WolfmanHarris

I've considered buying one or two as christmas gifts. My plan is to act VERY enthusiastic when people open them so I can elicit that always funny fake/confused gratitude. "Oh... Wow. Thanks. This is great." At only $20.00 retail, why not?

I actually watched this one, my first one since the second episode. By the tail end I was thinking this would be the ep where everyone got fired and there'd be a new cast or something. My fiance was getting so pissed at my continued comments. She didn't even want to watch the show in the first place.

All of the hospitals we deal with have enclosed bays that can not be easily accessed by pt.'s. Even then keys are not left in trucks, though they may be left unlocked when parked in these areas. When things are busy and trucks are parked outside, they are kept locked. On scene, well we have that "anti-theft" switch for a reason.

Care to explain this? Specifically the bolded section.

Maybe their the fentanyl lollypops? Otherwise I've never heard of this. I'll pop it into pubmed, but I have my doubts. Edit: I'm surprised as heck to say this, but I found a reference to glucose as an analgesic. Will keep searching, but for now look in the results section of this abstract. Edit 2: Very interesting indeed. Take a look at this abstract. Makes me wonder what the underlying cause might be. My current off the cuff thinking is that the glucose plus pacifier technique has more to do with enhanced distraction than an actual relief of pain. Still useful though. The search continues. Edit 3: Clinical guidelines for glucose analgesia. Edit 4: Maybe I should save these up, but I keep intending to go out the door and google keeps distracting me with more tidbits. Apparently glucose does not act on opiate receptors, as naxolone does not affect it.Read here. Hypothesized in another study that the relationship between glucose and opiod receptors is indirect and that glucose may result in the release of endogenous opiods.

Any standards based on static, rather than dynamic loads aren't worth the paper their written on. I don't care how much weight my box can take on its side, I want to know how much force it can withstand safely in a collision. That reminds me, I should look up and read our provincial standards.

Couldn't resist. And btw, the website it's from is well worth the visit. Just promise not to post them here, I've got them saved up for the most inappropriate times. Very Demotivational - Matt

Glad you're doing okay! I'm not to fond of my back being the crumple zone in a side impact either, but if I can I still try to stay buckled. I just can't quite reach anything from the bench, which means that on the calls where I'm actually returning L&S, I'm more likely to be unbelted. Not a fan of that concept at all. Quoted for agreement. I secure everything, even when I'm not attending. I've had partners give me looks like I'm a nattering mother hen as I climb around the truck clipping bags in for them while they're doing pt. care. But then again I've also had RN's on stat IFT's protest when I told them to buckle up. Favorite moment: Me: "And you'll find your seatbelt just behind you there on the bench." RN: "Oh thanks I don't need it." Me: "I'm sorry but if you could buckle up in the truck please." RN: "I'm been in Ambulances for years, I don't need a seatbelt." Me: "Perhaps, but in the event of a collision you will be a projectile and I don't trust my dodging ability as much as you do. So buckle up." (Helps our P&P requires it)

We've been midazolam only for quite awhile. I would love to see the research posted though.

Odd... here the province provides 50% funding w/ the muncipalities providing the balance. Generally speaking trucks and stations are comparable service to service and pay varies, but are in the same ball park province wide. Equipment and vehicle standards are set by the province and trucks must be retired at a standard mileage (can't recall the exact number but where I work it results in no front line truck older then 2006; busy suburban service). Sure the rich suburban service where I work has newer bases and trucks then the rural service in the area I live, but the one service is also far busier and in a growing area and even the service where I live replaced their HQ only 5 years previous to meet increased demand and is building a new base in the N end to ensure coverage. While rural areas generally have smaller, less equipped hospitals, thanks to an integrated and fully provincially funded critical care transfer system, high acuity patients are transferred to regional facilities with top care as required, including into the United States if a closer bed isn't available immediately. I don't expect to convince anyone here to suddenly become a pinko pseudo commie like those of us in Canukistan, Oz, Europe or the UK. The attitude we take towards government and it's involvement (or not) in our lives is very much a product of our national cultures and our individual upbringing and political slant. However, let's not forget that things are done very differently in other parts of the world and there's much to be learned from both sides. I for one would love to see the USA provide full coverage to their citizenry and landed immigrants regardless of income. I'd also like to see our individual hospital and health regions adopt some of the management techniques of some of the best performing system in the states to increase efficiency. See we can see eye to eye on individual issues. Now don't y'all have the warm and fuzzies?

Akroze, my friend fell through and I'm trying to figure out if I can swing it. We could potentially car pool from my place in Ptbo and split the driving and hotel. I mean if you could slum it with a PCP and all. PM me if interested.

We've been doing that for a few years no with some good success. I'll type up our CVA bypass protocol later.

We don't necessarily spend a lot of time on scene unless warranted, but time at the hospital does tend to take awhile. If I don't include offload delay and I don't include my response/transport times when I'm working the more rural stations (45min transport time) I'd say it takes an hour to ninety minutes from call received by dispatch to arrive hospital, plus triage and transfer time of about 30mins (avg pt. doesn't include criticals) and once offloaded about half an hour to get reporting done, reset the truck and get back on the road. However, once our stretcher is clear, we're considered available. We just don't leave the hospital until the ACR is printed and submitted to staff there. Edit: Just flipped through my note book. My last few calls as a snapshot: 13 min scene time, 0 transport, 0 turn-around (MVC sign off) 24 min scene time, 11 min transport, 40 min turnaround (CTAS 4 chronic lumbar pain) 16 min scene time, 1 min transport, 25 min turnaround (CTAS 2 ETOH/psych crisis) 69 min scene time, 27 min transport, turnaround not recorded (CTAS 3; thrown from horse, long extrication to truck) 59 min scene time, 0 transport, 0 turn-around (Emotional crisis, hand off to mental health team) 37 min scene time, 0 transport, 0 turn-around (Sudden onset headache, resolved, pt refused) 9 min scene time, 16 min transport, ~2.5 hr turnaround (CTAS 3 near syncope, general weakness) Offload Delay

Jeez triage and reporting takes more then ten minutes for me. Heck even properly packaging the pt., securing all equipment in the back and the like takes a couple of minutes. A good decon and repacking the monitor and bags a good ten minutes. Charting for us takes me over half an hour on a complicated call. Maybe the times the wheels are rolling equals ten minutes but that's it. (Oh and of course offload delay, but I think that's a uniquely Ontario thing sometimes.)

I don't think a true and thorough discussion of the causes of World War 1 or 2 or the entry of the United States into either is possible or likely on these pages and I won't try. I would like to, however, spend a moment on the HMS Hood. HMS Hood's destruction (if I recall correctly) was a product of a chain reaction caused by the lack of flash proof shutters separating the various compartments of the turret, gun lobby, handling room and magazine from each other thus controlling chain reactions. Bismark did not have this problem due to a peacetime training incident that resulted in a similar catastrophic destruction of a German vessel and allowed them to retrofit their designs early. To the best of my recollection, the explosion of HMS Hood was what lead to the wide spread adoption of these flash shutters in other allied naval designs. Either way I'd hardly call a previously unknown design flaw a mistake. Certainly not in the same calibre as the other, much larger missteps made by both sides during the course of the War. Honestly if we leave aside the excesses of the Nazi party and the Holocaust, both of which were largely unknown publicly, and neither of which was a motivating factor for the leaders of the allies before or during the war, we have little choice but to accept that propaganda value aside, WWII had little to do with defeating evil or defending freedom and is instead a continuation of the poorly settled political issues of the first world war. And of course the First World War had more to do with arms races and old school imperialism than it did Arch Duke Ferdinand. This isn't meant to diminish the extreme evil of the Holocaust, the mistreatment of prisoners, or the other evil deeds of the Nazis under Hitler, but instead to remind us that hindsight is 20-20 and how we view the war now does not necessarily represent the motivations of the various world leaders at that time. This is also more productive then actually engaging with sansbacon. Now who want's to watch "Band of Brothers" or "The Devil's Brigade?"

Found the explanation. They're a volunteer department. No jobs to protect. http://circlevillefire.com/

To my knowledge my service has had two collisions with another vehicle in four years. The second was last week (no serious injuries; can't speak to other details). There would literally be no way to compare the affect of any piece of equipment to crash rates. In fact based on numbers, our consultation with Dr. Levick and the changes that resulted in livery here resulted in a 100% increase in collisions from 2008. Coincidence does not equal correlation. And jeez how many wrecks does this service have?! On a side note, we're likely getting the growler on our trucks starting next year.

Best news there, TNT picking up "Southland"

I missed mine. Call for syncopal episode shortly after 10:00, took me right past 11:00.

In the spirit of the day I would like to humbly and respectfully request that all members respect a moment of silence (if the job makes that possible) fro 1100 to 1102 today. I would also ask that members consider staying off the city for the 11th hour today (as per the site's clock) and for the 11th hour wherever you are. The reasons should be clear to everyone. If not see Squint's thread for a reminder. "In flanders fields the poppies grow, between the crosses row on row. And mark the place, while in the sky, The lark, still bravely singing flies, Scarce heard amidst the guns below. We are the dead, short days ago, We lived felt dawn saw sunset glow. Loved and were loved and now we lie, in Flanders fields. So take up the quarrel with the foe, To you with failing hands we throw, The torch; hold it high. For if you break faith with us who died, We shall not sleep, though poppies grow, In Flanders field." Lest we forget.

I know a clinical trial being conducted on it in Toronto was recently ended having found that while it increased ROSC it did not have any affect on long term outcome. A quick search of the forum should find the link. (I'm on my phone atm and it's impossible to multi-task on it to find the link.)

You know vs-eh, everytime I start to get really really frustrated over those sorts of things I get a call like this: Code 4 (L&S) for a 78y/o F who had a fall. Downgraded to Code 3 while on route and call attended by ACP in response unit (really low car count at that point due to calls and we were coming from far out). Arrived to find a nice old lady surrounded by what I thought was family and neighbours sitting under a blanket in a folding chair. Minor wrist injury, small bump on the head and the usual embarrassment my elderly Italian pt's seem to have over putting people out. As we were working her to the truck I turned to talk to the family and learned that this crowd of people were actually just bystanders who stopped to help. One gentleman had gone into his house for the chair and blanket for the lady and stayed with her until we transported. She didn't even live on the street and had just been out for a stroll when she tripped over the sidewalk crack. Another call two weeks before: Code 4 for suspected CVA while behind the wheel. 45y/o M suffered sudden onset hemiparalysis, aphasia and AMS while driving. Wife managed to guide him to a stop and put it in park without careening off the road. Car behind stopped to help, called 911, stayed on scene until we were ready to leave and then one of the people volunteered to drive their car with the wife and son to the hospital for them (she was understandably distressed) and his wife drove their car. As a stroke bypass this would have been more than an hour detour for this helpful couple. Finally: When my grandfather suffered an SCA last year a bystander called 911, stayed with him and helped an RN who happened by with CPR until EMS arrived. He has survived neurologically intact and independent. I managed to meet the crew involved and thank them personally as well as the dispatchers, but in the shuffle these bystanders names and contact were never recorded. I know the majority of the time we'll still get the hands-off 3rd party caller crap, but one or two of the exceptions every so often helps you keep the faith in your fellow person.

Ya seems odd. If anything I do more 12 leads then some people I work with. The 12 or 15 lead is often my peace of mind to ensure I'm not seeing an atypical presentation MI. Especially with some of the populations I run into. (It's getting to the point that I'm willing to bet partners that a 40-50y/o M of Indian/Pakistani descent c/o abdo discomfort and general malaise is having an AMI.)

On a long enough timeline though an active poster should see these incidental negative average out and not drastically affect their rating. A new member or a less active one will see more variation but will stay in the neutral category (where I'd imagine the majority of membership will always be). A negative on an individual post, is not in my mind a big deal (really, it's a forum; what is a big deal?) it's just a single persons expression of disagreement, disgust, anger, etc. That single point speaks more to the person giving it then the poster. When these come together and form a positive or negative reputation, then it actually reflects on the member and their relationship with the board.

ALS in my region works in one of three ways - ALS truck (ACP/PCP Crew staffing a transport ambulance) - ACP Superintendent (can self-dispatch but usually 90% of their job is administrative) - ACP Paramedic Response Unit; there are between three and six of these trucks on at a time during peak hours spread around the region. They self-dispatch and redeploy to help bump up resources on large calls, cover busy areas, first respond and can provide ALS intercept when a regular ALS truck isn't available. These ACP do not always transport though. I had a difficult extrication from a horse trail yesterday and requested ACP attend for pain management. He arrived, took report verified necessary info with the pt. gave 50mcg fentanyl and then hung around until we cleared the scene and we were sure we didn't need anything else from him. The PRU are recognized and meant to be a stopgap though and are not meant to replace regular trucks. A PRU will be downstaffed to keep a regular ACP truck online.