DwayneEMTP

Most medics that I know HATE those schedules...capitals appropriate. It just doesn't allow enough quality time at home. By the time you travel in, and travel out, you've lost most of two days, and five days isn't much time...plus, on a remote site there is a definite advantage to knowing your patients, and that happens best in an extended time...The main reason that most of us stay with these gigs is that it gives us a chunk of time at home to travel, dink around, whatever... 99% of what's going to happen in these places, the care provided, is going to be emotional, and OTC drugs...People need to know their medic if they're going to accept emotional support from them. Plus I'll bet most others on site aren't working a 7/7 schedule, and it can create hard feelings if your medic is the only one doing so. AND, the travel into and out of such places can be really expensive, doing it weekly instead of monthly adds up at the end of the year to a ton of cash... It sounds as if you're trying to imagine this from a street medic's point of view. But if you intend to hire true, experienced remote medics instead of a bunch of your buddies, then you need to shift your thinking, in my opinion...

Curiosity, that's an excellent post, and my thoughts exactly. It's easy to think pie in the sky, but as the poster hasn't returned to explain the issues, it's unrealistic to say "Do what you want! Don't let anyone stop you!" which was kind of funny as I didn't see where anyone was trying to stop them. Putting out the money and the effort when it might not be physically realistic, isn't smart....

Kat, I'll walk off of this project tomorrow and come to work for you... I'm not sure about Canada, but in most of the rest of the world it works kind of like this... Usually the project puts constructs housing, though the level of housing varies greatly. Everywhere that I've been the medics have been considered 'management' with the perks that that entails. Usually other than getting better housing it entails nothing, as it should. Meals are also provided by the project site. At the company that I work for now, my company arranges and pays for all travel and then bills it back to the project, with a profit I believe. Most everywhere except here if a person travels more than 4hrs by air then they travel buisness class. (Yeah, I've never landed one of those gigs.) One issue that I see that will hinder you getting decent medics is having them take a break onsite. That's no break man. If you want your medics to be mental and emotionally healthy, then send them home. Work them 4-6 weeks without a break, but then bring in someone else and send them home to the bars, and women, and their families. Thinking of having them break onsite kind of shows that you don't really understand the stress of working remotely (that is the appearance that it gives to anyone considering working for you). I would never trust a company that expected me to do so. They are just too removed from the realities of the job to have any idea how to be trustworthy. Know what I mean? I'll respond more in private, staying well within the confines of my contractual obligations of non disclosure of course... :-) Or, if you want, I can give you a number to call..it'll cost you about $1/min, best case, but I'd be happy to talk to you if that would help?

There's really no tricks for access in my opinion. It's often easier to start an I/O than a peripheral IV. But before you move forward, get good with the landmarks. There is only one reason that I can imagine that you're having trouble with the landmarks, and that's because you haven't bothered to learn them. There are truly very few landmarks more easily identified than those on the Tibia. Please believe that I mean this with respect...move away from the "New medic turned loose on his own" mentality. You've decided to accept this gig, you've decided that you want to be the guy that people call when they need help. All of the "I'm only new" in the world isn't going to help them when they intelligence, competence and confidence instead. Step up Brother... Welcome to the City! I hope that you'll stick around for a bit...

That's interesting...definition by association and comparisson? The van story is a great example man.... "Though, it seems this young girl caught your eye to make her stand out from the rest of the children, thus making her really seem like she doesn't belong in that environment. Though, at the same time, the other children probably do not belong either... its just the other children are not in focus of what you were looking at. " Yeah, that makes a lot of sense. There is a huge tendency in my to just ignore the fact that I wish that children didn't have to live like this. I just sort of wash those thoughts with an 'it is what it is' brush, but yeah, maybe that works fine when all of the kids fit into the box in my brain that I've built for them, but not so well when a single child doesn't fit? Pretty cool....

Thanks doc...

It was loaded with porn, and then my hard drive (please don't say hard) crumped just before flying... And getting a girl on the side here is often a life or death proposition..not that desperate yet... Plus, I'm guessing that this isn't exactly the direction the OP intended for this thread...

Heh..there are times when I have to wake up the morning after I fly home and say..."Hell..sorry about that.." but she doesn't seem too disappointed in my behavior... :-) Girls are naughty!

I'm with you Brother. In fact, I'm probably one of those. Not because I believe the article necessarily, but because holding it as gospel also holds it as a baseline for the argument. Know what I mean? But your point is well take, and more than anything gave me the opportunity to make a point that's been bothering me for a while. That wasn't really fair to you, but, I'm sure you know the kinds of posts that I'm talking about... Sorry about that...

What is your injury specifically? Why do you limp? Why a tech school? Can you find a college based program instead? And finally, yes, you can do it if you choose to. I've seen 300lb, 70 year old men doing this job. If you're less capable than they are then my guess would be that attitude is the problem and not injury. Plus, if, by chance, you happen to be a 300lb lesbian, you are already half way there. A hot chick? Yeah, gonna be quite a bit harder... Good luck, I'd love to know what you decide.. Dwayne

Tell me MG! And, no! They're not broken...but exhausted! These issues, I thought, were supposed to get better as I get older...see no sign of that... :-)

Well, yeah! That's where all of the good learning is in this situation, right? Trying to guess, exploring the possibilities, comparing the relative value of different theories? I'm not really sure where the motivation to say, "No point in guessing, we weren't there and it's just a newspaper article" comes from...but it's mentioned often in these discussions. What is the down side to exploring these issues even if 100% of the reported information is bullshit? No offense to you Brother, as I love your posts, but I truly don't get this....

Doc, why do some doctors seem to choose, what can appear to the uninitiated, like in this case, a higher (relative to other vaginal deliveries) risk vaginal delivery instead of the C-Section? Shouldn't they have had a pretty good idea that this was going to be a difficult delivery? I'm guessing that there is a really complex differential involved in the decision, but what would that be do you think? Maybe in this case, if you're correct about the gestational diabetes, that the risk factor for mom might have been raised unacceptably high for such a surgical proceedure? Looking for guesses and speculation only in general. Not asking anyone to judge those involved in the story. I know with Babs/Dylan that she was induced (I don't know why..I just assumed that there were good reasons, though they weren't explained that I can remember.) During labor she had to stay in a very specific posture or Dylan's heart rate, according to external and then internal monitoring, would drop down into the 40s-50s. After this went on for a few hours we were notified that he was going to be removed C-section. She was prepped, and then suddenly the doc came in an said, "We're going to go ahead with a vaginal delivery.." There were stretches of time, during the hours that followed the no C-section decision, minutes long, while they tried to adjust her position again and again (I'm assuming it was because his head was being compressed) when he would brady back down into the 40s and this seemed to cause everyone a lot of concern.. Dylan is going to be 16 this year, so this isn't about blame or lawsuits, hopefully that would go without saying to most that know me, but I've always been curious why we went through so much drama to deliver vaginally...? Also, I hope that it goes without saying that I don't see a c-section as a benign proceedure.. Just curious...

You know, I thought about an internal decapitation instead, but they seemed to be pretty specific in the article...

Yeah, that's why I'm betting, if there is any truth at all in the story, that it went something like this... A vaginal delivery was attempted. The head and arm was delivered (the story makes more sense if it's the hand and crowning, which dad may have seen as the same thing) during which there is significant damage to the baby, and forcepts seem (for what I know if it) the most likely instrument to have cause it. At some point the doc decides that a vag delivery isn't going to happen so tries to push the baby backwards into a better position for c-section (though this seems unlikely). During the c-section it's discovered that pulling the head back through the birth canal just isn't a realistic option, so the head is severed, the head removed vaginally, and the body through the incision... Regardless of what happened, it sounds like a crazy kind of mess... Is anyone else surprised that the hospital wasn't named in the suite?

You can't see it in the avatar! Who, in their right mind, would go and look for further evidence that a naked woman isn't naked? Not me..I'll tell you that... But then, I do fly in 10 days, so pretty much every thought that I have now somehow involves either an airport or a naked person...there is that...

I'm thinking that possibly the bleeding came long before the head was removed, but mom and dad assumed that it came at the same time. Know what I mean? Lots of blood, ultimately the baby had no head, so removal of head must have caused lots of blood. But I'd be willing to bet that the blood came first, and then during the attempt to remove the body that the head had to be removed. The article makes it sound like, "oops! The head just popped right off!" Now, I've never tried to pull the head off of a baby, but I'm willing to bet that it wouldn't be accomplished without dragging mom all over the room by her kooch...and they probably would have mentioned that in the story..

If we could get people to be at least as focused on not causing violence issues as they are on self defense, then I'd be completely onboard... Unfortunately, the more prepared you make people to defend themselves, the less they feel the need to avoid conflict...ask any martial arts instructor. It's a huge reason that in most reputable martial arts the need to use violence, even in defense, is considered a spiritual and intellectual failure..

I'm guessing that by the time the C-section was deemed necessary that bringing the head back above the birth canal wasn't practical for some reason. The child, or so it sounds, would have already been considered deceased so was removed in two pieces, I'm guessing, so as to be safer for the mother. They don't make any mention of how they attempted to conceal the decapitation. I don't know much about delivering Babies, but force enough to sever arteries seems like a lot, just intuitively. Hopefully one of the docs will comment...

This is so good...what a bunch of bullshit. I hope that he makes a mint. You can't tell me that three cops, if they'd not been looking for a rodeo, couldn't have spotted an altered patient and known to look for a medical alert.

I love being called 'babe' or such by female providers, assuming they're looking at me when they do it...But I can't even tell you how bad I hate being called 'pardner' or such...It couldn't be more obvious to me that it's not meant to be endearing, but to create emotional distance instead. I use "Brother" a lot if it feels appropriate, even when I know their names sometimes, and it seems to be well recieved. But it's sincere... I think that most things are ok, as long as you're truly 'seeing' them when it's said, "Babe" or "hon" or "pardner" are all offensive when delivered with unfocused eyes while writing a report, or returning a text on your cell phone...

I agree completely 1040, except it feels like it was for the paramedic's benefit as well, as the reporter had to have gotten the story from somewhere? Of course, surely this story got him jammed up as well if he's known to have initiated it... Good point..I'd just assumed that it was him stirring the pot, but maybe not...

Three thoughts... First, I think that about every third male, and some of the females in Australia are named Phil. Second, what a friggin' dirtbag. Third, I see a snow storm of new check lists in this company's future...

The first story, hilarious, the story "Have you driven an ambulance before?" ("He should be stopping..is he going to stop?....why isn't he stopping?" Oh my God...funny), and a couple others are friggin' epic. I would have paid more than the cost of the book for those two alone. There are some here that will have some issues with some of the stories, and I didn't like all of the stories, nor did I expect to in a book of anectdotes. But what truly caught me off guard, and I swear that this is true, was that there were some stories that made me laugh so hard that I couldn't catch my breath... Glad I spent the money...