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Well has anyone notice the OP hasnt returned any responses gee wonder why. I am also surprised that Dwayne and Squint haven't jumped on this one, and if they do KN you will see what true Experinced EMS professionalism is all about. Most of us have been in this profession for 20+ years myself for 15 years. I have seen stupid at its best but let me tell you, a mentaly ill person banging their head until they knock themselve out, while doing naked reverse snow angels, and then the next comment about a flashlight shoved up someones ass IS NOT FUNNY. The OP got what he deserved from the others in this forum. Caring for Mentally ill people is skill that is learned from experince and the Warm and Fuzzy approch with most will just get you injured or killed. I for one have made the wrong post in these forums and I got the rath of the group and YES I learned my lesson. Now if the OP came back and said Hey your right this was in bad taste then the whole thing would have had a different tone. KN here is a little bit of friendly advise, Come back here when you realize that your little bit of schooling in the Warm and Fuzzy AKA ICARE bites you in the ass and that the people here have more experince than you will get in your career because you will be injured or killed with your attitude and learn from this forum. When you have had your pt try to punch the crap out of you because you took their high away, and you were to busy holding their hand instead of thinking ahead and having them restrained. When you have a severe head injury that tries to beat the crap out of you because you were to busy saying sweetnothings and not realizing that the pressure in their head is causeing the violent behaviour and last but not least when that young person is so strung out on drugs, and you forgot to do a good RBS and find the knife in their pocket because you were initiallizing ICARE they try to stab you. So you really should take the time to read some of these experienced people older posts and realize that in the EMS proffession is not full of Patients who really give a crap about your warm and fuzzy attitude. The old guys here have seen it all, they will share their experinces, some are crass and blunt but they have earned it. And to the OP this was really in bad taste, and there was nothing funny about either of your posts, I think Troll is a very good discription of you. Tyler we have seen you grow from a teenage wacker to someone who now has something mature to contribute in the forums. Happiness

Done deal brother. I'm going to call the cops and walk the street to try and keep him from getting hit by a car until they get there. If he's as injured as you state, he will be manageable pretty soon, just bide your time until he tips over. If it's really hot, or really cold outside, the same applies. Wait for him to tip over and then do your deal. The situation that you describe above is not possible to solve in a morally/ethically/professionally sound manner. This is one of those time when you say, "It's not my emergency. I didn't cause it. He's made it impossible for me to solve it. So until one of the above conditions changes, I'm going to wait." You have to accept this as a limitation of your treatment options, right? Again, accept that sometimes in this situation not only will you have to stand by and wait for the situation to change, sometimes you may have to run away and leave him to fend for himself! If he suddenly reaches into his car and comes out with a knife or a gun..or even a broken whiskey bottle...I'm leaving his dumb ass there. I will run down the road and sext with Babs until the cops come and never lose a moments sleep over it. I know you want to help him because he's hurt, but tell me this; if he was on fire and running around would you stand still and wait for him to come to you under the thinking that, "If I can hug him, then I can roll us both around on the ground and put the fire out. That is what's best for the patient." And it would be best for him, right? I think you already knew the answer brother, you just aren't comfortable with 'do nothing' as an answer. And I really get that. But in this job you must ALWAYS have that as one of your scene options, always. Ok? Excellent question! Also, use your spell check and proof read your posts, ok? You're way too smart to spell like that.. Dwayne

We're da ambulance drivahs. Weee-ooooh, weee-ooooh!

Wait for the police to arrive... If you fight him, and he injures himself; you've 1: Not accomplished anything; and 2: Opened a legal can of worms. Suggest he sit down and relax, and you do the same. If he were to become unconscious.. Treat him. If not, you're safety always comes first. I'm in a rural area too, we don't have police on duty at night. They're all "State Police", but they have to respond from home, like us; "On Call". But I'm not going to injure myself, or help someone to premature disability, just b/c they made a bad choice. I'm usually pretty good at convincing people they need to go. But I've been hit, spat upon and kicked a few times; and it's just not worth the fuss. Tell the cops to step it up, just try to convince the person to sit still, and chill.

Ok, I guess I and a number of other people who I know have both seen and done this procedure must have been sharing too much of something good (and potent)! Just from a quick search of "Google-pedia": # Now I can understand people being uncomfortable doing this and that is not a bad thing. Not having done that much of a study on it there seems to be some different opinions even on the best time to do it (end inspiratory or end expiratory). I think there is more risk of breath stacking with end inspiratory but I was taught to do it at end inspiratory so that is the method I use. The conundrum of not clamping in a critically ill patient is that that is the only patient that I would even consider doing it on. I rarely do it outside of the hospital setting but when I do it is on the pt who doesn't tolerate that loss of PEEP and lung de-recruitment. That is the rationale: to prevent loss of PEEP and lung de-recruitment. There are definitely times I would like to have a pocket Dr as well as a pocket mechanic however that is just not possible. Ultimately if you are not comfortable with or have never heard or seen a procedure done before than absolutely don't do it. However if you don't open up your mind to new ideas, techniques, practices, etc, than you are not doing yourself any favors and your professional growth will eventually be stunted.

I am king of sarcastic humor as a defense to stress.. But even I wouldn't laugh at this, it goes beyond Gallows Humor, and falls just before being a sick bastard. Mental illness is a disease, which may be able to be treated. It sickens me that you'd admit to laughing at the mentally ill. Whether or not you meant it that way, that's how I perceived your demeanor, after reading the post. Intent and Impact is a key term, when deciding what to share from the depths of your mind.

I am going with an aberrant wide complex tachycardia, not V-Tach, but I would be applying the pads anyway. My guess is the underlying problem is an electrolyte imbalance that is causing the dysrythmia, but it could be an MI. It will be interesting to see what the diagnosis actually was.

Dude, I've heard stories similar to this and worse over the years that I've been in EMS. They are not funny. There are a lot of reasons why they aren't. Add me to the list of "Don't find this funny" people.