Eydawn

GROAN, someone got into the old camp skits again... Wendy CO EMT-B

The hard part is, ERDoc, there are many who would. Not just saying in EMS, just saying in general. Just saying, if spitting was the issue here, and that was the response (as presented theoretically) then it was an overboard response. Yes, use enough force to get yourself out of the situation... but ONLY enough force to do so, and that line is always very fine. Wendy CO EMT-B

Hey, Lisa... if you want to PM me I'll PM you back a scenario- we can do it the slow way if that works better for you. And whatever pneumonic works for you, use it! I'll just have to translate (you might have to put the words, not just the letters, for me) into what I've learned, pneumonics and all. Wendy CO EMT-B

I'm not crucifying the EMT. What I'm discussing is the ethics of punching a patient, restrained or otherwise, and the benefits and risks of restraint tactics. I don't necessarily need to know exactly what happened in this situation; analyzing the idea is good for the moment (since that's all we pretty much ever get to do from news stories anyway). If the patient is threatening your life and immediate safety, and there is *no other* recourse, then by all means whack them hard enough to buy you time to get away. Spitting? Doesn't sound like it's immediately life threatening (especially if you're wearing the gear you should be) and really doesn't sound worthy of a punch. That's my opinion. Wendy CO EMT-B

Yes, we've certainly established that American EMS courses suck. Do you propose someone fail the course as a matter of moral principle, when they've put down several hundred if not thousands of dollars for it because BEFORE THEY GOT THERE they DIDN'T KNOW HOW SCREWED UP WE WERE.... ? You have to jump hoops to pass *any* class, since passing is at the discretion of the instructor. EMS hoops happen to be ridiculous acronyms and the farce that is the NREMT test. Wendy CO EMT-B

Well, at my current job I can't just punch folks when they're difficult to handle, even when they pose a threat to me. Just doesn't work that way! I certainly hope you never transport a client of mine who has cerebral palsy who expresses anger through spitting- since he can't really do anything else to express himself. I'd hate to have him take a punch. When you take on a responsibility as a medical provider, you take on accepting the limited toolbox you get to play with in regards to restraining someone prehospital. Punching someone is not good medical care. I can see a limited set of circumstances in which you would have to deliver a blow to get yourself out of the situation until you had more help to restrain the person. I can't see punching someone in retaliation for being spat upon and pretending that it was all ok and to everyone's benefit. I'm surprised to see you take this line, Dust... really and truly... smacks of ye old put them in the backboard sammich so they can't hurt me mentality for some reason. Isn't this why we have certain policies regarding when and what kind of physical restraints we can use, and why chemical restraints are preferred for people who are difficult to get under physical control? You can justify giving someone a haldol shot in the arse much more readily than you can justify striking them intentionally in the face... no? Wendy CO EMT-B

If you don't know how to restrain someone long enough to get a mask on them (be it a violent head injury or a drugged out motherf**ker) especially with police help present, you shouldn't be transporting them. And if *anyone* should be using direct force, it should be the cop- not you. What happened to the adage "do no harm"? Wendy CO EMT-B

I actually have to question Dust as well. If the guy was just spitting, why couldn't a mask be used? What's with punching the guy in the face? There's certain situations where emphatic self defense is warranted, but if there really was a cop present, why couldn't a different modus operandi have been used regarding restraints? Punching a patient just leads to paperwork and lawsuits, regardless of who's in the right or wrong... Wendy CO EMT-B

Dustdevil delivers his ideas with a minimum of excess. Ergo, he comes across as rude to many a first time reader. Lurk around a bit, read some of his lengthier posts, then see what he's trying to do before you challenge him... it'll make life a lot easier for you if you do decide to take him on! Wendy CO EMT-B

Yay! Fiznat's back! Can I say I've never been completely comfortable as a medical provider, even though I'm just a basic? I think complacency leads to arrogance and mistakes, whereas knowledge of one's shortcomings helps to compensate for them... Wendy CO EMT-B

I wouldn't claim I was special... I work with special people all day long, and let me tell you... it can be very challenging. (THIS IS A JOKE... for any who don't know me, I work with adults with developmental disabilities, and this is not meant to zing them or make fun of them or say that I think any less of them...) Not that it detracts from inherent personal worth or anything... but being special doesn't help you do your job. Being on top of your education and being aware of your limits does. I'm very good at certain physical skills... but let me ask you this... does good physical skill capacity mean you will use them correctly as warranted by a good assessment? What's that? Taking a BP doesn't teach you how to differentiate between CHF and pneumonia? Damn.. Wendy CO EMT-B

If I am on AIM, feel free to IM me. But you're going to have to fill me in on WTF PASTE and TEMPDRS mean. Never heard of them. Patient? Allergies? Signs? Time? Events? Is that what PASTE is? How about we use SAMPLE like most of the country is aware of... Wendy CO EMT-B

At the Scout Ranch, it is much more emotionally draining for me to take care of staff members I know and care about. These guys and gals are my good friends... which makes the stakes different on a personal level- not a professional level. I've done it a few times. I give them the same quality care I would anyone else, and stick it out until I've handed them off or they are out of danger. Then I go up into the hills and cry for a good long while. Then I make sure to connect back with them and tell them exactly how much they mean to me and do good followup care to make sure they don't end back up in the state they were in when they came into my lodge. Wendy CO EMT-B

It is not the literal delicacy that Michael refers to but rather the mental challenges associated with both fields. The firefighting field takes a strong personal resolve, persistance through physical challenge, and some sense of fulfillment in challenging personal danger. That's what I believe, and what I think Michael was trying to illustrate. The medical profession takes subtlety of thought, the ability to be empathetic while still protecting yourself to some degree from your patients' suffering, and a yen to challenge the unseen enemy (metabolic breakdown, pathogens, failing heart tissue) with persistence. EMS combines some elements of the two, but at heart remains more oriented towards the medical aspects and the strengths requisite therein. Yes, we face physical challenges, personal danger, and must react quickly, as many firefighters do. The challenges we face are inherently different, with different risks associated with failure. There will *always* be individuals who fall into both categories. People who thrive on danger and enjoy the mental challenges associated with medicine. People who are empathetic, but find joy in fighting a larger visible "enemy" as well. This is not to say that all people involved in either field have that yen, or that melding of personality traits. There are those who will thrive on working in both environments, because they happen to have the right combination, and there are those who will fail and combust from the inside as they try to fit into a world they don't belong in. In my personal experience, I have met many more firefighters who wanted ONLY to fight fire than I have firefighters who wanted to be medical practitioners. That's me. You might know several who are great medical practitioners... but the system itself is not ideal, because it eliminates several candidates who would be excellent at one profession or the other. And with the shortage of good medical care that seems to be endemic in many places, limiting your medical providers to those who are also good firefighters is counter-intuitive. Wendy CO EMT-B

Michael, very well put. Your writing is always a joy to peruse . Wendy CO EMT-B

With all due respect, Dwayne, I addressed the OP's question briefly and professionally in the 4th or 5th post in the thread. My quip about "impending n00b roastage" was directed at poster #2, who trotted out the faithful quote "EMT's save Paramedics" leading to my laughter and cringing. I also addressed him and advocated that he do some reading or google EMT vs. paramedic to see what could ensue from pursuing that comment further. Don't appreciate being lumped in there with the "go be a paramedic" posse. /end thread participation. Wendy CO EMT-B

Find yourself a nice A and P textbook and start getting friendly with it! Do some preliminary reading about how everything works, so that when you cover it the material will be somewhat familiar to you! As for links... don't have any offhand. I know there's a good anatomy link that someone (AnthonyM83? JPINFV?) has. Wendy CO EMT-B

Oh oh! Impending n00b roastage.. where's Dustdevil when you need him. To address the original poster: your experience counts for a lot, and your years lend credence to your intuition, especially if you've furthered your education and learned a lot about the drugs your partners use. If you think it may be a life/death/serious harm issue, definitely alert your partner! But you shouldn't be "babysitting" anyone. If your medics are incompetent to the level where it is detrimental to your patients, you need to inform your superiors so that remedial education can take place. To address the new fellow who dragged out a nice cliche... you are about to get it. We've been through this discussion many times, in many forms, with many people. Search EMT vs. Paramedic as a thread topic and *please* read some of what is there so we don't have a rehash of Dust Nukes New Guy.... We are responsible to each other and to our patients. We must ensure that we are delivering quality care at all levels, including stopping our partners from making gross mistakes. Leave personal differences in style aside, do what is best for the patient, and take it up the food chain if a problem persists. Wendy CO EMT-B

I'm not comfortable, off line medical direction or no, administering *any* dose of acetaminophen to a pediatric patient in this severe a condition without on-line medical direction. I simply do NOT know enough as a basic to make that decision solo, and refuse to do so. The adults are another story. They can choose to take it if it is available under their own cognizance. Kids are tricky. Now, I'm operating here under *my* camp protocol in my head... since I haven't had a chance to read yours. But I'll give you good odds I still call the doc before giving the kiddo any meds at all. Wendy CO EMT-B

Misread Adult #2's pulse rate. I'd expect his HR, RR and BP to be up from the emotional and physical stress of the incident; but he still is much lower priority than the kid with the potentially compromised airway and large surface area burns. He'd be riding shotgun in the van, unless he wanted to stay with Adult #1. So you have capability to transport long distances? No waiting. Call the doc, ask for tylenol for the kiddo, get going to the ER and if ALS meets us enroute, all the better. Wendy CO EMT-B

These are the couple I used when studying for the NREMT. Given, that was 3 years ago. But here's the links to them on Barnes and Noble. Numba One Numba Two Numba Three! Go to a bookstore, look through a few, and see which one jumps out at you. Won't reccomend these particulars over others, they're just what I used and they worked for me three years ago. Curriculum has changed, and I don't know how they've changed these particular study guide/practice exam books in response. Wendy CO EMT-B

Well damn. If the camp van is equipped to properly hold a supine patient, (aka GOOD restraints) then off we go for intercept. Other than that... pray? Lol... this is a really good example of the joys of camp medicine... Wendy CO EMT-B

Yeah... I had an intensive Human Physiology with Lab at Kalamazoo College... then I transferred to CSU, and I need anatomy, so I figured I'd go for the one with the cadaver lab attached. (Vick's Vaporub and I are about to become friends!) Can't help you on choice of medic book... anyone got ideas? Wendy CO EMT-B

What have I learned on EMTCity? What *haven't* I learned on EMTCity is a better question! I've learned that there is always another side to the story. I've learned to not shoot from the hip- to take time in formulating my responses, and to not take personal offense (even when something *is* directed at my person). I've realized that without my supplemental education as a biology major, I would have fallen into the EMT-B's save Paramedics trap and not even realized what I was doing- because that is what our culture conditions so many young EMT's to do. I've learned to listen to those with experience, and to weigh their opinions, but not to swallow it whole, so to speak. I've learned that my perspective has value, even though I am a young'n, and that even the newest member to the City can offer valuable discourse and help us shake up our perceptions. I've learned that I don't necessarily have to *fight* or counter every point that I disagree with to have a voice... and that choosing not to argue doesn't mean accepting silence. I've learned that gentle prodding and leading by example can quiet even some of the fiercest debates. Which surprised me to no end... never expected to have an unspoken forum rule named after me! I'm not going to go Oscar-esque.. but I am going to mention that I have developed friendships and relationships here that I never imagined, and that some of them have gotten me through some of the roughest times I've had in my life. I won't name you, because you know who you are. I can't thank you enough, and don't have the words to describe how I feel about you guys. I think almost every member here who contributes adds value to our City, and yes, we all look to the elders, and the prolific posters, and the unique posters as having had special influence. This is because they have. But it does not detract from those who post less, nor does it make their contributions less influential. I come here to relax, to learn, and to share what little I might have to offer. Thanks, you guys, and Admin, for giving us this opportunity to connect! Wendy CO EMT-B

Here. This is a class that can be taught in an hour. It's called Readyman, and it's the First Aid we teach to Webelos (older cub scouts, about 11 years old or so). You can "grow it up" for the college guys you're teaching, and leave out terminology like "hurry cases" but it is a great overview of basic, basic first aid. Readyman First Aid You pretty much want steps 2-8, and I would add stroke and anaphylactic reaction to the "hurry case" section. I've taught groups of 200 before in about an hour with this; make sure you have water handy and props! Wendy CO EMT-B