DwayneEMTP

You friggin' crack me up...

The main thing to remember on that is that, as mentioned before, that the vast, vast majority of the time there need be no issue. If things start out shitty for some reason, try and figure out what that reason is. Sometimes it will be just because there is so much excitement and they want to be part of it. In that case, thank them for helping and give them a job. I've found that asking ANYONE to hold the fluids is a winner. They are then the center of attention and the most important person in the room. And that makes anyone happy. On TV the person with the fluids is always the hero. Hit by a truck, multiple rocket launcher strikes, eaten by an aligator....Start an IV, yell, "Don't you leave me!" a few times and all is well with the world. Funny maybe, but no one is ever a problem again if you put them in charge of holding up the IV bag. Or they truly want to help because they're afraid that no one is doing anything. Then give them a job and explain to them what is being done... Or a camera crew will show up, and then you're simply screwed because you won't be able to find your patient for all of the firemen crowding around.. But for most things, there's a kind, logical solution. If things go off into the ditch normally you'll be able to follow the tracks back to the the crew. Though they will rarely see it that way. Dwayne

Thoughts for peace and healing for his family and all that loved him from the Womacks in Colorado... Dwayne

How can they know what you believe is necessary so that they know what to request? Here you go again with your certainties Beebs... I can see not implementing without your permission, but not requesting without your permission? That's a bit harsh, right? Have you never, with a chronically ill patient, looked first at the site where they point and say, "This is the easiest place to get an IV on me..."? You are going to find someday that you WILL run on patients that know more about their condition or their childrens condition and it's treatment than you ever will. It will pay you big dividends to listen to them. Some have explained their conditions and treatments to me at a level that I was pretty sure that they were telling the truth, but well above my ability to follow. Anyway, someday, and it will come, when you're called to a home to transport a child and the living room will have a hospital bed, IV pumps, bags of fluids piggybacked with second, third and forth drips, monitors, medications, and a really, really sick child...when that mom or dad, or brother, or sister tries to tell you what's best...you really, really better listen, as in my experience most of the people in those types of families could teach a physician level M&M on whatever it is that's slowly killing their baby... Just a heads up... Though you sound very certain above, I've know you long enough now to know that you can change your mind on a moments notice given good, productive information... But for now...do it 'cause I said so!! Heh...ok, maybe not... Dwayne

Bill...+5, excellent post... Dwayne

You know, in our situation, I can't really say about parenting, but what about families in general? I know that Babs and I enjoy a much richer, sexier, fuller life that we likely would have without out internet personas. Maybe this doesn't apply to all couples, but I can't see any reason that it should be about remote couples only... There are just simply some things that are really tough to say face to face. Some relationship things, some sexual things...I was shocked to find out who she was when we chatted online, mostly in a good way. There were a ton of things that she didn't know how to say. Of course the same is true of me as well, believe it or not, and our relationship is so much richer, and fuller, and relaxed than it was before. Would we ever have reached this point, said all of those things, if we didn't have the faceless internet to hide behind while we bared our souls? I don't know, but it doesn't feel like we would have... Now, it's possible that others here are going to tell me how they've never had such issues, that their relationships are open and honest with nothing hidden. After 25 years of marriage? On 99% of you I'm calling bullshit, the other 1%, rock on!! I don't see any way that the family dynamic can't change when run over with this relatively new technology. But the bottom line is that the core will/should still be living as 'a family'... As with everything new where humans are involved. If it becomes terribly popular we at first call it shit, then we get completely lost in it to our detriment, then after we've blown our wad we step back a bit and try and approach it from a more logical point of view....I think with social media that we're in the 'lost' stage... Was dad an asshole on the video? No idea as it's blocked here. But I'll tell you a couple of things that I believe. The first is that it makes little difference for his family. All of our idiotic crap seems to average out as long as there is love at the core. And if he was, it's good for the rest of us. We need people to be to kind, and to evil, and to stupid, and to raunchy and to chaste, etc....that is where we get the information that we need to get past the 'lost' stage and get on with the work of life, and being more productive...IMNSHO Dwayne

As chbare said, you MUST break this habit now. There is the real world and there is the testing process. If you try and take that NR this way, you are going to be totally screwed. Any attempt to be a deep thinker during these tests, and I don't care which one it is, will torpedo your odds of passing. It's not an easy process sometimes, but you truly will be going through medic school in two modes. The first, to learn all that you can about everything to try and become the best medic that you can be. The second to understand and defeat the testing process so that you can achieve goal one. See? Simple. It's really not as difficult as it sounds. Take your tests as if you were a basic taking them, (Not because Basics are stupid, but most basics wouldn't have the information to ask the deep, 'what if' questions on a paramedic exam) truly, stop all of that fancy thinking and 'what if'ing, and you'll see that most answers will be relatively simple, as in this case. The tests are not deep, they are not intended to see if you're smart or logical, and you certainly can give the shallow answers that the tests want without becoming a shallow thinker on scene. You can. Yes you can! Stop it now...(you can.) Should it be different? Of course...but this is a national test that's focused really more on money than on testing competency...it's one of the many silly hoops that most of us have to jump through. Stop wasting time being angry about it, you've got better things to do... It is what it is... Dwayne

And you know what really sucks?? Screaming white man syndrome....Have seen that a time or two too.... Dwayne

I can't watch it here, but sent the link to Babs and she said it was friggin' hilarious!

You mean when I dreged it up again, all the way back from what, a couple of hours after your last post? But you're right, man, whatever. We've both said our piece. Dwayne

I agree with all up to the point where a ped is involved. Legal age to consent then I don't have to follow the family's plan, unless their plan is better than mine, which has happened a couple of time while transporting chronically/critically ill pts. But with a ped the folks can have a significant impact. I'm grateful that I've never had this happen to me, but know other medics where it has. And it can really suck. I mean, I've had parents try to intervene with my care of their damaged child, but as stated by System, they were out of their brains with pain and grief and it just took a few mins, some compassion and explanation to get them onboard. But in the situation from the article, it's hard to imagine that they couldn't have managed that better. But then again, they had a critically injured patient, and depending on her behavior all along....who knows. But again, as System said, regardless of the woman's behavior, the medics should consider that solution a massive fail on their parts. Perhaps they did their best, but their best wasn't good enough this time... Dwayne

I've been watching this thread, getting more pissed all along, for a few days, but stayed out of it knowing that Mike E can take care of himself...But...Holy shit!! You mean to tell me P Mike that you've not heard the terms 'staticus hispanicus' and the like? I hate those terms, but I'll tell you what man, I hate the selfrighteous, "I am so pure that I can't imagine what you might be referring to!" bullshit even more! You mean to tell me that you've never been in the back of an ambulance with a well/or minimally acute man/woman of certain ethic backgrounds and been majorly pissed off because you couldn't possible determine what the problem was because of the screaming, moaning, fake attempts to hyperventilate and vomit, etc? You've never been there? Bullshit. You know what, you don't like his comments, ok. You've told him so, and he's apologized. But C'mon, he makes a good point. There were others in that thread, while you were participating(!) that talked about tramps, and bums, and hobos, and frequent fliers, yet they didn't get this whole line of shit. And if he started out in the funny forum, (which I'm pretty sure he did as I think I moved this conversation there when it become off color), and was then moved, then there is nothing wrong with his posts at all as he put the politically incorrect stuff where it belonged and someone else put it where it didn't. At least Island can admit that he understands where he's coming from but chooses not to think, speak, post in those terms. Not because he's to pure to have such thoughts, but because they're not productive nor professional. But the "I don't know what you mean? I have no idea what you might be referencing but because it uses the word 'black' I'm certain that it's offensive! And once you're as pure and professional as me you'll come to see that it's not possible to think, or feel, or say, or understand any politically correct ideas ever again!" Wanting better things for him is one thing, but now you're just flogging him so that you can wave your purity flag for the world to see. There's nothing productive happening here. He's trying to maintain some self respect and seems opposed to telling you to stop being an arrogant asshole. I didn't want to have to, but you just wouldn't friggin' let it go! You should be ashamed of choosing such a target. He's apologized, and apologized, and groveled, and explained, and tried to change his posts... Fuck's sake.....Give it a rest Brother... Dwayne

I get what you're saying LS, but what do your protocols say about traumatic arrest in general?

And lose bragging rights for pulling the answer out of the ether? I don't think so.... :-)

Yeah Island, good point... It will be interesting to see what the investigation has to say, but if it's even remotely honest, I'm guessing that she will not come out of it looking very good. And I hate the tone of the article that makes it sound, as I'm sure that she reported, that she said something like, "Please sir....May I...sniff, please be allowed to...sniff sniff...hold my husbands hand...moan...in his last moments of life?" And the response was, "NO! Now out on the road you whiny bitch!" When, in my experience, it was more than likely related to, "Stop this ambulance you ignorant motherfucker! Let me in the back! I swear to God I will have your job! I'm a taxpayer, I pay your salary! You better fucking listen to me! I'm a nurse you have to listen to MEEEEEEEEeeeeeeeee!!!!!!!!!" (Again, not sniping nurses, as I love you, (at least the boob people, I'm indifferent to the Murses) but guessing at the temperment of a nurse that manages to get thrown out of an ambulance." Probably not an exact quote, but having been in like situations where angry/upset people were disallowed riding based on their behavior, and based on the fact that her first call was to the papers, and I'm sure her second to a lawyer, I'd be willing to bet that I'm not far off... Dwayne

Jonas, I see in most of the articles that they mention 'paramedics' in several places, I'm not sure where you're getting your info that the call was run by basics?

All threads are within limits if they interest you and you approach them sincerely Brother.. Speaking of which, we're neighbors it appears? I too live in the Springs. Maybe we can arrange a cup of coffee when I get back stateside? Dwayne

Yeah, lurking is bad...But better than nothing! Not just for you, but for us as well. As DFIB mentioned, you have an opportunity to run your ideas past a ton of providers with higher education and more experience than yourself. No one is here on parole, they are all here by choice, and much of the reason that they choose so is to help out folks just getting started, like you. The flip side is, there are a ton of us that haven't seen a classroom in a few days, and some, like Mike above, that took their exams with charcoal sticks sharpened in the fire. The point being that there is a lot of really good and valuable information that you'll be exposed to that many have not considered for a while, but would like to. So your questions aren't a burden, so don't think like that. The only thing that irritates posters like me, is being timid and submissive. EMS when done well is very kind, and intelligent, and professional, but if you truly want to learn to be decent at this, at times it can be emotionally a full contact sport too. EMS is something that you will DO, not sit back and think about doing. Your ideas will have weight, and here is an excellent place to practice sorting those ideas and developing your logic trees. Get good with the fact that often the most value that you'll take away from a conversation is that you're idea was completely boneheaded, ill conceived, and ridiculous. Though I know of few here that would use such terms to describe it. While at first this can be really intimidating, as we all want to be right all the time, I think that you'll come to find that that is where the real power. Getting help with eliminating bullshit ideas that all of your buddies will consider facts and/or think are really cool. So, sit on your hands, lurk, and be welcome. Or participate and get busy with the business of choosing to be exceptional in the new career direction that you're considering. Good to have you man...I look forward to your thoughts. Dwayne

No one has ever taken me seriously, but I've suggested that the lady medics pack away a few of the expired LMAs...they seem custom made for the job, right?

I think that we all agree that L/S are a bad idea on a regular basis. But a couple of things come to mind for me... First, I wonder if any of the studies have been done in areas where emergent transport triggers the the traffic signals ahead, clearing the intersections ahead of the emergency vehicles? I've ridden once, I can't remember where, maybe Denver, where they had this and it seemed to make a huge difference over L/S alone. Also, in some of the places that I've worked, L/S had a larger impact on my ER response than on the traffic en route. I'm not exactly sure of the dynamic, but I've called in with patients, for example, a gunshot wound (rural service), "This is Dwayne, I'm en route with a 22 year old male GSW, 90% traumatic amputation to left humerus secondary to 12 g gunshot wound, significant loss of blood prior to EMS arrival, pt has thoracic damage to effected side, unknown depth of those pellet wounds. Pt is unresponsive at this time, B/P 66/0, resps 36, intubation imminent, yadda yadda yadda..." We arrive at the ER to...nothing. Wheel the pt inside to find two nurses hanging out by the radio, doc is in bed, RT/Xray haven't been notified, nothing. They see my pt covered in blood and freak out saying, "Why didn't you tell us that he was critical!!!" Really? That radio report failed because I didn't say the word 'critical'? Another pt with really bad asthma as well as some end stage pulmonary pathology, I can't remember what flavor. Tripoding, pale, diaphoretic, RR around 40, L/S silent in all fields...Keeps repeating, "No intubation...no...matter...what....no....intubation." to every question that I ask him. His wife verifies that he is refusing intubation regardless of the situation. Anyway, to make a long story short, I do my immediate treatments, which I have no faith are going to work, load him up, and though I don't believe that another minute or two will make any difference but having learned my lesson with the GSW, run in emergent. Low and behold, half the friggin' hospital is there upon my arrival... So here I think, and in many things, we can't rate any one intervention on only one criteria. Again, not having looked at the studies, is there more to any of them than, "L/S have been shown to save 5 seconds/2 miles traveled, is this time savings significant when pt M/M is considered?" Is there an educational value to people being exposed more to L/S? Perhaps more people would react intelligently instead of freaking out if they had more exposure? Is the danger from running L/S inherent in them, or is it the effect that they have on the drivers of the vehicles that is part/all of the issue? Would add'l training mitigate this issue? Is there a possible psych effect of some patients that may be beneficial? Hell, I don't know, I'm just pulling these things out of my ass...but maybe it makes the point. I wouldn't be opposed to l/s being removed from emergency vehicles with the exception of police cars, but then I still like being stuck with patients... Again, I'm not advocating for L/S use, but wondering instead of once again we're looking at a tunnel vision view of a larger equation. As well, this may sound snipey, but I think it's valid. Regardless of the safety issues involved, I would be willing to bet that Fire will be one of the biggest proponents for continued emergent response to everything as it's such a massive advertising vehicle for them. "Look at us! Saving another life!" I know it sounds facetious, but it's really not meant to...

Yeah, peeing every couple of hours doesn't sound excessive to me either.. Though I'm not very superstitious, when working the street I did pee constantly when possible. It seems that there is nothing more likely than a full bladder to guarantee that you will be first on scene of a 5 car pile up. Peeing in patients homes..I don't really see why it's such a huge issue assuming that it doesn't happen regularly. Though some seem to think that it would be more dignified to pee your pants than to do so. Especially when you work rural, sometimes it's that or peeing behind the house. I don't think that it's terribly professional, but we don't always have control over when and where we'll need to go. My biggest issue with peeing in someone's home is that I'd really rather not be alone in the room where they're most likely to have controlled substances that might mysteriously come up 'missing' when someone discovers that I've done so. If you're posting in the ambulance it can be tougher. But I made a habit of heading to the bathroom the moment I heard the tones begin. By the time dispatch was done announcing the address and nature of call I could be running to the rig, zipping as I went... :-) It is curious that he felt the need to mention it though. If you're reporting your frequency accurately, it seems that there is something else going on there that has nothing to do with urination... Dwayne

Yeah man...that made my day! And the thread title couldn't be more appropriate! Dwayne

Yeah, there are so many ways that intervening in this can go wrong, and very few that they can go right. If this is a friend, then maybe I'd stick my neck out a little bit. But if not, I don't think that I would, as there are a million ways that your efforts could be contstrued badly. I pulled a medic asside when I was on the oil spill in LA to mention that the racial things that he had on his FB page could possibly get him jammed up in the future. Normally I wouldn't try and protect such a idiot, but at the time I'd been told by another that he had two brothers in the Special Forces, one killed in combat, the other MIA. That kind of pushed me to butt in where I maybe didn't belong. He had many pics on his page that I felt were inappropriate. For example one with what appeared to be a black, unhealthy prostitute on her knees giving oral sex to a standing white man who was flipping off the camera and wearing a tshirt with a rebel flag and the phrase, "Happy black history week!" Another of an obviously impoverished black woman pushing a baby in a shopping cart with the caption, something to the effect of, "A responsible mom....conditioning her babe to a small room with bars." He became angry at my suggestion that he would be seen as a racist, as 'they're just jokes." And those of you that see my facebook page may notice that he continues to post on my wall now and then about what an arrogant asshole I am. Also, when I went back, before I realised he was pissed at me, to see if he'd taken them down, I noticed that several of the supervisors and management from the company had 'liked' and/or commented on them favorably... The point being that though I only tried to help secondary to his having two brothers that had served my country with valor (the second brother turned up with half of his face shot off.), and I don't really have any issues with being disliked by redneck bigots, regardless of their company position, it did no good, and ended up creating a mess. Would I do it again? Oh yeah, in a second. But you're smarter than that I think. Pick your battles where they can, and will matter Babe. I have a pretty strong suspicion that this isn't one of those cases. But, as Mike pointed out, you're smart enough to do the right thing, and stubborn as 12 mules with one carrot, so let us know what you decide... :-) Dwayne

You know what's funny, I've never really thought of medic school as anything other than hell on earth...but until reading doc's post I'd also never considered what it might have been like had I not had other committments. We're a single income family, so I had a minimum of 50hrs/week committment to work on top of all that comes with medic school. At one point doing 50hrs/work, 48hrs/clinicals, 27hrs/class all at the same time per week. Am I glad that I did it? Man, I love the life that, thanks to my friends, that I get to live as a medic. Would I do it again? Not for double the money that I make now. If you don't have a good support system and also still have to shoulder a full schedule of real life, I wouldn't even consider spending your time in this way for the rewards/salary of becoming a medic. If you have a good support system and don't have to shoulder all of those responsibilities...go for it...what could possibly go wrong? :-) Dwayne

So, I got something in my email from..someone, not sure who now, but it was talking about how the 911 calls of celebrities often end up online, or on TV. So why aren't they protected by HIPAA, or other patient privacy acts? Often these calls contain private and priveledged medical information, that is in fact being transfered electronically. Is it because those that create and record the calls aren't billing secondary to the information? Doesn't really matter I guess. It's just one of those things that bugs me. For some reason celebrities aren't protected the same as others. If the punishment should fit the crime, when Hugh Grant gets a blowjob from a hooker in an alley and it makes the news...that should be time served, as that sentence is certainly more harsh than anything that they are going to give me. Or so Kiwi tells me... And their private moments between themselves and 911, when they are in distress, the same as any of the rest of us, should be protected, shouldn't they? Or are they not protected for any of us? Perhaps I'm just not interesting enough to expose? Don't know.... Dwayne