spenac

Dust? Wasn't going to but now I will rant. It aggravates the heck out of me when people blame God for the bad they are facing when in fact often you can look and see how you or another human caused your bad state. Heck when I was broke it wasn't God punishing me it was I was stupid with money when I had it. When those babies died in the car wreck it was not God needing another angel that caused their death it was the parents not properly securing them because they did not want to take the time or hear the baby cry. In reality most of the time those blaming God for something bad are just trying to avoid accepting responsibility for their mistakes. Rant done for now.

I have to laugh and cry at the same time when I hear about parents paying for a baby sitter and all the other expenses that ad up to more than the one makes. To decide if a second income is worth it one must factor in the sitting fee, the additional wear and tear and payment, and insurance etc of a second car. Then the clothes for that job. Then the expenses like education related to that job. The list could go on and on but often when an honest evaluation of the situation many families would be better off financially if the lowest income parent stayed home or strictly only worked when the other parent was home, but that brings up other issues. More importantly being there for quality time during developmental years is priceless.

Surprises me when people still use such archaic methods to "catch" a "faker". Hand drop, why? If turns out your wrong you have done harm.

Research the drug on multiple sites and books. Hand write a long in depth card. Type up a condensed but complete card. Read the card into a recorder. Listen. Write from memory. Each time you ad a new card do the same but continue to rewrite from memory the previous drugs. Verify that you are correct each time you do the memory test. A lot of work? Yes but by using almost all your senses you will have greater long term use and recall of the material.

Lots of older Paramedics. Sometimes the age lends it self well to ems. Just keep in mind pay is not that great. See the thread Salary from a day or two ago.

There is no reason an ambulance system can not establish a denial protocol. There is no state law that requires transport of all callers. Yes you may have a protocol that does not allow but no one has ever produced a state law saying we must transport all callers though I have asked multiple times. There would have to be many checks and balances to be successful including making it harder than transporting that way the lazy medic would choose transport over not transport.

Do I need to get Joe to post a warning to beware the single emt is on the loose? Unless they lowered the rate and if you don't factor in standby time the Paramedics used to get paid as good as many RN's in the area.

You mean you guys don't eat while you work? It really just shows how rude some patients are. How dare he interrupt a medic singing about breakfast. Patients are all about themselves these days.

There is no one answer. Depends where you live. Some places pay less than minimum wage, yes it's legal how? They pay you a legal per hour then they use the laws that allow them not to pay certain hours as long as you had so many hours with no calls so you end up not being paid all hours at the station so when you include those free hours you are less than minimum wage. Some with limited OT will bring in $75000 a year with great benefits. Most are well below $50,000 for Paramedics and well below $35000 for basics. Many of both levels make less than $30000 a year even working lots of OT.

I like when people play devils advocate makes us think outside our comfort zones. Again if they continue as I mentioned I will help. If they need me to push drugs no problem much easier than doing chest compressions. My answer is if I am final say. My point is if there is no contact with anyone because radios dead and the pilot leaves it to me I will work the code with what we have but will not hesitate to call it when no doubt they are dead and I have at least met if not exceeded standard of care which for EMS is ACLS. Same goes if I'm in my fully equipped MICU ambulance I work them on scene until ROSC or until there is no doubts they are dead and we have met or exceeded the standard. I am not a fan of show codes. Now as someone mentioned the other passengers start to get angry causing trouble then my safety would dictate a show code to keep them calm so I and perhaps all on board don't die from the mob actions that could develop.

As quoted above I said I would continue assisting if they required it to continue. Standard of care in EMS is ACLS. That standard of care says consider discontinuing w/o pulling my book out I think it was 15 minutes with no ROSC. As to protocols they are only valid in the area the medical director signs them off for. But again I am willing to help continue cpr as above.

Age again does not matter. If we are only minutes away from landing somewhere with an organ transplant team ready to harvest my young patients organs then maybe we keep it going. If the airline wants to divert that is their choice. If they want to continue CPR that is their choice. Am I so calloused as to refuse to rotate with those that are doing CPR? No, if they are not allowed to stop I will offer to be in the rotation because it is unfair to them that because of the PR nightmare of stopping that they get stuck working so hard. My point is I am going to advise no need to divert and that I recommend based on accepted standards discontinuing life saving efforts.

Now the pregnant woman may not be pregnant. They have got women at the border acting pregnant that turned out to have a stash of dope strapped on instead. And even on cops we have seen granny actually hiding the dope as the gangs figure no one would suspect her. Sadly nowadays we need to consider the Israeli approach to aircraft security.

If they didn't screen them they would get accused of discriminating against the disabled wouldn't they?

Age etc does not change. Work 15-20 minutes if no ROSC code is stopped. No need to divert. Make sure the airport locates relatives to help with the children.

For those that actually added to the discussion with good facts or opinions rather than making asinine attacks thank you. The obvious answer was included in the poll it is the answer to most of what we do in EMS it is do it as needed, the third answer on the poll. When is it needed is more open to interpretation and probably more in the middle than the extreme I took as devils advocate and the extreme limits some placed in their comments.

Keep in mind it doesn't hurt you. Find the vein by palpation not by sight and you will have greater success. Rely on your senses as you slide it in you will feel it in your gentle hand. It is not hard but do not get frustrated.

Congrats Wendy. I know it will be a long tough road but I am confident you can succeed. A song for you.

So now we have done the compressions. Did AED ever say shock? Yes? Shock resume CPR check pulse after a full set of compressions. Any pulse? Breathing? No to shock or pulse then lets continue CPR push our epi. Follow the ACLS standard check pulse analyze with AED etc. No ROSC per current ACLS stop efforts go enjoy rest of the flight. If ROSC supportive care until turn over to the waiting Paramedics.

Don't know where that chat non sense came from. I have spent less time in chat than the majority of the old timers here and even many of those newer than me. I just gave you a negative for this post as it is completely nonfactual. Just because you disagree with an opinion does not mean it deserves a negative but I just did the same to you as a return the favor. I am not looking for pity, never have. Again not sure where you got that crap. You really have confused me with someone else. I have done something you have failed to do ever on here. I have brought original thoughts not just thoughts you have taken from others on the site and now you preach like they are gospel. As to admitting I was wrong or seeing someone else's point I have stated that multiple times on this site. As to this topic I have taken the devils advocate and preached the extremes with it in many forms as Wendy points out. Why it actually has gotten more EMS discussion going here than we have had in a year. This site is dieing quickly it seems. The only discussions that get much response are political not EMS and those are the same people spouting the same thing over and over again, as many pages as they go sadly there are actually very few posters. But I guess I am not allowed to do the same in your opinion. Do I actually think we will expose every patient? NO!! Do I think we need to look at improving our thought process as to when to do a more focused exam? Yes!!!!!! So by getting a discussion such as this it gets people thinking. One of the big false thinking is that they should not look unless blood is pouring out the regular clothes or a babies head is popping out. There is a balance based on assessment as Herbie mentioned. So Dwayne for whatever harm you perceive I have caused you in the past I apologize. Have a great day. edit for spelling

Wow there it is again not much we can do for it. Or as others state it won't change treatment plan. So then why do the basics take blood pressure? It will not change how they treat the patient, they can not raise or lower blood pressure. Why does the ER doc do a cat scan of a trauma patients head as even if it shows a bleed not going to change how he treats? Why? So you can properly decide your next course of action and where to send the patient. Wendy miss seeing you here. Thanks for your post.

Get someone with CPR training to help, usually the stewardess have that training. O2 via BVM. Is 30 and weak pulse at wrist or neck? Check for DNR. Any bleeding? Does chest rise with BVM? Any hives or other to indicate possible allergic reaction? Establish IV preferably 2 but doesn't look like you have a lock or another IV set up. Attach pads. Is AED type that will display EKG? If so what does it show. Go ahead and prepare your ACLS drugs as looks like you will be working if no DNR.

1. Based on you saying you would not expose how can you report what you see when you actually did not see? 2.Doing a proper exam which includes seeing the area of complaint is not going outside our scope of practice. 3.Not sure where you jumped out there for that statement but we all know criminal cases are handled differently. If the patient presents in such away that exposure is needed and patient agrees they will be exposed. 4.Again if you did not see you can not accurately report what is happening with your patient. The argument that it does not change my care does not fly. If that were the case much of what we do in EMS would be done away with as either our findings will not change care or we will not be able to fix it anyway. Maybe we should just be taxi drivers? 5.But we are very similar in that we do exams that help guide our decisions as to where a patient needs to go or even as to what priority the patient is and those choices can greatly impact the final outcome for that patient. The ER doc does much the same yes with much greater education but he still does exams to determine next treatment or what specialist they need. I am no claiming we are equal just that for us to do our part in the medical chain requires we do a proper exam. 6. Emergency Medical indicates that we practice medicine to our level. In our level often it is being the first eyes and ears for the doctor so they can determine based off our report just how urgent treatment is needed. We visualize for life threats, we stabilize as allowed, we report our findings to assist continuation of care. Our findings are not going to keep the doctor from doing their job but if we report it as minor it could put them way down the list to getting seen when in fact had we visualized we might have said something in the report that would tell the doctor hey this patient needs an even more focused exam ASAP so treatment can begin. I do apologize if my method of delivery seems attacking that is not my intent. My intent is to get people to think outside their comfort zone for the benefit of our patients.