spenac

Well I don't know why but I'll play voice of reason tonight. This is a news report. Much of it could be slanted to sell news. There is every possibility that we are not getting the full story. Would you want to be hung w/o a fair trail? Wow that was tough.

You can not force treatment or transport on anyone that does not want it. Speaking from personal experience with asthma, I have had to add O2 to break a severe attack. Once broke my regular meds maintained me just fine. I am sure many that we treat that are experienced asthmatics know this as well. That is why they ask for a treatment with O2 and then refuse transport. They know that they will be billed for expensive need less transport and tests. Often we as asthmatics can tell rather quickly how much relief we are getting. Other illnesses such as diabetes, angina, etc are similar in that people know what they need many times. That is why they refuse transport. Do they sometimes need more? Yes but surprisingly they will often tell you that somethings still not right. Listen to your patients many times you can learn a little something from them.

I hope I detect a lot of sarcasm. :shock:

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Why do you hate "RUSH" so much? A modern day warrior Mean, mean stride Today's Tom Sawyer Mean, mean pride

http://news.yahoo.com/s/ap/20090206/ap_on_re_us/octuplets "Doctors say the norm is to implant two or three embryos, at most, in women Suleman's age. "The revelation about one center treating her makes the treatment even harder to understand," said Arthur Caplan, bioethics chairman at the University of Pennsylvania. "They went ahead when she had six kids, knowing that she was a single mom ... and put embryos into her anyway."" [web:030b99e79e]http://news.yahoo.com/s/ap/20090206/ap_on_re_us/octuplets[/web:030b99e79e]

Over 100 active labor a year.

Nope we believe in saving topics not terminating them.

Thats true I forget that most are not as talented as I am.

Why? We deny transports to those that can safely go by other means. We also treat many conditions on scene but will not transport them. It will require more individuals get real education not just monkey skills.

I see your and Vents points. This is a reason I have fought against EMS wearing badges. I do not want to be confused with law enforcement. But at the same time when under attack we should have some means to protect ourselves. We can no rely on LE. They actually are rarely on scene with us so it will be up to us to do something with the patient pulls a weapon. But again there is no easy answer and sadly the statements about some being trigger happy is probably true.

Honestly having some form of self defense would be a great idea. But only for when theres no way out but to fight. Had the EMT that was shot had a gun or even a taser perhaps he could have fought back. We will never know.

He should be able to drive right over.

Holy crap. When will the madness end. We should make a rally of EMS and go and support keeping EMS seperate there. But since no one is that motivated at least go submit a comment in support of EMS staying seperate.

Cenrtalized dispatch seems to be a good idea. In fact the crap that is EMS in Jersey they actually have a centralized dispatch. Might be the only good example you can find in Jersey. Something has to happen. I have seen way to often the hospitals call one after the other until one agrees to fly in bad conditions. Plus you see subtle bribes in little gifts left with the nurses and with EMS so they hope you will call them first. Changes must happen. Helicoptors are not needed in probably more than 50% of the calls they fly much like ground ambulances are actually not needed in 90% of the calls they run. This goes back to the need to do away with the you call we haul mentality.

http://abcnews.go.com/Blotter/Story?id=6790176&page=1 [web:cc86f155fd]http://abcnews.go.com/Blotter/Story?id=6790176&page=1[/web:cc86f155fd]

Especially photos of you drunk doing disgusting things. Unless your applying for porn stars those usually keep you from getting hired.

Why? Intubation is an Intermediate skill. As an Intermediate I have intubated many patients. I even as an Intermediate can RSI and perform surgical cric. Sorry your starting to show your time away again.

Hey don't dis the massage therapist they are required to have more actual A&P than any basic and sadly than most Paramedic courses.

EMT. Yes what do I win? :shock: It is sad that on that list we are supposed to provide medical care that could be "life saving" yet require the least education. How stupid is that? Basics should require at least a 1 year college course and include a lot more medical education rather than put splint here training.

Exactly. W/o a "field" or "working" diagnosis you could not even place a bandaid on a cut. I do not know why so many are so afraid to admit that we must make a diagnosis of some sort if we are to do any more than be taxi drivers.

Scott33 said the following on another topic. "Yes we do, we do it all the time. Some of us just don't realize it. Take your "diff breather" call. A basic assessment should point to whether it is an asthmatic, COPDer, CHFer, Pneumonia etc, even with PMHx of "all of the above". We should already have ruled out some of the other possibilities prior to treatment beyond that of positioning and O2. The reason the poorer providers out there give nitrates and lasix (and God forbid, CPAP) to patients with pneumonia, is down to poor assessment skills, which neglects a consideration towards other co-morbidities, which could present with similar (go figure ) initial findings. This is the principle behind what AMLS are trying to endorse - possibilities to probabilities / ruling out and ruling in. It makes perfect sense if one knows what to look for, and encourages clinical development and a further understanding of common disease processes... …or we can just load and go. " I am a firm believer that we should examine patients, make a field diagnosis, treat, make a determination to transport or not. I do not feel that the patient has the right to demand transport, but has the right to refuse transport if they want to. I feel we need to be able to deny transport to those that do not need it. This is not lazy, this is actually using medical education. OK discuss if you want but try and not stoop to attacks or the crap that makes you be an idiot unless everyone agrees with you.

Good call and you will make a great medic. Never ignore your gut. With education you will be able to do so much for those you treat. Hang in there.

I hate you. Hows that? lol :twisted: Yes back on track so we can learn. We have all stated our opinions multiple times on transport discusions and after a vote it was determined I was the only right one. So no point in restarting it. :shock:

Nope they actually based on reports if accurate follow the lazy you discuss. They do not do proper exams then make a determination for need, again based on published reports that may or may not be accurate. You have condemned people based on news not on facts. Yes I am sure there are lazy medics out there. We are not lazy. It requires me more documentation to say no than it does to transport. But I think it is worth educating patients by saying no. Eventually maybe EMS will return to what it was meant to be for EMERGENCY.