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Anybody who has seen the movie "The Godfather" knows what a cannoli is. I have refrained from posting on this topic. Quite frankly, I'm sick of reading this crap constantly from our poor misguided comrade. Every post is the same. "Y'all won't hire me 'cause I's black" or, "Society is always putin' down the black man". Blah, blah, blah. If you don't expect to be coddled, then you won't feel you were passed over unfairly. Suck it up and study harder for the next time. Get over it. Take a litlle responability for yourself, I know, foriegn concept.

Actually the only ones who have the guilt are those with the victim mentality. WE have the guilt and it's up to the victims(and the courts) to point that guilt out.

More questions: Did this ever happen before? Kind and location of chest pain (sharp, oppressive, exact location, wandering, radiating, changing with chest movement)? Known allergies? Illnesses/symptoms the last few days (infect or else)? Recent injuries, accidents? From the medications: known diabetis -> is this correct? Since when? Last time to see a doctor about this? Your normal blood glucose level? Last checked (time, value)? Other known medical problems: high/low blood pressure? Smoker? No alcohol/drugs at the moment -> do you normally (ab)use alcohol/drugs? Since in hotel/travelling: from where (maybe remote places with infection risk)? How long on the road/plane? Stress? Last meal/beverage (contents, time)? Last urine normal or unusual (smelly, red, ...)? Last defecation (time, something unusual)? More measurements/inspections: Blood glucose level (in mg/dl please...)? ECG, 12 lead -> anything to see? Temperature? pharyngeal inspection (signs of infection)? lung sounds? bowel movements/sounds? Abdominal pain/abnormalities (palpation)? too bad you can't provide information about your pupils, so I'm assuming nothing unusual there (-> adequate reactions, no unusual visual effects) short neuro check #1: follow my finger with the eyes (up, down, right, left) -> reduced movement? short neuro check #2: stretch and lift arms in front of the chest, close eyes, try to hold them straight -> muscle tonus, sinking of one or both arms? short neuro check #3: close eyes, try to touch your nose with index finger of both hands (successively) -> muscle tonus, side consistent? short neuro check #4: lift arms/legs (successively) against my pressing -> muscle tonus, side consistent? Preparing transport: "Sir, you have some medical problem, most probably with your circulation (won't rule out neurological or other at this stage, but I won't say that). We can't be sure that you don't pass out any time again in a not so harmless environment. Considering that and you having a known history of at least diabetis, it should be checked and maybe adjusted. We want to take you to the hospital to have more possibilities for a diagnosis and care. Do you agree?" Get appropriate lifting tool (stretcher) near the room/bed. Intentionally let patient step up (slowly, controlled) to get to the stretcher to test if there may be an orthostatic problem. Get him see a hospital with more tools and a lab. Anything else: If not something special on the ECG or things change: no. Just monitoring. Personally I don't even see a reason for an i.v., others may do. Possible diagnosis on my call protocol would be now "situation after beeing unconscious for unknown time, poor general condition, known diabetis", differential diagnoses (depending on findings in above additional measurements): orthostatic disregulation of unknown reason diabetis disregulation (blood glucose level?) myocard related circulation problem (ECG?) infection (temperature?) intoxication (last meal?) neurologic related (recent injuries?) On this stage it could be almost anything. As long as he's stable and willing to come with us, I wouldn't try much to figure. Just gather information on scene, put him on monitoring, get him to a hospital following usual hygienic protocols (here: wearing gloves, desinfecting hands afterwards plus all equipment having direct/indirect contact with the patient - that's at least what we do after each call). I recently had a similar patient with several medical and psychological pre-diagnoses nearly passing out after a short hike, turned out he had an acute noro-virus infection. I don't know if it was this patient, but the hospital we brought him into was closed for more than a week due to a burst in noro-virus infections the day after...glad to have cleaned my stuff after patient contact, the hospital probably should've done that, too... Not to forget: surely hope it is better now, Ruff! Get well soon! EDIT: inserted short neuro checks - don't have the proper englis short terms, so described them.

You truly fit the description of racist Mr. Crotch. I find it comical that it’s okay for you to do, probably because you think it’s okay. Why do you feel the need to turn every thread into racism? That says “insecure” to me…

I don't know why I keep responding to you but here goes. How the hell can you make an agility test racially biased? Sexist maybe, but I guess when there's a fire, the fat people know when the women who can't carry them are on duty so they put in extra effort to get out before the FD gets there. All of those things you pointed out have nothing to do with race (tractors, stoops, cannoli, etc). They just have to do with what part of the country you grew up in and that has nothing to do with race. Anyone that doesn't know what a cannoli is doesn't deserve the job anyways.

I think crotchity must stand outside my ER and tell most of the pts coming in about the aluminium in deodorant, because I would say that 25% of them use it. Hey, like I said, I don't want to catch the Autism.

A few years of working overseas with limited resources has taught me to try to know every off label/alternate use of every medication you have access to. Knowing that Benedryl can help with nausea or that mag sulfate can help with severe asthma might save your butt. Of course those are just a few examples of medication uses that might not be in your protocols. Don't just have one way of doing things. For example know a couple different ways of getting IV access. Don't limit yourself to hands and arms, I've put IV's in chests veins, feet, the head, upper arm, and ankle to name a few. Sometimes starting an IV bevel up works better on the elderly and children. Think simple, cause sometimes simple works just as well or better than the complicated. Yea, the fancy toys are great but remember to treat your patient not the machine. You never know when a machine will break or you will work for a service that doesn't have that fancy widga gidga. Think outside the box!! Another example of simple is while working in overseas we had a patient that kept getting a nose bleed and didn't have access to labs. The PA working with us said to stab his finger with a lancet and then touch his finger to an index card and keep doing it every 10 seconds until it quit leaving blood on the card, then count up the spots of blood on the card and then you had an idea of what his clotting time was and helped us rule out a clotting time issue. ADVOCATE FOR YOUR PATIENTS! That's all I can think of off hand but I'm sure I could come up with a few more if I gave it some more thought. Sarah

This will really solve all of Chicago's problems: NOT ! Let's force them to hire 111 people that didn't score in the hiring range over more qualified folks. On top of that give a bunch of other losers cash payouts for not being smart enough to test well on a fair entrance exam. I don't care whether an applicant is green , red , white ,yellow, black, or some combination thereof. If you don't get a passing score on the entrance exam, you don't get hired. This is not about equal opportunity, It's about lowering the standards so minorities can get hired.' Reverse discrimination at it's finest!