DwayneEMTP

How so? The OP reads as if it was written my a mentally challenged child. What do you find funny about that exactly? If you'll look in the welcome section you will find another post, from someone claiming to be two months or so from finishing paramedic class yet the post couldn't have gotten a passing grade if written by a 4th grader. That's funny somehow? That these people will be populating the field that you wish to use to support your family? You're somehow kind for allowing it, yet we're assholes for attempting to correct one of the main tools they will need to succeed should they choose to move forward with this career choice? I'd love to hear your argument here. I gave your post the positive point, it was really good, but I look forward to your thoughts on the above. Dwayne

What kind of pacemaker did he have? I do believe that I would have done a 12 lead on this guy as I don't like that wide complex tachycardia. Also I believe, (because I always the the completely right and thorough thing, its my gift.) that I would have given a few liters of O2 not only because bringing his SATS up couldn't hurt, but to see if it would cause any change in his rate. Had the ER put him on Os when you returned to find his rate at 110? It sounds as if this guy has had about a gazillion clot issues in the recent past. In the time you had availabe, I mean 2.5 hrs is all day, I'm curious why you chose not to do an EKG or O2? Dwayne

Ahhhh! I think someone has a Canadian girlfriend!!! Taking the plunge brother? Who else "Plans" to move and THEN asks if he can work, what kind of money it will pay, what the hours are like, etc except someone in lust? Errr..I meant love. Good luck man..just poking a little fun at ya... Dwayne

Until, "Response time is the absolute priority for medical emergencies. Firefighters are in the best position to respond quickly and provide vital services." Is changed to, "Education is the absolute priority for medical emergencies. Firefighters are the most well educated and in the best position to respond quickly and provide vital services." I will always be opposed to fire based EMS. For me, it truly is that simple. Dwayne

Yeah, that's a great analogy! This is a great subject/thread. I haven't had many spare minutes in the past few days, but I'm really looking forward to seeing, and hopefully participating in it moving forward! Agree with the arguing/hand holding Fiz... :-) Threads where we agree are almost universally a waste of time. I love that Mobey came back with an outstanding primer for what Ugly is looking for, and a great place to begin to build a more complex picture. I couldn't have done what he did, and that's embarrassing, as he's right, It's basic medicine and we should all know it off the tip of our tongue. One of the many things that I love here, being reminded of what I don't know, or have forgotten, which allows me to remedy those things. Dwayne

Yeah man, fair enough. I'm afraid that I breezed over the posts, ran head on into his reply and then reread the posts in the context of him feeling put upon. This has been a weird week for me. I am lead medic on a project on "The Oil Spill" so have medics bounce in and out of here on a regular basis. It's been disheartening to find that the number one question that I answer from these medics is, "Do I get to put remote medic on my resume now??" I actually had a kid tell a group of women that were all aflutter about the delivery of ones's child in the next few days, "You know, amniotic fluid is really just baby piss! So when you're water breaks, it's really like you pissing on yourself. No, really, it's the exact same thing!" So, not only was I really unhappy that he would say such a stupid thing to a woman about to deliver her first child, but I pulled him aside and said, "You don't really believe that, right? Tell me you don't believe that!" He said, "Don't you? It's the truth!" I've been seriously considering if I really want to be associated with a profession that would allow such people to participate. It's disheartening sometimes to see that trying to be intelligent in EMS is a lot like washing your hands after you pee. As no one else does, it doesn't really matter. The first thing you touch is going to recontaminate you with all of their germs. It's frustrating to know that no matter how hard I study, try to learn, try to mentor, no matter what example I try to set for the people that assign our contracts, it's all for nothing as the very next medic they speak to is going to show it all to be a lie. So I'm afraid that I got on the "Knowledge is power! How is anything going to change if we don't support the noobs!!" bandwagon and got all self righteous and colored you and Mobey's post in any context that I found necessary to attack something and jump up on my soab box. As two of about a dozen of my favorite posters here, I'm really sorry that I did that. Rereading your posts, you are obviously correct. Taking the path that he had started down was certain to lead to confusion and frustration. My apologies for the undeserved generalization and criticism, as well as to all for ranting and raving in the middle of Ugly's thread without really thinking first. Have a great day all!!

Heh...I posted that last night during a party with a bunch of medics after a couple of adult beverages and we got to talking about this place. Though if I posted it today it would likely be much shorter and to the point, the testimonial still stands. :-) http://www.tribalhollywood.com/ Dorky post I know, as I'm not a big jewelry guy, but I find the older I get, and the more I am forced to pay premium prices for crap that when I find a good deal I want to run around telling everybody! Have a great day... Dwayne

Hey all, I don't know if this is going to be seen as SPAM or not, but I hope not. I have been seeing the tribal Hollywood ads on EMT City and I'm actually pretty happy about that. My first exposure to them was in Afghanistan when Babs sent me a necklace from them for our 23rd anniversary. When I first saw that box I thought, "yeah, we must really have gone off into the ditch. She knows I don't wear jewelry!" But the necklace was heavy...and made really, really well! I've been polishing it for three years now, and it shines up beautifully and is still tight and....well, I love it. I truly can't leave for work without it without feeling really awkward. For Christmas I got her a set of puzzle pieces. They intend them to be used for lovers signs, though puzzle pieces are also the accepted sign for autism, like pink is for breast cancer, so I got double duty for them...grin. When they came they were heavy, high quality stainless steel, beautiful. As every time that I've/we've ordered from them we've been surprised to get so much more than we'd hoped for. In this day and age if I order from online except from well established places like Amazon or such I've come to accept that I've just donated my money. But I can truly say that I would not sell any of the jewelry that we've purchased from Tribal Hollywood for twice what I've paid for it. The pieces were bought in love, and I'm convinced that they will still be displaying that love long after I'm dead and gone. Just to be clear. I've no association with Tribal Hollywood other than being a satisfied customer. Honest to God folks. If you want dollar for dollar a good deal, this is the place to do it. Dwayne

Man..I like that a lot... Thanks for sharing.. You know what's amazing..is that the doc took a picture of my brain the last time he checked my years, and it looks exactly like that picture! What are the odds.... Dwayne

Ruff, no offense taken at all! Though I would be offended if you didn't find me and/or my opinions valuable enough for argument. And a religious war here isn't such a bad thing,(textual bullets have very limited range and stopping power), as I believe one of the most valuable lessons that we can teach here, though it rarely happens, is the value of respectful, intelligent debate. Correct me if I'm wrong, but I seem to remember that you and I may have disagreed once or twice in the past? I mean my questions to be sincere, not rhetorical. At least to the non Christian crowd. And I agree completely with chbare on the inane nature of the discussion but believe that the value is not in the answers, but in learning to intelligently argue the questions. (Sorry, I'm trying to figure out how to reword that sentence so that it doesn't sound as if he and I disagree on the value of intelligently exploring questions, but have nothing so far.) I truly look forward to those with more intelligence, education and passion on these subjects continuing to move forward with this discussion. I believe it will be good, educational and relevant. Dwayne

You and I still disagree on this. I believe that you proved to belong in EMS more than just about anyone I've ever met. Doing what you did was right, the mistake you made was trusting that if you tried and then fell on your face that the others in the thread would pick you up and lead you around the puddle you fell in, and that just didn't happen. Had it come from someone else, or not been as filled with such enthusiasm then maybe I would feel differently, but I doubt it. Because of your questions I will be spending the spare time in my next few day review the physiology/pathophysiology surrounding your question. And that's what we're supposed to do, right? When did we decide that you have to know the answers before you ask a question? I'm still a little pissed, ok, a lot pissed by the attitude of, "Ummmm,,,,Yeah....You don't really belong here as you don't have the necessary education to understand it, nor will you likely ever use is, so...well....buh bye now..." Fuck that. I will be truly disappointed if you leave this experience believing that being brave and motivated enough to bite off more than you were prepared to chew somehow made you look like an asshole, or a whacker. If you choose to follow that line of reasoning then you must apply it to all that come after you. If it's right for you, it's right for them. Are you prepared to do that? Though we have a ton of great, smart, experienced providers now, we have lost a lot as well. When I was new the board was ruled by akflightmedic and Dustdevil, Rid and a bunch of others. Not that they had the only opinions, or always the right opinions, but they could pretty much be counted on to steer things back in the right direction is they went off into the ditch. There were times when I left discussions with them thinking, "You know what...fuck this. I don't know the right answer, I may never know the right answer, I'm not going to listen to this shit!" But I'd come back. Because they made sense. And many of the opinions that I hold dear now came from them then. And I came to understand that though I had the wacker mentality that being a hero was paramount, they were teaching me that knowledge is king, and all of my good deeds needed to follow intelligence and education. Also, that if I wasn't willing to stand up for my opinions, then they really weren't very important opinions at all.... I once pointed out a post to Babs where I was pretty hard on you, in fact was afraid that I may have scared you off, but you came right back to the thread, had rethought you stance, done some research and didn't slow down for a second! I said, "Hey babe! Will you look at this fucking kid!?! I just kicked his nuts up next to his tonsils and he didn't even skip a beat!! I think he gets it!" Of course "it" is my own personal vision how how the world should be...but it's the right vision, so screw the rest of you guys... It sounds that though I got all pissy about that thread that you've done what you always do, take the good from it, find a way to get stronger from it, and took off running without missing a beat...Keep taking your chances at bat, even if you don't think you can hit the ball. Because that's how we get better, stronger, braver, more competent, confident. Good on you brother. End of rant...(Well, almost. Will you PLEASE use your friggin' spell check??) Really, really end of rant. Dwayne

No worries brother. It wasn't my intention to invalidate your opinion or your experience, only to help you/me/us stay focused on the primary goal here, which is education and bringing EMS forward with intelligence and professionalism. Perhaps you can do what you've mentioned, but if it's left there without a counter opinion then many here that are new, that have been fed all of the hero bullshit and can't wait to save the world might want to follow that example. It's my belief that you wouldn't be happy if someone left your post with the opinion that throwing violent people to the ground and holding them for law enforcement was what you believed to be the correct, prudent and responsible thing for a provider to do. See? It wasn't my intention to burn you down but to be part of the team in creating a larger more productive picture. Of course most times I'm completely off in the ditch when I try to do such things, but it seems to be my nature. Thanks for participating. We all learn together. Should you ever choose not to correct a post of mine that you believe is in error, or maybe correct but stated in such a way as to leave those newer to the profession with the wrong impression, well, I won't thank you for standing quietly while I step on my dick. Agreement in education can be a terrible waste of time in my opinion. You will find that the weakest, least productive, most boring threads on the City occur when people agree. Thanks to all for your comments and taking the time out of your day to share with us. Dwayne Yeah man, it's a weird world we live in, right? Share this story here and you're an asshole, do the same thing when out of uniform and you're at best a limelight hero, at worst a good neighbor and responsible citizen.... It's hard to know where to draw the lines sometimes. So again, I hope you see the points above ,that I wasn't really judging you but your decision to use it as a teaching point when it was in contrast to the original paragraph of your post. And...for the record, even if I WAS questioning you, your ideas, your manhood and the sexual chastity of your mother...tell me to go and fuck myself. Not here, nor in real life, is there one single thing about me that is special, that makes me or my opinions better or more valid than another. I simply have 'another' opinion that I sometimes express a little more...straight forward..than some others. It might be louder, but it is certainly no better and in most cases proved to be either wholly, or at least partially wrong. You were contrary in your post in my opinion. If you give it a few minutes thought I'm willing to bet that you can find plenty of things in every one of my posts that could be cleared up or explained differently for the benefit of the board. Have a great day all... Dwayne

Hey man! Welcome to the city! There is much to learn here, lot's to teach, smart folks, and some chuckleheads like me...but it all averages out to be a good thing. Jump in..I look forward to your thoughts. Dwayne

I don't share Christian beliefs, though I do believe that I share many of the Christian values, and actually seem to live them more thoroughly and in more of a spirit of love and friendship than many of my Christian neighbors..at least if appears so to me. As we seem to be wanting to start a religious war in this thread, I'm going to throw in my two cents... Many of my Christian friends and neighbors feel pity for me when I choose to share my beliefs, or in their view, lack of beliefs and and find me unacceptable company until such a time as I see the error of my ways, repent, and become saved. It seems that Jesus, according to the bible, which I have in fact read cover to cover several times, Jesus had not trouble loving non believers, why do the mortal Christians find it so challenging to do the same? On the flip side, why is it that those that don't share the Christian beliefs seem to find such joy in trying to stain it for those that do? Many in the Christian faith are there for honest and sincere reasons, some others of course are just assholes. But if they find peace and community in their religion, where do you find the joy in trying to destroy that? What have you won by backing them into a corner that they can't possibly logically defend? The truth is awesome and powerful, it is the reason that I can't give myself over to a religion, but does being a lover of the truth demand that we have to state 'our' truth regardless of the cost to others? It's been my experience that trying to change someones' religious views is akin to telling people that smoking is going to kill them. You're wasting your breath. Something in life is going to drive them in one direction or another and they will make their choices, and then perhaps those choices will change. But simple statements will not do it. I am not a Christian, but I am in love with a Christian, most of the people most important to me are Christian of one faith or another. I don't want you to lose your faith, I simply don't want you to attempt to define me according to your beliefs. That seems reasonable, doesn't it? Dwayne

I guess my response from yesterday got lost in the ozone somewhere... But I remember it started with, "Really? We're really going to bag on the EMTB for exploring neurologic anatomy/physiology? Really? What the fuck is up with that??" I'm confident that that statement still belongs in this thread, though Ugly your "I'm going to go now and throw myslef on my sword" comments in this and the other thread are equally bullshit. You are much smarter and stronger than to cry just because you got you weenie smacked, whether you deserved it or not. And I don't believe that you did. I actually loved that you started this thread, and liked your post a lot. What was also lost was my statement saying that I have just been to far from this for a long time to give an intelligent reply so need to brush up before commenting, which is my goal for today. I'm flattered that you created a thread to try and offer point/counter point to the question I asked in the other thread. Driving outside of your normal lane to try and attack this problem, in my mind, represents the best of what we try to do here. But I'd really, really like you to employ some new tools next time something like this happens. First, lose the self pity. I'm not sure if you were having a bad day or what, but it doesn't suit you. You've never let people tell you that you don't belong in ALS discussions before, you shouldn't have allowed it to happen this time. Second, next time someone tells you that you shouldn't be fucking around in areas 'over your head', because you don't belong there, or you won't need it, tell them to go piss up a rope. Many folks here, particularly the ones in this thread are smart enough to guide you through those subjects, but no one, not even those here are smart enough to know what knowledge you need, and I'm disappointed that they tried to dissuade you instead of help. Anyway, having said all of that I had better get my morning work done. I'll try and get back to this thread in a bit, because if you don't belong here, I sure as hell don't belong here because I don't remember how any of that shit works at the level you're looking to discuss it. Have a great day all!! Dwayne

Speaking of derailing the thread....Good to see you Croaker! Where the hell you been?? Dwayne

I just so much love the way you think!! Screw the heros, have sex with a paramedic because everyone knows they...like sex and are....enthusiastic and will say thank you...and probably other really cool things I can't think of right now... Put that on a T shirt why don'tcha... Dwayne

Dang it..I misread it to say boobs...I thought that you were going to give US options! I love Redwings. Do you know if you have to have them polished? Even if you don't your employer will so you might as well get a good pair now. A really good pair, mine are around 15 years old, will run around $200 or so. I will never again wear a pair of boots that don't zip in EMS if I can help it. Non slip is a must, but a deep tread will track mud all over peoples houses, the hospital, your quarters, so something medium would be good. If you can't find zip up boots that you like talk to your Redwing dealer and he can sell you a zipper that will lace onto the front of your boots. Not as good as side zippers, but not bad either. Good luck! Dwayne

Matty's comment about his being egocentric got me to thinking... According to the bible, (whichever flavor you choose will work here I think) even Jesus didn't deny his brotherhood with his neighbors based on their religious beliefs, did he? Dwayne

Ahhh, but see, the problem with your answer Ugly is that the pt that I saw it in had a pulse rate of 28 when I first took it. Also, I've seen many, many, many pts with heart rates above 120 that didn't display diaphoresis at all, much less to this level. Moral of the story here is that we need to be really care to state, "this is what you need." when in fact it may be only sometimes that it happens, only one thing that you need, or had nothing to do with it in fact and was simply coincidental that it happened at the same time. Dwayne

NYCEMS9115, I would respectfully disagree. Because a situation worked out in the end does not then verify that it was a correct and intelligent decision. I used heroin a few times when I was growing up, and it worked out alright, but I'm guessing that most would be hard pressed to argue that it was an intelligent, healthy decision for me and/or my family. Saying that your 'partner just knew what you were going to do' seems to imply that you allow yourself into these situations on a regular basis. Again, if allowing yourself to be involved in those situations feeds a need that you have, then that's certainly your right as a human being, but it also sets a very dangerous example for those that come behind you as well as puts your partners in a danger not necessarily of their choosing. Safety first. Always. The only reason I'm getting so preachy is that you posted... "™Scene safety. Safety in numbers. Call for Police and additional resources. Safe distance. If you have determine that the patient is a danger to self and/or others..." Followed by.. " I went behind him & grabbed the waistline of his shorts and tripped him backwards over my body and braced his head; I held his body to the ground until PD came." in the same post, and in no logical intelligent place do they really belong together. I spent much of my younger life in wrestling and martial arts so you'll have a hard time convincing me that while taking down a violent pt that you could guarantee that you could 'cushion his head' while doing so or guarantee that no part of your or his body would accidentally strike hard surfaces. Not busting your balls brother. But this is a learning forum and I believe that your post was a bit braggy, and that you allowed that to override your lesson. Thanks for participating. I look forward to your thoughts.. Dwayne

Your honesty should be the gold standard that we judge all scenarios by here. I beat you on this one Fiznat! But because I'm smarter than you? Of course not, anyone that's been here for more than a week knows that's not true, but because I was scared. I would have tried cardioversion simply because I can come back from that if it's in error having created almost no physiologic changes if my decision was in error. Also the ASA for, hopefully, obvious reasons. Do YOU still believe that the medications were the less invasive choice of initial treatment for this patient? I would still like to hear your opinion, not the ACLS opinion, but your logic for choosing drugs instead of electricity. I'm just not getting your committed stance on that. I certainly respect it, but don't understand it. Do you know what they medicated with post conversion, if at all? Thanks for sharing brother. I don't think you realize your value to the City...It's massive. Dwayne Edited to fix a typo. No significant changes made.

As an aside...you really do seem to be having a hard time seeing the positive in things. "80% of the lunchroom conversation is negative." "If you don't graduate high school people say you're fucked for life." "No one wants to support me in my quest to become a paramedic." Who in the hell are you hanging around with? Why are you still hanging around with them? Run away!! When you are being abused by so much negativity in your life girl, it think it may be time to take a gut check and make sure it's not your attitude that is sucking and coloring everything around you. Opinion truly meant in support of our up and coming paramedic chick. :-) Dwayne