Just Plain Ruff

I will be there this time. I have 4 days off and I'll be bringing the wife, son and baby daughter. We're gonna make a short vacation out of it.

I've been in EMS for over 18 years (damn, that's a long time) and in that time the only occurrences of using a traction splint was on isolated femur fractures (not often) and also transfers from clinics and hospitals without orthopedic services to a receiving facility with ortho services. I can admit I've never placed one on a patient in the field. Like Terri says, usually the femur isn't the only thing broken on a call where you might put a traction splint on. Breathing and circulation are usually more pressing requirements. You can splint both legs with a long spine board if they ahve a fractured femur. As for the first study - I'm interested in it - I'd like to see just how often we knock out someone's resp drive with oxygen if they are COPD patients. I'm sure it's more prevalent in the hospital setting versus the EMS setting.

Ok, be honest here. After every call do you completely disinfect the ambulance? Or if you don't completely disinfect it, after what type of call do you perform better than average cleaning. I know that I'm slacking when it comes to the headaches and strokes and chest pains, I give the unit a quick wipe down. But do you after you bring in a suspected Communicable disease such as SARS, Flu, N1H1, pneumonia or TB, do you completely disinfect the ambulance. I'll admit I'm lacking in that area. But I guess my impetus now is that I don't want to bring home any of that crap to my infant daughter or my wife or son.

Well, droplet precautions should always be taken. That's a given. How bout when you are going to give a breathing treatment and you suspect, SARS or N1H1 or just the flu that you yourself don a mask - not a n95 one but a mask approved for droplet protection. If you proactively protect yourself then you proactively protect your family and the people you come into contact with. So the sensible thing to do is to protect yourself, your partner and disinfect your ambulance after each patient.

NO NO NO NO NO NO Emphatically NO NO NO No Texting while driving. If you do I'm going to have you stop the ambulance and I'm gonna drive and you will sit your sorry ass in the back of the ambulance and when we get back I'm gonna have a sit down with the supervisor/boss and discuss this behaviour. Got to run now, my wife is getting upset with me for being on the computer

Ok, I caught the last 25 minutes of this show. I was unimpressed but I did actually enjoy this show. I know it's not realistic and it takes bad medicine to the extreme but after hearing all the bad things about it I went in to the show with a horrible pre-conceived notion that it was going to be horrible. Well, I just got home from work and my wife said "Hey, That trauma show is on again" So I watched it. I was unimpressed with Rabbit and the others but hey, the girls were quite good looking and rabbit is a stud according to my wife. I did like how Rabbit talked to the girl when she was having trouble. I also liked the guy in the suit who talked and comforted the blond haired beauty who couldn't rectify herself with the John Doe. We've all been there I think. The show overall I'll give a C- but for the medical aspects I give it a D- or F. I didn't see the chopper incident or this would probably have gotten a D from me. I'm not going to count this show out completely, I will watch it tomorrow night and give it a 2nd chance.

Actually Phil, I have said nothing of the sort about allowing fire to control us. Unfortunately in many parts of this country is has been determined that the fire departments will run EMS. Be it a mandate from the county or the city that fire runs EMS but it's a fact of life that Fire will run EMS. I have also never said I supported the fire based ems but I do support the medics and the firefighters who do the job. Even though the fire department runs EMS does not make all Fire Medics bad. True that their core business, fighting fires has dropped significantly and they have to pick up the slack somewhere. I am all for separating EMS from Fire but let's not do it at the expense of medics jobs. If you are a firemedic and all you do is EMS then why is it that they cannot be a good medic. The bias here on this site shows over the last many debates that you can't do both. I'm a computer consultant, I did travelling to other cities to put ER computer systems in. I also worked on the side as a medic. Does the logic here on this site that you can't do both well apply to my situation too? I do computer work monday thru thursday and then medic work on the weekend. By that logic it would mean that I am not a good medic. Can someone who works two distinctly different jobs not be good at both of those jobs? If you argue that one can be good at two things then why are we arguing that you can't be a firefighter/medic too?

This is a standard week of questions by both my son and my sunday school kids You can answer any of them except number 10. 1. Why is blood red? 2. Where do babies come from? 3. Why are there craters on the moon 4. If you were a super hero who would you be and what would your super power be? 5. Why is the sky blue? 6. Where do babies come from? 7. Tell me about the birds and the bees 8. What is your favorite weapon 9. Did you know Barack Obama is our First Black president? 10. Who was the best president, George Bush or Barack Obama 11. Can we go back to Baltimore and do the pedal boats 12. Dad, when are you going to quit being on the ambulance and go back to travelling for work. (tough and loaded question) These are the questions in just one week that I can remember off the top of my head. Now how was your week.

True Admin I never meant for this to be it's own topic, but it is now. Yes, please don't muddy this discussion with personal animosity and preconceived notions.

Let me add a quesiton to this debate How long does it take for the N1H1 flu vaccination to take effect? Is it within a day or so or is it over a period of weeks or longer? How long does it take for the vaccination to be completely in effect? If states are not testing for this flu then why are we so up in arms about it. How will they come up with the valid numbers to show pandemic or not. Are we gonna trust the government's numbers of swine flu when we aren't testing for it???? It seems like any number that the government comes up with in any situation is always wrong anyway so do we trust the governments numbers anyway?

Well with some of the same symptoms as flu it's no wonder that they aren't testing anyone much anymore. Our hospital doesn't even have a rapid N1H1 flu test. So we can't test anyway. Of course we can send it out but those results come back 24-72 hours later and by then the worst part of the illness is over. Let's just treat everyone with the symptoms of flu or swine flu and go from there.

But that is some of the posters thought process here. My opinion only, you can be a good paramedic and a good firefighter both at the same time. It's all in how you apply yourself. If you put your effort into being a good provider and you are truly in it for the patient care then you can be a good paramedic as well as a firefighter. Unfortunately, fire departments are running fewer and fewer fire calls and more and more ambulance calls or calls for EMS. If your service is fire/ems (medic level) then your medics should be invested in providing good care. If they are not vested in good patient care then put them on a hook and ladder truck and let them eat smoke. Likewise if a firefighter is not invested in good firefighting then put them on a desk. I want to be sure of a couple of things when I call 911 1. My police are trained to do law enforcement 2. my fire fighters are trained to cut me out of my car and also to put my house out when it's on fire 3. When I'm hurt I expect my paramedics to be able to treat me appropriately and effectively. I do believe that you can do both.

Received this email from Veratect a communicable disease tracking group. Focusing on N1H1 but also other communicable diseases. I have contact info if anyone wants to be placed on their email list. US H1N1 Situation Update- Sept 29th United States H1N1 Situation Update- Sept 29, 2009 Background Veratect issued advisories on July 27th and August 6th documenting indications of an apparent resurgence of H1N1 from latitudes in the southern hemisphere, then across the equator to Mexico, followed by reporting inside the southern US. Veratect’s advisory posted on July 27th stated an expectation that reports of resurgence would be documented at the southern US border within one to two weeks. This occurred 10 days later. Veratect documented multiple school-based outbreaks of H1N1 in multiple states within days of first classes beginning in mid-August, an expected finding based on observations during the 1957 and 1968 pandemics in the United States. This was presented as evidence of resurgence, and later validated by epidemiological data. Of particular note, much of this reporting was in southern states that began classes early in the season, during a time when migrant worker southern border crossings peaked. It is unclear which of these events contributed the most to community transmission in the southern states. Current Situation Veratect sources report on 28 September that the "second wave" of pandemic (H1N1) 2009 is now prevalent across most of the United States. Officials from the Centers of Disease Control and Prevention (CDC) report that the virus is "spreading widely throughout the US" with 26 states experiencing widespread influenza activity, compared to 21 reported the week prior. Clusters continue to affect schools prompting closures. Sources report that 42 school closures were issued in eight states on 25 September alone. Much of the country is now moderately optimized for transmission based on meteorological parameters and approaching optimization. Local experiences with the pandemic remain highly varied, and it is unknown to what extent protective herd immunity has been achieved in those communities now reporting decreased transmission. Sources report that a vaccine for pandemic (H1N1) 2009 may be available as early as the first week of October, and officials are already establishing systems to track adverse reactions. Harvard Medical School, Johns Hopkins University and CDC will all seek information directly from vaccine recipients and insurance companies recording doctor’s visits post-vaccine to capture any instance of adverse reaction. Public health activists are also advising that vaccinations should target over 11 million illegal immigrants currently residing in the US, since their unvaccinated status could increase the health risk of others. Veratect sources report that federal investigations have determined that, despite months of planning, several local governments are not prepared to handle a surge of patients or quickly distribute vaccine. Areas where resources are lacking include volunteer health care workers, systems to track hospital equipment and beds, and plans for handling emergency department overflow. Sources also report that state and federal officials are drafting guidance on how doctors should triage a scarce supply of ventilators and pulmonary bypass machines (ECMO) that would be needed during a severe pandemic.

Point taken doc, point taken I still will wait till a larger group of people are vaccinated. do I run the risk of getting the swine flu? Yes indeedee My nephew has it right now. He only has the cough and fever and vomiting. Minor stuff if you ask me. Of course he's not immunocompromised though normally. If I get a feeling the vaccination is causing majore problems to people out there then I'm not going to get it. But if it appears that hundreds of thousands are getting the vaccine and no adverse effects on these people or a minimum of adverse effects then I'll take the shot. and yes personal choice and personal decisions are sacred. There is no other vaccine out there (correct me if I'm wrong) that is mandatory to get. So why make the N1H1 vaccine mandatory????

WEll, call volume for you alone is about 1300 to 1500 calls a year. The other ambulances run about the same. The only medics on the service are on the ambulance, there are no medics on the fire trucks. Can you as a firefighter/medic who's sole job is to be a medic, can we really lump people into the category that they are doing EMS a dis-service? We are on this board and many of the opinion that firemedics are less of a provider but if you are strictly a medic but with fire/medic title, can we automatically assume that that person is less of a provider than the person who only has the medic title. I'm just not understanding the hatred here of firemedics or am I just missing the boat altogether and is it just the organization that has firemedics that we despise? I am having a hard time grasping this concept some have here. I have many friends who are paramedics and firefighters who are excellent ems providers. I also know of some poor ff/medics but I know more good ff/medics than bad.

Let me ask a question regarding the fire based ems? Let's say that I'm a firefighter and paramedic working for a fire based ems service. I am hired completely for the ambulance and I never will work as a firefighter. I spend all my efforts on being a good paramedic and limited time on strictly keeping up my firefighting certs. Does that automatically make me a bad paramedic or sub-par paramedic just for being a firefighter and a paramedic?

I went to a chiropractic wellness center. They ran some machine down my back and it gave some color coded readings. They then tailored a regimented course of treatment for me that included 3x weekly adjustments, vitamin supplements and some food supplements. All this for a grand total of 7300 bucks over 3 years and they said I'd be completely cleansed and would feel better. 7300 bucks for all that. What a bargain. The only reason I would go to a chiropractor would be to get my back adjusted and that doesn't need to be done very often or to get a massage from their massage therapist. Many chiropractors are good but when they start to get into all the supplements and herbs and vitamins is when I start to call em out as quacks.

I are a paramedic, I are in need of new training. A new book is out "The idiots guide to cpr without rescue breathing" a 645 page compendium of step by step instructions on doing CPR without ventillations. So the question begs to be asked - will they be ceasing intubating these patients too? I mean if they don't do breathing for them then why do we need intubations?

I do like this rep system and Hopefully it's a tad bit better than what we originally had. Remember back when we could give a certain number of points to each persons post and some people had negative numbers in the double digits.

Dwayne, I agree with you to a point. I am fully willing to get a shot when it's proven effective. But to get a shot that may only be 50% effective even after 2 shots has a lot more convincing me to do. The flu shot has been around for years and even though it is effective for only about half the time, that time being when they guess the correct influenza strains I'm all in agreement to get. I have no problem getting either the flu shot or the pneumonia shot. But I'm not convinced that the N1H1 shot is effective nor am I convinced of the shots safety since it has been rushed to market without the testing that the flu shot, the mmr shot and the hepatitis shot's have undergone. Until that time that the n1h1 has been proven to be safe and I'll defer in taking this shot. Not sooner. I have not completely refused to take the shot, but I have refused to take a shot that is still quote unquote "experimental". if it is determined to be safe the hell yes I'm gonna get the shot but until the time that I'm convinced that it's safe then I'll hold off on the shot. but your criticism of our attitudes is holier than thou. You have your opinions of vaccinations and I have mine. You cannot hold our opinions against us just as I will not hold your opinions against you. on a happier note, how have you been and are you keeping safe? And one other thing ---- Have you seen my new daughter? All right, I must have missed the Nazi reference and the abortion reference but hey whoever made those arguments doesnt' have the whole picture and to use those arguments to compare it to this discussion is ludicrous and absurd.

Well, have you met Dust or others here. your description of yourself describes many on this board, and some of those it describes are married so don't count yourself out yet.

i work in a rural area and our traffic is very sparse at many times. I do not have a problem working a code to the hospital where I work at but only under certain criteria. 1. V-fib refractory to shocks and meds 2. Arrest in the ambulance 3. pediatric codes Asystole NOPE PEA after all reversible causes are addressed NOPE If you drive safely, slowly and carefully and you have enough help in the ambulance then I'll work the code to the ER. If the patient location is just across the street from the ER like we have a nursing home across the street, I'll shock, and then intubate and give the first round of drugs and then put em in the ambulance and transport the 1 minute to the ER. It's nice to have the extra help the ER can give. But if the criteria for death in the field is met by that particular code then no transport.

Trauma is the new emergency - Hollywood style. Give anything good to hollywood and they will F it up.

It's sad that we are even having this discussion. What I mean is that we have a vaccine that has from all accounts been rushed to production and distribution and the studies have not been completed. We have a public health discussion and concern that what is in the public health concern should trump personal choice. That personal choice is sacred if you ask me. I can refuse every medical procedure that is offered me but if we make vaccination mandatory then we take that choice away. We know more about the spreading of diseases and how to decrease the spread yet we are talking on here of forcing people to get the vaccination. There were mandatory evacuations during hurricane season yet many stayed. That was their choice to stay. If you refuse the vaccination and I'm still truly on the fence on this one, then if you get sick then by golly, it's your own fault and you need to take responsibility. If you get sick and you are not vaccinated then you pay the piper. I do think that if you are sick and not vaccinated then if you get sick you need to sequester yourself in your home till you are better.

I just read the most recent note posted by the family and my heart stopped when I read of her death. I am saddened and disheartened that Cancer has taken this vibrant life from us. There is another young lady on the caring bridge site named Lily Preston and she is also battling a brain tumor too. She and Alyssa would have been wonderful friends if they ever met. I am saddened and melancholy about this turn of events.