uglyEMT

maverick makes an excellent point. The chances of a military grade ( 1 kiloton or above) weapon actually being aquired and detonated in a populated area are extremly low. What is highly more likely is a "dirty" bomb. As for the damage, depending on what was used as the actual explosive, I would look twords an ANFO type, the damage can be extensive to the immediate area. Think Oklahoma City, but the radiation is localized, what is the real danger is the crowds runnning away. If they have "fallout" on them and scatter in all directions the radiation will be moved outside any containment area. Secondly unless responders have giger counters the "dirty" side wont be realized until effects become apparent. This is the biggest problem, we go running in thinking standard bomb and get a nice dose of rads before we know it. It is a total psychological weapon and one can see the reason why terrorists would love to get their hands on it. Two great examples of what would happen is the british movie Dirty War and a look at the history books about the Goiânia accident in Brazil. Dirty War I feel portrayed what would really happen fairly well. Lets just hope it never happens BTW if it happened in my response area.... I would drop a deuce and give a major diesel bolus in the opposite direction at code 3. Scene Safety anyone?

As the OP i will end this right here. hertzvanrental if you read past the original post to my second post in the thread "I also just reread my post, cant edit it for some reason, I mispoke when I said I diagnosed the NSTEMI, what i should have said was based on what my father described to me I felt it was an MI in progressed and had Mom call 911. My appologies." When i made the original post it was about 1hr after learning of my father so I wasnt in the right frame of mind at that point. Once I had a chance to collect myself I realized my mistake but unfortunatly was not able to edit the post because someone else posted already. On my second posting i said the above line. I appologize for the confusion it may have caused. Noone can diagnose over the phone and I appologize again for using that wording. My appologies everyone, sorry for the confusion.

HAHAHAHAHA Thanks annie for the good laugh

Hey Folks OP Here. I forgot about this thread until I seen it revived LOL Well alot has happened since my original post unfortunatly. Dad went for the second round of stents and unfortunaly had complications. He wound up having pericadial effusion due to artierial disection. They pulled 750cc of blood from the sac and had to go in and add another stent and something else (cant remeber the medical term they used sorry) to repair the bleed. Dad is in recovery now and soon will be going to acute care at KCC to get better. After acute care he will be going to sub-acute at Care One then finally home. My family and I have a long road ahead but feel the priognosis is good. Do not want to jinx anything. I have taken a leave of absence from EMS while he recovers and only have been doing administrative stuff at the squad. I feel I cant be 100% for my patients while thinking of Dad thus my removal from the squad. Once he gets better I will resume my duties. Thanks all for understanding.....

At least in wasn't NJ doing this or we would really be the worst state. Sorry Mass you got screwed on this one.

Gotcha Ruff. Basically what you were saying is born here then brought back then brought here again but because of their citizenship less likely to be stopped at the border. I believe in the post I posted the man was Pakistani then brought here as a child where he gained his citizenship and education then travel to Afghanastan to train in the camps and now is #2. Sort of the same thing but in reverse I appologize for that.

Unfortunatly he is correct. We now have a naturalized US citizen as the #2 in Al Crappa. Boy was brough over at 12 years of age, grew up here in Miami, educated at the schools, and U of M got his degree, then in 2002 returned to the sandbox was trained and when we captured the ruling number 2 behind Bin Ahole this man, now 30, became #2. arab news USA Today So the Senator might have misspoke about where he heard the info (all the stories state FBI) but what he heard was true and not fear mongering. Might have exagerated the threat a little but he is on base with the facts.

THIS SHOULD GET ALL OPPOSITIONS ATTENTION!!!! The free transit of citizens & commerce is a hallmark of the American experience. For purposes both commercial & personal, we have always been able to travel anywhere on public land without question or hindrance of any kind. Exceptions to this ultimate freedom granted by the U.S. Constitution have traditionally been been limited only by travel into military bases, hazardous material areas and temporary areas of natural disaster. Any other transit hindrances or obstacles were quickly addressed and cleared by the U.S. Government. Americans are an independent bunch -- and our roads lead everywhere without restriction. To learn that transportation within the southern quarter of an American state and within some of America's own national parks has become warning restricted is unacceptable. Finding the cause of this restriction to be the presence of armed criminals, drug smugglers & human traffickers is sobering. Worse, recent announcements from Mexican Drug Cartels warn that "their trerritory" is now South of U.S. Interstate Hiway 8. No, but you would not know it from the level of crime & threat to this once pristine part of America's Southwest. Ship Has Happened. McD Transit On The Sonoran Desert National Monument & Several Other Adjacent U.S. National Park Lands Has Now Been Restricted By Warning. Cargo Operations, Hiking, Camping, Scientific Research & General Land Use Are Now Have Restricted Warnings From The U.S. Government U.S. Interstate Highway 8: In the U.S. state of Arizona , Interstate 8 ( I-8 ) is a 178.36-mile (287.04 km) Interstate Highway that extends from the Arizona-California border to Interstate 10 near Casa Grande , Arizona . It serves the cities of Yuma and indirectly Phoenix and Tucson ; it is the major route westwards to San Diego , California . Essentially, it is a bifurcation of the Interstate 10 route which goes to Phoenix and then Riverside -- Los Angeles being the northern section, and Interstate 8 the southern. U.S. Federal Government Warning Signs Restrict American Transit Onto Lands South of U.S. Interstate 8 Across The State of Arizona The State of Arizona Does Not Erect These Signs. These Are From The U.S. Bureau of Land Management Murders, Robberies & Shoot-outs With Police Are On The Rise As Mexican Drug Cartels Spill Across The International Border The U.S. Bureau of Land Management has now placed these warnings in America's park lands such as The Sonoran Desert National Monument which read: " DANGER - PUBLIC WARNING TRAVEL NOT RECOMMENDED *Active Drug & Human Smuggling Area. *Visitors May Encounter Armed Criminals and Smuggling Vehicles Traveling At High Rates of Speed. *If You See Suspicious Activity Do Not Confront . * BLM Encourages Visitors To Use Public Lands North of Interstate 8 ." In Arizona, The Interstate 8 Highway Is Some 40 To 80 Miles North of The international Border Between The United States & The Republic of Mexico. Has The Untied States, In Effect, Ceded Control South of Interstate 8? The Cattle Ranchers In This Area Live In Fear And The Situations Worsems Every Day. If This Were 1870, The U.S. 4th Cavalry Would Surely Be Coming To Rescue The Homesteaders Against The Desperadoes. So What Now? We Are Invaed, So Hey, Let's Just Design A Cool New Sign! Cargo Law Website this is credited to the original author and owner of Cargo Law website

Thanks folks for the kind well wishes Dad is doing OK, got rushed back into the cath lab yesterday (right after posting this thread) had an arterial disection according to the cardiologist. BP at the time hit 68/43!!!! He is back in recovery as of this AM and again seems well (dont want to jinx it now). I understand what you are all saying. I haven't been in the field nearly long enough to understand much. Just over a year. Im so wet behind the ears I need a towel. One thing I have though is experience. I have been around too much tragedy too mention. One of the main reasons I became an EMT, I finally wanted to "get it". I wanted to be on the rig instead of in the rig. BTW remember to clean the celings, alot of rigs are dirty up there LOL Im a little off this morning due to lack of sleep so Im going to keep this short today. Thanks again for the well wishes, my Dad appreciates them, and its working so keep it up Thanks everyone. BTW I realized something I missed its Mount Sinai Hospital LOL I forgot the A.

Thank you tcripp, yes Dad is doing well now :) I know what you mean, I will be putting my uniform on tonight at the start of my shift and when i do I think it will mean a little more to me. When I do wear the uniform I do feel confident, I do walk a little taller. I have been a shoulder numerous times. I have been there at the end more then I would like. But through it all it was the comfort I gave that was the best medicine at that particular time. A while back I remember someone asking me if I was a hero. I responded quickly with an emphatic NO. I am not a hero, I am a person trained to help thats all. Then the person said I was wrong. I asked why he thought I was and got this as a response.... "You are a hero to me, you came at the bad time and helped me. Thats a hero." I never thought of it that way but I guess in that way we are. SSince then I realize that they called 911 for a reason, it might not seem to me to be a valid reason but in the end its their reason and it means it is at that moment their last resort. They utilized everything they could muster themselves and came up wanting so they call us. I dont let it get to my head though. I use it to help me through those days when I just want to be home, or with my family, or sleeping, or eating. It gets me through the bad calls, the BS calls. Makes me realize why I am an EMT. I guess the emotional side is coming out of me now because of my father and all the stuff I have bottled up inside. I just need to get it out and this is what it manifested as. I am glad for this place being here and allowing me to release what I need to. Thanks Gang

Hey folks. Im not a blog fan so I'll post it here. I think it may help others as well. If it doesnt then I appologize for wasting your time. If it does help your welcome Yesterday as I sat sitting on a bench across the street from Mt Sini Hospital waiting on word of my father going through heart surgery upstairs I began to think alot. I watched people going in and out, EMTs and Medics running back and forth to calls, I watched rigs pull in and out all the while thinking of who was in the back and why. Folks just going about their daily lives, some interupted. I began thinking of me as an EMT. What have I done, what have I offered, what have I given back. I began to run through calls in my head, the good ones, the bad ones, the fustrating ones, all of them I could remember. I came to realize that an EMT is who I am, not just on duty but off duty as well. Now I am not saying I have to run to every slip and fall or pull over for every accident I see. I mean I am an EMT all the time, the liscense does not take a day off or have off hours. My actions can have a bearing on my liscense be them good or bad. Then I began thinking deeper... Am I the EMT that does all I can for my patient? Am I the EMT that looks at every call as the BS call of the day? I think I am the prior. I try to do everything I can within my protocols to do the best I can for my patients. I dont want to be lack luster, I dont want to be "that guy". I came across this article back when I need some inspiration and now I use it all the time. "The Question" is what I belive is good for everyone in our profession, be them volunteers or paid or Bs or Ps. I think its good to know. As I sat there and watched I smiled at the new parents that appeared to be going home for the first time. I sighed at the old couple going in with one looking very fraile and the worry in the others eye. I got anxious looking at my watch and knowing Dad has been upstairs 2 hours already and I still haven't heard anything. I watched EMTs going in and out laughing, joking. Some looked bored, others exausted. But most looked confident. They had an aire about them. People on the street stepped a little around them, some nodding some smiling. But everyone appearing that at that moment the EMT was incharge of that area. It gave me perspective. I looked at what folks appaently see in us all the time but from the voyers spot. Outside of the situation without anyones knowledge so the dynamic has true, real, actual. It made me comprehend our role in peoples lives. Ugg I see this is rambling along and might not be coherent and I am sorry, I just need to get this out. I guess what I am trying to say is I see our place. What we do. Im not talking interventions or protocols. I am talking about what we do to peoples lives by being there, just being there. Then it happened to me, I became the patient of sorts. As I sat there an EMT came over to smoke a cig. I guess she noticed some worry on my face or the way I smoked mine. She asked the most basic of questions, "Nervous?" and I replied in typical well duh reaction. "Yea, Dad, heart surgery." (pointing up to the building) But without any distain for my short response she politely said, "Dont worry, there good in there." with that flicked her smoke to the ground and hustled across the street as her partner waved her to the rig, call I figured. That was it, that brief moment. I simple 3 lines of dialog and I felt better. Her words gave me comfort, just enough to take the edge off. THAT is what we do, we can comfort in an instant just by being there. Whoever you were I thank you. You made this worried son's day with the comfort you gave. After that I finished my umtenith smoke in a row and went up stairs. After 3 hours of operation Dad was wheeled out to a relieved Son and Wife A little exhausted but better. With us a little longer :) I am going to end this here but may continue later on when I think of things or respond to your comments, if any, and I hope you enjoy what I think I have found out about us as EMTs.

Rest in Peace Brother. Wish I got to know you. Prayers and thoughts to your family.

The next time the government marshals emergency personnel to respond to a disaster, the teams of police, firefighters and medical technicians might also include dentists. Dentists As Emergency Responders

Welcome to the City. Great to have you. I am relatively new to EMS my self so maybe I can help answer your questions. I got into EMS to help people. I had no illusions of being a hero or what you see on TV. I just wanted to be their in peoples time of need and help. I still feel that way today and I do feel I do help people and have an impact on their lives. BUT one thing that changed since then is I now realize at that moment I am helping someone to them I am their hero. You get into peoples lives briefly but at the worst time of their life, noone calls us if they are OK (remember if they called THEY feel its necessary not you). So to them aty that moment you are like a hero to them. It has made my job more rewarding knowing that. It helps keep a smile on my face when the world comes down around you. EMS is a second job for me and I am still in my "stable" job so I cant answer that. I can say that adding EMS as a second job did make me realize my stable job is boring LOL but I wouldnt leave it. Burnout does happen. The easiest way it does is letting everything get under your skin and turning into a bitter EMT. I know a few that have and its not pretty. If its not a major trauma they feel they are not needed and take it out on everyone around them including patients. Its always a good idea to have an escape, something you do when not on duty to forget everything. Just decompress. A good thing to remeber is to talk about it. Be it with a professional councilr, a priest, whoever just get it outside of you and out there. I am recently married and can say the marriage changed a little but I dont think for the worse. Their is bound to be days when it seems EMS is more important to you then your loved one as they see it. Their will be missed holidays, birthdays, anniversires and the like. Schedueling in EMS is a beotch, at least in my area. It has strengthened our marriage in other areas. When she see its getting to me, she is a rock and a shoulder to cry on. I dont get into details with her but let her know what I am feeling inside. This has helped us open new lines of communication with each other which, I feel, is always a good thing. Sometimes I see how proud she is of me in her eyes. It makes me feel proud No. Your not crazy. Hope this helps and good luck.

I was just reading a good blog post about this sort of thing. Not the golden hour perse but treating the MOI and not the patient. Had a point in it I think goes well here. When did we stop treating the patient and just start treat MOI? The golden hour is the same thing. It worked well for a while but with changing technolgy and more studies it has evolved into something different and needs to be changed. I did reread my previous post just want to add something (being edit wont let me).. the possible internal bleed... I should have said the extended extrication with signs and symptoms of internal bleeding. (BTW I use medivac for that if they can fly only because its an hour by ground to the nearest Level 1 but only 20min by air) Ok back on track now.... I do feel certain things are always going to be time crtical and in those instances speed is paramount. BUT not every emergency needs code 3 response or medivacs. What we need to do is start once again treating the patient and not the MOI. Should medivac be alerted for every entrapment? Yes ALERTED have BLS or ALS cancel when the patient assesment does not warrent it. Just because it might be an extrication doesnt mean the person is messed up. In a BLS / ALS system should ALS be alerted for every SOB or possible MI / Stroke/ ect ? Yes but have BLS cancel if not necessary. See what i am getting at? Not every trauma needs the golden hour rule. Certain things do but the 98% of the time just getting to the hospital safe is enough. My driving instructor during EVOC said a great thing to the class on the first day right after hello. "Remeber this class, no patient is going to survive if you kill them in the rig by having an accident." I think certain terms inside EMS in general are in need of updates same with certain corriculums. Certain things get outdated or change in one place but not everywhere. I think that needs to change as well, make it standardised. Just as maine has that C-spine check list so not every patient gets collared yet other places every MVA gets boards and collars.

A few things. With the ankle braclet idea. They do have it, just ask Lohan. Its what got her thrown in prison. As far as a slight hicup with it. What if a sober person is driving the car? I would say have the on/off under the driver seat with a short distance setting. If his in the seat it wont start. Oh what about someone else starting it then getting out and letting him drive... have a kill switch on it. They way things like Onstart stop the car. If its been started and he enters the driver seat area, bzzzt car dies. might be a good thing. The breathilizer ignition system works well too. Very hard to beat it, its not as easy as The 40 Year Old Virigin makes it out to be. Can it be done, yes it has been but the numbers show it works. Taking his priviliges away, does nothing. He will still drink and he will still drive until he gets caught then the process starts all over again. What this man needs is a couple of things. First he needs to be arrested. Not just picked up and make bail but actually locked up for a few days to think. Then he needs a good judge, firm but reasonable. Sentence should be 3 to 5 years suspended sentence with madatory rehab (6 weeks minimum) with counciling. Then after those docs feel he is good release him on probation for 3 years maybe 5 if necessary. While on probation mandatory AA meetings miss one then its a violation the guy goes in a does time. The ankle bracelet thingy for 2 years. After all this if he relapses or does pull a DUI then I would say a nice long jail sentence. Am I being too nice to this guy, not really. His disease is winning right now. If he getts the proper treatment and does the AA thing he will possibly break the cycle. the key is the meetings after rehab. Anyone can stay clean 6 weeks but if you come home to the same conditions that led to you needing rehab your doomed to repeat. The harshest crtics are the recovering alcholics at the meetings. They have heard it all, done it all and seen it all so excuses dont work. They can spot someone who even took a sip from about 1 mile away and wont let you forget about it. Its a tough gig to go through. BUT they are some of the nicest people when you need help and ask for it. From talking to you at 2am crying in a bathtub all the way to sitting with you on your porch sipping lemonade because you just want to talk. They will keep you honest and will help you get through it year after year. How do I gleam this insight? i have been there. I went to the bottom and stood in hell and fought my way back to the light. I went through the shame of a DUI, the family turmoil it caused. I looked at the pain I caused everyday. I got the help, I stuck to it, I still do. It may be a disease but its one with a cure if you are strong enough to want it.

wow that really sucks. Guess my squads old paper charting only isnt so bad after all. We keep them in a fireproof safe on premises for the required 5 years, then we personally shred them ourselves and the paper usually is used as kindling for our BBQ if not it is desposed of in the recycling center by 2 members. Old school I know but it works LOL

After reading the articles linked and doing some other research I agree to disagree LOL Let me explain. While I do believe the golden hour is an arbitrary number I do belive it should still be followed. I am not going to rush and possibly further injure myself or the patient to meet the "deadline" but I will look to resources at my disposal. Eg Medivac for the extended entrapment with possible internal injureies, meet ALS enroute for the difficulty breathing if my O2 is not doing the trick on scene, FD to help lift an obese patient if I feel me and my crew can not do it ourselves. Generic examples i know but wanting to show my logic. While I read the OPs article link i had to wonder to myself the statment that the golden hour follows no scientific method. That doesn't sound right, if a pt's survival is improved by any degree by getting to definitive care, especially in a trauma case, within a timely (in this case one hour) manner then doesn't that prove that it works? I understand that the term golden hour is what the folks get hung up on but isnt it more so a guide to help responders guage appropriate things during the course of a call? I know when i went through school thats how it was taught to me. Not a line in the sand but a gauge to help judge interventions. I do like what others have posted about the trimodal, I haven't heard of that before so I thank you for giving me something new to learn about.

Ok before I go any further I will put on the flame suit, my hazmat suit and SCBA from what I may get from this post..... My take on this issue is as follows. I dont see the problem, I really dont. You get stoped by a LEO he asks for ID you provide said ID, be it a DL, Green Card whatever you have for ID. He calls it in or types it in NCIC it comes back clean with no wants or warrents your on your way. What a 5 minute break from your life? Held up that whole time it takes for the comp to spit back your a real person thats not in trouble? I DONT SEE THE PROBLEM!!! You have to give ID during any traffic stop so why the big deal now? Oh thats right, you might be an illegal. Well guess what, you shouldnt be driving in the first place. Oh wait you were not driving, just walking down the street but grabbed the attention of the LEO. Well he asks for your ID, cant supply one? Illegal are you? Well sorry, do not pass go, do not collect 200 dollars. Have fun looking back across the border at us. Oh forgot your an American citizen (be in naturalized or what have you) it your RIGHT to be a beotch to the LEO and refuse. Now your dumbass is detained vs have a nice day. Your smart aren't you. Wait whats that? You did it for them, because you feel for them. Guess what they are I L L E G A L google it if you have to. Opps I steeped on the toes of the racial profiling folks. Sorry. Guess what folks, its not racial it being smart. Has nothing to do with your race as a whole but if you fit a description then guess what you might just be looked at a little closer. Does the TSA agent worry about 80yr old Gwenith Jones from Walla Walla or Bin Azid Mubarik 28 from Wackoastan? GOTCHA you even did it right there, there was that split second you looked right at just the names. Notice I just used names not discriptions of the people. See its not racial its just profiling. Incidently Mrs Jones had 2 ounces of black tar in her purse and Mr Mubarik was on his way to visit his sick grandmother in a US hospital because he works for the gov as an interpriter. Get off your high freakin horses and let LEOs do their jobs!! Yes the FIRST illegal immigrants were folks that came over on boats and stole the lands from the Natives. Since then though folks, rules were put in place to be followed and most did actually. Hear of Ellis Island in the shadow of Lady Liberty? Yup, the boats docked their first you got off, walked up to the guys yelling at you, spoke your name and got a piece of paper saying your american. Then you got off the island found a place to live and work, got cursed at spit on called lovely names like mic, wop beat up and just plain abused by the folks that thought they were the only ones to be here. Then you sucked it up, made some cash and went on with life and had kids. You cant believe our resource systems and how good they are so you dont mind paying for them. April 1 rolls around and the tax man comes by and collects, congradulations your a viable part of our society. Now your kids had it a little better and they went on with their lives and so on an so forth. Now lets take a look at today.. you run across a desert, or swim to shore, or walk through the woods find a place to settle down in. Its around a bunch of like minded and usually ethnic folks so you blend in. You get a job right away just by hanging out on a corner, or asking a friend, or by going to a gov office and asking for one. Some folks make fun of you and call you names too but generally nothing like the first immigrants. Then you start a family, have kids and get to enjoy our resources to their fullest extent all the while sending the money back home to let the rest of your family live better yet no taxes or anything paid to help offset the cost of using our resources. Sorry I dont see the comparison. You take but give nothing in return yet bitch about someone asking you to prove yourself? Sorry, Um hate to break it you but um your not a citizen thus are in no position to do so. Want to do that? Go back home, APPLY, and if your lucky and we say yes then by all means welcome to America. Sorry folks and everyone on this board if I offended you but I tried to make it as generic as possible and not limit it to just one type of person. These are my views, and soley mine. Ok back to taking my meds...... edited for spelling

doing a quick generic application shows a medic in NJ would pay $161.68. Its cheap to have my own defense and liscense protection in my honest opinion. Does your employer-provided insurance include license protection? In addition to being named in a malpractice lawsuit, one of the most serious risks that healthcare professionals face is the suspension or withdrawal of their license - without which you lose your ability to work. Employers rarely provide license protection, and in fact, are often the source of the complaint. With coverage through HPSO, you will be reimbursed for your defense of disciplinary charges and other covered expenses arising out of a covered incident

those scores must have been from teenagers doing it. I was 1.2 seconds slower and missed 28% more gates LOL That smoldering wreck in lane 2 was me BTW LOL In all honesty though. This is a HUGE problem now a days. I see WAY WAY WAY too many kids texting and driving, same goes for adults but they should know better anyways. I would LOVE to show kids in a drivers ed class some of the crash scenes we have been on and what the people look like afterwards. I actually had a Pt with the phone impailed in her shoulder!! Besides the steering wheel, ebrake lever, shifter handle and what was left of the windshield in various other parts of her anatomy. Would have been a perfect example for the teenagers to show the effects of a high speed collision. Might scare some of these kids straight actually. I know we bring actual vehicles to the schools once a year but it does not have the same effect on the kids as actual flesh and blood. Actually the flesh and blood might not work either, they are too damn numb to it from everything. maybe an autopsy might do the trick. Not one of those CSI, NCIS tv show autopsies but a real live MVA autopsy. Ok I'll go put my soap box away now and go back in the corner and take my meds

While not a medic I do carry an insurance policy due to the fact any wacko can sue a ham sandwich now a days. 3,000,000 dollar policy I pay 75 dollars a year HPSO