Dustdevil

Unfortunately, alcohol doesn't linger in the system long enough to really test for routinely. Otherwise, I'd have no problem with it. Although, some of us need alcohol to get laid. You start talking about affecting my sex life and we're going to have a problem! 8) Most smokers can't control their habit, and simply don't have the self discipline to make it through twelve-plus hours without a butt. That means they'll be sneaking out the back door, on the clock, to suck a fag. Or stewing in their own stench as they smoke half a pack in their car on the way to work. Twenty percent of American society imposing their habit on the other 80 percent simply isn't going to fly much longer, and now we are seeing the results of the majority fighting back. Enjoy them while you can!

This is almost identical to the scenario we got in a continuing ed discussion by e-mail a couple weeks ago. Must be something going around. :?

We've been asking for just that ever since the topic began. A paediatric seizure patient -- even if not actively seizing -- is not stable in this sense. Extremely poor judgement. And, the story said nothing about them being "flagged down." As I said before, this means that FDNY policy sucks arse, which I suspected to begin with. And, of course, since he was just following orders, it is even further proof that there was nothing "heroic" about it. He stumbled onto a guy with a gun through his own dumb luck and ran like a bitch. Not my definition of a hero. Had that been my wife and daughter in back, I'd be looking to shoot this guy too! He had absolutely no right to place them in danger like that. None. And I'd like to see the timeline on this from the dispatch tapes. How long did it take to finally get their patient to the hospital from when they started the transport? Way too farking long, I can tell you that much! And for what? Stupid whackerism, plain and simple.

You've got to be kidding. This same topic comes up here and on other forums all the time, and the response is always the same. I can't speak for what A.J. Heightman would be saying about the incident in JEMS, and I don't really care. That is why JEMS is irrelevant in EMS. But you can't seriously believe that the media would fault anybody for not abandoning a sick child to go check on a fender bender. And yes, it was just a fender bender. If he was well enough to shoot it out with the cops, he obviously did not require “aid” that took priority over the child, which is proof positive that the stop was unnecessary and the wrong thing to do. Who is "new to the profession?" Certainly not this guy. He's a paramedic and working for FDNY. We constantly hear here about how wonderful FDNY's "academy" is, so I am going to have to say this guy should have sufficient experience and training to be making sound field decisions, or they wouldn't have cut him loose as a medic. This is why we have SOPs. This is not a decision that anybody needs to be making on the fly. This isn't a patient dependent situation. This is a cut and dried operational scenario that should be clearly addressed both verbally and in writing from day one so that there is never any question in any employee's mind as to what the appropriate course of action is. This guy took the wrong one. The only question left is whether or not he violated policy by doing so. Violating policy and putting your partners and patients at risk isn't a mistake. It is at the very least, a display of very poor judgement. At worst, it is a violation of policy. You can't just write these off as "oh well" mistakes. They have to be addressed to prevent recurrence before somebody is killed.

Can you scan it and post the pics? I'm interested to know what's on the pages. I find it a bit strange that the ad doesn't say anything about the content of the pages. I mean really, wtf can be on all those pages that you can't live without? Seems to me that anybody who would buy it without even knowing what's in it is buying it strictly on whacker appeal. I'd say anybody who needs a checklist just to get them through a patient assessment isn't ready for the field yet. They don't need a checklist. They need more education and an internship.

No kidding! That's the first thing that struck me about this article! That's just how clueless JEMS is. That's why you can never get anything of substance out of JEMS. They exist only to feed into the whacker element. A.J. Heightman is an idiot. WTF is so heroic about throwing your partners and patients into a dangerous situation through your own stupidity, and then running like a little bitch when the $hit hits the fan? Heroic? Had Dutton kept right on driving, like he should have, there would never have been any need for his "heroics." FDNY is not a little mom & pop transfer service. It's the biggest EMS provider in the U.S. They have policies addressing everything. What is their policy on this? If their policy is to not stop, then Dutton needs to be fired. If their policy is to stop, then they need to change it. If they have no policy, then heads need to start rolling from the top down, and hopefully Dutton has learned a lesson from this. But I doubt it. All this hero worship BS has just reinforced his bad judgement, and probably strengthened his resolve to be an even bigger whacker in the future. Where the heck is Asys when you need him? I bet he'd like to bitch slap this guy.

Wow... I have to admit that when I read the topic title, I expected you to be the problem, and not the "slow" guy. I like my partner to chill out and pace himself, doing things in a deliberate and non-rushed manner. But dude... lethargic apathy is completely unacceptable. I wonder what this guy's previous experience was. Anyhow, it sounds like he's just a typical transfer jockey burnout. Probably never worked EMS in his life, and is used to being nothing but a taxi driver, so he doesn't give a crap. Sounds like this is about as much effort as he is willing to give for whatever money he is making to be a taxi driver and babysitter. I wouldn't tolerate it. But if management is putting you in a position to precept these guys, you need to have an understanding from the get-go about what is expected of you. Do they want you to shape this guy up and cut him loose? Do they want you to just observe him and report to them? Or is spending a shift with you just a formality, and he will be cut loose no matter what since, let's face it, transfer work isn't rocket surgery. Once you know what management is expecting of you, then you can respond appropriately. In fact, that is how I would begin my report to management. Ask them the above questions. They are going to know from you asking that, that you have some concerns. When they ask you for those concerns, that is your opening to spill it honestly. And completely, as it sounds like this guy has a laundry list of faults. Just be careful how you word things. Comments like "I wouldn't want to work with him at this point" are a lot better taken than ultimatums like, "I won't work with this guy." You want to maintain the trust they have in you to be objective. Good luck!

Completely disagree. Both rides should be identical. I don't want you stressing me out with your driving at any time, no matter where we are headed. It's all about consistency. Same ride at all times. That way it is instinct, and not a specific effort you have to make at specific times. There is no decision to make about "how do I drive now?" You will get the same quality ride anytime I am behind the wheel, and I expect the same out of you or you are history.

The codes are the easiest patients you will have. Simple algorhytmic protocols run from memory. It's the ones you are trying to keep from coding that will kick your arse. :wink:

Ya know, I had always heard that medic education in SA was pretty good. I'm a little surprised that, with your obvious inability to differentiate between a voluntary habit and a biological imperative, you were able to pass. :wink: But while we're tossing out absurdities, I'd like to mention that I would be very interested in working for an employer who banned menstruation in the workplace.

I LOVE this idea! This should be REQUIRED policy for all questions asked here, unless posed in a scenario! It forces us to exercise our own critical thinking skills, as well as doing some basic research on every question we ask, and then put ourselves "out there" for review and critique. Those are three crucial steps for self-improvement! Plus 10! :thumbright:

I think we should have a tobacco-free forum here where only non-smokers can post.

I can't get any of the links on that page to open up for me. I'd like to see exactly what is on the pages. Maybe the pages are just so awesomely laid out that there is some merit to this idea. To me it looks like one of those things that looks cool and is great on paper, but would quickly find itself in the junk closet at the station. Trust me, wearing things strapped to your leg is a pain in the arse and gets really old really fast. You definitely won't to do it all the time. And you won't take the time to put it on while enroute on a run. Guys out here are dumping their thigh holsters as soon as they can get a belt holster sent from home for that very reason. And how often do you really write a lot about your patient while performing care? Vital signs and a few Rx drugs maybe? The 3 inch tape is more than sufficient for that. And any more than that you'd write directly on your PCR anyhow, cuz only an idiot would want to write everything twice. Besides, if you're writing that much, you're probably either sitting in the ambulance, where a clipboard is more convenient, or standing on a scene, where you can't write on your knee. Even in an MCI I can't see any application for this. The triage officer is going to be standing with a clipboard, not sitting on his arse somewhere to write on his knee. Not impressed.

Meh... it's a fair and relevant question. I can't say I've ever seen this specifically addressed here. On the other hand, I do like MedicRN's approach. Think it through for yourself. Formulate an opinion. Then toss it out for discussion. Test yourself!

Time for a few more photos... A couple pics of my Iraqi Interpreter and I The beautiful Euphrates River, also known as the Eufeces River Another nurse I work with trying to teach the Iraqis to suture In front of the Iraqi hospital In my office Yes, that's a tactical black Littmann Master Cardiology. Don't be hatin'! And finally, the business side of my office

Excellent! Congratulations, and plus 5 for the positive attitude. Thanks for your contributions to the City. :thumbright:

Hey Daniel... I would stick with the CLS bag, or maybe 2 of them if you want to travel heavy. If you get a STOMP II or London Bridge bag, you'll probably stop carrying it after the first few weeks. It's just heavy and bulky to be taking up space in your Hummer. All the vehicles are now given a bag (I forget the name) that carries the collapsing field stretcher in the main compartment, and has outside compartments for medical supplies. Looks like a big backpack. I'd say just use that and keep it well outfitted yourself, then just put your personal stuff in the CLS bag. I wouldn't worry about acquiring anything stateside. Once you get here, just hit the closest BAS and grab a bag full of Israeli dressings, Asherman Chest Seals, HemCon dresssings or Celox pouches, and some new IV setups, airways, and CAT tourniquets. Big fat rolls of Kerlix are important for wound packing under the Izzy dressings, as well as for clearing out wounds before Celox or Quick Clot application. Not sure what the Army is doing for IFAKs now since I am assigned to the Marines now, but our IFAKs each have 2 Izzys, 2 Kerlix, 2 HemCons, a CAT, 2 triangulars, a Water Gel dressing, and Band Aids. If your guys each have something like that on their IBA, you'll find you won't need to carry much of your own in the field. About the only time I need my bag is for advanced stuff, prolonged care, injured on the FOB, and for Army guys who aren't good about carrying their own IFAK. Of course, don't forget the routine stuff like tweezers, assorted bandaids, ibuprofen, eye wash, antiseptic wipes, etc... for the minor boo boos. A lot of guys tend to forget about that. I'm going to try and get those photos reloaded to the earlier posts later today. Good luck! Look me up if you make it to Anbar Province.

That's it in a nutshell. The regulatory centre in the hypothalamus becomes unstable, resulting in several mechanisms becoming unreliable, including the kidneys and the ability to sweat. There is a common misconception that the reason heatstroke patients don't sweat is because they are dehydrated. This is only partially true, and only in exertional heatstroke patients. In most classic heatstroke cases, the patient is not dehydrated from sweating out. The body is simply not being told to sweat by the thermoregulation centre. This dysfunction can continue for weeks or a lifetime. And those with a history of heatstroke should be given follow-up testing at regular intervals to monitor this. Excellent question! I love it when somebody wants to know why something actually happens, instead of just accepting factoids without explanation! :thumbright:

Uhhh... you do realise that YOU are the reason that an EMT cannot make a living wage, right? :? You just said that you give it away for free. So why exactly would anybody think that is worth paying for? Do the math. :wink:

Ah! Now it seems so clear, I don't know how I missed it before! They turned up the lights really bright, which caused her to start photosynthesizing. That threw off her whole Krebs cycle, resulting in hyperglycaemia and lactic acidosis, which threw her over the edge into renal failure.

Only whackers know that. Your average old lady doesn't.

Not half as much as it sucks having a basic for a partner. :wink: And seriously... I hope you were joking with statement #5. :shock:

Pardon the fuzzy photos, but... EYE DROPS Note the word "Ophthalmic" and the large eye on the package. EAR DROPS Note words "Otic" and "FOR USE IN THE EARS ONLY," as well as the large ear on the package. Of course, problems exist. 1. They both have the Bausch & Lomb label, which most people automatically associate with eye products. 2. There is no eye or ear picture on the bottles themselves. 3. The printing on the labels on the bottles is extremely small, making it impossible to read if you have an eye problem, which is quite probable if you are using this product. This is the same reason that most companies stopped making all pre-filled cardiac meds in similar coloured boxes. Brainiac firemonkey medics were giving Lidocaine to hypoglycaemics and killing them. You'd think Bausch & Lomb would have gotten a clue by now and come up with a better plan.

Hey, I'm not bashing you. We all did it. I was a rookie once too. I took every opportunity to bomb intersections and drive like an arse, not just because it was "cool," but because when my patient was circling the drain, I was in a hurry to unload him off of my hands. It's a natural instinct. It's damn scary being "the one" who is in charge of that patient's life for the next ten minutes with so very little to work with. But with experience, you mellow out a little bit. You learn to do the best you can with what you have. And you see enough patients that you realise that you realise that those few minutes you might save simply do not make a difference to the patient's outcome. I won't lie to you and say that I grew out of that very quickly myself. I'm just trying to let you know earlier than I did that this is not the best way to go. The best thing you can do for your patient is not to drive faster, but to be a better medic.