Just Plain Ruff

So you don't advocate a passing score of 64 or 60%? that's what one of my last ACLS classes consisted of. Had a person take the test, failed it at 60%. They appealed the score, saying that they had a learning disability which made test taking difficult. The director of the class asked them to answer the questions they had gotten wrong, she read the questions. This would have been ok had the person not have gotten the answer key to review their answers prior to being re-tested. If you lower the score bar, then you would end up just like,.... wait for it..... ahem..... wait for it.... scroll down....... keep goin keep scrolling keep on scrolling Here comes the answer Chicago Fire department!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Just heard today that the only church destroyed at the site was a greek church. they want to rebuild the church on the site. Mayor Bloomberg says he doesn't want to allow it because it might be offensive to some!!! WTF - he's OK with a mosque very very close to the site yet he's not ok with a church being rebuilt. What a crock of crap.

You mean they have tricorders and transporters in Bavaria???

Dude, no offense taken at all. I knew what you were actually thinking. And Bernhard you are correct.

Actually the only ones who have the guilt are those with the victim mentality. WE have the guilt and it's up to the victims(and the courts) to point that guilt out.

I have the ultimate solution, As soon as the tricorder comes out, put a medic on every corner, it sure seems like we have a glut of medics and emt's out there. Put them on every corner, give em a skateboard and they can use the tricorder to evaluate, treat, diagnose and prescribe. If the tricorder says to transport, they use their transponder to request transport to the nearest medical center that the Tricorder determines that the patient should go. The doctors (holographic ones like the one in Deep space 9 or whatever) can do the rest. After the patient is seen they are either repaired/healed using the small device Dr. McCoy used to administer all his shots or they go into the sick bay and their treatment runs its course. If it's determined they need transport to a convalescent center they are beamed to a waiting shipulance and it sends them directly to the center of the doctors choosing. that's how it should work. It's coming soon, I'll be dead before that soon comes but it's coming.

Island emt seems to be the winner here. But since I did not get to the hospital that night I won't know if it's truly the right answer but all the symptoms fit. Even my diabetic doctor this morning said that was probably what it was. Now, who can guess the syndrome? Winner gets the Obtuse diagnosis award for the day. Pee'd standing up. Because of this incident and my wife's insistence on my calling my doc, as well as ERDoc's recomendation, I will be getting a cardiac stress test, EKG and blood work next week. YAY!!!!!!!!!

ooooh, just read one of the bloggers addendums. Hey Crotchity, why are you not outraged that the scores have to be lowered? why are you not outraged that the original passing score was 64??? 64% is failing in any school I know of. Why are you not pissed that the test givers felt that they had to lower the score so far? You seem only to be pissed that the black man was put down and oppressed and that's why it's racist. I think the underlying issue is this, why was the passing score originally 64%? Doesn't it make you mad that in order to pass the test you had to fail it first?

And for that you are welcome. But I really wasn't trying to make your point. I'm against racism in any form.

Well wouldn't that make the scores like 40 for passing. I'll bet that 75% of the current chicago fire departments members couldn't pass the physical agility. Plus sitting around watching television all day while running calls doesn't make these guys any smarter does it? By the way Crotchity, do you have any documentation of what the test questions were? I'm sure that they are out there. Plus to drop the passing score, doesn't that make it seem that the applicants overall were stupider than they should be? If the test is written to a 5th grade level like most of these types of tests, if you cannot pass it then should you really be tasked with using hyrdaulic machinery, driving a big red fire truck or God forbid, taking care of someone who is sick? Wasn't there a recent city who had to drop it's passing score to like 60 to get enough black applicants?

none of the above Vitals are 140/90, pulse 64, resp - 24, pulse ox 99. Takes metformin, insulin, gemfibrizil passed out was only witnessed by ME, and I'm not sure how long I was out. But when I woke up I found that I had been sleeping in my normal place in the bed. the time I woke up to go pee was 3:40 am. My alarm was set for 0710 I remember getting dizzy, light headed, some chest pain and sweating a bit but after I sat down on the bed and laid back, I remember nothing else other than getting up at 0700. I do remember lying back on the edge of the bed but do not remember getting up to go sleep normally with my head on the pillows. No drugs or alcohol. I cannot tell you what my pupils were like. I didn't check them. Remember this happened to me!!!! Well without the ambulance being called so I'm making up some vitals for the sake of the scenario.

All but the 911 ems call - scenario as follows. ERDOC as he was the doctor on this and cannot play unless he wants to do a teaching session after the right answer was given. 911 call on a passout now conscious On arrival find a 43 year old white male, sitting on the side of a hotel bed. Noticeably pale and slightly sweaty. History is patient woke up, went into the bathroom, went pee and started walking back to the bed and became dizzy, nauseous, light headed, some chest pain and sweaty. Patient seems to be in mild distress but otherwise says he feels fine now. Ask away.

Yeah usually the default ss# that is captured is 999-99-9999 or something like that. Seriously, you don't need a social security number to identify someone if you have your system designed right. I just give the office or doctors office or the ER my insurance card. I can't remember the last time I was asked when I went to the ED. Plus, it's not really anyone's business what my number is. If they are using an antiquated system that looks me up by social I say I don't give it out. Had a credit collection agency call me. They were trying to get money out of a turnip at the time. They asked for my social and I said I don't give that out. They demanded the social. I said, tough crap. She called me immature and trying to keep from paying the bill and I said "That's exactly what I'm trying to do" She hung up on me. I have lifelock and have been notified twice in the past that someone was using my number. It was stopped every time. Even if the person got past Lifelock my credit report would have scared them off since I have a credit score of 400 or so. I follow the Dave Ramsey Plan and the only thing I have on credit right now is my house and I got the house before I got on Dave's plan. Dave says in his show that he strives to keep a 0 credit score and pay for all things in cash. We do the same thing. You would not believe the inaccuracies of your credit report if you went to look. I had multiple inaccuracies and got them cleaned up. It took a while but now it's all cash only. The next car I get will be paid for in cash. So anyone who asks for my social will get the "I don't use it" and if they don't like it, tough.

Yeah but in rural areas that part theory isn't really in place except for the interstates. You can usually get people to move out of the way in rural areas. But the concept is sound in my opinion, I just don't see a need for them in a rural area. NYC or LA! Yep

True Dat, emssworld I can see these for urban ems, but rural with minimal traffic would really not benefit from them. But there would be the one time or several times a year when all the ambulances are out on calls and an additional call comes in that would make the bike medics a good thing. Maybe what should happen would be if bike medics are utilized in a rural area, they should be on call for the times that all ambulances are out. They are taken home on a off shift basis and only get called out if a medical emergency comes in that there are no ambulances available for. That would be a good thing. Or they could be used but if the ambulance is closer then they don't respond unless it's a major medical incident such as chest pain, code, shooting or the like. Those you can always use a 2nd set of hands in the back. But then you have the issue of what you do with the ambubike in the mean time while that medic is helping on the call. And how do you get the medic who drove the bike back to his bike? Especially when that call is way away from the ambubikes driver lives if he came from home. But even with a bike unit, there needs to be policies and procedures in place for those ambubike riders who think they have carte blanche to drive however the hell fast they want.

Yeah doc, a stinky crotchity or ruffems is one thing, but a stinky ERDoc who has to treat patients in a non-smelly environment is another. At least those of us in a dirty stinky job such as ff/medic or just medic can get away with stinking. I think I will go get some of that alluminum free deodorant. Surely the organic grocery stores sell non-aluminum deodorant.

Why not just put people in their cars or provide a couple of chase cars in the county budget. I mean cars are more expensive than motorcycles but they provide much more protection in a crash than a motorcycle does. What would the liability and insurance be for putting motorcycles on the streets? sure the bikes can get through traffic jams quicker but what other benefits will they serve in a rural area. I can just see it now. You get the young guns on the bikes. The call comes in, they go screaming down the road with their crotchrockets, driving well in excess of the speed limit (don't you dare say they won't) and they get to the scene. All the while the public is calling 911 to report a crazy speeding motorcycle that looks like a police bike with lights and sirens on it. I guess you can say I'm against putting medics on bikes in rural areas because seriously, how much true time are you going to save with a medic on a bike? you would be better served if you put another ambulance on the street. In the long run, cost/benefit analysis, I would bet you would see a better return on investment with another ambulance than a couple of motorcycle medics.

Actually the rumor I heard about the foot and leg veins in adults, especially elderly is that the added fluids running through the lower extremities, especially the tib/fib area was that "OH MAH GAWD" you might make a blood clot break off and where would you be then. I started foot lines in kids (babies a lot), as well as scalp veins. I have started lines in the big blue veins of one woman's breast, she had no veins in her arms or legs due to ahem - heroin abuse and meth injections. I have started EJ's, IJ's (only on cadavers), veins on Ahnold Shwarzeneger look alikes in their biceps and thighs. I've dropped numerous IO's on babies, adults, kids and the like. so getting the iv is paramount, where it's at is not. If the patient needs the IV then get the damn iv where you can and screw those who get pissed at where you placed it. Case in point, had a 75% burn from a meth lab explosion. I got the ivs in the AC space, through the burn, well because there was no place except her back that wasn't burned. Got to the burn center and this bitch of a ER nurse got mad at where I put my iv's and yanked em and then went to try to put hers up higher in the arms. She couldn't get the iv due to the burns and the anesthetist came in and proceeded to scream where are the iv's, "I was told there were IV"s where are the Fin iv's?" The nurse went on to tell him that they were trying to get them and the medic didn't have one started. I was in the room. The anesthetist looked at me and I said "I had two good iv's but she yanked them to start her own". Two other nurses backed me up. The anethetist then proceeded to kick her out of the room and he started a central line. To this day that nurse still hates me. So get the line if it has to be gotten.

I have had several chronic illnesses. First was sleep apnea. Ended up having a pallatopharyngealuvuloplasty or the sleep apnea surgery for short. What a game changer that surgery was for me. I finally got a good nights sleep after the healing. Suffered through sleep apnea for over 8 years. My sleep study put me with 82 apneic events. they said it was every hour but cant imagine that. My current chronic condition is diabetes. here is my medication regimen Metformin 2x day gembibrizil 2 times a day gut medicine daily Lantus nightly vitamins for 2 different vitamin deficiencies - daily Sticking my fingers 5-7 times a day depending on how I feel. Sending weekly blood sugar results to the doctors office I have no fewer than 4 doctors appointments a month I'm not running on the ambulance daily now but when I was I would try as best I can to check my sugar all the while trying to eat non sugared, low carb food which in EMS that's impossible. I cannot imagine having to do a nebulizer as often as you did but my feelings as a partner of someone who would have to, that if you are having to pull that machine out while you are working and if you are truly having an asthma attack then I don't really want you working. No offense in intended here but do you think you were truly giving your patients the best care that they needed if you were having to puff away on that nebulizer? It shows that you have addressed your illness by taking a job out of the field where you have the down time that you need to address your illness. If you need to chat you can always pm me. I'm a pretty good listener and I do have very broad shoulders.

had to quote myself here. I just read in the paper this morning that in a two day period two stunt pilots perished. One in KC MO where the pilot failed to pull up in time and another somewhere else that killed a stunt walker going from a plane to a helicopter. He was apparantly walking a tightrope or using a rope to go from plane to helicopter. If the 2nd person doesn't get a darwin award I'll be disappointed in the Darwin Awards. Walking a tightrope from plane to chopper. STUPID!!!!!!!! if you ask me. So what we need to do is to investigate stunt piloting and stunt tightrope walking from planes and add new regulations and safety equipment. It sounds like outdoor concert walking just got a little safer compared to the news stories of the day.

Aluminum is the only known substance to man that can effectively cover the smells of the american males underarm pit. they have tried steel, tin, copper, platinum, gold and silver. They even tried kryptonite but Aluminum or Aluminium(aussie speak) was the winner.

You mean you aren't using hamsters to turn the wheel to run the computers? I thought everyone had upgraded to hamster 2.10.10.11.203.34 Seems you really are in the dark ages. Feel free to pm me anytime.

Sounds like going to a concert outside in the pouring rain and strong winds is safer than driving your car, walking down the stairs, flying in a plane and drinking super hot coffee from mcdonalds.

Hey doc, did I answer your questions well enough about what you pM'd me about?