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I don't care whether it can be proved that her actions caused the death of the patient or not. Her decision to go to the far hospital was not motivated by the best interests of the patient but was in fact what was convenient for her. EPIC FAIL. Add to this that the medic admitted lying about the reason for the transport destination and there is no reason on earth that this person belongs in a patient care compartment or anywhere else that professionalism and dedication to the well being of other people is in her hands. And for this she gets 4 years of back pay on a legal technicality. The fact that the department couldn't get its act together to deal with this issue on a timely basis, not to mention its responsibility to ensure adequate standards for caregivers do the public a disservice beyond belief.

Prudent advice chbare - as usual, however, I have always had more guts than brains and I am not a stupid woman. I think my postings are a credit to my company because for all my faults, I have always been and will continue to be motivated by a search for insight, education and input all for the purpose of becoming a better provider. I don't like lawyers and won't get involved in a legal fracas. If my company doesn't want me around, then I don't want to be there. I am certainly not in the business for the money. I will not be intimidated to shut up. If I have broken company policy, I will take the correction. It certainly was not intentional. I am the one that has to look at myself in the mirror every morning (not a pretty sight now that I am in my 50s) and I can only do that if I stand up for what I think is right. I appreciate the messages of support. Believe it or not, this is me shaken and upset.

Ive seen some local fire trucks around here at Subways, KFC, and the such. I wonder just how wrong, i.e. funny, it would be if one of these trucks pulled up at KFC with the PETA ad on the side...lol And I just have to say that meat is muder.................... Tastey, tastey murder. Yummmm *I wonder if I will start getting negative votes now lol

1. You can't keep your story straight. That's not what you just said. 2. The B key is nowhere near the R key 3. There are standards in EMS. Maybe you should learn about them.

Just when I thought I had seen it all - there's this PETA wants to roast KFC in ads on city fire trucks By CHARLES WILSON - Associated Press Writer INDIANAPOLIS -- An animal rights group figures if KFC can use fire extinguishers to promote its chicken in Indianapolis, it should be able to denounce cruelty to the birds on city fire trucks. People for the Ethical Treatment for Animals made the $7,500 offer in a letter to Mayor Greg Ballard after the fast-food chain announced a deal this week to help pay for fire extinguishers and smoke detectors for the city in exchange for advertising on them. The ad proposed by PETA shows a plucked and scalded chicken alongside the taglines "Chickens Are Burned To Death At KFC" and "Boycott Cruelty." PETA claims many KFC chickens are scalded to death during processing at the slaughterhouse. A spokeswoman for the mayor questions the propriety of placing advertising on public safety vehicles. So here's my question is this what Indy fire will be sporting this fire prevention season? ONLY YOU CAN PREVENT BURNING DINNER

Also remember these equations people spit out: H30 + HC03 <-> H2CO3 <-> H20 + CO2 & H20 + CO2 <-> H2CO3 <-> H30 + HCO3, have a tendancy to form an equilibrium. Not equal parts, but no net change in reactant and product amount over time. Unfortunately, the human body is so dynamic that there is a constant struggle to maintain equilibrium. With that, something known as le chatelier's principle comes into play. Essentially, when you change any number of variables such as concentration of products, reactants or change temperature or pressure and you change the system, thus causing the system to attempt to re-establish equilibrium. A simple example: Reactants = A & B, Product = C. Formula in equilibrium = A + B <-> C. Now, let's play: I increase the amount of reactant A, le chatelier's principle dictates the formula will shift to the right and make more of the product C in order to re=establish equilibrium. Likewise, adding product C will cause a left shift and production of more A & B in order to re-establish equilibrium. This can help explain what giving somebody bicarb can increase the CO2 levels. Clearly, a bit more complicated but a good start to understanding more than the simple formulas you learn. Hope that helps. Take care, chbare.

Once again, I remind everyone here of the OTHER PETA: People Eating Tasty Animals!

Hmmmmmmm Anyhow, the NREMTP test is very simple. There are no tricks to passing it other than knowing entry level paramedic information. If you have to take the test more than once, I would look to the instructors, or maybe EMS is just not your bag. I re-certify every two years by the test, even though I have enough CEUs, just to keep tabs on the testing. I think the CBT is much easier than the old written, and I am sick of hearing how the man has put it to the "would be paramedics" taking the test..Conspiracy theory 101 is in session....

There have been reports and studies showing a direct correlation to reduced mortality and morbidity with higher educated nurses (ADN vs BSN. Something from the ACCN: I am curious where you get the information about the basic education classes included in the BSN programs, if you have not gone through one yourself. Your "BSN MGT 101" reference seems to be a sticking point for you. If you believe the only difference between associates and bachelors degree is this, you are sorely mistaken.. There have been many reports issued that also state that a major determinate in good patient outcomes is education of the caregiver, not experience. We could debate this all day, and the evidence to the benefit of BSN can be presented as well, I seriously doubt you will be swayed so the point is moot... Source: http://www.aacn.nche.edu/Media/FactSheets/ImpactEdNp.htm

That's an excellent, albeit sad point. It's the pervasive culture in EMS right now. When people join a new crowd or profession, they want to fit in. To fit in these days, mediocrity and apathy are key. Few dare to be different. Those that do are often isolated and ridiculed. It's damn difficult to change the culture one person at a time. But so long as the firemonkeys and vollies maintain their stranglehold on the political powers, that's really our only option. They will never allow EMS to become a respectable profession, where one can proudly practise excellence.

Lots of good ideas here, and as always because of differences in training, protocols, sizes of patients/ providers, transport times, back up availability- there is no one solution to a problem such as this. Experience will tell you what you need to do, and as has been mentioned many times, self preservation is the best policy- whatever it takes to stay safe. Also- listen to that little voice inside your head. He gets more and more brilliant, the longer you do this job. If you have a feeling someone may act up- BELIEVE IT, and be proactive. I'm always hesitant to use restraints for several reasons. First, in order to safely apply them, you need tons of help. Trying to tie up a combative patient with just 2 people is a recipe for disaster- someone is going to get hurt. Couple that with the confined space in the back of a rig and even if you have tons of help, you quickly run out of room, especially if you only have access to one side of the patient. Another reason- I have seen PCP ingestions where the patient treated leather restraints as if they were toys and snap the buckles. ideally you would apply them in a more controlled setting with plenty of space and assistance, but patients don't always present that way for you. Working in an ER, we would have at least 6-7 people to safely apply restraints. One for each limb, another to secure the torso, and 2 or more to actually apply and secure the restraints. Unless your rig is the size of an RV, that's too many people. My favorite restraint in a pinch- wide rolls of Kerlex. Yes, old school I know, but there's a reason it's so widely used- it works. It's readily available, quick to apply-especially if there's only 2 of you- and you don't need to fumble with keys, straps, and buckles. All you need is a couple quick slip knots and the job is done. Couple that with your seat belts and that person is not going anywhere. Yes, most places frown on this now, but I have yet to hear a hospital complain that a person has been restrained in this manner. They would much rather have a person present to them under control and be able to calmly assume care of the patient then to have them flailing and flopping as you roll through the doors. You simply need to ensure the gauze is wide enough as to not impair circulation or cause injury. It's also easy to remove- simply cut it off when you turn the patient over to the ER. A suggestion for new providers- talk to law enforcement people and/or a martial arts pro and get some tips for yourself or have an informal session for your people. I learned long ago from a partner who was a martial artist a couple simple techniques to control someone-- basic judo holds, pressure points, blocks, etc, and they have come in handy countless situations. They are also not for someone out of control- a novice use of martial arts moves will end up getting you hurt. These tips are very helpful for someone who is beginning to get squirrely- often times if the person feels you are in control of them- a simple arm lock, for example, gets their attention, shows that you will not tolerate them acting like a moron, and they tend to settle down. Unless someone is psychotic, even a drunk usually realizes when they are in a no win situation. The first time I saw the guy use a simple grasp of a person's thumb to render an idiot completely cooperative, I was a believer. No fighting, no wrestling, no injuries to anyone- problem solved.

Hey Tyson, welcome to the City. I'm going to take the less politically correct road here, as I have a feeling that's what you're really asking. How big is this guy? How big are you? This is what this situation says to me, that he started out being just sort of an ass, yet during transport this turned into an 'Oh Shit!' moment and you asking how to deal with it on your own? I get that... First off, for me, once he began to spit, all bets are off. Now he's gone from being an asshole to creating a significant bio hazard for me, and that just simply is not going to continue. Where I work it's pretty rural and PD is rarely on scene, often will not respond in a reasonable time if called, and when responding there are only a few officers that will be of any real help when they get there, so we tend to always think of resolving these types of problems without outside help. We have pretty progressive protocols so I'm allowed options for sedation, though if this isn't in my opinion a true psych, meaning that this is some spoiled kid acting like a weenie because it gets him attention, I may choose not to use them. I'm happy to use them to ease the situation for the truly mentally damaged, but not so quick for the spoiled idiot. Moot here I know as you don't have a chemical option. This just happened a few nights ago. I dropped the head of the cot, pt didn't have a shirt on or I would have pulled it up over his head, pushed his head to the side with my knee and put my full weight on that knee, mashing his head down into the cot. At this point I had complete control over him, not to mention eliminated the possibility for spitting and biting. I had my partner pull over, come to the back. While I kept his head mashed, all the while he's screaming about abuse and law suites, my partner pulled all of the straps as tight as they would go, tied each hand with Curlex to the Pt's thighs, pulled the chest and shoulder straps as tight as possible, to the point of restricting breathing even. This ended his options for any significant struggle. I put a surgical mask over his face, (this pt was a muscly 250 or so) and taped it in place with medical tape wrapped all the way around this head. None of this was done in anger, which I believe is a significant point. This guys was not happy, but he also understood that his dangerous behavior was not a game to me and was going to be neutralized. I'm not his mother or father, to be held hostage by such behavior, but I am a husband and a father who is going home without spreading disease to my family. Once he calmed a bit I loosened the chest strap so he could breath freely, chose a vein on the outside of his bicep and got an IV in case something else was going on here that I hadn't discovered yet, and we rode into the hospital. By the time we arrived he was calm and assisting me with his assessment like an honest to God human being. Now, you're probably going to see me get a beating for this answer, and my rating is likely to drop significantly, but that's OK, I'm wearing my big boy pants. And I do certainly see the need for this type of pt handling as a failure on my part. as there are many here that may be able to talk this pt into behaving without needing to resort to the above tactics as I most often can, but in my experience sometimes EMS simply becomes a contact sport. Now understand, had this been someone truly in mental pain I would have mashed his head into the mattress as described above but would have kept it there only so long as it would have taken for my partner to get me a line and some Versed from the lock box and life would have been peachy just the same. I simply don't like to be bullied or threatened into giving drugs by chronic assholes as opposed to those seriously ill. Bottom line is that you stay safe. If something like this works for you, go for it. If not, as mentioned above, get your ass out of the truck, call in PD, and get ready to eat some crow. :-) Dwayne

At my part-time job information is sent to alpha pagers if you’re on the list. They will include address and complaint, but that’s all. It is a nicety at this job because of the mumbling and/or screaming that goes on during the dispatch, just depends on the type off call. At my full-time job we don't do any of this because of the onboard computers which provide damn near everything you could ever want and more as far as info. This includes run cards, GPS mapping, call back numbers, so on and so forth. It's a good system, and does have some issues, but over all pretty good. somebody please subtract a point for this drivel...........geez!

It's not just a big scam. We make our people keep NR because NR has a higher CE standard than the state. I guess I'm not surprised when you say that the fire guys are the ones dumping NR.

Its the biggest scam I ever saw. Its setup to make you fail it the first time so you can go take it again. I know people have tooken it 4-5 times. I will be damn If I pay $70 6 times to pass a test that to say you can keep a patient breathing while on the way to the ER. That is what a class for. 70 dollars a pop *EMT-B TEST* is a joke. What ever happend to taking a state class then a test? Oh btw paying to get your CPR card and such. SCAM another money trick. It would be the best go get rid of the NR. Every state has different type of "standards" then others. So Please, quit sucking. BTW this will be my 2nd time taking the NR. If I don't pass it this time. i am getting a new job. I am nothing to have sucker and keep paying. I just take what I learned in class and go with it.

over ride her pump and allow her to pass peacefully and pain free.

You can only hope that they discontinue the NR. it's just a big scam anyways everyone i know doesn't even keep the NR once they get fire gigs.

So I am wondering: If you don't think you are very smart, why are you doing it? You are basically denigrating your own peers, your own profession. I am sure your local peers would appreciate hearing what you think of them. Nice team mate.