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Ill be finishing up my current book, "Better" by Dr. Atul Gawande, any day now and am looking for a solid book for my next read. I'd like to read something related to EMS. Have any suggestions?

Adios, Dick. My back thanks you eternally.

http://insidetv.aol.com/2009/10/29/nbc-cancels-medical-drama-trauma/ NBC Cancels 'Trauma' - Sends Medical Drama to the Morgue October 29, 2009 | By: Michael D. Ayers Just a month after the show's premiere, NBC is pulling the plug on its new medical series 'Trauma,' according to the The Hollywood Reporter. The network will still air all 13 episodes of the drama, which featured a team of paramedics working in San Francisco. 'Trauma' has been following NBC's once-promising 'Heroes,' averaging around 5.5 million viewers per week. After the series runs its course, the slightly more popular 'Chuck' will fill the Monday at 9PM time slot. In the wake of 'Trauma''s cancellation, it was also announced that 'Chuck' has been granted 19 episodes for its forthcoming season. Owing to the nightly 10PM time slot occupied by 'The Jay Leno Show,' 'Trauma' was one of the few new hourlong shows introduced by NBC this fall TV season -- and, according to the Los Angeles Times, it was also one of the most expensive to produce. A casual viewer could be forgiven for wondering if NBC's glory days are truly over. With this latest cancellation, the amount of original, scripted content that the network is producing is dwindling fast. Even 'Friday Night Lights,' the one NBC drama that is still receiving constant critical acclaim, won't air new episodes until next summer. Winter is looking to be long and cold for the peacock ... maybe even a bit traumatic.

This is a great double-whammy. "Trauma" gone and "Chuck" picked up for more episodes. Nice!

Oh I am heart broken .... tell me did Da Wabbit die from H1N1 ?

Why can't crews give swiney shots to other EMS, fire, police? Last year for what I think was a few weeks in a row, we had paramedics taken off the road (voluntarily) to do a flu clinic in our central station for us. Way better than standing in line for 3 hours (or 8). They're obviously competant at giving IM shots and obviously have permission from the medical director. What's the big deal? Saves time.

To parrot what Dwayne said, thanks for sharing with us how you feel. I would suggest that if you continue to have issues with the call, that you may wish to seek the help of a counselor. Psychological issues/stresses are not 'our' specialty. Honestly, this is a fairly anonymous forum. I think people want you to share the specifics of your call because it will help us all give you better advise about the situation. You obviously have the guts to come forward and tell us you have an issue. The choice is your's though and we still respect you either way you choose. From you post, it seems that you have taken a situation that you did not create, and in that situation did not perform some intervention that may, or may not have given the patient a 0.01% chance of living. It may be silly, but why not only blame yourself only 0.01%, instead of the 100% that we perceive you blaming yourself for? It seems you were only accountable for that 0.01% and not the full life of the patient (as in you did not cause the situation). You quoted 'everyone makes mistakes', 'you did your best', and all that Jazz. Sure, everybody makes mistakes, and a number of people try and do their best. What separates the professionals from the check collectors is what I believe to be 'perfect practice'. (that is not my saying, but one I like). Perfect practice does not mean you go through motions and hope to gain the experience you need. Perfect practice means that each time you go to your next call, you apply your past experience and new knowledge to perfect that task at hand. It is not something that just comes, but rather something you work hard to obtain. This is what the other posters were trying to say, in a sense. They say to review the call and be critical of yourself, to a point. I am saying to review the calls but to be active in using the review to make yourself a better provider. I hope you can find that inner peace you are probably needing. Good luck bro ! Matty

This is the way I see it - some areas of the US are populated primarily by the working class, with a lower proportion of the elderly. With less elderly come less NH's, and less of a need for hospitals and clinics in general. Charleston SC is a good example. 4 out of 5 people I've spoken to that live there are in their mid 20-s to mid 40's, and have relocated from other areas. I didn't see a whole lot of NH's, or elderly in general for that matter. The eldery that I did see were generally in much better health, on average, than the elderly in NY. In NYC, there are upwards of 8 million living there. There is a huge population of elderly, who are in pooper health, on average, than other areas of the US. There are an ungodly amount of NH's there. There are plenty of hospitals in the greater NY area as well. Remember that the population expands exponentially, and the proportion of elderly vs others will steadily rise, if not explode upward. The baby boomers will reach retirement sooner or later. Who's going to take care of all these elderly? In NYC, all 8 million+ will amplify any population shifts regarding age, more so than any other region in the US. Now THAT'S job security!

There has been much debate about whether it's more beneficial to earn less with less overhead, or earn more in an expensive area. I know one thing to be true - when comparing two different areas, assuming that the cost of living is proportional to compensation from each job, it's more beneficial financially to live in the more expensive region. What's more, saving 10% of a 50k/yr salary, or 10% of an 80k/yr salary? which pension is worth more, 75% of 50k, or 75% of 80k? With a 401k/403b, which is higher, a 6% match of 50k, or a 6 percent match of 80k? Make sense? Of course, if you're miserable where you live, all of the above is irrelevant. Why are medic school graduates looking for BLS work in the privates? BLS are a dime a dozen in NY, as well as anywhere, though. Anyone with a GED and free evenings can get their mcert. A shortage of medic jobs in NYC doesn't suprise me, with NY Methodist running three classes at once, Stonybrook, St. Vincent's and LaGuardia barfing out hundreds of medics every year.

Kev makes a great point, as usual. There is ALWAYS "something else" that could have been done. Always. It may be something you forgot. It may be something you never even learned. It may be something outside of your protocols. Most times it's just a total shot in the dark "feel good" measure that would have made no difference at all in the outcome. But remember, there is ALWAYS something else that could be done, so there is no point in agonising over it, because it makes no difference in the bottom line. Of course, this is not to stay that you should not critically review each and every run. You should. And when you have that revelation of the major step that you overlooked for whatever reason, the finality of the situation should drive the point home in a way that never again allows you to forget. But it IS going to happen. Period. You can either deal with it or not. But your career depends on you discovering that method which helps you to do so. That is where conversations such as this one are valuable. Nobody here can tell you how YOU should deal with it. We have no way of knowing what will work for you. The best we can do is to share what has worked for us, and for you to then go with your best instincts. On that, I wish you luck.

There is a lot of good information here, but to add my 2 cents ... I have 4 friends who have recently graduated Medic school with me, all with NYC 9-1-1 experience who haven't even been able to get a job doing BLS IFT ... They are some of the best new medics, and best EMT's I know, the job market is tough out here right now, apply around before committing ...

Got them today for family and myself. After doing my own research and considering the medical and ethical aspects of it, came to the conclusion that there lacks credible evidence to support not getting it. One thing to consider, it is almost pointless for a single member of a family to get it. If one person is going to, everyone should otherwise there is no point in getting it at all. With the H1N1 vaccine, you are less likely to act as a vector (carrier) and cross contaminate (read, bring it home with you.) What concerns me about H1N1 is it's effects and severity on young healthy people and the severity of illness which is disproportionate to the regular seasonal influenza (Influenza 'A' strains). I'm surprised by the lack of knowledge and understanding as well as the lack of consideration of strong and/or credible evidence but instead people will readily accept information from myth's or special interest groups. tniuqs, I hope you feel better soon.

sample size of 29 - bah humbug.. not enough to draw any conclusions. The study of people in car crashes would be interesting tho.. could contact hundreds of thousands of them and ask for DNA.

Seriously, wtf is that all about? I like to think a lot of those were just accidents, because otherwise it makes zero sense. I know I've done a couple of accidental plus or minus points while meaning to click something else, like the reply button. Anyhow, I used to not read because of my ADD. Now that the ADD is cured, I just don't have any motivation anymore. It's a curse. I may give Kelly a read though, because I do enjoy his blog and articles, and he's good people. One of the few that seems to "get it".

It's high time (good one I know), for marijuana to be legalized/decriminalized on a global scale, akin to alcohol. It's such an antiquated practice, I assume based on various historical circumstances that I'm not familiar with. From an EMS standpoint, alcohol related calls (either acute or chronic issues) FAR exceed by magnitudes the calls for ANY other substance abuse issue. This is true from small town to big city. I would estimate that 10-20% of the calls that I do on a daily basis directly involve alcohol as the primary or secondary reason why 911 was called. That is ten's of thousands of calls a year for the service I work in. In contrast, with regard to marijuana, I can probably count on one hand the number of marijuana related calls I get a year. These are always "acute", and almost always involving younger people experiencing anxiety attacks from use. You don't see a lot of marijuana fueled homicides, shootings, DUI, trauma, chronic health issues, "take me to rehab" calls. I also don't buy any type of argument that because marijuana is illegal/criminal, it might be inherently substantially less prevalent. Let's face it, cops generally don't care (unless you are being a dick) about your personal stash or the fact you have ingested it. Add to that that marijuana is extremely easy to acquire and cheap. Speaking from personal experience I'll say this. I'm a much nicer/better person smoking weed than I am drinking alcohol. Yes, I know, in an ideal world no one would have a vice/need an "escape" that involves ingesting chemicals, but for most that doesn't happen. Obviously I am 100% against the ingestion of any type of chemical that might impair judgement while working (this also can include prescribed narcotics/benzo's that are given for legit reasons on an individual basis). I feel sorry for those that get tested for THC and might be dismissed for intake and therefore fear its use. It boggles my mind that it is "ok" in the grand scheme to theoretically get hammered every night and/or week-end, yet you smoke a joint and you could be screwed? Get your head out of your ass people. EDIT - Does everyone have a "warn status" bar under their profile on the left? Lulz, I don't think I've posted in like 8 months, wondering if that is new or just for me.

Seriously? Someone is dinging our reputation points for this thread? I figured it wouldn't take long for some ass to start abusing this system. It would be nice to know why.

"En Route" by Kelly Grayson looks like a good read, and so does "Rescue 471: A Paramedic's Stories" by Peter Canning. These are exactly the kinds of books that i was looking for. Thanks for the help!

Is it because of a time issue that you don't read? If so, I like the way Kelly wrote his book, each chapter is only 2 or 3 pages and can therefore be easily set down to come back to later....a good book for the bathroom if ya know what I mean.

I was told to clean it every shift in EMT-B, wasn't until EMT-I clinical rotations in a hospital I learned that I should really be cleaning it between every contact. I use an alcohol swab usually or those wipes to wipe down the outside, I do remove the ring on the diaphragm and clean under the diaphragm but only after contact with an infectious patient... too much mess to do between every single patient unless there is a good reason to. I have seen people use those stethoscope condoms but seeing as I'm really allergic to Latex that isn't an option for me

I can understand why some of the Genx/Y'ers may feel insulted, but look at the descriptions that define the various generations. Baby boomers, Gen X'ers, depression era folks, every group has certain traits and characteristics assigned to them. Do these traits guarantee a person will behave/react/exhibit a certain behavior? No, but like any generalization, there is a kernel of truth to it. The reasons for these traits are usually the result of society and parental influences so it would be wrong to simply blame the person. We all are the results of our parents and what we were exposed to growing up, but as noted by scooby and others, we CHOOSE whether or not we are defined by these expectations. This is an article that talks about the entitlement generation in the context of college education and grades: http://www.nytimes.com/2009/02/18/education/18college.html?_r=1 As the parent of a 22 year old, I have a vested interest in this discussion. A very bright kid who attended a selective enrollment, elite high school, who despite his parents both having masters degrees and the Mrs working on her PHD as we speak, his "lack of enthusiasm" for effort and a lack of interest in his education did not come from home. He wants to be a cop, but won't put forth the requisite effort to meet the qualifications(2 yrs of college) It's always someone else's fault, looking for the easy way with the least amount of effort- we've experienced all the defining characteristics of this generation. External forces were obviously a stronger influence on him than the ones he received at home. Is he a bad kid- no, and thankfully not involved in anything bad or illegal- just waiting for the solutions to his problems to present themselves that require no effort. Frustrating- yep. I don't know what the answers are, but I do know that the entitlement mentality is a very real issue.

Thanks for the info guys and gals! Im going to hit Amazon.com and pick up these books.

Also, although not to any extreme, take a clue from M*A*S*H's Frank Burns. His attitude was, any patient who died on him was either unsalvagable, God's decision, or someone else's fault. Having said that, NEVER let it just roll off your back. Follow any and all of the suggestions made, and that will be made, in this string. One or more of them will be the right answer(s) for you.

Key to surviving in any medical field is to quickly review each case. Learn form any mistakes you spot. Then let it go and move forward. Everyone has had patients that could have faired a little better or had a slightly better chance of survival had they done everything perfect, yet none of them are perfect. But you grow as a provider when you learn and improve rather than dwelling and withdrawing.

Good for you brother. I'm grateful you took my comments in the spirit intended. I too think that you will do outstanding. Sometimes we get kicked in the boys and need to rely on our friends to tell us to stop, think, then rethink, and then get back to work. I'm practically a mistake factory. What keeps me up and running is identifying what I would have liked to have done differently, make a plan to help insure that I do so in the future, and then refuse to waste a bunch of mental energy, that my patients can use, telling myself what an idiot I am. I'm proud of you for deciding to be a professional, to take a little time to be confused, accept that that's sometimes necessary, seeking help, steering yourself back up out of the ditch and onto the road and going back to work. Good for you man... Dwayne

... just when I thought I had heard it all ...

That's quite a story, Paul- thanks for sharing it. Sounds like you went through hell and back. Yours is an object lesson anyone can learn from. I tell all my students and new guys/gals that one of the most important things you can do is watch the back of your coworker. We have had several members commit suicide or drink themselves to death over the last few years. I realize you cannot help someone who isn't ready to accept it, but you have to try. Hopefully you can intercept someone before they go down such a dark road that turning around is nearly impossible. Here's a little story. About a year ago, a friend of mine- an Iraqi war vet returned to the job after his tour of duty. As with many vets, he was having trouble adjusting to life back home and ending up with personal problems- a divorce, anger issues, and discipline problems at work. I notified our employee assistance people that this guy probably needed some help. To make a long story short, there was no program in place to deal with vets and their issues unless the person requested it. We all know how stubborn public safety folks can be about asking for and/or accepting help, so clearly we need to be more proactive in our efforts to reach out to folks. My buddy was approached by the counseling staff, was agreeable to the help- thank gawd, because it may have saved his life. He received counseling, the divorce was settled, after awhile felt a lot better, and he's dealing with everything in a healthy way.

You better make absolutely sure you have a patent line if you do this.

You were right on for a while... the reputation system enforces Group Think. Think like the group, get +1s. Think unpopularly, get -1. WE ought to be dealing with differences in ideas via responses with counterpoint, not votes as that is mental laziness. However, I'm not grading people on their english, either, so long as it is understandable and not painful to read. I guess you, like me, aren't sure where to comment on this since the Reputation System thread was locked for I don't know what reason. I guess it makes sense to talk about it in the thread where questionable ratings are occurring.

I would not stick my fingers in there to get it out,just the thought of that.

bummer... but shouldn't this be in "On the personal side"?

That is Stryking information

See and this is what I mean. You are obviously a throw back to the 60's, say "man" a lot, dreads, a "hippie", or whatever if you smoke weed. Just like all people who drink, drink 40's, $500 wine bottles, have flasks and mickey's on them, and their own moonshine still. Let me let you in on a little secret. No one I know that smokes weed wears tie-dye. I think marijuana tends to be equated with ultra-liberal, make love not war, tree huggers, that offends a lot of people in North America. The legal addictive substances (alcohol and tobacco) have very masculine, hard-nosed, get down to business, "cool" mystiques surrounding them. Real, important men drink and smoke. These are men of action, men who make the important decisions that make the world go 'round. Those who smoke weed sit at home, watch TV, probably do other drugs, and eat cheetoes. Drinkers and tobacco smokers are the productive people in society, pot smokers are not (and almost it is portrayed that they cannot be). Yes, I know that historic societal viewpoints are difficult to change. This is one that needs changing.

I would tell you to kiss my butt but I don't want DNA from the many people that you keep your lips pressed tight on, might give me some disease. I speak my mind no matter how unpopular. Sometimes my opinions same as some often its not. I just see no reason for such a cowardly attack.

The above in regards to Jim Carrey. Jim is taking a lesson from Liberace:

That is way to funny,best one I've heard for awhile.