Dustdevil

Since they are referred to as EMTs, it's hard to determine what their level of training actually is. But in MD, it's a moot point. They all suck. Just to reiterate the obvious, I notice it was -- as always -- a FIRE department.

I do, and they know it. That's why they're poisoning my food.

Totally NOT what I thought this thread was going to be about.

Hey, why not? So long as strict educational standards, with annual recertification, are maintained, I see no downside to it. And just think of all the jobs the new regulatory bureaucracy would create!

Quoted for profundity. This is exactly what gets most personnel injured. And it's why the whole idea of putting on a vest when you think you'll need it is so retarded.

I wonder if they are disturbed that the doctors are carrying weapons, or because the doctors need to carry weapons?

Not sure what the answer is, but in previous discussions here we have established that SFFD doesn't actually use Medtec ambulances.

Yep. We've discussed this before. If you think you're in a situation where you might be shot at, the answer is to not enter. Putting on a vest and going in anyhow is a recipe for epic fail. Nothing is more dangerous than a false sense of security.

Yeah, the whole III vs. IIIa thing gets confusing. IIIa will take a glancing or long distance blow from both 5.56 and 7.62 in a lot of cases, but it certainly is not rated for that. I believe IIIa is only up to 9mm SMG rounds. I've seen them take some pretty impressive punishment though! Unfortunately, most guys are no longer wearing a helmet by the time I saw them, so I couldn't get a good look at many of them.

Exactly. Excellent summation. I've seen a couple cases of this in my day, and it's not pretty. You'll never forget the smell of Gangrene once you've experienced it. The first patient I ever had with this did indeed die from sepsis. I actually had one of these patients in Iraq. Some medic missed the diagnosis on the first visit because he didn't want to do a proper exam. A week later, the guy comes in febrile and tachy and I immediately knew what was going on, before I even looked. Gangrene is bad enough on an otherwise healthy person. When you pile it on top of the multiple conditions this guy is sporting, it becomes a nightmare to manage. All of the normal supportive care you would give this guy has to be very carefully considered in light of the pre-existing conditions. And yeah, I thought about the APAP situation there. Not good for the liver, which is already in trouble.

I think the misspelling of your screen name is the only reason there is some reservation about your identity here. Regardless, whoEVER is posting this, I have big respect for. This is almost Fiznat-esque, the way you man-up to your misjudgements and move forward in a positive way. I'd hire you based on that, regardless of this unfortunate incident. I appreciate you coming here, Man. I hope you will continue to visit us and contribute. Best of luck, and sorry about your troubles.

I think you are better off admitting neither of them, if it comes to a legal situation. If you have no training, and your employer did not ensure that you were adequately trained and prepared, then you lose all liability, and it all goes to your employer. But once you are "certified", you are now the one responsible for intelligent, safe, and competent use of the skills you were taught. Like CrapMagnet and FireMedic65, I have a lot of years in the martial arts, with a belt and a few certificates and trophies to show for it. But you won't see me mouthing off about it in a legal deposition. You don't want to say anything that changes your status from victim to aggressor in the minds of the legal system or jury.

Scrotal abscess progressed to that level is bad news. Potentially fatal. The guy's pre-existing conditions are going to seriously complicate his treatment and recovery. At least he was admitted before circulatory collapse, which is the only good news here. He's still facing a long road in the ICU.

MICH and ACH (and LWH also) are all rated Level IIIa.

Pics or GTFO!

There is an exception for military personnel. Solution: Get her to join the National Guard. Not only will they help pay for her college, as well as giving her some valuable career training and life experience, but she'll then be eligible for a CHL.

You're kidding, right? Decades of martial arts practice -- literally devoting a lifetime to it -- is less worthy than a one day merit-badge for a few moves that you will never commit to muscle memory? Nigga puhleeze. The problem with so-called self-defence training is the same problem that exists with EMS training. People think that a short time spent learning a few "skills" is an education. It isn't. It's just enough to get you or someone else really badly hurt. Most every self-defence seminar I have ever seen was a total waste of time, and was sometimes even counterproductive. I don't care how awesome the instructor is, you cannot teach anything of long term use in 8 hours.

I think that's a great observation. It is indeed a very common factor in US EMS. The original medics in the US were founded on the concept of being the so-called "eyes and hands of the physician". That mindset has persisted all these years, just below the surface. Way too many medics have never been forced to step outside of their flowchart protocols and use their heads to think for themselves. They are still living the "eyes and hands" life from the 1970s. And honestly, that's probably a good thing in most of the country. Besides Dwayne's obvious aptitude for the practice, he was also blessed with a rookie gig that gave him a lot of rope and let him develop in a very independent, sink or swim atmosphere, where he quickly realised the value of critical thinking. There is no better place than Iraq to quickly realise the difference between the medical professionals and the protocol monkeys.

Damn! People didn't seem that depressed when I was in Japan. When I was in boot camp a million years ago, we had some nimrods mix ammonia and bleach together in an attempt to create a super cleaner to prepare for barracks inspection. The result was predictable. Although nobody died, it did result in new regulations that basically replaced all the cleaning chemicals with non-toxic crap that didn't really do the job. I've run my share of calls over the years where housewives did the same thing and ended up pretty sick. Never made an intentional suicide attempt from this though. I guess I retired just in time.

Dwayne, I could not be prouder of you if you were my own son. Watching you transition from the hopeful student into the consummate professional has truly been one of the most satisfying experiences in the last few years of my life. If we could somehow bottle your critical thinking skills, we could create a master race of medics that would ensure the rapid progression of our profession. When I precept or mentor a new medic, there is one concept that I stress above all others. That is to think critically and thoroughly evaluate EVERYTHING you do. Don't make a single move that you have not thought through. Don't do something just because that's how everyone else does it. Don't do something just because it's the easiest or fastest way. Don't do it just because it's the way you've always done it. Don't even do something just because it's the way you were taught in school, until you have thoroughly evaluated it from every angle and convinced yourself that it is the BEST way to do it. Everything from patient care, to how you drive, to how you chart, to how you make up your cot, to how you study, dress, and relate to your partner should be given that same level of consideration. The skill of thinking critically like that cannot be taught. It can only be stimulated. But some people simply cannot do it, no matter how hard they try. They still get by for a full career without killing too many people. And on the surface, they look as good as any other medic (or nurse, or doctor). But there is a clear and palpable difference. Dwayne just demonstrated that difference for us. And it is the very foundation of professionalism.

TM temps are notoriously inaccurate. But if one says the patient has a fever, you can bet that he does. And it's probably greater than the reading, so this patient definitely has some septic process going on. That jibes with the elevated heart rate, despite dig. The BP is a wild card because of the pre-existing HTN and concurrent antihypertensive therapy. This scenario is an excellent learning opportunity! Patients with multiple pre-existing issues going on always complicate the picture. Sure, you can just transport them all and let the ER sort them out. That's what the vast majority of EMS personnel will do, and that's a shame. But to me, the most exciting part of medical practice is the diagnostic process. And considering that probably 90 percent of all runs you make will not be snot-slinging trauma runs or full-arrests, if you don't also enjoy the challenge of the so-called "routine:" patients, you're going to burn out really quick.

^ Seriously not recommended.

Word. Hopefully their loss will further the cause of aeromedical safety. Fly high, Brothers and Sisters.

Another service turned this run down due to weather. That is not going to bode well for the pilot's culpability here.