Just Plain Ruff

I don't know but my wife is an example of having a respiratory issue with mag. She was admitted into the hospital last thursday with contractions. She's 2 months early. They start her on Mag Sulfate in her hospital room and her pulse ox drops dramatically while on the mag. I wasn't there so I don't know how that happened but it was a significant enough drop that the nurse refused the doctors orders to restart the mag. They put her on PRocardia for the contractions and they let up significantly but not without the procardia side effects to my wifes body. So can someone tell me why the mag dropped her Oxy sats? I can't remember and my books are of no help because they are all on the way to Eydawns house via the USPS who I hope gets them delivered before they go into shut down mode.

Why not sign up for a paramedic refresher course put on by a university or community college. Do your homework and don't fall for a course run by some yahoo but ask around and find a course that actually makes you think. You can sign up for the online versions but I'm pretty sure that you will get regurgiations of what you already know. I'll bet there are many refreshers put on by quality instructors who don't make you recite random facts and EMS info, but make you really think and put what you know and what you are learning into real practice ONe such instructor is Bob Page and another such instructor would be of the caliber of Mike Smith or Dr. Bledsoe if they do refreshers. Prolly not but you get my thought process here right? One question to ask yourself, would you go back to your school and take a refresher with them? If the answer is a resounding NO then you need a new direction and a new school to learn from. Books are one thing but seriously, a back to the basics class might just be what you need.

That's true AK, God did create Satan. I believe that Satan was one of God's chosen angels who wanted to do things his way and he was cast out and so goes the rest of the story. So yes, according to what I know and have read in the bible that God did create satan. He's the creator so God created him.

From what I heard, most Klansmen back in the days were democrats who were afraid that the black man was going to vote for the republicans. So do you hold the democratic party at fault for racism and lynchings?

Cool. You mean you can run a code without a ACLS Card???? Who'd have thunk it.

honestly, you don't even need a 12 lead for this. Just verification through a couple of shocks that the rhythm was one that should not be shocked. for the last patient we had, we just loaded him up in the ambulance after putting the magnet on him and drove him 80 miles to the cardiac facility that put it in. I mean there wasn't anything else wrong with him other than a loose wire that was shorting the device. They took him to the OR or wherever they put that thing in, replaced the device and the wires, and sent him home after a day or two. I don't even remember how long he was in the hospital for. Never got another call on him. the magnet should never be used/nor considered to be used by a EMS system without a cardiac monitor, ergo BLS system.

Oh goodness yes. You have to make sure that the AICD is not functioning right. I never just placed it on willy nilly. There was a line of AICD's that apparantly had malfunctioning connectors or something like that. some of our patients needed replacement AICD's. The only way I would put one of those magnets on is if I had a documented strip of the defib firing on a perfectly good non-shockable rhythem. Had one guy with a normal sinus rhythm getting shocked every 45 seconds. I'll run the strip through at least 3 if not 4 shocks and if rhythm is the same, I'll put the magnet on but not without medical control OK. I have to have med control approval to do this. I will also put the external defib patches on just in case the patient does get a shockable rhythm and the magnets on. Every one of the times I've put the magnet on, the patient did fine. But I'm going to make sure that I have a good rhythm prior to putting it on. I hope that I didn't sound Like I'd put it on immediately because that would be a stupid decision.

i'm a firm believer of having a magnet that is in each ambulance in order to help the patient. I don't say this lightly but I do recommend that before every ambulance service gets a magnet (looks like a doughnut) that you get training from a cardiologist who puts these devices in. You should also have a medical control group that approves of the magnets. I have had a number of patients with this happen to them. about 12 or so over 20 years. It hurts like hell for the patient and I feel very bad for them. It's pretty simple, just place the magnet directly over the bulge where the implanted defib is. Need to get online medical control involved in this procedure so they know what they are getting ready to receive. if you don't get the training from someone competent in this as well as no buy in by your medical control then don't do it. but of the 12 I've taken care of, the three that we used the magnet on thanked us for making it stop.

you Kiwis, just got to buck the trend don't ya. What do you have in place of ACLS?

here is the bottom line, if you are not allowed to give the medication, if you are working only in a first aid capacity even if you are a medic then you are just that, a first aider. You work to the job not the certification. If I'm working on a BLS truck but I'm a medic (why would I do that but it does happen), then you are effectively a EMT. If you are working on a fire truck without medic equipment but you are a medic, then you are working as an EMT. So working as a First Aider, you are expected to work as just that. You call 911, you try to stabilize the patient best you can, if you cannot get medical control to authorize the inhaler and the patient doesn't have an inhaler, then you don't give the inhaler. Sucks to be the rocket scientist who forgot their inhaler but life sucks. You use what equipment you have and hope the ambulance gets there in time to give the nebulizer and other meds as needed. Bottom line, my certification and livelihood require me to do my job as required. If I don't have the tools that's on the organizers of the event. My family requires that I provide for them and I cannot provide for them if I get fired or lose my cert because I went beyond my scope of practice for a given job. Without an order for the inhaler and I give it, I have just gone beyond my scope of practice and 99% of the time nothing will go wrong but theres always that 1%. but I'm going to do all I can to prompt someone in the audience with an inhaler to step up and use their personal inhaler. Maybe by saying "Boy, I really wish that you had brought your inhaler with you" loud enough for someone to hear and speak up and say "I have an inhaler" I'll reply with something like "I cannot use it, I need to get orders from a doctor to give it" and hopefully that person will step up and just give the inhaler. Wishful thinking I know. I am also a realist and I know that if the patient is in acute crisis, nothing is going to fix the issue aside from a nebulizer. The inhaler might stave it off but neb meds are needed. Let's just hope the ambulance gets there in time so I don't have to face that situation.

Just recently, Andre Carson Democrat of the congressional black caucaus(I believe that was the person) was recorded saying that the Tea Party wanted blacks to be second class citizens and the tea party wanted blacks to hang from trees. When confronted with his remarks, he said he stood by them. One of his staff said when called, that he made those statements in regards to the public school food budgets and food budgets all over being gutted by the republicans. Strangely from what I've read there have been no republican led food budgets gutted since 2006. And that was from a democratic controlled house/senate. So the black legislator from Florida Allen West Republican said that he needed to take those statements back because statements like that are inherently racist as well. that if the caucaus leader Emmanuel Cleaver Democrat from Missouri and leader of the caucaus, didn't say something in response to Carsons remarks, that West would more than lkely leave the Black Caucaus. It's remarks like this that make us all less of a people. When a black person brings out the race card, they usually don't have anything else constructive to say and are just spouting Bullshit and cow patties. Where is Crotchity on this issue? I read this in the USA today paper this morning. Where is Crotchity's outrage that one of his race could be racist? Where is his outrage over these comments? I'll tell you why he hasn't stood up, he hasnt' stood up because it's OK for a black man to cry racism even when the FACTS do not support his comments.

It seems to be everywhere that we are not.

See Dwayne, it's not that uncommon. You have two members who ascribe to the same build.

My son tells me that also

Well Crotchity gets so much disagreement from those of us here that I believe you felt it was your responsibility to be the one today to agree with him. Do not let it happen again.

Squint, it's all your fault.

Dwayne, I was dylan when I hit puberty. Or at least had this problem. It was so embarassing that my father and I had a long drive and we discussed it. My father said to me and I'll never forget where we were at the time. Driving down Wornall Road at 73rd street in KC MO on the way to my grandfathers house. My father said that our family has a strange way of growing hair. Our legs are always hairy, our chest get minimal hair and then our arms get hairy. We then grow bald. We arrived at my grandfathers house and I then noticed how hairy his arms were. Put it all in perspective. I grew out of it. I'm sure Dylan will also. If you are worried enough to post that personal info about your son here, then I would definately go to a doctor who specializes in autism and it's growth effects. Maybe an endocrinologist or better yet, pediatric endocrinologist. It might be his hormones at age 15 that are just playing havoc with his body. i know that Wiki isn't a valid tool but here is a nice article on Hirsutism. This might be his issue. http://en.wikipedia.org/wiki/Hirsutism Here is a link for abnormal puberty manifestations in boys and girls. http://www.patient.co.uk/doctor/Puberty-Normal-and-Abnormal.htm This from a chapter in a text book. Lots of scientific stuff here. http://www.endotext.org/pediatrics/pediatrics13/pediatrics13.htm One more option http://www.livestrong.com/article/237147-abnormal-hair-growth-in-children/ This site gives links at the bottom to many other puberty related sites. Maybe one of them can help. http://www.usc.edu/student-affairs/Health_Center/adolhealth/content/a1.html Above all, I've read a consistent theme in all the sites listed above, if you are concerned about this abnormal (which in reality might be normal for Dylan) then you need to go see a doctor. A good start would be his general pediatrician and then he can refer you to others. Or you can make an appointment to a specialist without the advice of Dylans pediatrician or physician. I think he's just a normal 15 year old going through the puberty. I have about 5 years before I get to experience it with my son. Can't wait.

It never made it here because I think i t might have been before Crotchity's time. I bet you would be hard pressed to find a dozen or so stories of the same thing regarding primarily minority companies not being "black" enough yet I'll bet that if we looked hard enough we could find hundreds of stories just like this turned around and focusing on primarily white companies who the EEOC and a number of other agencies in the federal government coming down on white companies who they deem not "black" enough. The chicago fire is a prime example of a department not being "black" enough.

isn't that the expert consultation that ACLS recommends?????

and isn't a prescription required for home oxygen? I believe that my grandfather who needed home oxygen needed a prescription. For one poster above to say that oxygen is allowed without a script, I believe that is a wrong statement. So you are saying that once you go through the EMT or paramedic course, that just because you were taught how to give let's say Adenocard or dopamine that it's ok to give it? What about an epi pen, you get taught how to administer it, right, you do know an epi pen requires a script right. So once you've been given training on how to give it it's ok to give it without the script or protocols to give such a medication? Can you clarify that response quoted above.

My apologies AK, it was one of Squint's replies that he had struck through part of my post. Again my apologies. Ok, one hypothetical question. If God didn't exist prior to those 1000's of Gods, could they not be one in the same? For arguments sake and my being obstinate - couldn't those God's that came before the Christian god, be the creators of the Christian God therefore negating your stance that God did not come out of nothing therefore he does have his own creator? Neither of us is going to win this discussion, it's a good one to have as a discussion but your views are entrenched by the way you have lived and mine are entrenched in the way I have lived. I have no intentions of swaying you to my side, I see that that would be impossible and I don't believe you can sway me to your side as that too is probably impossible. For you, it's all about you and your actions on how things are yet I choose to believe that there is a bigger thing out there. But enough about that. I would say I would pray for you but I don't think that would be taken as a positive thing by you, but then again, I could be wrong. Quote God did not exist for a very long time Are you sure he didn't exist prior to the bible times? Are you 100% sure that up until the bible was written, the language and ability to write things down hadn't come into it's fruition yet? The bible says that God created the heavens and the earth so since I'm taking that as literal history, then wouldn't if be fair to say that God predated every other god and the 1000's of God's you say existed before him actually existed after him? God as a written concept or subject only occurred in recent history, compared to the age of the earth/world. So couldn't he have been waiting till the right people came along to Out him, so to speak, to tell his story? You can answer that or not, I'm actually just thinking out loud and using my fingers to speak it. I have questions as to things in the bible, sure do. Bet you are surprised at that. I believe the bible is the word of God but I just have a hard time grasping all that was written. There are things in the bible that I question, but I believe that I'm supposed to question those things. Just as you question everything religious, I question how things came into being without a creator. But I'm waxing philisophical and I have work to do.

Dwayne, I don't remember her passing. I know you may have posted about it but I couldn't remember. I keep in touch with 2 caring bridge patients. I am sorry.

I can't introduce you to them. I have no answer to the question you just asked. You win that round. I've never thought it that way, something for me to think about. ASide from the condescending response, there is no need to talk to me like I'm a child. And are you going to delete or strike out every reference to God in these forums like you did to my original post? You have a lot of censuring to do starting with this thread. Better censor everyone who has ever mentioned God on the forums. The only answer to your question of how God came into existence would be that he has always been here. There hasn't been any period of time that he has not been here, so since he's always been here he has no mother or father. I think I'm done with this thread.