armymedic571

LMFAO,ahahahahahahahahahahahahaaaaa...... . This all may be true. But this screams Sexual Harrassment

Maybe a case where the ACLU would actually be useful......

It is from the Movie "Office Space" An awesome movie about a guy with really crappy management. "it's not that I am bad at my job. It's that I don't care." Ruff----> Most of the ideas and thoughts posted on this thread were really good. But, I can simplify this with one word. COMMUNICATION! It needs to be constant, and flow both ways. Good luck. Oh also, Don't be a manager! Be a Leader!

Thats it! Professional pride and Team cohesion. Work hard, play hard.....together.

He believes in hope and change Now back to reality.

Sorry, I couldn't help myself

Elephant Keeper??????? I don't think it is the title that is the issue, but the manner in which we present ourselves. This "holy'er than thou" or "I'm ALS (or BLS), therefore I am" attitude is what started this ..........ummm debate.

This sucks. I used to fly Army medevac at Ft Bliss. The terrain there is different to say the least. But we worked the group from SW all the time on I-10. Definetly a good bunch. There have been way to many Aeromedical crashes as of late. WHY?

HHmmmm. I see your point, especially about reading abstracts. However, I have a question in regards to ACPE. Would it be correct to state that diuretics have been used in the past (not necessarily by pre-hospital, but by MD's) to help reverse the shift of fluid in these cases? And if so, what is the potential benefit/risk in patients with well documented history of heart failure who are suffering from acute exacerbation?

! Joseph. You obviously haven't read through the postings. This is about good patient care. But what ever you have to do...........

Wendy, Thankyou for reading my mind and posting it in an intellegent, well thought out, and brief post. To build on what you have already stated. I think it is important to point out that we should focus on providing "medical care". Whether it be holding your patients hand or making them smile. I think we to often forget, we are in this business to not just help people but to improve the quality of life. BTW, is hand holding a BLS or ALS skill? <------------ that is a trick question. It is just good people skills.

double post

Care to restate Sport............ As a general rule. You should get your facts straight, and have a basis for your arguement, before posting. Although I disagree with seeing any provider working in tennis shoes and tee shirts. Well, if it is a disater......*&^( happens. I know a paramedic who worked in New Orleans that stayed and worked after he sent his family North. He had no uniform to wear. Just the clothes on his back. By the way. Most Disaster stock piles for everybody, not just Military and the FD. Once again....think before you type.

Magic, Welcome to the city. I like your post. I think this another example of why assessment and history are so important. I believe that was the point I was trying to make with discussing the mis-diagnosis of pneumonia. But, I am against taking this medication (furosemide) out of the tool box. We need to start increasing educational standards and stop dumbing down this profession.

Ummmmmmm. I cannot even comment. I am less intellegent for reading this.

LMFAO........hahahahahahaha.

That is my point exactly.

http://www.nhtsa.dot.gov/people/injury/ems/EMT-P/index.html Here is the link. Goto disk 1-8, page 4 I am not saying this is a skill whck all systems should perform, but one that could be considered in some of the very rural systems. I said should be considered. Not mandatory.... But that is just my opinion.

I can't say I totally agree with not speeding while responding to calls. Those in rural areas can save much needed time for those truly sick patients. However, I will concede that we run more BS than critical medical. Furthermore, I think a little common sense needs to be taken by the drivers of these vehicles in regards to road conditions, road types and the maneuverability of the vehicle. I think the real issue os transporting back to the hospital. Take your time. If they are that unstable. Call for help or call for helicopter.

As it should be. It is part of the national curriculum as is OG/NG tubes and central lines.....

Bravo........... Now that is a great idea......

Don't forget the foley....

We in PA have had the same shift away from Lasix as most. We still carry, but must call Command for its use. Here is a ling to our CHF protocol: http://www.dsf.health.state.pa.us/health/lib/health/ems/pa_protocols_-_master_-_effective_11-01-08.pdf Actually, I think that will give you call of the protocols, but there they are. We too, have advocated for the use of nitrates and CPAP. If you dont have CPAP, get it. It is one of the best non-invasive techiques you will ever do. NTG seems to be the key. So much so, we have started to give NTG drips. I am under the opinion that Lasix has its place in our bag O' tricks, but I can unstand why it was taken away in a manner of speaking. I think the underlying issue here is education, assessment and history. 1) Our providers are not proprerly educated. 2) Because of this, they do not complete adequate assessments. 3) And, they fail to do thorough Patient Histories. Why is this important. Many of our patients have multiple problems, some have multiple problems with the same parts of their bodies. In this case the lungs. How many patient have you had, that had CHF, COPD, and were currently treated for pneumonia. Great, so now they are having shortness of breath, what is the underlying cause? The only thing that will tell us (besides the pt's white count and BNP) is: Education, Assessment, and history. You cannot fault the system. We as providers did this to ourselves. The only thing we can do now is keep our standards high, and show the medical community that we can think on our feet, and make appropriate decisions in the field.

http://www.ncbi.nlm.nih.gov/pubmed/7782675?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=21 http://www.ncbi.nlm.nih.gov/pubmed/7531489?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=26 http://www.ncbi.nlm.nih.gov/pubmed/8087820?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=30 http://www.ncbi.nlm.nih.gov/pubmed/18672159?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2 http://www.ncbi.nlm.nih.gov/pubmed/15641233?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=8 Here are a few that I found that state that NTG is beneficial. Some of the results vary, but I could not find any that said that NTG Detracted from the overall outcome. These are only Abstracts, for that I apologize. Here is where I found them if you want to dig deeper: http://www.ncbi.nlm.nih.gov I like discussions like this. Perhaps we should start one for Morphine vs. Fentanyl in the chest pain patient....

I reread the OP's post....Whoops. On a side note. The job description is in there. You should read it.