HERBIE1

Many of the white supremacist groups use their interpretation of religion as a justification for their views and actions. THAT is the point here. Allowing them to march was certainly an affront to many Holocaust survivors who live in that town. But, they also knew a march or rally is a temporary, one day thing. As disgusting and offensive as it may be, these people knew that these groups were not setting up shop in their suburb. They allowed them to assemble because of the freedoms we have in this country. Setting up a permanent reminder of an atrocity, committed by a specific group, in the shadow of where a heinous crime was committed is something completely different. Huh? Wrong. I never said that, never implied it and I won't respond to a strawman. Wrong. Never said that. In fact, I said exactly the opposite. More strawmen. Really? So you would have no problem if a neo-Nazi hate group decided to build their own shrine next to a place like Auschwitz? You see nothing wrong with that? Just because it may be legal to do something, does not mean it's a good idea. Actions have consequences, and if we allow this group to build their mosque in that location, who do you think will be responsible for mitigating anything that results from that structure- the Muslims who worship at the mosque? I'm quite sure there were citizens, noncitizens, tourists, those here on visas, Buddhists, Muslims, Lutherans, atheists, and every other religion represented among the victims of 9/11. The hijackers did not fly planes into churches or other houses of worship. This was an attack on our way of life, on America as a whole. The people who died were merely collateral damage to them and their religions were of no consequence. Those towers were attacked because they are a well known symbol of this country, our political and ideological beliefs, and our way of life. A mosque is a symbol of Islam, just as a synagogue or temple is a symbol of Judaism, and a Catholic church is a symbol of Christianity. Do these structures all represent the views of every extreme sect of those religious groups? Of course not, and nobody would argue that point, but they DO represent a broader religious viewpoint. Let's look back over the last 20-30 years and see who has been responsible for the majority of terror attacks. The USS Cole, US embassies, army bases, both WTC attacks, the Pentagon, Flight 93, the recent underwear bomber, the shoe bomber- what do all of these acts have in common? What symbol or artifact would you use to express the common factor in all those incidents? The stated intent of the group that wants to build that mosque was to promote peace and understanding for their religion. I do not doubt that for one minute. It's a noble goal, and I'm all for it. I object to WHERE they intend to make that statement. If something like this is allowed, there will be consequences. Guaranteed. Why would we knowingly subject ourselves to another potential disaster if we can possibly avoid it? The potential downside of allowing this to go forward far outweighs the possible good that may come from it. Build the mosque, promote your desire for peace, understanding, and tolerance, but do NOT do it in the shadow of one of our country's worst disasters which was perpetrated by a group who uses that religion- as warped as their view of their religion may be- as justification for their actions. If these Muslim leaders cannot see the harm or offense that many will take from this, then I question their stated intentions.Tolerance and understanding is a 2-way street. Well said. While I have no way of knowing the true intentions of this guy, many times a public face is the polar opposite of what someone actually believes. Like I posted, this is about symbolism and making a statement. As we both noted, the WTC was a symbol of the country as a whole, and the stated goal of these jihadists is to convert everyone to their way of thinking. It's not about compromise. In Sharia law, religion and society rules are one in the same, and there is no room for debate. As such, a mosque- in terms of that brand of Islam- represents more than just a religion, it's a symbol of what they feel the world should be. We have a separation of church and state here- completely antithetical to what these radicals believe. It's just an opinion, but to me, ideas like building this mosque in the shadows of Ground zero are simply a way of injecting their ideas into the mainstream of our society. They prey upon our ideas of tolerance and being PC, and they know many here will bend over backwards to prevent any appearance of being intolerant to a contrary opinion. They use our ideas and freedoms against us. We have seen sleeper cell types like the recent Pakastani who lived here for years- was educated here, worked, raised a family, and assimilated into our society until it was time to engage in their true calling. I think we will see many more instances of these "home-grown terrorists".

Actually, in this context, no there is not. Years ago we a KKK rally here in the middle of a Jewish area. As distasteful and insensitive as it may have been, the rally was allowed to go on. With the freedoms we have, we are also supposed to have responsibilities, but some do not abide by this notion. In both cases, people object to the extreme hate, prejudice and bigotry, and do not care about offending anyone or being insensitive. I really like these comparisons. I'll ignore the Crusade reference- red herring. We believed the world was flat at this time, that the sun was the center of the universe, and lots of things that we think are pretty silly now. Let's keep things relatively current. What single religious- or any other- "group" do people such as isolated nut jobs like the Unibomber, McVeigh, or abortion clinic bombers represent? The unibomber hated technology, McVeigh hated government intrusion in his life, and abortion clinic bombers are ultra right wing, bible thumping nut jobs. Where's the commonality there? How can you equate them with radical Muslims who have a common bond- their fanatical brand of one type of religion and an avowed jihad? There are crazy people in this world, who do crazy things, for all types of crazy reasons, but don't pretend they have anything in common with a group who expresses a single minded desire to spread their brand of "religion", at any cost. Who were the hijackers on 9/11? What was the common tie that bound them? What is the common tie that binds all these different terrorists, who originate in countries all over the world? My objection to the mosque is not about Islam. True Islam has nothing in common with the flavor practiced by jihadists. The jihadists view Muslims that do not agree with them in the same light as any other infidel. In their eyes, they are no different than Christians. Torn down? No, but I certainly think that building another one, WITHIN SIGHT of the WTC's is the height of absurdity and insolence, and a problem waiting to happen. Which came first? Again, torn down- no, but establishing an abortion clinic within site of an existing Catholic church is similarly absurd, and asking for trouble.

Here's the deal. No, all Muslims do not believe the extreme lunacy of radical Islam, just as all Christians do not agree with white supremacist's bastardization of Christianity. Does that mean we should allow the KKK to set up a few burning crosses in the middle of an area of a city that is predominantly black? I'm sick and tired of all this PC bull. Sorry folks, but all over the planet, terrorists are predominantly Muslim in nature. Shall we list all the recent attacks perpetrated by radical Muslims? They want to build a new mosque? Fine, but NYC is a big area- pick another spot. WHY does it need to be in such close proximity to the WTC site? It's a slap in the face to those who died and the families they left behind. Every single one of those 9/11 hijackers were Muslim, what they did was because of their "religion". Fact. I don't give a crap if those who want to build that mosque are the best people on the planet. It's wrong and completely insensitive, and if these Muslims cannot understand that, then maybe they aren't the best examples of people who follow Islam.

I am quite certain the police will organize an informal boycott of this place, but I'd love to see the general public jump in on it. Anyone who supports local LEO's do not patronize this establishment. Friends, family, and supporters pass out flyers and spread the word. I'm quite certain there are far more people who support the police than those who do not like them. A vocal minority can get the press, but I'd love to see payback here. The owner has the right to refuse service to anyone, but the public also has the right to show their disapproval of this guy's ideas- which I hope they do. I don't care what type of problems they may have had there, to indict an entire department because of an isolated incident or 2 is ridiculous.

So who will this whack job vegan call if his store is being robbed- Whole Foods, or some organic vegetable farm? No offense to any here who may be vegans, but in my experience, every person I have met who has these extreme or fringe ideas is at least a sandwich short of a picnic.

I worked with a guy who carried around a big spit cup. He tried to bring it into the rig and I said no friggin way would I tolerate that. Disgusting. Swallow it or spit it on the ground, but seeing someone constantly spit into a cup grosses me out.

Here's the deal. Like everything, local protocols and regulations differ. Our state statutes say that the caller defines what an emergency is, thus, nobody is turned away. It's not our job to determine whether or not WE think the issue is a true emergency. Now obviously someone who calls and complains of abdominal pain x's 3 months and they cannot take it any more- is that an "emergency"? Of course not, but then we(or more accurately, a lawyer) can "what if" the situation to death. What if they have a dissecting AAA and it's finally ready to rupture? Likely- no, but without further tests to confirm that DX, we have no foolproof way of ruling it out either in the field, either. If your system has options other than transport via ambulance, then it's a good thing. Most places do not. So, in the interest of risk management, despite overburdening an already taxed EMS and hospital system, we bring them in, they wait for hours in an ER, and are sent home with a DX of constipation. For most of us, this will not change any time soon because it's all about potential liability, and rather than address the root problem, we get a reflexive CYA policy. \Edit- Just as an aside, with a private provider, unless it's a 911 response, the only limiting factor is whether or not the patient's complaint will warrant reimbursement by an insurance carrier. If it's cash up front, then it really does not matter.

I am hours from a Angio Lab let alone a hospital. Another example of the vast differences between our various systems. I can see the benefits of thrombolytics in a situation such as yours. I cannot imagine working in such a remote area.

Looks like a good idea for a PSA. Noticed this at the bottom right of the page. Seems like it would certainly get someone's attention- until they realize "Annie" doesn't look like those models. LOL "Now that we’ve got you interested in learning CPR and the abdominal thrust, go get properly certified by taking a class through one of the many certifying authorities in your local area"

Depends on your system and protocols. First, our system is also urban and very busy, but very slow to adopt new ideas- or eliminate those that do not work. Many systems do not transport traumatic arrests if they meet certain criteria(besides the usual decomp, decapitation, rigor, etc)- ours does not allow for that. One of our protocols is to bilaterally needle decompress traumatic arrests. I've done dozens of them.

From one of the initial reports I heard, they were in the middle of installing one of those safety devices when the explosion happened. Bad timing.

The gang bangers have generally left us alone, but I know what you are saying. I had an interesting- and pretty blunt conversation once with a gang banger who had multiple GSW's. It was the usual chaos on the scene, and our patient was pretty out of it- or so I thought. After we worked him up and started transport, he woke him up with some fluids and asked what the commotion on the scene was all about. I told him of a couple comments like you noted- "he was supposed to die, leave him alone," etc. He said they weren't really pissed at us, but this is about their street cred. He said his shooting was payback for a prior incident his gang was involved in. I explained we cannot pick and choose who we work on, and unless the person is obviously dead, we have no choice. His response- "Well, I guess next time they need to do a better job." No remorse, no fear- and completely matter of fact about his situation. Interesting.

Like assessing lung sounds, the only way to become proficient is to practice. As was mentioned, palpate as many people as possible. Review your A&P, and look for landmarks. One thing to keep in mind- be sure the angiocatheter is long enough for the procedure to be successful- some angios are only 1 inch long, and that is not enough.

I hate to say it., but I am not surprised. Calling 911 for menstrual cramps or bleeding is something I think every urban provider has dealt with. The fact that the mom was allegedly an EMTB is also not surprising, but I would also suggest she's probably full of BS. I've had people claim they were "nurses", and I've asked a few routine questions about a patient's medications or PMH and they finally admit they were "only" LPN"s, CNA's, or Medical Technicians. Looking for a lotto settlement, maybe? Maybe the hospital told them that calling 911 and going to an ER was silly and they decided to get even with everyone because she looked so foolish?

Thanks. I'll never forget that call, even though it was nearly 25 years ago. I remember I was working with a fairly new medic who was scared to death because we "disobeyed" a doctor. After we left the ICU, I sat him down and explained that we don't work for that doctor, we work for the patient. I explained that we didn't just make a decision on our own, we confirmed it with medical control, which is exactly what we are supposed to do. We do what's right for the patient, and if you know you are right, you stand your ground- regardless of whom you are dealing with. Let's just say this was not among the top tier of hospitals (and still is, I believe) a very small, nontraditional ER, which meant if we brought in a cardiac arrest to the ER in the middle of the night, we would need to work that patient in the ER until a resident from the floor could come down and take over. Generally, the only thing the doc would do is confirm tube placement, confirm asystole, or simply pronounce them on the spot. Who made the complaint- the family or the ER? Did the patient code or something?

Unless their EMT license was a condition of employment, the crosstrained folks very well could go back to being a "regular" FF. Sickening. Immoral. Unethical, and for a profession that claims to have so much pride in their work, apparently it doesn't apply to their medical training- the majority of their calls.

This topic is just another small example of how different our systems are across the globe, and while many problems we face are similar, there is no panacea to cure all the ills because of these differences. If it is a nonemergent transfer and the patient can sit in a wheel chair, we have "medicars" where the attendant only needs a D/L. If they go in an ambulance, both providers need to be at least EMT-B. Well said, Dwayne. You said a mouthful here. It's up to us to have our own moral compass, which I feel is far more valuable than medical knowledge and can be applied in our personal lives as well. Almost any idiot can commit EMS protocols to memory, but the true top notch provider lets his own personal ethics and standards dictate how they live their life AND do their job. I think too little emphasis is placed on this in schools. When I teach my EMS administration class, I devote a great deal of time to ethics and morals, and how it relates to our profession. I propose difficult scenarios, we talk them out, and often times there is no "right" answer, just the best possible solution to a complicated problem. It's fascinating to watch the students express their opinions, and defend them. Many of these guys are firefighters, and they are used to black and white situations- if A, then do B. Rarely are you faced with a moral dilemma when fighting a fire, so many of them are uncomfortable with the topic at first. The variables of medicine ensure that as soon as we may become comfortable in our roles, a patient and/or a situation throws us a curve ball. I loved the fact that these guys were expanding their horizons and their thinking, and several have noted on my evaluations that they enjoyed being challenged like that. I have used a similar scenario as this in the past, and it always generates a good debate.

Thanks for posting. You said your intentions were positive and supportive of EMS. I don't doubt that. Any other reasons for doing it? Are you interested pursuing a career in the media arts or was this just for fun? You certainly have a knack for this. Maybe the department can use your talents. Obviously folks here have differing opinions on what exactly this can do for our profession, but I don't think anyone was questioning your integrity. Although I'm not a fan of rap, it was certainly well done. Good luck.

Ah-gotcha. Most places around here require a drivers license- nobody functions as just a driver- even on BLS rigs, and both people need to be EMT-B's.

I don't know about your location, but here each provider has a license and the same level of training, which means you are equally responsible for the info contained in that report. Thus, each of you is supposed to sign each report. As providers, you are both responsible for patient care. Now in the case of long time partners, you KNOW the other person and trust their skills. As an officer, in my agency, I am responsible for writing the report. I sign my name but print my partner's. I was told by our system folks this is acceptable. If there is an unusual call or want to clarify important details, I have my partner look over the report to add anything he feels is appropriate before I finish it. My partner is an excellent medic, has excellent skills and I trust his judgment 100%. If he says something, I believe it. I've known him for years, and he's been in this business almost as long as I have. When I work with someone new, one of the first things I ask is if they want to see the report before they sign it or are they OK with me printing their name. Some do, although I have a reputation of being a stickler for details and my patient reports are very thorough. As far as court cases go, I've never been a defendant, but have testified and done depositions dozens of times as a witness. The lawyers always want to know who wrote the report, and usually are the ones who need to testify, although sometimes, one partner recalls or sees something different at the scene than the other, so both testimonies are needed. Obviously, if you are being accused of something and patient care and/or treatment is in question, both providers need to testify. Huh? How can you work on an ambulance without a license/certification?

Tell him that unless you know he has taken vitals, you will not sign the run sheet. Do them yourself. After you load the PT, grab the BP cuff and ears and obtain the V/S. The guy will either be guilted into it while working with you or you simply do them yourself. Do NOT trust someone who is this blatant about poor patient care. Years ago when I was on the privates, we were supposed to take a patient out of an ICU to go to another hospital. No special meds or drips, but it was someone with a very sick heart. We asked the nurse what the vitals were and she said- stable, normotensive. We looked at the guy and he LOOKED like he was ready to code. I told my partner to manually check his BP and it was 60 systolic. I told the nurse this guy was NOT stable and asked if they were going to do anything about the BP. She checked with the resident and he blew it off- "Just transport him". I said I was not comfortable with that BP and called our medical control. We were instructed NOT to take the patient. Of course the doc and nurse had a hissy fit, we put them on the phone with our doc, and the resident looked really sheepish. He hung up the phone and directed a tirade at us. We ignored the guy and walked away, expecting to catch hell from our bosses because we pissed off one of our big accounts. I told the boss the story and surprisingly, he backed us up. It's your license to lose. Protect it and your livelyhood.

Go to your own FB page and scroll all the way down to the bottom left. It says English(US). Click on it, and you get a list of languages- English(Pirate) is on that list. click on that and see how your page looks. Pretty funny.

Maybe I'm just an old fogey, but add my name to the list of folks who do not see this as anything that promotes our profession or even provides positive exposure. I know some say there is no such thing as bad publicity, but I disagree. All I kept thinking about as I watched that clip (now I'm dating myself) was the rap "song" by Public Enemy, "911 is a Joke". This is a link to the lyrics, just as an FYI- http://www.publicenemy.com/index.php?page=page5&item=3&num=58 That attitude is the roots of rap- angry, violent, and thuggish. Yes, I know not all rap is that way but if we really want to promote ourselves as professionals, and advance an agenda, then what group should we be targeting? Who thinks that people in positions of power and authority in the health care profession or regulatory agencies listen to rap music? What do you think their opinions would be of people using this as a promotional tool? If you are trying to recruit youngsters to EMS from the inner city- MAYBE this is a good idea, but I'm still not buying it. The FDNY funded this? Wow.

As someone who has dealt with a couple duty related injuries, here's a couple tips. You are correct- they will try to keep their costs to a minimum. When I hurt my L5/S1 disc, they went the conservative- (AKA cheapest) route. I had to see department recommended doctors and follow their advice and treatment. I KNEW it was more than a simple sprain or strain and wanted an MRI. The docs refused- said that's not their procedure. So- did 3 months of PT- did everything required and was still in pain every single day- it never improved. They finally agreed to an MRI and VOILA- here's your problem- a bulging disc. Did the steroid injections- did not work. They said the only thing left was a fusion, which I declined. The pain was tolerable, and they said if I could tolerate the pain I could go back to work. I did- and that was 10 years ago. To this day, I wonder how much I aggravated my condition by the PT. Be proactive in your care. PUSH for what you need. Do your homework on your problem and any possible treatments/follow ups that you should have. Do not let them shortchange you- this is your future health.

Congrats, Lisa and keep up the good work!