uglyEMT

Ok well I had to Google a few things like the meds just to see what they were for but anyways. Here is my idea. Could it be Brown Recluse spider bites? The fever, pain, general malaise, weakness and diahrea sound an awful lot like the reaction to one. The lesions on the hands, being two small nodules, sounds like a bite as well. Being there are no other S&S of infection elsewhere and vitals seem within normal limits given his history. Also building on Dwayne's idea of homeless or home bound its logical. No history of IV drug use to me would rule out them being injection sites with bad needles. Also him leaving mid treatment from another hospital tells me he is not a pill popper. I have had this bite 2 times before so I am also talking from experience LOL If it really is a bite then the lesions would start to necros soon. It looks like they are about 2 to 4 days old as they haven't yet opened up.

Welcome to the City! You've come to a good place to learn and ask questions. Congrats on the Phsyc degree and state cert! As far as fear or low confidence being an EMT. I think every single one of us has been that way when we first started. I know I was. I mean truely sweating through my uniform nervous. As time goes on your confidence builds. You will have A HA moments that make stepping stones to better confidence. Sometimes they are subtile ones but one day you look around at yourself and realize it happened. Faking made a great point. if you can try a vollunteer service in the begining to get your feet wet and build some of that confidence up. Sink or swim tacts work on a few people but most will learn how to "deal" with it and it makes them less of a provider. You hear about folks "fudging" vitals on PCRs, missing certain things because the ED is 2 minutes away, ect ect. That is not the provider you want to be. As far as being shy. No worries. I am sure your not shy around friends and family am I correct? It will get to be the same way with your partners. You become friends and family. You get a repore going and everything flows. I know with my partner we dont need much verbal communication to get things done. We flow, we act as one person sometimes which is scary but effective. Again it comes with time. I had a partner that never said a word. Shy little thing, if she said two words a shift I was amazed. Yet when it came to patient care, this women was exceptional. Had so much knowledge that she spotted things I over looked and did what had to be done. It made me a better provider because of it. She pushed me without a word and I am thankful for it. Getting to being afraid of not being perfect. This is going to sound harsh but bear with me please. YOUR HUMAN, NO HUMAN IS PERFECT. Things happen. We may miss things because they get masked by other things, we have bad days. Do we save them all, HECK NO. What you need to learn is just because an outcome didnt go well take what you can from it a learn from it. It takes a real great provider to admit mistakes, own them, and move on. When you can do that the knowledge gleemed will be invaulable. Takes a strong person to OWN their mistakes. Dont be afraid of them. Learn from them. have I made some, yes, do I wish I didnt? Of course. But what I did do was sit down, owned them, reviewed what could have been done, and educated myself to hopefully not do them again. Just as Dwayne said with his example, he learned to trust his instincts and not machines, this made him a better provider which benifits us all. Again welcome to the City and hopefully we help you in your choices.

My partner and I were talking about this last night while waiting for the tones to drop. We came to the conclusion that it is possible the reason that this person feels we should enter ahead of PD is the damn TV shows and also a skewed view of military medics. (I am not saying anything about military or SWAT medics here, just he may have a skewed view). Too many episodes of TV shows show us in a poor light to begin with, but when they show us sneaking into a violent scene to rescue a wounded person or using our rig as a shield, ect ect the lay person views this as what we do everyday. They come to expect us to do these things and when we dont they are up in arms over it. I feel what needs to be done is a PSA or ride alongs whatever. We need to educate folks on what are roles (Bs, Is, Ps) really are in the prehospital environment. We all know what we are taught from day one, SCENE SAFETY, we come first, then our partner, finally the patient. I know it would boggle lay persons minds that we think that way but if they could see it from our point of view most, if not all, would agree that we are correct in our thinking. We as an industry need to educate the public. Hell fire dept across the country (I am speaking from the American system, I dont have knowledge of international systems) always do educational things with schools, PTAs, organizations, PSAs, ect. I never could figure out why we dont. We need to educate to get rid of the stigma that TV shows portray us as. If a town, service, county, ect really wants tactical EMS (thats what he really is asking for here) then make a division, service, teams and train them as such. Budget issues? Attach them to the PD then. Teach proper scene clearing, tactical principles, recon, sweep and clear. Give them body armor, no not your average stab vest or flak vest, I mean SWAT body armor. Then and only then if you have a scene which really needs EMS (in any of its capacities) to really enter before PD you have them at the ready. As I type that sentence I laughed about a thought, folks will say well we dont need that all the time yada yada BUT no one complains of SWAT in the PD service do they? Police have levels of service just as we do when you thing about the difference between your average LEO and a SWAT member. Your average beat cop will hold up behind their vehicle and ask for assistance with a hold up suspect or an outgunned suspect. SWAT shows up and does all their cool things. They are not an everday service in use but when required they do their job. Why not EMS in this person's mind? Tactical EMS for those violent scenes. Heck you can have those members still roll with their normal duty crews but when that scene comes up they get punched out and do their thing. Ok I know that may be extreme but heck at 7am after a mind numbing shift wierd things happen upstairs in my belfry. I think this councilmen really needs a ride along! Bring him into those "bad" areas at 2am on a Saturday night, show him what the streets are really like instead of his warm cushy bed. Show him how fast a scene goes from difficulty breathing to man with gun screaming he's going to kill you. Or better yet, have him ready to go when that violent scene punches out and have him see what it means to be in that exact situation without PD. Scared straight program with a twist LOL Ok I might have rambled a little there and went every which way but I think you can see where I am coming from and where I am going with this post. EDUCATE THE MASSES I know in January when I take my roll as First LT in my squad I am going to sit down with my Captain and some city leaders and try to get a program initiated, at least to the grammer schools and then the high school. Dont know any high school kid that wouldnt want to see an extrication or a grammer school kid that wouldnt want to see the rig and play with a siren. Thats all for now...

First I would get my CPR certification out of the way. Most schools require the students to be certified before class begins. Next I would start learning my anatomy, would be good to know where everything is and what it does. You will learn basic anatomy in class for sure but having some knowledge before hand will help. Beyond that its up to you how much you want to learn. Class is usually fast paced and goes by quickly just touching on certain things. Yes some chapters are taught more then others but most of the time its up to you to learn the material. Not much you can really do before class begins other then the anatomy stuff. The rest will need to be learned and taught during the class time and practicals. Hope this helps a little and BTW good luck in school.

I am wondering here. When did race become part of the problem with the article? I have reread the entire thing on multiple sites and reread this thread multiple times. I never spotted race until a poster made it about race. From my understanding the councilman wants EMS to respond directly into VIOLENT CRIME scenes without waiting for PD response. I dont see where a distinction is made in that statement. White black brown yellow purple green anyone can be violent, from "poor white trash" to "wealthy movie stars" to everyone in between. I think the big thing to remember here is VIOLENT CRIME scenes. Dispatched VIOLENT CRIME scenes. Yes I understand where folks are coming from by saying certain neighborhoods and such. Yes I dont see the world through rose colored glasses and understand that certain areas and folks can be and usually are disturbed by seeing anyone in uniform. We make generalities based on experience and history of areas and know when we should or should not enter. If I am not mistaken this article stems from an incident during the summer where a EMS crew staged a block or so away from a multiple shooting scene while PD secured the area and one of the shooting victims perished. What made it enraging to the local people was that they were pounding on the sides of the ambulance wanting them to get out and help the victim but wouldn't until PD said all clear. I also believe a bystander carried one of the vicitims to the rig in their arms and the crew didnt get out. I might be confusing to seperate incidents but I do believe I have my facts straight. I am not going to go down the whole race card road, I am sick and tired of everything devolving into a race issue so I will stop here with it. Bottom line, if you are dispatched to a violent crime scene I dont think any of us would enter without PD. Vest or no vest it is still a crime scene and as such needs to be secured prior to our entry.

Ok got it now. As a basic I would try and get on a squad be it local or FD. Up in that area I am not sure if your ambulance is fire based or stand alone. Get on a rig and start running calls Its the best training you will ever get.

Thanks for the cool discussion Dwayne! I agree with you, I dont hate anybody based on their color creed nationality religon ect ect. I do wish we all could get along (sorry Rodny) but unfortunatly Asshats are everywhere and nothing we do changes that fact. Again thanks for the cool discussion

Honestly if you have a patient you are unable to safely lift with just you and your partner call for a lift assist! Your safety and that of the patient is paramount. In my area a lift assist call is usually answered by the FD personel. Besides the LEO that responds with us two or three FD guys show up and help. Same goes at the hospital, if you needed a lift assist to get them in have one to get them out. Go into the ED and ask for an orderly or what-have-you to come out and help. The extra minutes you take to get a lift assist will save you and your partner's back in the long run. We have a saying at our squad.... When in doubt punch it out! Just meaning that if we are unsure of the lift just call for the assist.

Actually there is nothing to prosicute. There is no hate crime here. Bad taste yes but nothing illegal. The only time 1st admendment cant be used is to insight violence. That is why the KKK, Arian Brotherhood, ect ect can hold rallies and such with permit. They keep the rehtoric just below the level of insighting violence. Being he also hung a Klan'smen too he has the whole "Im not a racist" thing going for him. Yes its disturbing and disgusting especially in this day and age but unfortunatly it happens. As for what Ruff is asking about. Ruff to attach hate crime to an act it has to be deamed a prosicutable offence. IE beating the crap out of someone is assault and battery. Now during the offence say something dirogitory about the person's race creed sexual status or religon NOW its a hate crime thus moves you from A&B to Hate Crime. As for speech, unless your calling on folks to riot or cause violence then you can say anything you wish without worring about hate crime. Its a grey area for sure and a tight rope for legal teams but thankfully in our great country you can say what you wish without fear of persicution or prosicution. Not saying its right but it is legal. I still feel this guy was an Asshat

Well as a BLS I will shoot at it Flail chest is 3 or more ribs that are broken and only held in place by the ligaments and muscles of the chest wall. How do I fix it? Pressure, Pressure, Pressure. Either with my hand, a sand bag, anything to keep pressure on the segment. Short term concerns? Punctured lung, tension pneumo or pneumothorax. This is definatly an ALS call. I would load and go and contact my ALS via radio for a line of sight meet up. No playing around with this patient, we are looking at a multi system trauma and really in the field we have no way of telling the extent of the internal damage. If a Level 1 is too far out I would actually call for a bird! Long Term? Well I would think pnemonia. I am not a doctor so diagnosis isnt in my SOP Kidding LOL I would think pain managment, surgical response to the flail, and infection at the site of the chest tube. I have only seen one in my time as a BLS, caused by blunt force trauma from an unrestrained passenger and a dash board meeting during a telephone pole interview

Quick question. Are you going to be a Basic or a Medic? You state paramedic school in January then say Basic by May. Just wondering thats all, its a big difference when it comes to jobs.

OH NO!!! MY SINCER APPOLOGIES I was rescued by USCG Rescue Swimmers! I have the utmost respect and admiration for them!!! I guess I should have worded that sentence better, my appologies. Very sorry about this confusion to anyone I may have disrespected with my comment Above all I want to say thank you to anyone that is part of this elite group, be them Rescue Swimmers, Pararescue, or Air Rescue. You all deserve to brag as much as you want. I wouldn't even attempt to do a tenth of what you do everyday. Thank You All!!!! Again I regret that my statement previous was misconstrude and again if I offendded anyone I apologize. You ARE the best!!!

Richard in the USCG they are called Helicopter Rescue Swimmers http://www.uscg.mil/directives/cim/3000-3999/CIM_3710_4B.pdf In the Air Force they are called Pararescuemen http://www.pararescue.com/overview.aspx Navy has the Air Rescue Swimmer http://www.navy.com/navy/careers/special-operations/air-rescue/?campaign=search_Reprise/Google/AIRR+Navy/naval+rescue+swimmer&sid=naval+rescue+swimmer Army does not have this service neither does the Marines each are the most elite in their field and each have different rolls. But one thing is common throughout each branch, these guys are the shit, best of the best!! I have had the great misfortune of meeting USCG Rescue Swimmers up close and personal.

Thanks Dwayne. I am sorry that the wackers are doing that to you guys. When I heard Pararescue I figured AF. But dang they are screwing that up now too. Just like giving berets to all Army members instead of just the Green Berets. (no offence to any service member folks, you all are amazing and I applaude you in all your uniforms) I mean hell Coast Guardsmen dont even call themselves Pararescue just Rescue Swimmer, Im surprised they let it happen but I guess like you said, it was already printed. Nice PR nightmare if a real Pararescue gets a hold of it and goes to the media. Well at least you know where you are. I know some folks will talk it up and make it more than it really is. Which is unfortunate because as you said it just demeams or diminishes the actual role of those elite folks that actually earned the right. In a lesser sense its like an EMT being called a Medic. Yes sometimes lay persons dont know the distinction so it happens but if the B or I rides on the distinction with the patient then there is a problem. I always correct my patients when they say either heres the medics or they ask if I like being a medic. Thanks for the response Dwayne.

LOL these are all great ones. keep em coming I'll add You curse at the TV when they show a crash outside your response zone You have been mad when on vacation you find out your crew had a great call you would have been on You took your pager with you on vacation without realizing it You have a wrist watch tan line w/ indent on your arm. Your daily off duty shoes are just the low cut version of your duty boots Your biggest pet peeve is TV medical shows You've been in a Doctors office w/ a family member and look at the charts and actually know what they mean before the nurse does Your the family doctor consult over the phone w/ a member 2000 miles away Your spouse knows your tones Your spouse critiques your radio speak when you get home Ill leave it at that for now

Dwayne I was doing research for funny pictures for you but alas I can not find them appantly nothing to joke about. I am wondering though, by doing some research are you in the Airforce and assigned to the Gulf Cleanup or are these wackers calling anyone using a helicopter a pararescueman? I mean no offense at all I am just wondering. Seems that the title of Pararescueman is an elite thing, not just an off the cuff thing. If you are then I congradulate you Sir, must have been hell of a ride to get there. If not then these wackers are going to PO some folks. Not you BTW, you didnt title the card yourself

understand that. My class was like that somewhat. The housewives were going from either ER nurse (not RN) or RNs that were bored and wanted to get on rigs so they kept it civil. The 20 somethings, I think some were younger then that, teens maybe.. now those were the nutty ones. I know what you mean about victims. We had 2 that would be on the ground before practicales even started. LOL I hung around with the few folks that I knew were going to make a carrer out of it. We had our study group and pushed each other. We didnt have the awkaward giggling at things or a touching during assesment. It was straight foward they way we would handle ourselves in a real situation. I think it boils down once again to what has been said before. If you have the moral integerity then it wont happen, if you have the moral fortitude of one of our lovely celebrity criminals then well I need not explain. As a side topic I began thinking of how the person is a provider besides either an EMSex or what-have-you. I think those that would consider it are also the ones that will fudge PCRs (12 if they are breathing 18-20 if ill w/o even looking, 120/80 cause it looks good, ect ect ect) I wont go off on a tangent here, i will make it another thread though....

All good points Richard. I do fall in the porcupine role now that they added my dispatch mobile unit to my car. At least my cb and frms/gmrs antennas are low profile and hide behind my roof rack bars. I dont stand out too much I never fell into wacker territory either. Just my dash light. I did have to add rear lightbar and tag stick now that i may have to roll to scene directly but that came recently and was not my choice. You got some good replies Richard. Can always tell a veteran by the replies

WOW Ruff Thats alot more then mine. I think out of it 4 or 6 people hooked up. A few females in the class were already married so they were pretty straight in class. It was the 20 somethings that went a little nutty. We had one female go from partner to partner until a hookup happened, I avoided her like the plague. Our instructors were already married so it was fun hearing them go back and forth with one another during different lectures. wow after reading the school responses maybe we are all whores LOL

You wouldn't believe