Leaderboard

You know, I had a conversation very much like this online with a feminist a few months ago. She was up in arms because she knew of a girl that got drunk at a party, ended up having sex with some drunk kid, and the next day called it rape. I asked her if this girl had been physically damaged in some way, and she said that she had not, but because of her level of intoxication she was defenseless and that made it rape. I asked her if the boy was also intoxicated, to which she said that it didn't matter, he should have known better. She was enraged when this kid wasn't arrested for this heinous crime. Not every act, nor personal failure needs a law created to allow you to escape responsibility. Some things suck. That is how we learn to prepare to avoid them in the future. These attitudes towards women hurt my heart in the same way that Crotchity's concerning blacks do. They scream that they are equal in every way yet tiny but very vocal sub groups constantly fight for the special considerations that we normally reserve for children, animals and the mentally infirm. I believe that both groups are insulted and defined by these exaggerated special protections and their ability to fully participate retarded. Not by the rules that exist, though I certainly do believe that racism is alive and well, (as is agism, sexism, weightism, etc) but by the constant reminder that these groups must be treated like mentally damaged children or those that have succeeded through hard work and commitment will face the wrath of the politically correct. Crotchity's claims that the system was so biased that a black man can't compete spits in the face of the 20% of the fire dept that have chosen to do just that. Anyone remember that movie, some horror flick where a white supremest and a black gang member are caged next to each other? At one point the black man mentions something about the white wanting to kill him. The white man says something like, "Kill you? I love you man! You've killed more n*ggers than I ever could!" That is where I see the Crotchity's of the world. A toxin to their race. Weakening them from the inside and causing them to be ostracized in general. Unfortunately though I see white attitudes changing, I see no sign that Crotchity will ever choose to stop repressing the race that he hollowly claims to have so much love for. Dwayne Edited to ad text in italics. Second edit. "The Equal Employment Opportunity Commission (EEOC) ruled that Chicago was “twice as likely to hire white applicants than black applicants.” Ironically, blacks are overrepresented in the EEOC by 625 percent, but I don’t think the bloated agency has to worry about being sued." http://lashawnbarber.com/archives/2005/03/26/racist/ Surely then you are outraged by this? Dwayne

Tranexamic acid has been approved for use in the Joint Theater Trauma System Clinical Practice Guidelines, including for prehospital use in patients expected to require massive transfusion. Civilian price is $9/dose, (military price about $1.50/dose) and it is shelf stable at room temperature. CPG is posted on the US Army Institute for Surgical Research website, and is attached here. I believe some civilian prehospital systems will follow suit in the future. 'zilla Excerpt from August 2011 CPG: Joint Theater Trauma System Clinical Practice Guideline Guideline Only/Not a Substitute for Clinical Judgment August 2011 Page 4 of 24 Damage Control Resuscitation At Level IIb/III Treatment Facilities 5. Tranexamic Acid Tranexamic acid (TXA), an anti-fibrinolytic agent, has been used to decrease bleeding and the need for blood transfusions in coronary artery bypass grafting (CABG), orthotopic liver transplantation, hip and knee arthroplasty, and other surgical settings. A recent meta-analysis reported that TXA is effective for preventing blood loss in surgery and reducing transfusion, and was not associated with increased vascular occlusive events. 4 (For additional information concerning TXA, see Appendix D). The early use of TXA (i.e. as soon as possible after injury but ideally not later than 3 hours post injury) should be strongly considered for any patient requiring blood products in the treatment of combat-related hemorrhage and is most strongly advocated in patients judged likely to require massive transfusion (e.g., significant injury and risk factors of massive transfusion). It may be utilized in circumstances when in the judgment of the physician, a casualty has life-threatening hemorrhagic injury and high potential for development of coagulopathy or outright presence of coagulopathy. Use of TXA within 3 hours of injury is associated with the greatest likelihood of clinical benefit. Initial use of TXA after 3 hours post injury may have no benefit and may in fact worsen survival. Therefore it is strongly recommended that TXA not be administered to patients when the time from injury is known to be or suspected to be greater than 3 hours. a. Considerations for Use TXA (intravenous trade name: cyklokapron) is supplied in ampoules of 1000 mg in 10ml water for injection. Infuse 1 gram of tranexamic acid in 100 ml of 0.9% NS over 10 minutes intravenously in a separate IV line from any containing blood and blood products (more rapid injection has been reported to cause hypotension). Hextend® should be avoided as a carrier fluid. Infuse a second 1-gram dose intravenously over 8 hours infused with 0.9% NS carrier. There are presently no data from randomized controlled trials to support administration of further doses to trauma patients. However, if a patient has received the initial dosing of TXA and continues to show signs of ongoing hemorrhage, strong consideration should be given to re-dosing the patient as above. TXA may be administered to patients requiring MT even if they have an associated TBI. Joint Theater Trauma System Clinical Practice Guideline Guideline Only/Not a Substitute for Clinical Judgment August 2011 Page 5 of 24 Damage Control Resuscitation At Level IIb/III Treatment Facilities In patients who continue to have life-threatening hemorrhage despite TXA use and adequate 1:1:1 resuscitation, clinical judgment is warranted as to the use of additional pro-coagulant agents such as rFVIIa. b. Storage Room temperature (15-30° Celsius / 59-86° Fahrenheit). Storage at temperatures great than these may reduce or destroy the efficacy of TXA. 6. Recombinant Factor VIIa (rFVIIa) Recombinant Factor VIIa (rFVIIa) has recently been associated with improved hemostasis in combat casualties, decreasing blood loss by 23% (see Appendix C for more information on the use of rFVIIa). The use of this product should be reserved for those patients likely to require massive transfusion (e.g. significant injury and risk factors) and is at the discretion of the treating physician. It should be the judgment of the provider that the casualty has a life-threatening hemorrhage and coagulopathy. 1) Usual Dose: 100 mcg/kg intravenously; may be repeated in 20 minutes. 2) Contraindications: Active cardiac disease. 3) Storage: Refrigerate (2–8°C/36–46°F) prior to reconstitution and use. The FDA recently approved a room temperature stable product. This will be distributed throughout the USCENTCOM AOR as the current supplies are exhausted. ETA: I included the FVIIa guidelines for reference as well, and expect we'll see a lot less Novoseven use now with TXA being approved.

I work with plenty of black chief officers. In fact, there are a disproportionate number of them, when you consider how many of them, scored on their promotional exams. Some are dumb as a bag of hammers and the ONLY reason they have their title is because of affirmative action, statistical gymnastics, and preferential treatment MANDATED by a collective bargaining agreement. Others are whip smart, and in nearly 30 years of being in this profession, my favorite, most qualified, most professional and most intelligent boss happened to be black, He EARNED his promotions, EARNED the MBA he got, EARNED the respect he received, and sadly he retired early- in large part because of how backwards the system is. He was tired of seeing mediocrity and stupidity being rewarded. Sounds like sour grapes to me. Study harder next time. NO, sounds like simple math to me. 12% of this country is black, and there are entire areas of this country where there are no black folks. You do realize that by constantly playing the victim, you actually perpetuate the stereotypes you hate so much, right? By promoting the notion that the only way a black man can succeed is by set asides, lawsuits, and special considerations, it plays right into the hands of those who think your race is inferior. Forget the nonsense about paybacks for past injustices- this is about the here and now. If I were an intelligent, hard working black man- the norm- I would be pissed about decisions like this one. If someone cannot do well on a race neutral exam written at a 6th grade level, then I suggest they look to a more suitable job- like pushing a broom. The reason you use such a wide brush is because if you actually addressed the individual points made here, you would have no argument. Simply regurgitating age old, race baiting talking points is NOT a debate, or even a discussion.

Bullshit. It is the law of averages..I know very few medics who are black, and those who I do know are extremely talented. At the risk of you bringing up the "the education system is slanted against the black community" crap, if there are very few black medics, there's going to be an even lower percentage of black supervisors. I work critical care transports now. But in the County we are based the local EMS system has 4 black shift supervisors and this is in the South. It can be done. One just have to apply themselves, get the same education as everyone else and excel at what they do, just like everyone else, to get ahead. Stop looking for the easy way out. If we (us white folks) had to go to school and obtain an education, apply for a job and compete for it on an equal playing field, then so do you. Frankly, I would be pissed if I was passed over for a position when I scored higher, interviewed better and had higher qualifications, than the individual that was awarded the job because I was white. That's discrimination.

Well said as usual, Dwayne. I have no idea how old crochity is, but he reminds me of the old school, and increasingly irrelevant poverty pimps like Al Sharpton and Jesse Jackson. They see EVERYTHING through a prism of racism. Every alleged wrong perpetrated on a minority HAS TO BE RACISM. There simply is no other possible explanation in their eyes. It has become such a pervasive belief that entire regulatory agencies exist because of this notion-and use this as their "business motto" to pursue cases such as this. In the case of the CFD, I'll repeat something that crochity and the race baiters always seem to ignore. This exam was RACE NEUTRAL, written by a black PHD consultant who's speciality is creating unbiased exams. So the only way this lawsuit could have moved forward is to say that since blacks were under represented in the results, thus racism must exist- even though the test was NOT biased. Thus, in the eyes of EEOC type groups, discrimination isn't necessarily even an action, it's simply about the results. It boggles the mind of any rational thinking person. Ahem- there are plenty of alternative explanations why the disparate results happened, but none that would generate press for the poverty pimps, none that would justify an agency's existence, and none that would generate a lotto pay out for folks who have no right to receive one. The problem is, this ruling also affects every current member of the CFD, since these lotto winners also get back dated seniority, which bumps every person hired after the date of the exam. That in turn affects promotional exams, retirement plans- all because of unPC exam results. Not to mention many of these folks will never be able to work enough years to even qualify for a full pension before they reach mandatory retirement age(unless of course they change that rule for them too). I want to make a disclaimer here. I will NEVER claim that racism or any type of bias does not exist in this country. We are human beings- with all the associated faults and failings. We envy, we covet, we distrust those who are different, ie we are not perfect. BUT- and this is a big BUT- There are laws that exist to protect folks from real bias. When cases like this go through, I think it cheapens every single legitimate racism claim. Folks are tired of hearing the cries of racism- especially when too many times, it simply does not exist. Do I sound bitter or angry? Damn right. I'm sick and tired of this BS. I've been adversely affected by crap like this years ago, and every time it happens, I am utterly astonished that we have yet to move beyond this point. \\\End rant. Sorry- a bit edgy lately...

If the playing field were completely level, I would be against discrimination against anyone for any reason, but discrimination against whites happens so rarely, I would not shed many tears if it happened. As far as asking about how tests can be discriminatory, we argued that to death in previous posts. But I have a solution, but I doubt white folks would be brave enough to make it the rule: 1. Interviews for hiring and promotion are done by the neighboring jurisdictions personnel, no one from that department can be in the process, except maybe one member from the HR Department (this gets rid of the buddy-buddy system, or bribes or brown-nosing the chiefs (decision makers). 2. All interviews are blinded, the applicant sits in another room and can not be seen, and uses one of those voice changing devices that changes their spoken word into the same monotone computer voice (cant tell male/female, ethnicity or nationality). The applicants are then given a "score" for interviewing. 3. The applicants are given one written test, written by a test-writing company or university, and are scored with no curves or weird formulas. Again, the test is taken in private, applicants are not seen. 4. Once the applicants have both scores, background check, drugscreen, and physical done, the outside interviewers hold a one day skills observation test (or physical agility test) where the applicants are viewed for the first time by the outside panel, and they score using the same score sheet for all. If it is a physical agility test then everyone is graded by the amount of time it took to complete the test. To establish a minimum cut off that is fair, I would mandate that everyone that is a current employee from chief on down to rookie has to take that same physical agility (or skills / if skills it has to be national registry format) test annually; they would then average everyone's time/grade to create a "department average". Applicants must surpass the department average to be considered for the position. It is not fair to disqualify a female for not being able to pass the test, when half of your department is so overweight that they can not pass the same test; Skills Score should be weighted to = 50% of your total score Interview and Written are weighted to = 25% each of the total score for a total of 50% Tell me why that isn't fair ? And if you site extra costs, there shouldn't be any. When it is the other department's turn to do the same procedure, you will do it for them to pay them back (no extra payroll). To protect employers I would be fine with a 90 day orientation period where the applicant is only awarded temporary employment and can be terminated if the candidate is somehow unacceptable, but the employer will have to show clear proof of why the applicant is unacceptable and document the steps they took to try to bring the applicant up to standard.