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So this is not work related burnout, but it is something that I'm sure if affecting many of us and is starting to way heavily on me... absolutely awful spelling and grammer on the forums. I don't mean simple mistakes, like the ones that I'm sure are scattered through my post now, but flat out barely legible posts. It seems that efforts to address this in the read me fall on deaf ears as the attention to detail necessary to read such an important post, is going to be lacking in someone unable to spend the time on basic punctuation and capitalization. Efforts by individual members fall on deaf ears or face backlash. I will be blunt, if I have to decipher your posts due to poor grammer, spelling and sentence structure, I assume you are an idiot and will filter your contributions through that assumption. Regardless of how you perform on the street or in a clinical setting, in my mind you could not possibly be a competent professional. That being said, I can only ignore so much; I'm sure I am not alone. My proposed solution, insane as it may be, is this: new threads that do not show the most basic attention to proper English should receive a PM warning them to edit it or have it removed from Admin. I know this may sound harsh, but I believe it may be the only reasonable alternative to these individuals being tackled by other members. Perhaps I'm mad, but a "great" man once said, in a movie I only kinda remember but think is well known: "I'm mad as hell and I'm not going to take it anymore!" Regards, - Matt P.S. Perhaps this should have been under Funny Stuff? I'm nearing shift change and I'm no longer sure how much of this post was meant ironically.

So much for this thread being a good fit for the "funny stuff" forum! That said I do think it's still salvageable. I think we could have some truly beneficial discussion over the subject of "Lifeline Calls". I'll start. Not too long ago I took a lifeline call at 0300 for a diabetic patient. On arrival we quickly discovered the patient was not experiencing any kind of immediate life threat. This particular old-timer was concerned his BGL might be too high or too low. He had recently acquired a new glucometer and, being illiterate, could not figure out how to make the machine work. For the sake of being a thorough provider I completed a set of vitals including BGL. Having put the gentleman's mind at ease regarding his BGL he promptly refused transport. Do you know what I did instead of leaving immediately after receiving a patient refusal? I programmed the patient's glucometer for him. Then I showed him how to use it. It took me a whole ten minutes and guess what? We haven't been back to this gentleman's residence for anything but real medical emergencies since. Sometimes reducing the number of non essential calls your service does is as simple as spending an extra ten minutes with your patients to make them informed users of the service.

I am a 60 year old man who lives with his family in India. I too work in the medical proffession in a large Hospital in Delhi. I am a stretcher Bearer dealing with the movement of both dead and living patients and visitors. I am of low caste but am reasonbly intelligent and am of a polite and cleanly disposition. I wish to communicate with American Paramedics and learn all about your duties and tasks. It is my ambition is to become a Paramedic myself in your beautiful and affluent nation. Please communicate with me and allow me to fulfill my desires of moving my family to the USA.

So let me get this straight. Me being Afrikaans, or the next person being Hindi, Russian whatever that has difficulty in using grammar properly makes me unprofessional and an idiot? I personally take offence to the stance and claims in the above posts. No-one has the right to judge me or anyone else for that matter on their professionalism based on the mistakes they make here. If anyone wants to be so near sighted and childish as to base their professional opinion of someone else's professionalism on spelling and grammar, shame on you. I still fail to see how someone not being able to spell a word or use the correct grammar (which still remains to explain which spelling or grammar is being referred to, US, UK, Aus, SA English??) has anything to do whatsoever with the persons ability to do what he or she has been trained to do, alleviate pain and suffering.

I agree with what everyone is saying here. The problem that I feel is being overlooked is that she is a volunteer. Im not sure how NJ defines duty to act, but where Im from its really a grey area. Just because the department drops a tone for a medical call doesnt mean I have to go. (of course Im gonna go without question) My legal duty to act doesnt come into play until I check en route over the radio. I do both paid and volly work. Personnally she needs to pull her head out her butt, and remember that its the citizens that provide the funding for new equipment, and that she has a direct impact on the PR of her department. If she isnt goint to take care of the citizens she is sworn to protect. If I was living in her district I would be appauled if they asked for additional funding. From a patient care stand point Im not going to allow a guilt cloud over my head cuz a kiddo had flu like symptoms and crashed. (I know that it maybe far fetch).

Historically, medications and such always do take longer to be approved in Canada than in the US. I had my doubts on getting the H1N1 as there is really no information on long term effects of the vaccine. There was no scare tactic used on me such as how the media whipped everyone up into a frenzy, then told everyone to stay at home if they have the flu unless respiratory difficulty is present. I made my decision on the information available and had the shot. If my shoulder necroses in 2 years and moves my elbow to the other side of my arm, well, it was my decision. (I'm double jointed anyhow)

AS a PALS instructor, The Pediatric AED pads have essentially a " Voltage Regulator" that will dial down the joules from 360 - 50 joules....If they are in VFIB / Pulseless Vtach and the 6H's and 5T's have been ruled out, you NEED to be shocking the patient....End of story, regardless of age.....The bottom line after all the BS and anecdotal crap, is you still have a lethal rhythm that is potentially reversible..... Not quite sure why so many people are afraid of the NEO / PEDI population, Dead is Dead, they will continue to remain DEAD if you do nothing....... Respectfully, JW

I have to disagree doc...to an extent. I'm with you all the way when it comes to those who speak the English language as their native tongue, but, for those who are trying to communicate with their counterparts and don't have the English skills we were raised with, I have to cut them some slack. Over the years I've chatted with many who have a poorly constructed post only because they are not all that familiar with the language written in these forums because these are not just American forums, but world wide. Isn't that the whole purpose of websites like this? To be able to simplify communication with our counterparts across the globe? To dismiss these people out of hand as being idiots is nearsighted at best. Just last summer I gave a tour of my EMS service to a medic from Hungary who didn't speak a word of English, but when the translator with us was unable to interpret the phrase "subarachnoid Hemorrhage" the medic knew exactly what I meant. From that point on I continued to use as much Latin as I could so I wouldn't have to dumb it down into words our interpreter could translate. Yet another context to consider is those who have a different regional dialect or regional spelling differences than some others. For example, Those from the U.S.A. put "ize" at the ends of words such as victimize or realize. Those in the British commonwealth use 'ise" as in realise and victimise. I've even had people call me an idiot for that very reason because in their arrogance they assume that everyone should communicate just like them. Edit: Nice post SA-Medic, guess I'm a slower typer than you.

I am one of the guilty parties with regards to spelling, grammar and sentence structure. What I would like to state though, is that this site has become more and more international. Not everyone in the freaking world speaks "American English" in fact, not everyone speaks English in their daily lives. Looking at my daily work live as an example, if I spoke 20 words English in a day, it's lots. Sadly, there's more than one English "dialect" in this world. How you, as a professional, feel you are qualified to judge someone an idiot based on their English proficiency and therefore judge them on a professional basis even though you personally do not know them is beyond even my "idiotic" grasp. As for AK's msg on the new shorthand, agreed 100% with you dude. It seriously gets my back up, I do not have the time or energy to even try and decipher what the person is trying to say. For interest sake, if you use Firefox as a browser. It has a built in spell check facility.

Paramedic at my service are now officially helping with Public Health at the community clinics and are now being set-up to run some mobile clinics in the next couple weeks. This is all above and beyond usual coverage and does not impact response in any way/

I am with you completely on that...and I think that's what Vent has been trying to say. By caring for your patient and taking the time to program it and show them how to use it, you have avoided further "abuse." Now if only more people would take the time to educate their patients instead of blow them off as abusing the system...

So far public health in BC hasn't made any attempt to use paramedics for H1N1 inoculations. I guess they would rather spin their wheels with far too few public health nurses available to provide the mass inoculations needed. It doesn't make any sense to use 3500 capable paramedics to provide vaccinations enmass does it? Why use the very crews you would call should someone have an adverse reaction? There's no way paramedics could possibly vaccinate nursing home residents in their homes is there? Paramedics couldn't possibly visit schools for an afternoon to provide vaccinations? Ah hell most of BC's paramedics haven't been inoculated themselves yet. Providing care in someone’s home doesn't put you at any kind of exposure risk does it? Just last week I treated a possible H1N1 patient. 39 y/o female, hx. of asthma and fibromyalgia. She had just come home from the hospital 20 minutes before where she had been treated for SOB with Ventolin (Albuterol) and Atrovent. Her initial room air SPO2 was 77%, with wheezes throughout, poor entry to the bases, and course crackles up to the mid lung fields. She had a fever @ 39 deg Celsius, chills, and diaphoresis. I took precautions before getting within 20 feet of the patient wearing an N95, eye protection, and the usual gloves. My partner, an old timer who was convinced this is all a hoax so drug companies can make a killing, did not take any eye or respiratory precautions. Not wanting to contaminate the ambulance, I treated this patient with 5mg Ventolin in 5mL NS by nebulizer on scene. Guess which one of us, myself or my partner, is now isolated at home with a nasty case of the flu. This is the real thing and the only way I know of to stall the spread is mass vaccination. Every deployable resource needs to be put in play and I have yet to see it.

I agree we shouldn't be social workers...but part of our job is prevention is it not? Do we not help install child safety seats to protect children? Do we not go around and help check smoke detectors (my county started this last year of going door to door and checking every single smoke detector after a string of deaths related to malfunctioning smoke detectors)? Do we not have slogans to buckle up? Or wear a helmet to school aged kids? Part of our jobs is to prevent injury and death. If this also includes service calls to help someone into bed to prevent them from falling and breaking a hip or worse...then so be it. It is part of the job. If you don't like it, work to fix the system instead of complain about it. Work with the patients who call once a day or week to find a better solution. When I was in EMS we had numerous frequent fliers, whenever we did transport the patient, I would make sure the hospital got a social work consult for them. If we didn't transport and it was serious like they were falling or continuously unable to get out of bed on their own or walk to their bed then I would call the elder abuse hot line to get social services involved. Be proactive. We are often the only advocates for these patients. EMS isn't all about the glory and saving that code or running that big trauma. It's often about making a difference in peoples lives sometimes on the most basic of levels. This isn't all to say that there isn't abuse of the system, but unless we do something to educate and solve the problem the abuse is going to continue and probably get worse. WOAH... I just saw this... When is it EVER okay to damage an alarm box for a patient???? It's the Boy Who Cried Wolf Story...and in my eyes as the patient...they have every right to sue those medics! Also, why is it the higher ups job to get them into a nursing home...why not be proactive and take the steps yourself?? Patients always need our respect. Unless you yourself have been disabled and faced what they face you have no right to judge them and treat them with a lack of respect.

If you have worked in research for 25 years, then surely you know that sound medicine is based on dispassionate scientific study, not an overly emotional response. Certainly you must realize that the link you provided has no scientific merit, its an opinion piece that states only a hypothesis- the "cytokine storm" theory- is the cause for mortality amoung the young. In fact, it states numerous times that more research is needed, and the only tangible evidence stated is the rather underwhelming fact that "proinflammatory cytokines are elevated in the presence of influenza infection," basicly informing us that the immune system responds to infection. Although an interesting, and possibly correct hypothesis, your "example" falls far short of answering your rather haughty query of how the virus works and how it effects the immune system. I'm afraid that with your lack of compeling evidence, tnuigs will not, in fact, back off. Lastly, I believe that Health Canada has been quite dilligent about ensuring that this vaccine is safe, which is one of the reasons it took longer to be released here than in the USA.

Now there is certainly a lot of feedback on this one ... here's my little opinion. My service does in fact have a bariatric unit, I guess we're fortunate for that. We've apparently gotten good use of it, fortunately I've never had to call for it myself. Not entirely sure where I stand on this ... I mean, I think huge people on airplanes should pay for two seats if their rumps spill on over onto my seat. It's annoying when you have one hip going numb because some butterball is taking up 7 inches of your seat. So, should there be a separate fee for use of the twinkie truck, it's oversized stretcher and hydraulic lift? Probably. It's unfortunate that people let themselves get THAT big, however I'm always glad when I don't have to try and "move a mountain" ... hehehe

Nothing exciting really, just the typical ones ... mild headache, nausea, low grade fever. Weak/tired as well, which bothered me the most. I don't think I had ever been exhausted to the core like that before ... still, better than the flu.

Back off on a debate? That is now called pandemic and causing panic because of the lack of enough approved for use vaccinations, well, I for one actually trusts my National Health Care Advisors, maybe this as you put it self serving political leader was way smarter than all of us here, her staff I bet are now immunized so she most likely accomplished her goal. http://www.hc-sc.gc.ca/ahc-asc/index-eng.php Or should we just do a goggle search and check out all the real snake oil and profiteer's capitalizing with the magic cure, gogi, silver coins and a plethora of other crap and misinformation ? In this thread and others related there have been quiet a few actual evidence medicine studies been presented the use of ventolin (and delivery means) in the H1N1 patient thread presented by mobey and I saw no comments by yourself and an excellent post in this thread by one explaining for this demographic audience the immune response, perhaps you did not read that one? So if you call yourself a researcher then why would you post a link to a news article Published: April 30, 2009 when the first wave was reported in mexico (the virus has now mutated and spread at an incredibly rapid rate even beyond the projected models of WHO) the link is very dated with opinion and some conjecture by one retired MD and no where in that article does it state adverse effects short or long term with the present vaccine in production both varieties, it is quite clear in the news article cytokine storm" or hypercytokinemia that may be causing death more frequently in younger adults,(proven now in Ontario) and now even more evidence since that time in regards to increasing incidents in ARDS, again higher than expected but I would you like to discuss that item as I would be most happy to discuss that topic, although the vast majority of readers in EMT city would be scratching their heads from tying to understand Arterial Blood gases analysis alone, no offence intended. We will agree to disagree that this thread initially presented in a knee jerked manner does have more merit and in regards to another topic that we prematurely eat our own and solidarity for a cause affecting the safety of EMS and First Responders IMHO is sadly lacking, quite clearly you took the bait and responded emotionally, I have plenty of time on my hands to debate because I was not as fortunate as Siffalass and am sequestered to my home. cheers

I'm curious what side effects you had, if you don't mind sharing.

???? Harsh. Are you sure? Could you elaborate on this with some details?

Err, he's been banned guys

Welcome aboard, Gupta. We have a bunch of countries represented in this "city", and to the best of my knowledge, you might be the first from India. I have to be a bit of a negative person in one regard: While we don't have a "caste system", were you to come to the United States, you could definitely get the training for working on an ambulance, but be discriminated against due to your age. I'm 55, which is old enough to retire from my employer, the Fire Department of New York City (FDNY), in the Emergency Medical Service Command (mission specific, as I don't fight fires), and have been so employed almost 25 years, a different way to reach retirement. However, I sometimes wonder if either my age or employment longevity has become an issue used to prevent me from getting a lateral transfer to something like teaching at the EMS Academy, instead of working on an ambulance. Having said that, I still must say that your experiences, were you to attempt to get employed here in the United States, might be totally different than mine. Good Luck in all your EMS endeavors, and again, welcome aboard.

Welcome and can't wait to hear from you in your postings ! I always find it exciting to learn from those around the world. Take care and be safe.

Here's one of the papers the 2005 recs cite: http://circ.ahajournals.org/cgi/content/full/107/25/3250?ijkey=af2ae50aebcf6ba19653bb2ebdbbe24a7a0462d7&keytype2=tf_ipsecsha But that doesn't distinguish between pedis older and younger than 1. And that's from 2003 anyway. If anyone has newer data it'd be nice to see.

Here's a news flash for you Herb, the new education standards are coming out whether you like it or not. Having 4 -7 different levels for EMS providers each state and each state different from each other is of no benefit to EMS, the patient or the individual who tries to move from state to state. I grew up, got an education and starting working with those who didn't just sit in the easy chair at the station spewing complaints about their patients, their job and their life. Read you own negative comments on this forum and use those as an example to what I am talking about. There are some secret ways to staying in a profession for over 30 years and that is not to stop learning and not to put up with crap from burnt out EMT(P)s who have long ago stopped caring. I continued my education to make a difference and some can't handle change. I think your arguments for the many different levels and that everything is fine in EMS have demonstrated that attitude greatly. It is time some in EMS decide if they want to be part of the future or it they should just get out and shut up if they have nothing productive left to offer this profession and the public they serve. Change is coming whether you like it or not. Maybe you should also broaden your reading opinions from more than just an anonymous EMS forum. Have you even been to a regional, state or national education meeting to discuss anything pertaining to EMS? You actually know a few people on this forum that have and it is a shame you consider all of them "out of touch". I'm sure Dr. Bledsoe likes hearing he is out of touch. How about Rid? What about our two ED doctors that take time to educate those in EMS and support the providers? You generalize and bash way too many things and people you know very little about.

It truly sucks to be a patient advocate in EMS. You can always expect to be bashed if you offer the views from the patient, hospital or HHA's side on some situations. Tell us about your experience with disabled patients and home care situations. Have you done anything to improve the situation? Have you talked to quads, paras and the elderly about their frustrations? Have you talked with the reps from LifeLine or whatever company in your area? Have you offered training to the home health agencies? It may sound like I'm over the top because I provide additional information and not just find someone or something to blame. Seeing the situation in only one dimension does not give you a full view of the problems. Blaming the patient is the easy way out. Of course, some in EMS would rather just piss and moan on an EMS forum about their dislikes about the system and patients rather than attempting to assist companies to find a better solution for their clients and patients. Thus, you become as much of the problem as those that "abuse" the system. As least HERBIE is consistent. However, he doesn't consider the budget cuts that have put patients into home care situations with inadequate resources. I seriously doubt if he has participated in any petitions to get more funding for Medicare. EMS is a "me first" profession which is also why it doesn't get much support from other healthcare professions in some of their efforts for better funding. Other professions (NP, PA, RT, OT, SLP, RN, PT, MD) include the patients when they are lobbying for better reimbursement and funding. They don't criticize medical needs patients or the agencies that attempt to provide the with care. They try to work with these companies to see how the patient can be benefited and in turn, it usually benefits them as well. But for some opinions here, it would probably be easier just to build large nursing homes warehouse style instead of trying to work out some home care situations. Now, for those who want to say "I'm over the top" again, please for to the national association websites for any of the professions I mentioned and see what legislative actions they are working on. I don't just pull this stuff out of thin air. It comes from many years of being active in both of my chosen professions. Unfortunately, EMS has been the toughest for legislative issues largely because of the "me first and only" attitudes that exist in this profession. This is true for some individuals and the many different agencies that do EMS. It is also evident by the 50+ different certs this profession has just to please some and not for the benefit of either the profession or the patient. The new big screen TVs, patio furniture and barbecue sets are a pretty nice also. I also find that those who run only 2 calls per 24 hour shift complaining the loudest about being overworked with LifeLine calls. Those in busy areas are usually relieved when it is a public assist patient where the lifting and paperwork are minimal.

The system is not perfect and the OP did not state what other resources the quadriplegic person had. I would hope that he had a voice activated phone but for some that might not be the case. Also, some systems do call the person before sending a fire truck and an ambulance. If it is not emergent, the primary care giver might be called. The systems are not always perfect but by no means is it always the patient's fault. Find out how the system can be improved and don't just lay the total blame of inappropriate use of EMS on the quadriplegic person.

Rock shoes.... I have to agree with you that paramedics from poor producing programs will not be suitable for such a program as an Advanced paramedic practicioner. However, that level of pre-hospital provider is exactly what is needed. Part of the issue is that we need to get our educational standards down as a nation and not by state.. But that is a different thread altogether. I actually find that the PA's skill set to be more towards the paramedics than a NP. NO offense to our nurses. But once again we have to talk dollars. You can pay a NP or PA the going rate, or a Paramedic their salary with some extra benies and save money. This will actually help to keep taxes under control, and provide the revenue for more positions. i think this goes back to the discussion that WE as providers (EMT-B to Paramedic) need to raise our standards not lower them. To bad we don't have as strong a lobby like the nurses do..... By the way. One of the services out in Pitt tried to put a flight crew (Nurse and Paramedic ) in a chase truck to do such things. Help Paramedics in trouble, do house calls for minor things. All the skills and knowledge of a flight crew in a truck, maybe even have the flight Doc on certain days. But no.. The State medical director put the Kybosh on it.... I hate backwards thinking, risk adverse morons.......but that is just my opinion. Cheers

Fat people get FAT by eating way more calories than they burn off. Ever been at a restaurant and watched a FAT person eat. They don't order a small salad and a water. They order a big deluxe triple cheeseburger and a large fry along with a desert , Oh and don't forget the 32 oz sized DIET coke! Like the quart of DIET coke will keep them from putting on weight! [ Hope you note the sarcasm ] To blame a "medical issue " as the reason they are FAT is just a crock. They eat too much, period. Yes once they get fat, they more than likely develop health problems. I treated a 5' tall 10 year old recently that outweighed me by thirty pounds. I'm 6'2" & 205 lbs, same weight as 35 years ago when I got married & 10 lbs more than when i graduated from High school.

http://www.medpagetoday.com/InfectiousDisease/SwineFlu/13989 Not one for the conspiracy thing. However, I am a parent. I have worked in healthcare and research for the past 25 years. I do not jump on the bandwagon of panic and immediately trust a shot that has not been proven to protect myself or my child. It may react differently in my child than it does me. Do you even understand how this virus works? How it affects a healthly immune system? As for what this thread was originally started for, yes, I think that gal was self serving. But WTF, let her push everyone out the way and trample her way to the front of the line for her shot. Back off Tniugs.

This is a huge opportunity to exchange ideas and information we are in your debt if you would share some of your wisdom, you live in an extremely beautiful country and as of yet I have not been afforded the opportunity to visit but I do enjoy the cultural food especially samosa I understand it is considered a "snack" but I eat them as if a meal, is this acceptable I suspect NOT? My first question and please excuse my ignorance of the caste system, please correct me but if you were born into a family for example a shoe maker would you then be forced to become (as the son of a shoemaker) become a shoe maker ? Leading me to my next query ... what caste were you born to ? Your Hospital in Delhi your position would most likely be called a Porter in the USA, and besides movement of patients within hospital do you transport in the community as well and by what mode of transport do you use in Delhi, motorized vehicles and what type 4 wheel or 3 wheel or 2 ? And a difficult question the understanding between wealth versus being rich, I have visited and worked in some "considered" 3rd world country's, this has always confounded me why would you wish to leave your homeland and live in a true RAT RACE we live in in North America with the high incidence of Cardiac illness and Cancers related to processed foods and high stress lifestyles ? cheers

I am aghast with shock and indignation ! Am I alone in thinking that the very fact you even considered taping a purile American sit-com before going on a priority detail showed a gross lack of proffessional , moral and ethical responsibility ? I will not recant my original statement regarding your actions. What is more my colonial cousin ! In England Ambulance Services are run with military precision. Between jobs we do not lark about watching television. We are given a myriad of duties, ie cleaning vehicles,cleaning the Station,checking stocks etc,etc. In England we have no time for slacking ! I can only assume your indignation has been caused by the guilt that my wise words have provoked.

(no bearing at all) So whats the difference cause virus's are not as big as a threat ..... no I don't buy it for a millisecond, nice try though During WW1 more died from Spanish flu than in combat (just a little comparison to blow that comparison out of the water) And just on the news again we lost another 14 year old boy in Ontario, arrested at home and EMS responded ... it took just 2 days for him to die, a 13 y/0 girl the day before, no history, healthy kids this just not unexplainable we don't understand it yet. If you somehow believe that wearing a mask gloves and glasses is adequate or you believe that your training on any EMS level is adequate for infectious disease control for aerosolized particles and decon of truck .... please think again. I comment this EMT for taking a stand ... now if you will excuse me ...I have first wash my keyboard and then go lay down, cause i am good to no any one right now. cheers

Well Mister Im replying now ! Edited by AK..! Oh my god ! That a fellow American and a Medical proffessional should act in such a callous and heartless way leaves me shocked and hurting deep inside. I am so not happy with your disrespectful attitude. Im in a dark place far from my comfort zone. Your lack of empathy is sickening.

Fuckin' OUCH!!!!!! I was going to point you towards UK immigration requirements, but having just been insulted (or is it libeled?) I will leave you your own discoveries. BTW, do the UK still own India?

From one urban ems'er to another thanks 'tsk' for giving ventmedic what for. We have a ed alarm abuser that has been know to press it 3-5 times a day. Medics have "damaged his alarm box" and used all means possible but the ems higher ups have yet to do there job and get him in a nursing home. This pt doesnt need our respect or lessons on being disabled he needs to stop abusing the system. This is just one example of abuse. Thankfully you didnt need ems tonight where we ran for 2 hrs constantly out of squads.

Point taken: Thing is sometimes you have to stir the pot a bit to get results and this swine flu panic generated over the long term will go a very long way to educate the non believers for all vaccines IMHO. I think tom5706 makes a very good point, you can't knee jerk response demanding an immediate yank a licence for an news interview to enlighten only, can you? I just believe in free speech we so need more leaders in EMS like her, I would bet shes on the road today is my bet ! On to the hand washing vs other methods to keep this thread on an educational track: Oddly enough both these papers present somewhat opposing findings, but note well the non enveloped virus and from my background an 70/30 or 60/40 blend of alcohol based antibacterials rupture the cell wall of the bacterium. So next on my little research project is does this release the virus attached to RNA/DNA ?

Looking at the second study, my question would be what the definition of "significant." For example, transporting with lights and sirens "[statistically] significantly" decreases transport time, however it is rarely "[clinically] significant."

In my country we believe a man convicted of outragous offences of criminal activity or lewd acts of sexual or moral perversity must suffer the consequences until the day he dies. A man who is a criminal or murderer or fornicator must be punished and allowed no respite from persecution. Only in the next life is he free to persue a career in emt . His past sins will only then be absolved.

Yea Health care is all a government conspiracy, hello this is just one little strain of the yearly vaccinations. Yup agreed, Polio has damn near been eradicated from the face of the planet, TB affects the same level of individuals in North America, Meningococcal vaccine does work and hasn't stopped outbreaks, should I go on or should I just your pull your head out of your ass ? Yea there's very occasional unwanted side effects and/or death but compare the risk benefit ratio and well words escape me btw American Pediatric Society has proven that the level of mercury (more in a Tuna sandwich) does NOT lead to A.D.D. but I ain't doing the links for you. No just following the most knowledgeable medical minds advice in the free world and she is making a public wake up call oh yea the shame of it all. Yea Karma, it treats influenza A, Hep B and A, TB and works on yellow fever too.. Not the point at all yes theres always something out there to catch its called ignorance and it appears some need a vaccination for that too. come visit said the spider to the fly .....

Well put. Just as not everyone is cut out for medical school, not everyone is cut out to rise through the ranks and become an administrator. I equate this issue with the world of academia, a world my wife is intimately involved in, and I dabble in as adjunct faculty in a university. Many ideas come out of the hallowed halls of a university, but thankfully precious few of them are ever implemented. Why? Because they are impractical and do not take into account the problems of applying them to the real world. The bottom line is that NOBODY is advocating disrespecting someone who is an invalid, or ignoring their needs. I simply know that I am NOT trained to be a social worker, a gerontologist, a psychologist, or a rehab expert. People spend YEARS training for these professions and I would not presume to understand the intricacies involved with addressing the needs of this population, nor would I expect someone who saw Rescue 911 to be an expert on prehospital care.

I am very dismissive of it, 5000 EMS providers (rough estimate) cover NYC's 9-1-1 calls throughout 5 boroughs ... NYC's population according to the 2008 Census is 8,363,710. Do the math, its a great idea but its not practical. Our call volume already taxes our system, during peak hours lower priority jobs can easily wait for over an hour before an ambulance even begins to respond.

Change, for change's sake is not the answer. You have a clear bias toward providing social services to our patients. I do not agree that is an appropriate or even logical use of EMS services and resources in cash strapped communities, especially when these are best addressed by another profession that has the proper education, training, and resources. I don't care how many levels of providers there are if they can be justified. That's like saying that a small town looking for a doctor should not be satisfied with anything less than a John Hopkins trained neurosurgeon to be the town's sole Family Practitioner. It's not your material I have the problem with, it's your attitude. Everyone has their own opinions and are entitled to them, but you pontificate, belittle, and generally act superior to most here. Generalizations are fun, aren't they? I wondered if you would get that part. I also made the generalization that most here are not as lazy as you describe them to be. Why no comment on that? As for "burnt out", like many I went through a phase, but got over it years ago. Like many in busy urban areas, things beyond our control DO affect you. Some remain that way, some self medicate or engage in self destructive behaviors, some leave the profession completely, and others change their attitudes. I learned to adapt, get educated, understand how things work, and a stint in administration also opened my eyes to a lot of things most street level providers have never seen. Things are never as simple as they appear. I prefer to be proactive in my own venue and use my experience and education to effect change from within. I teach, mentor, and explain why certain policies are the way they are. I dispel common and long held myths about how public safety works, citing appropriate references from my studies. I am also not arrogant enough to claim proficiency in an area I received no formal training in.