AnthonyM83

Man, I wish that were so. I'd take a daily beating if it allowed me to stay concentrated on book work for longer periods of time. Not even kidding, I'd take the pain and bruising to have the reading attention span of some of my friends.

Well, background checks for babysitters usually does just mean criminal check, but that's pretty ridiculous that it's not in all 50 states. Or are the state checks in addition to the DOJ/FBI check that most agencies do (what I've had to do for EMS and elementary school jobs). The idea of speed babysitter interviews isn't that bad. It's more interview than you get with more babysitting services, isn't it? They just send you a random sitter....whereas this way you actually meet them first and get a vibe for them.

It's messed up. I think the law only says it's illegal to create or have possession or disperse child pornography without mentioning whether it's your own picture or how old you are. Reminds me of CA's sexual intercourse law. It's illegal to have sex with a minor, period. No exceptions for if you're a minor of the same age. A 17yro who has sex with a 17yro is still guilty of having sex with a minor (of course never heard of someone being charged for it...)

The removal of the kids is messed up, despite the names. YET, there could be a good case about the psychological damage they could be doing to them by giving them those names and raising them with those ideals. BUT that's what freedom of speech and of beliefs is about. You CAN have F'ed up beliefs and you CAN raise your children that way. It's probably as damaging as some certain religions, but we accept that parents have to right to raise their kids believing what they like.

That's messed up. But the charges are correct. Stupid to actually prosecute on this. That's totally F'ing up someone's future, having a child porn charge b/c their friends sent them pics.

Around here it's usually the driver's job to restock all the equipment after each call, which usually includes replacing all the patches, rolling up the 3-lead cords in one pocket, the 12-lead cords in the other with an extra patch packet. The O2 sat gets rolled up on itself and wedged in the space where all the cords come out, near the carrying handle. Capnography, ped O2 sensor, large chest pads, etc all go in the back pocket. Or some variation of that, but you always leave it ready for the next call. Only occasionally do people forget to roll them up nicely. If they bunch them up messily, the EMTs are usually asked to roll them up nicely.

Case law because the statute law never addresses it . . .

It's a very famous photograph...

I think the validating feelings part is acknowledging their feelings are real and justified (yes, you got dumped...it's normal to feel really sad)...they need someone who understands them...but then follow up with explanation that it's still not justified behavior. Then, you just lose the connection with them. Some of these people are going through things I've never had to experience...who am I to tell them, their feelings are unjustified. That does not mean I'm saying their actions or method of addressing their feelings are justified.

Don't most of our articles in JEMS and other publications come from equal or less academic background? I think it's a valid point. We sometimes assume that a patient with a recent hx of self-injury is a psycho lunatic who might start shanking you in the back of the ambulance. Yes, you must always keep EMT safety in mind, since the person has already shown one instability, but if they're in touch with reality (non psychotic) and not with weapons in hand, treat them as a normal person. I don't think the article referred to situations where person is actively harming themselves with weapon in hand. Of course, then think scene safety. That's reacting to the scene/situation, rather than the patient.

Since no one left a follow-up question: Explain the concept of Cushing's Triad? Differentiate from Cushing's Reflex.

I don't think a cop would feel too comfortable with that. Yes, it's confined space, but as soon as your driver brakes and pulls over, you can exit (yes, there might be a delay). We almost had a use of force case when a PCP patient broke his restraints on the freeway and deputy's taser had no effect...my partner could have been killed in seconds...

Better for what? And is this in all conditions? I'm used to hot weather with very cooling winds. You can FEEL heat circulating out from your sleeves when the wind hits you. I guess if it's so hot that the wind is hot too, that's a problem, but we're usually not in the sun for long periods of times. I mainly care about thinner material, though. I'll wear the polo. Just feels nice to be able to feel the AC when we jump back in the rig (yes, consideration of patient is made, but on hot days, they often appreciate it too)

I was told soft board immobilization is pretty common in Europe. Would others agree?

Negative. That statement implies that the presence of police makes your scene safe or that a good scene survey will identify all potential threats. It also implies that scenes do not suddenly change without warning. It also makes the assumption that police are available for every single potentially unsafe scene. My experiences tell me different, despite being more aware of my environment than most others. Despite all that, I wouldn't feel comfortable with 99.5% of my coworkers carrying a gun. Being allowed to carry a weapon in an official capacity (with all the liability behind it) would require extensive training that just might not be worth it. I know too many EMS personnel who would abuse it, too. As far as being assaulted due to being mistaken as a cop, it happens. Usually, it's just a shove or attempted swing or lunge from EtOH or psych patients. Most bad guys don't just start firing into scenes, but I know on our scenes, it can be very hard to determine who is PD, FD, and Ambulance. Only difference is duty belt and badge shape, and for more observant eyes the ballistic vest underneath. But if everyone's leaning over someone, from a distance no difference. But even cops don't get random shooters at scenes that much, so of course cases of EMS being actually shot would be rare. BUT I have verbally been told by patients and bystanders that they thought I was cop on a NUMBER of occasions.

I might not be adverse to T-shirts during heat waves, if the design is as professional as possible and they are tucked in and the rest of the uniform is maintained. It's possible to make them look semi-professional. But as a regular uniform, I would say no, unless working inclement weather areas. A uniform shift with the required undershirt can make working some calls in the heat pretty tough. A t-shirt only can make a significant difference through the course of the day. But this would probably be for 3 digit temps, in my opinion.

Are those descriptions of Ventilation and Respiration generally accepted? I was taught Ventilation is the process of taking air into and out of of lungs (more having to do with air getting in/out) and Respiration is the exchange of O2/CO2 at the cellular level (at lungs and at tissues).

Congratulations 'Ziller. Totally exciting. Now remember, you can still make time for EMTCity...baby on one leg, keyboard on the other.

Dude, I know exactly what you're talking about. I've been on some scenes where there is so much going on, yet afterwards when people are recounting it, I remember about an 1/8 of that, because I was zoned in on my patient. It used to happen at car accidents a lot (regular ones with multiple minor injuries...not like the one you had) until I made myself pause before going in to a patient and doing a walk-through. It let me know extent of situation, details on damage to vehicles (important if you're going to be explaining the MOI to the receiving ER doc), and where everyone else was (potentially a safety issue, too). So, I guess my answer is don't v-line directly for your patient, take a better scene survey even if it takes you half a minute. Then every now and then look up from your scene and re-evaluate. Whenever someone else comes up to you to ask questions (scene commander, for example) is a good time to really give him and the scene your attention (rather than just shouting a quick answer and going back to your patient). Also, helps you keep track of your resources better when it's time to get out of there. Just my thoughts on it. Like the others said, it's probably good to just get the heck out...but still want to keep aware...

Or the doc just thought it meant something different? (AKA just sedate versus sedate/paralyze/intubate)

You know, it would kinda make sense. When you take a BP, your overall blood pressure gets increased to a degree, right? Regardless of what side. Out of left or right, obviously left side because the aorta more directly goes to the left arm. But I imagine you'd never know exactly what the breaking point is going to be that causes the full rupture and a case where the breaking point is that low, one would imagine they weren't going to make it anyway. If no one can find a study on it, then my guess is the author created that piece of advice...it's not that it doesn't make sense, just that it's usually negligible pressure, except for 1 out of whatever hundred cases?

There were many attendees . . . . But they all sat in the back . . . Our first station is IO's, which we practice with real bone on real cadavers. Then, we practice get to needle decompress an induced pnuemothorax. BEandP and AnthonyM83 put their first intubations under their belts under the guidance of DustDevil, Akroeze, and the medical students. No pictures were allowed in these rooms for the privacy of the cadaver donors. Next is an airway station, which included various equipment, included two "video scopes" that made intubating a cinch. One dummy was even computer controlled, that allowed proctor to create edema and other difficulties intubating through his computer screen, realtime. Next was some practicing with surgical airways. We practiced on pig trachs to allow for multiple attempts, using different equipment. Here Dust performs his first incision into the cricothyroid membrane. Here Akroeze ponders what other impromptu surgeries he might get away with... Now, it's Brendan's turn. He jumps right into it. Things start heating up as AnthonyM83 heckles from the sidelines (Canadians were the prime joke targets for the weekend). Anthony takes a picture of the group (from Day 2...Sorry Jake and Chris) After spending almost five minutes showing a fellow EMT girl how to use his camera phone, Anthony is finally able to get in on one of the pictures. Yup, I'm as intense as always. Then, it's time for lunch. The group somehow ends up separated with ALS sitting on upper rows and BLS sitting on lower rows . . . hmmm. Anyway, then we back for a scenario where Brendan and Anthony save a life...with a little help from some local EMTs who do EMS for their university and another medic. The patient dummy was one of those state of the art ones that speaks, has a pulse, allows for taking actual accurate BP's,...and umm fully anatomically correct. The more experienced Dust, Akroeze, and others act as judges. Next station is Tac Med. Doczilla shows us his combat pack and various TQ's and hemostatic agents, as well as reviews the modified ABC's for combat trauma. Here Doczilla demonstrates an Israeli dressing (reminds me of a "BloodStopper" roll) on Alex. As much as I tried to convince him to do a real demonstration by amputating Alex's arm, he wouldn't allow it. Too much mess he said. I do have to say Doczilla turned out to be exactly how I thought he'd be. Great guy, great speaker, knows his stuff, and I recognized him immediately! Next we did the brain and heart stations, with anatomy lessons holding the real organs in our hands and explanations on what happens during CVA's and MI's, with review of 12-leads. Then, we went to the long-anticipated amputation station, which we ended up having to rush, through...but we all got a chance to cut some bone with different tools. No one got sick unlike the first day, apparently! Last station was a general cadaver anatomy station where I got to ask a bunch of questions relating patient conditions to actual anatomy...got to run the bowel (ref: House MD) and got great explanations on how different abdominal pains present (much better than any of the explanations I ever got in EMT school). The resident at that station was great. (and hawt) Lastly, Dust and I went out for some food and drinks with 'Zilla. Unfortunately, he couldn't quite hold his liquor and this is how we had after only 3/4 of a drink. I had to cut myself off too to make him feel better. Doczilla after one drink (with a meal):

Does anyone have any literature saying how quickly they can be affected by O2 in the EMS setting. That and paraquat poisoning (sorry to steer it to these topics)....I can't get any straight info on TIME tables.

Mallory-Weiss Tear?

There's a questions about what you'd do if you were attacked by a bear . . .??? I'll go ahead and give them benefit of the doubt and believe their claim that they weren't properly educated prior to being given the test. Everyone knows I'm all about increasing standards and educational requirements, but you also can't expect an entire department to know exactly what's going to be expected of them without being told. Their EMT school apparently didn't prepare them for the test, so the department should give them the preparation (not just study time) before making them take the test. These are full-time jobs that people worked hard for . . . (Again, this is assuming their claim of improper training/education for the test is true.)