Just Plain Ruff

I've got a great new upgrade to a product that we use every day inthe field but don't want to mention it unless someone here has the venture capital that could fund the product development and introduction to market. I think it will make our lives in the field, the ER's lifes easier and the patient comfort better. If you have the venture capital to help me move this to market then we should talk. Please don't contact me just to find out what the product is just so you can bring it to market because I'm working on getting a patent on it. M

apparantly this is not the first time he has been better than the nurses but that's an ongoing thing in his hospital and he doesn't post that. Quote: (as close as I can get)"who cares if I rag on the nurses" well I haven't seen Systemlord reply since we started raggin on him so maybe now he knows how they feel. He obviously doesn't know the difference between an emergency and not an emergency. So Barry worshipper - I guess in your book a person with status epilepticus is not an emergency, cardiac arrest is that one? GSW to head must require non-emergency response hMmmmm just what do you classify as a emergency a hip fracture to the nearest ortho facility? Please back up why you did not consider this pregnant seizing patient an emergency. If you cannot do that then you might want to reconsider your field of work.

for pure entertainment value I do like Saved. I have stopped looking for errors basically. The glaring ones yes but the not so glaring, not really looking. If asked if the episodes could be done better then heck yeah they could be but for pure entertainment value I like the show. As for what dust says, I agree on the overacting but - I spend many hours a day with an overbearing client manager, a client who doesn not know thier processes yet expects me to know them and then driving in the great city(ha ha) of Miami where everyday may be your last time driving I like to go to the hotel, get a quick workout in, then get dinner and then sit down to something that does not make me have to think and I can just veg out(isnt' that what 'TV is for) then I do enjoy those shows. Hope you are staying safe over there dust - by the way how long does it take a package to get to me after you have mailed it to me.

People can truly be retarded. I mean how retarded is it that they take the oldest unit and replace it with a new one. HMMMM I guess if replacing the oldest unit and getting a new one is retarded then maybe the "smart" thing to do is to keep the oldest one and sell the newest one and replace it with a used unit. I have no idea where this post came from or the thought processes on the post were. Original poster - please clarifiy your post. You've left a lot of people with many questions. But seriously if your volunteer service can afford a three nice new ambulances over that period of time, maybe your service could think about going paid.

Good morning all - I finished the 5th episode of Saved last night. I have to say, they have done something right at least. I do like this show, I never thought I would say that after the first 2 horrible episodes but it shows that they may have let the original medic/advisors go and got new ones. The first episodes I couldn't count the number of errors without having to grab my wifes hands to keep adding away. The 3rd thru last nights episodes the errors have been few and far between. I am developing a liking for the main characters especially the lady paramedic and her newbie partner. I know this show is pure fiction and there are items that are unreal and such but for entertainment value I look forward to it each week now. It helps though that "The Closer" is on before Saved but I do like the show now. Just my thoughts after 5 episodes.

I for one as a ER paramedic who took reports, it wasnt really important to us to know the gcs unless it was less than 8. Sure go ahead and give the components if that is what you need to do. I've also been involved in many ER's across the country and in each of the departments you could see the reactions of nurses to different types of reports. Long winded reports got glazed looks from the nurses unless the patient was critical. I listened to one paramedic give his report and when he got 3 minutes into and started on all the patients med hx and medications taken along with dosages the nurse walked away. At the end of his report he requested lasix and morphine yet did he get the order approved Heck no - there was no one listening to his report at that time. So I followed the KISS rule - keep it simple stupid BUT with that said - do what you are required if you have to give each component of the gcs then go ahead but as for your way is better, I say my way is better. but then again that's whats great about this country My way is better than yours.

cool I'm in the KC MO area but with travelling monday thru thursday and then having only 3 days with my son and wife I don't think I can give up some ofthe free time I have to attend this groups meetings or what not. It's a cool theme though.

I'm not sure I follow. Are you asking if we've ever treated someone with other than first aid at a SCA Event??? Isnt' this the same types of groups that attend the renaissance festival type events? there is a group that I think qualifies in our area but all they do that I can see when I drive to the park that they frequent is they dress up like knights and damsels and beat the heck out of each other with replica wooden swords and shield. Is this the same type of group you are talking about? I've been on scene on standby for these types of events and I love the middle ages style dress and festivities so I liked it. Am I off base here or what?

This is just too good to pass up. just by reading the topic I knew that this would be a rural ER bashing post. Just what part of this scene was not an emergency????? I have worked in those types of ER's. I have worked in two ER's where there are one or two nurses on in the ER. They are usually very good. But the case you have tried to keep from slamming on the nurses you work with, which you failed to do so sounds like a true emergency. You actually said two things, I'm not here to rag on nurses and then you say immediately after that "well maybe a little" 9 months pregnant, seizes at home, then again in the ER parking lot or wherever she siezed the 2nd time is a extremely critical patient. Sure sounds like you came in and saved the day. ONe other consideration other than eclampsia could be an amniotic fluid emboli to the brain which is an almost 100% fatal occurrence. The fact that you considered this a non-emergency patient makes me question your understanding of pregnant patients that seize especially pregnant patients who are due within a day or two of the seizures. This my friend is a extremely critical patient and the fact that you didn't realize after the fact even when you drove this patient 160Km to another hospital where she was immediately wheeled into the OR and intubated - apparantly you failed to realize even then that this was a critical patient. Were there any other patients in the er? That could have added to the stress and "freak out factor" if they had other patients that they had to take care of also and it was just the two of them. Consider also the fact that not only do you have a mother's life in the balance, you also have a full term baby in tremendous danger too. I'd do some research on eclampsia, seizures in late pregnancy and also amniotic fluid emboli. If it is a small hospital in a small rural town then I can bet you that one of the nurses may have known the patient which puts another big pucker factor as you never want to treat your friends or family members. Finally the other question is this which has been asked once already - why no air transport. This patient was a prime example to be flown. At least the nurses knew enough and were able to call for Barry's help.

Yes that was my first choice, not to chew thru the straps but seriously I would consider romazicon but here are some articles and web sites to supplement the discussion soon to happen here http://forums.firehouse.com/archive/index.php/t-36280.html http://www.fpnotebook.com/PSY155.htm http://www.enh.org/healthandwellness/biote...5.aspx?lid=1093 http://redpoll.pharmacy.ualberta.ca/drugba.../APRD00974.html i think you will find that for patients who are on benzo's and take an overdose of those benzos that it is contraindicated in that type of overdose. If they just take a bunch of granny's valiums or what not's then it's not contraindicated. The thing we have to watch out for is that patients who take benzos for seizures and then they overdose on the benzos in a suicide attempt of gesture then we run a tremendous risk of causing them a seizure and then we have to hit them with an antiseizure medication. Like one of the cardinal rules in medicine states: 1st do no harm!!!!!!!! If the person is on long term benzo care and they overdose, hold the romazicon and treat the patient supportively - IV, o2, monitor and if needed intubation to protect their airway. I've never run a successful benzo only overdose fatality. Add alcohol and such to it then we are in a different scenario anyway. I guess the thing to get out of all these articles is give romazicon at your and your patients own risk and if you give it have alternate emergency measures available.

Another fine topic for discussion by our friend GA(i'm serious really) Posted: Wed Jul 19, 2006 8:58 pm Post subject: EMS Folks With Addiction Problems -------------------------------------------------------------------------------- I was wondering how most of your services deal with those employees who have been found to have addiction problems. I am not talking about the ones who come forward and ask for help, I am talking about the ones who either come to work intoxicated, or have been caught with a hand in the cookie jar. Most services that I have been affiliated with have let these employees resign, instead of being terminated (although they would terminate if they dont resign), because it is easier to deal with legally. But then, most do not report this problem to the State or governing EMS body, so these people just find jobs at services that dont drug test, or they clean their act up long enough to get through the drug test of the next employer. 1. How does your state/ territory/employer handle this issue ? this is really handled service by service. I Have a friend in the past who got caught in the proverbial cookie jar and he resigned but started working nearly immediately at a different service. Don't know how this employer is treating this person - are they treating him differently if they know about the abuse - don't have a clue. 2. What are your personal feelings on the issue, should they be reported and have their license revoked, or do you recommend another punishment ? My feelings are this - it's black and white - you get caught stealing narcs from your service then you are gone. No if's and or buts. OUT on your arse 3. If you are for revocation, how long do you suggest it be revoked ? If you are caught by the employer stealing drugs and you fail a drug test that shows the stolen drug then you should have your license suspended at least if not taken from you. You can participate in a rehab program but then you have to have extra scrutiny on you over a period of oh, let's just say LIFE!!! Once an addict always an addict 4. Would your service hire someone who has successfully completed rehab, or are they tainted forever ? I don't think I'd hire someone as a medic if they had a history of addiction to narcotics. But that's just me. I know that many drug addicts successfully kick the habit but the risk to the service is just too great. If a service loses it's narcotic license then effectively the service cannot run. If I did hire that person then they would have to undergo more scrutiny than the ordinary medic. Those are my thoughts.

Walrus thanks for the clarification. I'm glad to see that you don't do that stuff to other people. in my first year of being an emt I did some pranks but was very quickly put in my place by more senior members of the agency.

Walrus I too am surprised at your bragging about your hi-jinks. I can tell you if you put vaseline on my toilet seat or had women call my wife claiming they were hookers, I'd have you written up in a heartbeat and file a grievance against you. Those actions are immature and totally uncalled for. I can relate one experience I had as an emt. I was given a coke with 240 milligrams of lasix in it. I didn't realize why it tasted so bad but I attributed it to the ice in the cup. I pee'd and pee'd all day and ended up having to return to the station due to feeling so terrible. Next thing I know I'm being transported emergent to the ER for being unresponsive. My electrolytes were on the critical low, my heart rate rhythm were on the critically unstable side. I spent 2 days in the ICU of the hospital and then 3 more days in the general med floor. Needless to say the medic who put the drug in my drink was terminated and lost his license. Pranks are fun sometimes but they have real critical life implications. So when people talk about how cool it is to pull pranks on others I cringe when I hear them. You sir need to reevaluate your activity you call fun.

for the canadians here what is the price for a person from the US or other country to travel in an ambulance. Is it a lot more or the same???

I can't say for the group here but in the state of missouri the state has put out a refusal form that fits the missouri guidelines. As for services I've worked for, we give a call 911 back if needed form and document the risks of refusal and in the other box I always put "Death" as a consequence of refusal. It works a lot of times.

I don't see any hate here GA. Good debate. Took a while but it was a good debate.

Some useful links regarding AMI Inferior wall MI with extension to right ventricle. http://heart.bmjjournals.com/cgi/content/abstract/49/4/368 http://content.onlinejacc.org/cgi/content/abstract/24/3/624 http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract

GA thanks for the clarification.

so you leave printed instructions for a specific problem with the patient??? I have a question on that, I believe that that will definately put you in a very precarious legal position as it sounds a lot like you are diagnosing a patients problem. It's my understanding that the only person who can diagnose something is a doctor or NP/PA. I would be curious to see how your legal department looks at this "diagnosis" that it sounds like you are doing. I'm just trying to get a clear picture of what exactly you put on the documentation you leave with the patient. It seems a little like diagnosing. Of course I could be wrong. Let me ask you one more question. The no transport rate - is that number include calls that you got called out on but got cancelled on or is this number only refusals? I'm curious. The only problem I have with your apology is that you still quoted the high percentage rate yet refuse to cite services that have that rate. In my opinion it makes your original premise of the post null and void but that is just my opinion. Next time you begin a personal attack please re-read and think about what you are posting. I never delved into personal attacks on you yet you did to me and that my friend is unprofessional.

GA here is what I'm gonna do. I'm gonna call my friends at the following services and ask them what their refusal rates are. I will post these numbers but I will not post their names as sometimes services do not want this information going out. I will call NYHQ emergency services (New York HOspital Queens, Queens New York) Patterson New Jersey EMS I will personally go over to the nearest fire department station here in miami and talk to someone on the on duty medic truck Detroit Michigan Baltimore, MD Colorado Springs, Colorado (AMR) Seattle Washington and LAFD and several others. I'll try to have those figures tomorrow. These are friends of mine so I won't mention what their names are but the services are some of the busiest in the country. What my expectation is of you is that you provide the service names , no contact info in the list, and tell us what services in the country have upwards of 50% no transport. What I think the group also wants to know is what is your services rate of no transports? is it in the 50% range? I see you've been notoriously absent from this post the past while or so so I wonder if you really don't have the figures to prove the points you were making.

GA read my post, I posted 6 services and their refusal/no transport rates. Please read my posts before you come here saying you are waiting for figures. How many more figures do you want. I posted mine, please post yours or are you going to hide behind "not wanting to embarass the services"

medic callie WOW What a story One more call -- pedestrian struck - near complete amputation of his right leg above mid-shaft femur -only thing holding the leg together was the femoral artery. Additional damage to the person was you could see into his pelvic cavity, rectum, intestines. bladder and all the inner workings. He survived

So this firefighter has been warned in the past for this, he should have been fired. Policies are there for a reason. The guys been warned in the past and didn't heed the warnings, then he should be canned.

GA medic, step away from the Kool Aid. You come here posting facts but refuse to divulge what services have a 50% refusal rate. You sir are the one who refuses to give hard facts. You also need to re-read who personally attacked who first. I told you to back up your supposed facts with cold hard facts yet you started the personal attacks. Let's see Here is my list and maybe you will have the kahonas to respond with your services. MAST KCMO less than 50% refusal rate (per a medic there) AMR Independence MO, about 12% no transport (per a in-law that works there) Golden Valley EMS - Clinton MO I used to work there and I know their numbers - about 5% no transports Bates County EMS - Butler MO Less than about 10% (I also used to work there) Windsor EMS - Windsor MO runs 200 calls or so a year and their no transport rate is less than 5 percent. So GA, I've named the services I know of, I can also get figures from colorado springs, miami, New York City and others. So name your figures or stop posting figures you cannot back up.

GA Medic, bash me all you want, you just post things and stir the pot and then get mad when someone disagrees with you. I am also not a democrat as I back up my arguments with valid points yet you only back them up with refusing to post names of services. I have been working in the business a lot longer than you and am not new. If you would have read my previous post you will see my experience laid out. I also have worked in 2 separate er's, I consult with ER's that would dwarf your hospital in size. So before you slam me and call me names you had better get your facts straight or just be quiet.