DwayneEMTP

Man...outstanding response. I truly don't know how I feel on this issue now. So are you saying then Crotchity that you and your black partner would drive into the redneck trailer park while a drunken party was going on without concern for your safety? (For the record, I spent the majority of my childhood as poor white trash (Each word working as a separate and combined description) and it has also been my experience that trailer parks were common places for us to live. It is also my experience that if you would choose to do as described that you should no longer be allowed to make significant decisions on an ambulance) I think I see your point, but your point seems to imply that if I haven't been attacked in this house then I am a bigot for considering the fact that my coworkers have been endangered in the houses on either side? You seem enraged that a child would have a delay in care simply because he happened to become wounded in the middle of a war zone, say, Compton. And truly sad it is, but isn't it also a fact of life? I hope you will consider the above as sincere questions as intended. The others that say that it is a neighborhood/social strata issue make good points, but those descriptions of the problem seem to be missing something for me. To on the other hand make it a strictly racial issue is off in the ditch as well...Man, I don't know..I'm on the fence and getting splinters, so I look forward to the continued debate... Dwayne

Kind of EMS related... http://www.youtube.com/watch?v=b-JRQXYy9wk Not EMS related, but I like them...

An old Cherokee Indian was speaking to his grandson: “A fight is going on inside me,” he said to the boy. “It is a terrible fight and it is between two wolves. One is evil–he is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego. The other is good — he is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith. This same fight is going on inside you, and inside every other person, too.” The grandson thought about it for a long minute, and then asked his grandfather, “Which wolf will win?” The old Cherokee simply replied, “The one you feed.” True, right?? Dwayne

Yeah, sorry, I guess I didn't get your point... I think that I can agree with that point, though I've only known one person that went to a 10 week school and she entered with a bacchealors degree so I'm not sure that it counts. As well, are you going to get some rock starts as well chuckleheads from each program. Sure, at least I'm confident you will, but we can't create our programs based on that fact (assuming that it is one), we need to create programs for the masses, right? And to do that requires focus and planning. Heh...Me too Have a great day! Dwayne

Good on you! Now relax, get comfortable, don't be super intimidated, and hopefully you'll have a great time! Good luck. Come back and share how your first paid day on the ambulance goes, ok? Dwayne

Wecome Christopher! Glad to have you!

That was my question as well. To dress up as a Klansman or black person and be offensive seems like it would be one thing, to show a black person being killed seems like it would be another. As to him being prosecuted, I can't remember if it was in the article or the video I watched, but he's done this at least several years in a row now. I love how he says something to the effect, "People are shaking my hand and showing their gratitude for someone still being proud of their white heritage." What a dickhead. If I hang my dog from a tree is that then somehow showing my pride in being human? And Herbie, Ruff, as far as hate crime legislation going against the first amendment, I believe that covers actions, doesn't it? If I beat you because you're black, then I've committed a hate crime. If I state that "I wish all of the kikes and N****** in the world would just die" then I believe that I've moved back to protected speech. Not sure though. For the record, as these discussions when had in a frank, open manner are subject to misunderstanding. I don't love or hate any particular color, sexual orientation (Well, ok, so I do have a preference here), religion, etc, etc, etc. I want every person on the planet to be able to succeed, or fail, and find love based strictly on their desires and/or abilities. I choose not to hate, and I refuse to support haters when possible. Cool discussion.. Dwayne

So, I stumbled across this asshat, (in my opinion) while looking at useless shit... For those of you in the United States...Protected speech or not? And why? http://www.angryblac...loween-display/ And of course our brothers and sisters from outside the U.S. are welcome, I just have no idea for the most part if the context stays the same.. Dwayne

Bless you IE, but did you get the part about letting the BLS and new ALS take some shots?

Holy shit! Someone that's actually thinking about EMS from a different perspective. I have to chastise you a bit, as your first few posts are supposed to be about decapitations and spurting arteries.... But if you insist on exploring this avenue...I have nothing to add. I'm sorry. I use a scoop every chance I get. I hate spine boards. Every make, type, color, material, I hate them all. I don't know the different scoop brands, or makers, or styles, I just know that there is nothing mashing against my patient's spine and ribs for the most part. And for me, that is almost always a good thing. My betters here will have much more intelligent advice I'm sure. I just wanted to chime in and mention that..you're weird...I'll be keeping an eye on you freako... Dwayne Edited for typos.

I really kind of hate to chime in here, as it seems like bad advice, but I've also felt this, though I don't do it as often because it feels less stable. Maybe chbare or others will bring their physics educations to hear on this issue... Dwayne

Hey Joliet, welcome to the City! Though I'm pretty sure that's not the answer you were looking for, it truly is the golden ticket to these situations. You wouldn't enter a scene with a person with a gun or knife, right? Or a car dangling off of a cliff? Why? Because scene safety is our primary concern. We can not allow the problems of our patients to convince us to take career anding chances for ourselves. That's just bad, irresponsible medical practice. Sometimes the most macho thing you can do is have the balls/ovaries to say, "I can't do this." If you truly are in a situation where you have no help, then that is completely irresponsible on the part of your employer. To expect a two person crew to be able to overcome any and all obstacles they may encounter is simply ignorant. Should we be able to deal with adversity? Sure. Is it realistic to assume that we can overcome ALL adversity? Of course it sounds ridiculous event to say it, doesn't it. Use help. But if you must use untrained help make sure that you take the minute or two necessary to school them on lifting, when to lift, what will happen after the lift, etc. Great question! I'm just not aware of any magic bullets for this issue... Dwayne Edited to add text in italics for accuracy. (Though I'm not completely convinced that balls or ovaries has a terrible lot to do with anything 'balls' related. But just in case...) No contextual changes made.

No need to thank me. I'm guessing you know that I don't give them out unless you meet my self deluded bullshit standard for quality. Your posts, whether I agree or not, are always well considered and presented. I don't know anyone here that doesn't respect that. I agree to a point. I believe that if you were to become an accountant, then online is fine. A medical biller? Perhaps the same, though I know nothing of what they do, it just sounds like a logical, detail oriented job. Is there something that I think is so special about paramedic medicine that you should only be able to come up the way I did? Yeah, but I think it's the same thing that's special about carpentry, or plumbing, or auto mechanics, horse training. This job, for me, is sometimes as much about my eyes, ears, nose, and hands as it is my brain. (and thank God for that.) You mention you did your best with just you and your mannequin. Where did you get a mannequin to practice on? Is one given out as part of the learning materials? I didn't see it on the equipment list. And I'm not talking one of those hundred dollar little things some teach cpr on, as that would be useless to a medic student, but the base level, several thousand dollar model that would still meet just the minimum needs. Right? Most aren't going to have them. How long did it take you to get good at taking a rock solid blood pressure? Do you really believe that that is best learned, for the first time, under the pressure of clinicals? Did you REALLY learn to recognize pathologic breath sounds from the recordings we've all heard at one time or another online? Yeah, me...not so much. How much of your AAS class was spent sweating your balls/boobs off in front of the class while you tried to remember in what order to apply the KEDS straps? Or being in charge of your team during scenarios and wanting to die because you couldn't remember what fucking condition makes you febrile, gives you a headache and makes it painful to touch your chin to your chest!! Damn it!!! But you did learn, and partially, at least I believe that most of us did, sometimes in a pressure cooker. I look back at that stress now and think how ridiculous that was...But it wasn't then and it helped to teach me to deal with medicine and stress together in the future. Right, or no? How will that be recreated in the online environment? I was once surfing Mardi Gras boob pics and stumbled onto gay bondage porn. It was stressful, I will admit, but don't believe that it helped me in my EMS career. What do you do with miss introvert when it's time to step out into the real world? Or Mr 25 year old hero whacker that hasn't had to have his behavior judged until after he's completed his studies...hasn't had anyone to say, "You've gotten great grades, but you're behavior is going to make you the laughing stock of EMS." How will he be guided in that regard? It may seem like I'm splitting hairs but I truly, truly believe that these are all important things that happen when exposed to peer pressure over time...and I don't see that time in this program. Again agreed, but again you're only addressing didactics. And EMS is only didactic in small parts. Before I develop a working diagnosis I've examined skins, pt anxiety level, sound/rate/depth of breathing, how they move their arms and legs, the way they form their words, the quality of their pulse, the condition of their house and car...etc, etc, etc. And all of those things take practice and I studied them throughout my entire paramedic education. I don't see how one can gain those tools in the few weeks they'll have available during scheduled clinicals. Having the knowledge without the skills is like having a computer without a monitor I believe. And if there's a limit to how much you can slow it then I'm good with that. If you can go forever, then I'm not. Again, I believe that a certain level of stress needs to be built into EMS. So that we can handle the never ending tv like blood and guts we deal with on a daily basis? Heh...of course not. But so people can develop the tools for coping that so few seem to have today. We aren't tv heros, but we sometimes are put into some pretty shitty situations and expected to perform in a professional manner. We weren't born with that ability, it needs to be learned. And what about the granny call at the end of a 24? Don't you think that that is stressful? I do, over time. I'm not sure I completely agree. I would have been the worst hero bullshit whacker medic on the planet if I hadn't come to the City. Dust, ak, chbare, and many others here and gone convinced me that if I wanted to play in their sandbox, and I wanted to so badly that I could taste it, that I needed to be able to run with the big dogs. I followed their advice, and have never regretted it, though I'm still more qualified in the poodle or chihuahua category. I agree again, but for that to happen, we can't put all of that aside... Thanks for your thoughts girl.. Dwayne I don't know why tcripp, but I just saw your tag line and laughed so hard I about peed my pants. Even now, I have no idea what makes that so funny, but I'm powerless against it... :-) Cool as hell.. Dwayne

I've seen it twice, and once was almost a duplicate to the video, the second, as Mobey stated, just looked like a strange swelling under the pectoris muscle. I'm guessing due to splinting secondary to spasm, though that didn't occur to me at the time. My official working diagnosis for that injured part was, "Wow, that's weird, better keep an eye on it." I was told of the diagnosis later at the ER. Can you take a run at the rest of the questions FP? I'm proud, though not surprised to see you being the first to jump in. And Mike, that Pararescueman technical specialist ninja to you... Doctors only wish they could be so macho. (Some AF guy is going to see my badge and beat the shit out of me...I just know it.) Dwayne

Actually I don't know anything about this guy, but from the video I'm pretty confident that I know how he ended up here. In the past we've had some pretty brave and adventurous BLS/New to ALS providers that liked to jump in and explore these types of things. I just wish I had more info. Perhaps those of you that have more experience with this type of injury can help field questions? I've only see it twice since being a medic so am certainly no expert. C'mon folks. Those of you that have looked, but are afraid you're too stupid to play? You're not. This is a pretty simple/complex type of case. What say you? Dwayne Note. I originally found it here.. http://www.medicalvideos.us/ and may, or may not have misrepresented myself as a physician to get it, though after having done, or not done so I don't think it was, or wasn't necessary to gain access to the site. Just sayin'...

What is flail chest? What caused it? What are your primary short term concerns? Longer term concerns? Load and go/stay and play? Why? Treatment? Please folks, if you know all of the above answers, please don't ruin it for those that can learn by asking and exploring. We already know you're smart. To the rest that are familiar with this, please feel free to jump into this thread in a mentor-ish way and help it move along if you would. I have no info on this patient so we're going to deal with him in gross terms only, OK? Dwayne

That link is pretty cool Mobey! To tell the truth I've never even considered that. They told me in school that people will either, 1) get zapped if they are touching the pt, 2) leak enough of the current from the pt to make defib unreliable. And I've not bothered to give it another thought since. As with focus on compressions instead of ventilations it seems that this could be significant. Not nearly so much as the vent changes, but something. And in CPR it seems that it's the little somethings that often make the big difference. Thanks for the link. Good thread Noah...thanks for posting man. Dwayne Edited because I had point A and point B but didn't realize that B+) = . Not exactly what I was going for. No contextual changes made.

You know Doc, though I hate to think it as he's sometimes had valuable opinions, I think we've pretty much got to put Crotchity in the troll catergory. Though his opinions have often been unpopular I do believe that he used to have some points of view, sometimes the racist ones most of all, that were worth considering despite the fact that they were often politically incorrect.... Unfortunately now he simply posts those types of ideas and runs away... That's too bad. Have a great day all! Dwayne

What do you base this statement on? I'm not aware of knowing any graduates of these programs and have never taken one... Agreed. And I hope that I made it clear that I wasn't labeling this school as one. Only attempting to show the OP that if s/he wanted to be different in EMS that there was likely not going to be a convenient, shorter way to do so. Again, I have no doubt, but the quality of those clinical programs varies greatly, perhaps more greatly than the quality of schools. I believe that in a program that teaches paramedic medicine online that the clinicals must be planned and focused on the limitations that are inherent in that. Simply giving a student an ambulance to ride on or an ER to attend to is not going to get it done in this instance I believe. Yeah, I was thinking about this after I posted..I thought, "what kind of pipe dream bullshit was that?" Heh.... You're right...most won't care in the least, and that breaks my heart. Some will though. Yeah, agreed. Though it causes me actual physical pain to say so... Agreed again, but I do believe that this is different. It seems that an online program is going to come with so many built in weaknesses in practice, training, hands on interaction, that it would be even more vital to increase the educational standards to compensate. I have a really bad feeling about a school that would choose not to. I would have much more confidence in the site as well if they didn't hit all of the wanker hot buttons. Study at home! Less expensive! Fewer practice and clinical hours and you can do them all at once!! Etc... See? Had I seen something that led me to believe that they were intent on mitigating the inherent online deficits I would maybe have been able to get on board based on you and tcripps recommendation. But the fact that she's a nice woman really doesn't make up for the fact that, at least from what's available on their website, they don't compensate for the online learning. Yeah.... How? Even the 10 week courses are 6 days/wk I think... I saw on my phone that you had posted and thought, "Ah shit...this is going to suck..." But it didn't. I'm grateful for your insight and thoughts. It will be interesting to see how it all shakes out. Dwayne

Hey Girl, thanks for your reply. The reason I asked is to try and figure out what education you've already obtained to try and help you decide what might be good to do while you wait. Unfortunately I didn't help myself very much with my questions.. Did you have A&P prior to beginning your nursing program, or during it? What other courses have you taken? I also asked why you've changed because it's not an uncommon story to hear people that find nursing school to be too challenging drop it for medic in the hopes that it will be easier. When speaking to these folks it has not been my experience that they have found that to be true. After hearing what classes you've taken some of us may be able to more productively give you some idea of decent ways to spend your time while you wait for classes to start again. You sound smart and energetic! That's a great start...I look forward to your comments... Dwayne

I'm not familiar with the head of this school or the school itself, but I think that there are some significant questions you need to consider before you choose this path.... Why would you choose to take an online course as opposed to getting a brick and mortar education? Is it that it's cheap? In my experience you often get what you pay for. More convenient? If you were to discover that it is a half asses school (which I'm certainly not claiming that it is) would you still choose to take it instead of making the necessary sacrifices to go to a community college? If the answer is yes then you've just become part of the EMS problem instead of part of the solution. I went through the site pretty well, at least the paramedic portion, though I could have missed much, and though I can find pages of information concerning payments and refund explanations, which I think is honest and relevant, I couldn't find any information really concerning the education. They claim to have a higher than average first time pass rate for NREMTP, but you really should be able to teach a dancing monkey to pass the NR without a whole lot of trouble if that is your focus. What I didn't see were any prerequisites. I truly believe that college level anatomy and physiology are vital to becoming a skilled provider, and it doesn't appear that those are necessary here, nor could I find where it showed to be a significant part of the online education. Again, I didn't read every page and if I've missed it I have every confidence that spenac will point it out for me. It's not clear what the clinicals consist of either. Who supervises them? Who will you spend your ride time and hospital time with? Will there be any hospital time? As I don't believe it is required by the DOT curriculum, though again I'm not sure. If the rest of your education is going to be spent alone, you really, really need to be sure that your clinical time will be high quality and focused. There are significant questions here I think. You might even want to call around to your local agencies and see if they are willing to hire paramedics that have graduated from an online course. I would be terribly hesitant to do so. EMS is a contact sport. It requires people that are able to touch patients, use their hands, confront others when necessary, lead groups, manage human and mechanical resources. Those things can not be learned in any significant way behind a computer. I believe that many mature adults will come to EMS education with a significant part of these particular skill sets, but those that are a bit younger...well, I just don't see them developing those skills in a vacuum. A huge part of AAS degree EMS education involves learning while doing. Thinking about doing is not even in the same universe as the actual doing. Tcripp and spenac both claim to have a personal relationship with the woman that runs the school and say that she is honorable. Spenac and I aren't exactly buddies, but I've nothing but respect for tcripps opinions to date and have no reason to dubt her, the problem is that there are honorable people turning out whackers every day. Unless you simply have a hardon for a patch that allows you to run lights and sirens in an ambulance I believe that a very close look is warranted here. Dwayne