letmesleep

This should be treated like any other sport that American children get involved in. In EMS we typically spend our Friday nights at the local High school watching Football, Basketball, Wrestling, and even volley ball, so why would this sport be any different? MMA should be treated as any other sport when it comes to kids. Parents should even step it up a notch due to the potential for injury, they have this information available going in to it with their children. Parents should take the time to be RESPONSIBLE for the kids they brought in to this world, and be involved instead of using this or any other sport as a means of "baby-sitting". mark me down for it being a sport.......with all due respect to those out there who have made it your life-style!

Ok, so I went on a trip last weekend with my beautiful Fiancee, and family/ friends. My fiancee and I are both medics at different Districs, but you all know how medics (EMTs) are, we still talk shop. We are all partying, have a great time and some people from another campsite came over to hang with us (obviously our party was much better). This isn't a problem for us, all are welcome with us, but this guy appeared hygienically deprived a bit. He accidently scratches someone with his finger nail during a drinking game, and they lost it, worried about contracting something from "Mr. smell good". This got me to thinking about the silent killers that we deal with, and the unseen dangers of our job. I started thinking about Hep C, multiple blood borne pathogens, the driver that isn't paying attention to the road when we are on a scene...so on and so forth. I ran this around in my head all weekend trying to put together a thread for us all to discuss, but at no time did it interfere with the drinking....lol. All was good and the trip was a blast, nobody got injured and only one person went to jail for a few hours. We got home, unpacked, and chilled on Sunday. Monday we got up and started to do some running for wedding stuff when we got the news that Ryan Hummert had been shot and killed. I do have a friend who works for Maplewood (not Ryan), but other than that, neither one of us knew him (not that it really matters, he's a brother). I never in my thoughts over the weekend even put such a scenario together, but how REAL it is. Just let this be a reminder to be careful out there. Things at both Districts that we work for have been erie this week for sure, even tho we are crossed the county and in the next county over from Maplewood, but we all feel the pain of our fallen brother. The funeral is tomorrow, and our prayers are with him and his family. Be at peace my BROTHER.......................................

I never realized how often grover actually "got it"......what a *BLEEP, BLEEP, BLEEPING* horndog

IDIOT!!!!!!

Its time to move away from the a**hole who did this no matter what the cause and take care of the family of our fallen BROTHER. Its a sad day in St Louis Co, as well as the surrounding areas.

Ran in to a couple of the Maplewood guys at LEONS yesterday, and they are still in disbelief, but said they are holding up ok so far......Not suprised, just good to hear from one of the CAPTs! http://www.ksdk.com/news/local/story.aspx?...mp;provider=top

what are you complaining about? A free, all inclusive trip to "SUNNY CALIFORNIA"? stop your bitching! sorry couldn't resist, just joking, but seriously be safe if your on your way!

no problem, I didn't take it that way, thanks! please continue!

ok, I don't think the first question was written well......I'm not so much asking if the "old schoolers" should be expected to keep up with the changing treatments of medicine. Obviously they should, and ramming "2 of bicarb" isn't going to cut it. I'm asking more along the lines of the everyday station "way" of doing things, how they talk to the public, so on and so forth. If this question isn't making sense then feel free to just skip it.....any one else have a better example of what is being asked? thanks for the input.

A deep conversation in another thread was started about "old school" vs. "new school" medics (and EMTs), ok, actually it hijacked the thread. I was inspired by another member to start a sperate thread to continue the discussion on this topic. I will say right off the bat that this could get a little heated, so let me remind everybody of 2 things I think we should keep in the back of our heads: 1) We are all well educated in our own right, and should be as respectful as possible to each other 2) Be a professional when you answer some questions: Should "old school" ways of doing things change with up-to-date treatments? Are the newer medics and EMTs coming in to the field with more knowledge base? Can we and/or should we try to learn from each other? What do you want to learn from the other generation? What is your over all perception of the other generation? How do we make change to better understand each other? answer 1 or all, however you feel you want to respond!

Sounds to me like a few people need to calm down and remember that this supposed to be a discussion not an argument. *Never* did I say that any of YOU should put face down transport in your "toolbox" of tricks, in fact quite the opposite, don't! *Never* did I state one way is better than another! *Never* did I state that I wouldn't reconsider the use of prone transport when placed in that position again! It is hard to think straight when your "getting your butt whooped" wendy, but isn't that what we are trained to do? Aren't we trained to think straight in a time of crisis no matter what it may be? It's really cool how different quotes have been pulled from here and there, but did the whole statement get read or was it just a quick skim through? I'm not just picking on wendy here either! CBEMT, in your second quote from me about evaluation.....did you read the rest of it? where it states that a Pt should be rolled back over immediately after they have started calming down, or did you just pull out the part your needed to make you point? It would be the following sentence making reference to FIREDOC. You may not be interested in how closely i monitor my Pt, but the question was put on the table. As far as the reference to leaches JPINFV, I'll have to look around a bit, but I'm very positive that some hospitals have been, at least, doing research on promotion of blood flow with the use of leaches in recent years, and believe it or not I think I have even seen some studies on the use of maggots as well. Look, I have stated here that WE are not in disagreence over the topic of prone transport, and I will take a moment to also THANK YOU ALL, for teaching me some new information on this issue. I would like to address your "lesson" to me about standard of care/ medicine as a science/ and case study in regards to being "old school". I find it interesting how easy it is to forget where the career came from. Your all right, there have been multiple changes in medicine over the past 15 years of my career (personally) that make a lot of my inital education "out dated". JPINFV, you made a good point, and I have also stated something like that in another thread, about changing OUR standards. Does that mean that YOU as the newer generation have NOTHING to learn from those of us who have been here since you started kindergarten? You, as a newer generation of medic have more knowledge base than my generation ever did comming out of school. You have the ability to find information at your finger tips right out of the gate. Study after study is available here on the internet, but read it. Yes, all of this is here for me too, but I'm not discussing me right now, you'll get a chance to do that when I post this. All I have been asking YOU to do in the past few pages of this thread is to open your mind, and get away from the "Nevers" because there is not absolutes in medicine. You can find a study to justify whipping front to back vs. back to front, but use the information to guide you through your career not dictate you through, otherwise you get stuck on the "cookbook" medicine that is so very much loved here in the city (that was sarcasm). I hope to have further discussions in the future with you, because you are all very intelignet as well, but remember that those of us who have built this career for you to carry in to the future and especially those before me, still have plenty to offer. There is always going to be a situation arise that you or I have never seen or even thought we'd run in too (science), WE are going to handle it as best as we can as to not harm, but to help the Pt (standard of care), and hopefully that situation will help teach the next person what to look forward too (case study). Thanks!

OK, time out wendy. Why is their treatment wrong if they still have protocols and equipment on their truck in the case of the MAST pants? This is my whole argument. WE both do agree on the continuing education, and sounds like WE both agree on changing with an ever evolving medicine, but why are they wrong? Another point that I'm trying to make (and I will concede that my point may not be coming acrossed very well) is, as you stated that you are not an x-ray or MRI, is there another way to evaluate this pt? As far as transporting in the prone position, it has been done before by me and others, and as far as improved medical care (or better) from your choice of treatment there is none, It would be the same as far as over all Tx. When a Pt gets transported in the prone position, they should be evaluated more closely than a "typical" Pt in a supine position. Even if talking to your Pt pisses them off and aggitates them you know they have an airway (much like a baby crying in a peds scenario), but also in this situation the provider should increase how often the VS are taken. Firedoc also pointed out that the Pt should be turned back over as soon as they have calmed down, either on there own or with sedation.....and that should be done immediately! This Pt shouldn't be left alone at any time including after arrival in the ED. It's not so black and white which is why medicine is a science, all I'm saying is that there may be a time, and if that time occurs what are we going to do? Call in your ALS truck for transport, but don't look down on others that take another approach. I think this has gotten way of the original issue about restraining your (generalized) Pt, and I haven't heard back from those who said they would hand the whole thing over to PD.

Obviously there is 2 sides to this issue, and it appears to have a similar effect as Roe vs. Wade......... I have done this before, it has been many, many years ago. As I have stated in this thread, I will think twice about using a prone position to transport in the future. I also have stated different ways to ensure the safety of the Pt. This isn't some random/ unheard of means of transport, and does take a little more time and effort than simply sitting back and relaxing after the Pt has been restrained. I didn't ask YOU or anybody here to put this in your "toolbox" of treatments, in fact don't! If you are uncomfortable with this, by all means stay as far away as possible from it, but don't judge me for using it. I have also used the "coma cocktail", and epi down the tube in the past, so what? Times have changed and WE as professionals should be responsible for changing with the times. All of the different means for restraint mentioned early in the thread are old (LBB sandwich as an example), and may still get used, but just because we have evolved from those days, does that make it wrong to use them these days? If somebody out there throws MAST pants on a Pt with IVs, are they wrong for doing that?

"standard of care", you'd be suprised how many providers out there would utilize the prone position in this day and age as a last resort. As FIREDOC has pointed out, there MAY be times this procedure is needed, but there is also a way to do it to minimize the risk of harm. My point here is not to sell anybody on the idea, and as it's been proven with research there is a huge risk, but should WE judge others for using it? Open your mind, put someone else's shoes on. I only want to know why prone should NEVER EVER EVER be used, why are we so hung up on such an absolute? here you go.....I *NEVER* asked you to change anything, just asked why I shouldn't use this means of transport.

I totally agree with you FIREDOC, but it isn't just the groups of racist that I have a problem with. It's the everyday crap the comes out of people's mouths that gets under my skin, but even worse is those of us who "care" for the sick and injured and/or "keep the peace" that bothers me.

I'm not hell bent on transporting in the prone position, just wondering why people are so afraid too. I see the evidence that it is a danger for the Pt, but there is NO absolute in EMS, so how is it that people here are so stuck on the NEVERS. Just trying to open the thought process' a bit after reading another thread and seeing many who stated (and this isn't a direct quote at all) that it's difficult as hell to monitor the Pt when they are thrashing around in restraints. Agree, but not impossible! I guess remembering the "old" days when we talked too, and observed our Pts without the neato little devices we have now is getting the best of me. How many times have you seen newer folks sit back after a Pt was restrained and start typing out their PCR? Prone may not be the best decision out there, but is there NEVER a time that it may be need or utilized? thats all. EYDAWN, I guess using the protocols is a good way to stay "within the law" or as you stated "good legal standing", but if I get lucky and don't harm the psych Pt, then how am I any different than those FFs that ignored command in the freelancing thread? As long as I get lucky there should be NO recourse, right? I really am not trying to pick a fight here, I just don't understand the NEVERS.

Thanks JAKE, I'm going to pull out the old "protocol" book and look in to this thiamine thing, I wonder now why WE have never gotten orders for this on a diabetic call.....maybe a phone call to the MED director is in order as well to shed some light on it....hmmmm!

Yea, maybe I do have a chip on my shoulder when it comes to the childish attitude in this field in regards to racism. Someone here wrote something along the lines of 1 step forward 4 steps back (about a totally different thread and topic), but how fitting. I am all for blowing off steam, and playing pranks, cracking jokes here and there, but to drop to such a level of UNprofessionalism is damaging to all of us. We have been talking the past few days about reporters viewing our forums and taking sarcasm out of context, and such, and the fact that the general public doesn't understand US like we would like them too. There is NO second guessing these acts of racism that have no place in EMS let alone any emergency services. This situation is going to put a negative spin on the EMS system (at the very minimum, in that community) for a long time to come. It's sad as hell that providers working in that system are in a situation where they feel they HAVE to get body armor to go to work. A chip? damn right I have a chip! I also want to share my opinion about the hazing, like I said jokes and pranks for blowing off steam is one thing, but taking it to a level of hurting someone is totally different, and I believe if this "prank" had gone through the way it was supposed to it could have had a horrible ending.

SPENAC, I know that Thiamine is used on alcoholics yada yada, but other than a known diabetic with alcohol use and/or abuse is there anything you can tell me about why it would be given as a follow up to the D-50? I have never heard of this one before, just wondering?

I typically will give the entire 25g IVP in a known diabetic who is found unresponsive if family is present to tell me or they are a frequent flier. I also think that you have to use some common sense as well tho, knowing how the drug metabolizes and how your diabetic Pts are going to respond short and long term needs to be considered, again it all comes down to a good Pt Hx. Pt to Pt, call to call, there is no REAL standard in my opinion. As far as thiamine, I'll have to investigate a little, but is there some thought process that it improves the response to D-50? I know that "back in the day" we had the "coma cocktail", but I think we have gotten away from that type of "cook book" medicine

We have all heard of freelancing in EMS before. I was just wanting to get some input on where you may have seen it happen, or have you gotten caught up in it, due to somebody else's bad judgement? Big situation (like WTC) or small (the county fair) doesn't really matter, having a system in place and following direction from command keeps things under control and utilizes resources appropriately, and without waste. Agree or disagree? What can be done (on a scene) when it occurs to stop it, and how can you (as an organization and a provider) learn from it? Every area/ region/ district is going to have their own system to some degree, so what happens when medics/ cops/ FF deviate from the system? Thoughts?

What amazes me the most so far is how bothered people seem to be over the hazing, and how nobody has even commented on the racism yet. How is it that such a field like EMS seems to tolerate that thought process within it's walls in this day and age, but "don't you dare question my professionalism". How is there room for racism against a human being in medicine period? "We care about our Pts", but then have no problem tossing around racial jokes, slurs, or pranks like this. BS!

Wait a second there chief, RSI the biggness and stick a tube in her face....umm in case some reporter is trolling this, thats a good thing! How did the Pt do with an advanced airway? No, big deal about the helicopter, if what I think is wrong with her, theres a good chance that it won't matter much any ways. She may be looking at long term rehab or a hospice. so, any changes?

first of all is this confirmation that this is our only pt? "Your partner finally returns with an aide who says "oh crap, that's her" and runs off." If so, cancel the inbound BLS truck! ECHOBURGER has an OPA in and bagging, lets get her suctioned out and get her intubated, we got what 7 people here now so lets get her down the steps and out to the truck while we bag her at a rate of 12 to 20 for now. Somebody would have been sent to retrieve her chart and we will just take the whole damn thing. en route an IV NS, I would like an 18g with her, but we may be a little limited. I would have asked about a helicopter, but I have a feeling you were going to shoot that idea down, but? Does her chart have anything about her Hx? maybe CVA or HTN? did we get the chart? Hows she doing at this point? any changes with the bad a** vent that we have on board? continue with suction as needed, and reassess.

I'm also not as educated on this issue as I would like to be, but I do believe in my recent PALS class the AHA is saying that 8 to 12 is recommended per minute......I do need to double check that, but I'm almost positive thats what they said.