DwayneEMTP
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Everything posted by DwayneEMTP
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The walk is on 22/Sept...but any time when it's good for you to donate to this amazing charity is good Kate... No worries...Hugs
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"I swear, sometimes girls can be so ungrateful. I made her breakfast in bed and instead of saying, "Thank you" she's all, like, "How the hell did you get into my house!!"
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Hi everyone. I know that when I look back I see thousands of people perusing these threads. I'm hoping that I can convince just a few to participate. EMS is a pretty small brother/sisterhood, and this cause is important, maybe we can try and make a difference as a team? I don't benefit financially in any way from this. Babs is on the board for the local Colorado Springs charity walk for Autism Speaks and she and Dylan are trying to raise money for that cause. Now, more than ever maybe, we need the research dollars. I'll post statistics below. There is just no significant, true, research being done on autism and it is suffocating because of that. Autism Speaks is committed to science based research projects, as well as providing support to families using science based techniques. (My family doesn't benefit from any such programs. I'm motivated from a research perspective only.) Look at this... Did you know ... Autism now affects 1 in 88 children and 1 in 54 boys Autism prevalence figures are growing More children will be diagnosed with autism this year than with AIDS, diabetes & cancer combined Autism is the fastest-growing serious developmental disability in the U.S. Autism costs the nation $137 billion per year Autism receives less than 5% of the research funding of many less prevalent childhood diseases Boys are four times more likely than girls to have autism There is no medical detection or cure for autism Prevalence vs. Private Funding Leukemia: Affects 1 in 1,200 / Funding: $277 million Muscular Dystrophy: Affects 1 in 100,000 / Funding: $162 million Pediatric AIDS: Affects 1 in 300 / Funding: $394 million Juvenile Diabetes: Affects 1 in 500 / Funding: $156 million Autism: Affects 1 in 88 / Funding: $79 million (http://www.autismspe...ts-about-autism) Dylan's page is, http://www.walknowfo...supId=362897320 I know that most of us don't believe that $20 can make much of a difference, but man, millions of dollars has been raised by folks giving just a few dollars at a time... Thanks everyone, for any help that you can give... Dwayne
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(Borrowed from Chip Stannard, as there was no share button.) Funny non the less.. The Most Interesting Medic In the World.... He delivers babies with Apgar scores of 11. Patients offer to name their illnesses after him. His chest compressions are so effective, 90 a minute are enough. He has more standing orders than his medical director. Hospitals divert their patients to him. He secretes his own disinfectant. Nursing homes prepare elaborate patient histories just for him. He finishe...
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MCIs: Patients who ask about other patients
DwayneEMTP replied to DMM4047's topic in General EMS Discussion
It depends mostly on the condition of the patient that I'm currently treating. If they are calm and for the most part uninjured we'll have different conversations than if they have an active MI, are significantly traumatized or emotionally out of control for any reason. In most significant cases anxiety and aggitation are my enemies. If I have to lie to effect those variables then, within limits, I will. I've often told an active MI, "Susan, you know that you're having a heart attack, but we've got a pretty good handle on it now...I can see your stats improving quickly now so I want you to just relax, breath, and trust that I have this under control, ok?" Do I see any significant improvements? Do I really have it under control? No...but knowing that doesn't help her and believing that I do won't effect any decisions that she'll make concerning her care and almost always drops their anxiety level significantly. Is this a slippery slope? I don't know... If I know that my aggitated, bleeding, freaking out, traumatized patient's family member was killed on scene will I tell them the truth? No. "Mike, you are in danger now Brother. I need to get some things done so that I can keep you safe. When we left the scene another team was looking after your daughter/son/wife and I know them, they're really good. I know you're terrified, I truly get that, but right now you have to be strong enough to care for yourself so that you can be strong enough to care for your family when we get to the hospital, ok?" Honest? No, not really, but I believe it to be good medicine. "Always tell the truth" is a decent rule, but sometimes, depending on your motivation, not the best medicine. And I, at least I hope, would never deliver the news to the drunk driver about the people that he killed to punish him/her. My committment has to be to improving patients within my limited ability. Choosing to purposely queer their condition for the satisfaction of punishing them them for their bad behavior is just to far into the murky areas of morality and ethics for me to try and figure out. And once you've chosen to injur a patient for personal satisfaction, how do you come back from that? -
There are things we don't want to happen but we have to accept, Things we don't want to know but we have to learn, and people we can't live without but we have to let go. ~ ♥ Jennifer Jareau
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And I'm guessing that the bomb was covered with...something...to catch shrapnel. I've never thought about those kinds of issues...thanks for sharing that...
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Guys....Just because it's a research questions doesn't mean that he's not interested in general discussion on the topic, right? I'm rarely satisfied simply by "answers" found through peer reviewed sources as they don't answer all of the questions that I might have on the subject. Once again we're being a bit hard on a new member for bringing a really good question...I had to Google TD as I'd not even heard those words in years.... Why is it so important to demand to know why he's asking the question? Participate, or don't...easy, right?
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Yeah...I see all of your points and stand corrected. Though it shouldn't be that way in an optimum learning environment, you're right that these environments most often are that way, and we need to work the best we can within the paramaters allowed, until they can be changed. Thanks all...
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Because you get maximum effect from a bullet nearly instantly, from a tranq, not so much. You might shoot him with a dart now, but he's not tipping over any time soon...Sorry Brother, you've seen to many TV shows..
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"Do not accept any of my words on faith, Believing them just because I said them. Be like an analyst buying gold, who cuts, burns, And critically examines his product for authenticity. Only accept what passes the test By proving useful and beneficial in your life." -The Buddha
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“Cultivate the habit of being grateful for every good thing that comes to you, and to give thanks continuously. And because all things have contributed to your advancement, you should include all things in your gratitude.” ~ ♥ Ralph Waldo Emerson
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All good points but there is much to be learned when you're told that, I'm assuming, you're only pain management is contraindicated on a small population of patients that will need it most. And discussion isn't only about change, it's also, and more often, about learning, developing logic trees, playing out "what ifs" in class so that you can be more prepared in real life. And I couldn't really hate the, "take it up with them in private" argument worse than I do. We all know that many of the questions that others have asked were in our heads as well, and we want to take an, assumed, appropriate question, as this one seems to be to me, asked in (I hope) an appropriately respectful manner and have it moved into the back room where only the two people will benefit from the discussion? I just don't get that... I read a quote when I was young that said, "I've never known a truly intelligent person that didn't say 'I don't know' on a regular basis." That resonated with me for some reason generations ago, and I paid attention to it, and have found it to be very true. If your questions aren't being satisfied, if your teacher is unwilling to explore issues that they don't have an instant answer for, then it's high time that they stopped pretending to be an educator.
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"What would your life be like if the only things/People that would continue in your life tomorrow were those that you noticed, and were grateful for, today?"
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"Sometimes in our spiritual work we feel like we are working and working but not getting anywhere. We have to know with certainty that even though we don’t feel it, the earth is still moving. Even though we don’t see it right away, our changes create a shift. As long as you’re on the path, you are making progress, even though you may not feel the movement. The work keeps on going whether you feel it or not. As long as you stick with it, you’ll be given opportunities t...
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Hey Brandi, welcome! Jump in! There is some to be learned from lurking, but much, much more to be learned from participating. Also, participating is an excellent way to practice putting your thoughts together with a little bit of pressure in front of others, which is an every call 'thing' in EMS. Don't be timid, ok?
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I can't speak to skills Chris. I know that I worried about certain skills as I use them so seldom in my current gig. I've only started about a half dozen IVs in the last 6 months. But each was a good start on significantly volume challenged patients, so I've stopped worrying about 'forgetting' how to do that properly. Though our clinic sees 40-70 patients per day, I only see 5 or so, not counting dealing with the 2-5 significantly ill/injured patients per week. I like to listen to lung sounds, feel pulse qualities, etc to try and keep a decent baseline for more or less 'well' patients. 5/day seems comfortable for me, to see if my clinical findings match my impression of the patient presentation, though I certainly can't defend that as a valid number. On thing that I've found that surpised me in seeing fewer patients is that it feels like I do 'cleaner' assessments and I'm seeming to see that I do better medicine now. Not sure though of course, as I don't have anyone onsite to critique such thoughts. I seem to find, and this probably sounds silly, that I seem to start with a cleaner chalkboard when developing my differential than I did when I saw many more patients. I think all that work in this field find that patients often come in groupings. The flu is going around so many of the patients that we see are victims, at least partially, of that illness, so we begin to group certain symptoms in with other patients that we've recently seen believing that we "know" what's going on based on the recent, common knowledge. I know that this is a weakness that I guard against with dehydration at my current site. "Aches and pains, headache, relatively elavated B/P, Pulse rate....I'm pretty sure that I know what's going on, but let's verify." I don't think that that is bad as long as it's on the radar, but I've found that without having so much constant exposure to those patients that I seem to be a stronger clinitian without those thoughts in my head...I'm not sure if this is making sense or not.... I guess what I'm trying to say is that seeing less patients seems to have dropped my general, intuitive confidence level, and having less confidence has seemed to highten my focus even more strongly on assessment skills and I seem to be doing better medicine now, than when I saw 25 patients per day, because of it. I know...lots of "seems" but that's the danger of a single medic gig with no one to verify your thoughts/assessments. So other than "monkey skills" perhaps less patient exposure can be turned into a strength instead of a weakness?
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Yeah, what a bunch of fucking cowards. And you know what makes me even the maddest, though maybe it shouldn't, is that the cop just wouldn't stop until he caused the fight and then he blamed it on Kelly Thomas. What a fucking coward. At one point there are several cops on him and one hits him over and over and over in the head and face with his maglight....Craziness. In my previous life as an animal trainer I was helping to train some dogs for the LAPD. During one of the training sessions I was told, and I swear that this is true, "No one will tell you this, but every cops goal is to kill someone before they retire. That's why people get shot 40 times, we just want to fucking kill someone to get even for all of the shit that they put us through..." (the words of the cops I was training for, not testimony on my part) It would appear, from videos like this, that that sentiment is true for some, I'd say to many, cops. Horrible video for all of the many things that it illuminates...Kelly had been diagnosed with schitzophrenia. Edit: a timeline for the whole issue. http://www.nbclosangeles.com/news/local/Timeline-The-Kelly-Thomas-Case-in-Fullerton-126851443.html
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Why does this not surprise me. Only in NJ (I hope)
DwayneEMTP replied to JakeEMTP's topic in General EMS Discussion
In professional fire houses? Craziness... -
Another Reason We Have A Poor View In The Public Eye
DwayneEMTP replied to Quakefire's topic in General EMS Discussion
I'm confident that English is not the native language of the author. Babs and I laughed our asses off at this this morning...That has got to be coming from a site overseas or something... -
If you look for the truth outside yourself, It gets farther and farther away. Today walking alone, I meet it everywhere I step. It is the same as me, yet I am not it. Only if you understand it in this way Will you merge with the way things are. ~ Tung-Shan ~
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I've read posts here and articles online about these conflicts arising. The problem that I tend to have with those conflicts is that regardless of the place, they've called for emergency assistance and nearly everyone has some idea of what form that assistance comes in. I've been irritated by the idea that I should show up and be expected to conform to religious ceremonies that aren't mine. I will be as courteous as I can, but if you tell me that pastor Bubba is unresponsive and not breathing then I'm going into your church, as is my moral and ethical responsibility now that I've been called, and you will have to ask God's forgiveness on my behalf later. I've only been called to a place of religious worship maybe a half dozen times, but each case was critical...in fact I think about 5 were active MIs or arrests and one was an active seizure. You might believe that refusing to commit time to a religious primer disrespectful to your religion, but I believe your opinion to be disrespectful to human life and suffering and in this situation, if it can't be resolved in the next 15 seconds, I'm going to win and you'll have to take up the issue with your God and my supervisors. I won't purposely allow your brother or sister to suffer to avoid hurting your feelings. I've been called to provide emergency care, not to prove my respect for your Deity. If your God or your religious community is offended my my desire to mitigate suffering over religious conformity then perhaps it's time to revisit the spirit of your religion. I have a huge amount of respect for your desire to become educated to the religious desires of the community that you serve, but if conforming to those desires retards your ability to provide prompt, safe, care then I sincerely believe that you need to reevaluate the spirit of the job that you've chosen, which, in my opinion, is patient advocacy.
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Can an individual, that's not part of a company, have a medical director if a doc will sign off on them?
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"The planet does not need more 'successful people'. The planet desperately needs more peacemakers, healers, restorers, storytellers and lovers of all kinds. It needs people to live well in their places. It needs people with moral courage willing to join the struggle to make the world habitable and humane and these qualities have little to do with success as our culture is the set. " ~H.H.The Dalai Lama
