Just Plain Ruff

For the new medication or the new procedure how bout this Some of the best resources are the educators from the drug companies. If your service can partner with a training entity somewhere in your state this is what can be done. Partner with the training entity to provide the certificates for classes held. submit the paperwork for let's say the new drug to the training entity. ASk the drug company to have their drug rep come to your service and do an inservice with your crews. The training officer for your service should get the drug info in advance so he can make up a 5 question test. After the inservice, give the participants the quiz. Submit the records to your training entity and Wham 1-4 hours of classroom hours. Minimal cost to your service, minimal cost to your employees and everyone is happy. If you carry 30 drugs on the ambulance then why not provide 5 inservices of 2 hours length that covers 6 drugs each inservice??? On to the procedure or device training. The device companies also have people who can come out and give an hour long talk to the staff on the particular device. Call it a training session on the new device. We had an hour long (lasted 15 mins) inservice on the new EZ IO drill by our training officer. If your training officer is associated with your training entity, then why can't that person put on a 4 hour inservice a month. That's 48 hours of CEU's a year. Or why not have him put on 48 hours of classes that will cover what a refresher will cover? Apart from Online learning, there is a myriad of alternative ways of getting CEU's other than sending your people to classes far away. All it takes is some creative thinking. For the volunteer (yeah I said it) agencies out there - hold a fund raiser and use those funds to provide each member (they should be regular active members, not just those who want the hours) with a subscription to one of the online CEU sites.

But seriously, over 200 dumbtards did this, hopefully they all get caught, fired and banned but what will happen is that those working for the private services will get fired outright. Those that work for non-union public services will also get fired Those that work for union companies will just be put on the fire truck until they can get their licenses back in good standing. I wonder how many other states have this as an issue but just haven't had it put out in the open air by the "unbiased media" I know of several medics who are good friends with ACLS instructors and PALS instructors and have not had to go through a ACLS/PALS refresher class or recert course in 15 years. Their buddy just signs them off. These guys work for a very rural service, running 300 calls a year and they make about 9 per hour. They say they just do not have the money to be able to get to classes or to take time off work. In the state of missouri we have the ability to get all our ceu's online(except cpr, acls, pals, ITLS). You read an article and take a test, get the credit. Usually each of these articles goes for 2-3 credits or hours. The cost is around 90 bucks for the entire kit and kaboodle. I did this program for my relicensure 2 years ago and it took me 4 weeks to get all 150 hours. That was allowing for only 12 hours of credit per day taking these tests.

There are some on this forum who think that all Firefighters do is sit in their recliners and watch television. They have plenty of time to study the material while watching Dancing with the stars.

That's exactly what I'm trying to get at. The first time he came here, he was asking for advice and complaining about a death that he thought was suspiciously covered up because the person was I think an undocumented or illegal alien or maybe a documented one. (Just why are we documenting aliens? I thought they came from outerspace and didn't exist) This time it's a school that is closed and he wants to make them give him his money back or something. In the original thread he didn't give specifics and it's the same MO here on this thread. But the good thing is this, he came back to day with a response to a response that was posted 3 days ago. Maybe he will get to the others in three days from now.

You say the combination of airway skills is the key to this issue and then you say that the protocol was irrelevant. Well I say you are talking out of both sides of your mouth. You specifically mention the "Protocol" which was not taught during the exam. You are the one who brought up the protocol issue. According to your lead off point it is indeed relevant. Shouldn't a paramedic student be expected to know airway skills and if they were indeed not taught in class then that might be a point of contention but as a paramedic student and you know as well as anyone else on this site, that AIRWAY is very very important. Did you take the initiative to learn these skills on your own or did you just sit back and think "I wonder when we are going to be taught about airway" Why are you coming here after so long complaining about this? Is is just to get sympathy and say "we feel your pain" or what's the motive behind this?

Ok, we will ask again, Did you know that this protocol was going to be possibly tested? Did you know ahead of time what that protocol was? Please tell us about the protocol you failed? Please give us a synopsis of what you are wanting us to do? If you want support you can't just come in here, level a few unsubstantiated facts, disparage an instructor who is not here to defend himself and then expect that we will jump behind you just on your word. first off we do not know you and you haven't been around here long enough to get a pass on us being skeptical. Your first attempt at posting on here was a few months ago where you said you were a PCP student. (confused I am) In your first attempt at posting here you were trying to re-open a months if not years old death case and wanted our support for that too. I believe that we weren't so supportive at that time either. You never came back to tell us if you succeeded in getting it reopened or not. So this time you are trying to re-open a year or so old paramedic school situation that was found to be valid by the board that oversee's the classes or whatnot. Please provide us with more information. It would improve your case here. If you cannot do that, then please drop this.

Damn Dwayne, no wonder why you haven't answered my PM, what with your sexual fetish with Goth Barbie and rafters and then you providing a really good post above, I can see where all your energy has gone. But seriously, I'm in agreement with most of your thoughts but they are your thoughts so who am I to disagree with any of them. I have never thought about what came before the beginning? Makes me think a little harder. Maybe before the beginning which my bible clearly says "In the beginning God created" and so on, maybe before that beginning of US, humanity, God was working on another project? Who am I to say. I do know one thing, I will ask him that very question when I see him. But remember, God created the act of free will. You can say you do something in God's name yet are you really doing it for God? Without the act of free will you would be fulfilling God's actions, not your own. Put free will into it and you can do anything in anyone's name. I could go out, kill 20 women or men and say I did it in Ronald Reagans name and it makes me no less culpable than the people who do what they do in the name of religion. But I digress. Why am I here? I have no freaking Idea other than my thoughts which I shared the other day. Do I have a clue? Nope but I can assume some things of why I'm here. Are they right, nope or maybe yep. Don't know. This is a very good thread and one with great answers. I do apologize for any pulpit banging that I did in an earlier thread but I don't apologize for my belief system. I would not expect anyone else to apologize for theirs. That's the great thing about both the USA and this forum. We can share our beliefs and thoughts while they may provide arguments and disagreements, they are free to share and we are able to share them. In some countries this discussion as well as the Internet that hosts this forum would not be allowed and we would be forced to meet in private or not at all.

True true true but..... The physician had two EKG's. EKG 1 - 1 year old EKG 2 - very recent How can the physician say non-specific changes when the ekgs show no change from previous to new. Isn't that contradictory? Not trying to be argumentative but I am at a loss with this physicians thought process. I guess I could go ask her but I don't know her.

Sadly I do not have any copies of the 12 leads. What struck me as strange is that if the Dr. is saying there are non-specific changes and then goes to the next step and saying that there are no changes from previous EKG doesn't that seem strange?

this is posted after a particularly frustrating day so it might come off as a rant. There should be a mass firing (see rationale below) of all those involved. That would free up a bunch of jobs for those who don't have them. If they knowingly paid for the certs and didn't go to any classes, then they falsified their relicensure and they should be revoked and banned from practicing in Mass or any other state. This is exactly the kind of thing that shows that we as a profession have a LONG LONG way to go before we are considered professionals. If you get 200 or more in one state who did this what kind of message does this send to the public. It sends this message to the public. They don't care enough to do the required steps so will they cut corners when they come get me. This goes directly to the public wanting a competent provider that will help them. The public no longer will have faith that they are being treated by someone who is competent and if they didn't care enough to fulfill the requirements of the relicensure then they didn't care enough to take care of me completely. Hey, if anyone on this site did this, let us know why you were so LAZY as to do this? I'm sure we'd all like to hear your answer but I'll bet that those who did this don't have the guts to do that. But I can see it now, these emt's and paramedics are going to whine because they got caught. They are going to say that this was the only way they could get all their hours and they shouldn't get punished because it's not their fault. IT's the Man's fault for putting too many hours to recert that they didn't have time or some other lame ass excuse. What the hell, I'm done I guess. I'd love to hear what dust has to say about this.

Fair enough, I was just commenting on it looked strange. I still think it's fake but hey, that's just me. The people who took the photo can say anything they want. The dimensions just look strange to me. It must just be the angle. No-one ever told me my depth perception was flawless. But seriously I truly do like the picture. It's pretty cool. (if it's real he he he he )

Ok, I'm reviewing some old charts today and I came across this gem. New EKG done today, Old EKG done 14 months ago. The reading reads out as this. His electrocardiogram showed a normal sinus rhythm with a rate of 75, first degree AV block, non-specific ST-T wave changes. I do have an old EKG to compare it with from 03/03/2009 and this is unchanged from previously done. Ok my question is this. IF the EKG is unchanged from 14 months ago then how can he have non-specific st-t wave changes??? If he has only two ekg's to review the new one and the old one and they are unchanged - where is he getting the non-specific st-t wave changes at? I don't understand it. I'm at a loss to describe it. I might preface this that this is not a cardiologist reading these two EKG's.

I've seen some really really good photoshopped photos. Shadowing is not really that hard to do NOW to quote Shrek, I'm not saying it is, and I'm not saying it isn't But that's the way it looks to me. IMHO

No offense 4C6 but it sure looks strange if you ask me. The helicopters just don't look to scale versus the ambulances in the back of the photo. The helicopters look about 30-40 feet above the ambulances and they are bigger than the ambulances in the back. It just looks fake if you ask me Is the picture cool? you betcha but the scale is just wrong in my opinion. Is anyone else seeing what I'm seeing? Or is it just time for new glasses.

At my old workplace we had a woman (employee) who had seizures. She would be seizing and when you asked her a question she would answer. Every neurologist she went to that tested and evaluated her called them Atypical seizures. The two things that would bring her out of the seizure would either be valium or just letting them stop on their own. She could answer all the questions that you asked her yet her body was just flailing away. These seizures got so frequent that she started wearing a bicycle helmet while working because she would just go down and after more than one or two bouts of stitches it was decided she wear some head protection. She doesn't work anymore because I believe the seizures are too frequent but we never get calls on her. So this could be one of those types of cases.

Just what is this mysterious protocol? Fess up.

Heck of a photoshop image. The helicopters look cropped in. But well done and pretty darn neat.

I'll take the God part out of this. I am here so I can make a difference. I have done so in so many ways. From my children and raising them to be good kids, to know right from wrong and to do the right things, not always cause that will never happen, but to consistently look at their actions and the consequences that happen from any action, be it good, bad or ugly. I am here to be freinds to people who I am friends with, to love those I love and to tolerate or try to see the viewpoints of others. I am here not to make the world a better place because damnit, you can only make your part of the world a better place, not the entire world. I am here to provide the knowledge I have to those who need that knowledge. To teach the teachable but to listen to those who know a lot more than I do. I am here to use my medical skills to help people. The quote gives a reason for existence, to enrich the world - How have I enriched the World? I don't think I have enriched the WORLD? How can we be so arrogant to say "I have enriched the world?" I don't think we can ever say that. As a collective people in this world, sure the world is enriched because we were here but to be so high and mighty to say "I" enriched the world, that's hogwash. I have enriched my tiny tiny little part of my own world. I have enriched it by the friendships I have and had, by the people I know and who know me. I have enriched the world by meeting people on the internet who do not share my core belief systems and I do not share theirs yet civility ensues and discussion are had and our understanding grow and grows. My legacy I hope is that I leave my little part of the world a better place, an enriched place. Be that from helping a sick person or just having someone know that I was there for them. My desire is to leave a legacy that can stand the test of time, one that continues and blossoms into a change or betterment of a little larger area than what I was a part of. Have I done this? I don't have a clue, maybe, maybe not. I do know that I do have a legacy and it is my children. May they follow the advice and mistakes that I have made and take the advice and the knowledge of my mistakes and use them to construct their lives in a way that they too make a difference. Can I say this with certainty that I have done this, nope. I hope I have. I hope that one day after I have died, that someone can say, It's good he was here, my life/world/environment is a little better off because of him. That would be the legacy I would like to leave. So the answer to the question (what was the question again?) is this - IF I enrich the world just a smidgen and I hope I have, then my purpose on the earth was fruitful and enriching. a long winded answer to the question.

Dwayne, we've taken this to Pm's. Let's not muddy the waters by our discussion. It's fruitful to say the least. Let's let this thread get back to it's original intention, not the two of us discussing our thoughts. Peace Dwayne, then why are you sending me video of you on the rafters. Barbie is lodging a complaint with the action figure justice league. I do apologize for taking the original post out of context, that was not my intent.

The other thing I wanted to respond to was that I believe I gave a rational answer in the first post. Dwayne, you apparantly do not think I did. Let me put the ball on the other foot, what is your rational argument for your belief system? I'd love to hear it. If you wish to take this to PM's then thats fine too.

Well Dwayne, I believe what I believe. I believe that God is real. I hope that you put the same emphasis on someone who believes in Allah. He's a god yet you can't see him. I would hope that you would hold the person who says they believe in Allah to the same microscope as you hold me and any other Christian. I have apologized in the past for some remarks I have made and I have tried to temper my thoughts with lesser negativity. But that's just that with religion. It's a belief system. I believe that history has proven many aspects of the bible. I believe it will prove more in the future. Archeologists have proven many things that have happened in the bible yet that proof is still being discounted by those who don't believe. I take my belief in God at face value, I believe that he is real and I have no "proof" other than what was written in the Bible. If that makes my religion unbelievable then sorry about that. The bible to me is the inherrent word of God and that's not debatable with me. Just like the Koran or the Quran is the basis of those religions belief system. I respect your opinions, I do not agree with you on your belief and I'm still praying for ya bro. I hope that's ok.

Sorry Matt but the Evolution discussion and rationale was allowed so I'm putting my 2 cents in. I'm a Christian and for you to discount that answer and say that I can't say I was put here to Glorify MY God then this discussion is moot. But hey, it's your discussion I do believe that I was put here to Glorify God but I'll go a different route I am on this earth to do only one thing. To make the people that I come into contact with better than they were before they met or came into contact with me. With that being said, My niche in this world is to help people and "take care of their health issues so they can lead a better life" I can fix or at least stave off their illnesses (most of the time) and help them. I have a unique area where I make the most difference in peoples lives and that is taking care of their emergency medical needs. I believe that my skills were given to me by God and I just use those skills very well. Others may not follow my take or they may disagree with my reference to God but that is what I believe. I can help people or I can get out of the way and let nature take it's course. My choice is to help people and that I do very well. I hope that my interaction with people leave them "feeling better about themselves" or maybe they say "hey that cracker is crazy"

Actually, the story focused on the copiers older than 5 years of age. The new copies have a hard drive but that hard drive only stores the current copy job. The manufacturers state that the hard drive is wiped after each use. Do I believe that, nope nope nope. I don't believe it a second. But that's what they claim.

My gut was not to take him to our local hospital. My gut was correct. He arrived at the cardiac center, worked up for Right sided AMI. Don't know what his outcome past that was. I do know that his troponin was around 5.4 or so. I called the ICU he was at the day before and they said that there was no evidence of any bi-fascicular block on his EKG but he did have the A-fib and the right bundle block. I did indeed fly him to the cardiac center. More than likely he would have tolerated the trip by ground though. The sudden onset of profound weakness without the presence of low or high blood sugar really pushed me towards my decision. I think he may be getting a defib/pacemaker placed in a day or so. The nurse wasn't sure.

I have not been able to upload this to the site cause it's too big so I put it on photobucket. I was able to scan the 12 lead in question Ruff http://i4.photobucket.com/albums/y136/ruffems/12lead.jpg