Just Plain Ruff

I think that the minute that you are called out to a suspected drunk driver and you make contact then haven't you become the caregiver for the driver? You are getting ready to do a procedure that only a physician can order you to do, draw blood, even if it is in your protocol. As a matter of fact, will you have protocols that will address this issue? Will you have protocols that cover your butt with your medical director's butt as a umbrella when you cannot get the blood? What if you cause a cellulitis and the patient requires IV antibiotics or god forbid there is a resultant staph or MRSA exposure and illness when you didn't wash your hands after the last nursing home patient you took care of, put on your gloves and you exposed the driver to the infectious agents on your gloves or whatever. What happens if the patient passes out from the blood draw and he hits his head on the officers car door or whatever? These are all real world situations that could happen, some more often than others but what kind of protection will your ambulance service and the jurisdiction you are under provide you? I'm suspecting that your ass will be out in the wind yelling, "Who's going to protect me" So aside from the ethical and medical aspects, let's discuss the legal ramifications of doing this. Just because there's a law allowing us to do it doesn't mean it's a good idea for us to actually do it.

The sad thing is that these kids right now probably do not know who hitler was other than he was a great man that their parents admire, even idolize. When this child gets to be old enough to truly understand what Hitler stood for and this goes above and beyond the whitewashed public school teachings, then they will truly know and understand what a bunch of stupid and mean people their parents really are. Hopefully it will move them to distance themselves from their parents and maybe a good hearted attorney will help them with their name changes. Maybe not. But in the end, the children of this A+ family will suffer the wrath of all the school yard bullies from kindergarden up to high school These are the kids who will grow up fast, be able to kick the pants off of the bullies and protect themselves. These are the kids who might just grow up to be upstanding citizens regardless of how hard their parents tried to keep them on the same levels as themselves. I'd like to be able to follow these kids lives to see how they turn out. I'll be that the producers of "Anna Nicole Live" or the show with Jessica Simpson or even that show about the midget family would bend over backwards to exploit these kids and make a shitload of money in the process. Aint america Great!

disloyalty, that's downright fraud and they broke the terms of the contract/RFP/BID that you both signed. I'd ask for the money back from that unscrupulous dealer. Make sure you let the dis-satisfaction get around too. Word of mouth will hurt that dealer. But then again, what do you expect from a Car dealer??

That is a great site. Lots of education. Thanks for the link.

ok let me ask this, we've pretty much established that IN route is a good route to go especially with peds. So how are you all doing this? My thoughts would be to draw up the med, put a little extra saline in the syringe to facilitate good coverage and then spray via a NON-NEEDLED syringe into the back of the nose. Is this the correct way to do this?

it's a good cause. if you have a paypal address or a website to get your bailed out let me know.

we carry 2 big vials of Versed and we also carry 20mgs of valium. I always give 5 of valium first and if that doesn't work I move to Versed. I had a alcohol induced seizure that would not respond to valium, nor would i respond to versed. I went ahead and paralyzed and intubated the patient because he was thrashing around on the cot and the straps were as tight as I could make them. His pulse ox started to fall and I elected to paralyze and intubate him. I know that the seizure was not stopping in his mind but his body stopped. His sugar prior to the valium was 108 and after intubation was 36 and we gave an amp of d50. When we got to the ER we weaned him off the tube and his seizure had stopped. He recovered without any problems and went to the icu for the night. He was discharged with depakote and one other seizure meds. We just saw him the other day and he told us that he is having breakthru seizures which are being monitored by a doctor in KC MO. Nice kid, too much alcohol yields bad mojo if you ask me.

I prefer dilaudid or fentanyl than toluene.

Was that the patient was high on something or Scuba's high on something. It's all semantics right?

this is no worse than the 17 year old having sex with the 15 year old, both consensual yet the 17 year old gets a statutory rape charge.

It's a judgement call on every single call. You make that determination at the time of the call. do you transport or not. We had a 37 year old code at 3am today(tuesday). Asystole throughout. If we werent' 25 minutes to the hospital we would havce worked her until we got to the hospital. I suspect that if you are just across from the hospital I think it would be a bad decision not to load them up and take em to the ER. Hell, why not just wheel em there. It's less than a block. I think that many physicians would be pissed at us if we worked a patient who lived less than a 10th of a mile from the ER and didn't bring them in. I think the courts might have something to say about this also. You had a fully stocked ER with plenty of resources available less than a minute away might be considered negligent care on your part. I don't have the statistics or evidence to back it up but I just think you might see a deposition in your future if this scenario happened to you.

You should not have to have all the trucks move at the same time. Just the ones that border the car that went out on the call. Move the two cars adjacent to the called car and have them move to a pre-set location. It's silly to move every car around if one car in the south goes on a call. Why not just move the car to the north and the one to east or west.

And by all means, all mentors and field training officers need to be consistent across the board. I have a friend who is going thru a rough patch and her biggest complaint with the field training officer process is that they are not consistent. One will gig her for not doing something, then she corrects that action according to the current field training officer and then when she's put with another fto they gig her for doing it the way the previous fto told her to do it. If you are going to be a fto or mentor, the group of mentors/fto's have to follow the same freaking playbook not personal preference or "it's the way I've always done it" You have to be consistent. did I mention that each fto needs to be consistent in requirements so the newbies don't get confused in their evaluation process.

and the murder weapon was a candlestick in the library Tim Curry actually did it

to not coddle these criminals and not give them everything in prison that they were used to on the outside is tantamount to cruel and unusual punishment. There was a inmate who sued the state because he only got one slice of cheese on his sandwich instead of two. He claimed they were trying to starve him. It made it to court, cost the taxpayers 50K or so and in the end he was given a 2nd slice of cheese. Does anyone realize that most prison libraries have more resources than many law libraries?

Now wait a darn second here, I have the inside scoop on why he did this. In the game, if you revert back to a previous saved game all the monsters you did kill come back allive at that point. So he had the video game controller in one hand and the rifle in the other. He told his mom and dad to close their eyes. They did, he saved the game, then he shot them and try as he might, he couldn't get the saved game to come up. So in the end, his mom stayed dead and dad stayed shot. They need to use the saved game excuse for a defense, it holds just as much fricking weight as the video game defense itself. I think they need to put him in a cell, have the walls of his cell actually be video screens and let him see hs mother's picture and fathers pictures every single day of his incarcerated life. oh, wait that would be cruel and unusual punishment.

I ordered the book and I got a quisinart though. It was kind of a tough fit but it's a nice basic quisinart.

Happy birthday you ole hag. But seriously, happy birthday and just so everyone knows that you are 30 this year instead of your customary 29 again, which of course has been going on for the past 29 birthdays.

Best 16 bucks I ever spent was on the Patriot Burger at the Wharf Rat. You also cannot beat the beer and ale there. When it was a stones throw from the marriott Inner Harbor hotel it was a favorite of mine to go there and get a bite.

I think I can come still but I'm not gonna be able to get into the conference. I do have a very good friend in DC that I'll visit but I might just be there for two days and one night. Anybody want to pull their resources and help an old man like me get into the conference. hahahahahah

I only use darts for the ones I cannot catch. did I tell anyone that I raise my own poison dart frogs?

Changes have occurred that may make me unable to attend. I have a free flight up there, I have Terri's hotel room to share but it's the cost of the conference and the associated stuff there that I'll have a hell of a time paying for. Just so everyone knows, you do not have to take a taxi to downtown baltimore from BWI airport. The train is like 2.50 or more now but it's dirt cheap and you can go to camden yards station get off, walk 1block to 12 blocks and be at your hotel. The inner harbor is a great place to stay and you should be able to get everything you need right there. I know of a great steak restaurant close to the conference that I spent many a night at when I was consulting for the Shock Trauma Center.

I wanted to clarify some things on our narc list morphine we can give up to 10mg's for pain without orders Fentanyl - up to 100mcg before we call for orders nitro, aspirin, toradol, versed, valium and every other medication we can give without calling in for orders. RSI needs no orders just justification of why you did it in the run report. I have found that sux is a great drug for pain, my pain from listening to the patient scream, just give it to em, intubate em and they won't be screaming anymore. Make sure you give versed and some pain relief before you paralyze them. The last two sentences above are said with sarcasm dripping

What is the best online nursing program out there? Is that program accredited? I have a paramedic co-worker who is wanting to do this and time constraints and travel constraints may force her into the online nursing school world. I know Vent and Dust and AK have given great information in the past but I can't find those posts even with using the Great and Illustrious search function we have here. I think that she is turning towards the Excelsior program. Any info would be greatly appreciated.

Thirdly, this bill seems written poorly with little research and planning. The bill leaves out the Licensed Paramedic as someone who is required to perform these draws, and as minute and ridiculous as this third point is, it does raise the question on how much research was done prior to this bill being submitted. I understand the social dilemma that DUI has become these days, but without effective punishment it is going to continue. Quoted from a previous post Again, politicians did little research which is par for the course. I'll bet this bill won't pass muster in court. If it does, then I fear that other states will follow. Slippery slope if you ask me. It would be cheaper if they trained LEO's to do this.