Just Plain Ruff

Yep that's it. I think I actually gave away a copy from one of my infamous contests on emt city a while back. Note to self, I have to do another one soon. That book taught me more than any medic class, documentation class etc. It tells you how to write a legally defensible report. I have never been to court as a defendant based on my reports. I have been asked to clarify soem points but never as a defendant in a malpractice or negligence case. I think this book helped me stay that way. I recommend to get it.

Any patient can refuse. Even a minor but they can't really refuse but they can get their parents to refuse for them. I do believe the story about the diving woman, I've heard it before and having it based in the ocean area. Maybe an urban legend though. When I document a refusal I document the following Their loc why they want to refuse and their reasons I document on our refusal form the risks and benefits (are there any benefits) of refusing. I always put down the word DEATH. I also sometimes when the reason is stupid such as "I don't like doctors" I have the patient write that on the refusal form. I also get either my partner or the patients spousal unit or someone on the scene not affiliated with my ambulance service such as a cop or the person who called 911 in the first place. I put their name and address printed out under their signature. If you document completely then your risk of getting sued is less once the lawyer looks at the form. Sure the lawyer might take the case anyway but at least I have crossed my t's and dotted my i's There is another resource I use quite a bit. I don't even think it's in print any more. It's by Kate Dernocour (sorry about spelling) and it's on how to write a legally defensible report. You may be able to find it in a used book website.

ok, I'll be the ahole in this bunch. It sounds like you have done your due diligence and it's time to get your hands dirty. If you won't do it then someone else has to. Have a sit down come to christ meeting with them and tell em that they are just not getting it. ASk em WHY??? What is hindering their getting into the scene and lending a helping hand without being asked. If they say "Uh, I donnno" then I hate to say it but maybe it's time to kick their butt to the curb and say "Go find a different career" Firing someone is never easy and it sure sounds like you've done your steps to keep em from getting axed but seriously How many more calls where they stand and do nothing do you have to endure before either someone gets hurt or YOU get hurt by this "bystanders" attitude and work ethic. I'm sure it's prestigious for everyone on your department for being volunteer firefighters or emt's or whatever but prestige is just not good enough here. This person is a liability and you and your patients will only pay the price It's time for a put up or shut up meeting. just my 2 cents though

Lady GAGA is all woman unless she is a man at the time. I've seen pictures of her naked but they aren't anything to write home about. But then again, PHotoshop is pretty good at faking things. Regardless, I'd not want to meet up with her when we both were horny, might be a frightening experience.

"I'll be the hero" "I'll be the big guy on campus" "holy crap, we're going down, I'm sorry lady, I should have waited for the ground crews to get to you" Another senseless loss of life.

I'm sorry but the questions asked are just the wrong questions to ask first. Have you even considered the main equipment side of the equation. The helicopter. the more logical question for this group would be who would you call to talk about getting a helicopter in your area. Do you have about 30 million dollars in capital to do this? If you are wanting to fly patients then you are going to need to go a lot deeper than these radio questions. I don't think you are serious. I think this is actually a joke. No offense guy but you sound like the wrong person to do this. Contact the closest helicpoter service in your area and discuss this with them. Maybe if you can prove that you can provide a certain number of calls a year then maybe they will put a bird in your area. If you can't show them a bonafide need for a helicopter in your area then you won't get very far. I'm VERY VERY VERY skeptical about your intentions.

Until we do the following two things, then this will still happen 1. NO Chopper Shopping 2. I know this happens many places already but until the crews are not told what the call nature is, this will continue to happen. It's less of a likelihood that a crew will go and get Granny Jones who is 96 years old with an MI but much more likely that they will throw caution to the wind when it's a 5 year old trauma or 10 year old medical patient. Patient condition or call type should not play into their decision making. It should be dispatched as either interfacility or scene flight. That's it. 3. One other - each crew should be empowered to say NO if they don't think it's a good flight. Some services do a majority rules, some do one crew member says no then it's no but others go regardless if the crews object. when these three things happen we will have a safer flight life but there will still be crashes no matter what happens but they will be less.

Holy Crap - If starbucks has to do something like this then we are really SCREWED.

AT&T will take a 1 billion Non-cash Charge on their accounting books based on the healthcare reform bill that just passed. Read the article for the unintended consequences of this bill. http://www.google.com/hostednews/ap/article/ALeqM5gOfZ-GqupWhK1jO7SwYD4-G5bUWQD9EMIN582 One thing that jumped out at me on this article is this Companies say the health care overhaul will require them to start paying taxes next year on a subsidy they receive for retiree drug coverage I have realized after reading this article that this bill er new law will have farther reaching consequences than just affecting me and my family in insurance costs. It will affect the businesses that we use everyday. This is another reason why this bill is so bad for the US. The 1 billion charge is 1/3 of AT&T's profits for last year. Thanks Congress and Obama.

Back in the 1700's 1771 and beyond to be more focused, we had initially peaceful discourse. Until the various oppressive acts were passed we had somewhat peaceful discourse. AFter the oppresive acts such as the stamp act and others the founding fathers and the colonists felt they had no other choice and they rebelled. Even during the war, there were overtures of peace to Britain. But in the end, we fought, we died and we won our liberty. I hope that this does not happen here but there are some who are advocating this. I suggest a different course other than violence because violence is well wrong. I suggest that you support the opponents of these congressional leaders in their campaigns. If you do not vote then you have no and I repeat NO business bitching and moaning about anything that the congress does. If you voted for the guy who lost then you can complain. If you do not make your voice heard in the halls of congress by sending letters or calling your elected reps then you can't complain too loudly. I went to DC yesterday. I saw several members of congress. One was Senator Collins of Maine. I talked to her and urged her to work to get rid of this bad bill. She said she was working with many colleagues on this but she couldn't make any promises. I told her I was not her constituent but I was a citizen and as a citizen I was voicing my opinion. Another person I talked to yesterday was Denny Rehberg. I didn't ask if he was a rep or a dem. I also discussed healthcare and the military and he said he was also working on a solution to the bill that was passed. I could only assume he was a republican. I feel that I have done at least a small part in helping make my opinions known. If you do not act then you cannot bitch. Does anyone know the definition of insanity??? It's doing the same thing over and over and over and expecting a different result. If you only complain, and complain and complain, and you expect a different result out of your complaining but don't do anything solid then you are insane. Actions without results are just Actions. WE need to take back our government and that happens one ousting at a time. Let me ask one question - Does anyone ever think that there could be a coup in our country?

Unfortunately another case of chopper shopping. NOTE TO EMT CITY members. If one service turns you down, just take the patient by ground. SAFER in the long run. This proves it. I think we over utilize helicopters anyway.

Awe dammit, now another area I need to steer clear of. JUst kidding Seriously Congrats to you. I know it was a long tough road but you did it. Now the real learning begins.

Let me ask two questions. Question 1 - does anyone here think that the cost estimates will turn out to be right for this bill or are you like me, skeptical because the history of this government is to live beyond it's means. We take in less money in taxes than we put out or we would have a balanced budget or a budget surplus. Question 2 - soon to follow but I lost my train of thought.

This corresponds to the Obama Care thread we have been having. Subject: promised land Over five thousand years ago, Moses said to the children of Israel , "Pick up your shovel, mount your asses and camels, and I will lead you to the promised land". Nearly 75 years ago, Roosevelt said, "Lay down your shovels, sit on your asses, and light up a Camel, this is the promised land". Now, Obama has stolen your shovel, taxed your asses, raised the price of Camels, and mortgaged the promised land. I was so depressed last night thinking about Health Care Plans, the economy, the overwhelming Federal deficit, lost jobs, Savings, Social Security, retirement funds, etc. ....so I called Lifeline, the suicide help line. It was outsourced to a call center Pakistan . I told them I was suicidal. They all got excited and asked if I could drive a truck ..........

Yep, it's called gloating. He's so proud of himself that he and his compatriots forced this one on us that he thinks he's invincible. Well you know what, He's NOT!!! He's not invincible when it comes to re-election - Even though the average american has the attention span and memory of a GNAT, the american people will be watching what happens over the next 7 months. If this bill turns out like I think it is going to, then the american people are going to respond in kind (they screwed us, we're gonna screw them) and many of those who voted for the bill will be out and the one who signed the bill is goign to be out too. Unfortunately, at this time do the republicans have anyone better than Obama yet? I don't think so. There is a line in one of my favorite songs "No matter what you've heard, Impossible is not a word, it's just a reason, for someone not to try" which fits here. It's not impossible to get them out, but its just a reason no to try.

Brent, first off hows the baby? Second, if we put Washington, Jefferson, Franklin, Adams and the others in a room they would drink the Jones flavored Kool Aid and go back to heaven. If they didn't drink the kool aid, then I could see them just locking the door and waiting till this roller coaster ride was over. They'd be dead by then too. I think the founding fathers are rolling over, vomiting and hoping that they don't get reincarnated.

Ok, Kudos for Franco to come here with hat in hand. I won't apologize for what I said because I believe in my heart that professionalism does not include taking pictures of yourself in company garb and then posting it to flickr or facebook. I also believe that in order for us to be professional we need to take this social networking seriously and remember Just like what is happening to Franco, if you post something it is forever. What I do find to be a good thing is Franco setting the record straight. I'm not going to jump to any conclusion and you will find that I have been consistent in my criticism on this site that people jump the gun and go straight to the lynching. I don't believe I did that. If there were policies broken then the consequences have to be accepted. I know they are grey according to Franco but seriously, discipline should be the same across the board. Each and every person working at your company should know and expect that if a certain policy is broken then XYZ is what happens, EVERY SINGLE TIME. This way there are no pissing and moaning when you get fired. I do wish you luck out there Franco. Sounds like you are a good guy. You can fight this, you can fight it just to force the company to either rewrite these gray policies or to try to force the company to apply the discipline across the board, consistently to each person and not just on a person by person basis. One thing that I do have a question is this, you specifically stated that no-one other than you, your partner and the reporter has seen the pics but then you went on to say that your friends don't see the big deal. This is the only part of your story that I find troubling. Since I believe New York is a right to work state then they can fire you for any reason. Sucks but remember, you can also fire that company for any reason. They don't have to give you 2 weeks, nor do you have to give them 2 weeks. I do wish you luck.

lest anyone think I am totally against this concept of healthcare reform I AM NOT. I am just against this bill. Let me say some more about why this bill is bad or is not right 1. There is no tort reform in it. One major reason that doctors are leaving states that have such high malpractice insurance rates is because of the costs and judgements that are so high that the physicians cannot pay for the coverage. (no malpractice insurance reform eh???) 2. To purchase health insurance for my company my rates were quoted as 1400 per month. That is slightly more than I bring in a month after taxes with my company. Sometimes I make a LOT more a month and sometimes I make less. Some would say it evens out but it's expensive. Maybe this bill will lower that cost but to include everyone with pre-existing conditions for all 35 million people I think not. 3. Pre-existing condition coverage for kids - I'm all for that. Most of the conditions that kids have that cannot be covered is due to no fault of their own. They should be covered. 4. Rationing - already going on it's called the pre-existing condition clause and the medical necessity clause. If insurance for all get's covered, then bariatric surgery, cosmetic surgery, ABORTION and many other elective surgeries that do not need to be done will be done. I'm good with rationing some elective surgeries and definatel NO ABORTIONS. But under the bill if a insurance company chooses to allow Abortions then that plan will pay for this. I will have no part in a plan that pays for abortion. I would rather pay the fine than get coverage under that plan. 5. The cost - In order to cover the 32 or so million people it is a absolute certainty that everyone's insurance rates will go UP UP UP. Our taxes will be going up because even with the premiums which will go up the budget numbers that are touted are all based on conjecture and conjecture only. They estimated High I think so when those cost start to jump up then the costs to everyone will go up. 6. I think that if you want to see a unsuccessful universal health care plan just look at Massachussetts. They estimated one number and the final numbers I have heard and read were at least double the original cost or maybe even triple. I had a phone call so I lost my train of thought so I'll leave it here for now.

Ok, with all the talk on this site of us wanting to be professional and considered professionals and these yahoos do this and we are defending them. I'm sorry, taking stupid pictures of yourself and then posting them online is the height of "professionalism" if you ask me. If we are going to tout professionalism on this site then we need to be consistent in our stance. Am I the only one who sees a discrepancy here?

you contradict yourself. YOu first say it was a case of wrongful termination but the next instance you are saying that you don't know how things should be handled. The article says that they took pictures of them texting while either driving or the unit was parked. If their agency is like mine they more than likely have a zero tolerance policy on texting and driving so I suspect this is one of the reasons they got canned. If you take a picture of yourself doing something against company policy and someone in management sees that picture then its your own freaking fault. I got to say I'm not getting any sympathy feelings for these yahoos. The article says that they took pictures of them texting while either driving or the unit was parked. If their agency is like mine they more than likely have a zero tolerance policy on texting and driving so I suspect this is one of the reasons they got canned. If you take a picture of yourself doing something against company policy and someone in management sees that picture then its your own freaking fault. I got to say I'm not getting any sympathy feelings for these yahoos.

Where in the US constitution or any State constitution does it say Healthcare is a RIGHT? NO WHERE. As far as I'm concerned the only rights given you are those in the Bill of rights. Is driving a right? What else do we consider a right? If there are other things that are not in the constitution and Bill of rights that are considered rights, then damnit, these need a bill/law to make restitution and make the government give us that right. What congress effectively did was to make healthcare a right and since it's a right the government has to pay for it somehow. I'm so sick of all this rhetoric. We need to provide reform but not at the expense of our countries detriment. In one year let's see how this affects us. We can all come back around this table and talk about either how screwed up this bill made the country or how hunky dory the bill worked. I hope that this bill is the panacea that the libs/dems say it is but I am very very skeptical.

Nice!!!!!!!!!!!! And cheap too. I could put a bunch of grain and stuff in there and have them for a good long time.

NOW I"M PISSED I just found that since I have a major pre-existing condition, I still won't be able to be covered and not be denied due to pre-existing conditions until 2014. That's 4 years away. So what they are saying is that I'm still going to be uninsured for 4 more years unless I get group coverage from a full-time employer. But since I have my own company I can get group coverage for my company at 1400 per MONTH. So for the next 4 years, if I want to get coverage I need to close my small business and go with a full time employer to get coverage. How is that small business or middle class friendly. One question to everyone on this forum who is posting here. Have you read the bill? I haven't but I plan to. As soon as I finish watching the snow melt. On second thought - I might just read it while watching the snow melt.

ABSOLUTELY If you currently think Government in your life is intrusive, just wait.

Well after yesterday's vote and the way I see this country going I'm setting up a survival kit and starting to read how to books on survival in either the wilderness or how to hunker down when the shit hits the fan. I have found that I am woefully unprepared for the worst case scenario. I hope that if I DO Survive that I will have the ability to survive in some sort of comfortably fashion. I think that 3-6 months of food and supplies would do me and the family well. I am also going to purchase at least a rifle and a handgun and at least 1000 rounds of ammmo, as soon as the money comes available. So to make this thread more pertinent to worst case scenario. What kind of supplies would someone need to be relatively well stocked?