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>> Its just TV to me<< The power of television has been debated ad nauseum since Felix the Cat first appeared in early TV demonstrations. The bottom line however is we are so overexposed to TV it might be hard for us to realize how much it does manage our perceptions. Especially in younger people. There are several young EMTs in the Paramedic Prep class I'm attending that are all ga-ga over EMS air transport. They know little to nothing about aircrew safety statistics, the over triage, especially in pediatric cases, of many patients, and the exsisting studies that show lack of improvement in patient outcomes. What they do see is the percieved glamor, and in the case of one female student, how cool she'll look in that flightsuit. And she actually said it was the show "Trauma" that peaked her interest. She's a EMT in a small IFT company and I don't think she's even seen a helicopter up close. Skepticism, in most of us, only comes with age and experience. So to say, in effect, TV is just TV is a stretch for the general population. It's more about what information we take in, and the quaility of that information, not its source. For example "Emergency" vs "Trauma" - one good - one bad - and both from the same source, television. If viewing TV was a medical procedure we'd have to call it invasive. And if we spent more of our spare time reading peer-reviewed EMS journals instead of watching TV we'd all be better off . . . NickD

That is actually a very small dose for the purpose of RSI. You may skate by with a minimum of 0.1 mg/kg. However, this will still be ~7mg in the "average" adult. With that, the slow onset and hemodynamic implications of midazolam do not make it a very good candidate for RSI. Take care, chbare.

Caught a blurb about this on the bulletin board at one of our hospitals, couldn't find the exact article but I did find this one, thought I'd share. Does anyone have any experience with this, or is it implemented in their service? How does it work for you? Saving time, saving muscle: The 12-Lead EKG program Full Text: http://www.stjohn.org/innerpage.aspx?PageID=5242

Dust forwarded this video. IT IS SHEER GENIUS. What a great way to vent frustration and identify an issue. I have told everybody to boycott the trauma show and A.J at JEMS is doing the same. I have emailed the link to everybody I know and they love it. I could not resist the chance to send the link to Randolph Mantooth. He'll laugh his ass off. I'll let you know what he says (he loves this kind of stuff). Again, sheer genius lurks somewhere in the confines of this list. Thanks for letting me in on it. Bryan Bledsoe, DO, FACEP P.S. There is an "E" at the end of "Bledsoe" (e.g., Drew Bledsoe). But, it's all good.

Has any one else noticed this? 2007 - Chinese year of the Chicken .......... Bird Flu Pandemic devastated most parts of Asia .. 2008 - Chinese year of the Horse .............. Equine Influenza decimated Australian racing. 2009 - Chinese year of the Pig ................ Swine Flu Pandemic terrifying people around the globe. It gets worse next year, 2010 - Chinese year of the Cock ......... what could possibly go wrong?

So you used to put the drunks behind the wheel now your going to save them ? hmmm ok this is plausible, sure hope you have put away some tips I hope to get through school ...just saying its a bloody shame that you guys are not paid decently and that the volunteer service are undercutting you ... honestly after 4 years on this site I can see THAT light. Firstly if you have actually spent > 25 years doing this job I believe your personal sensitivities would be a bit more affected, we are not "mad" we are using the pen as it can be more effective than the sword, this is a TV show that disrespects the profession and yet unfortunately many viewers are keyed into the just the blood, guts, glory and explosions and will believe it is closer to a documentary and again geared to the grade 8 education that most TV shows are focused ie SEX + Fast cars + Explosions = Success in TV ..meh ... I watch Discovery and documentaries and TLC, or the military channel the demographics are a changing in the viewing public. Fact of the matter is the real call volume is NOT TRAUMA at all it is complex metabolic problems, cardiac and seizures that are the top of the hit parade (not sexy in the slightest btw)the vast majority of calls, ETOH being the underlying social problem, I wonder if that "theme" will surface hey and lets not forget my favorite type call ... retuning the grannies back home AFTER they have recovered ... nothing better in my books. Many times EMS is like urinating in a dark pair of pants ... You do get that warm all over feeling, but YOU hope no one notices. This show needs better writers, that listen to advisors and a real big name to become truly successful TV series (we can only hope) I like Will Smith .. ever see "Seven Pounds" just saying RABBIT is headed to the stew pot if he shows his face around any true professionals in EMS, I love how they kill off and very unexpectedly the CSI "special agents" just to keep it real, cause that is real life for cops and if the producers are watching maybe they will take a hint Secondly your NOT going to watch the show BUT your NOT boycotting ?? I am a bit confused Now a reality check will a "boycott work ?" .. NO is the short answer. Bledsoe stepping up to the plate and just suggesting that, well it WILL send a message count on it! Rock ON BEB !

It's funny what you come across at 4am on youtube.

Im 28 You're right, im not a full timer, i havent been around the block and seen it all, but im not claiming to. Im just a volunteer EMT-B and havent been working for long at all, ill be starting medic school next semester. But ive chosen this as a career because i love it, not so i can tell people that i save lives for a living. I sure as hell didnt choose this career path for the money! Its going to be quite a pay cut from bartending. I definately dont have enough scope of the profession yet to be as mad as you guys about the show, and i can see how most of you are upset, im just not seeing why people are SO mad. Its just TV to me. There are other shows out there that offend or annoy me, but im not going to boycott them, i just wont watch them. Im not trying to argue with anyone's opinion of the show because we are all entitled to our own opinions, i was simply leaving mine. Is it a great show? Of course not. Does it offend some EMS workers? Absolutely. Ive just never been one to let a TV show get to me.

Bartender? One question how long have you been in active full time 911 EMS and at what level? I'm just asking because if you function as a volunteer that shows up occasionally to calls (and no guys I'm not knocking good volunteers - I'm knocking the ones that show up to just the "cool" calls or once a month or so just long enough to say they are still on the dept)I hardly think you have enough scope of the profession to form a qualifying opinion, nor to understand why those of us that do the job for a living are a bit disturbed with what is portrayed.

Are there alot of EMS responces to your Bus's??

While, like Dwayne, I am very a-political in nature, I do take a certain amount of perverse pleasure watching and listening to people rancor about. I believe that this point has been skirted around during this discussion... and I'll try to explain my perception. It appears to me that this prize is being awarded to Obama for being a World-wide "symbol" for peace. During his campaign he was lauded as a symbol for "change," and with that for peace as well. He has become an international symbol for these concepts. We all understand that there are many instances of symbols being over hyped, and no one has a better hype-machine behind them than the first African-American President in US history. Obama has a chance to be far more powerful as a symbol than he does as an actual catalyst for change through his policies and regulations. Symbols are powerful, people mobilize around them and then they become catalysts themselves. My guess is that the Nobel people want to use this symbolism... to hitch their wagons to this world-wide phenomena of "Change" and "Hope" and "Peace." So we may ask ourselves... what has he done to deserve it? And it is a fair question... but who is a more unifying figure in our world today than Obama? Do the other 209 people on the list of nominees have the same name recognition to get entire nations to stand up and take notice? Nope... in my opinion... it's all about symbolism. For the record... I vote for the guy who built the schools in Afghanistan for Girls.

No idea, but I'll tell you one thing, I'll be getting THAT vaccine! Dwayne

We tried all kinds of adjustments. Used the recommended specs in the directions. I just can't believe that none of us could figure it out. My guess is, it was broke. That makes more sense when you explain it that way. A lot less movement with a vent.

I've had good luck with it in all aspects of care, it has a -5cm/H2O demand valve trigger for the spontaneously breathing patient, a nice variety of settings for the ventilator. and as a test I set the CPAP to the highest setting and it uses about 700 litres/hour. I'd have preferred one with separate respiratory rate and tidal volume controls, but there was a cost vs benefit issue in there. I'd have also preferred something a little lower than the 60cm/H2O pressure limit, but it's also not adjustable. 50 would have been my choice.

PART 2: Commissioner: Not anytime soon. Fire Chief: Fine. I'll buy some ambulances out of my current budget and staff them with fire medics. Commissioner: You don't have a transport license. Fire Chief: Yes, but eventually you'll have to give me one or the public will wonder why YOU are stopping the FD from saving lives. (This is why Fire will always win)

In it's final 2 years, instead of being an attempt at balanced Fire/PD/EMS storylines, it de-evolved into a PD show, where EMS, and even Fire, became minor secondary storylines.

Ok. Just to clarify, I meant transmission of ekg via cell phone. Not EKGs themselves.

I notice that my earlier post was connivently ignored. So I will ask again. How would the Firefighters like it is it was EMS trying to take over their "profession"? So that EMS could control the funds. And how much goes into EMS equipment and training as opposed to how much is spent on shiny red fire trucks and fire toys? How many calls per year actually require a fire engine as opposed to how many calls require an ambulance? And again, I am talking about really REQUIRING a fire engine, not how many just got a fire engine because that's how you roll. The bottom line is Fire wants to take over EMS because they want to control the money. Just like grandma in the back room with the crackheads living off her SSI. On any given day, compare the number of fires against the number of medical calls, we've figured out how to reduce fires, but we've yet to find a way to stop aging and dying and injurys. Fire was quick to see this and start moving to take over so they control the money. We were sleeping because we'd been running all night.

do something exactly like trauma-life in the er on discovery health, have camera crews go on calls and put cameras in the bus id watch it

The specs on it look better than some so it might be able to do decent CPAP and ventilate post code on an unresponsive patient. The thing with ventilators, if the patient is trying to breathe spontaneously and the machine isn't sensitive enough or doesn't have the capability to meet flow demands, few 911 ALS or even some CCTs have the ability to provide adequate sedation. In the hospital, we occasionally use the ParaPac portable ventilator for MRI. http://www.smiths-medical.com/upload/products/PDF/Respiratory.pdf (specs near the bottom - the specs for the Carevent are on the links above) It is a little work horse and can achieve a decent flow but we often have to give a good dose of something to chill some patients. Luckily Diprivan (Propofol) is usually hanging. I have quizzed patients who have been transported many times which they prefer and it usually the LTV 1000 or 1200 with a real liking for the 1200. The internal turbine in the LTV is hard to beat among the transport vents. I like the valving also for its responsiveness and ease of acceleration to meet the patient's demand. It is fairly rugged and handles the rough terrain of HEMS. The sleek design allows it to hug the curves to travel just about anywhere including cramped CT Scan rooms. Nice option package with can include a good monitor makes it versatile for CCT. It handles most critical care respiratory patients very well when taken for a long distance transport. Gas consumption gets decent mileage also. And, it was the ventilator choice of Superman. But, it is impractical for most 911 ALS unless they also do "real" CCT and have adequate training. I'm spoiled. After growing up with Elder demand valves, it is time for some luxury. BTW, my opinion of the Oxylator is that it is a Elder demand valve that they attempted to give some "thinking ability" to but the limited feedback data capabilities can fool it and the health care provider. http://www.lifesavingsystemsinc.com/documentation/LSI-Oxylator-BPM%20Rate%20Changes%20&%20Indications%20EM-100,%20EMX.pdf

I can honestly say that I have done much more in my lifetime -- or even just the last few years -- deserving of a Nobel Peace Prize than Barack Obama. So have probably half the medics on this forum. So yes, the Nobel Prize is rendered completely irrelevant by this gesture. Ronald Reagan was not even nominated for a Nobel Peace Prize for eight years of actual significant achievements. There are damn few winners since 1980 who can match his achievements. Talk tough, achieve greatness = loser Talk nonsense, achieve nothing = winner