Eydawn

Let me get this straight... this firefighter JUST wants to be a FF, no? And his department is forcing him to become a paramedic, which he seems to be incapable of doing? Sucks to be him... Wonder if the IAFF would help this guy keep his job... since it seems to be discriminating against those who do the hose end of the job well but have neither the inclination nor the stomach (or vasovagal tone) for the medical side... I mean yeah, it is ludicrous that he's suing. But, we know that Fire and EMS are not the optimal combination... perhaps this fellow could be a good example of that! And perhaps he should seek employment at a non-EMS involved agency where you don't *have* to try to be both. Who knows why he passes out when administering IV's? Deep seated phobia? Faker extraordinaire? Makes me wonder. Wendy CO EMT-B

ROFL, Dwayne! Well, if her cath pulls out and she oozes everywhere, that's icky. And it's hard to move with an IV in your arm sometimes! (No personal experience here... not me...) Whether or not this is socially appropriate, she really shouldn't be out walkies when she's supposed to be hanging in the ER. That's what friends are for- to go fetch the Kinderbars or whatever it is she was after. I know to always bring a book whenever I'm going to be anywhere near a hospital (as a patient or a companion) because they operate veeerrrryyy verrrrrrrrrrrrrry sloooooooowwwwwwwwllllly....... if there isn't a lot wrong with you. If there is, then it's hurry, hurry, ok you're not dying NOW, so now you wait. *Shrugs* I think this is kind of a stupid move and indicates the mental functioning of the person out walkies... kind of like going to a job interview in your pajamas- it's going to get you a funny look or two and might get your pic in the paper! Wendy CO EMT-B

Which national park? Sounds like a cluster. You don't need to tweak everyone's protocols, you just need to provide the best care you can to patients who are being transported by your service. That includes being the best medical provider you can be. Are there "turf" issues? People starting interventions that your service can't continue and you having to take on out of service providers to transport patients? What's the real problem here- be specific with why it seems like an issue. Wendy CO EMT-B

I don't think a history of Hep B or C should preclude you as long as you test clear for "non-contagious"... didn't know that was possible, but apparently it is. AIDS/HIV? Nope. Go spend time with your family, volunteer at the library... don't engage in any activity where you have a high likelihood of exposing someone to it. TB? Hells no... until you have a negative 2 step skin test and clear chest X rays.... Wendy CO EMT-B

I think the sticking point for many is the recent "bipolar dx" and that is why many are waving the flag of "get out of EMS! Here's your sign!" regarding this individual. This isn't going to be the only incident. It never is with someone diagnosed with bipolar disorder, or cyclothymia, or any of the related conditions. Even when they are well controlled with medications, there is the potential for building a med tolerance or developing a toxic episode (at the prescribed dose, no less!) both of which lead to altered mental status that is not easily nor quickly resolved and could put patients in danger. Now that this has had a while to percolate through my brain a bit, I'd say it is all dependent on the level of severity. Is this person truly bipolar? Cyclothymic? What's the cycling time between mania and low? Obviously the low was very bad... how bad does the mania get? If this is someone who ends up being on a long cycle and having only brief episodes of either low or mania, perhaps an IFT job with a lower stress threshold could be appropriate while keeping this person in the field. I do agree that 911 response is probably not the place for them to stay... but education (especially education about the effects of psychiatric conditions on EMS providers) might be the ticket, especially if this person likes to teach. I don't think they should be precluded from *any* involvement in the field, and I also question the accuracy of the diagnosis because many people with severe depression get misdiagnosed as bipolar and vice versa... until there's been a window for the meds to be tweaked and more data gathered by the individual's mental health provider, what do we know? Wendy CO EMT-B

Her original post says that the partner gave the pt a spray of nitro and off they went, with no IV access established. I wouldn't give nitro with a BP that low and a patient looking utterly like crap... perhaps I need some more education as to nitro use however. Would you give nitro in an unstable MI with a systolic BP above 100 for pain relief? Or would you give something else, like morphine? Why? Wendy CO EMT-B

Crying is not weakness. Suppressing what you actually feel and denying yourself the chance to process the call at the emotional, cognitive, and personal level *is* weakness. It may be very hard to face how you feel- I know that I pull the "pretend normal" bit very often when I feel exactly the opposite, thinking I'm doing those around me and myself a favor by being "strong." But really, all it does is hinder the process and make things much more difficult to figure out in the end. Go with your gut. But let yourself be human, and allow yourself the time to cry, work through the emotions, and then think about what you experienced emotionally afterwards. This will take time! Something that affects you profoundly takes a good while to integrate and understand. There are still things that I am processing that I have dealt with; they don't incapacitate me on the daily level, but occasionally they crop back up and I have to stop and think through them again. If you want to PM me, feel free... I'm always there to listen, so to speak. Don't let anyone force you to examine anything- take it at your own pace. If you don't want to go to CISD and rehash it, then don't. CISD works for some (who are receptive to a group catharsis) and harms others (who prefer to deal with emotional problems more on their own or in a trusted relationship). If you feel in your gut that it will not help you, don't go. Also, remember... not everything is in your control. There are things beyond human ability to control, including weather, and sometimes, bad trauma. Remember that you did not fail; you did what you could... and tomorrow, you will give what you can to the next patient who needs you. Remember, that we are here to do what we can in someone's darkest hour. Here's my personal philosophy. If someone is meant to pass (as wierd as it may seem in some cases, or as unfair as it may be) then they will despite your best efforts- because it wasn't meant to be. That doesn't mean that you don't do what you can- because you *can* make a difference, and sometimes you're meant to bring someone from the brink back. That's just me... but I know hearing different perspectives sometimes helps. Hang in there! We're here for you. Wendy CO EMT-B

Purr *sev* uh rate. (My translation since I never could read the frickin' dictionary version...) Perseverate. Per Dictionary.Com Wendy CO EMT-B

If we choose not to engage in the important dialogue about our services as EMS here, be it the volunteer vs. paid or medic vs. EMT-B argument, where will we choose to engage? If you can't persevere and explore the nuances that arise with each successive round of the argument, and choose not to participate anymore, you relegate yourself to the water cooler once more, waiting for someone else to come up with the solution for you. Yes, I know it seems redundant to go through it all again, in different manifestations-- but it is vaulable; yes I know some believe it should be a "sticky" so new members can see what's been said... but how is that productive? I know that I, as a newer EMT, would have brushed this site off and decided that it wasn't worth my time if someone had just pointed me towards a locked "sticky" and looked down upon me for bringing up the question. The world itself is divisive. Any question asked begs people to line up on opposite sides of the room, with scatterings in the middle. We might as well stop talking about *anything* at all if this is the route that things are going down. Being diverse, being human-- that is where our strength and intelligence resides. If you decide that you're tired of people disagreeing, and head for the hills... you've just acted to remove yourself from the dialogue, and hence, decrease its diversity. Keep arguing this. The only way to learn is through discussion. As long as it doesn't degrade immediately into "yo momma's UGLY and she's a volley..." it is vaulable, even if it does reach that point eventually in the thread. Wendy CO EMT-B

Having dealt with many bipolar people... Michael nailed it... it is very difficult when one is detached from reality on either a high or a low to be responsible for and compliant with the meds. Often bipolar people need a caring other to help them monitor what they are doing.... not speaking from personal experience with either the detachment or the meds thank goodness, but I have watched it happen so many times. The sad part is that many of these people are brilliant and immensely capable when they are in the middle ground or well controlled by the meds (and a balance can be very hard to strike for some!) I sincerely hope this woman gets help. I would suspend her in-service on a medical leave and then reassess in a few months. This is a medical problem like any other.... --Wendy (keyboard on the fritz!) CO EMT-B

As long as we get new members who haven't been exposed to the EMT-B education discussion then we will continue to have this conversation. Isn't that a *good* thing? I thought we wanted discussion to change things! Any good scientist will tell you that it is always an uphill battle to get a paradigm shift moving. Aren't we still debating evolution? It's an accepted biological theory (akin to a law in physics) yet many still refuse to accept it. Did Galileo give up? How about Newton? Why should we? The more you analyze an issue, the more you have to work to convince others of the merits of your ideas, the better foundation your stance gains. Therefore, I will say again... no likee? NO frickin clickee. No readee!!!!! I think it's important to discuss this as we get new members in. Please tell me I am not the only one. I know it feels like the same argument over and over again... but nonetheless, it is important! Wendy CO EMT-B

Thomas, it isn't that EMT-B's don't know anything, but rather that we don't know enough of the RIGHT things and aren't given time to process what we DO learn. Tell me that you haven't gone through the years and connected the dots... "Oh, so THAT is why that drug does this..." etc. If you think about how long we're given to learn basic medical care, and then add in that many people come into the EMT-B course without prior or outside knowledge (you and I fall into the other category it would seem), do you really think the time we're given to learn in is adequate? Did you think just the EMT-B anatomy and physiology was adequate enough to let you differentiate between just another asthmatic SOB call and something warranting immediate paramedic intervention because your patient is pre-code? I did at first. I've since grown up some, (I took the course when I was 18, for reference) taken more anatomy and physiology at the college level for my biology major, and read and integrated as much medically related knowledge as I have time to peruse. Yes, you can be a very good EMT-basic, but the fact remains that the level itself (not the providers!) is flawed. That is why many here are passionate about discouraging people to remain at the current EMT-B level and encouraging education. I myself do not discount experiential education... but I do know that if you work with chemistry, for exampe, having only had a high school chemistry course, there is only so much that your years of experience can teach you. Yes, you absorb a good deal more information and make more connections... but unless you sit down and study organic chemistry and inorganic chemistry and biochemistry you don't have the same understanding as those who have- which *I* feel is limiting. I agree that anyone practicing prehospital medicine at any of our current levels needs to be a dedicated provider and display competence if not excellence at those levels. If you want to work half-arsed, go join the rest of the slackers and get out of this field. But while dedicating our commitment to excellent medical care, why not attempt to change our system and become better educated providers? Wouldn't that better serve our understanding, and directly influence the depth of our patient care ability? It won't change how you treat someone, or your coworkers-- that always lies within the person. But it will change how you think about what you're seeing in your assessment and increase your toolbox, giving your patient the best odds possible. That make more sense? Wendy CO EMT-B

Some valid points, especially about complacency regardless of education level, have been brought up here. Let's have more discussion on those. I know it's hard to be a great medical provider at the EMT-B level simply because your assessment skills haven't been brought up to snuff through a nice in-depth education, but certainly we can perform what we have been taught to the best of our ability and not be half arsed there, no? Any thoughts on this? Wendy CO EMT-B

Then check out this link... that would actually be my father playing! Wendy CO EMT-B

Portly means rotund, fat, round in shape... it's an older descriptive term. I like that word! Wendy

Don't stop writing! Keep in here. PM me if you want advice with dealing with emotionally difficult patients. Wendy CO EMT-B

So in the trials that they did with fetal rats and cerebellar malformation due to alcohol exposure... I wonder if B vitamins would have changed or fixed anything! Hm... Wendy CO EMT-B

Oh my gosh, it really was what I thought it was... :shock: It's a last resort for people in dire health straits... at least, that's what I've learned about it. But it can be the shock tactic some need to get their lives back in order... Wendy CO EMT-B

For someone only vaguely familiar with the whole weight loss reduction surgery option, could someone please tell me what "dumping" refers to? I'd love to know... because I'm sure what I'm imagining isn't correct. Wendy CO EMT-B

GOOD LUCK ON THE INTERVIEW!!!!! Figured it's good karma for mine (and I hope it goes well for you!) Wendy CO EMT-B

Actually, was just eyeing a Walther 380 just last night. I'm old enough to pack now and I'd certainly like to be able to defend myself should I find myself a home invasion crime victim. But I digress. OK, Dwayne... queue up with the rest for your fruit salad and meds... (no offense meant to anyone) /back on topic Wendy CO EMT-B

The "whold" mercy thing? Someone IS getting "whold" lol.... No mercy, Dwayne... unless you can think of a good reason (other than being "whold!") Wendy CO EMT-B

After all I let slide from you, Dwayne? Alright... revel in it... but no more mercy! Wendy CO EMT-B

:roll: Oh .... my..... gawd.... LAME pun! Wendy CO EMT-B

Man I must've been tired! MNEMONIC, not pneumonic... my apologies... Wendy