DwayneEMTP

Ok, finally I give up. You simply are an idiot. Not misunderstood, not silly because you became disgruntled, simply an idiot. How was your assumption wrong? What part of my behavior do you find dishonorable? Who is to gain if I jump on your bandwagon and attempt to get a bunch of people to rally against you? I have many friends here, but not a single one that would support me in such destructive behavior, nor have any respect for me is I participated in such an idiotic thing. I chose not to do so, and as usual you have a attempted to create the most potent negative you could think of from that. That God you’re really not that good at any of this. I’ve never claimed otherwise. The fact that you choose to cry at every comment instead of discuss it like a grown up doesn't make me a bully. I've heard from someone I trust that you're a strong contributor on another board. Smart, intelligent, considerate. To bad you decided to be a wuss on this one. I asked you kindly to stop polluting our threads with pointless comments that did nothing to contribute but only drew attention to yourself. You told me to go pound sand, that you'd clutter the threads if you wanted to. I criticized you for polluting the threads and you told me you would continue to do so because you thought it was fun. And now, at least you've become entertaining in your constant "poor me" crybaby crap. I've just been sitting back munching popcorn brother. I've never seen this happen and I've said a truckload of idiot things in conversations with him. He is kind enough to challenge us all to be smarter, to think deeper, to validate our logic, and yeah, some weak minded people consider that unkind and aggressive. You seem to be one of them. I've never claimed to be otherwise, though it's not my intent. And this doesn't narrow down the search for your mysterious, almost certainly imaginary, friend, as almost everyone I know would fit that comment in somewhere in a description of me. I'd like to check you our on the other sites you post to. (unfortunatley you will likely read that as a threat. But it is not) I think you are almost certainly smart, and can be kind and interesting. I think maybe you made a bad start here, or perhaps wanted to see what it was like to play the ass on a site that you're not personally invested in. I hope I'm right...I hope I find that I find that I owe you a wheelbarrow full of apologies. And for the record. I'm not sure where you got the idea about me "hunting you down" in the threads. I've been involved in these threads a few days before you found them, our meetings come from clicking on like threads as we seem to have common interests, but you can trust me when I tell you that I don’t give you enough thought that it would cause me to make the effort to hunt you down. Dwayne

OK, see, this is why girls scare me me.....does this mean: A) OK, I went and reviewed the thread and see your point, so keep doin' your thing man. Carefully note my sarcasm, because if you keep screwing around in a thread I was enjoying I'm going to come back and kick your nuts up somewhere around your tonsils. :shock: C) As you have a penis it is pointless to try and reason with you, so I give up, do what your going to do because you're just going to do it anyway. :? D) I had hope for better from you, but am once again reminded that both of your brain cells are perpetually vapor locked. E) All of the above and none of the above. Or, was it perhaps some clever ploy to get me to see that trying to figure it out is too much work so I'll just go back to downloading porn? I choose E, plus that last sentence too...but just in case, as I don't want anything traumatic happening to my nuts, I'll do my best to help get the thread back on topic.. Spenac, I sometimes find my posts shocking. But I'm not clear about which part of which post, all or in part you're referring to here. Practical jokes..good. Playing them irresponsibly, or on people that have no interest in participating....bad. Dwayne

The only thing I remember having said to you before was that I was offended that you wanted a thread locked. You had accused someone of arrogance if I remember right, and I made the point that it was terribly arrogant to think that you should decide what we should read and discus and what we shouldn’t. I still think so. You show your ignorance even more so with this statement for two reasons. First, I can get 30 soldiers signed up as new member is the next three hours that will tell you to pack your bags...you challenge is ridiculously easy. Second, I have no desire to chase you away, only to attempt to challenge you to stop cluttering the threads with mindless comments. It dilutes and cheapens the threads as well as forces some of us to view your intelligent posts as ignorance gotten lucky. I want you to stay, and participate and argue with me, to correct my opinions and help me be smarter tomorrow than I am today. That won't happen if you're gone. There is only one other member that I've made such comments to Doc, and that doesn't bode well for Kat's future intelligence, as I'm guessing he and EMTDon (or whatever his name is) are buddies. Don is tireless in his ignorance...let's hope it's not catching. Dwayne

I hear ya Ruff... The problem with threads like these, as with say, spanking arguments is that we're arguing an undefined label and not specific behaviors. I see where you're coming from, but the assault that happened to you would not be considered a joke to any responsible adult I know, and certainly isn't even on the radar for a professional medic. Jokes are good, they are fun, unless they come in a constant stream, which doesn't work for me. We need to have this discussion without the absolutes, the recriminations and the self righteousness. Put baby powder on my visor and I'm going to hunt you down and feed it to you...you can count on that. Make people think I don't even have basic social skills, that can be funny, if it's meant to be funny. A friend of mine from Bagram Afg wrote a gnarly hate letter, cut the header out of an email that he'd sent to about 50 people at my previous company, pasted it on the top of his hate email, and sent it to himself from my account, which I had left open. I saw the hateful text, which I abhor, with the header showing it went to everyone who was anyone and immediately went into kill mode. I blasted out of my chair and as I was doing so could hear him yelling, "It's a fake!! It's a fake God damnit!! I didn't send it to anyone!!" So I'm standing there all puffed up like a peacock, fully in John Wayne mode, when I discover, as I would have known had I thought instead of simply acting, that I'm all dressed up with nowhere to go! The other medics are laughing so hard that there are tears running down their faces...I'm feeling like such an asshole that I can't breath for laughing, it was perfect. That's my idea of a first rate practical joke. SENDING the letter would have been over the line, plus it would have been easy, only a stupid person would have found that funny. Like the powder on the fan blade. What fun is it if any mental midget can do it? But he considered who I was, how I thought, and bargained on my behavior being what it was to make it work, and like a sap I stepped right into his little trap...that's awesome. I think we should return this thread to the OP now, allow people to discuss their greatest practical jokes, and hopefully those that have played the ones that many of us find objectionable will learn from this thread instead of having everyone constantly re explain why they're simply beyond redemption because they didn't think of all of this stuff before. Dwayne

Man, what I hate about this thread, every time it comes up, is the self-righteous attitudes. Play a practical joke and your unprofessional, you compromise patient safety, you endanger the health of your coworkers and the profession as a whole. What a bunch of utter bullshit. I've got a family full of Dr.s and nurses, as well as know a few paramedics that are considered the ultimate in professionalism, yet have never know, not a single one, that was so uptight as to freak out over a harmless joke. When folks get tired, they do silly things. And at silly times, silly things can be funny as hell, as well as a way to hit the mental reset button before people start to go at each other's throats. It's well known to those that I work with that I NEVER pass gas, burp, blow my nose or dispense any other bodily substances in the presence of others. I just have a thing about that, don't do it, not ever. Once, of the guys here that is rather proud of his flatulence snuck up and passed gas next to me during a meeting, and of course everyone around me smelled it long before I could escape, and made a huge deal out of my "lack of manners." It was hilarious...we were all tired, and cold, and didn't want to be in this briefing, and because of that it was exactly the right thing at exactly the right moment. Not a single person actually believed that I was guilty of the offense, but they had an awesome time giving me hell about it, I was fine being the brunt of the joke (didn't touch my stuff, impune my ability to respond, or damage more then our senses of smell) and everyone got to blow of a little steam…so to speak. It was a practical joke. It happened in the workplace while many of use were tasked to respond to calls. But I now read this thread and find that because I participated that I can no longer be considered professional, nor a patient advocate, nor anything really but a behaviorally pathologic anchor to the EMS profession as a whole. Yeah, right. Dwayne

Yeah, with about half of it made up of the idiotic responses you use to pad your post count. Try building numbers with intelligence instead of this, "I'm so smart that I can't be bothered" stupidity. It seems like I remember you having a couple of smart posts, it's unfortunate that in the other 80% or so that you go out or your way to be childish and ignorant. Yeah, the "No practical jokes or someone could die" mentality is a little hardcore for me. If I'm intelligent enough to do decent medicine, which of course is constantly in question, then perhaps I'm intelligent enough to consider the ramifications of some silly joke. I'm not a big fan of regular practical jokes. If they're clever, non destructive, and don't involve touching my things, hell, burn off a little steam. If I or my things will be damaged or endangered, or my response times compromised, then it's time to grow up and think of the mission first. Laughter and good feelings though are also good for teamwork, which is also good for the mission, and that should be figured in as well. People that are all bound up, tense and constantly serious in my opinion rarely if ever rank amongst the medics that appear strongest to me. There is a balance to all things..simply find the logical, intelligent, responsible one here. And for the record, I’ve always found the plastic wrap over the toilet bowel to be pretty friggin hilarious. Just sayin’…. Dwayne

You don't, unless you're willing to go to the mat. That means documenting his medical treatment of this patient as well as the other patients that he feels unworthy, and comparing it to the patients that don't cause him to feel so. He sounds like an asshole, or perhaps a burnout, or maybe he was just having a shitty night. But unless there was bad medicine following this comment, I think you just decide that you don't like him very much, that he hurt your feelings at a bad time, and move on. Anything else is simply setting yourself up for a beating. Sorry to hear about your tragedy, but as pissed as you may be, unless you have documentation that he backed up his statement with substandard medicine, you just need to move on. Dwayne

Yeah, I think I see what you want, but the two situations don't really equate. What are the likely reasons for an arrest in a child vs 90 y/o? Right, much different and most often less permanent for the child. What are the odds of successful ROSC? Much more likely with a much better long term prognosis, again, for the child. Does the family (Who's present) wish a full code? Also, I can work the child, and if successful have a prognosis that isn't negatively defined by my interventions. But again, I hope you'll notice that none of this for me, or that I can see for the others that chose not to work it, revolves around their current quality of life. They are decisions based on science based medicine that simply says that in certain situations the odds of providing a positive outcome, even if ROSC is obtained, is so small that it makes no sense to attempt it. You seem to want to get people to compare the value of the child to the value of the elderly woman, and that comparison has no place in this equation. This is about who has the most viable body, not who has the more precious soul. Dwayne

No worries Chevy... If your confident, then understand that the only thing that will cause you to fail IS the jitters. Make yourself relax and not take everything so seriously. It's a game just like in class. Say the same thing, and they'll mark the same boxes. OK? Good luck man, make this fun, and you'll make it as easy as pie.. Dwayne

Maybe Matty, But I've never heard of it. And Google was no help, at least with the meager info I supplied it. My issue, yeah, is with the CPR. That's why I would have no issues having my partner give PPV while I get with medcon. There is no way that I can see that this pt can survive CPR, and it is almost certainly not going to save her. So I'm opposed to damaging her when the ends are all negative with no realistic hint of a positive. If there is an option that allows for sufficient CPR without causing her physical damage, and I have some reason to believe that my above assumptions are incorrect, then I might be up for that...Though it's late, so I'll need to let it percolate for a bit.... Dwayne

Yeah, I'm not sure what exactly the protocol states, the PPV was my nod at CYA in case I was asked later if I initiated CPR. Again, I'm not suggesting anyone "cowboy up" and break their protocols, only that the Medcon that I worked under would not look favorably upon making the obviously futile devision to traumatize this woman. If you lose, no ROSC, she dies. If you 'win', ROSC, she dies from the damage you caused winning. I don't see the logic there. Dwayne

I think you'll be in the minority of thinking paramedics that would work this pt, though as often happens, I could be wrong. I didn't make a single decision based on her quality of life. I didn't mention her tubes or mentation status. I believe I laid out clearly my reasons for letting her alone. She is asystolic, which many systems, within given parameters are not going to work anyway. She's been down around 10 mins, though if this is the average CNF that I'm familiar with, they have found her dead and are only claiming to have watched her taking her last breaths. She's 89 years old, which means we are going to badly damage her thoracic cavity if proper CPR is performed, so on the .01% (Pulled that out of my rear of course) chance of ROSC then she can die painfully of pneumonia in a few days, assuming there is any neural viability allowing for after being down so long. If your Macho demands that you beat up on an old woman with almost 0% chance of causing a positive outcome and a near 100% chance of causing her detriment, then knock yourself out hotshot. But if that is what you bring to my previous medical director in Colorado Springs? You better hope you had an application on file in Pueblo. Dwayne

Hmmmmm.....Is it bad that that picture made me vomit pea soup while my head was spinning 'round like a top? Ok, good, I didn't think so. Dwayne

The number one reason I would never, ever, ever buy one of these flashlights? They are liars. It seems obvious to me that all of the testimonials, besides being utter bullshit, were written by the same person. They lied about their testimonials, making them and everything they touch suspect for me, and putting them off limits for my money. Leave out the fact that they have falsely convinced many of the great unwashed that they've bought more than a flashlight, and that they attempted to insult my very limited intelligence by presenting their nonsense as fact, and that they, in partner ship with YOU my friend, have stolen 30 seconds of my life that I may never be able to get back. (I'm moving pretty fast though, I may gain 30 seconds before I die, so I'll withhold judgement on that last.) and you're still left with liars. Yeah, not a very elegant reason, but it's very much how I viewed their product and company. And which, Just sayin', is how I think you viewed it as well... :wink: Dwayne

Yeah, with asystole, almost certainly down most of the 10 minutes, likely more unless this is an exceptional nursing facility, not going to work it unless medcon is willing to go to the mat over it. Will obviously check for other signs of death, certainly check pupils, attach ETCO2 to shore up my case with medcon, have my partner apply PPV while I call for permission to leave this girl alone. If this is a normal temp 50 y/o it's unlikely medcon is going to refuse my request, with an 89 y/o woman it's a near certainty s/he will comply. We can't save her because her tired old body can't survive proper CPR. ROSC means nothing to her if she has no medical issues at all, in this state there is no good outcome, so we might as well do the least amount of harm. Dwayne

Good for you SD! Even though you leave the site knowing you must have passed, it's still pretty friggin' awesome to see it in writing, huh?? Congratulations man.... Dwayne

A dead body part.... I had a transfer to the front gate the other day. Three patients, two with abdominal/thoracic gunshot wounds three days post op, and a third with IV antibiotics and unresolved gangrene somewhere below his right knee. In Afghanistan you quickly learn that bathing habits are completely different that for most of us in other parts of the world. They bath their rear ends, hands and feet regularly, the rest almost never. This makes some people very angry, but simply makes perfect sense to me in a world where there is precious little water. But, it can make transporting them in the back of a hot ambulance a little bit challenging. Pt A, sitting in the jump seat is two days without a bath, has urine and feces in his undergarments and soaked up into his clothing. Smelled pretty bad, but we've all smelled ‘pretty bad’ before. Body odor is remarkable even when compared to the soiled clothing. Pt B is on a stretcher, with absolutely the worst body odor that I've ever smelled. All have Foley's in place as well as two having chest tubes bilat, so just smell from the catch containers can be challenging at times, but this was a lot....(I’m not sure how well any of this translates to those used to the catch containers being changed hourly, but here I’ve rarely (ever?) seen them changed before they are full, yes, chest tubes included…) Pt C appears in better shape, but his R lower leg is bandaged completely around the foot and up to the Knee. And it’s emanating the most putrid smell that I have ever smelled on a human. Notice I didn't say a living human, as I've never smelled anything so bad on a dead body. Now understand, that while this is certainly a sad state of affairs for these three gentlemen, the only place for me to be in the back of the truck is to kneel on my jump bag in the center of the three. No ventilation and perhaps 100-105F in the back, yeah...not great, but I've decided that as I've worn my big boy pants, I will do my job. I tell Mikey to "get us there the best you can man...I need out of the back." He responds, "Roger." Off we go. Maybe 3 minutes into transport and 30 seconds after I think, "Hell, I can stand anything for 10 minutes." I think, "Oh yeah, I'm gonna puke." Poop, Pee, Puke, necrosis, I have historically been able to do ok with all, but today I'm about to learn that the combination may take me to a new level. I tell Mikey to hurry the hell up! At which point ambulance control comes on the radio and says, "Med 6, you left the hospital without your medications, return for them, over." I look up and see that our drug box is not in the truck! Not much of an ambulance without the drug box...But I am not going back! I say, "Ambulance control, Medic 6, negative on the meds, I'm confident that I can manage these patients without my drug box." To Mikey, "Don't you 'Uuurrrrff" Listen to 'rrrrreeeeetttchchhch' them Mikey, God damn it!" Mikey, "Rodger." To me, "Medic 6 you must return for the medications, OVER!" To them, "Negative! I'm (pantpantpantpant) confident I can manage my pt load without the "UUUuuuuurrrrrrrrrrr" Drug BOX! OVER!" To me, "Medic 6, not YOUR drug box, the hospital didn't give you the PATIENT'S MEDICATIONS!" You....have.....got.....to.....be.....friggin....kidding me! These folks have it hard enough, of course I can't continue without their meds. Finally had to pull over, let the back air out for a few, Mikey "Wow, you look like shit.... hehe" Me, "Mikey, I swear to God that if you would like to get even a single day older that you will NOT go down that road......" Mikey, "Roger." Anyway, I'm not sure how funny this story is to those that have never been in a position to have to try and manage their emesis as well as pt care, Hell, not sure it will be funny even to those that have, but looking back I think it's pretty funny. The EMS Gods seem to like me humble... :-) Dwayne

Good for you man! Hell of a ride, HUH? And just in time for Christmas!! Merry Christmas brother, congratulations. Dwayne

Yeah, I don't really get it either. The posters complaining about the length of the thread are the same ones that have been complaining about the 'tone' of the conversation over and over, making it an unusually long and boring thread. I too think Crotchity, though I've not read many of his posts, was simply trying to take the point, which seems obvious to him, and keep refining it down until people were forced to split the atom and make the decision. People said, "My cert is more important than the babie’s life." He said, "But is it more important that Anyone's life?" and then he asked "Why?" and attempted to explore the reasons why, only people started bitching and complaining instead of participating. To me, the most offensive thing in this entire thread, far and away, is the request to lock it. Kat, you have the ability to look away man. You can stay out of the conversation instead of continuing to add your silly remarks, or you can stay, and continue to add your silly remarks, but don't you friggin dare to assume that you are so incredibly intelligent that you know what the rest of us should be allowed to discuss, or not discuss and to what point we should be allowed to do so. And you all call Crotchity arrogant? Really…. I'm truly shocked by the number of intelligent people here that continued to complain instead of choosing to participate, or NOT! It truly is as simple as that! I agree that fighting for the integrity of the board is worth doing, I've been known to do it too. But I don't see that happening here. I see people attacking simply because they were offended...and that should be a sin here. I don't know Crotchity from Adam. Have no opinion of his posts other than the last 5-6 pages of this thread, but unless he was posting naked pics of himself doing something very distasteful, I don't really get where all of this anger and "bully" nonsense is coming from? I think maybe the City is getting a little too touchy feely...Sometimes learning is difficult, and sometimes you don't want it to happen, but here, the solution is as simple as not clicking a button. Dwayne

Yeah, hopefully I made right with Mobey. I like his posts and his attitude even if he won't listen to a friggin thing I say... :wink: Actually, I think I like that best. And I've noticed a little shift. There is definately a learning curve, both mentally and physiologically here I think, but I'm shifting back. When half the people I like at the City mention I might wanna quit being an ass I take it as a sign. :shock: But in all seriousness...I hear you loud and clear brother...thanks for the thoughts. Dwayne

Here is what I read.... Question, supported below. Compliment to the basics here, with the disclaimer that he's gotten the information on "general" basics from this site and not personal knowledge. And then uses that information only to compare 'our' basics with ‘other’ basics, not with predators or pedophiles. An opinion, combined with a theory, closed with an opinion that perhaps we've made it too easy for predators to have access to susceptible victims. That makes perfect sense to me. And for the record, regarding sleep, I played the bullshit Afghanistan card as an excuse for jumping on Mobey, yet anyone over here knows it was crap to do so and I should be, and am, embarrassed that I made excuses for being a dick. I have it way easier than most over here so have no reason for special favors when I've been an ass or an idiot. Sometimes a rose is just a rose, and sometimes a dick is just a dick. I've made it as easy as I know how to quote the parts where you feel he insults basics, or states that basics are an issue in any way. Please feel free to do so, as this is an important point to me, and I look forward to getting it all sorted out. Dwayne

Merry Christmas to you to FM, stay safe. Dwayne

Bullshit. It's the obvious question that should be asked in this thread by any thinking person. You can get into the field with a few weeks of simple training, many people give the ambulance trust and respect, the cost is low, access to victims is high. Would the fact that becoming a medic make a difference? Don't know, just saying it's an obvious question and it doesn't disrespect any basics except those that don't want to look at this situation honestly. Is it important to identify the categories that the offenders come from? Of course! If they are mostly basics then we protect the patients by making it harder to qualify, or making the prequalifying security tighter. If basics are in the minority, then we need to learn to screen the types of people that are becoming medics, assuming this is a problem at all. With 900,000 (according to the article) I'd be curious to know how the offense percentage compares with police, fire, hospitals, or even a random selection of the general public. There is no use yelling fire if the number is ridiculously low, though of course it still gives necessary data to attempt to eliminate the issue entirely. When did you decide that you are the appropriateness monitor for these threads? Doc, what the hell are you doing apologizing for asking a valid question that you obviously made very clear?? The City has always, (since I’ve been a member, and before) prided itself on seeking education despite PC appearances. What the hell is going on here? Dwayne

Bilat T's to give me time to get my assessment, vitals and start some fluids. Life before limb, and I can't pack wounds and look for the less sexy life threats at the same time, right? Manage the airway, possible nasal intubation? Adjust fluid volume to around 80-90 systolic as mentioned before, get appropriate pain control on board, then deal with the legs when I'm comfortable with everything else. Med control advises bilat amputation and my feeling is that I can't keep him from crumping without it? No, I have no issue with it. The legs have been described as hamburger, and this may be accurate, and it sounds like cutting them the rest of the way off will be no huge trick. The trick here, if we run with these assumptions; that he must get moved or die (say from an internal bleed as well as the obvious. Abd pain with distension becoming remarkable), that the legs below mid thigh do not appear salvageable in the time available, and that med control has decided from your serial reports that the patient is deteriorating, then attention should be directed to caring for and maintaining perfusion in the stumps. Amputate to the distal extremes possible, move T's distal if possible, get on the road, monitor vitals, monitor stump perfusion, get to the hospital. It seems as though when I was watching a documentary about baby Jessica (in the well, right?) that they showed a medic going down in the hole and the voiceover from the medic was something like, “I had been given instructions to simply pull her leg free (It was pinned up against her between her chest and the tubing wall if I remember), breaking it if necessary, and if that was unsuccessful I was instructed to amputate it, but to get the girl out by whatever means were necessary.” And then went on to describe the horror of thinking of removing a child’s leg, etc. Not sure why, after this long entrapment that that job fell to a medic, and my memory is a hinky thing, so perhaps I’m remembering incorrectly. Field amputations are not unheard of. The anatomy here is pretty straight forward, even though more complex than the baby scenario perhaps, but still, not rocket science. Dwayne