DwayneEMTP

Hell..I might actually be home on those dates..I'll have to check..I'd love to go! Dwayne

You did fine. This is in no way an indication of your suitability, or not, for this profession. Your' "break ribs and get bloody" buddy? He's a douche and needs to go back to flipping burgers. I find scenes to be strangely relaxing most times. I get really calm and focused. The world gets really clear...But it's not always been that way. I've had trouble starting an IV because the nervous sweat was running into my eyes and my hands were shaking...but that's experience. Experience teaches some that they do their best work ramped up and driving hard, it's taught me to slow down. And it will teach you what you need to know too. You are good at NOTHING significant without experience. To expect yourself to be prepared for something that you've never had the opportunity to prepare for is just being to hard on yourself. You showed up, I'm willing to bet you would have participated if necessary, good on you. Dwayne

HLPP can you truly not see past your ems manager/obesity advocate point of view to see that once again you are ignoring the reality of risk/benefit? I know that you are smart enough to grasp the concept...what is going on? Also, out of the last 5 years I've spent all except about 14 months doing remote medicine. That means, in most cases, treatment to resolution or until transfer to a higher level of care can be arranged. I often fight this battle from folks that freak out and want to endanger relatively stable patients in a relatively unsafe manner. I'm often unpopular because I believe that they can wait for a more appropriate, and often more expensive means of transport. Please, please, please Google risk/benefit-cost/benefit. Understanding it will not only help you make sounder decisions, but unfortunately you will find it painful too, as you see you're black and white world turn to gray..... Dwayne

Welcome Blake, good to have you man... The good new is that the NZ standards for medics rock! The bad news, I've never met a single NZ medic that's mentally sound. So you'll want to start counseling immediately upon entering the medic program as those programs seem likely to warp you in some really strange ways.... Been warned... Dwayne

What's up HLPPs? You had such a strong, maybe even arrogant opinion...Did it somehow just evaporate at the first sign of significant debate? Dwayne

Hey man, Welcome back! We can always use another opinion... Dwayne

I'll be treating Chinese and Mongolians and will be the only non Chinese/Mongolian on site I'm told. I'm pretty excited about it to tell the truth. Working with Chinese doctors and nurses on a satellite project about 35 miles from the main mine. The mine, copper and gold, is responsible for 30% of the entire countries GNP. 11,000 people total at the main site. 1,100 people at my site I'm told, building a road through Mongolia to China, so I'm thinking, and hoping, that there should be decent medicine to do and new things to learn. Thanks for the well wishes all. I'll post pics when I can...I wish you all were coming too! Hey! Think of the stories to tell if we had the First Annual EMTCity Mongolian Get Together! Dwayne I'm not sure what you mean here? You've certainly always appeared professional to me... Dwayne

Hey all, Just a quick note to say that I'm off to Oyu Tolgoi, Mongolia. Though I'm never happy to leave home, I'm truly excited to see what this new country holds in store. I'll be working a 4wk on/4 wk off rotation with 28hrs of flights each way...Not terribly excited about the travel, but little that's interesting seems to come without some sacrifice. Being a remote medic has truly changed everything about my life. It's given me the confidence to do my very best medicine, experiences that have shaped me in amazing ways, and most important to me, given me perspective....it's shown me what is truly important if not in 'life' in general, at least in my life. I mention this only to make the point this point....If you believe that the City is somewhere that you come only to become stronger as a provider, only to become more intelligent, only to stay current in EMS, then you've missed one of the major opportunities available here. Networking and making true friends. If not for the advice of Asysin2leads I believe I would have quit medic school, and I'd likely have never chosen an AAS in Paramedic Medicine if for not having my intellectual balls busted by him, Dust, ak, and many others here. Akflightmedic got me into Afghanistan when I was worth even less than I am now as a medic. He said, "You've got the education, you seem to have the balls for it, I think you'd be a good fit." This happened at a get together that involved the now departed Dust Devil, who seconded those thoughts. Up to that point they'd had nothing to judge me on other than my opinions here and viewing how those opinions had changed over time. Ak also helped me get my gig on the BP oil spill, that led to the offshore oil fields, and friends of mine spoke for me again and now I'm off to Mongolia. Just the other night Mobey hit me over the head with a brick to make the point, "Why are you traveling so far from home when there are the same, or better opportunities available in Canada?" Excellent question, also posed to me by Annie. So the spare time during my year contract in Mongolia will be spent trying to make myself hire-able in Canada. Maybe none of these things sounds good, or sexy, or exciting to you, and if not, I get that, as it's not for everyone. But just as many people have been helped by their friends here to succeed in main stream EMS. What I'm trying to say, in my silly, long winded way, is that I cherish my EMS career. Not only because it's been enriched by being a member here, but because it would almost certainly have never been possible had I not been a member here. Don't waste your time here guys and gals. Don't fool yourself into thinking that 'this is just anonymous words on an internet forum." Because though it is certainly possible that that is all that you may take from it, it is absolutely not all that is available. Lets all look out for each other. Lets all keep helping each other to succeed. And maybe most of all...lets not forget that we're friends...with all that that entails. Dwayne Edit. Ok, so it's not such a short note after all...sue me. :-)

I leave for Mongolia on the 12th. Working a 4wk on/4wk off schedule. I've been blessed that Babs is willing to carry the lion's share of our lives so that I have the freedom to go, but I hate to leave at the same time. 2 years and I'm done hopefully. I have no idea what 'done' is going to look like, but I don't want to leave home for so long any more, and I'm unwilling to go back to the streets in a normal sense and be constantly recovering from, or preparing for another shift. I guess I'd better get my shit together. Should your situation ever change and you decide you want to try remote medicine, let me know. I would speak up for you in a second, and I know others here would as well. Being a remote paramedic has truly changed my life, and I don't use that as simply a figure of speech. Thanks for reading my post. As always with your posts here, I look forward to your thoughts. Dwayne

Ditto with Babs, no antidepressants. Hey, what do you know about hyperbaric O2 therapy for autistics? I'm going to trial with Dylan I think...the majority of the abstracts for the studies I've seen (Sounds very scholarly, right? I read lots of abstracts...) seem really positive..but I'm not sure... This is what happened. We took Dylan to the dentist for the first time when he wouldn't be put under general anesthesia. He was given Nitrous instead, plus O2 of course. The afternoon after the visit he was really happy and animated. At first we thought that maybe it was because he done something that not only normally people do, but something that brave grown ups do. Know what I mean? But he seemed to be speaking in more complex sentences, asking more complex question, laughing more and much more clingy. So that got me to searching for possible side effects of the Nitrous and the O2. Nothing on the gas, but TONS on the anti inflamatory properties of O2, and the possibility of autism, in gross terms, being inflamation of certain parts of the brain. Of course this entire post comes with the * of parents monitoring their own children during a one time episode. You get that complete lack of value that has I'm sure.. Anyway, I'm going to try it I think, even too this new job in Mongolia so that hopefully I can afford it, and wondered if you'd heard anything about it? I look forward to your thoughts...Kisses to that boy of yours.. Dwayne

Ok...abridged answer. Of course decisions should be critically evaluated. But that's not what HLPPs was doing. She was stating that she should be fired based on this call. It sounds like she saw it as straight forward. Risk/benefit. Google it. Man, do whatever is necessary. But please don't make any more critical decisions until it's well understood. There are a million ways that this call could have been, but what we have available to discuss is the scenario presented here. I once was reprimanded because the local hospital was trying to empty out because of an upcoming blizzard. They wanted me to take a 80+ year old active MI on a 90 minute transport to a cath lab along with a 280lb prisoner from the local nursing home, who was under police supervision, to the same city, to be transferred to a physch hospital. Their argument was that he was well medicated and hadn't been an 'issue' in several days and was considered 'low risk for violence.' I met him, he seemed sweet as pie, and I refused him. I was not going to be distracted by a second patient while trying to care for a patient that was likely going to die before the end of the transfer anyway. If he was good, it was a bad situation, if he was bad it was a catastrophic situation. See, being a paramedic and all, I believe that I am morally and ethically obligated to make such decisions. I transferred my elderly patient on the 4 hr turn around, then came back, loaded him up and did the same thing again. It made for a long night in snowy conditions, but it was the responsible thing to do. My bosses were pissed because it "would probably have been fine. We've done it many times before." But they weren't responsible for my patients well being, I was. Fuck the legal ramifications if you want, and the argument remains the same. And I can't claim to have not hauled children on their mother's laps. There have been times when I had relatively hypoxic children that I couldn't keep a mask on and would fight me when I attempted blowby that I felt needed other care that I couldn't provide if they were strapped into our inflatable seat. So I had the mother hold them, provide the O2, and I did my work. I felt that the benefits outweighed the risks... See...there's that pesky phrase again... Dwayne

What an excellent, intelligent second post. Good on you brother. As Nypaemet39 said, there are a million ways to go. But you should not even consider a program that doesn't demand college level A&P at least. You can certainly become a medic without it, but in no time you will know that you have placed yourself at the bottom of the pack. You don't strike me as a follower. If you want to do real paramedic medicine in the more respected, progressive services, you will need a top notch education. Yeah, that sounds about right. I went back to school at 40 with no previous college level education. It took me about 3 yrs to get my AAS in Paramedic Medicine. Maybe a little bit more. None of the better schools that I'm aware of insist on that. For some reason, unlike all of the other medical professions, it's considered 'normal' to have experience before education. Many of us here disagree that experience first is better. I had no time in EMS before becoming a medic. Not by choice, but as you mention, Basic jobs are hard to come by. Don't waste that time. If you want to be a medic spend your time becoming educated. The rest will work itself out during clinicals if you bring mature life experience to the table. I love my job but have been a remote duty medic for several years now. But, as you can see in another thread ongoing here, many services have no interest in helping people, only moving them. On the one hand about half of the medics I know love their jobs. On the other, I don't believe that I know a single dagree'd medic that doesn't wish that they had spent their educational time preparing for a field that pays better and has more diversity. Walk into any EMS room and say, "I'm thinking of becoming a medic, what do you think?" And you'll receive a resounding, unified, "Become a nurse!" Same amount of time invested in education, better money, massive diversity in career paths. I've limited experience with many 911 companies, but if the tattoos are not what would be considered by most to be offensive, and if the provider they are attached to is clean and professional, I would expect them most often to be a non issue. I can't think of any medics that want a job that don't have one. Unfortunately because of the need for medics, many that I know should never be employable, but they are. You will have a ton of options for employment as a medic. Though keep in mind that I've recently worked with medics from all over the country on the BP oil spill and met medics with several years experience making $9/hr at home. Though I lived in Mora MN for about 7 years, it's been long ago and I have no good information on either the Medic economy there or what your age may mean to them. Good to have you here Brother. Great questions. Dwayne Edited to adjust formatting only.

Hey man, welcome to the City. Are you medical in the Navy, or is EMS a separate interest for you? Good on you for beginning to post right away. There is little value here for the passive. Good to have you...I look forward to your thoughts... Dwayne

Easily gets my vote for the most idiotic thing said on the City so far this month. Fyre, she's not going to be able to understand the whole concept of cost/benefit. She's made that clear I think. Which leads me to believe, and I'm truly not meaning this as an insult, that the 'manager' in her description is for a paid per call volly service. Girl, the fact that you're unable to grasp the fact that a paramedic is responsible for all who enter their care, and all of the results of anything that follows makes me wonder what, exactly, you really do for a living. I'm smelling bullshit here, I'm just not sure exactly what flavor it might be. If this is an emergent patient, then you operate on one set of priorities, non emergent, another. Anyone in this field should know that. And to imply that this decision is being made based on discrimination against fat people certainly speaks more to your mentality than it does to the scenario presented. And to suggest that loading her onto the floor of an ambulance in an unsafe manner like a wounded cow instead of insisting that she, like non bariatric patients, is provided a safe means of transfer is just transparent hypocrisy. If all goes well, as it seems that it has in the past, then there are no issues other than your inability to make sound, patient focused decisions. If it doesn't go well, say, with even a minor fender bender, then every ailment real or imagined just became the responsibility of the medic that accepted this patient and chose to transport in an unsafe manner. And if it is more than a fender bender and there are real patient deficits due to the medics decision to transport in this fashion then it is well past time that you stop considering yourself a true patient focused provider and simply admit to be the whacker that you've proved to be. It may be time for you to get out of the office for a while and back on the street where real world, difficult decisions have to be made. And JP, to suggest that this patient should be transported despite a providers misgivings simply because some other asshole is willing to do it is the very weakest and impotent possible logic for a prehospital provider. I'm not assigning those labels to you, as I know differently from your previous post, but to this line of logic only. MG, if you had been dismissed over this incident you should have used that as a sign that it's past time to move on to a more professional service. A hardcore medic friend of mine once said, after I'd been fired from a service for what I considered to be aggressive, but strong medicine, that he'd never met a good medic that hadn't been fired. Though I've not found this to be the end all barometer for medical providers I've certainly seen the truth in it over the years. There is no question whether or not a bariatric rig could have been provided for this lady. I've worked some really remote places and it's always an option, though it means giving the transport to another, non local company. The fact that these services were willing to risk harming her instead of bringing it in shows that they are more concerned with snatching calls than customer care. I think that you did good MG...And for what it's worth, I'd be your partner any time. Dwayne

Man...As zmedic said... I can only add that nerves are what will kill you in this process. Try and relax. A lot of missed and/or fumbled answers really aren't repaired by someone saying, "Gosh, I'm sorry, I'm just really nervous." Everyone will be nervous, but some will handle it better than others. Often those folks will go to the front of the line. Good luck.. Dwayne

Say, does all of this talk of regret and missed opportunities make anyone else think that another City get together might be in order? It certainly does for me... Dwayne

I don't think that there is any doubt that being fat is a bad thing, and that creating a lot more skinny, healthy people would be good in every way, including lowering the burden on healthcare, but attacking fat kids just doesn't seem like an even halfway sane way of going about it...

I'm 48, but am often confused for a teenager, so I'm not sure if I count or not.... Went back for my medic when I was 40. I wouldn't trade entering the field with significant life experience for anything...Of course I have nothing to compare it to. Dwayne

FE2, how did you come to the conclusion that this is not a pseudoseizure? Dwayne

Yeah, man, tape is the bomb. I carried a couple of rolls on my and asked my partner to keep it with him. It seems that you're buried in rolls of tape, until you need it, and then suddenly it's transported to another dimension or something...

Not different at all. I think you misunderstood the sentence that you quoted. It doesn't say that good sex makes a good relationship, but that good sex is an excellent barometer for the relationship as a whole. Sex is open, and honest, with no place to hide. A good sex life demands respect and excellent communication. It's as emotionally exposed as we can ever get. If the sex is good then it's a really safe bet that the rest of the relationship is healthy as well. If it's not good, or not often, then it's time to sit down for a long heart to heart to figure out what's broken. CM, still operating from the stereotype of men that says that if they've got a warm place to get off that all is well with the world...We're not all like that... Dwayne

This is idiotic. It's the same shit that doesn't work. It's like criticizing kids for being dumb after they graduate from high school. When did they get put in charge of their education? What life skills are they supposed to use to manage those things that need to be managed in order to succeed? This campaign is going to make targets of fat kids. They are going to become victims for something that they have not lived long enough to know how to control. Educating the parents of fat kids while providing medical care is different. You are accessing the source then. It won't do much good, but at least you're playing in the right ball field. I would love to see this tracked, though I can't imagine that there is a way to do so. So much eating is done because we confuse emotional needs with physical ones. Screw with these kids emotions, as this campaign will, and then see how fat they get. In fact I'm willing to bet that there will more than a few of them that get dead as well. Good God...publicly attacking children. Every time I come to believe that there are some levels that we just won't stoop to I'm proved wrong. I hate everything about this. It's ignorant, and harmful, and just plain mean spirited. Dwayne

Yeah, man. When I came here is was to get advice because I was enrolled in AMRs 7 month medic program. No A&P, no sciences and/or biology of any kind. I would have hated so much to be that provider. I think I wanted to know what kind of pants to buy or something...grin...I can't remember now. I too talked to Rob about three weeks ago, maybe more, I lose track of the time on this schedule. It was terrible. He was exhausted and angry, and just so completely ready for this battle to be over. I'm grateful that it is. He is a big part of the reason that I stay at the City when things get shitty. He, as well as many others have given so much to me, changed the path of my career, and as with akflightmedic, the path of my life, to such a degree that I just can't walk away without trying to give at least a little bit of that back. I hope that all here will remember those things, and feel the same obligation. If you do, the City could go back to being the resource it once was when everyone's balls shriveled just a bit when it came time to go head to head with Dusty. But the feeling of knowledge, and power, and understanding that came from coming out the other side made every goose bump worth it. I loved him as my friend, as I've come to love many of you here. In different times, lets remember that this isn't just words on a forum...Let's let him remind us of at least that. Have a great day all. Tip one back for the Dust Devil. Dwayne

Brother, let me break this down for you, and I'm not being shitty, as it can be hard to understand where people are coming from if you don't live/work in this field. You believe that you helped, that you showed that you care by leaving your home and showing up. Many others do the same, and like you, most often they harm people with their ignorance. Now, don't confuse the words ignorant and stupid. You can fix ignorance... The bent steering wheel is a huge deal to most of us here as it tells us that the pt, in one way or another, transferred a ton of energy from his body to the stearing wheel, and that almost never comes without significant injury. Almost every injury that can happen from that mechanism is going to be life threatening, and most of them will cause the medics to have a battle to control and maintain the patients perfusion. (blood pressure) Now the body will fight to keep that blood pressure up, to keep the organs fed. But by giving him the Nitro you gave him a medicine chemically designed to fight against the body's efforts to save itself. You claimed that his 'vitals were fine' but not a single paramedic in this conversation, no matter how many years they've been practicing would make that statement on this patient without taking them again and again over a period of time. If this patient had any of the injuries common with this type of accident there is a very good chance that you killed him with your treatment. It is likely a good thing that you ran away, as there is also a good chance that you would be in jail now if you hadn't. It looks, from the outside looking in, like people are doing a bunch of mindless bullshit when you watch them on scene. But most of the important stuff is happening in their heads, not in their hands. You hurt a man. You claim you wanted to help, but all here are telling you that you almost certainly harmed him instead, yet your response remains, "Well at least I did something!" This is a professional forum full of people that have payed their dues for the right to go behind the yellow tape. Most have payed with years of their lives. They are intelligent, and have the ability to help people. You should really, really not kid yourself into believing that just by running to an accident and being willing to get bloody makes you a good guy. As in this case, it doesn't. Stop pretending that you want to help by buying bandages and hanging out with the local volly squad and actually get committed to doing some good and get the education necessary to do so. In this case, this man would have been better off if you had never shown up. He would have been healthier and safer if he has sat there alone until professional responders showed up. That's not your fault, because you didn't know better. But now you do. So what are you going to do? Continue to cry about it, or get the education to Do good, instead of Pretending to do good? Not running away, and continuing to participate in the forums is a good start. If you have the balls for it. Dwayne

Fair enough. Could you do us all the favor of quoting the part(s) of his statement(s) where you feel you were chastised? I see him asking you to comment on what he considers to be an irony, yet you replied with a tantrum. You again claim that he is trying to bracket you, or censure you because of your opinions and/or proclaimed sexual orientation instead of the lack of content in the arguments you make and the way you choose to present yourself. You claim to be enraged and confused by the ignorant, intolerant view that you believe non gay people have of the gay community? Bullshit. You're to smart for that. When you act like an ignorant child it is ridiculous to expect people to treat you otherwise. No matter how many laws you attempt to pass, or how often you cry, particularly here, no one will be fooled or bullied into calling an apple and orange. Behave in the way that you would like to be treated and perceived. Your cry of "I'm gay so I should be able to do and say anything and I should still be loved and accepted!" seems to play well on Oprah, but not so much in the real world. Does that suck? No man...It's the way it should be. Please see my more compete thoughts in the posts above. Dwayne