cosgrojo

How is it that a Bash Dust thread starts and it turns into a love-fest? Mr. Devil, You have truly scared everybody in this forum silly. Kudos on the accomplishment, but I don't like seeing everyone agree with you all the time. Because honestly there are times when you have holes in your arguments... occasionally gaping holes. Either the majority of posters here lack the ability for individual thought and analysis, or they are afraid of you. And that is just silly, because none of this is real... Nobody is 100% right all the time. And Dust is the first to tell people he has gotten housed a few times on arguments. So what I'm saying here people... don't kowtow to anyone! Stand up for yourself... just do it intelligently, or prepare to be dusted. As for me... I'm always ready. :wink:

I can handle gross. :wink:

BLS before ALS.... (I'm only doing this because I haven't the foggiest idea what "plotzing" is... and I'm very curious to witness it.

Timmy, in the U.S. you wouldn't be let near an ambulance because you are 17 y/o, not because of your training. I have garnered that there are systems of EMS in other parts of the world that are superior in many aspects over ours. But honestly... I think you are putting a little too much emphasis on 911 (or 000) calls. *about to break out a cliche here* Some of the worst calls I've done have been on transfer rigs. If you want to feel like you aren't ready because of your education.. fine.. congrats on trying to better yourself. But don't make the mistake of assuming that bad calls only happen when a response is requested. My partner and I did a return trip for a guy that had a wheel-chair van ordered for him. Walky-talky and all that. My company didn't have any w/c's available so sent our ambulance to take them back. En route he goes gray and clutches his chest. Quick work-up, turns out he is throwing multi-focal PVC's. He has no cardiac hx, so by definition they are malignant. This was supposed to be a wheel chair call. You never know what is going to be thrown at you, be prepared ALL the time. If you are afraid of being on an ambulance... than you should probably be afraid of band-aid patrol as well, because it can happen to you there as well. At least if you are on the ambulance, you can get the pt towards definitive care. EMS is not that complicated, you don't need to have the education of a thoracic surgeon. I would never sit here and say that a good medic is worse than an EMT I or B. That is hogswollop. But in my experiences there are just as many bad Paramedics out there as there are bad Basics. The difference is that medics have more things to hurt the pt with. Absolutely, you give me a choice between a good basic and a good medic, I take the medic. But I'll take the good basic over the bad medic any day of the week. This is not a ALS vs. BLS thing, I just want the guy/girl that is GOOD at their job, not bad at it. So maybe that's the answer for me... If you are good at your job(whatever that level is), then let's rock and roll... if you stink at it, get the heck away from me, my ambulance, and my patient. 8)

DD- is this a cry for help? Are you trying to tell us you are a champagne alcoholic? :shock: If this isn't funny, I apologize, it made me chuckle.

Maybe people with ADHD shouldn't be allowed to post on this forum.... :violent2: Since you are new to these forums, I will not expect you to have read every other post on this site. This has been pretty thoroughly fleshed out, and I dare say we haven't gotten anywhere with it. If you would like to bash ALS (which is funny, because I think you are ALS), you may join spenac in one of his many bash the (fill in the blank) threads. If it is about education, than make it about that. If you want to be a part of these posts. Take your time and think out your ideas first... and don't bash people's spell-checking unless your s%#t is clean. :wink:

whit. relax... joke... stop taking this so seriously. :wink:

Honestly Whit, you need to know... I laughed for 5 minutes after I read this... pricelessly funny.

My father always told me there are no stupid questions... only stupid people. I don't know why he kept telling me this after I asked questions... But I digress... Your observations are spot on. Any good provider is able to learn in ALL situations. Sometimes you are learning what to do, others what not to do. Listen to what Dust and Whit are saying on this one. Be careful who you emulate. Try to find someone who doesn't seem to mind answering questions. As a general rule, if they don't want to answer you, it's probably because they don't know the answer. This job is like putting together a puzzle. You start off by putting the edges up first (protocols), and then work on putting the rest of it in until you have a clear picture.

Yes, short essay is perfect. Punctuation and grammar count (this is going to be college level stuff here). Answers must contain well-thought out ideas with as much supportive data as possible (depending on topic). And all answers will be graded by your peers... wait a minute... that's not a good idea... RESET: And all answers will be graded by Admin, Ridryder, & AKflight. To ensure impartiality. Cuz' lets be honest... if DD is grading, everyone fails... If I grade, no one will understand my grading system, and I won't post grades for several days. If It2ker grades, everyone gets an A (why is she always so darn happy?) If whit72 is grading, he'll just agree with Dust in the end after attempting to put up a fight. If Aussery1 is grading everone will get a grade of "Q", and no one will have the foggiest idea what is going on. If Timmy is grading, no matter what the grade we all end up at Chuck-E-Cheese. And spenac will just start a thread about bashing the grading system altogether.

Drills and mock-disasters would be the best way to keep sharp. But un-fortunately they take up money, and sometimes may not be approved for training. One thing that we do at my place of employment (btw it was started by employees, not the company) is come up with a topic of the week and encourage people to participate in answering the questions. There is a point system set up for the varying difficulty of the scenario, and at the end of a 3-month span, the employee with the highest point total gets a 50 dollar gift certificate somewhere. We are having decent success with participation, and we find people are discussing EMS and situational medicine a lot more than normal while at work. Good luck!

EMTCITY pop-quiz forum? Excellent idea! Are you listening ADMIN?

You don't get to be Chief Executive Officer of Mickey Dee's without being tough. :wink:

Yes. Then you must summarize them and provide useful bullet points for all of us.

Uhh.. no problemo... but I clearly stated that the thread was started with Dust's consent (in fact it was the very first line of the original post). It is quite possible I confused people with my incredible grasp of vocaboolaree. I apologize for my sesquipedalian proclivities.

"I haven't called 911 in 2 days! I must be getting better... right?" No, and if you breathe through the O2 tubing in your NOSE you may be able to breathe better. "I'm scared you are going to drop me!" They don't pay me for my good looks dear... I throw that in for free. :wink: EMT: "Are you in any pain?" PT: "None at all." EMT: "Do you have any chest pain? PT: "Yes, it hurts bad." :x "Does my cell phone work in this ambulance?" No, we are too close to the airport.

Don't think I don't know who holds my protocols in their hands... :wink:

I'm voting for whoever has an MD at the end of his/her name.

If anything, this letter probably reminded a couple of frequent fliers that they haven't dialed 911 in a while... boy those hospital meals are tasty!

Your pony is getting tired.

No arguement here... but I think that maybe the overriding issue is that they promise ALS on every responding rig, and they don't want to appear as if they are not giving what their promise is. Regardless of what the outcome is. Just think it may be a tad dangerous for the patients. BTW... where you been man?

Two words.... Stale urine. *cringing just thinking about it*

Thank you for bringing something new the the conversation. Ground transport for non-emergent transfers is extremely important. I would also add that ALS transfer busses need to be staffed for patients being transferred to a higher level of care or to specialists (you may have mentioned that... and if you did, I apologize). And the need for an available critical care unit is also a component of any "perfect" system. Question: If you have a run of calls and all of your primary response units are occupied, do you call on an available transfer bus, or call on the mutual aid system? I ask because there is a private company in my area that prides itself on having ALS on every rig, and if a 911 call comes in and they have nobody but a BLS rig, they will call another company (or activate mutual aid) to do the call (even if the other service has no ALS). How do you feel about that? Is it cutting of your nose to spite your face... or is it building up a brand name?

Agreed, I see this all the time. Most departments is my area are volly squads that are lucky to have a paramedic but usually have some sort of intermediate semi-available. Luckily there is a local resource hospital that has it's own intercept service that can provide ALS when needed (with a really good group of competant medics). The problem is that is one truck that is responsible for somewhere around10-16 townships... a lot of area to cover with response times sometimes in the 30-40 minutes. The burden for this service is so great that they are trying to go out of their way to help the local municipalities set up ALS guidelines and training for their people. It's a seemingly slow process, considering most municipalities don't want to foot the bill for these things.

I agree with rid. If you start questioning the scarcity and needs of these things, you are making some very slippery decisions. In a civilized culture, with the relative affluence that we enjoy in this country, withholding blood products based on age and efficacy of outcome raises some pretty scary societal implications.