Over Simplified?

While fueling the rig I saw the sign above, which raised a thought. Doesn't the use of a Credit or Debit card negate the "payer" as Cash Customers? So is this sigh really necessary than? Frankly should this over simplification of a concept have to be this redundant within such a small space?

Obviously if we have to have such a sign even exist, which obviously we do, it really needs to be quite large. The individuals it is intended for aren't going to see this misplaced signpost plastered to the steel support beam of the gas station. Rather they need an enormous neon sign on top of the building that asks a simple question and then will answer it for them (No thinking involved): USING CASH? PREPAY. Maybe add additional blinking lights, flashing arrows to point at the glowing neon light pollution. That way Joe Public is drawn to the sigh much like bugs to a light, they'll ask them selves "Am I using cash?...Hmmm...Yes I will have to use cash to buy my gas today, what of it? Oh I understand, I must Prepay"

So that got me thinking about some of the people I've had the pleasure of training over the years. The ones who didn't see the giant neon sign above the stations which read's "You don't know it all, apply within, we teach"  The fresh out of Basic class, who already working their way through the Medic Class with out an ounce of real exposure, new hire. By the time they are getting out of the Medic class they are so full of them selves and how well they have the book knowledge down that a little basic, such as myself, is nothing more than the proverbial "Ambulance Driver"or the "Bitch" to do all the crap calls.

Granted, I may not almost be done with the eighteen months (or less) of schooling that you have under your belt that has taught you how to read cardiac rhythms, given you the "skills" to push drugs, start IV's, or intubate a patient, and given you the ability to read protocols. But I do have a couple of years of experience and more calls under my belt than some agencies have in a year.

So it may be advisable to listen to what I have to say, and don't automatically answer "Ya, I know". If I've picked up on something you're doing incorrect or am attempting to refine your hop-scotch assessments, your incoherent patch reports its because its apparent you don't "know"...Ya Know?

So do not brush off the guy who's "just" a Basic that could be the one to save your ass if you ever get cleared as a Medic. Our Basic's are the best assest you could ever have in your bag of tools. Though you are the one with the eighteen months of education, so you tell me; what should our basic's neon signs say?

Be Safe
Ambulance Junkie

Trauma note taking

We all have different techniques for keeping track of pertinant assessments. Many people have these Tricks of the trade they do with out second thought. I'd like to share one that I find most useful for the trauma call.

I typically scribe on my left glove all my findings from assessments, so I have the info readily available for a patch report to the ER or nurse report. I found scribing this way inauspicious during a trauma call because of all the dirt, grime, blood and various other substances that typically get on gloves. Also during a trauma I am more likely to change gloves and then lose any info I have scribed.

This Scenario is assuming that your rapid initial assessment has determined that the best course of action allows you to remain on scene with your patient. Let me repeat myself, this is not the proverbial "load and go" yet rather you can "Stay and Play" we are talking about. This technique is rather helpful when remembering all those injuries for later on in the call or after all said and done.

Once the Pt is in the rig and you can focus on your primary detailed physical assessment take a roll of 3 inch tape over lapped vertically 2-3 times. Sectioning it into three areas and place on the cabinets along the patient or the wall/ cabinets behind you. The three sections represent the three sections of the body to focus on in a trauma. Head/Neck, Chest/Arms/ABD and Pelvis/Legs. Now every time you find a injury during  your primary assessment you write the findings on the tape, allowing you to re-evaluate systematically on secondary assessments. This technique also lets you take the findings on these sections into the ER for the staff to see and use.

This is an easy skill to get a young provider to do while you preform the assessments. In the case you are with a driver only, you can use them to scribe for you to help out.

By breaking down a trauma assessment from head to toe you have a record of all the DCAP-BTLS (Deformities, Contusions, Abrasions, Punctures, Burns, Tenderness, Lacerations, Swelling) for all the Non EMS'ers. This will alleviate forgetting any injuries when documenting or when sharing during a report to a nurse.

Now not to say this couldn't be done during a "load and go" depending on various factors, such as transport times, Multiple providers in the back Ect. During those times more important life saving interventions of course  take presidence.

I'm glad to pass this off to my readers for I was passed onto me from a great mentor. She's no longer on the streets but misses it greatly. I hope this bit of info helps, I know it has for me.

Be Safe
Ambulance Junkie