DwayneEMTP

"For each procedure performed, patients were 2.63 time LESS likely to survive." (From article referenced in OP) Just my knee jerk response. It would be interesting to see the entire study. How did they quantify injuries and/or they're physiologic effect on the chances of survival? Wouldn't it seem logical to assume, that in the 'majority' of cases that the number of interventions would increase with the severity of the trauma? And the 'working' conclusion that increased interventions = decreased successful outcomes means that "stop thinking, just run to the hospital" (move backwards 20 years) should increase outcomes brings the integrity of the entire study into question in my mind. It's a defeatist, ignorant approach to drawing soft conclusions from data that wouldn't support the development of a decent hypothesis. "Was it because law enforcement made the decision that they could get the patient to the hospital quicker than waiting for EMS? Were the EMS patients further away from the hospital? Were there scene safety issues that prevented EMS from gaining access to the patient? " (As above) I'm not clear how it can even be considered a credible study if these questions, amongst many, many others weren't addressed. I guess I'm not really clear if the authors of the study came to these conclusions, or they were arrived at by the doctor writing the article. Despite what they seem to be attempting here...correlation does not imply causation. A quote from a sci-fi book my wife made me read, and I like it: "Information is not knowledge." (Sorry, I can't remember the source) But he was speaking about our current generation that, by having access to the Internet and it's myriad of unverified sources, is often no longer able, nor many times interested in, sifting fact from fiction. If a piece of information is interesting, it is accepted a knowledge with very little scrutiny. It sounds like these folks come up with some interesting information. It remains to be seen if there is any knowledge to be gleaned from it. Have a great day all. Dwayne

I'll wait until you have time to answer the previous questions before I respond... But I do want to say this: I can't remember the last time we had two honest to God firemen in one of these discussions that actually wanted to, were able to, and agressively did, discuss the issues from the fire side. This thread is turning into a real treat! Dwayne

It's ok Wendy, I take credit for things you say all the time! (Don't tell anyone) Dwayne

Paramedicks...You have to admit...that's pretty dang funny.

Why is it better to have fire lift the "fatties" instead of other medics? Fire burns, of course, but how many fires do you fight compared to the number of medicals that you run? The national average is what? 80%-92% medical calls for fire depts (depending on who's numbers you use)? Why does it make sense to have fire running those calls, as stated above, instead of medics? Is it your opinion, as it seems to be, that simply "someone" showing up is acceptable? So if your house is on fire, you'll be satisfied if they send an ambulance immediately, while you wait 10 mins for fire suppression professionals? I mean, after all, the ambulance has a fire extinquisher! (akin to the firetruck having an AED) If we didn't have a firehouse every few blocks (but very few fires) then the money 'might' be available for the training of medical professionals to respond to medical calls. Cut the number of firehouses and people will die? How many died in fires last year (civilian and fire) compared to trauma and cardiac issues (civilian and fire) that basic units are not equiped or educated to deal with? As long as you come with the same, tired, "you need us because we fight what you fear!" nonsense...this conversation will go nowhere. Dwayne

Wow. Eloquent and intelligent response Captain. I look forward to your further posts. A couple of things I seem to see differently on the private/fire issue than you do. First. If I have an MI, the most likely response (in my area) will be a fire truck with 6 people trained to the basic level in a couple of minutes, while I wait 5-10 minutes for medics with ALS knowledge and supplies to arrive? Why is that a good thing? As a citizen only, I would love to halve the number of firehouses and double the number of medic units and reverse the above scenario. And I have mixed feeling on the quality of fire medics. In any of my biology classes, without exception the worst students have been those getting their medic to be able to apply to fire. They rarely show up for class, talk and doodle during lecture, are happy, and sometimes eager to explain to anyone that will listen why it's idiotic that a fireman should need all of these useless classes. That has been my experience throughout college prereqs and in medic school as well. Now, where I get confused is on the flip side of this. I've just completed my phase one clinicals with a private company, and with very few exceptions, when on scene, wished that I had been attached to the fire medics (who were all women, which surprised me for some reason) instead of the units I was with. I saw much more aggressive treatment, compassion and professionalism from the fire medics than the crew (singular experience) I was riding with. I'm not sure what this says, to tell the truth. The fire students I see seem to have no respect for education or professionalism, yet the (very few) fire medics I was exposed to seemed to be the opposite. Though my experience is so limited that it certainly can't be considered any type of evidence, this is where the logic for my arguements comes from. (Edited to add this sentence.) So, I guess I don't really know anything, dang it. Well, perhaps this. I know that you and Dustdevil, though scrapping now, are going to develop a lot of respect for each other. One of the reasons for his tone (And I'm in no way an apologist for him) is that it's VERY rare that we get someone from the fire side that is intelligent, eloquent, and willing to be involved in passionate, heated debate without running away. And there is no one one this forum that I've been exposed to that appreciates being shown an error in their thinking more so than Dustdevil. Even if it comes from a hosemenkey. Normally we are exposed to a few ignorant, common stereotyped comments that don't hold up to logical scrutiny, and then they disappear. When we are blessed with someone that sticks, many of us are happy for the great resource that offers, as it is, not absent, but lacking here. Welcome to the City. Thanks for your thoughts! Dwayne

Dust's post reminds me of something that I seem to have discovered. Working construction, my hands are pretty tough. I've driven many crazy when they have located a vein via palp, placed my hand on it, yet what was obvious to them seems nonexistant to me! I've found that it's easier for me to press a little harder, feel for the "divot" (A little concave, that I believe is the bottom of the vein instead of the top), and then back the pressure of to get a feel for the 'quality' of the vein. It doesn't seem to require such a gentle touch at first, as when pressing harder you can feel yourself 'stumble' across the veins, and then back the pressure off to decide if it has the qualities you like before committing to it. Again, I must state that this makes my technique sound much more elegant than it really is. I get a general idea of location, and then go for it. Normally the above steps are applied with heavier patients, or sticks that I have a low level of confidence for success. From the start I made the whole process much more difficult that it needed to be... Good luck! Dwayne

I believe that's true, though I'm far from sure, unless they are notified of the recording. It seems a small sign would fit that bill. Also, I would imagine, in reference to Vent's post, that the data is simply rotated without being watched for the most part, unless it's needed for a complaint or QA. Then you track down the dirtbag that is responsible and violate them on HIPAA, as well as fire them for being morally and eithically unsound to work in the health professions. Again, I'm sure there's more to this than I'm seeing...It just seems that if the recording in your ambulance is going to sneak up and catch you being professional, kind, and compassionate, that that would be a good thing. Dwayne

I disagree. (though perhaps this is a different question) How long are you willing to withhold patient care to figure out that this is a psych patient? Get him in the truck, treat appropriately, notify the authorities there was a threat and move on. I have a hard time believing any of us is going to allow an obvious threat to go unreported based on fear of a HIPAA violation. I think the real question is this: Do we allow EMS to become a target on MANY calls, so that we can have the miniscule chance that one of you will recognize the one in 10 million (Ok, so I pulled that number out of my butt) people that might be a terrorist? And how many innocent people are going to be reported in the meanwhile? It would be nice to think that we could say, "You know, these folks gave me the heeby jeebies" and someone would simply take a look at them. But as evidenced by Scars removal of a medics age and name in another thread, throwing out this information ruins people's lives! Let EMS stick to what it does best. Make people, on a terrible day of their lives, feel a little better. Report what makes you go "Oh shit!" And leave the rest to the cops. Dwayne

I agree with Scar... When I finished they said "You did exceptional." I thought, "Yikes, that kind of sucks, there really wasn't anything that interesting on it!" Relax, ABCs, go home and wait to see if they call. Good luck! Dwayne

Hell, I'm still trying to come to terms with the fact that you took the time to edit the name and age of the medic! How cool/respectful is that? =D> As many know, I'm still a student doing phase II preceptorship, so my opinion is worth about as much as your average 6th grader. But I don't really see the issue. If it's good for the cops, that seem to have a much larger diversity of situations to be 'caught' in, why not EMS? I can't believe there aren't negatives...I just don't see what they might be... Dwayne

A tip from the Peanut Gallery? Slow down. You OWN the proctors at these stations. (I worked as a proctor for a couple of basic NRs) Everyone worries about how they look, that makes them nervous, and they forget stuff. This is butt simple. Take your time, do your thing, when they ask "is there anything else you'd like to do or say?" Start from the top and do it all over again. If you don't know what to say, get a brain freeze...say "I'm going to check/recheck PMS." When I went into my KED station the proctor was a lady, with hug muscles, five O'clock shadow, and boobs. (appeared to be a man, living as a woman) S/he caught me completely off guard! (I mean no disrespect to this person, it's simply that my personal experience hadn't prepared me to digest this contrast in just a few seconds without asking questions, which I felt would have been inappropriate at the time). So I turned to my 'patient' and said "Hi, I'm Dwayne, do you know where you are?" (Yeah, goofy, but if it's not on the critical fail, so what do I care?) "I'm going to assess PMS", "Do you remember the accident?" (Again, not on the skill sheet right?) The proctor seemed to be having no end to fun at my expense.... :shock: The point being this. It didn't matter if s/he thought I was smart, competent, politically correct, or handsome. It only mattered that in the next ten minutes I hit each check box and went on my way. (We later sat down, after I was done testing, and not only is s/he much funnier and smarter than I ever hope to be, but explained that s/he in fact did have a great time watching me process my thoughts/feelings :wink: ) You have what? 10 minutes to do a 3 minute skill? Do it, then do it again, go home and worry about things that are really hard. You'll nail this. Just don't confuse yourself by thinking that the proctor is responsible for your pass/fail. They are there to mark the little boxes (just like in basic). You control the stations, you decide what gets a checkmark and what doesn't. It really is as simple as that... Good luck to you all. Dwayne Edited (as always) for spelling.

Yeah, Ok, I hear you. After writing that post, while going over tomorrow's schedule, something occurred to me. I've kind of been going after this type of post (the posts that have no value other than to “hear” yourself talk.) for a while, thinking that there were many that were tired of them. It kind of felt like I was doing my part to help the board stay professional. Finally I realized what was probably obvious to many others from the get go...I'm the only one kicking up a stink. This certainly isn't my board, though I've become pretty invested in it, and I have no right to make others uncomfortable attempting to resolve something that seems to be an issue for me exclusively. The above post irks me because it smacks of the kid that runs around the playground pulling the girls hair, but is quiet as a church mouse when the boys are around. I hate bullies, and selective bullies the worst. That's my issue and I'll attempt to keep it my issue from now on. I've discovered one of the best reasons for working as a basic before becoming a medic. I gives one a chance to be exposed to all of the lazy, caustic, disrespectful, ignorant nonsense that comes with the job. I'm afraid I've let my clinical irritations run over onto the board... Though I won't apologize for the comments I've made, they were honest and meant to be productive, I'll attempt to rein them in in the future. My thanks to Wendy and Scar for jerking my chain. My apologies to the forums for becoming overly self righteous. Have a great day all. Dwayne

I didn't blow it out of proportion at all. You more or less called her a wacker. Yet you somehow failed to mention that you "also" did that in your little rant above when describing how "helpful" you were. And I'm not clear where you felt anyone asked you for an appology? My original post was much clearer, though Wendy felt it was unkind. It's your endless stream of "Look! I must not be a dork because I'm calling you a dork!" comments that got on my nerve. You must have done something amazing to before I got here that so many people laugh at you behind their hands, yet don't confront you about these silly posts. But until I'm let in on that little secret I'm going to continue to have issues with the fact that you snipe at the new folks, yet fall all over yourself to ingratiate yourself to those that are respected here. It's cheap, and cowardly, and beneath you....this enless penis measuring contest you feel the need to have with the nOObs. I would find this much easier to take if you EVER had the gnads to pick on someone that established here and willing to slap your ding dong in the dirt. But you don't. It's always someone that isn't prepared to defend themselves. Why is that? Take a pill, relax, chill, and quite getting your thrills taking cheap shots at the folks that don't know how to defend themselves yet...and all will be fine. I don't believe it's a kinder, gentler City at all. I've been here two years or so, every now and then we just get tired of the crap littering up the threads. Hopefully that clears up my meaning for you. Dwayne

Ok Wendy...for you. (Though I'm thoroughly sick of the established members taking pot shots at the new folks...) And, little miss smarty pants, I'll have you know I did a very complete...and err...extensive search...I will just have to assume my Google's broken...or something... Dwayne

Sorry Jamie, I tried searching for it without luck (Which I'm sure you tried as well). Welcome to the City! This was a great place to ask your question, someone will bring you an answer I'll bet. Keep posting, ignore the crap you've seen in this thread...it gets better, I promise! Dwayne Edited to remove inflammatory rant.

Yikes, I'm sorry you took it that way, it was intended to be a humorous challenge. No offense intended. Dwayne

Shame on you for taking the easy way out! And in your own thread?! (said tactfully) You've never been in an arguement? I don't understand the above statement. Can anyone help?

Actually, I think it's pretty interesting. Tact, do you use it every day? With every kind of person? Does you tactfulnes increase or decrease when you're online? Must tact come from genuine feeling or is tact used strictly for gain and/or manipulation acceptable? Hmmm.... Dwayne

Just one more example of why we love you best Kaisu... Dwayne

I strongly disagree. Yours beats it hands down. Bullsh!t. They were countable, you were simply too lazy, or unable, to count them. Pitching a fit is not an acceptable replacement for logic here. Wow. I have a lot of respect for many of your posts. But there is nothing respectable about this one. "warning: Adult material may be located on this board." This warning, plain as day, is viewed upon entering the Humor forum. Adult material means material that you may find offensive. When an adult finds a post offensive, most often, they then attempt to define what is found offensive, why they felt it was offensive, and then make some effort to effect the poster's future attitudes on the matter. This helps to educate us all, making the City, and the world a better place. (Wendy's Law) To me, easily the most offensive thing that can come out of a person's mouth is, "make them shut up!", or "Lock this thread" (As in, "I've had my say, so there can't possibly be anything else productive to come from it."). That attitude is ignorant, oppressive, degrading to us all, and unacceptable in a thinking, analytical, evolving society. I know from your posting history that you're too smart to believe that attempting to force others with opinions that we find distasteful to keep their opinions in the dark where they can't be effected by others not sharing their views is a good thing. The original post sexualized women, stereotyped Muslims, made men look like idiotic, intoxicated erections. Not great perhaps, but it was a joke after all. Your reaction to that post attempted to insult and degrade us all. Dwayne Edited for minor changes in context and punctuation.

Though I can absolutely see moral, ethical, and possibly constitutional issues here, I only need safety to make the decision for me. If you think blue uniforms, or badges make you a target for the bad guys, what will happen when: "EMS joins forces with law enforcement to keep our country safe!" Headlines are common place? Just a thought... Dwayne

Pretty cool Doc, thanks for that! Dwayne

Did they have that experience with more than one preceptor? Was it a medic rotation?

Oh hell. :oops: