28 March 2009

Dispatch

27 March 2009
Another day on the bus. The previous day was extremely busy for my service, so I thought that this one would be busy also. I was wrong, at least for the first six hours of my eight hour tour. The day began as most days in private service EMS, dialysis transports and return trips to the nursing home. The service I work for has been increasing the number of trucks on the street recently, today we had seven medics on the street for a total of nineteen transport ambulances. With so many paramedics I knew that I would be busy with the 'chuck' run all day long. I am not bothered by chucking people.

After the fourth run for my truck (which I teched so my partner could get a brake) we went back to a posting location. We did not stay long, we finally had the chace to make a priority 1 (code 3) run. Dispatch sends us the info, elderly female with difficulty breathing, a nursing home clear across the county. My partner is driving and we hit the road, lights and siren blaring. Five minutes pass and they send another truck to a priority 1 run right near where we had been. I have not knowledge of where this ALS truck cleared from but I thought they might be west of our location. I thought about trying to swap runs with them, but I decided that dispatch would know best. As it happenes so often in private ambulance service, we passed the other ALS truck, going opposite directions on the highway.

Surely the dispatcher could have seen this error? Why do they spend so much time crossing trucks, wasting fuel and time? Most of our dispatch staff have never been on the street, however they do have CAD to assist them, and they hear us enough to know where the facilities are located. I make it a point to tell them my exact location when they call my number. I am hoping they will use their brain and send me to the closest available run, not across town, when there is a closer truck.

My patient required a breathing treatment and a trip to the ER (non emergency). When we arrived on scene the nursing home staff told us she had a SpO2 of 50% on 3 lpm by nasal cannula and she had an irregular heart beat. The PT was laying supine in bed. I removed the nasal cannula, listened to her lungs and administered a breathing treatment before getting her on our cot. When will nursing homes get their act together and stop placing 2 miles of oxygen tubing connected to a concentrator at 2-3 liters per minute. This does your patient no good if they are having a hard time breathing, seriously people. LPN's are useless, if they cannot understand the concept.

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