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Subject: Cowboy boots A Lady went into a bar in Waco and saw a cowboy with his feet propped up on a table. He had the biggest boots she'd ever seen. The woman asked the cowboy if it's true what they say about men with big feet being well endowed. The cowboy grinned and said, 'Shore is, little lady. Why don't you come on out to the bunkhouse and let me prove it to you?' The woman wanted to find out for herself, so she spent the night with him. The next morning she handed him a $100 bill. Blushing, he said, 'Well, thankya, ma'am. Ah'm real flattered. Ain't nobody ever paid me fer mah services before.' 'Don't be flattered ... take the money and buy yourself some boots that fit.

A tutor assisting us with some giving sets the other day followed up a talk we had from a nurse on drip calculations, by saying in the broadest accent I've heard in a while (roughly equivalent to Bubba's southern drawl) "Now, forget all that crap. In Ambulance we have two drip rates: s**t loads..and none". I laughed and thought of you for some reason.

I like it! A society advocating for paramedic working conditions, education etc. funded by the whackers among us? I see no fault with this plan. Squint gets a pension, we all get an advocacy group, and everyone wins. It looks like the wheels are starting to fall off for BCAS management. Funny how cars go unstaffed during flu season when a company loses the ability to force overtime and treats its employees like garbage. More and more people are working only their scheduled shifts for reasons of their own. The truth is that people are not abandoning shifts. The tap is simply running dry because we're burnt out. B.C. Ambulance warns of delays due to staff shortages

Without lab work, how do you know what the actual cause for hypoxia is unless it's blindingly obvious (like trauma)? If the patient is presenting as hypoxic, it's appropriate to provide supplemental O2 in the prehospital environment. That's different than providing it because the angels on my shoulder are whispering that the patient might be anemic, even if the patient isn't presenting as hypoxic. Additionally, as shock and hypovolemia increases, you will start to see affects on the brain and respiratory centers. Just because a patient has one condition that doesn't require a treatment (not just oxygen), doesn't mean that it can't cause other conditions that require a treatment. Additionally, in terms of protocol, the same reason why plenty of protocols require any oxygen given to be delivered via NRB mask if possible. Poor educational standards.

Pain induced hypoxia is a good one. That being hypoxia that stems from a decreased minute volume due to pain on inspiration. Namely broken ribs, but I'm sure there's a plethora of conditions that would cause this trouble. Especially for the BLS guys who might not necessarily have any pharmacological analgesia. Seeing as you are looking for experience: When I had my appendix out I had a left over bubble of laprosocopy gas left over which was quite painful for a few days, particularly on inspiration. after a few moments I would start to feel increasingly short of breath which would make me breath harder which hurt, etc. It would come and go in "attacks". Whenever I'd have an "attack", they would whack a pulse ox on, and a nasal cannula and 5 mins later, no troubles. I like the idea of this thread. As time goes on I think we are going to see more precautions and relative contraindications for certain Fi02s. We sit an learn at uni how archaic the "Everyone gets 8 through a hudson" idea is, then we sit down in prac classes and that's exactly what we get taught to do. It grinds my gears.

In response to Ruff and for us to air our opinions here is my reason that I for the most part oppose fire based Paramedics. In the illustration Ruff gave the fire Paramedics were strictly working on the ambulance, fine that allows them to be focused health care providers. But when forced to be multitaskers it is hard to believe they can be the best when divided, ie jack of all trades master of none. Also the Paramedic that is forced to fight fire may just do the minimum because their heart is not in fire and the fire fighter that is forced to be a Paramedic may as well. I also get frustrated when I see so many fire services just raping EMS by taking the money brought in by EMS and instead of making more improvements on EMS they spend it on more fire toys. Another gripe has been seeing the fire services and the fire union actually stand in the way of advancement in EMS. OK that is just a start of this topic look forward to a peaceful discussion.

I have mixed feelings on this topic. To give you a sense of where I'm coming from, I started as a first responder at the age of 16 with a local venturing crew. We did a lot of standby support at Boy Scout events as well as other public events, and we were also given the opportunity to shadow in a local ER and ride along with one of our advisor EMTs on a 911 ambulance. I thought it was cool as hell. I was very interested in medicine, and this experience helped draw my interest further. Here's the pros, as I see it: You get in early, and you learn early on whether or not this field is for you. You are younger and stronger, and have better reflexes, which is always a plus. Exposure is always a good thing. You can develop some very good habits, as you are malleable and impressionable. You can also develop bad ones if you don't have good mentorship, just as it is in any other field. Here's the cons: 16 is way too young to be on an ambulance. I'm lucky that I had a good mentor to guide me, but in all reality I was a liability. I didn't see it then, but I surely see it now. I don't regret having done the program, but I wouldn't have let me do it if I were my parents. There's a reason the program has been discontinued. I'm not the reason, but some of my age-mates were. You really don't know how much you don't know at the age of 16, or even 18. It's very easy to buy into the hero-mentality at that age- all of us wanted to do something amazing, and damn, riding in the ambulance can't get much more heroic! When you're that young, it's very exciting... which can be distracting. Getting into EMS that young and not pursuing a degree traps many at the Basic level for years to come... you're making decent money (better than you would at most entry level jobs in my area), you're doing something interesting, why would you invest in a degree? There are exceptions to this rule, as I can name some younger paramedics who are excellent at what they do. But most of my compatriots from that crew dicked around at the Basic level for a whole lot longer than they should have. I also know that emotional and intellectual maturity vary by age, but there is a reason we have the age of majority. I know that I was much more adept at handling myself and difficult situations at age 18 than I was at age 16, and I know that I am eons beyond that point now at the age of 23. I also recognize that there's a whole lot more for me to learn, and that there is a lot that I simply just don't understand. Also, think about the fact that many companies refuse to insure a driver until they are 21... it's not just because 21's a pretty number, it's partly because statistics show that younger drivers have more accidents. You need time to gain driving intelligence and experience, just as you need time with many other skills. I would not be comfortable allowing me at age 17 to drive an ambulance... and I have always been a very cautious driver. With all due respect to FormerEMSLT297, I would have to argue that the military is a whole different world. Most people are forced to grow up fairly quickly when they enter the military, and it is a very positive experience for many of them. I would say that an 18 year old who has been conditioned properly by the military is better suited to take care of blast injuries and the trauma of war than an 18 year old civilian who's just barely out of Mom's house. There's a system of accountability and personal development in the military. But, I would also argue that the military molds people too quickly in some ways, and doesn't give them enough of the emotional and cognitive tools to deal with the horrors that they see. There's a reason that PTSD and other mental illnesses are so prevalent in returning veterans. I really wish that our armed forces would step up to the plate and provide better mental health care. I see it in my cousins, I see it in a coworker of mine... and if there weren't such a stigma against receiving mental health services, our returning soldiers would be better off. As it is, many of them suffer needlessly and find it difficult to near impossible to re-integrate fully into civilian life. But that's a whole different can of worms! Bottom line: I would say that it doesn't matter if someone is in high school or just graduating, but they must be at least 18 prior to entering EMS. I also don't think kids should be on the ambulance. It's too risky on a variety of levels. I also think that this wouldn't really be a problem if EMS education were more similar to traditional professional or academic education, as that provides you a minimum of 3 years to develop and reach an age where you can be insured as a company driver... ;-) Wendy CO EMT-B

I had first aid classes back in grammar school for "general knowledge" as it was also required. The same for high school. I think the classes actually added up to more hours than today's EMT. However, the intention of the class was not to make one a professional or even prepare them to be an ambulance attendant back in those days. It was a class to introduce one to a few life saving techniques just as the ARC and CPR classes are today. I would not want a 16 or 17 year old EMT anymore than I would want a 16 year old RN taking care of me or any family member. A patient should also have some expectation of privacy that they are not on public display for the amusement of the teenagers in their community. Take the class for your own knowledge or take the ARC classes. Wait until you are at least 18 to make it an official cert and job choice.

There will always be folks eager to show their expertise in a certain area. The thing about a diverse group as we have here is that everyone has their niche and will gladly share their sometimes extensive knowledge of a particular area. Nice to know- sure. Informative- absolutely. Practical and appropriate for this context? Not always. Just take what you need from the discussion, and if your question still isn't answered after all the sword rattling, ask it again. Threads frequently get side tracked.

Nasal? NRB. Thiamine and Dextrose, PRN too... Or so I am told...

Yep, That is because they are parking them in the ground routinely.......

Did the whackers run out of places on their POVs to install more than $20,000.00 worth of lights? Since they've turned their vehicles into 'rolling disco balls', now it's time to start turning the house into a 'dance club'? I'm surprised that no one has suggested mounting a full sized light bar to the ceiling and wiring a power converter into the house electrical system in addition to trying to find a 'trigger device' to activate it! While we're at it, how about wiring a siren into it as well? now THAT will be GUARANTEED to roll even the most 'sound sleeper' out of bed when the next call comes in!

Sheila, the Aussie housewife, stepped out of the shower slipped on the bathroom floor. did the splits and suction-cupped herself to the floor. She yelled out for her husband, "Bruce! Bruce come quick!" Bruce came running in. Bruce, I've bloody suctioned myself to the floor," "S'truth, love. " Bruce said trying to pull her up. "You're stuck fast girl. I'll go across the road and get Bluey to help." They came back and tried to pull her up. "No way, " Bluey says, "she's stuck good, let's try Plan B." "Plan B ?" exclaimed Bruce, "what's that?" "I'll go home and get my hammer and chisel and we'll break the tiles under her," replied Bluey. "Spot on," Bruce said, "while you're away, I'll just play with her nipples." "Hey hold on mate - Play with her nipples? Not exactly a good time for that mate!" says Bluey "No, No" Bruce replied, "but I reckon if I can get her wet enough, we can slide her into the kitchen where the tiles are less expensive".