DwayneEMTP

Nice Ian... Yeah MG I think that many do. I had to have Bio201 (Anatomy) prior, and you could take Bio202 (physiology) at the same time as the course. And yeah...it makes all the difference having even that level of college science before going into medic school...

The problem that many have, and it sounds as if you do too, when viewed from a behavioral science point of view is that all of that "harden the fuck up" bullshit that you went through when you were new has a way of being superstitiously reinforcing. What that means is that it appears to be useful when in fact it has little to do, and often retards the learning, growing process. You can call that new age bullshit if you want, but you'll have a really hard time defending that point of view... The old and ignorant point of view that you make people confident by continously beating them down until they can overcome it just isn't true. You can teach people to say "fuck you. I don't care about your opinion any more." but that's not the same as making them competent and confident. Confidence comes from competence, and compentence comes from working in an environment that allows you to take chances without constantly covering your ass. Hardening up the new guys is very reinforcing for those doing the hardening as it makes them feel really powerful. But in fact it's just a bunch of limp dicks pounding on folks that have no way to defend themselves...pretty pitiful. Bring people up with you. This isn't about not hurting their feelings, but about understanding that they aren't at your level yet and you can't insult them up to your level. You have to train and encourage them to that level. You'll find that if you take this path instead that you'll create rockstar medics in 1/3 of the time that it took to create you...and that should be the goal, shouldn't it? Explain how you like things done before calls, explain what you want done during calls, do a call review on every call so that you'll both do better next time and remember that pointing out successes is 10x more powerful, at least, than pointing out failures.... It's all just good training really. Should they need it? Who cares? How does making that determination help anyone? They do need it...step up and give it to them...easy, peasy...

Wait! We turned the page, she's gone and now I'm on top of you! Not hot at all!! At least theoretically.....

Exactly...which is why I get frustrated with folks that bring "What? You can't change it, so why argue about it?" Most things we can't change, but we can try and exercise our brains sometimes... That's why you're such a gift here...to make sure we don't spend all of our time arguing over whether or not dog O2 masks are a good idea or not.. :-) I do truly believe that the mental exercise of debate has value of it's own, regardless of the subject...And, that being the case, theoretically, we should spend less time debating hosemonkeys and more debating sex...I mean, I know we've got girls here that can hold their own...so to speak...

None taken as I'm certainly one of those...in fact the one thing that kept ringing through my head while I was reading was.."One time at ATP cAMP..." And then you said, "back door" and I was a complete loss after that... Thanks for that though....It's frustrating to have at least kind of learned much of that years ago only to find that most of that much has fallen out of my brain from disuse...

Putting this in only for fun, as the thread has petered out anyway... Current time via ground, around 18hrs...by air during daylight, about two hours, after dusk/before dawn, no transport options possible... Sorry, but in this crowd of providers I have to trump with the distance card as I'm sure as hell not going to do it with brains...

Man, that's a good question. I know that it can be good for spasm, and this is more or less a giant spasm, right? I'm not sure how aggressive it would be compared to the other options though? I've never heard of it used or even considered in such a situation... So, to sum up, no idea. But I love the question...

I guess that I don't understand the controversy. It doesn't sound like they needed a helicopter for either of these patients but are just stomping their feet because they couldn't toss some calls to their buddy that owns the private company? Not sure....

Wait, and then there is the pic of the pretty girl kissing the dog...(is it weird that having her on top of me seems kinda hot??) Yeah, ok, I retract my gender guessing logic..

Man..that's beautiful sentiment. I feel bad now, as I was only coming in here to trash another hero poem... :-) Pretty cool man..thanks for posting.

(Note: Posting at the same time as Island, redundancy is accidental.) This protocol seems to assume the the B's in this area are also able to do BGLs? I'm mixed on this....but the one thing that struck me is that there is only one indicated dose, the full 2mgs. Half in each nostril... I've only used 2mgs in one shot once, and that's when an attempted suicide OD went into resp arrest just as we walked in so I jammed it up her nose and pulled the trigger. She woke up kind, but in really bad discomfort and really agitated...I've not seen those symptoms when I titrate. She'd had enough problems already, I'd really have rather brought her up more slowly... Do you think that it's an all or nothing because it's a basic skill?

Thanks guys..instructions would be awesome, but I'll take a look and see if I can get lucky...

You know, the nurse wasn't necessarily incompetent if she was working withing the processes put in place by the hospital....

I hear you Brother... What kind of a program are you going into? College based or cert program? College based should expect bio201/bio202... (anatomy and physiology)

Because my partner was an experienced basic with really thick skin. He got that I was way out of my comfort zone and took my tone in that spirit rather than be offended. It's been my limited experience that often Vollies, not always, but often, need to be handled more delicately...

Yeah RS, I talked to the Physio rep this morning and that's the same answer that he gave...though he sounded less than certain. Thanks for your help everyone!!

Thanks Man... What I'm having trouble figuring out is exactly where Physio drew the line. Are the leads running in diagnostic mode simply because they've been applied or is there no diagnostic mode unless you hit the 12 lead button?

Why are they too slow? Why did they do it differently? Nerves? Inattention? Arrogance? Probably my biggest personal trait that irritates people, besides just generally being an idiot, is that I love to debate. The vast majority of what I want to know about EMS I don't know. And the things that I do know I'm not terribly confident are right. Even if I'm confident that they were right yesterday, I'm not confident that they're still right today. I want to know why you did what you did, what line of logic did you follow, did you consider other things, what made you choose that order, is that the way you always do it or was there something in this call that caused you to choose a different path, what was it? So that I can compare it to my own thinking. Nothing makes me happier than to have someone kindly shred my calls and question my logic, though it rarely happens. Often I'll be in, what I consider a conversation, only to hear, "Never mind, I guess you know everything." And every time it catches me completely off guard as the whole reason that I was in the conversation is my conviction that I rarely know anything for sure. I get just enough reinforcement from running into others like me so that the habit doesn't just extinguish on it's own..so I'm not sure what to do... As far as snapping, it's hard to say really without knowing all of the variables. I once had a chronic COPDer crumping on me in Hicksville. Resps around 48 bpm, pale, becoming altered, etc. Bad. The patient and his wife had made it clear that he was not to be intubated, no matter the reasoning, period. I was bagging in a neb through CPAP, pushed steroids, etc. and was losing ground. I'd told my partner, "Light it up and let's go...best time we can make." After a few minutes we were still sitting on scene and I yelled, "C'mon! Let's move!!" and my partner calmly said, "Getting there, getting there, they're moving the police cars out of the way..." No harm done. Had that been a volly, then not only would it have gone differently, but it would have been counter productive as well. I guess that maybe that's my biggest point. If you believe that we're all here to elevate each other then you have to realize that being rude is counter productive. It makes people nervous, and nervous people make silly errors, and that means that you, as much or more than they, have queered your call and compromised patient care. Same result if you behave in a manner that makes people want to avoid you, or afraid to work with you. I believe that snapping comes from arrogance. For me not being arrogant is really easy, as each time that I've started down that path, as I'm guessing most of us have at one time or another, the EMS Gods have put a patient, or a much better provider in my path to show me that I'm really just a wannabe douche. Not sure who said this, but I think that's it's really true, "Each day we do the best we can. When we know better, then we do better." There is no benefit to making people that are already struggling and insecure feel bad about themselves when we're all trying to do the best that we can... (Sorry so yacky...jungle fever...)

Any time... How goes your studies?

Yeah, man. One nurse was fired and another resigned over this I guess... What a horrible situation. I can't even begin to imagine what it must have been like to be the person that had to approach a family, waiting for news of successful surgery on two of their kids, and have to explain this... And though it sounds as if there were plenty of issues to go around...to be the nurse that put the kidney in the trash? Horrific...She's going to be crucified...worse I think, as at least crucifiction has a finite period of suffering and humiliation. The only thing that I feel good about in this story? That though we may have a bit of fun with the occasional sensational story of someone getting bit on the head, no one here is making fun of the amazing amount of human suffering represented in this story, despite the obvious and easy material....That's cool...

The problems with that Island, as I see it anyway, is that where EMS is concerned there is truly a tax base "Pie", and while we accept our 'thank you' letters, the fire depts accept the tax dollars that EMS needs to grow, improve, and cover properly and uses them to buy another giant truck that they rarely (Again, nationally speaking) use except to go and watch the privates do medical calls... Know what I mean? I'm not pretending that there's an answer. Fire has been pretending to be heroic for...well...a really long time now. Most of the rest of us have decided to try and be more realistic, but the fantasy is getting paid while the reality is still plugging along broke...So it's not really working..Right?

Exactly!! If only I could make my own points so well... Thanks Brother...

Yeah, see. I was afraid of that... So, not having a diagnostic mode, what does that mean to our interpratation of elevations/depressions, recipricals, etc? You know, I'm just going to show myself an idiot for the good of the cause, as I'm sure that I should know these things...but, the fact is, that I don't. Thanks for your help everyone! This thread isn't exactly a barn burner, but I like it a lot...

But is the once or twice in a lifetime saving of that dog, or another, justify the stocking of pet stuff and the hastles that that will cause? I'm going with no, but you, without intending to maybe, certainly swayed me off of my argument more than I'd thought possible...I'll have to think down that line... And, I mean, even if it is? We all know that that isn't why Fire is doing it...I'd be willing to bet that once that newspaper article ran that within two weeks there won't be three guys there that have any idea where all of that crap went to..