DwayneEMTP

Holy shit tniuqs, actually, after the first paragraph I was wondering, "I wonder who wrote that for him? I can't remember the last time that he had a whole paragraph made up of correctly formulated sentences!" Perhaps I'm getting you confused with someone else, but I don't think so. Though a tad hypocritical, I do in fact like your point. Dwayne

LMFAO .... That's awesome!! Man, think if you get them a leather sheath with your name on it that matches the one you carry your gloves it!! Holy shit! I don't have a gay bone in my body, but I might do ya if I saw you in that sexy rig!! (Good job brother...) Dwayne

The benefits of removing Fire depts from EMS to improve quality and education. Truly, I can guarantee you that if you run with creating a requirement for min of AAS as entry level to paramedic medicine you will have the love of your ER doc and medical advisor, but the scorn of your EMS supervisors. But if you have balls, that is truly the way to go. Almost everything wrong with EMS revolves around that. As Kiwi said, most other countries wouldn't let most of our folks on an ambulance. We're still the better providers, don't get me wrong, because of our spirit...just sayin'... You might hit up Lone Star, as he's recently done a college level paper on the same subject, he may be able to help you with resources. Dwayne

LOL...Those were hilarious! Though in my neck of the woods we call them little Johny jokes... Not sure what you mean about putting my name though? :-) Three of my favs... Little Johnny's mom takes him to Kindergarten, and when dropping him off tells the teacher that it's best if Johnny isn't allowed to talk in class. The teacher doesn't like mom's attitude, as Johnny looks sweet.... As they go through the alphabet in the morning the teacher is asking the kids to name words that begin with a letter. At the letter A little Johnny is the first with his hand in the air so the teacher calls on him. "Asshole!" Johnny yells, causing the teacher to believe that perhaps mom knew what she was talking about! Letter B Johnny's hand is up, teacher thinks, "Bitch, bastard...." so ignores Johnny, and this continues with each letter until they reach the letter R, and the teacher can't think of any foul language that might go with R?? So she finally calls on Johnny again, "Rat" Johnny says. Glowing the teacher says, "Johnny! That's perfect!" Johny says, while holding his arms far apart, "A big fucking rat with a cock this long!" .... Little Johnny and little Happiness are playing in the park when Johnny pulls down his shorts, points at his penis and says, "look! I have one of these..." Happiness pulls down her shorts and doesn't have one, and she's heart broken and begins to cry. Johnny, being a sensitive sort then chases Happiness out of the park with his weenie hanging out chanting, "I have one of theee-eese, I have one of thee-eese!" After running home crying Happiness soon returns to the park, looking very satisfied with herself. Johnny quickly runs up, pulls down his shorts, points at his little penis and yells," I have one of thee-eeeeese!!" Happiness smiles and pulls down her shorts pointing at her vagina and says, "Mom says that that is ok, because as long as I have one of these then I get as many of those as I want...." So there!! And thus begins the love/hate relationship between men and women.... :-) Little Dwayne and little sally are playing doctor when finally the clothes come off. Little Sally points to Dwayne's penis and says, "What is that?" Little Dwayne says, "You know, I'm not sure what it's called...I pee out of it, and it acts weird sometimes, but other than that, I'm not really sure. Let me go and ask my dad." He runs home and catches dad getting out of the shower, points at his penis and asks, "Dad, what is that thing??" Dad says, "Son, this is a penis. In fact, this is a perfect penis!" Little Dwayne runs back to Sally's house, and very proud of his new knowledge pulls down his shorts and says, "Sally, this is a penis. And if it was 3 inches shorter it would be a perfect penis!" :-)

Not to dis Dave, as I'm sure he's likely correct in the population he's discussing, but you're most likely looking for the more common EMT basic answer, and that would be V-Fib as Wendy stated, and to my understanding, for her stated reasons. Also, Mobey is absolutely correct. You will find that on a professional forum that most often those most qualified to answer your questions will feel that if you can't be bothered to proofread your questions then they will not be bothered to answer them. See? Mobey was actually doing you a huge favor by pointing out something that most would ignore, he just didn't wrap it in velvet before delivering it to you. But you can handle it.. :-) Dwayne

Man...this thread has gone in so many more positive directions that I'd hoped and not to a single negative place that I'd feared... Awesome guys and gals, thanks for the education! And I'm not being fascetious...I don't remember the last time that I thought of the 'rule of thumb' or that there was a relatively reliable distance between telephone poles that you could use to measure a safe distance from a hazard. Cool as hell... I seem to find, for myself, that there is not a single EMS related discussion, no matter how banal the subject, that I don't find something new, or am reminded of something that I knew but had forgotten. Thanks for your time everyone...But more than that, thanks for your amazing spirits. Dwayne

Man, every one of those was awesome recommendations. I couldn't think of even a single decent option...Great job doc! Dwayne

Face value. :-) Dwayne

Although there isn't a lot that ALS can do for these folks Ugly, there are certainly things that they should be considering....Right? Dwayne

There are no words to describe how much I loved that video! Seriously...If any part of that video pissed you off then it's time for a whacker check... Dwayne

Though I'm not sure that I completely understand the rest of what you said above... Yeah, I see that now. My apologies for misreading it before. I do believe that there are other ways to state the opinions that I make, and gentler ways. But I'm not good at those ways, as I try and focus on being clear over being kind, sometimes to the detriment of my goals. Also, if there is a gentler way, I don't necessarily believe that it is a better way. Paramedic medicine in my experience is physically, mentally and emotionally a contact sport. I have had people light into me both guns blazing over decisions that I have made. They don't tend to fare well, as I'm not terribly delicate, but many that come here initially, and many leaving school now, tend to be. I believe that we should feel obligated to help increase all of the necessary skills we all need to succeed in our chosen profession. Being able to accept and respond to productive criticism is one of those skills I believe, and a vital one at that. The "you should be ashamed" comment gave me a little 'ping' when I typed it though it was meant in the "Assie, shame on you for telling that blond joke AGAIN!" vein, though I can see now that it certainly didn't come across in that spirit when typed. Thanks for bringing to my attention. But again, it's my feeling that the OP has more than the necessary intestinal fortitude to say, "Fuck you and your 'shame on you', this is what I was thinking..." and would have been the better for the exchange. And all EMS criticism is very personal isn't it? Unless there is another medic on my truck that I'm unaware of, any criticism that comes from my truck, my care, my decisions or my documentation are aimed at me or mine. I think that that is very personal. And we'll stop eating our young when we teach our young to have enough self respect that they stop walking around looking like snacks, right? Agreed, with one exception. Though it shouldn't be our goal to make others feel bad for their opinions, how often do we see noobs or students post their questions or comments, have them questioned, and then never hear from that person again? Do you feel that it's healthy in our profession to be so delicate that having someone question your thoughts, in an appropriate manner, should create such a debilitating condition that they are unwilling to post a reply? (Not what I think is happening here by the way. Medic school is busy I know, so I'm confident that the OP is busy, not hiding.) Do we help them, or our profession by attempting to wrap each response in velvet so that there can be no possible offense drawn from it? How does one advocate for their patient when they are unable to advocate for themselves? Learning to stand up for yourself and your opinions is a skill not much different than learning to tie your shoes or spoon cereal to your mouth. It needs to be practiced, in different ways, in different places, under different levels of duress before it can be counted on. I tend to find posting here to be stressful sometimes believe it or not!! I have a lot of respect for the opinions of many here and hate it when i come off looking like a monkey fucking a football secondary to one of my best thoughts. But that is the value here too. Thinking before posting has taught me to formulate my thoughts much more clearly and completely before posting, and that habit has infected the rest of my professional life as well. I speak more properly, present myself better because of many of the lesson I've learned here. When we attack our 'young' we teach them insecurity and fear, when we coddle them we teach them to be weak and impotent, I strive for, though admittedly often miss, a middle ground of professional respect, where I neither disrespect them for their opinions nor disrespect them by assuming that they are unable to tolerate adult debate. It is always my intention to treat them with professional adult respect, though at times I do try to challenge those that seem up for it, so as not to let them get bored. I believe that this conversation is an excellent example of what I mean. My post was far from perfect. You attacked it in an intelligent, kind way, and in the very best spirit of what we do here, and I, as well as others I hope, have learned from that. Very little intelligent debate can happen here if people are going to faint at the first sign of adversity, yet too often I seem to see that happening. I'm grateful for your response, and for finding me and my opinions important enough for you to sacrifice time our of your busy day to correct. That's cool as hell. Have a great day all.... Dwayne

Good for you for stepping up Brian! A private tutoring session with chbare is worth much more than the time spent here! But I disagree with your assertion that you should have researched before answering. Though he did say that folks would need to research the answers to his questions, trying to work these problems through with the information in your head, in my opinion, is ALWAYS the right thing to do first! This is how you build logic trees, it's also how you allow your brain to learn to function as if you were on a call. Autonomous and without Google. So, if you're going to post something claiming that it is fact, then you certainly should site the reasons that you claim it to be so, otherwise there is no shame, in fact you should be proud, of working the problems out with only the supplies that nature put on above your shoulders. Excellent responses so far. I'm not going to participate in the answer at this point, as you're doing fine without my goofy help. I just wanted to jump in quick and make the point above. As you were.... :-) Dwayne

Here you go brother.... {http://www.youtube.c...h?v=zvDEVhR7u4U}

I made it clear that I don't believe that he missed 'doing' anything. Again, you're trying to tag me with that assumption. I claimed that he didn't report it correctly. Or, perhaps you can correct me, what is a normal set of vitals signs for a 90 year old male in this situation? You'll need to quote the part of my post where I claimed that the medics played any part in this pts mortality. Had it raised his suspicions I would have expected that he would have told us in what direction his suspicions pointed him. Are you truly going to tell me that you've not seen new and seasoned medics alike that have been dispatched to a "drunk" and were nearly unable to see anything upon arrival besides a drunk? This is a post call review, in which he states that his personal view is that the pt was old and dying. That is a very weak diagnosis, and one that I don't believe he should be happy with now, nor feel comfortable making in the future. Something was killing this patient while he was in this mans care, and something finished killing him two days later. What I was wishing for him is that he would have a 'feel' for what was going on anatomically/physiologically and not be satisfied with "He's old and dying." I've witnessed the deaths of many, many "old and dying" people and very rarely has their death come from a common cause. And very rarely was a unable to get at least a hint of what that cause may have been. I wish that for him. Agreed. He considered the fact that he was old. But again, failed to report which aspect of being old the he believed was killing him. According to what was reported, this was a perfectly healthy 90 year old that died. No history, no abnormal assessment values, no pain. So....why did he die? I hope for him to need to know that. My criticism was hoped to have cause two things to happen. First, convince this young new medic that being criticized is the life blood of EMS, that it's GOOD to have people tell you that you were weak in places, in this case case reporting, so that you can become stronger. Second, to allow him to come back and speak for himself. A very necessary medic skill and something that I know for a fact he is perfectly capable of, and in doing show others here that may be more timid that having a spirited debate is not the end of the world. See? Though I do applaud you for coming to his defense. Dwayne

I know nothing about fire, but I know that I wouldn't have used a backboard in this situation as I don't see the point in having several men exposed for an extended period when one man could have dragged each by a perfectly good arm or leg to other rescuers. Great learning video I think. Dwayne

Thoughts of peace and healing for those involved an all who love them from the Womacks in Colorado... Even you North, though you choose not to come and play any more! Chin up brother... Dwayne

What? I don't get it.... I thought all of those things were obvious? Dwayne

A few things, lest those that are newer misunderstand and believe that we're critiquing this man instead of learning from him... His radio traffic was calm and professional, as I'm willing to bet he was as well.. Very rural roads, and though I can't remember if I saw road signs or not, I'm willing to bet that he didn't need them. When I've lived in such areas I've personally know the vast majority of the people that lived there leading me to believe that he is more likely to run into trouble for a friend than he might have been for a stranger. He saw people down, and again calmly asked that fire and EMS expedite...No whacker behavior here, just fatally poor judgement. Then, the key to his fatal error in my opinion..He reported "smoke", not vapor, (as in another thread with a patient dying of being' old?'), created this mindset and I'm guessing that in his mind it then became relatively harmless smoke...and ran into it. It seemed that he became aware early on that he was in trouble and tried to drag his pt from the area, but instinctively dragged him toward his car, and into further trouble. Terribly sad video I think. This is what we have firemen for. One of the things that they train for, why they get all of their almost never used fancy toys, for these times. If there is any question, let them do their stuff. Dwayne Yeah, man, I'd thought that he'd run out the other side of the vapor and we couldn't see him! It couldn't have been more than 5-6 breaths. Thanks for the MSDS! Nasty stuff! I'm guessing that if ALS could have gotten to him right when they arrived that there is little or nothing that they could have done to save him... Dwayne

My apologies if this has been posted before, but perhaps it couldn't hurt to see it again? http://www.youtube.com/watch?v=zvDEVhR7u4U What are this man's errors? Edited to add question and change formatting.

Maybe this will help? http://www.youtube.com/watch?v=zvDEVhR7u4U

Good question I think, and interesting. One issue that I have though, what are normal limits for vitals signs for a 90 year old male? Particularly one complaining of transient chest pain and generalized weakness? What do you suppose the odds are of a 90 year old that TRULY has no previous history? I've had some, and was shocked to my core each time, but never accept that when told by this age group without extensive investigation. Just curious. You've already trumped your classmates by being brave enough to come here and hang your business out where strangers (Notice I didn't say perfect strangers) can judge you. So far they are still hiding in class talking out of their collective asses... don't go backwards now man.. Don't bail on this thread just because you caught a little criticism, get your ass back in here an participate! Trust me on this... I think that you did miss some things, and shame on your for "My personal view is he was old and dying..." , because if that was your mind set after developing your initial impression then that sets you up for doing really bad medicine. And have you ever seen an official diagnosis of 'old?' Old could mean long term coronary, pulmonary, vascular, neurological degradation or those things could simply be the herd of horses that you're supposed to pick the zebra out of, right? I don't think that there were any skills that you didn't perform that you should have. But for your future medic career I think that there are perceptions that could be changed and degrees of suspicion that can and should be added for all of your 'obvious' patients. Good question man... Have a good day. Dwayne Edited to ad everything after the quote. And again for a grammatical error.

LMAO...that's awesome! Mommy should have been more clear, and possibly sober... :-) Dwayne

Yeah, I found the above telling, as it appears Herbie did as well, that you said that you have a new job, and you have a new schedule but you think that perhaps it's her that's having a hard time adjusting? I have news for you brother, any time you make a change in your life, you change too. Sometimes you change little, sometimes you change a lot, but you are not the same person you were, not 100%, then before you took the job. Listen to her and find out what it is that she wants and needs and then see if you want to give it to her. That's what relationships are about, right? When my wife Barbara (Babs) tells me that something in our relationship is broken, or that she is unhappy for some reason, I immediately stop what I'm doing and listen, and believe her. She sees me much more clearly than I see myself at times, despite what my penis would have me believe, and she tends to be THE expert on what makes her happy and not, see? So it pays to listen to her... Babs mentioned to me gently a few times that I seemed distant sometimes when we talked. I didn't feel any different, yet decided to pay more attention and see if she was noticing things I wasn't. And she was. I remember one instance in particular, (My wife is a homemaker, caring for me and my 14 year old autistic son who is home schooled) where she suddenly stopped talking and walked quietly away saying, "I'm sorry, I can see you're not interested in this, I shouldn't be trying to cram it down your throat." The reason it sticks out in my mind is that she was telling me about a tv show, like Oprah, or some such, and the thought going through my mind at that moment was, "Good God! Please! I've been puked on, pissed on, spit at, told a family that their baby is dead and going to stay that way, will you please stop yapping about Oprah!!" I've never felt, and in fact may have never been, a bigger asshole in my life than I was at that moment. And I've been a pretty big asshole at times. She was good enough while standing by me throughout medic school, she's good enough to shoulder all of our home responsibilities while I run around playing macho medic, but I'm suddenly too good to hear about her day if that involves something interesting she saw on television? Bullshit, right? Do I now want to hear about what's happening on Oprah? Actually I do. Babs is smart, and kind, and sexy, and funny, and the things she wants to talk about are most times smart and interesting. Plus, she needs my time, and even more important, she needs my attention. The world tells our mates that we are something different because we're in this profession. That we're somehow braver, and more competent than meer mortals. Not Godlike like hosemonkeys of course, but somehow better than most. And our mates need to know that we're not buying into that hero bullshit. That we're still husbands, fathers, boyfriends and fiances first, and the rest is work. Is our job different? Sort of. In most jobs if you had to work 60hrs/wk to make a living you'd tell them to go and fuck themselves. In EMS for some reason most are willing to give up a lot to stay. Me included of course, as I type this from my little FEMA trailer at the end of the world. Is it more stressful? No, I don't believe so, and we need to stop telling ourselves that it is. Even when I've been bloody, or running to the ER with my sphincter chewing big chunks of styrofoam out of the seat Ive not found this job to me worse than many others. I've stressed harder wondering how I was going to get hay up before a big storm, or get a roof on a house before it snowed. And just a few assides. First, I think that sex makes an awesome barometer for a relationship. If you are spending more time 'working' on your relationship than you are spending getting naked and sweaty, then it IS time to sit down and figure out what's broken. Stop what you're doing right now. Go in and screw your brains out, and THEN talk about what's going on with this new job...You'll both be less defensive, more receptive, less rushed..(.and besides, by the time she's done yapping about all of that you'll be ready to hit it again! Ok, so maybe that was insensitive.) And with that, I swear to God, I have made my one and only incursion into your sex life... Second, isn't 7 years a long time to be engaged? Isn't it time to shit or get off the pot Mr. Heroic life saving EMT guy??? That's what I've got brother. Like most of my opinions it's likely mostly bullshit, but if you're able to find something in there that resonates with you then maybe it will help. Dwayne