DwayneEMTP

To tell the truth, I can't think of a single time that I've seen anyone shoot down a young person for being involved in EMS. Not here, nor in my professional career unless they were asking for advice. I have often heard advice that a person asking for opinions didn't want to hear, but in my opinion it's most often been sound advice. You say, "I know I'll have to work a million hours to try and support the family I will never see. I know that I will have financial difficulties. I know that I will likely burn out." How, if we care about your our your life at all, are we supposed to encourage you down that path? Is it honesty that you want when you ask for opinions or a bunch of fantasy rah rah bullshit? A kid once came into the EMS room where a bunch of us were doing paperwork. He was doing his Basic ride along and the medic he was riding with said, "Go ahead and ask your question here." He said, "I'm trying to decided if I want to become a paramedic first, or get my nursing degree first..." In unison we all said, "Nursing!" Because we're all burned out an negative? No, because it's good advice. We all laughed and explained why, if he was set on doing both, nursing first made the most sense. Now, you and I are certainly on the same page as far as hanging out with EMSers. I cherish my assignment right now because I get to live in a little FEMA trailer in a marina and I don't have to spend my nights in a big house full of medics. Bitching, complaining, pissing and moaning is the order of the day. For me, it doesn't matter much because I simply refuse to allow myself to be exposed to all of that negative energy. When it happens, I leave. I don't know if it's right or wrong, good or bad in general, I just know that the negative talk is wrong and bad for me. Make your decisions babe. Do what you want to do, but you certainly should not develop a habit of thanking and cherishing those that will support you and cheer you on even as they are watching you drive off into the ditch. Do I love being a paramedic? I absolutely do, and even more so the opportunities it's given me to travel and do cool stuff. Was it a great career choice? Was my investment of time in education well reimbursed when compared to other career choices? Of course not. There are people on this project with a 30hr OSHA certificates that make 3x as much as I do. Good advice is good advice whether you want to hear it or not. Dwayne Edited to remove a bunch of duplicate words that seemed to have sprung up like weeds...No contextual changes made.

Buzz kill....

Yeah, man...No doubt that that is a poor way to go, but you know, he may have already gotten himself reelected next term. It's a world gone crazy. We're fighting the 'war on terror' against religions around the world while all the time proclaiming freedom of religion, and from religion, in our country despite the fact that religion still runs our country. It will be interesting to see how far the Anti defamation league is willing to go with this. I believe they should go all the way. Dwayne

And even MORE little known facts.... As well as the phrase, "Ohhhhh...thank you sir, may I have another?? I have been a veerrrrry bad girl!" And all of those lonely woman began to scheme and yack and do crazy God only knows what chick stuff creating the origins of Feminism as we know it today. (I fucking hate golf) And created an entire country of young boys with erections that wanted to Kill Fred Flintstone. (And yeah, it got even worse when I Dream of Jeannie came along!) And yet still, they don't listen..... It might be impossible, but I'm willing to let you try.... :-) A myth according to Snopes.com What do internet porn, doggy style sex, hidden bathroom cams, and baby oil orgies have in common? Hmmm..I can't remember. I'd heard somewhere...Yeah....Can't remember. Sorry. Do you mean something you can eat and eat but it never goes bad? Hmmmm....This is a tough game... As well as the phrase, "Your Honor I swear to God I was just tightening the bed when she fell and became entangled! Nude...And while I was helping to free her...... Damn it! I thought it was, "If I order a pint will you blow me??" No wonder I keep getting my ass kicked in England... You're welcome. Sharing information is what we do here and I'm more than happy to contribute. Dwayne

What! They didn't have paramedics when you were a kid? :-) Dwayne

Fair enough brother.... But having said that, I would have given him ASA and welded him. Just putting that on the table so I can see how big of an asshole I would be later... Hey, and what the hell does fiznat stand for? Dwayne Also, though you may have become tachypneic and diaphoretic from eating chicken wings, wouldn't that also make the anxious, diaphoretic chest pain with with a decent blood pressure and h/r stable? And would you also consider this pt stable despite knowing that the odds are that he's in big trouble? Does anyone have any idea what level of hemodynamic compromise is necessary to cause the level of diaphoresis that is mentioned in this pt? I've only seen it in severely ill patients, hemodynamically challenged from either cardiovascular pathologies or trauma, so perhaps my inexperience with it in regards to pts not so sick is pushing me off into the ditch? Has anyone seen this level in a pt that is not critical from something? Ok...I guess I saw it once in a guy that vagal'd down secondary to a mombo shot of Rocephin. But otherwise...Well, you see my point. Dwayne

LMFDO!! Are you accepting advanced orders? I'll need several... Dwayne

Can you cite the source for these statement? I'm not doubting you, but I'm not able to place this hierarchy that you all keep mentioning in my head. Does ACLS even cover treatment of hemodynamically questionable patients with unknown rhythm disturbance? Truly not being a dickhead, at least not on purpose. I'm just not sure how to argue these points, which I really, really want to do..grin, without knowing their source. Thanks to all for keeping this discussion in the spirit intended. I'm truly not sure what is best, I'm only trying to argue what I believe I would do, and why. This conversation has been way overdue for me! It's reminded me to get back to revisit cardiology, that's for sure. Dwayne To those choosing drugs over electricity, I'm truly curious as to the answer to Mobey's question, and it's justification. Dwayne

Done deal brother. I'm going to call the cops and walk the street to try and keep him from getting hit by a car until they get there. If he's as injured as you state, he will be manageable pretty soon, just bide your time until he tips over. If it's really hot, or really cold outside, the same applies. Wait for him to tip over and then do your deal. The situation that you describe above is not possible to solve in a morally/ethically/professionally sound manner. This is one of those time when you say, "It's not my emergency. I didn't cause it. He's made it impossible for me to solve it. So until one of the above conditions changes, I'm going to wait." You have to accept this as a limitation of your treatment options, right? Again, accept that sometimes in this situation not only will you have to stand by and wait for the situation to change, sometimes you may have to run away and leave him to fend for himself! If he suddenly reaches into his car and comes out with a knife or a gun..or even a broken whiskey bottle...I'm leaving his dumb ass there. I will run down the road and sext with Babs until the cops come and never lose a moments sleep over it. I know you want to help him because he's hurt, but tell me this; if he was on fire and running around would you stand still and wait for him to come to you under the thinking that, "If I can hug him, then I can roll us both around on the ground and put the fire out. That is what's best for the patient." And it would be best for him, right? I think you already knew the answer brother, you just aren't comfortable with 'do nothing' as an answer. And I really get that. But in this job you must ALWAYS have that as one of your scene options, always. Ok? Excellent question! Also, use your spell check and proof read your posts, ok? You're way too smart to spell like that.. Dwayne

I'm with chbare on this. I believe that he needs treatment, (the pt, not chbare) though I know that I seem to feel that he's more seriously in need of that treatment than many here, and treatment should be considered from less invasive to more invasive and cardioversion would be the least invasive at this point, wouldn't it? A chance of success, also a chance of new diagnostic data and minimal physiologic change if it proves unsuccessful. Of all of the treatment options available, it seems as if we're avoiding cardioversion for the same reason that people avoid EJs and nasal intubation, not because of logical treatment decisions but because of the medics comfort with the options available. Amiodarone does seem like an odd first choice for a rhythm that hasn't been identified yet, doesn't it? Dwayne

I'm not sure what the ACLS definition of symptomatic/stable is? But I'm going to stay with unstable for now. He's not mentally altered, and that's awesome, but we're obviously having circulation compromise issues severe enough to cause the diaphoresis and tachypnea. I'm really not all that impressed with his vitals to tell the truth as we're only dealing with one set. This guys is diaphoretic, tachypneic, and anxious. Your initial impression before you involved the machines was 'Holy Shit!" That all spells trouble in my book. What would I do? Punt to my basic partner..he's smarter than I am.. :-) Dwayne

Hey Cutie, Mobey is actually doing you a favor, though you won't likely see it that way at first. It is very, very common these days for potiential employers to Google their new hire prospects just to see what they can see. Do you truly want a potential employer to see that you are to dumb, or to lazy to attempt to present yourself in a professional manner? Your posts make you look ignorant, but I have a feeling that there is so much more to you than than you've shown so far. Time to step up to the plate babe. This is where we separate the wheat from the chaff. Good to have you here. I'm excited to see you succeed. Dwayne Edited to fix a typo. No contextual changes made. See Cutie? Not pretending to be smarter than you, I'm just trying to do the best I can and that's what we all hope for you.

No brother, thank you. I've actually gone back to your blog a million times for inspiration when I was feeling hinky. And if anyone thinks I say these things because Fiz and I are friends..well, I don't think that we've ever even traded emails, or chatted privately. It's simply an amazing accounting of his thoughts, feelings and experiences written so well, and with such honesty that I really have read through it several times and got hooked on the friggin' thing again when I went to get the address for this thread! In fact, the only thing about it that really irritates me is that it's kind of like the City. You can tell people of it's value, explain to them why they should really at least take a taste if they're serious about EMS, yet 90% won't do it. I wish I was better at conveying such thoughts to others.... Hey Fiz, do you think I could copy and paste some of your entries that I think would make for good discussion? I understand completely if you'd rather I didn't, as I know you've put in an immense amount of work on it, and perhaps you would rather it not be read out of order, and context, but I think that would be a fun and valuable thing if you're up for it. You can reply privately if you like...sorry to put you on the spot, but I'm thinking you can handle it... And yeah...you'd make me a happy ol' goofy medic if you want back to it. Dwayne

Yeah, man, I wish I could give this post more than one point. And why do you want to keep people that are so lazy and incompetent that they are unwilling and/or unable to write an acceptable report? How do you trust such a person to put their hands on a patient? Also, like Toni said, many will simply not need prompting. There are many that are hoping that you will teach them, and then push them to behave in a manner that they can be proud of. No one is proud of behaving in the manner you describe, but they will continue to do it because they get to wear their Tshirts and have people call them heros. Be prepared to lose some Wankers, but also to watch those that actually want to work for their community bloom when you raise the standard!! Good people suffocate when buried in shit..wait and see what happens when you give your good folks an IV injection of self esteem.... If you want a squad full of children, then continue to treat them like children and beg them to show up. Treat them like adults and put a few hoops that they need to jump through before they show up and everyone will be so much happier. Way past time Lady. By the way...I've had this strange....feeling....for the last few hours...It's like pressure, but not in my chest exactly...think you could take a look?

How adorable was that!! Thanks for sharing girl... Dwayne

Hey all, I'm looking for a safety video that was shown by KBR before deploying to AFG. It shows a man telling the story about how he was burned at a (?) gas plant I think? I believe that he's got an east coast accent, though I can't remember for sure. But he talks about why he was burned so badly because of scoffing at safety requirements, about his time spent in the burn ward...etc. Easily the most powerful story telling that I've ever seen. I would love to find it if anyone has any idea where it might be.. Thanks all!! Dwayne

LOL Squint, right on both accts! That's what I'm sayin'!!!

You can, but it seems like a queer choice given the content of the thread. And I hear you about the majority of the country being opposed to the censorship, but acknowledging that would have hindered by ability to call our Canadian girl members' chastity/sexual morality into question, which was the real reason for my post...grin. Some times even I have to stretch if I'm going to find some way to work sex into a serious topic. Dwayne

Heh...if you were dumb that wouldn't be a problem!! But I think that the process is more important than the answer brother... Besides..I didn't yell before..I just asked..in a threatening manner, but quietly. Thanks for playing! You knowledge and insight is invaluable here... Dwayne

All I can really add to this is that it's been my experience that the more repressed a group is publicly, the more tawdry (shameful and indecent) they tend to be privately. (Anyone ever been naked with a Catholic school girl? OH...MY...God!) So, though it should be a sin to mutilate such a classic song, the Canadian women tend to be smokin' hot and naughty! So I say to Canada...just keep doing what you're doing neighbor...human rights and freedom of speech and thought are only worth so much...I've got your back... Dwayne

You know, I don't disagree with this, as I did it for a few weeks. But what did you do about decon? I found that I spent way more time with my hands on my phone than I liked and wasn't confident that it was even possible to decon it in anything other than a feel good sort of way. Plus, I could find things in my cheat sheet faster..grin. Dwayne

Initial impression? Pulse quality? Mentation level? Anxiety level? Skins? Going to leave it there for now so many can play. Thanks for this Fiz...these can be scary calls. Dwayne

Yeah, I'm going with the 'Yay' crowd as well. I used to carry one the I purchased but found that it was too big and a pain in the ass, as I never looked at it. Like you mentioned, I didn't need it to tell me everything, just the more complex though rarely used things. So I make my own, laminate the pages and then staple them together. This is usually good for about a year and then it starts falling apart and I make another one. I also agree that sometimes having a superstitious talisman in your pocket can be a good thing. I don't tend to be superstitious but I read a book once where the detective in the novel used Tarot cards on his tougher cases. He didn't believe in the supernatural but believed the using the Tarot logic forced him out of his normal lines of thought and that that was a good thing. I believe that if a cheat sheet makes you 'feel' more confident, whether or not it should, that that is a good thing. (Though my stethoscope does have magic powers and can hear things that others can't. Just sayin'. And that's not superstitious it just obviously true. An no, non believer, I don't want to try and prove it.) ;I believe that most of us, maybe not Crotchity, but normal people, have some moments of insecurity. I rarely look at my cheat sheets, but I look at it like this; It makes me feel more confident knowing that I can look at it, confidence leads to calmness, calmness leads to clearer thinking, clearer thinking leads to me having no need to look at my book, and therefore my book is an obvious necessity. See? Simple really... As medgirl? (can't remember) said, the phone numbers for you local hospital, you supervisors, flight service are good. I keep ped dosages for all meds and adult dosages for meds that I use uncommonly, for example I'm pretty sure there is a calcium channel blocker in my kit somewhere.. :-) Drip calcs for almost everything that I might want to mix. etc. See, just uncommon stuff. But you put in whatever you need into your medicine bag, whatever makes you feel better, calmer, more confident. Awesome question...but of course we've come to expect them from you. You know, I was going to put here, "You should just take whatever Fiz and Medicgirl, Eydawn say and use it. They just have obviously good insight." But then thought, that though that wouldn't have been bad advice, you really are in the same category too. (Of course there are many others, but in this thread we have an awesome representation.) You're logic is terrific, your medic spirit is obvious, and you're confident and intelligent enough to throw your ideas out for review even when you already know A good answers if not the only good answer. (Another plug for Fiz's blog. If you've not read his Baby Medic blog, it should be required reading for all medic students and new medics. http://babymedic.blogspot.com/search?updated-min=2006-01-01T00%3A00%3A00-05%3A00&updated-max=2007-01-01T00%3A00%3A00-05%3A00&max-results=11) In the last few years I've overcome much of my insecurity and have felt good and productive trying to act as a mentor here when I could, but it's truly exciting to see that the kids (in the EMS sense, not chronologically) are passing me up again. That each passing month I have less and less to offer yet more and more to gain! Often now it's more productive for me to shut up and listen then to talk. (Most likely that has ALWAYS been the case but I'm just now catching on.) and what an amazing thing that is to see happening here. Thanks to all of you that take time out of your days to participate. That are brave enough to subject your ideas to assault so that I have the opportunity to learn from them. For showing those of us that have been here a few days, and those that started yesterday, that the EMS spirit is alive and well and refuses to be drowned in ignorance regardless of the efforts made by some to do so. I applaud you. Dwayne