AnthonyM83

Might such a philosophy cause larger damage to the population's overall health if people are scared to call for medics in emergencies or delay on it until a problem gets really bad (not just drugs, but also immigration issues or at college parties were underage drinking was present, and so on).

Nah...cause during training scenarios you put out fake calls on the radio too, but it's not actually reporting a crime b/c the person receiving the report has been told it's not real beforehand. --break-- Oh, and it wasn't even a meth lab, right? It was just possession for distribution.

I wouldn't rank prossession of meth (which a local PD could make several arrests per day on) up there with murder and rape which causes immediate devastation to the victim and family. Also a murderer, rapist, kidnapper or others of that sort are much more of an immediate threat to the community, while meth is a slower process. I would probably worry about other things like drunk drivers, pedophiles, or domestic violence, even major meth labs before simple street level possession. They're all major in that they're felonies (except first offense DUI) and that they're bad dangerous things, but when drawing a distinction between what might justify using an ambulance as concealment, I rank it on the low side...relatively.

I don't like that idea. MAYBE if they were trying to make an arrest for something really major like a murderer, rapist, or a hostage situation, but not for drugs. You don't want people getting a fear-association with EMS workers.

THAT we do see around here. I've even been at an accident that resulted from people taking the passing ambulance as an opportunity to pass cars.

I'm not writing as someone who's been employed in the field in EMS (b/c I haven't), but in the jobs/agencies I work for, I always look at the social aspect of the job. Does it seem like I'd really like my co-workers or the people/clients I'll be working for? I need to have people I like surrounding me...even if the employer is crappy, we can still b**ch about how crappy our supplies are or about the boss. The people I'm around seem to decide (long-term) what my overall attitude about my job is. The other is feeling like I'm really DOING something...be it helping people or getting important tasks done.

I didn't know that was legal in ANY place, unless they were specifically being given an escort...but following an ambulance on an emergency run is not an escort. EDIT/ADD: You can't break traffic rules just because the ambulance in front of you is doing it. Even following it within a certain distance without speeding or running lights is illegal I think.

That's really great Shozzy. I wish we could such programs all over. There might also be use in having another program when they hit 11th grade for reinforcement. I bet you could lower the alcohol related trauma in the older kids as well. As someone who just finished school, I know that those various trainings we get seem to wear off after awhile, but for a long time we'll remain very sensitive to the issue, be it drugs or diversity issues or sexual assault awareness. And except for the really social deviants who are going to choose to break the rules anyway just because they don't care, most students are highly responsive to social pressures. At my high school people were ultra aware about not driving after drinking and people would turn in their keys during house parties. If someone were to drive drunk one weekend, they'd would've been taking a lot of flak the following Monday. But you have to keep re-inforce the trainings for them to stick and remain the social norms. In college a lot of the old warnings from teachers wore off, but we also became hyper sensitive to other things like sexual assault...b/c that's what the school focused on. It was constantly on our minds and it became dangerously uncool to publically disregard the trainings/classes we'd attended on the topic. Again social influence at work. PS Sorry for the rambling

Nope I wouldn't, but this isn't about having someone arrested. It's about someone later asking you how you thought it wasn't pertinent to include possible drug use for a seizure patient...why not do it since the cops aren't going to be reading your PCR.

You could practice scenarios and definitions with a stuffed animal at home. If you're visual you might remember hypovolemic shock better if you have the memory of holding a stuff animal of some kind and imagining all his fluids bleeding out of him and you giving him a diagnosis...though probably a little more complex...and not quite as morbid (though the more morbid the image, the better it sticks in your head). The more you can act out, the more visual memories you'll have to recall during the test. Also, it might help to make notecards in very tiny writing with several definitions on one index card. I found that during tests I can more easily recall a small card (because it's a small field of vision...more like a picture) and can even recall where on the card I took those notes, and then scan for it. It's like when you can remember that you read about a topic and it was on the upper right corner of a right-side page...but there's way to many right-side pages to go through in your head. With index cards, you only have a few to recall visually.

I remember reading an article about an MD who was a cop on the SWAT team some time ago. I think it might have been in Texas as well (don't suppose there are THAT many MD SWAT members in TX...)... though CA's EMS Director was a part-time police officer / doc for awhile...

If it comes out that you were there and saw all the drugs and the patient ends up having complications due to drugs, I can see someone asking you, "You mean you were there with a downed patient and saw drugs and paraphenlia all around...and it didn't occur to you that this MIGHT be relevant in your medical report? Hello?" If the report is confidential from law enforcement, I would probably briefly describe a little of what I saw. I'll try to protect the patient, but honestly I'm not going to be OVERLY concerned about protecting their privacy if they're big time drug distributers.

That's what I was thinking for this scenario. Next time you're on a medical and one of the cops you're buddy buddy with rolls up, if you have time you can give him the hot tip...help him with a felony stat Not that I'm promoting this option, but I'm sure if he decided to go this route, he wouldn't wait on the patient just for LE to arrive. It should only take a few seconds to request PD assistance as he gets stuff out of his med bag. Now, if you retreated and waited for them to clear the scene, that'd be different.

No, I don't think it's that much different. You "sliding scale" of what you decide to report is different, but there'll still be some things you do and some things you don't, even while on-duty. If you recognized one of the guys in the house a murder suspect or you saw a map of a terrorist bombing on the kitchen table or some other extreme example, you'd still report it, despite you being EMS. Now, I believe in having some level of trust and confidentiality with patients, so they're not scared to call 911 for a medical, but see it all depends on the crime. Also, yes by being EMS got you into their house, but they invited you in. There was time to move him into the hallway before FD arrival if they had that much drug content inside.

Right, but the reverse of that is do you never report anything? License plates of injury hit-and-runs, a house down your block dealing drugs to neighborhood kids, someone breaking into your neighbor's car, recognizing a murder suspect from a wanted poster. Some you might, some you might not. So, even if you're in EMS, I think there's still a sliding scale. I'm not saying to necessarily report it in this scenario, but whatever your decision, it should be based on a personal sliding scale. I don't think it's best for the community to refuse to report simply because you're not required.

Is there any responsiblity as a citizen?

I came upon this during an unrelated search. Thought you guys might be interested. http://www.bls.gov/oco/ocos101.htm Our growth rate is predicted as "much faster than average" through 2014. They also have a line sentence about the high turnover rate.

Right, I think that point needed to be made, rather than dismissing Trendelenberg (implying for all purposes) Though it's anecdotal, I've put myself into it and have felt immediate relief...and onset of "faintiness" was slowlly increasing, but recovery was pretty much instant. I don't think it was timing.

Once again, what do the myth studies say about modified Trendelenburg in regards to stopping light headedness and preventing fainting after drop in BP...which is what I was taught the main purpose of it was...not cardiac output stuff.

Do any of those studies specifically address cranial blood flow? Does it still have a use for correcting light-headedness and preventing fainting? I know modified Trendelenberg has definitely made me feel immediately better in such situations.

Cops are the funniest people I know

I found this online version of an email forward I received a few years ago. I almost never forward stuff, but I did that one because it was such a powerful story. (BTW, it's been verified by those eRumor sites...it's not made up) Warning graphic pictures (I received some angry emails back when I sent this out): http://fnnc.org/drunk-driving.html

Interesting post Dust. I specifically like the talk about a rescue personality. I've been taught that it's something that develops, not usually innately born with it, so not an actual psychological "personality" though some personalities are more pre-disposed to those behaviors they mentioned than others. I didn't read the whole article, but the intro seemed to be making the point that CISD was strongly dependent on whether emergency workers were of that "rescue personality". Why? Is the point that if you are, then you don't need CISD? I can offer that as far as children go, CISD will help decrease the chances of developing post traumatic stress disorder in children who WANT it. BUT in those who are forced to talk about and relive the event when that's not how they want to deal with it, it will INCREASE chances of developing PTSD. I'm sure there's a similar pattern in adults and it surprises me that those who run the CISD programs don't know this (or listen to this), as it's not obscure or new knowledge.

Then there's also me who doesn't ONLY see a need for doctorates, yet still thinks that doctorates could work if on a different track than practicing medicine. In the way that usually a Psy.D is for clinical psychologists and PhD for research psychologists. Or in the way police officers and criminal justice PhDs are on different tracks, so it doesn't matter if education requirements aren't increased in order for someont to get their criminal justice PhD. I'm all for increasing the education requirements of the EMTs, but I think that's separate from the doctorate issue. The doctorates probably wouldn't be working in ambulances, unless they did it as a side thing or during a specific phase of their training.