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Sorry Squint. Nurses trying to take over paramedic jobs sets me off some days. Nurse/Paramedic turf wars should be a thread all unto itself. As for the IAFF, comment left. Point of fact, I'm ashamed of MacLean’s for publishing such tripe. I wonder how much the IAFF paid MacLean’s. I'm no business major but it's impossible for me to fathom how staffing a pumper or rescue for medical calls is more cost effective than staffing an ambulance.

Now Im not a scientist but girls lets hope this stays in the bed bug population http://www.boingboing.net/2009/12/17/bug-powder-causes-ma.html

A109 E SWEET ! So we have room to move and work and no turbulence ... I wish I would be thinking: 1: Drowning/ Near Drowning. 2: Box Jellyfish, Stone Fish, Irukandji,(sp) Portuguese Man o War ? 3: Bent or Pulmonary Emboli, as not a professional diver. 4: Hypothermia ? Have WE made contact with patient and are we prepared with PPE if the case of the marine critters are still on the patient? Any history to to event: Like lhat is being done in the back of the truck ... is patient awake, is the pt intubated, wearing a scuba or sting resistant suit, whats being done for this patient ? cheers

On or off shift does not matter, the facts of the call are this: 1. You did not cause the injury. 2. If the neurosurgeons could not save this person, then it is doubtful that a paramedic/emt could either. 3. You mention mistakes were made, but again, those were not made by you; they were made by others. If you could magically go back in time and respond to the call, I am guessing that there is a 99.99% chance the outcome would still be the same. Maybe the call would have been smoother, maybe you would know that EMS did all that it could do, but massive head injuries rarely have a good outcome no matter what is done. There is only so much that we superheros can do. A famous quote can be borrowed from the TV show MASH that relates to this issue: "1. Young men die in wars. 2. Doctor's can't change rule # 1." The same is true of EMS, definitely go talk to a counselor.

I'm going to be blunt and I'm going to do it in the open forum because this is something that everyone who is suffering from a similar problem should see. If it has been a while from the incident and it is still troubling you this much, then you should probably seek professional help. There is absolutely nothing wrong with seeking professional counseling over this. Seeking help (real help, not forum help) doesn't make you weak, just like someone calling 911 because their having a heart attack and using your professional services as an EMS responder doesn't make them weak.

What she said! Seriously, the most common mistakes I see are: 1.) Placing leads V1 and V2 one intercostal space too high on the anterior chest (in some cases even higher) 2.) Placing leads V1 and V2 too far apart (make a "peace sign" with your fingers and you should be able to touch both electrodes) 3.) Placing lead V3 directly under lead V2 4.) Placing lead V4 under the nipple instead of visualizing the midclavicular line Other common mistakes that aren't related to lead placement are failure to undress the patient from the waist up and leaving a female's bra on. Protect a female's dignity and get her covered up as soon as possible, but don't place leads down the front of a shirt or reach up under a bra. It's absurd. STEMI patients should be completely undressed (similar to trauma) anyway. Beyond that it's just taking pride in your workmanship. Shave the chest (hopefully for male patients) and use the benzoin tincture. It works! Also, if you're using rectangular electrodes, line up the edges and make it all symmetrical. It helps keep you organized. There's no value in putting some lengthwise, some width-wise, and some diagonal. Make sure the leads aren't all tangled up. Strand them out individually to minimize artifact. Don't wrap the O2 line, the IV line, the ECG line, and the BP line together. It's a mess, it looks unprofessional, and it's harder to troubleshoot problems. Be sure the patient isn't holding him/herself up with his/her arms. The muscle tremors will be noted as artifact. The patient should be in a relaxed semi-Fowlers position and breathing normally. You can lay a towel and/or blankets on top once the electrodes are placed to minimize shivering or Parkinsonian tremors. If you don't settle for imperfection you will almost never have problems with poor data quality (which confounds computerized measurements and interpretations, makes nuanced interpretations more difficult, and harms the credibility of prehospital 12-lead ECG programs). Good luck! Tom

I deal with reciprocity for inbound medics to our company. Texas, Louisiana, and Mississippi accept NREMT for training. Application to the state is a form from the state website and a fee, generally $60-$100 or so depending upon your practice level. Basically you are obtaining a state license. There are other requirements, i.e. fingerprints, background investigation, etc. Sometimes this can take time, so plan your move accordingly and start well in advance in you are thinking about that. Hope this helped. Terry EMT/Paramedic Recruiter Acadian Ambulance Service, Inc. 800-259-3333, ext 1571

when someone is sick or injured

That chicks got some wheels on her she caught my escalade 97

Rhode Island uses them and it seems to be a huge joke because a big contraindication of them is < 5 minutes from a hospital. There are very few places in RI that are more then 10 minutes from a hospital. Had to learn them in my basic class though. One of the instructors told us that there was some documentation from Texas saying how using them causes people's hospital stays to be longer. -Bamx

OK first can we take the helo scouting for elk? Secondly if we go in the direction of the bends then we are going to have to fly low not to aggravate the situation more. gotta due some research to be productive at this level but i'm stickin with the scouting for elk plan