Just Plain Ruff

now Terri, H1N1 Vaccine and Insulin sound and look the same. This gives true dat to "I'm not smarter than a 5th grader" This story just defies logic.

Thank you AK I knew you would be one of those who I really wanted to hear from. The job is a computer consultant job that will put me in a majority of the hospitals over in Dubai/Abu Dhabi. I will be working on the emergency department piece of their software. I'm just in the infancy stage of this opportunity so I've not talked much more than "insane money, wonderful work environment and New country" I'm still working on getting more info.

Holy crap, someone on this site actually admitting they are wrong. I really wasn't busting your chops or anything like that. I originally thought it was Dubai but the company I'm trying to get on with corrected me too. I'm looking forward to this possibility. It looks like this is going to be a longer proces than I thought. Maybe up to 2 months to get everything authenticated and processed for this company.

WRONG!!!!!!!!!!! http://maps.google.com/maps?hl=en&source=hp&q=abu+dhabi&um=1&ie=UTF-8&hq=&hnear=Abu+Dhabi+-+United+Arab+Emirates&gl=us&ei=t7NXS_HiJs2Ptgehv-yqBA&sa=X&oi=geocode_result&ct=title&resnum=1&ved=0CA4Q8gEwAA

hey Guys, I've got a question for those who have been to the Middle East and have lived there. I have an opportunity that might be too good to pass up. I have the opportunity to go to Abu Dhabi and work on their emergency department computer systems. Not sure of when I'll be going but probably within the next two months. It will be a semi-permanent placement of at least a year. Lots of benefits and the like. Plus pay is insanely good. I'm concerned about a couple of thngs 1. How are christians treated there, are there christian churches that I and my family attend? 2. How are their women treated there? do women there need a male escort to go out and about 3. Food - are there fast food restaurants that my son can get his happy meal 4. What are the driving requirements. Lots of others but those can start it all.

makes you think of vehicular failure? Seizure of the driver? Who knows.

Once your personal safety is at risk then all bets are definately off. If it's me or the patient then you can be darned sure that before I'm taken out that patient is going to be dead first. But if you have any way of getting out of the ambulance you better take it because you as a professional provider, you are responsible for keeping the scene safe. If you lose control and the patient gets hurt but you can defend your actions then yeah, you're going to get sued but at least you are safe. If a patient goes bat shit crazy on me and I can't get out of the ambulance then that patient is gonna get hurt. It all bois down to this, if you go home safe at the end of your shift then your day was good.

Ok, I haven't posted in a while but this is a good one. One way to change the toon of the dumbass doctors who won't give you orders for chemical restraints. Let the patient be completely combative when you arrive at the ER, Let the patient go bat crap crazy in the ER, have him hit the doctor and knock him out. Then call the cops and have them shoot the bastard. Let the doctor know that this would have been avoided had he have had the balls to give you sedation orders. Or better yet, get your medical director to write you a protocol that precludes you having to call the hospital. If the hospital isn't going to look out for you then your medical director should. One other thing, the first time one of you guys get's hurt from the doctor not giving you sedation orders, take the doctor and hospital to court citing that your injuries were a direct cause of them not giving you orders for sedation. Or you can do what some medics I've worked with, IV em, Versed em, Sux em and tube em. Tell the doc that you were concerned about their ability to protect their airway and you RSI'd em. Not saying it will cover your ass but someone has to. And finally - when in doubt, stop the ambulance, get out and wait for the police. No sense in getting yourself hurt. The ambulance and it's equipment can be replaced, YOU CAN'T Be. Most times when the police hear that the patient assaulted you they are not so nice. If your service isn't going to help you keep safe then you need to find a new service or you need to work to make the changes happen. Your safety is 100% your responsibility. Protocols and medications only go so far.

If food affects you that much then maybe ems is not for you. Nothing worse on a call than when you have to take a dumpage and there is no place to go do it at. If the food goes right through you and you need to be able to find a bathroom at a moments notice EMS should not be for you. 9.9999/10 you will need to go #2 and you will be either stuck running a long distance transfer or doing a fire stand by out in rural minnesota with nothing but wide open fields in front of you and 50 news cameras and cell phone cameras there and you don't want to get caught with your pants down right?

Underbid a contract to get it then don't complain about not making any money. But to have a single non-emergency provider in the state just reeks of monopolizim but I'm sure that there is more to this story not printed.

Now that Atlanta airport was funny. the original post - not so much I have been on the receiving end of correction by numerous people on this board regarding my stance on the Islamic faith as well as some other things. I tend to believe I'm able to look past those beliefs and see the other side. I am sure that my beliefs shock many of the Islamic faith yet many of us (christians and islamists) can sit down and have a calm discussion for each of our sides and come away from that discussion better more informed people. I have been chastised and torn apart by some but in the end, it's all a learning experience and I felt that I've come away from the discussions a better person. My views have not changed much but I do see the other side. If we can all learn from each others experiences then we can all become a better society and community. not sure if this has anything to do with the topic at hand but hey, I felt like sharing.

6 tubes 6 successful - 4 in field and 2 in hospital on the patient floor. i agree JWade with not accepting a 82% success rate but there are patients that just don't want to be intubated no matter how hard you want to intubate them. Rescue airways are there for that reason.

We are going to see more and more of this during this season. There are so many people out there hurting that many more of this will follow.

Actually the Airlines would not allow this guy to sit that way. Unfortunately if he has to sit like this then he'd probably not be able to fly unless he purchased a 2nd seat. I have been in the position of the guy in the middle seat and it was messy. I made a complaint to the flight attendants and said that I objected to this one woman sitting by me. Had a good long discussion with the woman and told her it was nothing personal and she actually didn't get mad. She did apologize to me for the predicament. But I refused to sit next to her based on the fact that there was no way she could sit in our row comfortably and that either I received a refund or they moved me to a open first class seat. The airline was not about to refund my money and they had 1 open first class seat. I pushed the issue and after a delay of 20 minutes for the plane to leave the gate I was moved to first class and the woman got two seats. I even had the young 10 year old next to me flying by herselft tell me "you can have part of my seat" which was very nice of her but I did not take her up on that offer. The woman was relieved and I was pampered in First class luxury for a flight from jacksonville Florida to Seattle Washington. 5 hours. I know I made some people angry that I delayed the flight but I'm not going to be forced to sit next to someone that size when I know good and well that my ticket cost me way more than hers did because I had to book it one day in advance and it cost my client 1150.00 I was fed, given a blanket, got all the soda and beer I wanted (I didn't drink a lot of beer) and I was happy. I am not against people that size flying but when it comes to my comfort and sanity I'm going to argue the point. If you need more than one seat to get to your destination on a airplane then you should have to purchase 2 seats. Sorry if this makes any one mad but I have spent the last 9 years travelling on planes twice a week and it's a supreme hassle to begin with and to add someone who takes up 2 seats and try to fit them in one seat that barely seats me, I'm gonna speak up. The downside to this whole situation was that when I got off the plane I was approached by two uniformed police officers and a guy in a suit who asked me why I delayed the flight. I explained it to them and that was that.

Epic fail on the airplane seat. Well again, the picture fails to load. Here's the link. If someone can put it on here that would be great. <a href='http://www.emtcity.com/index.php?app=gallery&module=images&img=516'><img src='http://www.emtcity.com/uploads/1259231812/gallery_1843_51_56287.jpg' alt='Too big for the airplane seat' /></a> It's also in my gallery page.

It was nice knowing you all. Farewell cruel wo

I get these on a regular basis. I even got one of these idiots to send me a picture with them holding their id and passport.

Well you have shown your true colors Diazamoron. A wife and kids and a girlfriend on the side. A girlfriend so you are a troll and a cheater. You are dirt in my opinion.

You need to get in writing why they won't let you take the class. If it's strictly because you are pregnant then you have a good case of discrimination or whatever they call it these days. too much political correctness. Once you get it in writing why you can't take the class, but that will dictate your next move. One could ask the following question depending on how far along you are, why can't you wait to take the class when you aren't pregnant? Sue them for discrimination and then take the class. But seriously - let us knwo what they say.

So Kevin, your reply does not even warrant a reply but since you made it a point of showing how wrong I was. Let's look at it this way. 1. The brits indeed did surrender and turn over their weapons to George Washington. 2. The war of 1812 is considered to be a war by many historians. 3. Late entry into the war, be glad that we got in the war and dropped the bomb on Japan which no other country was willing to do, thus saving many more deaths on both sides. 4. Yes all the money that came from the US saved many millions from starvation and helped rebuild your country as well as Japan and France. You might well say that we saved your asses after we won the war for you. that is all.

What? I believe that they are indeed coming to the US for the medical care. For some people in the socialized medicine countries, the only way to get a operation or procedure done in a timely manner is to come to the US. Once the procedure is done, then they go back to their country.

Matt, I've heard figures of 2500 up to 200K a year coming here for treatment. I have also heard of a large number of pregnant women being transferred from Canadian hospitals for c-sections because they can't get them done in Canada. like every inflammatory comment or divisive discussion I'm sure the numbers are either trumped up or dumbed down to suit each sides argument as being the right one. I cannot find any good solid numbers in an exhaustive (30 seconds) search of Google.

Nice article I came across. Interesting article. Shows that the UK provides better primary care than the US. So why are so many people under socialized medicine coming to the USA for care? It's a long read, but the most important parts are in the first couple of paragraphs. US performs poorly against UK and other developed countries in primary care From: The British Journal of Healthcare Computing and Information Management | November 05, 2009 The UK has been ranked as having one of the best primary health care systems in the world in a survey by the leading US think tank the Commonwealth Fund and published online today in the journal Health Affairs [1]. The survey queried more than 10,000 primary care physicians in 11 developed countries: Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States). Fifty-eight percent of primary care doctors in the US report their patients often have difficulty paying for medications and care, and half of US doctors spend substantial time dealing with restrictions insurance companies place on their patients’ care, according to findings from the 2009 Commonwealth Fund International Health Policy Survey published online today in the journal Health Affairs. The majority (69%) of US doctors report that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments (compared to 97% in the Netherlands and 89% in New Zealand and the UK that do have after hours care). US doctors were also far less likely to use health information technology that helps reduce errors and improve care — only 46% of U.S. doctors use electronic medical records compared to 99% of doctors in the Netherlands and 97% of doctors in New Zealand and Norway. The NHS was rated highly in a number of key areas including being the only country where the majority of doctors feel the quality of healthcare is improving. The annual survey of international healthcare comparisons this year polled primary care doctors for their views on their health systems. The UK was rated top in several categories including: improvements in quality over the past three years; least likely to report long waiting times for patients referred for specialist care; managing chronic conditions with specialist teams; using financial incentives to reward doctors for good patient experience; the use of patient satisfaction and experience data to improve services; and the use of comparative data to review doctors’ clinical performance. Speaking from Washington at the Commonwealth Fund’s 2009 international health symposium, Health Secretary Andy Burnham said: “This is an important moment for the NHS. The journey to overhaul the quality of care over the last ten years has paid off. Clinicians now say they are confident they are treating and caring for patients in ways that match the best healthcare systems in the world. The NHS is not perfect but it has moved from poor to good and I want to see it go from good to great on the next stage of the journey. “Primary care services are at the heart of the NHS, preventing illness, managing disease and helping people live healthier lives. Most recently our GPs have been doing a fantastic job at the forefront of our response to the swine flu outbreak starting the vaccination programme. “We will build on these great achievements, and focus on the challenge for the next decade – greater choice, more personalised and high quality care, taking the NHS from good to great. “I would like today to pay tribute to the hard working NHS staff across the country and congratulate them for this magnificent achievement. This is a proud day for NHS staff and for the millions of patients they look after so well.” During a three-day visit to Washington the Health Secretary will also be discussing key global health challenges such as the swine flu pandemic, the health effects of climate change and the shared challenge of obesity with his US counterpart and other opposite numbers. The state of primary care in the US "We spend far more than any of the other countries in the survey, yet a majority of US primary care doctors say their patients often can’t afford care, and a wide majority of primary care physicians don’t have advanced computer systems to access patient test results, anticipate and avoid medication errors, or support care for chronically ill patients," said Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the article. "The patient-centered chronic care model originated in the US, yet other countries are moving forward faster to support care teams including nurses, spending time with patients, and assuring access to after-hours. The study underscores the pressing need for national reforms to close the performance gap to improve outcomes and reduce costs." The survey describes a US primary care system that is under stress and highlights areas where the US can learn from other countries. Notably, the US could look to improve by using financial incentives to improve quality and efficiency, expanding access to health care and simplifying insurance, expanding the use of health information technology to prevent medical errors, and using a medical home approach to primary care where patients have options for care at any time of day or night, teams of health care providers to manage conditions, and continuity of care. Many of the areas in which the US lags would be addressed by proposed health reform legislation currently under consideration in Congress. "Access barriers, lack of information, and inadequate financial support for preventive and chronic care undermine primary care doctors' efforts to provide timely, high quality care and put the US far behind what many other countries are able to achieve," said Commonwealth Fund President Karen Davis. "Our weak primary care system puts patients at risk, and results in poorer health outcomes, and higher costs. The survey provides yet another reminder of the urgent need for reforms that make accessible, high-quality primary care a national priority." Survey Highlights Access and barriers to care More than half of U.S. physicians (58%) report their patients often have difficulty paying for medications or other out-of-pocket costs, compared to between 5% and 37% in the other countries. U.S. physicians are also 4 times or more as likely as physicians in some other countries—Australia, Netherlands, Sweden and the U.K.—to report major problems with the time they or their staff spend getting patients needed medication or treatment due to insurance coverage restrictions. About half (48%) of US physicians report this is a major problem, compared to just 6% in the UK. Twenty-eight percent of US doctors report their patients often face long waits to see a specialist — a rate similar to that reported by Australian (35%) and UK (22%) physicians, the lowest rates in the survey. Three-quarters of Canadian and Italian physicians reported long waits. After-hours care outside the emergency room Most US primary care doctors say they have no arrangement for access to care after normal office hours except for directing patients to a hospital emergency room. Just 29% of US doctors report any arrangement for patients to see a doctor or nurse after hours, a drop from 40 percent in the 2006 Commonwealth Fund International Health Policy Survey. In contrast, nearly all doctors in the Netherlands (97%), and large majorities in New Zealand (89%) and the UK (89%) report after-hours provision, as do more than three of four doctors in France (78%) and Italy (77%). Health information technology While nearly half (46%) of U.S. primary care doctors report using electronic medical records (EMRs) — up from 28% in 2006 — US primary care practices, along with Canadian doctors, continue to lag well behind other leading countries. EMRs are nearly universal in the Netherlands (99%), New Zealand (97%), the UK (96%), Australia (95%), Italy (94%), Norway (97%), and Sweden (94%). In addition to basic EMRs, the survey asked about a range of 13 possible computer functions, including electronic medication prescribing and alerts for medication errors, ordering lab tests and viewing test results, and support and prompts for preventive care and follow-up care with patients. Here country results varied widely, ranging from nearly all to half of doctors reporting at least nine of 14 possible computerized functions in New Zealand (92%), Australia (91%), the UK (89%), Italy (66%), and the Netherlands (54%), to one fourth or fewer practices in the U.S. (26%), Canada (14%), France (15%), and Norway (19%). Notably, in the United States, advanced information capacity was concentrated in larger group practices and those affiliated with integrated care systems. In contrast, in the seven countries with near universal use of EMRs, there was little or no difference in advanced health information technology use by practice size. The authors note that in these countries national policies and standards have supported wide adoption of information technology in primary care practices. Financial incentives to improve quality Every country in the survey, to some degree, uses financial incentives to improve primary care, preventive care, or disease management. Primary care physicians in the US, however, are among the least likely to report that they receive financial incentives for quality improvement, such as bonuses for achieving high patient satisfaction ratings, increasing preventive care, use of teams, or managing patients with chronic disease or complex needs. Only one-third of US physicians reported receiving any financial incentives for the six quality improvement measures in the survey. Rates were also low in Sweden and Norway. In contrast, significant majorities of doctors in the UK (89%), the Netherlands (81%), New Zealand (80%), Italy (70%) and Australia (65%) report some type of extra financial incentive or target support to improve primary care capacity. Use of care teams and systems to care for patients with chronic illness Teams that include health professionals such as nurses serve an important role in managing care, especially for chronic conditions. The survey results indicate that use of teams is widespread in Sweden (98%), the UK, (98%), the Netherlands (91%), Australia (88%), New Zealand (88%), Germany (73%) and Norway (73%). Use of teams was far less frequent in the United States (59%), Canada (52%), and France (11%) based on primary care physician reports. Use of evidence-based guidelines for chronic disease was high in all countries for diabetes, asthma, and hypertension but notably lower for depression. Yet, providing written instructions for patients to manage care at home is not yet routine in any country — gaps exist in all. Only in Italy did more than half of physicians (63%) say they routinely provide written instructions to chronically ill patients for managing care at home. Quality reporting and feedback Many countries in the survey have also been investing in information on performance to provide incentive and benchmarks. The authors note that "information that peers have met with success is often instrumental to guide and drive innovation." Asked about comparative information systems, doctors in the U.K. are most likely to routinely receive and review data on clinical outcomes (89%), followed by Sweden (71%), New Zealand (68%), and the Netherlands (65%). Less than half of doctors in other surveyed countries — including the US at 43% — report such reviews. UK physicians (65%) were by far the most likely to report they receive data on how they compare to other practices and, along with Sweden and New Zealand doctors, the most likely to have information on patient experiences. Notably, US doctors lagged well behind these leading countries on feedback on both clinical quality and patient experiences. Tracking medical errors The study finds that half or more primary care doctors in Canada, France, Germany, Italy and the Netherlands report not yet having a process to identify "adverse events" and take action. Just one in five U.S. primary care physicians say they have a process that works well to identify risks and take follow up actions; one third said they have no process. At 56 percent, UK physicians were most likely to say they have processes they think work well, followed by Sweden (41%), New Zealand (32%), and Australia (32%). Looking across survey results, the authors conclude that national policies have been instrumental in the leading countries to achieve round-the-clock access, information systems, and advance primary care teams. They note that "overall, the survey highlights the lack of national policies focused on US primary care. Unless primary care practices are part of more integrated care systems, they are on their own facing multiple payers with uncoordinated policies." Pressing need for US reforms Following survey findings that point out lagging US performance, Commonwealth Fund President Karen Davis noted that key national reforms could make a significant difference by: Covering everyone, with a set of benefits that emphasizes primary care and prevention and which remove financial barriers and support primary care physicians as well as their patients; Providing financial incentives focused on value and health outcomes; Supporting primary care practices and their capacity to serve as ― medical homes with 24-hour access, use of teams of health professionals, and continuity of care; Accelerating the adoption and use of health information technology, including electronic medication prescribing to reduce risks of errors; Simplifying insurance to reduce complexity and paperwork for doctors and their staff; and Investing in information systems with quality reporting and feedback to spread improved care and safety. Reference 1. Cathy Schoen, M.A., Robin Osborn, M.B.A., Michelle M. Doty, Ph.D., David Squires, Jordon Peugh, M.A., and Sandra Applebaum. A Survey of Primary Care Physicians in 11 Countries, 2009: Perspectives on Care, Costs, and Experiences. Health Affairs Web Exclusive, Nov. 4, 2009, w1171–w1183. The full article is available at: http://content.healthaffairs.org/cgi/content/abstract/ hlthaff.28.6.w1171 Further information Further information on the study from The Commonwealth Fund, including an online charting tool using international health data, is available at: http://www.commonwealthfund.org/Content/Publications/ In-the-Literature/2009/Nov/A-Survey-of-Primary-Care-Physicians.aspx

AK the voice of reason again. I stand corrected by you which I am too often most days. It is too bad you don't understand my religious beliefs but at least you are honest in your opinion. It is good to know we can have this kind of discourse rather than one that is vehement and so often the case on this forum and life in general these days. But I'll shut it now and not say anymore lest my opinions get me more bad reputation. But on a serious note, I need to discuss with you privately regarding opportunities for employment over where you are. Not for me but for a colleague. I will email you privately. but in changing my views like one person has privately emailed me, I'm not going to but I will attempt to be more tolerant towards others. As for the Hindu faith, I have no issues with Hinduism. As a matter of fact, whatever anyone wants to believe in is ok with me but I do not have to agree that they are right nor do they need to agree that I am right in my belief. And if I appear intolerant of others religion or belief system then I guess that is how I will appear.

Kaisu, I did get the point but since I made the comment regarding Islam I expanded on that. I figured out the guy was Hindu when he posted the first time. Jeesh, Kaisu, Lighten up.