DwayneEMTP

I'm curious what reason they gave for refusing. If she’s adamant and experiencing anxiety about the ashes, I just don't see the issue with it. If she's truly a cardiac pt then reducing her stress level is high up on my list of interventions. I can do it with drugs, sure, but why not just take the urn? It seems like obvious, simple, basic medicine makes this decision, even if you are without compassion. If she was making the same request for her bible, or a piece of religious jewelry, would you not take that? Or are you unwilling to step outside the box and use this opportunity to create possibly significant physiological change simply because you have drugs that might give similar results? The only reason I can see for not taking it is if she states something like, "I'm not leaving without my husband! He's out in the garage somewhere, I saw him just before we moved here!" Second reason, compassion. It's no skin of my back if we take it. It's not a bio hazard, likely smaller than a breadbox. It seems to me we're tasked with giving compassionate relief from pain whenever possible, physical and mental. Right? How is this somehow differrent simply because the desired relief used to be human? Dwayne

I guess if you equate the watching of adult dramas to openly expressing attitudes and language that relates to racial fear and hatred you might have a point. But I don’t think you do. At what time of day is it professional, or even slightly sensible, to allow a teenage girl to sit on the sofa with a bunch of pumped up hosemonkey late at night? And this argument isn't new. And nearly everyone that brings it states they were, "With my rookie 18y/o female partner when, without warning we walked in on porn! Of course I took her back to the truck, but it was too late." Need a new story...And yeah. If you've been in EMS for 24 years you know very well that sometimes appropriateness goes by a clock. The language many use in the parking lot at 0300 is not the same that they use in the church rectory at noon on Sunday. You seem to have a self righteous agenda that is clouding these issues. And how do you remain in EMS for 24 years without learning how to have an intelligent discussion? I asked for your background, yet before giving it you declare that it's irrelevant. I disagree. From the 'vibe' I'm getting from your posts I'm guessing female. If so, there is a not uncommon bias to porn with many women. I'm a 45y/o white male, you'd probably benefit from that knowledge if we're discussing feminism issues when trying to understand my perspective. And it truly makes debate and discussion much easier and more productive if you don't decide for the both of us which information is useful and which is not. Besides…I’m ringing the troll bell on you babe. As Atheists go, there is only one on here that I’m aware of that would be so ignorant as to choose such a screen name unless you are simply trying to stir up shit. Gonna have to do better…sorry. Dwayne

Man, you sound really angry.... I agree with you, and disagree with you. It's not the medics problem to solve while on scene, but it is absolutely the medics problem to solve while not, the same way nurses unite to resolve nursing issues and Dr.s unite to resolve doctor issues. If EMS is going to grow as a profession, which you keep mentioning in your posts, professionalism, then they need to be active, have an intelligent opinion, help formulate a plans, and help promote resolutions. It's really not that difficult to spout off about pt advocacy and compassion, it's much different when those opinions commit you to taking action, which takes time. I've read two other of your posts, and I definately get the feeling that you've come here to lecture to the ignorant. There are plenty of ignorant in EMS, but this isn't the best place if you wish to spout off in stead of discuss. Welcome to the City. I look forward to your thoughts. Dwayne

Well....first off, I'm having trouble taking professional advice from someone who's screen name shows them to claim to be my God. Just sayin'... And it's difficult to discuss this with you as you've decided to lecture instead of debate. What is your history in EMS? I'm in no way trying to make you feel that you don't belong, but it helps put your thoughts into context if we know what your background is, as I seriously doubt that you've been in a fire of EMS stating and seen porn playing. Of course, depending on your definition of porn. So what makes you think this is an issue? If you've been here long you know I'm not a big fan of firemen, and I've been in a fire/EMS house or two, yet have never seen porn playing, by my definition. And lastly, the vast majority of the things I do for pleasure I wouldn't do in front of my mother...again, just sayin'... Dwayne

EDIT: (My epiphany came to late to do a proper edit.) I was in an obviously foul mood when I posted the above. Upon rereading, I'm comfortable with all of the above with the exception of the "even for a fire medic" comment, as I know of no fire medic, or fire basic for that matter that would traumatize an elderly cardiac pt to avoid the incovnenience of having to deal with the half gallon size container containing the ashes of her late husband. My apologies to Firemen in general taking that petty shot. Dwayne Dwayne

The weakest, lamest possible answer. You don't want the responsibility of managing this container, yet you claim to be a medic? The container management doesn't even rate on my radar of medical responsibilities, of which my patient's comfort and calm state of mind being two of the highest priorities. This is a nobrainer. Ask Fire to grab the urn, or strap in onto the gourney between her calves, and roll. Shameful answer even for a fire medic. You should know. This answer even more ridiculous than the first! This is a forum for the sharing of knowledge and ideas. If you can't be bothered to develp ideas, and then support them rationally, please spare us the posts where you just want to hear yourself talk. Suggestion. Next time you're proofing your post and you think, "Huh. That doesn't add to this discussion at all. In fact, it just sounds ridiculous." Feel free to hit the 'delete' button. Dwayne

What is that saying? If you use the inverse ratio...the bigger the gun the smaller....? Hell, I can't remember...Nope, I got nothing. Dwayne

I am posting this hours after I began to think and write it. It's ealy morning, I've got about 6 minutes left on my internet connection, so have not time to proof it as I'd like as I may not be able to get back to this for a few days. No disrespect meant to those here for the errors. Dwayne Michael, I don’t pretend to completely understand you stance, but it sounds as if you’re saying that because everyone has preconceived emotional reactions to certain issues that that then justifies a refusal to accept greater evidence to contrary opinions that might possibly cause one to over rule their emotions with logical thought? That the individual is at least partially resolved of the responsibility or rational though through the gift of being ‘one of the many’? Yeah, I know I’m asking for a response that will give me a mental brain cramp of biblical proportions. I disagree with your stance, as I understand it, that prejudice are acceptable as long as identified as such, so then not to be acted on to anyone’s detriment. I do in fact believe us to be victims of prejudice, though I believe that once you have identified them, that you are then obligated, (though who holds the title on that obligation I’m unclear) to attempt to resolve them when information becomes available. I don’t believe you’re obligated to actively see out information of every subject that you may have an ignorant opinion on, but simply obligated to assess it when it falls into your lap, so to speak. Isn’t the only option voluntary ignorance? If you choose to actively ignore such evidence, aren’t you then actively pursuing ignorance? And should the pursuit of ignorance be supported in any way in a loving, intelligent society? You claim an uneducated prejudice that dreadlocks are unhygienic. Perhaps you’re right, or not, I have not idea. But having stated such thoughts, when someone now comes to you with evidence that you’ve been previously ignorant of, showing that perhaps your loosely held opinion is incorrect, is it not your obligation to apply those facts and then adjust your opinion if necessary? Or is there a standard or weight of personal importance that the issue must hold before that obligation become self enforceable? I’m not sure. Dreadlocks are not a part of my personal life, so their hygienic merits are of no concern to me, so perhaps it fails the “affects me’ test, releasing me from the obligation to adjust my opinion. Again, not sure. But if Barbara or Dylan decide to become part of the dreadlock movement I believe my opinion, and my logical obligation perhaps change. Hmmm…I think this is what my brother in law would call a rabbit trail. I do know that my scientific sensibilities are daily offended by my belief in a higher power, an entity that I believe to exist in some form despite my inability to weigh or measure it an any way. It would seem that before I can comment on ak’s comment that I must resolve this paradox for myself, though I don’t believe that I do. See, I’ve written a clause into my personal logic contract that states, and I paraphrase, that “some issues are simply to big and complex to digest and resolve in one sitting.” I’ve given me a free pass, having decided that this will likely be a lifetime argument that I’ll only likely resolve when I go to nothingness, or hear Satan saying, “Man, you’ve made some pretty crappy life choices.” So is there a burden of merit that must be met before we’re mentally obligated to apply new facts to an old problem? This I know. The comment “This is my opinion and I will not change it regardless of the volume or merit of information provided me” offends me. The reason it offends me interests me. Yeah, not much I know, but it’s what I’ve got. This I know. You’re off in the ditch on pit bulls. Just sayin’….(And yes, I very much felt baited by that part of your dialog. :wink: ) This I think. That the merits or evils of limiting the possession of firearms can be a life altering, sometimes world altering step to take so, in my little world it meets the criterium for “this thought must be adjusted, given new, logical accurate information.” This I believe. That the chance to flex both brain cells in the company of those that reside on the City is a gift, and I thank you all for your time and opinions. Even if you’re wrong, like ak obviously is. Have a great day all. Dwayne

Hey Cynical, welcome to the City!! As mentioned above, thanks for watching out for Kaisu, God knows she needs it! She can be a hell fire pain in the ass sometimes when she gets going, but we all know she's really just a kitten at heart. I look forward to seeing you post if you should choose to do so. And for those private stories that just need to be told, friend to friend? You'll notice the PM button on the bottom of this window. Make sure and send them my way, OK? I can keep a secret... Dwayne

Good for you lady! I actually feel that my basic was much tougher than my medic. I was scared, around a bunch of other scared people, had no idea what to expect. I did well, but found it to be very difficult. When my time came for medic I breezed through! Good luck with the resto of your testing, don't freak out and it'll be easy. Dwayne

Not sniping man, but what would cause you to believe a completely obtunded person's gag reflex was intact? Unless this was a 90 y/o alchoholic, what did he gain by not being intubated? What was your motivation for not intubating? Worked how? The two tools serve almost completely different perposes. The trumpet aleviates the need to breath past the tongue. The tube protects the patient from aspiration. I'm not clear how you believe doing the former was a replacement for the latter? See what I mean? What an awsome discussion this has turned into! When it started I was ok with the tube alone if they were breathing comfortably and not fighting it. What a presumptive bonehead I can be sometimes..... Dwayne

C'mon folks, the union has every right to be upset. It says right in their handbook; Lying, violence, intimidation, blackmail, destruction of persona property, etc are all acceptable means of negotiation...but that danged video taping is just going to far! I'm on board with Dust. If they hadn't have found a camera, nothing would have made them happier than to have placed one. And for the record, I'll be holding the phone for the update that, "this was all just a big misunderstanding" when AMR proves thatt there was never a camera in the first place. Dwayne

There is an overly kind poster that sometimes accuses me of being modest, but I have to believe there are times, like this one, that I'm simply truly not as smart as many. Are we really talking about finding landmarks through clothing on a dead person to avoid offending the modesty of said....dead person? See, I'm not that smart. Dead means a lot of things need to happen quickly in my world. CPR, airway management, Monitor, vascular access, etc. And I don't have the brains to cause, direct and monitor those things while making sure some middle aged perv. doesn't get a peek at a 16 y/o tit. We had an Afg local that fell through a ceiling 12 feet onto a concrete floor. On the way down he slashed his face on a piece of ductwork from the R corner of his mouth to the corner of his R ear. Not full thickness (which I didn't know at first of course) but you could see the shape of his teeth on the remaining tissue when the wound was exposed...perhaps one layr of tissue remained. While I did my 'medic thang' I ordered his clothes cut off. If you don't know, Afg men (I have no contact with Afg women who I assume feel the same, but I don't know for a fact) have a MAJOR issue with being exposed in public. When we started to cut his pants he started to freak out...puking, bleeding, freaking out, he was a busy fellow. Someone higher up in my medical chain of command was yelling that "You can't expose him in public!" The medic cutting looked at me, I yelled "Get his clothes off!!" and soon he was naked with the exception of a piece of t-shirt covering his penis when we could manage it. Turns out that when I looked at his buttox it appeared that someone had slipped a very large bagel under the skin at the base of his lumbar spine. Would I have found it with his pants on? Yeah, probably. But I found it sooner, with much better visualization than I would have had had I simply palped or "peeked" under his pants as I see many do. I believe the MOI dictated exposure of the entire pt, and did so despite his complaints and that of a medical superior (in rank, not clear if intelligence). Anyway, I guess my point is this. If you can do good medicine while keeping the rules of prudence in mind, then kudos to you. I simply don't seem to have the capacity to do so...So fair warning girls...if you decide to keel over in front of this dumb ol' fat medic...pray you've been working out and wore clean underwear. Dwayne

And what is more dangerous than even UNregulated distribution of assault rifles? Closed minds. I would have bet good money I'd never hear such a comment come from you ol' man...tsk tsk. Dwayne

Someone misinformed you son. 8 seconds is 8 seconds. I've spent a huge part of my life around rodeo, even went to "clown school" before they became bull fighters. Walking off is about pride and balls. I mean, what else is there? 99% of these guys leave their families 10 months out of the year for 10 grande a year. You have to have something to be proud of, because your sacrafices are idiotic. I mean, when someone says, "What do you do for a living?" You say, "I'm a bull rider." How do you respond when they say, "Why?" Yep, better protect the balls image.... Walking off is an important part of the tradition. To take proper care of them you'll have to fight them, and should you manage to win? Expect to get your ass kicked in every rodeo bar for the rest of your life... :-) Doesn't change the fact that they need to be competent to refuse, and I'm obligated to give them care if they aren't. Tradition be damned. They have thier job, to be as macho as possible. I have mine. To keep them safe when they can't do so themselves. I love the rodeo tradition, but see "cowboys" in about the same vein as hosemonkeys. Lots of hero worship but very little substance, with the rare exception. Yet in both cases the rare exception can be something to behold. Dwayne

4 month program vs a two year degree program? It's a no brainer. Despite Fires best efforts, EMS truly is moving forward with education. Many here convinced me that I needed to get my degree as opposed to a cert and I've not for one second regretted it. Now, not everyone will agree. When I rode in Pueblo I learned quickly not to mention it or to get very deep into A&P when asking questions. The degree was viewed with scorn. When I rode in the Springs (CO) it was viewed immediately, and to the best of my knowledge, universally as a "stand up" way to start my EMS career. I was congratulated and given the benefit of the doubt by all that were made aware of it, and my preceptors were shy about making it common knowledge. One program is short...The other longer and tougher...in both you will reap what you sew. Good luck to you... Dwayne

Pguy, you asked P3 for "facts", which you claim to have provided. Pulling a bunch of figures out of your rear and swearing to them doesn't make them facts. You go on in your further posts to claim that experience is not an issue in this population as all of those medics were "Hired for there experience." According to you. If you want facts then make some attempt to back up all of the nonsense that you currently claim to be facts. Until then you have no right to ask. And accepting that a person can quote local figures, trends, and represent the thinking of the local populace, yet is unable to spell or use grammar correctly is simply asking to much. Dwayne

Babs is searching through the garage....We've got a ton or two...We'll send them off soon... Good on you Ol' man.... Dwayne

Actually, I have a lot of respect for the fact that there was no retribution after they went to the ground. I appears the medic took a pretty good shot, maybe more. I would have been WAY pissed. But when they hit the ground it appears that he went about simply trying to restrain him in as non violent of way as possible as opposed to 'splaining to him the level of his displeasure. Professional behavior. Pretty cool. Dwayne

I am only familiar with Colorado Springs and Pueblo. Both are AMR. In Pueblo Fire is first response with medic engines. AMR controls the scene from time of arrival. Both start at $15.90/hr with 4/12s then 3/12s. I would burn my medic ticket before working in Pueblo. AMR is amatuerish, the medics are weak, the mentality is ALWAYS load N go, regardless of the situation. I only worked around a small percentage of medics there, but they were sloppy in their person as well as their medicine. Fire as well was always sloppy, and constantly angry at patients for making them respond. Now turn an almost perfect 180 degrees and you have the Springs. I worked around and had contact with a few dozen of thier medic/basic teams. VERY smart, competent, confident medics. I can't remember a time when we sat in the EMS room at the hospital that someone didn't ask for a case review of one of their calls, and the review almost always followed the physiology, pharmacology, and expanding differential possibilities as far as we were mentally able to take it. You very much do not want to run to the hospital with a critical pt that you had positive intervention options for and try to explain to the medical director that you thought it best "just to hurry and get them to difinitive care" unless you're ready to move on. The medical director there demands that medics practice medicine, and if you don't have the confidence to do so, he will not keep you on his lisence. 15-20 minute scene times were not uncommon with non trauma issues. Hour long scene times were not uncommon with the mentally challenged or mentally disturbed pts. as they have a pretty comprehensive list of mental health professionals, created by the AMR medics, that you were to call before simply dropping them at the hospital. Fire controls the pt until released to AMR for transport, but they are very professional in dress and behavior. They also seem to be aware that as they will not be transporting (Though they can ride in if they choose) that releasing pt care early to the private company just makes sense. And they are almost always happy to do so, as well as assist in care for as long, and in any way, as needed. Only once or twice did I end up in dick measuring contests with Fire, and I think that had at least a little bit to do with my student status, but the other firemen had little patience for it and would help work it out. Plus, though it's unlikely, it is possible that I may have just been an ass on those occasions. I know...hard to believe. I found everything that's broken in EMS in Pueblo, and everything inspiring in the Springs. Both are hiring nearly constantly, though the Springs has a hiring program that washes out a signigicant number of applicants. Other than these two systems I don't really know much about the rest of CO EMS. Good luck to you! CO is a beautiful state....And if we can figure out how to keep the Texans from sneaking across the border we have every hope of keeping it that way... :-) Dwayne

Hey Brother. Tough gig you've got at the moment, but you know what? We've seen that you can hang when things get tough. My wife and I helped her mother die, immediately followed by her father, immediately fallowed by my mother. It's not my intention to 'one up' you, I hope you can see that, but only to let you see that I know where you're coming from. I think you'll find that it's often difficult to know what to do. Sometimes your wishes may conflict with those of your wife's or mother in law's, other times you may be too tired to think clearly, other family members that perhaps should be carrying part of the load don't, and that can make you angry. The grief causes stress and the stress causes misunderstandings and unrational behavior. It's part of the package. Don't try and pretend that you should be doing better. The situation is broken and you have to accept that sometimes you're going to be broken within it. Get good with that. Accept that you need a ton of rest. A ton of rest. Did I mention rest? Take it day by day the best you can. Forgive yourself for the times you fail to meet the unreasonable standards you've set for your behavior, expect the family members that haven't been through this life changing situation to do and say truly incomprehensible things, and then forgive them for that. Take a deep breath, be an advocate for your mother in laws' choices for her life, love your wife, get naked and nasty when the stress becomes unmanigeable, find a hundred things a day to laugh about, and get back to posting regularly so that those here, though you've never met them, can share their strength with you. Be strong man...Let us know how you're doing. Dwayne

Yeah, I can see it both ways. Where I am now, most things are pretty mundane. But I've found that there is a lot to be learned in the mundane. I've become a fan of dermal issues. They are weird, and complex, and incredibly varied. They are so outside of our normal scope of concern (yeah, my new phrase) in EMS that each one takes me to new places...and there are plenty of derm issues in Afghanistan. Do I get my blood pumping when we get the call for a trauma? You bet your ass, but they are almost universally disappointing. I think we get programmed for trauma excitement, but the bottom line is that there is very little A&P mystery to a severe trauma, at least to the point that we have control before transferring care at the military hospital. Most of my interventions are basic (by ALS standards). There is very little mystery, almost never do I come back from a trauma with some nugget of information I remembered from school that the other medics didn't think of. I like the adrenalin..and we have it between 3-8 times/month, but the sneaky little skin problem, or headache, or unresolving hypertension is much more interesting in this environment. And that's what keeps me fired up. So, do I need the drama? No...Do I want the drama? Yeah, a little drama keeps me a little nervous, on edge, feeling like maybe I better study harder because something I do might actually make a difference. (NOTE: Just to be clear, this environment is a little different than normal EMS in that interventions need to be considered to pathology resolution as opposed to transfer of care at the hospital. So perhaps this doesn't apply to the original posting as I first thought it might.... :-( ) Dwayne

I see two likely problems with this idea... One, I am fully on board with the idea that a woman that is being raped has two options; first, she can go along and pray that she lives through the ordeal by trying to give the rapist what he wants, hoping he'll take it and go. Second, she can kill him. Anything in between risks her life, which is unacceptable. Enraging a rapist is proven to get her physically damaged, or killed, there is very little in between. And safety is the goal I think, right? Second, and I can't see exactly how this thing works, but I can see where having one of these things clamped on your wee wee would be, by most liberal juries at least, to be considered an automatic rape conviction. Can no one see that there is a type of woman that would use this device in a manner that it wasn't intended? Unfortunately, we still feel that a raped woman is a raped woman. I abhor rape, but equally abhor the woman that will use the false accusation for her own benefit, or revenge. What happens to the woman that seduces a man into such a device? C'mon...let's not pretend that she will pay the equal price for her deed. One of the things that makes false rape accusations so insidious is the fact that these women are riding on the backs of those that have been terribly damaged to fulfill their own alternate agendas...with very little price to pay for doing so. For the moment, until there is much more solid data to support this as a positive idea, I have to give my 'no' vote to such a device. Dwayne.

Wow....thanks everyone... Wendy, you are the sweetest. How cool is it that you and Kaisu and others have followed her all of this time? Cool as hell I think. This new tumor is pretty miserable. I guess it's in a part of her brain that causes her almost continuous n/v yet her antiemetics are no longer effective. Thank you all for the love and support that you've sent her. My new goal in life is to someday be as strong, and brave, and joyful as this very sick little 15 year old girl. I'm not holding out much hope that I'll succeed. Have a great day all.... Dwayne

The problem is that you're talking two different issues. You speak of firemen in the same conversation that you mention medicine, professionalism and education. Fire is not involved in paramedic medicine. They are leeches that need to ride the back of EMS to continue to justify their needlessly bloated budgets. When we speak of continued, and increased education we can not realistically do so with Fire as part of the solution as the fire unions have proven for two generations now that they don't want the medicine. They only want the money. Speaking of Fire when you speak about "us" is akin to speaking of Vtach as part of hemodynamic stability. You only reference it in regards to its pathologic affect on the system. I'm having a hard time imagining a world in which fire is not going to come to control EMS in the U.S. Perhaps it's better that we just give it to them, take the 25yr step back in time, so that we can at least begin the maturing process necessary to produce the EMS system and standards that we all know are possible. Dwayne