DwayneEMTP

I stand corrected...evidently is was what it appeared to be... :oops:

Man, I thought that was cool as hell... Unfortunately, I missed so many that the children of Africa are now required to send ME rice...But I'll keep practicing! I found that it has a gazillion words that are just at the peripheral of my understanding...I've not used them in conversation, but could usually figure them out. Fun...and hopefully a little helpful for others. Dwayne

Which question?

Yeah, I have to believe the point here is not the one we've assumed it is... What's up with this medictx? I'm guessing you had a point we're missing, but you're gonna have to help us out... Texas....always getting trouble from Texas.... Dwayne

Why is it that the headlines always read... "Midtown Fire save 14 lives after multicar pile up!!" But then... "Police, fire and EMS attempt cover-up!!" Always the bride's maid and never the bride.... :wink: Dwayne

Fair enough all... I just can't get a handle on your logic. That certainly doesn't mean it doesn't apply, I just don't see it. Michael once cautioned that I sometimes make partial arguments based on the belief that the logic that preceeded my thoughts is "So obvious that it shouldn't really need to be explained to anyone." I just can't seem to find the key to this one that would show the "obviousness" that jumps out at me. I do understand that to be one of my many weaknesses. Would I have issues with someone with HIV/AIDS, Hep, etc working on my son, who I adore above all else? None. With the data available, if I did, I would also be forced to be ever vigilant that he's not attacked by Bigfoot, or abducted by aliens, or possesed by demons. Again, with the exception of TB, which in my mind doesn't seem to belong in the same catergory as the others. And even then, would I run screaming from the room if I knew that the properly masked/washed nurse taking his vitals or giving his injections had TB. Of course not. The SCIENCE tells me that would be silly. So I'm grateful that you all have taken the time to share your opinions. Some people much smarter than me have ended up on the 'misguided' side of this discussion. Thank goodness some terribly smart people have landed on my side as well. For me though, you might just as well argue that the sky is orange with polka dots. My logic says it's blue (in general of course), all of the scientific data suggests that it's blue, common sense says that it appears to be blue. I'm going to be a while getting on board with the "polka dot" crowd. Have a great day all! Great discussion! Dwayne Edited for minor grammar and spelling errors. No changes in content/context.

Good Job Bunni! Congratulations! Dwayne

It's simply that as many have stated here, almost certainly we're killing many people simply by breathing on them. I can't figure out how you are comfortable suggesting that people with the above diseases be removed from EMS when they pose an astronomically small risk to patients, yet do not demand that all EMS workers wear complete BSI (Masks, gowns) to eliminate the very obvious HUGE risk of contaminating weak patients with the everyday viral/bacterial illnesses that we know will kill many of them? It's as if you're attacking the murder rate in the US. You are demanding that poisons all be removed from possible use, but saying that guns are ok. See what I mean? If infection is truly your issue, why get so worked up saving the (theoretically) one person a year that might be effected yet ignore the 10,000 that we KNOW will be effected? Dwayne

:shock: What! Then what am I supposed to do with the rest of my day?!? Yeah, Ruff got a little pissed during this conversation. I'd hoped that showing him the error of his ways would make him feel better... But he's full grown, doesn't need us to defend him, and will be itching to get back into the fray at the first opportunity. Chin up ol'man! It's all just sparring, no good guys, or bad guys, just shared opinions to learn from.... Dwayne

As I mentioned before... The only reason this conversation is continuing with such vigor is that you continue to ignore ccmedoc’s pertinent question and continue to say the same things over and over... And you have ignored Vent's posts completely. That is always a mistake in my book. If you insist on continuing to rant about "You know how EMS is! Every day we climb through wreckage, and sling our blood over everyone near!" then you'll continue to have a point. If you step back into the realities of EMS, the diseases involved (with the exception of TB), and the science involved in the transmission risks, then you're simply back to imitating Chicken Little and screaming about the sky falling. I truly want to hear what you have to say, but you simply keep repeating the same things over and over and they appear to me to be based in panic, fear, and ignorance. (Lone, it's my hope that you'll read this as an attempt to be clear, not insulting) If you want to win this argument on logic instead of brute force, then you have to address the posts by Vent and ccmedoc. No one here has missed the fact that you have been careful to dodge them and their logical contribution to the question. Good discussion though! Dwayne

As one of my instructors used to say.... "This is an amazing tool/device/drug! It's one of those rare things you can use to truly make a difference in a patient's life!...but it's expensive so don't expect to see it on an ambulance any time soon..." Dwayne

Ok, again my apologies for the above post that was supposed to be a PM. :oops: I think I've got it figured out. I went into the "quote" function to cut it out and paste it into the PM, but decided to edit it first, and THEN cut it into a PM, Lost my focus and got both brain cells concentrating on different things, forgot that I never actually cut it out and moved it....and wallah! See, simple! :? Sorry all for littering up the thread. I'll try and pay better attention in the future. Dwayne

I lock everything unless I want the line yesterday. Even cardiac, as it seems that every seriously ill patient we get is down the narrow stairs and the IVs get pulled. So I start a lock, plug in the fluids if we're going to be there a few mins, unhook it to get out to the truck, and then plug it back in. Plus the nurses give us an atta boy when it comes time to gown the patients. We have needless systems in the Springs, so attaching a line is very easy. I don't know if that would make a difference to others.

My apologies ccmedic for the misunderstanding. I had quoted your question as the one to be answered, my post was to Lone Star or others of the ...misguided camp... :wink: Though I can see now as I look back at it that I failed to make that clear. I have a lot of respect for you opinions, and quoted you as I believed you had made this one very clear as well as posed one of the most, if not the most relevent question in this thread. Thanks for taking the time to respond! Dwayne

It was very plain, but for the level of conversation, way too simple in my opinion. I would be interested in your opinion as opposed to you simply raising your hand and yelling..."Yeah! What he said!" See what I mean? Dwayne

Sorry man, I got distracted. The whole "infectious disease in EMS" thread is getting on my nerves... :wink: But I agree with you here. The more you know, the more cloudy everything gets...for a while...then it opens up whole new vistas of ideas! Pretty cool! Yeah. We have a minimum of 500 hours preceptorship, 300 in the hospital. Our preceptorship is broke up into four phases of 125 hrs each. They should all be preceptored by a different medic. I've had 7 or 8 now as some left for other states, a couple left to teach, etc. That's one of the beefs I had with school actually. Pts are near dead and then we make 'em hunky dory, or they are fine and we kill them. I've found the influence we have mostly, not always, is usually baby steps in the right direction. I give nitro, lasix to my pulmonary edema, apply CPAP and somewhere near the hospital he gets a little better...know what I mean? Yeah! Giving fluid to hypovolemia is good! Unless we raise the BP above 90 systolic and blow their new clots, which is bad. So we keep it lower, and don't perfuse the brain with ICP-Way bad! So we raise it a little to perfuse the damaged brain-Good! But we dilute the clotting factor and they stroke...way, way, bad. Is that what you were thinking of? I now find that I love the physiology puzzle...but it scared that pants off of me in the beginning!!! I like your ideas, and the way you think. Thanks for sharing your thoughts with me. I have to hit the sack...off to work early tomorrow...I'll look back during the day if I can, if not then in the evening... Have a great day! Dwayne

Three things...First, I think when operating from your perspective you should feel obligated to answer the above question. Second, I think you have gone completely insane. Third, it seems obvious, unless you've simply skipped over posts such as VentMedic's, that you're bringing your personal fears and predjudices to this conversation. You and I often agree on things...but there is simply no logical/factual support for your point of view that I can see...at least none that has been shown to date. Nice Don, way to go buddy! Do you just look up some days and think,"Oh my god! I haven't posted anything in a couple of days!" And then simply post the first silly thing that pops into your head? Have you not noticed that many here actually support their thoughts and ideas with lines of logic? I completely disagree with LS, but at least he showed me the respect to explain where he's coming from. In the future, please, take a minute to at least partially digest your thoughts before flushing them over the rest of us. Thanks. Dwayne

Yeah, as CC said, all she really did was go out into public as a "sick person" and that made them uncomfortable. Too bad for them. I once got a ticket for peeing on the side of the freeway. When the highway patrolman was writing me a ticket I asked what it was for. He said, "Indecent exposure, public urination." (I was in the middle of Montana out in some bushes). So I asked him to note on the ticket that nothing "private" had actually been exposed, and he did so. So I went to court on it. (I was passing through but ended up staying 2 weeks so I could run this by the judge) When in the courtroom, with a hilarious judge, thank goodness… I said, "Sir, how could it be indecent exposure, when I only exposed my back to anyone passing by? People often see my back, and I've never gotten a ticket for it before" He asked, "Well, wasn't it obvious that you were urinating on the side of the road?" I said, "Well, probably. So it's actually a ticket because people were offended to discover that I pee, even though they didn't actually see me peeing? He said, "That makes it sound silly doesn't it?" I said, "Does that mean that if I mention here that you urinate, that you must also now have to get a ticket? Because as people don't seem to have known that before, you can bet they're going to be offended!" (Yeah, not exactly the most amazing logic, but I was 22 and living in my van at the time...cut me a break.) Thank goodness he thought I was funny, and not simply a smartass like most. (This was a little town, I can't remember the name, so it was just the drunks and yours truly, the evil peeing guy, in court) He said, "How about urinating in public?" I said, "There wasn't much public there, so I don't see how it fits." He said, "It was, in fact, on public property." So I said, "Well, I was peeing, and if it was public property than I don't have an argument for that." He said, "$5.00 fine for public urination...see ya later." Anyway, besides the fact that I am very fond of this story, my point in telling is that nobody was harmed. Some people became offended by my "peeing posture”, without being able to actually see me pee, there were no health issues (just me and the cattle), someone just needed something to squawk about. Anyone in scrubs has more than likely been exposed to this lady's and at least a dozen other people's germs. The lady went shopping, exposed mostly to her own germs. Unless she escaped from isolation, she wins the "clean" debate hands down. This story is just plain ignorant. (Ok, theirs and mine, but mine doesn't hurt anyone... :wink: ) Dwayne

Mateo, I'd love a thread dedicated to this, but have no idea what the subject would be. I'm going to move our conversation to PM, I'd like to hear more of your thoughts! My apologies for hijacking the thread. Dwayne

"approach problems with logic instead of emotion..." I could agree with that sentence Brock. Dwayne

I am a medical professional. (sort of) I don't freak out over nonsense. I would have no issue with it at all unless the person treating me claimed that anal sex, sharing dirty needles, or some other means of exchanging contaminated bodily materials was suggested for my treatment. (again, pending review of TB. Even then if they were masked I wouldn't have an issue with it) In which case I would demand a second opinion.... :shock: Dwayne Edited to clarify a poorly worded sentence. No contextual changes made.

Man, I guess I'm going to disagree with just about everyone here. And I have to tell you that it hurts my heart to even see HIV even mentioned in this context amongst medical professionals... Hep, I don't see the issue. If you have the habit of involving yourself in behavior that causes you to bleed on your patients then that behavior should certainly get you removed from the truck, not your HIV or Hep status. This is CRAZY! And the "Do no harm" argument is very weak. I would be willing to bet that more patients with HIV, HEP, pulmonary compromise, and the aged, to a power of 10 at least, have been injured or killed by the EMS worker with dirty hands/tools, influenza, or even this years cold. I’ve heard a million time, “Oh God. I should have stayed home, but I need the overtime….” Of course, I know no one HERE has ever done such an irresponsible thing…Yeah. This is an illogical, knee jerk, non medical idea that discriminates against those with little to no risk of harming their patients (MY knee jerk reaction to TB is no, but I'd have to review it a bit) based on panic. I would be disappointed to see it supported on Monetel or some other such silly show, but to see it supported here is disturbing. Not the question, I love the question, I simply expected it to fall flat as everyone shot coffee through their noses at the mere thought of it. It has no place in EMS unless you can come up with better excuses than listed above. It belongs with the "You can’t shop with an IV!!!" thread. (My opologies if I was a little vague about how I feel about this...) Dwayne

Thanks Mateo_1387, Well hell. Now I'm going to have to rethink the whole dang issue. What got me thinking along these lines is my first preceptorship. She asked for the EKG finding for IWMI, which I knew, but not the treatment. So I guessed, Vitals, ASA, IV, Nitro(if vitals to support it)...etc. To which she said, "Great, you just killed you patient!" She ranted about the preload/afterload (She always ranted...I'm pretty sure she didn't possess a conversational tone of voice) Anyway, I said, "But if we establish two large bore IVs and sit on the bags we should be able to support the pressure while improving perfusion, right?" To which she said, for the hundreth time, "You wouldn't even make a decent basic, you have no business dealing in theoretical medicine!!!" At which point I dragged her by the hair out into traffic and danced around gleefully while she was turned into a puddle. (OK, I didn't really do that. but I did learn not to aske these kinds of questions as her grasp of A&P was too weak to be able to participate in any intelligent conversation) Anyway. That's why this question intrigues me. I hate the "You did X and now s/he's dead!" Speaking of my past preceptor, not anyone here. It seems to me that everything in medicine is give and take. Nothing is free. And on the flip side I don't see many "instant death" choices that aren't obvious. Sorry, I notice I'm wandering. I just wanted to make it clear that I'm not arguing my point of view (As should be ovious from the bonehead mistakes from my previous couple of posts), only that I like the question, and appreciate the feedback. Dwayne

Hmmm. I'll have to check the protocols. Maybe I stepped on my weenie here. We were taught that the risk of serious infection is greater with an EJ, maybe I confused what the protocols say with something I've heard...I'll check it. Thanks for the response. Dwayne