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Greetings! My name is Christopher Heiss and I'm a Critical Care Paramedic. I'm a graduate of Pennsylvania College of Technology and I work for Susquehanna Regional EMS (an EMS division of Susquehanna Health System) in Williamsport, PA. We're a very busy and highly progressive squad- and MICU-based system seated in the heart of North Central Pennsylvania. Aside from my position as a field provider, I'm currently active with the National Registry of EMTs with exam item writing and psychomotor skills evaluation. In addition, I'm an active participant with the annual EMS Today Conference and Exposition "JEMS Games" as a competition judge. I look forward to meeting with many of you and to participate in the various discussion posts on this forum!

First question you should answer, just so you will learn, and have more knowledge than before is 'what is the difference between a pneumothorax and a tension pneumothorax? I like that you think about other possible injuries present with an injury such as a flail chest. Besides damage to the heart, what other injuries could you suspect? A couple of points to bring up... concerning the posts where I have made certain lines stand out in bold. First, concerning treatment with sandbags and IV bags, it is now considered to be outdated treatment. IV bags and sand bags (weight) placed on the chest can hinder the effort of breathing. Mobey brought up a treatment that is useable, a pillow or towel for the patient to use to splint their fractures themselves. I had not heard of this, but think it sounds like a good idea ! So, I will ask, since sandbags/IV bags are considered outdated now, what other splinting technique is recommended? When you find this technique, what would be an improper way to apply the splint, and why? (to give you a hint as to the improper application of the recommended splint, think of how its application would possibly hinder the effort of breathing) In reference to pressure x3 and sandbags....see the above response. It has been surmised that in trauma, we can predict the underlying injuries based on the mechanism of injury. With that in mind, mechanism + the area of the rib cage injured can give us great clues as to what injuries are present, before hemodynamic changes may be seen. What other short term injuries may be suspected if the patient was struck in the rib cage? (think about what the ribs are attached to) Pneumonia may very well be a complication that flail chest segment patient may have to endure. To help you think of some other 'pulmonary problems' the patient may experience, what complications will commonly present in the hospital/ICU? (it is possible to see these in the field too, but not common, in my experience) I think another aspect for people to explore is signs/symptoms, and assessment findings you would expect to see, feel, or hear?

I neither think that it falls under 1st amendment protectionnor that it is something that the government should regulate. Tasteless and tactless? Definitely. Offensive? Sure. However I don't expect the government to protect me from things that are tasteless and/or offensive.

An old Cherokee Indian was speaking to his grandson: “A fight is going on inside me,” he said to the boy. “It is a terrible fight and it is between two wolves. One is evil–he is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego. The other is good — he is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith. This same fight is going on inside you, and inside every other person, too.” The grandson thought about it for a long minute, and then asked his grandfather, “Which wolf will win?” The old Cherokee simply replied, “The one you feed.” True, right?? Dwayne

That's pretty racist of you crotchity. I've responded to a few trailer parks in my days and have seen plenty of non-white people. So according to you, just because it is a trailer park means that it is inhabited by poor white people. Nope, not too racist. As for this asshat, does he really think that sending unarmed, unprotected, untrained people into a dangerous scene is a good idea? As others have said, instead of needing to treat 1 victim, it's better to treat 3 victims? That makes a lot of sense. The assailant was mad enough to shoot/stab/beat someone, do you really think he will think twice about taking out an EMS crew trying to help the person he was trying to kill? Hospitals go on lock-down or whatever their procedures are when a violence victim comes in because of the possibility of the assailants coming in to finish off the job and anyone that gets in the way. Assclown.

Crotchity, in the original article, at the start of the second paragraph, it states “City Councilman Kenneth Stokes has threatened to reverse the contract American Medical Response has to serve in the area if the company doesn't send its workers into violent crime scenes, even before police arrive.” I think that makes the intent of Councilman Stokes’ comments very clear. As much as you want it to be, since you have brought it up in other threads, this Councilman is not basing his comments on race, and the replies from EMS are not either. It is a question of “is the scene violent? Yes or No.” End of story. Using race as an excuse, or a crutch in situations like this is just that, and excuse or a crutch. The true issue is that this idiot wants EMS to respond prior to police to violent scenes. Race is only an issue when we allow it to be, and instead of looking at the sins of the past, how about looking to the future, and trying to solve problems instead of creating problems where none exist. Let's keep this thread on topic - that this councilman has his head up his *** and needs to be educated about scene safety and the role of EMS.