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Just to add my 0.02. I don't think it is necessary for a woman to have an exam in the field under most circumstances. Obviously if she is giving birth then it might not be a bad idea to take a look. Heavy bleeding will be another reason, but should usually be obvious from the outside. In all other cases, you don't have the proper tools to do the proper exam, so why do it half assed? Does anyone carry a speculum on their ambulance? Has anyone been trained to do a bimanual exam? An exam by someone in the field will add very little (no, I do not mean that to put anyone down) to the pt's care. I would have to say in this case, keep the pt's dignity and let her go through the exam, only once, in the ER.

I just completed my intro into als... I passed the test, the class, and the assessments. now its on to basic ekg and als medical care and my internship!!! I can't wait... that test was very hard and the average score for that test was a 60... thank goodness i got much higher than that Wish me luck with my intership. I am so nervous to start an iv on an actual human

I like your attitude, I really do. It would be nice to be presented more in a more professional light. I'll even go you one better. I think that not only should they pull that commercial but they should remove all programs that show firemen doing all sorts of heroic nonsense. I know you're likely to be offended, but lets be honest. If it's good for EMS to be shown in a more accurate professional light, then certainly the same is good for Fire, right? Unfortunately, neither is likely to happen in our lifetimes... Welcome to the City man. Thanks for posting, and don't take the ribbing to seriously. Dwayne

I'm just like any other guy on the face of the planet. I like checking out the female form whenever possible. But there are times it's appropriate, and there are times that it's not (not even gonna address the ones that I'd wish I didn't have to see ). To expose a female patient just because she says "It hurts 'down there." isn't enough justification without exploring other avenues first; one of them being a detailed history that's as complete as possible. To expose a patient 'just because we can' ranks right up there with the same thinking process of "This is the way we've ALWAYS done it!". I WILL expose a female patient (with privacy concerns addressed as much as possible) IF there is enough evidence to support the action. Having been both the practitioner and the patient, I can see both sides of the situation here. There is a place and time for everything we do, regarless of the level of licensure we hold. Taking baseline vitals on scene, only helps the doctor decide if the patient is improving with what treatments we've adminstered or if the situation is still 'out of control'. It gives that doctor an idea of the condition of the patient when we 'found them'. I may not be able to do a great deal to mitigate the situation the patient is in, but that doesn't mean that taking baseline vitals and detailed assessments are a waste of time. As far as not posting as much as I used to, I'm taking 15 credit hours per quarter (which translates into around 30 credit hours per semester). I've been quite busy with schoolwork, and I've got some pretty 'heavy classes' to deal with.

See, I told you it would be good for you... This is the crux of it here. Nailed it on the head, Dwayne. Except I think the monitor is more than a shiny toy, as I certainly can't distinguish between different kinds of cardiac without seeing a rhythm... (I over-generalize, but you get what I'm saying...) Ding ding ding! We have another winner here... this is an example of good in-depth thinking with regard to expose/not expose. And yikes on that psych call... any chick that can stab herself in the vajayjay and anus with an ice pick needs some serious help... Sometimes we all need a good smack. It's just the way it is. Myself included. Spenac, take heed here. You get so wrapped up in your own posts sometimes that you become *impossible* to actually debate with. Playing devil's advocate is all well and good until you get too lost in it and lose the actual purpose of your debate. And I prefer individuals playing devil's ad to clearly state so within a few posts. Spenac, I don't think you are playing devil's advocate here, I think you're consistently taking an over-exaggerated stance towards the exposure issue, and you always have. Hot damn, Matty, I didn't realize there had been 4 go-rounds with this... and that to me says it all. Want to inject some life into the forums? Don't troll. Part of why I've been absent from the City so long is because I've had better things to do. Seriously- I love the forums, I've learned INCREDIBLE amounts here, but I got sick of the bullshit. That last little bit with Ventmedic coming back as a sock puppet really disgusted me, as I used to respect her and look forward to reading what she had to say. When you're starting nursing school in January, working full-time, taking 14 credits, husband back at school full-time and trying to have a life in between SAR commitments and everything else mentioned above, playing with trolls drops pretty low on the list. I now read a lot of food and healthy living blogs- because there are excellent authors there with very little "ME ME ME!" ego going on. I can read a good, insightful blog about body image issues and nutritional status without getting pissed off and distracted from the million other things I *have* to be attending to, and it provides me with relaxation instead of irritation. Wendy CO EMT-B

Let me take a stab at this from my holy crap Im only BLS perspective Slumps over? Get him on the floor preferably away from onlookers OK non ALS drugs? Is it asprin? If so have it on stand-by if we get him back and he can swallow. Have stewardess get the pads on him while I secure airway. Does he have a gag reflex? If so, nasal him. Get an O2 tank and start bagging him. Check for medic alert tags. Have stewardess see if he has a travel companion and also check for his carry on. While bagging ask the stewardess to see if anyone else, including flight crew, has CPR training, if we start it might be awhile. Have stewardess notify the pilot of the situation, see if he can divert to the nearest airport and have medics on stanby for arrival. Keep bagging, change O2 tank as necessary. Check pulse again, still there? Still at 30? Keep Bagging. until we hear the next phase I will sit here patiently awaiting info and keep baggin and switching tanks LOL

I don't know about anyone else but the new Burger King advertisement of breakfast sandwiches where they have the patient standing while attached to a LSB and several other interventions done rubs me the wrong way. No self respecting crew would do something like this, we would be fired. I think this ad should be pulled or changed and take EMS out of the equation. Maybe I am just too sensitive but things that show us in a bad light should be protested. Just my humble opinion.

We are medical professionals and if we do not see the vagina or the testicle that the patient says hurts we can not help nor can we relay accurate report to the doctor. We must do a complete focused exam on the area of complaint and that means looking, listening, feeling. Do not be bashful, do it like you have done it a million times and the patient will have no problem with it and the doctor will respect your report more as you actually relayed patients complaint combined with what you found during exam. It is my pet peeve that so many do not act as professionals and do the job that needs done. As soon as it deals with a persons no-nos they refuse to touch or look, lets just load and go. Vital information could be missed that could delay the care they need.

Good ol’ classic Spenac post, pose a question that seems to ask for opinion, yet he already knows what the correct answer is (at least by his viewpoint). If you’re answer agrees even halfway with his, then you are still completely wrong… and furthermore are deemed scared, unprofessional, bashful, and therefore must obviously be incapable of saying penis and vagina without giggling, so you must surely call them private parts and no no’s… I digress… So, what was the point of this post Spenac? Did you’re post from the past covering this topic get deleted or something? Felt enough time went by that you could duplicate it without many noticing? I take it you also expose and palpate the vagina and anus of all the rape victims you encounter? How do they feel about your ‘professional exam’? I guess you do the same for the child victims too? Do you also prefer to do prostate exams on all males over 40? I bet that one goes over real well...