DwayneEMTP

Damn it! I'd hoped that this was going to be a story about a giant doll with awesome boobs that I could drink tequila out of... Agreed with those above. C'mon man...it's breast feeding! I like that one woman says, "Uh uh! No way, way to sexual!" Sexual? As ak says...American is so completely screwed up sexually...I mean, not me...if everyone was like me then we'd be fine..but those other freaks..like you....Just sayin.. What are they afraid of? That baby girls are going to choose to become preggers so that they can breast feed? It's ok to feed with a bottle, but not to choose to emulate making the best possible choice for your future child? Good God... But, then again..... Dwayne

I get where you might feel that way, but I'm curious how you would define negative? And you're screen name...isn't that kind of what you're talking about? And CM is right, it was your post, in which you didn't even take a moment to address the posters question, that threw things off into the ditch. Many, including me would consider that negative. I would truly be interested in discussing this with you, but, as with you, I've noticed a trend. Those that come to complain without also contributing, directed at this thread alone, rarely hang around to continue. They seem to feed their "I'm a better person that all of them!" need in the one or two drive by's and then hit the road. I truly hope that you turn out to be in exception. After all, telling a person that they're hungry isn't a kindness if you can't be bothered to take a moment to teach them to search for food... Dwayne

Right MM! :-) Where I think that too many people go off into the ditch is blaming the job, or the training/education process for these issues. When I was finishing my medic I had a 50/wk minimum commitment to work, 28hr/week class schedule and 48hrs/wk of clinicals...and my wife didn't leave me, or hate me, or complain at me. She understood that it was the price I had to pay to help insure that I would never again have to beg for a $10/hr job. And I've never had too either. Now, I am away from home at least two weeks/month sometimes more, and she doesn't really love it, but she understands that I'm more happy, and manly, and macho when I get to go and play my medic games..and she likes me like that, so she wins as do I..so again, we do what we need to do, what is good for us. I also think that I am better for me, and for my family when I get to go off and get paid to go to interesting places and do interesting things, so it all works out in the end. Besides, the weeks home is like a really long, horny, happy honeymoon...and that forgives a lot. If I was home and working the streets again, we would adjust for that and again be ridiculously happy. If I was unemployed (knock on wood) we would adjust...etc, etc, etc. Or we could choose to be selfish and bullheaded, be unhappy and allow those life situations to be blamed for our unhappiness instead of our attitudes and choices. K, that guy doesn't have an issue with your independence because he's a man, but because he's a coward and an asshole. You two have an amazing opportunity to live really cool, though often separate, lives, but he's not mature enough to do that. If you want to date mental/emotional midgets then you have to accept that you'll never get to ride the really cool, sexy, toe curling roller coasters..it's just a fact of life. Word of advice to all in EMS. If you believe that your relationship is being ruined by EMS you're simply kidding yourself. I don't care how many hours you work, how bloody you get, what your spouse does for a living...etc, etc. Every single gloriously happy couple I've ever met has worked, gone to school, had responsibilities....and not any of them that I am aware of earned their living sitting home together reading self help books. EMS has a really, really nasty habit of wanting itself to be 'special' and 'harder' than all of the other professions...it's not for the vast majority of providers. Some relationships are just not meant to be. But for some reason people seem to believe that even if your life sucks, you're supposed to suck it up and go on 'loving' whoever you're stuck with. I'm going to blame religion for much of that and simple insecurity for the rest. If you're spending more time working on your relationship than you're spending getting laid then you need to get help, or get out, as something is broken. Sorry all. I'm really not trying to sound really arrogant. But EMS truly, no matter how hard we try and make it a hero sport, isn't. It's a hobby for some, a job for others, and a career for many of us, but we're never going to shoot Osama. We're never going to be better or stronger or more stressed than other professions unless we choose so. Why? Because the dynamics really aren't that different. K, the little bit of time we've spent getting to know each other tells me that you are a little worn out, have a lot on your plate right now, with a long way to go...and perhaps it's helping you to be a little less secure than you would normally be and causing you to hang onto this douche longer than you should. I have nothing but respect for you...but it sounds as if that is not the case for the man/boy that you describe. Chicks like to say that all of the good men are taken...I just refuse to believe that that is true, as men say the same about women, and yet every day I meet strong, beautiful, sexy, confident women...perhaps they're just not man enough for them? MM, you are a peach. You're posts are intelligent, funny, often sexy. I love everything about them..if we ever find ourselves in the same neighborhood I'd consider it a favor if you'd let me buy you a cup of coffee. Keep your chin up K...You're having a few bad weeks...but compared to what you've come through in life, they're not going to even remain a blip on the radar for long...and not to worry...I'll start looking for you a decent boyfriend...you can count on me! Dwayne Fixed that for you And no need to apologize for coming back to this thread. You came back, and I'm grateful for that...you belong here. You wait and see if I'm not right... Dwayne

Simply the possibility of this being a cardiac event. This doesn't appear to be a significant trauma at this point but but we won't really know for sure until we have serial assessment values. The ASA can help, and i"m not convinced based on the pts presentation at this point that it will be a significant detriment, though, of course I could get caught with my pants down here. In this context I believe that you use sequelae incorrectly, I think that you're looking for 'adverse effect', as well 'adverse sequelae' is redundant. Not busting your balls here brother, I just know that you would not be happy with that going uncorrected. And yeah, I am, though 324 of ASA shouldn't be disastrous if I've given it needlessly, but may give him a decrease in morbidity if I haven't. I can't recommend this course of treatment. Though it is what I believe I would do, it may be difficult to defend should you find the need to do so later. If your boss wants to kick your ass and call this a straight trauma then you are defenseless when this treatment is compared to your trauma protocol. Here, though Nitro may be the correct treatment, I'm not a good enough provider to be able to reliably assess around it. Know what I mean? Though I'm relatively confident that I'm not going to find any traumatic boogie men hiding in this patient I don't want to create any significant hemodynamic changes until I have a chance to track his vitals for a bit. If I give the nitro and his pressure drops by 20 points, his heart rate increases, and he complains of blurred vision and a headache in the next 3-5 mins is that the nitro or is he compensating for something that I haven't yet discovered? 80% says it's all a Nitro effect, but the 20% is going to kick his, and my, ass. Great scenario brother. Dwayne

I'm with Mike.. Other than a generalized 'feeling' when comparing the legs/ankles to the other extremities and even distal to proximal, pitting is the most important finding for me...not in the assessment, but in the finite edema/non edema context. Dwayne

Thanks!

Of course. So can we continue to discuss the creation of other shirts in this thread then? Dwayne

Oh, I guess I do remember them.... But we need some new ones...just sayin'... :-) Dwayne

Haha...That's awesome! Dwayne

Hey, let's see it! Can you post a picture? Do you do computer graphical art? And we try and plan get togethers on a pretty regular basis.... A lot of really, really good things happened to me because I went to visit some EMS folks in Florida.. Me, akflightmedic, Dustdevil, Matty...hell, can't remember his screen name now..... Mateo? You and I and a whole bunch of EMTCity folks aren't that far apart...maybe it's time to work on a get together again? Anyone up for trying another get together? (I'm already raising Ruffsters hand for him) Hey, I just Google mapped Beloit. It looks beautiful but a word of advice..if you want to run EMS, by definition, there have to be some people where you work!! 4,000 people? Really? You need to apply someplace bigger. What is the nearest real town near you that actually has electricity? Say, within 2hrs? 2c4, what does the EMTCity Tshirt look like? Can you post a picture? Dwayne Edited to correct some silly shit I never should have missed in the first place. No significant changes made.

Oh my God...that's funny as hell right there! That's what I get for trying to multitask... Dwayne

Hmmmm....not sure. But like our too uncommon get togethers I'd really like to come up with something from the spirit of the City, from those of us that post regularly and seem to share a common energy..Know what I mean? Holy shit..how gay does that sound... Dwaynee

Hey all! We've started a small business with Dylan, www.dylans-way.com in order to give him a way to make some money, now that he's a teen, give him some job and life skills, and create a way to provide donations to people/institutions that are doing good things for him and his autistic brothers and sisters. Our Fav at the moment is Autism Speaks. I was hoping, if this doesn't get killed as spam, to create a tshirt for EMTCity with the donation proceeds going to the City instead of an autism cause as a way to raise money for the site. We donate $5/shirt to autism causes now, but could just as easily donate it to the City for allowing us all to do this here. (For the record, I've sent several emails to Admin for advertising rates and/or permission to put this up without a response. I'm confident that s/he is really busy.) So if we do an EMT City thsirt, what would it be? Babs and I have been arguing about this, good naturedly, for a few days now..as I like whimsical, while she likes more straight forward. I'm thinking, as I saw something like it before, "Paramedic (Of course can say firman, EMT, etc) "Please buckle up, or I may get to see you naked!" WWW.EMTCity.com Hell...have to run for a bit..Any have any interest/ideas? Dwayne

Holy shit...what made you think that this would be too simple for many?? I couldn't find one single worthwhile thing to add to this thread, but much less find this call simple! Thanks for sharing man..great scenario..we've had some good ones lately! I miss them! Dwayne

Did you remove the KED to do your assessment? Or was it left in place? Was it placed by career hosemonkeys or 5 calls/month vollies? -1 if you chose to assess around it without a significant reason for leaving it in place (flail chest segment, etc) as it's simply not possible to do even a EMT-basic assessment with it on. Also, if you DID leave it on then you were dishonest in many of your reported values above as it's also not possible to get good palp findings/lung sounds/abd assessment with it in place. (Heh...I get that this is a scenario my friend, having a little fun with you, but if it's more than a made up scenario....well, just sayin...) Where exactly is the pain in his chest? What is his personal cardiac/medical history. What kind of things is he saying? What kinds of questions is he asking? What was his reaction when you stuck him with the IV? Does it appear that the accident was his fault? You might try 'unremarkable' for your 'non diagnostic' ECGs. It seems to be less confusing, plus, to me, non diagnostic implies (Haven't looked it up) that it played no part in the diagnosis, and in this case I'm guessing that it gave you at least a heart rate, rhythm, and SPO2, right? For me, this patient is cardiac for now for a couple of reasons. First, his age, next, the location of the pain and that it is not effected by resps/palp, and third, it's not uncommon, or so I've heard in JEMS or something, that single passenger, single vehicle accidents that cross a line of traffic have a wickedly high incidence of cardiac involvement. If I can't fine a contraindication, and I'm 30mins out from the hospital (boarding, transport time) then I'm going to give him some ASA. For now I will hold off on the Nitro, but the ASA can possibly make a significant difference in this patients outcome. Excellent scenario. We've not had many good ones in a really long time...since chbare got too busy to do them... Just sayin'...not to anyone in particular mind you...just sayin' in a general, non finger pointing way... Dwayne Edited to change Ked to KED, no other changes.

Awesome insight from a parent. Thanks for doing that! Any experience with EMS in regards to your girls? Anything that you can share concerning attitudes, treatments, care of the CF patient that maybe we wouldn't normally think about but might allow us to provide better care for these patients? Dwayne Edited to correct some grammar..nothing substantial.

Outstanding!! But you didn't leave the next question before you left!

Personal history, family history, Meds? Dwayne

So it's been a while since we've done an education Round Robbin, so I thought I'd take my turn at starting one, with a little bit of a twist. Each person answers the questions of the person before and then adds a new focus for the next question. The question will always be, more or less, "Define (X) and the anatomical/physiologic role that it plays, may play in EMS care." I would like the answers in two parts. The first part being everything that you can pull out of your head. (Part A) And secondly what you can find to supplement that through research, but only a few minutes..you are going to be really pissed if you spend two hours researching something something only to find that you come back and the game has moved on by three questions. Also, because I hate it when that happens, and most often I'm passed by by some shithead that gave a flippant answer just so he could ask his "no one will ever get THIS questions" we're going to try using place markers. If you read a question, and would like to answer it, Post, "I've got this one!" and then please answer within the next 30 mins or so...not sure how that will work, but lets try, ok? And often these threads are dominated by those that are sitting at home doing nothing so that they can answer so quickly that no one else can participate. Please, participation is vital for people to learn...if you see your name more than twice or three times on a page, try and give someone else a chance to answer unless you see a lull in the thread. Major points... This is for learning. We should try to give topics that will help people be better practitioners, not to try and prove that we're smart enough to Google something that no one can answer, and worse, that no one cares about. Please cit your sources! What got me thinking about this today is that I was mentally reviewing body system in my head and found that I maybe couldn't give a decent talk on ANY of them without some research. Though I have always been amazed by the information that comes to me when I need it in the ambulance. There is no shame in not knowing every body system down to the cellular level off the top of your head. The only shame is in forgetting that you should have that as a goal..And even more so claiming someone else's work as your own. Give your BEST answer in A. It will allow people to say, "Ah, I see where you thought that, but maybe it will help if you think of it like this...." then show your research as well as anything you may have learned from it if you like. Please stay in the spirit of the game. These are almost always ruined by someone that has to try and prove that they know the exact definition of Gynocockusrot, it's physiological paths, proper treatments, etc, "right off the top of their head" and it's just a coincidence that their answers match the first one Googled when you check. Ok, so, your best answer, then your quickly researched answer, cited, then the topic for the next person that is likely at least partial knowable to them but also applicable to being in an ambulance. And if a question is obviously meant for our BLS brothers and sisters, please don't jump all over it with your medic degree without giving them a chance to answer. And please remember that your answer is meant to teach those that read it...so speaking above everyone's head fails...Thanks for playing all! Dwayne Edited to add txt in bold. First Topic.... As it's Cystic Fibrosis awareness month, lets start with that. Please be specific! Define Cystic Fibrosis and the anatomical/physiologic role that it plays, may play in EMS care.

Holy shit..it's not just the Huffington Post. Obama truly does believe that he killed Bin Laden all by himself ..Friggin' asswipe. I'll bet my left nut...my favorite one for some reason, that this is what happened. For generations friggin' Pakistan supports the Taliban causes, causing the death of thousands of the worlds young men...they get a big flood, come to the US, as well as others of course..the US says, "You know, we've known for a long time that you have shithead in Pakistan, you tell us where, and allow us to come and get him and you'll not only get your money, but we'll claim that it was partially your idea and the world will forget that you're evil pricks! Pakistan said, "Well...alright then!!" I'll bet you that Obama knew nothing of the particulars until after it was over, yet he's happy to take all of the credit. I hate that. Babies train their guts out, risk their lives, and old men that have never dropped a bead of military sweat take the credit. Liars, and cheaters and bullshit artists all taking the credit for what was almost certainly accomplished by a bunch of children fighting the wars of their fathers... Thanks for the American respect Squint, though I'll tell you what... I was shocked by the number of Canadian Fallen Comrade ceremonies I went to when in Afghanistan..AK was always there too, going to many, many more before and after me....Who knew the 'Welcome to my nayboo' ood!" Canadians were also friggin' bad ass warriors?? I had no idea there were even Canadian soldiers IN Afghanistan, much less the crucial role that they play. Love to our Armed Forces no matter where in the world..and especially today to the Special Forces. It's a crazy world... Dwayne

Welcome! What knowledge of EMS practice? Jump in my friend...You still have much to learn..as you always will, as it should always be... Dwayne

just playing with you Ugly... It's nearly impossible for me to imagine someone in even poor condition injuring themselves doing proper compressions, back straight/arms locked, but of course it's always possible to injur/reinjur a weak area from before... Only your Doc knows for sure.. Dwayne