DwayneEMTP

Actually, from talking to many of the old timers in EMS it was not uncommon in days gone by to work an obviously dead, cold baby/child...(Even a cold adult if there was no dependent lividity/rigor, for practice in places that saw such people rarely.) I believe that they were called 'compassion codes', with the exact goal of convincing the family that all that could be done, was done. I don't find this question foolish at all. We had a long day of death and dying in paramedic school. It was pretty amazing and much of it was counterintuitive for me. Three of the guest speakers were a psychologist, the owner of a funeral home, and a physician. On compassion codes the thing that stuck with me was that though it was still relatively common with children, according to one or more of them, I don't remember which, but the psychologist claimed that "people know obvious death when they see it", as if it's part of our genetic hard wiring. They were adamant that compassion codes create a major mind fuck with people that have family members in that situation forcing them from the early stages of grieving, to "Wait...I thought they were dead, but I was wrong?!" (logic colliding with intuition which, many of us know, can be pretty painful), pulled from the grieving cycle back into hopefulness, then shocked again to get to the hospital to find that not only isn't their loved one alive, but that they were almost certainly tricked into believing that it might be so in the first place, which makes them very angry. Though I won't run a code on someone obviously dead, I have made a big show, depending on the people present, of checking carefully for a pulse, running a three lead, looking it over carefully...just dorky stuff that I'm convinced in my little pea brain will remove any lingering thoughts in the family's mind of "are you sure?" before delivering the news, explaining the lack of heroic measures, and beginning to decide what type of care the family will need to cope in the short term.

Agreed. Mikey is trolling now it appears and let's just bring that to a halt...

You're in the Springs? Let's have coffee when I get home! I'll buy!

For the record, and maybe I'm showing my age, but my biggest issue was with the attitude of, "Could you please help me, but while doing so, don't waste my time with any of your happy horseshit...I've never done what you do, nor know anything about it, but I know enough to know that other than, within this tiny window, you have nothing of importance to offer me because I've already Googled EMS and know all about it..." It's just such a common, and poisonous attitude in EMS...

Wow, amazing how those of you in the south assume that those that live in the north are all racists.... And of course this case is about race. The police had decided that it was a non issue before the public outcry, and that came because a black kid got shot in a decent neighbourhood...I've only just Googled it yesterday and followed the timelines...so I don't really have a dog in this fight... I live in Colorado Springs, where, in my experience, relatively speaking, there are only a handful of blacks. There are also, in my experience, only a handful of Mexicans, Thais, Phillipinos, Cubans, Pollocks, Russians, Ethiopians, etc...Have we been cold to them all?? To the best of my knowledge, it's an amazingly tolerant city to all races, sexes and sexual orientations. Holy shit, we've just legalized weed! (Sort of) Is it possible that blacks live often in the areas you mention because that is where their traditional U.S. heritage is? Mikey, you're wicked smart, surely your not suggesting that in every community that has few blacks that blacks have moved there, been treated poorly, refused jobs, and then run back and told all of the other southern blacks how horrible it is there, preventing others from going? Is there, like, a black party line for such things that I'm not aware of? Some sort of blackstuff.com that white people haven't heard about yet where you share such information? I've never lived in Las Angeles, though I've visited...that's not where my small town culture lives, nor most of the attitudes or energy that I know. I live where I know how things work. Though, I've heard rumors on whiteysecrets.com (if that's a real website, it's coincidence only, as I just made it up) that there is a significant population of black families that have made their way out of the south. Does discrimination happen still? Of course it does...possibly just as much black against white as white against black..., as well as brown against white, white against brown, black against brown, black against yellow and all other flavors of idiocy. But to claim that the main reason that many communities have only a few black families is because they are intolerant is craziness... What is truly, terribly sad? That following generations of racism, that many blacks have chosen to celebrate the hard won victories of those that came before them, of all races, by claiming, "It's our turn to have ignorant hateful attitudes now!!" What a waste...

"I would love to be able to just get out long enough to pop into work and remind myself that what I am right now is NOT me." Yeah, that's a biggie, right? As Mobes mentioned...you don't have to be up to be useful. EMTCity is constantly really short of scenarios/case reviews...there are many, many here, myself included that benefit any time someone is brave enough to post them...

Hey man, how long do you have before your class starts? Anatomy and physiology are your friends in EMS. If you can get those in college level courses you'll be shocked at how much benefit they offer you...

You know Coney, it strikes me wrong when you say, "Hi all..I could sure use some help.... but don't give me any Google bullshit, or any of your stupid opinions...." Good luck in your search... Which fire dept is offering your accelerated medic course?

Hey...welcome to the City! That sucks, really, really bad...no question about that lady...but...it's doable. For now I'm going to ask you to consider the depression as a symptom of the anatomical pathologies and try not to take it too seriously, yet. Do you know what I mean? This is a really bad time to consider life changes. Your perspective is just way too screwed up. Do you have a family that you have to care for also? Sometimes we just have to wait...and yeah, I get that this isn't a medic's strong point. But it just is. Being a remote medic I find that sometimes the most horrible depression/loneliness hits me. When I was newer I dealt with it in destructive, irresponsible ways...but now I've come to consider it more like a virus, as if I got the flu or other such illness. I can't wish it away, think it away, medicate it away...but if I do what I can just to stay near the center of my lane, whatever it is that my brain needed to sort seems to get sorted and it goes away and I return to my normal dorky self. I think that it's just part of the mental process of being moved away from what we know of, or hope to be "normal"? I'm no shrink, but that's how it feels to me. Get out of bed, even when it hurts and even if you feel like a newborn giraffe when you use your crutches...start a diary, call your friends, write a book, post more to the City...but try not to self medicate your mental pain...it sounds as if right now you don't know what the outcome will be with your leg, so stop trying to guess and instead, every day move yourself to a place where you'll be a better provider when you're healthy. And if not a provider, a better manager, supervisor, or teacher...but you don't have enough information to hate life. Unfortunately you have way more time than you need to examine reasons to hate life... Does it suck now? Yeah...but injuries are supposed to suck...that's just their nature. Just try not to allow the suckiness to be the only thing in your day, ok? I'm glad that you're here...I look forward to your thoughts... Dwayne

iStater, your post was great..I wish that you'd post more often! We, when we're not off in the ditch, are about learning and trying to apply that learning, you're a perfect fit. Maybe you've noticed, at least rumor has it, that there might be one or two other RN/RRTs here... Welcome..I hope that you'll stick around...but, be gentle, remember, a bunch of us are only goofy paramedics.. :-)

Man, I'm so happy to see that some of the police officers are actually suffering for this...Not enough of them, in my opinion, but at least some... Thanks for the updates Brother...I let this fall off of my radar, but I'd love to see how it turns out...

Yeah, we all have stories like that, about first loves that last 40 years, but I'll bet that we're all also much more familiar with the kids that suffer through their relationships because they made a poor choice, (And I don't believe that any pairing can be successful if they will just try hard enough), or had a relationship that failed all together. I see very few truly passionate and happy relationships...So I'm with Mikey..if love smacks you in the face then by all means, gobble it up...but if you find that you're working on your relationship more than your chasing each other around naked...it's broken...keep looking until the spark grabs you and won't let go...

Actually he has a living will addressing 'life support' only, there is no mention of resuscitation or prehospital care at all.. I can't see where you would be any less obligated to do a full code here than with anyone else? Actually he has a living will addressing 'life support' only, there is no mention of resuscitation or prehospital care at all.. I can't see where you would be any less obligated to do a full code here than with anyone else? Me- full prehospital treatment

I never use the GCS. I don't see its value in a vacuum, and I don't see its value inside of a verbal or written report that will already be describing those values more thoroughly. When it has been required for paperwork I've recorded it later from memory. Probably bad, but there you have it . If it was important to a doc I was working with I'd certainly do it, but that's never been the case... BSA will always be an estimate... On the few severe burns that I've had I've tried to visualize it as accurately as I could. But I can't see why doing so would ever be necessary with a screaming patient in front of me... I've already made my transport decisions so it's not necessary until I'm ready to talk on the radio, right? Ditto the GCS. And I'm not going to be doing that until I've managed the basics... If I need flight my partner can call and 'medic requests flight for critical burn patient' has always done the trick.. I can't think of another value the I'd purposely spitball... But many values are subjective... LOC, Degree of pain, amount of blood loss... I can't really see why guessing at the GCS would be necessary? Not sniping Brother... Just curious...

I'm not sure what a cc is either... But if they really got upset in this situation then they're not terribly bright and I hope that cc doesn't imply some type of training position.. Use an intervention that requires both of my hands to be occupied, or one that leaves them free to do other stuff, like, say... Vitals, lung sounds, etc..? Yeah Brother... You were off in the ditch... Tell your cc that next time you'll be sure to prove to the world that you know the 'paper cup trick' instead of continuing to do medicine instead... Grrrr... This stuff makes me crazy... Good post man... These are important points that, truly, can't be repeated often enough... Think instead of follow... Good on you..

Man, one thing that I love about the above examples is the lack of abbreviations.. So often it seems that people believe that if you want to be one of the cool kids that you need to abbreviate your PCR (patient care report) to death no matter how much harder it makes it to read and understand.... Really great to see that the actual cool kids want a clear and productive document instead...

Thanks Mike... I've clicked that before but couldn't tell what it did.. And I can't tell you how much I love Mikey's advice to do what you love and then let the cards fall as they may... And test driving a ton of relationships isn't bad advice either in my opinion... Believe that every new lust is temporary... Plan to keep it simple...Plan to walk away... When the right one comes along you won't be able to imagine leaving... So often it breaks my heart to see young people suffering along trying to fix their broken relationships when they only stay because it's to scary to get out.. Trade short term pain for long term passion every day of the week...

Does anyone know how to 'like' posts on the mobile/DROID, ver of the city?

And it is more than likely better that you don't test the in your volly gear... Some places will be ok with volly service, other won't like it so much... And I'm with Island.. Suit first... And I think that you're thinking about it the exact right amount. There are a gazillion basics applying for every spot... If your over thinking doesn't stress you out.. Think away! But being really stressed at an interview won't give your prospective employer much faith in you.. Or shouldn't in any case.. But, then again, at many services hiring decisions are made based on a ton of insane criteria that have little to do with intelligence and competence... Good luck Brother!

You know, I gave this a lot of thought during and after treating the lady on the plane for 14 hours... I'd just been delivered a triple tequila in the hopes that I'd be able to sleep for part of the flight...I'd not touched it yet, but what if I had? Would I then have stood by while she was handcuffed, screaming, half the crew sitting on her while she pounded her face on the floor for the next, however many hours before she became exhausted? I'm not sure. Would that have been safest? No question, but offering to help and sedate a patient while off duty already opened me up to significant risk. I've never possesed the skill that many seem to have of removing my humanity from being a medic. There is of course a significant internal risk/benefit discussion that goes on in such moments, but my scale is pretty creaky and lopsided. It's an easy soapbox discussion to say, "Have a sip and you no longer do anything but put on bandaids", but watching someone choke to death because I wanted to cover my ass when I believed that I had realistic interventions to apply? Man, I can't imagine that happening, and hope that that always remains true. Doing a surgical cric? Yeah, also don't see that happening in that situation regardless of sobriety status. I think that part of the issues here are that we talk about drinking like we talk about spanking. As if there's only sober, and drunk. One extreme or another. But in the real world there's a ton of gray in between. I'm not pretending to know the right answer...just sort of thinking out loud I guess...

I think that the downside to dating within the profession is that it's an easy, commonly accepted reason for relationship issues and failure. "What happened with you guys?" "S/he just couldn't handle the fact that we worked different shifts/services/the stress" etc. It's like hearing that a cop gets divorced, people nod their head in sympath and think, "Yeah, it's tough being a cop's wife.." What nonsense. Relationship should be built on the fact that you've met someone that makes you crazy to be away from. There will always be some issues. But if they make you laugh, hold your hand even when you're stupid, and make you want to get naked constantly...it makes little difference what the job is, in my opinion. Babs and I have been together for 27 years and I've worked every type of job imaginable, the last 17 of those while she cared for our autistic son...there's been plenty of stress, but I've never, not for a single moment, looked at another woman and wished that I could trade...Is that because I'm amazingly great at relationships? No...not so much...but I did wait until I found someone that I couldn't live without before deciding to commit... Look at the person that you're with, when you get there...and if you can imagine living without them? You probably should...That should be your barometer...

What do you think? http://www.ems1.com/ems-management/articles/1466874-EMS-modesty-will-be-our-downfall/ "I winced when I saw this story break this morning. In some ways I wasn't surprised that EMS has come up short again on the public awareness stick. We're not celebrities; most of us do not crave the limelight. We like to think that we do our jobs quietly and without notice. While admirable, there are consequences for not being visible within our community. We would do well to take lessons from our fire-based brethren and our fellow law enforcement colleagues. Through education and awareness campaigns that have lasted decades, they have woven themselves into the fabric of their neighborhoods. EMS remains more of a shadowy element in the public safety net, even though the chances of someone needing emergency care is great compared to a fire suppression or law enforcement response."

Man, it is good to see some of our psycho old timers coming back! Really cool... As to the finances...I remember Rob/Dust Devil presenting an pretty compelling argument that any area that has a professional trash service can't cry 'poverty' when discussing EMS...I can't find it now though...it was a few days ago, so maybe it was lost in the transition..

Man, had they event invented glucose yet in 1974?? (yeah.. I know glucose wasn't invented... I'm trying to make a funny... Just go with it...)

I think that mikeymedic's point was that it's pretty easy to cast stones in an internet forum. We've all made mistakes, but sometimes that fact seems to be forgotten in these types of threads. I think that he was also trying to point out that posting over and over on the obvious problem, instead of exploring the possible solutions, is also what sometimes happens in these threads and maybe shouldn't be the goal of an educational forum. But that's just my read on it. I've been arrested for DUI, 30 odd years ago, been arrested for fighting, for drinking, and another time for fighting and drinking (Like to bring things full circle when I can. I'm goal oriented that way)...all stupid shit that my generation of 'cowboy redneck' did at a younger age. Yet I've managed to turn into a halfway decent husband, father and provider..hopefully at least. Though this thread has gone completely off in the ditch, I do think that it's been worthwhile and productive simply for the peripheral things that have been addressed...