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Its all up to you, the problem with the folks who whine about EMS pay is that they lack discipline in handling their finances. Yes, it is nice to have 2 new cars and a new house that is too big, and to eat out every day and night, but it is not necessary. Choose the job you love, live within the budget that job supports. Nothing worse than being trapped in a job you hate because you cant afford to quit.

Fondling in Bed After 20 years of marriage, a couple was lying in bed one evening, when the wife felt her husband begin to fondle her in ways he hadn’t in quite some time. It almost tickled as his fingers started at her neck, and then began moving down past the small of her back. He then proceeded to place his hand on her left inner arm, caressed past the side of her breast again, working down her side, passed gently over her buttock and down her leg to her calf. Then, he proceeded up her inner thigh, stopping just at the uppermost portion of her leg. He continued in the same manner on her right side, then suddenly stopped, rolled over and started to watch the TV. As she had become quite aroused by this caressing, she asked in a loving voice, “That was wonderful. Why did you stop?” He said, “I found the remote.”

I really intended to stay out of this one, and it looks like a consensus has already been reached. But after reading all the replies, I think this issue is A. being blown way out of proportion (MATEO !) and B. Being made way too complicated. Take it from a 20-something year old female, the population I believe that you are most likely to encounter with ob/gyn emergencies and the least likely to be educated about what exactly is going on. Pelvic/vaginal examinations, be they visualization or palpation, should be done a very strictly need-to-know basis. It will not and should not change our treatment, and spare me the 12 lead argument. There is just too much risk in this highly litigious society, especially for male providers, without any real proximate benefit. All we really need to be assessing for down there is excessive bleeding or presentation of a baby's head. If your patient is pregnant, a lot of that modesty is probably out the window anyway and a visual check for crowning is acceptable but should be done discreetly. If there is excessive bleeding you are probably going to see it. And even if you don't, you can ask in a way that even the stupidest chromosomal deficient piece of trailer trash can understand. A simple, how many times in the last 30 minutes have you had to change your pad or tampon question should give you an understanding of what you are dealing with. Some are claiming that we can't take the patient's word for how much they are bleeding and it may not be apparent, (ie we can't treat what we can't see). Well I say that any half-ass decent paramedic should be very closely monitoring any patient with vaginal bleeding, regardless of how much they claim it is or even what they see. Like Spenac said, they could be compensating with normal vitals. We should be prepared to aggressively treat hemorrhagic shock in these patients and checking out their crotch isn't going to be able make us any better prepared to do that than we already should be.

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.

Actually, if they require it, they should provide proper training to fully utilize it, which includes knowing how to determine S3, S4, gallops, rubs, murmurs, etc. After all, what good is buying top of the line if you can't use it to its full potential?