HERBIE1

Agreed, but as the saying goes, common sense is not very common. There are some here who feel you need about 12 years of education to perform that task. Never mind the fact that medical assistants with a fraction of the training we have have been approved to do it.

LOL That's just WRONG.

OK, all these replies, and nobody has yet suggested this genetic component may be XY/XX related?? I'm shocked- all you PC folks are cowards! \\\dons flame proof jacket...

I stand corrected. I thought I was a cold-hearted SOB, but I'm a warm and fuzzy teddy bear compared to some here.

LMAO I had no idea Ahhnold- or at least his speech writers- could be so clever. Sends a message, doesn't it?

They do make quite a couple, don't they? She's smoking hot, and he's an idiot. LOL Personally, I never thought Jim Carey was funny. I liked a couple of his characters on "In Living Color", but I just don't get the guy's humor or his immense popularity. Back to the immunization thing for a moment- can you imagine what would happen if they ever DO prove a link to problems like autism? I realize there is nothing but anecdotal evidence for it now, but it does make you think. I am skittish about so many inoculations now, and all the antimicrobial products we are using. I really think we have weakened our immune systems to the point where they aren't nearly as effective as they used to be, but that's just a personal opinion.

Most of those I work with would disagree with you- from new guys to old farts like me. Ironically, I've been told by many that I can be a cold-hearted SOB, and that may very well be true- except when it comes to kids. If an 80 year old dies, is it tragic- of course. The family experiences a loss and they mourn the death of a relative, but the person lived a long life, had the opportunity to experience all kinds of things- raise a family, work, contribute to society. When a child dies, I look at the wasted potential, of all the things they could have done, of what they could have become, of what might have been. This child could have grown up to find a cure for cancer, or solved our energy problems. Any child- regardless of their surroundings, has nothing but possibilities and a blank page they will fill. Different strokes, I guess.

LMAO When? After this thing has already run it's course? My gawd, could the government move any slower on this? As an aside- So does this mean that the next problem we'll have is an autism epidemic because millions of kids have been given the mercury in the H1N1 vaccine? (For the record, I'm not in the "inoculations cause autism" camp. It's just an offhand comment) I'll bet folks like Jenny McCarthy are hopping mad about this.

I can understand why some of the Genx/Y'ers may feel insulted, but look at the descriptions that define the various generations. Baby boomers, Gen X'ers, depression era folks, every group has certain traits and characteristics assigned to them. Do these traits guarantee a person will behave/react/exhibit a certain behavior? No, but like any generalization, there is a kernel of truth to it. The reasons for these traits are usually the result of society and parental influences so it would be wrong to simply blame the person. We all are the results of our parents and what we were exposed to growing up, but as noted by scooby and others, we CHOOSE whether or not we are defined by these expectations. This is an article that talks about the entitlement generation in the context of college education and grades: http://www.nytimes.com/2009/02/18/education/18college.html?_r=1 As the parent of a 22 year old, I have a vested interest in this discussion. A very bright kid who attended a selective enrollment, elite high school, who despite his parents both having masters degrees and the Mrs working on her PHD as we speak, his "lack of enthusiasm" for effort and a lack of interest in his education did not come from home. He wants to be a cop, but won't put forth the requisite effort to meet the qualifications(2 yrs of college) It's always someone else's fault, looking for the easy way with the least amount of effort- we've experienced all the defining characteristics of this generation. External forces were obviously a stronger influence on him than the ones he received at home. Is he a bad kid- no, and thankfully not involved in anything bad or illegal- just waiting for the solutions to his problems to present themselves that require no effort. Frustrating- yep. I don't know what the answers are, but I do know that the entitlement mentality is a very real issue.

You'll be fine, bud. Peds arrests are horrible. ALWAYS. Regardless of the situation. They will make you angry, sad, disgusted, amazed, and every other emotion in between- as will any call you run. The problem is, with peds, the most vulnerable of us all, those emotions are amplified 10 fold. I have no idea what your call volume is or where you work, but there WILL be more horrible calls. You'll question yourself(and that is a good thing), question your personal deity, and question the sanity of the human race. The longer you do this, the more you'll realize that we do our parts, do the best we can, and despite it all, people live, and people die. Sometimes we can change those outcomes, sometimes we cannot. Go hug your child, a relative, and appreciate what you have. It helps.

That's quite a story, Paul- thanks for sharing it. Sounds like you went through hell and back. Yours is an object lesson anyone can learn from. I tell all my students and new guys/gals that one of the most important things you can do is watch the back of your coworker. We have had several members commit suicide or drink themselves to death over the last few years. I realize you cannot help someone who isn't ready to accept it, but you have to try. Hopefully you can intercept someone before they go down such a dark road that turning around is nearly impossible. Here's a little story. About a year ago, a friend of mine- an Iraqi war vet returned to the job after his tour of duty. As with many vets, he was having trouble adjusting to life back home and ending up with personal problems- a divorce, anger issues, and discipline problems at work. I notified our employee assistance people that this guy probably needed some help. To make a long story short, there was no program in place to deal with vets and their issues unless the person requested it. We all know how stubborn public safety folks can be about asking for and/or accepting help, so clearly we need to be more proactive in our efforts to reach out to folks. My buddy was approached by the counseling staff, was agreeable to the help- thank gawd, because it may have saved his life. He received counseling, the divorce was settled, after awhile felt a lot better, and he's dealing with everything in a healthy way.

Here's the real deal, folks. BFD is indeed afraid of Random Alcohol and Drug Testing. I know for a fact the city of Boston was asking around other cities who had this policy. This statement is dead on: “(It’s) just another attempt by the firefighters to distort the truth and draw people’s attention away from the real issues of drug and alcohol testing,” said Menino’s campaign spokesman Nick Martin." The union knows that some of it's people will not be able to stay clean and end up getting fired, unless they have some type of treatment that gives them a second chance after counseling. The union cannot openly oppose this idea too loudly- how can you justify refusing drug and alcohol testing?

"Those" calls SHOULD bother any provider worth their salt. I'd hate to work with anyone who didn't get upset when something bad happens. "Those" calls could be anything from a question about the care you provided or simply a bad situation. My (and most provider's) Achilles Heel is kids. Had a stretch years ago when every shift I had a pediatric arrest- 4 in a row. SIDS, trauma, abuse, medical issues- it was bad. I was a new dad at the time, so they hit me hard, and after the 2nd one, I dreaded going into work. I talked with coworkers and even the department chaplain. Sometimes there are no "answers" and simply talking it out gets you through it. Like you said, anyone who's been doing this awhile has been in the same boat- more than once and the key is to NOT keep it bottled up inside. We are human, we get upset, and we wonder how we can do it better the next time. That's what it's all about.

Agreed. Book knowledge only gets you so far. That's why I have a problem with a a fresh EMTB who enters a paramedic program right after they graduate as a Basic. Yes, most paramedic programs are SUPPOSED to require some minimum of street experience before you are allowed to enroll, but we all know that does not always happen. You need to walk before you can run, and you need to learn, understand, and BE ABLE TO APPLY the basics before you move on to more advanced care. I've dealt with paramedics who have gone that fast track route and the vast majority of them are in way over their heads, and an undue burden on their partners. When you have to explain to a licensed paramedic how to change a regulator on a D tank or how to properly lift a cot, there is a problem. (True story) As everyone has noted, any specialized training is over and above what you already know, and until you have a firm grasp on the basic job of ALS care, I simply think you cannot be effective at something such as a critical care medic or a flight medic. Look for available options such a critical care tech, and ER tech in a busy ER, or as was noted, see if a critical care company is willing to hire you as a driver so you can be exposed to and begin to learn what the job entails. Take all the requisite classes and THEN start looking for work as a CCT. Maybe you can find a company willing to hire you and pay for your certifications as a reward for future employment.

I noticed you said there were multiple critical patients. Well, this is basic triage, then. The "best" solution is a very grey area in these situations. It is crucial to QI/QA your actions- especially on critical calls, but you cannot beat yourself up over it. You do the best you can given your resources,, the surroundings, and available personnel. Shoulda, coulda, and woulda's are OK to help you for the next situation, but unless you did something like a missed esophageal intubation, I'm sure it's not as bad as you think. Sometimes we are forced to make judgment calls that may not sit well with us later. You simply do the best you can. The most difficult thing in the world is to leave a critically injured person who if they were your only victim, you may be able to help. With multiple victims, you look for people who have the best chance at survival and hope for the best. There's always second guessing- even with single victims- maybe I could have driven faster, maybe I could have pushed more fluids, if only we didn't hit that traffic on the way to the call, if I had gotten the IV quicker we could have pushed the meds faster... generally it's not as bad as you think. As we all know, when someone's number is up, there's usually not a damn thing we can do about it. The fact that it's bothering you means it's a learning experience- either you can do something better next time, or you may simply realize that sometimes "feces occurs" despite our best efforts.

This woman is the former mayor of a town? Holy smokes- apparently they have some real all-stars in this area. I feel bad for the residents of that area.

An oldie but a goodie. And that first sentence is something husbands everywhere should remember if he wants to keep the peace: "Marriage is a relationship in which one person is always right, and the other is usually the husband." No truer words were ever spoken.

I would take a step back and say personal pride is the issue- it's something either you have or you don't. One definition of ethics I really like is- how you act and what you say when nobody else is around. In other words, do you do the right thing/say the right thing just because someone is watching you or to keep yourself out of trouble? If the only time you behave correctly/do the right thing is when there is a possibility someone may see you, then you have have ethics of convenience. Right or wrong, I think everyone takes a short cut now and then, but as long as that is not your SOP, I see no real harm- we aren't perfect, nor are we machines. I'll echo the comment about the Genx/Y'ers. It may be cliche or an oversimplification, but there is a different work ethic these days. This is the entitlement generation, and without derailing the thread, I'll just say I hope this attitude changes- for the sake of our profession, and for society as a whole.

Wow. Horrible.

"Mayumi described that she and Richard Heene devised this hoax approximately two weeks earlier.... She and Richard had instructed their three children to lie to authorities as well as the media regarding this hoax," the affidavit said. Interesting... Apparently the mrs has sold her hubby out. I don't think the kids should be taken away from the parents but the city. state, and feds should sue the hell out of this guy. Let him have his reality show(it will be the only way he can afford to pay anything back) and every dime he makes from it should be used to compensate everyone involved in the search. They should also include a hefty fine, for good measure.

Here's an article from the Washington Times. Although the vaccine is available to health care workers, most people do not yet have access to it. A report I heard this AM also said that the government is way behind in production of the vaccine, and the majority of the supply may not be available until December. I think the government seriously mishandled this whole thing. We have been warned since last year about this potential pandemic, yet they were still not able to ramp up and have an ample supply of the vaccine available. Slight derailment here, and certainly fuel for another thread, but... does it bother anyone that the same government that cannot handle a serious problem that was predicted well over a year ago, but wants us to believe that they have the solution to our health care problems with a public model, single payer insurance idea they will administer and control? Originally published 04:45 a.m., October 20, 2009, updated 02:32 p.m., October 20, 2009 Study: H1N1 vaccine too late to help most Ann Geracimos The H1N1 vaccine will arrive too late to help most Americans who will be infected during this flu season, according to a study conducted by scholars at Purdue University. The study also estimates that the virus - commonly referred to as the swine flu bug - will infect about 60 percent of the U.S. population, although only about 25 percent of Americans will fall ill. Published Oct. 15 in Eurosurveillance, a scientific journal devoted to epidemiology and the surveillance and control of communicable diseases, the study was conducted by professors Sherry Towers and Zhilan Feng of, respectively, Purdue's statistics and mathematics departments. "The model predicts that there will be a significant wave in autumn, with 63% of the population being infected, and that this wave will peak so early that the planned [u.S. Centers for Disease Control and Prevention] vaccination campaign will likely not have a large effect on the total number of people ultimately infected by the pandemic H1N1 influenza virus," the authors wrote in their study. The authors said that this is the week, through Oct. 24, during which the greatest number of people would be infected. The vaccination program has barely started in the U.S. "The model predicts that the peak wave of infection will occur near the end of October in week 42, with 8% of the population being infected during that week. By the end of 2009, the model predicts that a total of 63% of the population will have been infected," the authors wrote in a conclusion that ignored the effects of a CDC vaccination program. But even "when the model was modified to include the effect of the planned vaccination scheme," that adjustment yielded only "a relative reduction of about 6% in the total number of people infected" by the end of the year 2009. Ms. Towers cautioned in a phone interview with The Washington Times that while enough of the U.S. population probably won't get enough of the vaccine before or during the peak of the pandemic, that is no reason not to get protection. "Based on our study alone it would be bad to discourage people from getting the vaccine, because what if our study is wrong," she said. She called some comments in the press "a lot of hysteria. In reality, the overwhelming majority of people getting sick are going to have a mild illness." The study cautioned that while a majority of the U.S. population would become infected by the virus, previous studies "showed that up to 60% of seasonal influenza infections are asymptomatic." That is, people became infected but showed no symptoms. "If the same is true of the current pandemic influenza, about a quarter of the population will fall ill," the authors wrote. Canada is in a much more dire straits on vaccination, Ms. Towers noted in her interview, because of relative slowness of the country's equivalent of the Food and Drug Administration (FDA) to approve the vaccine. "They are more cautious and conservative and sitting on at least 1 million doses waiting for delivery. They won't begin vaccination until the first week of November," she said. However, the study, which used data only though the week ending Aug. 22, assumed that "the planned CDC vaccination program against pandemic H1N1 influenza will begin with six to seven million doses being delivered by the end of the first full week in October." That assumption turned out to be more optimistic about the program's numbers than turned out to be case - about 6.8 million doses were available and 3.7 million doses had been ordered, the CDC said on Oct. 9. Shipments reported Friday were down by a quarter, because of a slowdown in production caused by difficulties of processing great numbers. The study also assumed that all adults would achieve full immunity shortly after receiving inoculations and assumed that children and adults are equally responsive to the flu vaccine. Both assumptions are medically dubious, though hard to compensate for statistically. All these statistical assumptions and prediction errors would lead the study to underestimate the number of infections. The study was based on a statistical analysis of weekly reports from the CDC for a model derived from the observed spread of the H1N1 virus "during summer 2009 to predict the behavior of the pandemic during autumn 2009." A White House scenario released in late August by a group of presidential advisers had predicted that anywhere from 30 percent to 50 percent of the population would get the novel virus strain, and an estimate on the number of deaths ranged from 30,000 to 90,000. The regular seasonal flu normally affects up to 20 percent of the population, with 36,000 deaths resulting. Dr. Thomas Frieden, CDC director, cautioned at the time that such a prognosis was unlikely unless the virus changed and mutated into another form, which, to date, has not happened. Further estimates and availability of vaccine doses are due from CDC officials Tuesday. But the Purdue scholars' study predicts a higher rate of infection and illness than previous projections because, the authors explained to The Washington Times in separate e-mails, they used a better formula - "a seasonally forced SIR model" that adjusts the rates of infection spread for the different times of the year. "However, one aspect of influenza that needs to be added to the [sIR] model is its seasonal nature; it is more infectious in the fall and winter in the northern hemisphere than it is in the summer. We refer to this as 'seasonal forcing.' ... Our model takes this seasonal forcing into account," Ms. Towers wrote.

I think the issue for some is education WITHIN the EMS field. Personally, my thought is that in order to address the problems we have in EMS require knowledge that is NOT unique to EMS- like management and leadership training. All the certifications in the world will not make you politically savvy or understand the processes involved in pushing an agenda.

You brought up an interesting- and very important- point. "Education" for the sake of education, is fine, and I'm all for it. I love to learn- about LOTS of things. My interests are varied and I have taken classes in many different disciplines- some related to work, some not. I take my hat off to someone like you that takes all the various certifications available to them- that is education for a very specific purpose. It may or may not make you a better provider, but knowledge of any kind is a good thing. I took many of those classes but I will admit I no longer am as ambitious in that regard. I went in another direction- I went to grad school to learn about the management aspect of public safety. It may or may not pay off for me professionally, but personally I have learned a lot. I have a greater understanding of the behind the scenes mechanics of how and why things happen as they do. It helped me in my management stint, and I hope to return to it soon. Being a provider is still fun, I love what I do, I am very good at it, BUT I want more. I want to be able to change things for future providers, and an advanced EMS degree is not the route I have chosen. My reasons are many, and I may or may not be able to effect those changes, but I continue to try, even now. One thing I have learned is that education alone - especially in a large organization- is not enough to get policies changed or to push an initiative. Often times logic, facts, and reason are ignored when establishing new policies. Sadly, politics and $$$ are generally the most important motivators, which is why I say that in order to change the system, often times you need to be a part of it.

Kids are the toughest issue for even trained providers.