DwayneEMTP

Seeing as how this thread has been thoroughly hijacked already, a couple of things always strike me when these conversations come up... First, is the number of people willing to arrogantly define faith, how it works, why it exists, all the while claiming they don't have any and can't understand it. The second being the interesting paradox of good, God fearing Christians that can shed tears over the Holocaust, yet are fully in support of a God that could create a Hell....? In this scenario, what is the difference between God and Hitler? See what I mean? Both side are wrong. So obviously there must be a God. Or not. Simple. Dwayne Edited to remove redundant punctuation. Not context change.

That's way cool Kaisu! I know this stuff should probably be in my head by now, but I find I'm constantly going back to review it...This will be much easier! Thanks for the link! Dwayne

Still trying to learn the protocols for CO. Springs. Plus I've been riding the 4p-4a shift for clinicals and have found it's easier to stay on that schedule when I don't have to work at my day job... Hell Doc. This has been kind of fun! It's like running around inside the school when it's closed and no one is there! (Not that I've done that....that would be bad) Dwayne

I don't know about CO...But after looking at that page I can tell you... Michelle wants me... I can see it in her eyes....yes...of course I know it's a picture....but....still....she does....(so there) Dwayne

You can count on if Doc... My thinking at the time was "Fire controls the patient until they release them to the private, so it's their decision, their ass." But it turned out that "control" didn't really matter to a "good" medic. He advocated for the patient regardless of the rules...I'll not soon forget that. You know, some of the simplest things, like the above example, seem to escape me at times, while the things I was nervous about...my first cardiac arrest, or my first pulmonary edema with audible rales from the porch, the answers just lined up in my head and it seemed like someone was whispering instructions in my ear...I was that confident. It's almost completely opposite of what I expected. When I have all day to think, I can turn "my wrist hurts" into a stroke/cardiac arrest/UTI combo, but when time is short (knocking on my head for luck) it seems that I get calmer, and more confident...I don't get it really.... It's not until after the calls when my decisions were most important that I go "Holly shite! It all seemed so clear at the time, but what if I'd been wrong!?" Another great lesson from my current preceptors; "What if I would have been wrong?" is great post call thinking for every run. "Holly shite!" Is energy consuming, panicky, poisonous thinking that can make me mentally impotent and has to go. And so it will. Thanks for your thoughts Doc... Dwayne

I was visiting with Dust via PM a few days back and was explaining that... He replied in part: This was in response to my first EMS witnessed arrest, but applies to much "smaller" things as well... And it got me to thinking. I could write a book on the things I've been taught during this preceptorship (no one would want to read it, but still). There have been some moments though that just stick out in my head. And I wondered what those moments were for others? For example, (I'm going to look like a bigger idiot than usual here, but am going to go with it anyway.) MVC, a larger Buick t-boned, intrusion into the driver compartment, driver side, to the point where there is approx. 8-12 inches of the drivers seat showing. Fire has been on scene ten minutes or so and are taking a refusal from a 24 y/o unrestrained driver that looks perfectly fine! He's laughing, talking about how lucky he was, remembers the entire accident, has no intention of going to the hospital. No ETOH/drugs, etc. I tell my medic that fire is getting a refusal, thinking he'll be happy to be back in service. He pushes to the middle of the crowd, pushes the clipboard with the paperwork asside, and explains to the young man exactly why anyone that has anyone that loves them, is completely insane (my words, not his) to risk the injuries he may have to avoid going to the hospital. He decides to go. As he's explaining things to this kid, I realize that he had already built a working differential from simply looking at the car. He didn't need a patient, didn't require any blood, and had no intention of taking the easy way out instead of doing his job completely. I know, I know! First week of basic class! But it's almost surreal (to me) to see a patient without a scratch on him (trust me, after looking like an idiot up front, I made SURE I wasn't missing anything in the ambulance) come out of that car. My first thought? "Wow, he was lucky!" I could certainly have built a like differential had the patient been obviously damaged...but my brain took a complete holiday when he was "fine". I know to most of you this is going to seem completely dorky...but it kicked me square in the teeth and changed the way I'll look at patients for the rest of my life... Anyway, I have a bunch of these little "lightbulbs", but would like to hear about yours as well if you want to share. If I can share this story, you should be able to share anything!! :oops: I look forward to your replies... Dwayne

(I'm not claiming this as real, only funny. Dwayne) Hotel Soap The following letters are taken from an actual incident between a London hotel and one of its guests. The Hotel ended up submitting the letters to the London Sunday Times! Dear Maid, Please do not leave any more of those little bars of soap in my bathroom since I have brought my own bath-sized Dial. Please remove the six unopened little bars from the shelf under the medicine chest and another three in the shower soap dish. They are in my way. Thank you, S. Berman ------------------------------------------------------------------------ Dear Room 635, I am not your regular maid. She will be back tomorrow, Thursday, from her day off. I took the 3 hotel soaps out of the shower soap dish as you requested. The 6 bars on your shelf I took out of your way and put on top of your Kleenex dispenser in case you should change your mind. This leaves only the 3 bars I left today which my instructions from the management is to leave 3 soaps daily. I hope this is satisfactory. Kathy, Relief Maid ------------------------------------------------------------------------ Dear Maid, I hope you are my regular maid. Apparently Kathy did not tell you about my note to her concerning the little bars of soap. When I got back to my room this evening I found you had added 3 little Camays to the shelf under my medicine cabinet. I am going to be here in the hotel for two weeks and have brought my own bath-size Dial so I won't need those 6 little Camays which are on the shelf. They are in my way when shaving, brushing teeth, etc. Please remove them. S. Berman ------------------------------------------------------------------------ Dear Mr. Berman, My day off was last Wed. so the relief maid left 3 hotel soaps which we are instructed by the management. I took the 6 soaps which were in your way on the shelf and put them in the soap dish where your Dial was. I put the Dial in the medicine cabinet for your convenience. I didn't remove the 3 complimentary soaps which are always placed inside the medicine cabinet for all new check-ins and which you did not object to when you checked in last Monday. Please let me know if I can of further assistance. Your regular maid, Dotty ----------------------------------------------------------------------- Dear Mr. Berman, The assistant manager, Mr. Kensedder, informed me this morning that you called him last evening and said you were unhappy with your maid service. I have assigned a new girl to your room. I hope you will accept my apologies for any past inconvenience. If you have any future complaints please contact me so I can give it my personal attention. Call extension 1108 between 8AM and 5PM. Thank you. Elaine Carmen Housekeeper ------------------------------------------------------------------------- Dear Miss Carmen, It is impossible to contact you by phone since I leave the hotel for business at 7:45 AM and don't get back before 5:30 or 6PM. That's the reason I called Mr. Kensedder last night. You were already off duty. I only asked Mr. Kensedder if he could do anything about those little bars of soap. The new maid you assigned me must have thought I was a new check-in today, since she left another 3 bars of hotel soap in my medicine cabinet along with her regular delivery of 3 bars on the bath-room shelf. In just 5 days here I have accumulated 24 little bars of soap. Why are you doing this to me? S. Berman ------------------------------------------------------------------------ Dear Mr. Berman, Your maid, Kathy, has been instructed to stop delivering soap to your room and remove the extra soaps. If I can be of further assistance, please call extension 1108 between 8AM and 5PM. Thank you, Elaine Carmen Housekeeper ------------------------------------------------------------------------ Dear Mr. Kensedder, My bath-size Dial is missing. Every bar of soap was taken from my room including my own bath-size Dial. I came in late last night and had to call the bellhop to bring me 4 little Cashmere Bouquets. S. Berman ------------------------------------------------------------------------ Dear Mr. Berman, I have informed our housekeeper, Elaine Carmen, of your soap problem. I cannot understand why there was no soap in your room since our maids are instructed to leave 3 bars of soap each time they service a room. The situation will be rectified immediately. Please accept my apologies for the inconvenience. Martin L. Kensedder Assistant Manager ------------------------------------------------------------------------ Dear Mrs. Carmen, Who the hell left 54 little bars of Camay in my room? I came in last night and found 54 little bars of soap. I don't want 54 little bars of Camay. I want my one damn bar of bath-size Dial. Do you realize I have 54 bars of soap in here. All I want is my bath size Dial. Please give me back my bath-size Dial. S. Berman ------------------------------------------------------------------------ Dear Mr. Berman, You complained of too much soap in your room so I had them removed. Then you complained to Mr. Kensedder that all your soap was missing so I personally returned them. The 24 Camays which had been taken and the 3 Camays you are supposed to receive daily. I don't know anything about the 4 Cashmere Bouquets. Obviously your maid, Kathy, did not know I had returned your soaps so she also brought 24 Camays plus the 3 daily Camays. I don't know where you got the idea this hotel issues bath-size Dial. I was able to locate some bath-size Ivory which I left in your room. Elaine Carmen Housekeeper ------------------------------------------------------------------------ Dear Mrs. Carmen, Just a short note to bring you up-to-date on my latest soap inventory. As of today I possess: - On the shelf under medicine cabinet - 18 Camay in 4 stacks of 4 and 1 stack of 2. - On the Kleenex dispenser - 11 Camay in 2 stacks of 4 and 1 stack of 3. - On the bedroom dresser - 1 stack of 3 Cashmere Bouquet, - 1 stack of 4 hotel-size Ivory, and 8 Camay in 2 stacks of 4. - Inside the medicine cabinet - 14 Camay in 3 stacks of 4 and 1 stack of 2. - In the shower soap dish - 6 Camay, very moist. - On the northeast corner of tub - 1 Cashmere Bouquet, slightly used. - On the northwest corner of tub - 6 Camays in 2 stacks of 3. Please ask Kathy when she services my room to make sure the stacks are neatly piled and dusted. Also, please advise her that stacks of more than 4 have a tendency to tip. May I suggest that my bedroom window sill is not in use and will make an excellent spot for future soap deliveries. One more item, I have purchased another bar of bath-sized Dial which I am keeping in the hotel vault in order to avoid further misunderstandings. S. Berman

Did you mean Throckmorton's sign? (Sorry Doc, I don't get that many "one-up" (No pun intended) opportunities with my little pea brain...have to take 'em where I can get 'em.) Dwayne

Edema of face/hands/feet? Either way I'm going to go on eclampsia as the larger life threat here...If it turns out to be sugar, the worst that's likely to happen in the short term is we'll bring down her BP a bit...(assuming all previous interventions have been accomplished IV,O2,monitor,glucose) 14/16g IV wherever we can get it... 5mg diazepam push, with 5 more standing by... 4g mag sulfate in 250mL saline to run in over 10 mins with airway support nearby... At first nonseizure moment, get a second IV (simply for redundancy), new vitals, get packaged and enroute... And hope I don't turn out to be a complete idiot... As usual I decided to post without research, so It's likely I'm completely off in the ditch here...But if so, with the exception of the diazepam/fetus interaction, I don't see where this is going to take her backwards... Dwayne

This is the average 6 year old's opinion...thanks for sharing it... Dwayne

Yikes...ditto...where did you come from! (Not you Jake...grin...we know where you're from!) Dwayne

Yeah...Asys is good that way.... Dwayne

Oh man...it was a fair question...c'mon guys.... Dwayne

Wait...this is now my favorite post in the last few months...(give me a break! I'm old!) Dwayne

Though it's no secret I've found many valuable posts here..this may in fact be my favorite for the last several months... Dwayne

Abrasive at times...sure.... Just make sure you're not confusing abrasive v. honest the other times... It's a common mistake.. Welcome to all the new folks...you are the life blood of this site... Dwayne

Oh yeah...this thread is starting to show promise! Dwayne

Thanks spenac...I actually stumbled across it on accident...but I still have no idea WHAT it is.... Just sort of a 'stream of consciousness' thing....?

Yeah, chat and forums are two different things...let's keep it that way... And not to worry. Vs never hangs in these discussions long...try not to take it too seriously... Dwayne

First word of advice. Read carefully before responding. Do you really want to defend the fact that that is what you pulled out of the above post? Just a thought. And welcome! I'm not at all sniping at you, just speaking as one that's had to say "Ooops...I guess that's not what I really meant", more than I care to remember. I look forward to your posts.... Dwayne Edit: Late post...I guess that's what I get for making Mac & Cheese between hitting the Reply and Submit buttons...

:shock: I thought God wrote those.... (Does this mean I can stop worrying about the tall, dark, handsome man that is supposed to sweep me off my feet? I've been losing sleep....) Dwayne

Ok, I'll say it...what the hell is a word cloud? Dwayne

Man, I believe that is so true. The only time I've been truly uncomfortable with my current (completely fictional preceptor :wink: ) was following a cardiac arrest... She was reading my (fictional) PCR and said (along the lines of..) Medic: "Are you comfortable with this PCR?" Me-thinking (Hell, I think we gave too little bicarb....I had written "administered sodium bicarb", like a wuss "forgetting" to put the dosage) Me: " Yes ma'am" Medic: "So you're comfortable with the types and amounts of drugs we pushed, and the times that we pushed them?" Me-thinking(God damnit! Why didn't I mention the bicarb first?!?!?!? She's going to bring up the bicarb!) (She gave one amp of bicarb while we were moving the patient, when 80mEqs would have been more appropriate, and then went back to epi/atropine when we got into the ambulance) (Certainly pointing out her mistake isn't the right thing to do?) Me: "Except for the bicard, I believe we didn't give enough." Medic: "Did you believe that then?" Me-thinking(Of course I have to say yes...then she's going ask why I didn't speak my mind!!) Me: "Yes" Medic: "What kept you from speaking up?" Me: "I felt it was possible that with your larger body of experience that you had decided something else was more important, or perhaps it was a mistake, and based on the current body of research, a very minor mistake." Medic: "And is it your belief that allowing me to overlook that mistake was somehow doing me a favor? That I find being "right" better than being good? Or if I am the type of medic that didn't care that it was a mistake, was it instead your thinking that you were being an advocate for future patients by allowing my behavior to go documented?" Me-thinking (Ok, I really, really, hate this conversation!) Me: "This is what I now believe. That I tried to do the "right thing" by being vague on my report. That in doing so, I cheated you by not mentioning this at the time when it could have been corrected. Also if you were a different kind of medic, I didn't do my job, by allowing you to continue to do sloppy medicine, and in both cases cheapened myself and my word to people that might count on it/me in the future. And what I know most of all? that I will NEVER put myself into a position to have to justify such stupid reasoning again." Medic: "Good enough for me. Want a pepsi?" Me-Thinking (I could never have made those points, that well, with no one feeling intimidated if I had 20 years and a brain transplant from a smart person.) Me: "Yeah, thanks. And thanks for making me think that through." Medic: "No problem." As we're getting off of shift several hours later, she says "Dwayne. Have a good day! By the way, it was a mistake. I wish you would have said something" She hands me a copy of her PCR that was completed several hours before our fictional conversation. "See you tomorrow." Of course her incorrect dosage of bicarb was well documented... Of course the fictional conversation didn't go exactly like that, but pretty close. And should the fictional medic in question ever read it I hope she sees the spirit of our conversation captured here. Anyway, I know I look like a dork when I go on like this...I just keep hoping that if others see that there are amazing preceptors, lessons to be learned, and opportunities to learn them..they'll keep searching until they find them... Have a great day all... Dwayne