Christopher.Collins

No no no! All natural mal citizens in some countries must enlist on their 18th birthday. Anyone (male) who lives in the country as a naturalized citizen must enlist after 2 years of citizenship (provided they meet age critera, of course it wouldnt apply to a 50 year old).

The privacey thing pretty much applies to you not violating it. I mean yea sure the patient could use privacey all together in any situation though, and is entitled to it... but there isnt a whole lot you can do in this scenario. It probably wont work at a bar but Ive been through this scenario dozens of times. The company I used to work for provides ALS coverage to the Foxwoods Resort casino. Being on "crew" as we called it, I had a shift there. And the things you see when it comes to getting between a person and gambaling. We'll get a call for chest pains at the poker tables... get there and a guy could be slumped over circling the drain, and everyone around him will keep playing. Hell people will crowd around, not to watch or make things difficult, just to play. The slots even, we could have a patient on the ground at a slot machine... and someone leaning over them using their machine. Anyways to my point. The security was great there... considering some are Security/EMS. We have BLS backup and regular security will usually bring a bunch of sheets and make a wall around the patient. Again, wont work at a bar.... but if they can spare the people and have some table clothes, it helps. I remember another instance at a dunkin donuts where a women went into active seizures as I ordered my breakfast, right at the (one and only) door. People started climbing over and around us... even when I threatened to have them temporarily detained (police were just arriving and my old dept works great with them). Even after the store opened its back delievery doors for customers, they still climbed over us. But yea, get used to being just a peice of meat to Joe Public... one of thoes "yea I was there stories."

No mats in my area, just wood chips... Its high time people just suck it up with the pansy-fication of this country. I mean, I wasnt around when a spanking or smack upside the head was common and acceptable, but I always knew my place. Today, if you even look at your kid wrong, the school system will just call social services, get the kid on some ADD meds and who knows what else. Suck it up people, go head first down the slide... a bump on the head is good once in a while but no crying or you dont get dessert.

Eh, maybe Im just a stickler for safety. I have yet to jump into an MVA with no gear (minus the whole helmet on the roof thing)... but then again I havnt worked for an agency that dosnt provide gear either.

Its unfortunate that having the best of the best equipment by no means garuntees the best of the best performance and team work. Does it make the job easier? Quite possibly... but after spending all that money to get the latest and better working model to make the employees happy (on duty), they still go home with less than they diserve. Ive always believed that you must love your chosen proffession more than you should have a good paying one... but how can one choose to burn out at a lousy desk job but support their family vs. maybe losing family support over a pay check but loving what you do? I had a job interview today with a private organization, it went quite well and I expressed great interest in pursuing my medic and maybe RN certifications (the company owns a rehab facility as well). They went on to explain how they have a hard time staffing medics in one area and offer differential to work there because its heavy competition with the municipal systems. I hate saying the word competition in the medical field... but I always make note to ask how well a company I apply for works with other agencies. There should be no competition... but Im not ganna be second or third due (next to another agency) rig if no one agrees to play nice. I dont care who does more 9-1-1s vs transports.

Yea see I got all of the above in my rigs... however you were lucky to have working lights to go with that siren. Legal? To the best of my knowledge no. My base was perched on a hill overlooking the city, and very much in my opinion resembles an observatory. Dispatch (the evil corporate spies to the CEO) have the top floor made pretty much out of windows and sees everything. On top of litterally seeing us, they could track our speed with GPS as well. Now I like safety and I dont drive like a moron, and I dont take it from my partners either, so Im cool with this. But I dont take to well to going down the street Code 5 (lights and sirens) being yelled at by dispatch for noth having my lights on in an ambulance that is known to have electrical problems. Note the following: Supervisors know of this problem Majority of all dispatchers (except for like 2) are EMTs and ride frequently Dispatch assigns who is in what rig for the day and knows what rigs dont work (or are supposed to be told this if otherwise) The CEO of the company OWNS a garage right down the street from base There are 32 rigs and they are not all staffed at night (and are rarely all staffed at day time hours either) With all that said... I noted to dispatch my lights are swtiched on and that Im requesting (in form of a demand not asking) to be placed out of service at the end of the call to switch to another ambulance. They agree, and we get back to base, show the super who denies the vehicle change. Needless to say I wasnt a happy camper trying to argue that one. From there on the remainder of my career with that company I made it my personal mission to beat the hell out of that junk pile (see Tom Seizmore in Bringing out the Dead).

Wow, sounds like I should actually see this movie, it sounds rather interesting. Isnt it great now that we are no longer kids they are making childrens movies that we as adults can still enjoy? BTW LifeSavR, yes this is my real name... I have nothing to hide. .... or do I? :twisted:

Errrrr I dont know why Im even going to comment on this... While I (and Im sure many others) do agree that we shouldnt have to be firefighters to do EMS and visa versca (for fairness)... thats just how it is. Picture this... you roll up to an MVA (as EMS) but your service does not provide any form of extrication gear. This pretty much means all patient care, untill extrication is complete, will have to be performed by the FD. First Responders (at least in the State of Connecticut) can not place a c-collar on a patient... no EMTs in the FD? Well I guess that pt isnt getting a collar right away! Now what it that patient or another is critical but its going to be a long extrication? They may need fluids and more. The case of the month in JEMS a couple months back featured a young woman in an MVA (rollover on to its roof) with her arm pinned under it through the sun roof. Theres a little more than BLS involved there. A few months back (also in JEMS) one of the regular columnists (Gary Ludwig of Memphis FD I believe) posted an article on FF's requiring medic certification to be hired. His major point in the article is a service requiring such cert and the perspective member not wanting to do this as part of their career. For example (this may not be accurate, just sake of example) if I wanted to join Memphis FD but had no interest in being a medic, Ill have to do it anyways if I really want a position there. This as Chief Ludwig goes on to explain, in concern, may lead too lack of commitment, poor judgment ect... in otherwords kind of half a**ing it because its not what you want. Not to mention its additional schooling after the academy, which takes away from personal and family time on top of work. Most people I know who want their medics are stressed enough balancing school, work family, etc. but imagine how one feels that dosnt want it? I can understand why some people dont want to do EMS when they become fire, and others dont want fire to become EMS. Unfortunatley in most cases I feel it will never work that way, having a choice that is. If your dream is to work EMS at XYZ Fire Department because they have the best protocols, people, funding, etc... then expect to spend time at the academy and also work fire from time to time because alot of FDs may have you alternate Ambulance/Fire. If your not willing to do this then either go to FDNY (no offense guys, not intended as a stab) or work strictly EMS. On the other hand if you want to be Joe Firefighter and just hump hose and climb ladders.... but want to work in a major city you may have to get your medic, probably EMT bare minimum. Not exactly sure why outside of my afore mentioned reason that there may be times where standalone EMS cant access a scene. Thats just how it is.

Fortunatley here in Connecticut most agencies have a good relationship with the fire department... and even the ones that dont still pull it together on calls. Not to mention FD is usually EMS first responders and are automatically sent out. Even the large rural areas they still responded. This is not to say I havnt been on calls where a couple extra hands would have been appreciated... and yes I have worked bariatrics with said 120lb 5'nothing partners lol. As far as "treoging" calls goes Ive only had that problem once. I was working in your standard Type II rig with a partner that couldnt lift two stuffed animals on a pole (see Spongebob Squarepants). We had a pickup at a hospital to tx to a rehabilitaion facility for a recent injury he sustained... he wasnt morbidly obese but large enough that our rig and standard sized stryker may have been uncomfortable (because of his injury/surgery and size). The hospital was shocked that they didnt get a bariatric unit sent (weight and other factors are required to be given to dispatch for tx's). I consulted the patient (as politley as possible) and staff asking if they would both mind waiting about 35 minutes to have a more comfort accomodating unit sent out. They both agreed in appreciation. Dispatch flat out denied it. I know for a fact the unit was sitting at base the whole day and there were available crews to man it. So we wound up with the tx... my partner nearly dropped the damn stretcher, the pt was uncomfortable the entire trip (about 25-30 min)... and uppon arrival back at base the unit was still available. Oh yea and the stretcher dropped down on my knee, fortunatley there has been no long term damage. I filed a complaint and it was thrown out. I could prove to this day that there was available man power in the crew room and the unit was in base the whole time... we didnt need lift assist, just someone to bring us the rig and take ours back ( something weve done many times and thus making both units still available).

On a lighter side... My old firehouse has a playground next to it. At night time we use it for training in gull gear and SCBA; anything from RIT to SAR to firefighter survival. It is nice to hear that they are now incorporating burn houses into these playgrounds... itll save time and money as well as travel to the nearest one :twisted:

Ok Doc I gatta be honest, I followed almost all of what happened but now Im confused as to who you did what to? I mean Im assuming the aresst was the one with the monitor on at least.

Im answering this one because the last post didnt leave a question. Id be a cardiologist. I already have a heart problem which has lead to alot of study and learning of the cirrculatory system. Its one of the most fascinating parts of the body to me. I dont think I could do peds because theres so much to explain that they wouldnt understand at some ages. I was a ped when I was diagnosed and I didnt get it. Sure I could explain to the parents... but they arnt the patient. Plus peds grow up so you dont get them forever. Eat SPAM for the rest of your life (at least one meal a day) or spend a week eating cockroaches trying to survive in a collapsed building? Sorry, I really got nothing, Im not a good question asker... lol

I too have worked for both and currently have an interview for another private organization on Friday. I honestly have no preference. I like public because its more 9-1-1, but I like private because it can be a break from all 9-1-1. Also with private you may have access to equipment you dont with a public service; i.e barriatric equipment, which is a great reassurance if you dont have an pt info and arrive to find a morbidly obese patient, you know you can call the barriatric unit (if your not it). I will add that I gained alot of experience with 6 months in the private sector vs. 5 years in a quiet volunteer/public service. All thoes non-emergent transports gave me time to build confidence in talking to the person (which I completley lacked before) rather getting tunnel vision and just treating the patient.

We should do what they do in Greece and some other countries... mandate that all male (natural) citizens join the armed forces for a minimum of two years. But in fairness we could make it for females too. Ive seen some real half ass cr@p join the service... and they have come out really decent people.

I remember one department I used to belong to; our ambulance company had their annual banquet. Most members of the fire department are also members of the ambulance (two seperate agencies). Almost everyone got wasted that night because two neighboring towns bring in one of their ambulances to cover us so we can celebrate. Anyways one thing leads to another most everyone is drunk that night and first thing the next morning at sun up a fully involved structure fire. A large 2 story house.

Great story doc... well great as in its a hell of a situation (training a newbie and 2 critical pts), not so great outcome though. Hey if he wanted to sit on the womans chest to perform compressions on the hubby then go for it!! Just curious what type of rig were you in? Deffinatley woulda sucked in a van. What did you have for manpower if any (by backup I would assume another ambulance to tx other pt)?

Interesting read... thanks Spenac. Anyways, out of curiosity (if anyone knows)... how do they get to testing this and other new procedures (that would require immediate useage) on people? I am to assume that it must be done and succeed many times before they could make it an actual protocol to withold high flow in such cases, and that a pt or immediate family must consent to experiemtnal procedures. Also, its not like you can always consult the pt's family as this would be a treatment that would be with-held immediatley and family wont always be available. I can see how it works for concious pt's and pt's with family immediatley available, or in the case of prcedures that dont need to be performed right away (incase both the afore mentioned are not applicable). Just wondering. Always loved a job like this where theres always something new and informative to learn.

My first loss was during my first responder days... the all of one whole year they lasted before I caved in and went EMT. I was 17 years old and on my usual Wednesdat night duty shift with my mentor/MRT instructor. We got called to an unconcious, unresponsive. My parter had went to the scene because she lived near by, so my driver and I got the rig. Arrive on scene, FD said to grab a board its code 100 (CPR is in progress). All I could think was great, thanks for the update en-route... we do have radios. During calls like these in a volly department Im sure you all know everyone comes out of the woodwork, even members you may not know exist. Even being a part of the ambulance crew didnt get me inside to the patient because of overcrowding. Finally when we get in back of the rig its my partner (who had now been doing compressions for over 5 minutes), the medic and medic student pushing drugs, and me bagging. I remember her asking me to take over compressions, I had never seen her so exhausted before, and we switched with what looked like surgical precision and coreography. The drive to the clinic seemed to take forever, it was hot and crowded and here I am standing over a dead body trying to maintain balance and adequit compressions (which the medic said were perfect, a shock to me) all while going down the (would be smoother as dirt/gravel) back roads of Westbrook. Anyways we got to the clinic where she was pronounced and after I cleaned up the rig I kinda hung back to relax, I was tired. The medic and my partner knew this was a first for me, CPR and loss... so they came outside to sort of debrief me. I recieved many compliments for my form during compressions, the way I tri-podded myself to keep balance among other things. This was before all these ambulance and fire truck crashes and before people started urging seatbelt use at all times. Two things stuck with me from that call. 1) the few minutes I was inside I saw a picture of the patient, she was incredably beautiful for a woman in her late 50s early 60s. This pretty much gave me an understanding of thoes people who say thats not my husband/wife/etc hooked up to all thoes machines. You never woulda guessed it was her. 2) nothing about the loss actually upset me, I was expecting to be upset or disturbed (that feeling of not doing good enough) but I was fine. I cared about her and her family, but in the end it didnt matter. I felt cold. To this day fatalities do not bother me... Im sure itll catch up one time or another though, we arnt invincible.

Wait a minute..! No I cant be kidding, I dated a girl that worked at wal-mart and she thought I just drove the ambulance. Errrrr she thought she had such a tough job and that I had no reason to complain about just driving.... even that day that guy got ripped apart in a motorcycle accident she litterally said "what would you know, you didnt have to do anything but drive." Ahhhh this is making me agry *morphs into the Hulk* Ok so I didnt morph for real but she really thought she was supperior in job skill... shes now my ex girlfriend

Ok so heres a question for someone who may be better versed in ambulance billing and polotics. Where the hell does all my money go after my wallet is raped for a transport? I see bigger ambulance bills than hospital bills. I know I can probably break it down; gas, maintinence, equipment/drugs... etc. but with the money EMS pulls in how can they not afford to pay employees more? Im obviously not talking about small organizations though. But my point is... unless its a private fire department, I dont pay a bill for fire services and Ive never gotten a bill from PD either. Of course Im sure this is why they get all the grants. But after buying new toys they still manage to pay their guys better?

I guess my only question is what do we define as fat and obese? I dont think I know many people who maintain their actual body weight... annorexics included. ~~~~~~~~ http://blog.wired.com/wiredscience/2008/07...=1&mbid=yhp The blockbuster Disney movie, Wall-E, was criticized for its portrayal of a future in which not just some humans, but all of humanity becomes obese. A new study from Johns Hopkins, however, finds that its depiction comes uncomfortably close to projections from public health researchers. As one of our commenters wrote, echoing other critics, "The future presented in the film was ridiculous and over-the-top in how unlikely it was, and portrayed humans as fat, disgusting, and stupid animals (which may be true of some people, but not of many)." The new study, however, finds that if something doesn't change with the American food system, almost 9 out of 10 Americans will be fat by 2030. “National survey data show that the prevalence of overweight and obese adults in the U.S. has increased steadily over the past three decades,” said Youfa Wang, MD, PhD, lead author of the study and a professor at Hopkins' Center for Human Nutrition. “If these trends continue, more than 86 percent of adults will be overweight or obese by 2030." It's not just an aesthetic problem, either. The health risks associated with obesity are well-known and the researchers say treating obesity-related conditions could result in nearly one trillion dollars of added health care costs. The projections appear in the July 2008 issue of the journal Obesity. Image: The Captain from Wall-E. Via Worstpreviews.com. WiSci 2.0: Alexis Madrigal's Twitter , Google Reader feed, and webpage; Wired Science on Facebook.

In the areas Ive worked EMS in southern and south eastern Connecticut anything involving the elderly as well as MVAs are the most common. Without any statistics I couldnt tell you which is more dominant. We have tons of nursing homes with at least 3 or 4 different private ambulance companies (that I know of off hand) to ship them around, and plenty of major roadways... and plenty of dangerous roadways. Im sure it made national news when I-95 was shut down both ways for a day at exit 75? 2 tractor trailers (1 diesel tanker which jumped the medean into oncoming) and 3 cars... tripple fatality. Traffic was backed up over several miles, people parked on side roads for 5+ hours without moving... etc. Finally the state is starting to expand the highways but the rate everything is moving congestion will deem another expansion by completion... just like last time.

Fortunatley CB, Im sure we wont be seeing something like this on every new car... for a long time at least. We filthy rich Americans are to busy buying gas just to get us to work to buy more gas these days that Im sure we wont be spending money to add this option to grandmas neon lol. I will say its a rather cool concept though... Id rather have that than the flip up doors on a lambo or ferrarii, imagine roll overs?

I agree that there isn't a lot of info given. I've experience a similar instance while loading a stretcher, however we did everything in the right (pt properly secured including the now required shoulder straps). The pt was extremely combative and while we got him to co-operate and go with us decided to fight us while loading, the safety catch didn't catch and the stretcher fell out while raising the legs and collapsed to the ground. He was properly secured and at the moment before we loaded co-operative, just decided to fight at the wrong time. He threatened to sue and that daddy was a lawyer... well daddy believed the 1/2 dozen firefighters, 2 EMS personnel and 4 cops on scene. Daddy was also more pi$$ed that his brand new Mustang GT was rolled over in the street by his under-aged drunken son. Cover your @$$es guys... I was up to my waist in paperwork from this incident, but using proper procedures, documentation and having plenty of witnesses saved us on that one. I know it may seem like common sense, and I know its sometimes easier to write and do less... but think of the trouble you could see for not doing it. I don't know how many run reports I've read where the narratives were simple as "picked up pt w/diff breathing, applied O2, tx to hospital w/no change." I'm sure you've all seen reports like that too. It shouldn't matter how simple the call, every report should be written like its going to court, the same for incident reports. And is it really worth saccrificing your home or other possesions of value because you couldn't stand next to a stretcher, or buckle a seatbelt?