paramedic units are equipped the same as a hospital in regards to ACLS to treat cardiac arrests.
Our training in regards to ACLS is the same as a doctors.
The American Heart Association has determined through research and studies that a hospital can do no more to determine the outcome of a patient in unresponsive cardiac arrest than a paramedic in the field.
If a doctor wants paramedics to bring a 80 year old full arrest from a con home he can so order it. This differs from region to region but ACLS is the national standard.
Our treatment was monitored directly by a base station hospital where there was a doctor that could be consulted on any, call medical or trauma or the occasional hard head that was dying in front of us but refusing medical aid.
My 6 months of paramedic school don't compare to what schooling a doc goes through. Never said it did but I guess I have to put pertinent negatives in. That was the reason I took a giant step backwards after I delivered a patient and a treatment report up to arrival at the ED.

Thanks for the reply. It's easier to put you on ignore that way.

Uh...no. Ambulances do not have “hundreds” of different medications on them, despite your assertion. And over the decades I’ve seen many cardiac arrest victims brought in being ventilated by BVM’s because...for whatever reason, or reasons...the paramedics were unable to intubate the patient in the field. And in every instance, we were able to intubate the patient in the ER. I’ve also seen, too many times, patients brought in with ETT’s in the esophagus instead of in the trachea. Again, not bangin’ on EMS...as I’ve been very involved with it for a long time. But a paramedic is not an ERMD. And the back of an ambulance is not an ER.

We (L.A. County) were in a cricothyrotomy study for a year or so. We didn't do enough to even come to a conclusion and the 2-3 that did happen were bloody messes so we never got it a added to our field protocols. Same with peds intubation, not enough data. So hospitals here do crikes but medics do not. The conclusion was that in almost all cases we are within 20 minutes of a paramedic receiving hospital and we were just supposed to do the best we could until we could transfer care.
We were required to get a docs ID if he insisted on getting involved and usually got them to back off if their license number was going to be on record. Even when we went to their offices they backed away. A podiatrist or kidney specialist isn't always going to help if they want to be in charge. We met a young doctor on a 3 victim TC that volunteered to be an extra set of hands. He was really cool surfer doc, and thought what we were doing was really cool and decided to come hang out with us for a couple shifts and eventually switched over to emergency medicine at our trauma center.

not wading thru this thread due to the typical Campfire arguments going on...

But I do want to add, thank God and God Bless those that are EMTs and Paramedics...

Spent time doing that 40 plus years ago...life took another path tho..
If I was younger I'd go back to it...its worthwhile to our society...

Thank you folks for all you do...you don't receive the appreciation you deserve, until you've saved some individuals life.
Then the patient and family think you're the greatest people on earth...

Best regards and thank you.

There is sometimes much more to treating these patients ‘after’ their arrival to the ER than just the ACLS that was being done by EMS.

Dont have a heart attack?

Agreed. Very much.

Thats what I read.

I didn’t say ambulances had hundreds, I said medic units. I don’t know where in the country you are and maybe it’s true where you are, but that doesn’t mean it’s true everywhere. There’s a huge difference in a medic program that’s a month or two long on bankers hours and one that’s one year and basically 24/7 unless sleeping.

I’m not trying to make it sound like er’s aren’t good. My point was around here if the medics can’t get ROSC back I doubt an er could have. Other places could be very different though. It sounds like wherever you are that is true.

It’s all good. I’m sorry if I came across as being anti-EMS. I love EMS. I love taking care of patients in the field.