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Everything posted by Just Plain Ruff
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So what are you asking us? is this one of those "Our instructor gave us these two topics and we need to write a paper and I want you guys to write my paper for me" or what are you wanting from us? Yes we have had those people come here with just such a request. give us more info please in what you are asking.
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There is no guarantee he will continue on and get his EMT license. Maybe he's just doing this for class time or some other reason. I would take Off Label's advice and complete the course and mind your side of things. These things have a way of working their way out.
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Wonder what the charge was? but all things serious - what a evil person.
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X-ray Equipment needed in the Ambulance?
Just Plain Ruff replied to XRayMan's topic in Equiqment and Apparatus
Hey XRayMan, I hear where you are coming from but I'm not of the school of thought that we should have these in the ambulance. My reason, it's more stuff to put on a already overworked medic. Splint the injury as found, transport the patient to the hospital and let the hospital sort it out. I already have enough to do and enough to learn to not have to add X-ray tech/reader to my list of certs. Plus this will add a new level of billing and expertise that EMS is NOT equipped to tackle at this time. Heck we have enough time dealing with being called ambulance drivers, can you imagine our brains exploding when we get called ambulance xray machine drivers? Some of our peeps on this site (most are gone) would have a stroke and then we'd have to call the Strokulance to come get them. Who will get to bill the patient - the ambulance company, the medic who reads the x-ray initially, or the radiologist who does the final reading or all three? Is this an ALS or BLS skill? What happens if we read it wrong and the patient refuses based upon the incorrect reading and several days down the road the patient finds out that they have a actual fracture and needs surgery? who pays for the mis diagnoses? Lots of issues here. I vote NO -
Any new blood to this site would be helpful. I'm not sure how much of a response you will get but please post away to your heart's content. I'm looking forward to what you have. But please don't get discouraged at the lack of response to your posts as this site is not the same as it was 5 or so years ago.
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Hi Laurknee13 - I've seen that you have posted a couple of basic questions that honestly should have been answered in your EMT class. But since you are asking no - you should open the oxygen up to 15lpm for the BVM. Have you asked your instructor these questions?
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no - continue on to the h ospital - the AED can be put on while you are enroute to the hospital.
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Your best bet is to call the registry and ask them. They can tell you the best answer of all. Otherwise I would put it down under Ambulance Safety or Crew Resource Management. The worst they can say is that it's mis-categorized and they can let you know where it needs to go come relicensure time. You should get credit none-the-less but best bet is to contact them and ask them. Ruff
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Hey Defiant1 - if you are willing to move - our service is hiring EMT's, probably pays more than what you are making now. If you get in medic school you could easily pull in around 65000 a year and that's a conservative estimate after you get out of medic school. We are in a rural area of missouri - 55 miles south of Kansas city - running about 2000 calls a year. If you can get your missouri license and willing to move we can always use a good EMT who has aspirations to go to medic school. Hey Defiant1 - if you are willing to move - our service is hiring EMT's, probably pays more than what you are making now. If you get in medic school you could easily pull in around 65000 a year and that's a conservative estimate after you get out of medic school. We are in a rural area of missouri - 55 miles south of Kansas city - running about 2000 calls a year. If you can get your missouri license and willing to move we can always use a good EMT who has aspirations to go to medic school.
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Deny Patients a Ride In the Ambulance - What Laws?
Just Plain Ruff replied to spenac's topic in General EMS Discussion
Problem is, we've been told over and over that we are not doctors and the only way to determine if someone is truly having a medical emergency is to transport them to the ER for evaluation. Every medic I know is not willing to risk their licensure in order to buck the system and tell a patient that they don't qualify for a ambulance and they need to find another way to the hospital. They not in a million years want to be the test case for a patient who truly didn't need an ambulance yet that patient felt they needed one for that stubbed toe or small laceration or what not and the patient sue that ambulance service and the medic with the Case resting on "what training did that medic have to rule out that I wasn't truly having a medical emergency that didn't require an ambulance transport???" Because we all know that many ambulance services will drop that medic and not support him/her for turfing that patient off to a UBER or a taxi cab even if there was a policy or guideline or protocol that in all actuality supported the medic refusing transport but the ambulance service see's a loss of the legal case in both the court of law and the court of public appeal. The medic is the one who is going to lose out in the end. I'm not willing to risk my license just to turf a patient just to save my company a dollar or two policy/guideline/protocol or no and I don't think many of my colleagues will be willing to either. -
So, here's a thought, one that you might want to think about. I have a Misdemeanor conviction from 1986. I plead guilty, paid fine, went on my merry way. Was told that it didn't show up anymore after 15 or more years. So color me surprised when.... about 4 years ago, had a job that I really wanted, they did a background check, and guess what showed up. Yeppers, that conviction. Thank goodness I put down the info about the conviction otherwise I would have lost out on the job. Just be careful about not telling an employer about convictions that you don't think will show up sometimes will and if you lied about them on your application and they find out you lied - your job is history. Word to the wise.
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Yes the spam, it get's through the awesome spam filters Admin has set up every so often, and people report it and Admin deletes it. It's everywhere. Just look at Facebook and if Facebook cannot keep it off their site with their billions of dollars of resources then we honestly cannot expect Admin to be able to keep it off here with the limited resources he/she has. But I see less here than I see on facebook which is excellent.
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Did you explain this to your new employer when you interviewed with them? I'm sure that if they want to keep you they will work around it but if you come to them out of the blue and say "Hey, I'm in medic school and need tuesdays off for the next foreseeable future" and they had no idea you were in medic school, they might be a little upset with you. But the flip side of the coin would be that you will then be a medic for them to use and abuse when you get your medic license so they might overlook that issue. All in all, if the employer is worth it's salt they will work with you and give you the time off to pursue your medic class. But I know there are a lot of services who say tough shit, you work for the collective BORG now, you do what we tell you and if you don't like it don't let the door hit you where the good lord split you. hopefully you don't work for one of those. Good luck
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Where did you get the idea that he was looking to become a managing editor?
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I would be worried but not extremely worried. I would actually not be asking advice from a forum like this or from the internet at all, you should be talking to an attorney and seeing what he/she says. Good reputable attorney's often give 1 hour free consultations. Or do you have a friend who is an attorney who could advise you. I would continue on with your journey into Nursing or phsycianhood and follow what your attorney tells you to. The internet is a minefield of bad advice and please don't step into it without getting an attorney involved. did the investigator tell you why it's taken 2 years for them to get into this? This sounds like someone from your past is throwing stones and trying to see what will hit. did you have someone you pissed off way back at your old school that might have a old axe to grind??? Be honest with the investigator but only after you speak with the attorney. Do you see the underlying theme of my advice - don't do anything until you have talked to your attorney. I wish you the best.
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Well I'm not sure how my new job will want my narrative. It's been 9 years since I wrote one and I'm getting back into the swing of things starting May 15th. But my reports when I used to write them were hand written on a paper report form. yeah, it was before computers got in our way of writing reports and before we had to tick off all those legal mumbo jumbo boxes to make the bean counters happy. So I'll give you a idea of what my narrative was like. Remember this was a long time ago so I'm sure others have better ways of doing things now. But I can tell you, my narratives never pulled me into court. 1st paragraph - What happened - why you were called, what you found, what bystanders said, what patient said, what you observed. etc patient exam/assessment - the formatting of this site makes it hard to put it all down line by line but here goes Heent(head, ears, eyes, nose, throat); Neck; Chest; Lungs; Heart; Back; Abdomen; Pelvis; Gi/GU; Extrems; Neuro/GCS/RTS/ (all of these go on their own lines with what your exam findings are) What is your Impression/Impact - what did you really decide is wrong with this patient - they say we don't diagnose but we really do. So don't be afraid to say if they are having chest pain to say chest pain or if their 12 lead shows elevation in II, III and AVF to say that. What is your impression or suspicions. And now your treatment - Number them sequentially - from when you got there to when you dropped them off at the hospital - make sure you put down if they got better or if they got worse. Don't be afraid to say that if your treatment made them worse - say it because sometimes your treatments make them worse. Sometimes your treatment like Synchronize cardioversion causes them to go into v-fib. that makes them worse. Or you give them Lidocaine to a paced rhythm (honestly I didn't see the pacer spikes- really i didnt' and you nearly code them) put that in the report. (man I felt like crap on that one - but I was a brand new medic and I learn from my mistakes and teach from those mistakes). That's all I got. Oh yeah there's one more thing - there is a very obscure book out there, if you can find it, buy it and never let it go - I did and the person lost it. It's called "The Missing Protocol-A Legally Defensible Report" by Denise Graham It doesn't tell you how to write a report but it does tell you how to write a report that will keep you out of court if you do it correctly. It's out of print so I'm not sure if you can find it, I haven't been able to find it. May the person who lost my copy be crapped upon by a thousand camels with IBS and C-diff. I hope this helped.
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NREMT TEST -Replies So needed
Just Plain Ruff replied to Shorty1213's topic in Education and Training
sorry you haven't gotten a response but this is my advice 1. do not allow him to retake the test until you speak directly with the registry. 2. Talk to them about what accomodations they can give him and what he qualifies for. 3. Ask them what kind of study guides or assistance they can offer for him to prep for the next attempt at the test. 4. DO NOT ALLOW HIM TO TAKE THE TEST AGAIN until you have done all 3 of the above. He only gets 2 more times before he has to I believe take a refresher course and you don't want him to do that. Just call the registry and talk to them. We can give you advice here but please go to the source and call them directly, they are the experts about their testing process and what accomodations that they can offer someone with a disability. That's my advice. -
Ok, heres what I purchased today from Amazon shears BONTIME Trauma Shears - Premium Quality EMT Shears, Stainless Steel Bandage Scissors for Medical, First Aid, ER, Nurse, Doctor, 7-Inch(2- Pack, boots - already have non-steel toed boots. I think I can wait a while to purchase those if ever. I never needed them when I was practicing prior to leaving so I'm hedging my bets that I won't need them now. pen light - https://www.amazon.com/gp/product/B07N1G7179/ref=ppx_yo_dt_b_asin_title_o02_s00?ie=UTF8&psc=1 Belt - going to purchase the belt when I get my pants Already have my field guide - have purchased already I think that's what a guy with a few years under his belt in the field actually needs. any other suggestions that won't make me look like a total dumbass???? One other thing, after digging through my storage boxes, I found my Littman Cardiology II stethoscope that I've had since 1992. The only thing I need to purchase is new earpieces as there is a hole in one of them The replacement earpieces will be here tomorrow.
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I want to add to my post Fentanyl is a great drug. It can be used on most anyone. I've used it from 2 year olds to 80 year olds and probably older but I can't remember. I don't remember a patient ask me personally to give them fentanyl, but remember I've been out of the field full time for 9 years, (part time for several), but I've been asked to give patients dilaupid(yeah I know it's spelled wrong) more times than I have fingers and toes. There is abuse potential in a lot of stuff we give. Hell there's abuse potential in flexeril as well, that's what a friend of mine was hooked on and what eventually killed him in an over dose when he took an entire bottle (90) pills because he was just tired of livin and wanted out. So I do not believe we should get rid of fentanyl just because it's the soup du jour of the addicts this year and last. 10 years ago, I believe diluadid was the soup du jour of addicts in my emergency room. It's what they asked for by name. Who knows what will be on the menu in 3-5 years from now. But for goodness sake, don't take a tool out of our arsenal because a small subset of the population have made it their drug of choice to abuse and kill themselves with. That would be I believe foolish and a knee jerk reaction, but then again, it's what we in america are known for, knee jerk reactions to a problem without finding a solution first.
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Ok, so I can make it official. I got the call with the offer. I will find out my start date Friday when I go down and pee in a cup and sign the forms for my background check. I'm clean as a whistle though so that shouldn't be a problem. Now I gotta figure out how to pay for all the gear(I'm not a noob so I won't go overboard) that I need. 2 - 3 pairs of ems pants stethoscope shears boots They provide the shirts but I have to buy them(they order them for me) pen light Belt Already have my field guide I think that's what a guy with a few years under his belt in the field actually needs. any other suggestions that won't make me look like a total dumbass????
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Yes we do have alternatives but I say keep it. A great mentor one time told me this, if a person is going to get hooked off one single EMS administration of a drug we give them, then they are probably hooked on something already.
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Cardiac Collapse + Nitro + ED Meds
Just Plain Ruff replied to stillnotcharlie's topic in Patient Care
Yes I agree that this sounds like a real situation. And yes there is a lot missing. Would like the original poster to return to give more information. If this is his loved one that would be very helpful to know. If he's searching for answers to why paramedics or emt's did this or that and this might go to court for malpractice, he's not really going to get any information from us to possibly hang those medics out to dry as that is what the court system is for and that's what the expert witnesses get paid big bucks to do. I don't expect the OP to return but I would like him/her to do so in order for us to understand more of what they are wanting us to answer. -
Oh my goodness Mike, you hit the nail on the head. There have been more jobs lost, more marriages ruined, more relationships destroyed and more homes ruined by facebook than any other electronic medium every before. I personally know of at least 20 couples who have divorced because of facebook. I personally know of 30 people who have lost their jobs due to inappropriate facebook postings. I have multiple friends at work, church, and outside church who's children have sent Dickpics/naked pics to their girlfriends/boyfriends that have then gone viral over other media and it has ruined their childrens lives. I actually counsel and do small group lectures/sessions around my area on how to address it when this does happen to your family. Facebook is not the only culpret. There are other social media sites that are just as bad, some are even worse, some MUCH MUCH MUCH worse. I am putting together a teaching slideshow that I will be using with my small groups and hopefully be able to get this citywide/statewide someday. If I can get a non-profit put together and a sponsor group to back me I would love to take it nationwide because I feel so strongly about it. Guys/gals - I have 2 daughters 7 and 9 years old, and a 16 year old son. it's out there and ready and waiting for them. My son is a good kid, he's already been hit with some of the garbage that is out there. I weep for those who have been hit harder than we have. I set up my son's facebook account when he hit age 14. It has all the privacy filters and such. I have his password, I am his friend on facebook, his mother is his friend on facebook. We see every post he posts, he posts maybe 1-2 times every week. he knows the risks and dangers but he still got caught up in the cesspool of the other dangerous social media sites. I won't go into it here. It was not as bad as it could have been and we got through it. I have Police officer friends who work in Kansas City's Sex trafficking undercover world and I've been on their raids, and I watched them arrest a shit bag who was getting ready to have sex with a 3 year old. I cried my eyes out for 2 days. But she is safe and in foster care. I wanted to kill the guy and so did the officers but he is spending the rest of his life amongst the worst of the worst. It's awful and terrible. These are the officers that I've worked with to build some of my material. I've also worked with officers who work cyber crimes and crimes against minors division. it's out there, and our job to keep our kids safe. Sorry that this got off the rails but it's on us to keep our families safe, especially our daughters. and our son's. More to come
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I've been here for many years. I've seen it when we had dozens of new posts a day, the chat room was jumpin and we had active members who checked this site on a daily basis. Now, it's lucky to see a new post once every two to three weeks. I still check this site about every 3-5 days or whenever the site decides to notify me of a new post which is hit or miss. Honestly I do not believe this site is relevant to a new provider as there just are not enough active members here to be a good site to come to. Can that change - yes I believe it could but there are so many facebook groups that honestly are just as good as we Used to be. We used to be the site of choice prior to Facebook becoming the place to be. Now Facebook is the place and with Facebook's instant responsiveness, this site unfortunately cannot hold a candle to Facebook. Good discussion can be had here but there has to be people to discuss things with and I don't see that here. There was a time a couple of months back that I wrote a post pointing out we had X number of members but in a period of X number of months there were only 2 new posts and a small number of replies to existing posts. I was needless to say Dismayed but it is what it is. I'd love for this site to return to it's prominence it once had but I fear that it is never to be again. Maybe but maybe not. Who knows, maybe someone else has a different take. EMT City, Dinosaur still holding on? Prove me wrong!!!