Just Plain Ruff

Hey Dwayne, I worked in a small county. There have been 3 incidents in the past year that taxed our resources but made no difference in the wait of 15 mins. The first was a terrible crash, 5 helicopters, 7 critical patients. 4 ambulances on scene taking care of the patients until helicopter evac The second was a a large building fire where the first pumper truck was the only one there for 30 minutes until a neighboring city got there with another truck. building a total loss. Was a total loss by the time the first pumper got there. Third - large factory fire - multiple agencies, multiple units. Still had enough units available for a medical call and a mvc. So the big ones happen with such rarity in smaller areas that it doesn't make a lot of statistical sense to send a large response to each incident.

Ok, so then we should all be buried alive if we administer Adenosine because there have been cases of Adenosine induced Asystole in SVT and since that further endangers the health of the patient then we should not give it by your line of reasoning. I've looked all over on reputable drug references and do not see any Absolute contraindications to Atropine administration in relation to heart blocks. Just sayin

but on the other hand Fiznat, if it's in your protocols to do a trial run of atropine while you get the pacer ready then you did not deviate from your protocols and you are in essence covered. Can you still be sued for a adverse event, yep but your protocols do offer you some protection.

fiznat hits the nail on the head they called cause she probably wasn't feeling well. She had stable vitals other than a rapid heart rate. We do vagal and nothing happens (so far no harm) WE decide to do adenosine and we cause her to code (we did harm) even though we know this is sometimes the outcome of adenosine We now have moved her from stable to dead. I think the family might have a bit of a problem with this. So how do we deal with this situation. She has a DNR, the doctor agrees that we honor the DNR. We don't code her and she passes away. I can see the family and their point of view, that we killed granny. Just how do we get ourselves out of this sticky situation? I hope it never happens to any of us here but it does and has to some. How do we extricate ourselves from this situation? I think that is the next question that we have to answer. What do you tell the family? Do you request a supervisor or what?

Here is a great link to good info on Addison's http://endocrine.niddk.nih.gov/pubs/addison/addison.htm ok, if your doctor says you can work and says to you that Addison's disease will not keep you from fulfilling the aspects of the job then your prospective employer has no right to know. They can't even ask you about medical history. They can ask you "do you have any conditions that would cause you problems and not allow you to carry out your duties as a EMT or Medic" If you can keep your disease in check and manage it like many diabetics do then there is no reason why you should stop your attempts at doing this job. Now if you said Yes to the conditions question the employer might ask then they might not hire you. But since you seem to be able to keep your disease under control then I think you are all right to keep working towards the job you want. I have two friends with Addisions or some form of it and both are medics. they know when they are getting into trouble and they fix it. I would think you could do the same. Goodluck.

Medic induced DNR compliance. call medical control - say you gave adenosine, she coded, she has a dnr what do you want to do. Isn't the first rule of medicine to Do No Harm?

Might want to look up NiftyMedic on the forums. He hasn't posted in a while but he probably still get's pm's from here. He works for that agency I believe. Nifty you out there?

Another place to start - Polk County. They cover the Lakeland Florida area. I don't know if they are hiring but Lakeland isn't a very far drive from Orlando, I drove farther for my job. Plus my weekly commute is 1100 miles long. But I can probably get you more info on who to talk to at Polk County after September 8th.

I actaully think you made the right choice. Remember more call volume does not always mean more calls. What I mean by that is this, the big huge entity runs both 911 and transfers. The higher call volume in this case includes the transfers which there are times in that type of service that all you will be doing one day is doing transfers. Other days you might only do 911 it all depends on the timing of where you are at. I have also found that the big behemoth ambulance services look upon their employees as a number and not a person. Firings for minor infractions are commonplace. I know this firsthand because I've worked for one of the behemoth services and vowed NEVER again. A smaller service like the one mentioned offer less calls but consider running non-stop, not getting to eat except from vending machines, sitting in your ambulance for up to 14 to 24 hours and not getting any downtime. Is getting to run more calls really worth it? I think you made the right decision, let us know in 6 months what you think.

pleased with doing them for a few years???? Come back here in 6 months and let us know how pleased you are. If you are not interested in doing the 911 calls and all you want to be is a IFT person then more power to you but I'm sure you didn't get in to this line of work to drive back and forth from hospital to nursing home again and again. If you are not interested in doing the 911 calls and just want to do the IFT's then you are one of the odd men/women out and I applaud you for only wanting to do IFT's. I suspect that in 6 months you will have a different toon.

I totally agree with CH and Doc Electricity has it's place but I have always been of the opinion that chemical rather than electrical. If they need electricity then by golly they are going to get it but like doc says, it's not going to cause harm in the emergency setting. If it doesn't work then pace them. but why not use one of your tried and true tools that does not hurt before you go and start to jolt em with electricity. If the atropine doesn't work what time did it cost you? Just the time to administer it and wait a couple of minutes to see if the effects are going to work. while you are waiting for atropine to work or not, you can be drawing up the valium or ativan and putting pacer pads on the patient's chest. If it works and keeps working then you've saved the patient from getting 60 jolts a minute for a 10-20 minute ambulance ride. I go for atropine first unless the patient is so critical that they can't wait and pacing is immediately needed.

Actually the security line was the easiest of the entire day. Security at Kansas City International is probably the easiest of all the security lines I've ever gone through.

ok, I love the travelling public (well not really) but...... My travel day started at 0300 Got to the airport - so far so good First flight takes off without problems until we land. ON landing we hear this big boom and then the left side of the plan starts to shimmy and vibrate. I immediately think, Tire blow out. We have arrived at Dallas Love Field. WE get to the gate and I'm scheduled to take the same plane to Houston. The captain says "sorry folks, we can usually take off with one tire out but not with two." in a joking manner. We are delayed 40 minutes to get the two tires replaced. We get the tires replaced and head on in to Houston. No problems there. Get off the plane, wait for the next plane and board it. I am sitting in the row behind the exit row. Exit row only has 1 person in it. The plane pushes back away from the gate. We get 500 feet away and the rain comes. Downpour that caused all traffic to stop and wait the storm out. So the lady sitting in the window seat takes out a set of nail clippers and then takes her shoes off and begins to clip her toe nails. After the 1st nail lands on my lap I ask her to stop. She continues. The 2nd one lands in my book that I'm reading. I took it and put it on her lap. She got pissed, called the stewardess and made a complaint. I told her she was F*(*&&ing nuts and moved. The flight attendant told her that she needed to put her nail clippers away. The lady complied but only reluctantly. What the hell is with the flying public. Are they all going nuts. Every flight I'm on has rude passengers, people who cut in line when they should be behind me or others. Others who drink so much that they can barely walk when they get off the plane. Others who don't listen to the flight attendants. Others who get up to go to the bathroom when we are landing and get pissed when the flight attendants tell them to get back to their seats. I fly because I have to for work, if I didn't have to I'd chuck it all. I just had to vent. I got into my destination 2 hours late and the car company had closed my reservation. I then have to re-set the rental and they ran my credit card a 2nd time so I have no money tonight until I get paid to eat anything other than what my hotel has at their food area. What a great day!!!!!!!

The clerks in Lakeland Florida hate me. I keep checking their 20's and 10's. Have not found a counterfeit yet. I'm actually to the point where I probably need to get a new pen because the one I've been using is getting dry. I have in my stockpile at home about 1000 2$ bills. Anyone remember the silver certificates? I have quite a few of those. My grandmother gave me a bunch prior to her passing away. I find coins to be some of the most beautiful works of art that you can have and the value never goes down. Getting an uncirculated coin of any kind is one of my favorite things.

Hey, AK had some great ideas. but it is Jet Blue with the all you can fly program right now. Get it ASAP if yuou are going to do it . They sold out last year. I spent some time riding with Acadian. Great group of guys and gals. Good service. If you are contemplating the move to Acadian coverage area just be willing to live anywhere that Acadian covers. When I rode, they did not guarantee me a spot in Lafayette or anywhere. Where there were openings they put you there. You could request a location but there were no guarantees. I do know that Acadian will allow you to ride if you call them saying you are considering the move. I'm sure they all will.

I worked for a service where as a newbie you had to do the Transfer car. All you did was nursing home transports all day long for 24 hours in a row. We were in a county that was not our primary providing area so we did not EVER have a chance to run emergency. I HATED IT. I at the time had the mentality that "I got into this line of work to save people and run the good calls". After about 6 months got moved up to doing half and half. one day each week I'd work transfer and then the other shifts I'd do the 911 car. Loved that mix. I realized that 911 wasn't all it was cracked up to be but only hearing about the good calls I was living with rose colored glasses on. I currently am not int he field right now as I am making significantly more money doing ER consulting than EMS and I'm trying to find a service I can provide part time work for. If you get "stuck" doing IFT's day after day after day I am sure it gets BORING and tedious. Yes these are patients that need us surely they do but seriously, how much can you truly learn patient care wise from a patient on an IFT? I can think of the obvious points such as learning about patient history, medications and getting good stories from the military vets but patient care wise there's not a lot of new stuff to glean from Grandma Moses sitting on your cot going from the ER to the nursing home that is 1500 feet from the ED Entrance.

I'm not against media taking photos but what the article specifically points out is that he was inside the area of the accident which makes me think that he was very very close, if not right in there near the rescuers. I also didn't post the article text in full out of deference for the lawsuit and I believe I pointed that out in my post. The article did not make clear if he had credentials but it sure made it sound like this guy was acting on behalf of the fire department as a photographer. And if he was acting on behalf of the fire department and being paid to take photographs of the scene and area then he should have had some sort of ID. Just having bunker gear and a helmet doesn't make him part of the fire department. Anyone like you said can print and ID and anyone can purchase bunker gear and make themself look like a fire fighter by going to EBAY or Craigslist and finding a seller. So your ID comparison doesn't wash either. Listen, I know the law allows any photographer to take any photos they want of someone in public because we don't have an expectation of privacy when we are out in public but this guy is a previous EMS worker and I believe he was using his status as the photographer for the fire department in question to get up close to the action. Besides I believe the article says that he was going to sell the photos or may sell them to channel 9 news and other papers. He used his status as the fire department's photographer to get in close and will make money off his special photographers' status. I cannot prove anything in the above statement but those are my thoughts and assumptions on the matter. The guy was using his special status to get the pictures and as a result he should have been identified as a representative of the fire department. The troopers did not recognize him so they thought he was being intrusive and they took his camera for evidence. Did they do the right thing, not sure. The article also does not say if they asked him to leave or back off. Unfortunately he lost his camera, were the troopers justified in doing what they did or ignorant but I think this is just goign to become a pissing match between his lawyers and the highway patrol. Should they give him his camera back, yes they should. Will they, doesn't sound like it. Quote State police said they are keeping it because pictures taken so close to the scene might display evidence related to the wreck. More bullshit. If they think there was evidence that needed photographing, they can do it themselves. Or- here's a crazy thought- give him a business card and ask him for copies once he downloads them off the camera! They're stalling, because they know that there is absolutely no face-saving way out of this. CB, evidence needs to be collected as it happens. You have a fire department that is cutting a car apart to get the patient out of it. That evidence is lost now but they have an out. They have a camera with the pictures showing what the car looked like before and also after. I'm not saying that they police didn't do something wrong in this situation. You seem to be jumping to this guys side even though probably not all the facts are in on the situation. How many times have we on this site said "let's not cricify anyone until the whole story is out" which is exactly what isn't happening here. You are slamming the troopers and I suspect that there is more to this story than the news article is putting in it. If indeed the guy did no harm and did what he said he did and the troopers were in the wrong, we need to let this play out and see what happens. I'm sure you would want the same if you were in either the photographers shoes or the troopers shoes. Agree or not, I'm just sayin.

Well Herbie, Missouri tried to do just what you said to limit Phelps and the Missouri Supreme Court ruled that law violated his 1st Amendment rights. So the solution you suggested - Tried and failed by the State of Missouri.

Fair enough. I am of the opinion that we have beaten this horse to a pulp. I don't think there is any more value to be gained from this topic. Those who have spoken have said their piece either for or against the mosque. I think we are just like the New Yorkers, some for it, some against. I think the consensus is that the placement of this cultural center SUCKS and is INSENSITIVE but I think that's all that can be said from here on out.

You left off some of the article. If you are going to quote the article and only use some of it for your purposes makes the post skewed in favor of this guy. He was taking pictures inside the accident scene. To me that says he was inside the area where only Emergency workers should be. The troopers did not know him. It was unclear that he had any credentials. Plus the cameras these days have pretty good zoom so he could have easily stayed out of the way if he had any type of good quality camera. If He was taking pictures of the patient which I find distasteful and disrespectful. We've discussed this ad nauseum here about providers taking pictures. He's a provider (at least he was) so he should know to have respect for the victim or injured party. The general public as well as the troopers would assume that he was taking photos of the victim even though he said he wasn't. I'm not going to quote the article based on the sites current legal issues. But the guy didn't have credentials showing he was a freelance photographer (I didn't read that he did). This guy is a former EMT so he should know better than to take pictures of the victims themselves. This may very well have been ignorance on the officers part but if this is a criminal case then he's out of a camera because it's evidence now. I don't really feel sorry for him. I don't really have respect for people who take financial advantage of others pain and grief. He takes the pictures and then sells them to the newspapers. I can't seem to get myself to give him much support. Maybe others might.

NONE!!!!!!!!!! But the pope is going to visit the synagogue in Rome though, I think it's the only synagogue in Rome. http://www.catholicnewsagency.com/news/popes_visit_to_roman_synagogue_confirmed/ But isn't Vatican City 100% roman catholic in nature so why are we even discussing a Synagogue in Vatican City. Isnt' this question a red herring?

I didn't think it was pointless. I have my reasons why I don't think it's pointless but they are too long to post here with all the assorted nuances accompanied to them. I would welcome the discussion though but it's better for a private convo. Matt, I lost your phone number in a recent phone crash. Can you pM me your number again. OR just send me a text if you still have mine. Take care

did you get the scope? Not clear on that. If you have not gotten your scope let me know, I have a store just up the street from me with a great selection of stethoscopes. I can go get the scope for you and have them ship it to you. I bet you'll get it before you get the one from mystethoscope.com Just an offer.

You misinterpreted my comment, be that your misinterpretation or my inability to fully express what I was trying to say, one will never know,,,, but. I was not saying and never have said that McVeigh blew up the fed building for christian reasons. I was simply saying that I don't vilify all christians becuase of what McVeigh did nor do I vilify all muslims for what the 15 did. I can see where you might have gotten that idea but that was never my intended take on the issue.