Eydawn

I think the issue at hand here is not that gun control needs to be increased, nor that gun manufacture and sale needs to be decreased. The plain fact of the matter in *this* particular situation is that a mentally deranged psychopath acquired firearms despite all of the legislation that's been enacted, and utilized them to take the lives of 32 innocent people and injure several more. He also caused a giant national problem that is hurting *many* innocent people at this very moment. Grief, paranoia, and overreactive school districts, to name part of that problem. The gun sale checks failed. The system is not at fault; the application of it is where we have seen the failure. He also managed to fly under the radar of mental health professionals because (IN MY OPINION WITH LIMITED EXPERIENCE) it is a very fine line to walk in this nation regarding where you make the judgement call to completely restrict someone, and when you wait to see if the individual in question gets better or worse per whatever treatment course (or lack thereof) that is being undertaken. Obviously that judgement call was grossly in error, and any professional in the realm of psychiatry/psychology that has ever had an encounter with this individual is probably undergoing a crisis regarding their competence and culpability. And people *miss* stuff. I know individuals who have given off blatant warning signs of mental illness or instability who have completely escaped the notice of teachers and (on the college level) residential coordinators until a crisis point was reached. I'm talking *glaring* red flags, perhaps not to the level of seriousness exhibited by the VA nut, but flags that should have been intercepted and dealt with much sooner than they were. People need to be aware of this stuff. You can't afford to not care on some level about the person next to you. Take an interest in them. Figure out what's going on and for the love of Mike, if you see something that strikes you as frightening, if context is reasonable, then contact whatever authority is most appropriate for where you are. Guns are an accessory in killing people... but so are fertilizer, oxygen tanks, bricks, biological and chemical agents, and fists. They all operate on different scales. I don't believe for a second that further restricting guns will make me one bit safer in my every day life. We *always* run the risk of dying on any given day from any given cause, including school or workplace tragedies brought about by psychopaths. Be aware of your surroundings! Grow a little bit of healthy paranoia and know where your exits are and how you would react to a situation like this! I am firmly convinced that this individual would have killed as many if not more people if he had not had access to guns. Might have taken him a little longer, but that kind of psychopathy is what leads to serial killers. It's just things like this that shock the collective consciousness that come to the surface and create the atmosphere of sacrificing freedoms for a sliver of "safety". You are never safe. Get over it. Learn to deal with it. It's going to be debated until the end of time as to whether restricting private gun ownership will prevent tragedies. I don't think it will, and that's my take on the matter. You might trade a single act of horrendous violence for many smaller acts of evil by doing so, but in the end you do not keep people any safer. Look at home invasion crime rates in Britain. Look at muggings and personal attacks. Give it a couple years- I guarantee you that if someone wanted to perpetrate an act like this in Great Britain or Australia, they would find a way to do so. All that more gun legislation will do is take away the ability of the average Joe or Josephine to protect home and family, and completely remove the ability for the population to correct matters if the government should degenerate into something that no American citizen wants to see. I don't remember who said it, and I'm sure someone will supply that, but a quote from my US History course has stuck with me. To paraphrase: When the government becomes so abjectly corrupt that it is no longer tolerable by individuals attempting to live normal lives then it is the duty of that people to overthrow that government and re-establish order. I hope that day never comes. But I want a fighting chance for survival if things degenerate to that level, and I know taking away guns isn't going to further that aim in the slightest. Now, can we get off of the gun control argument and look around to see what we can do for each other at this point? A lot of us are edgy for various reasons... let's not add to the atmosphere of severe paranoia and hysteria that sweeps the nation post media coverage of an event like this. To echo the man whose comments unwittingly started this thread, be safe out there. Hug your families and tell your friends you care about them. Life is precious and fragile. Wendy CO EMT-B MI EMT-B

Well put! The radio is *not* the cell phone... I kind of look at it like I'm hollering at the other person where everyone can hear, except the radio's my go-between... so if I wouldn't yell it in front of kids (usually cub scouts) I won't directly say it on the radio. You can dodge around things though if you really need to talk to someone. Only if you've got the time and you're sure they're going to understand what you're saying. I did it with my coworkers at the summer camp a couple of times. Came in handy. Wendy CO EMT-B MI EMT-B

Haha! Asys cracked me up... Drhousemovieoftheweekitis.... I agree, I asked if there was any evidence of trauma... I'd also be considering boarding/C-spining this kid since I don't know what's causing all this and kids are A: clumsy and B: stupid (on occasion). Wendy CO EMT-B MI EMT-B

Hammer, I guess I was still in creative writing mode... "Full orientation questionnaire" for me refers to every possible question I can think of to assess the orientation of these kids. The standard battery of questions you ask and then some, like who's the president/governor, how many quarters in $1.50, where are you, who are you with, why are you here, what were you doing before you got here, what time is it, what city/province/state are we in, where is the capital located, how many feet does a dog have, what color is this thingy over here, how many fingers am I holding up, what's your doctor's name.... most people can get the obvious ones even in a drunken/altered state I've found, so I just get creative and ask things they'd be expected to know and can't necessarily look around to figure out the answer to. I like to pepper the questions in there as I'm asking other assessment questions. If nothing else sometimes it makes folks laugh, and it certainly gives a much better picture of how awake, alert and oriented folks really are. For example... I could answer the standard ones in my sleep because I've asked them so many times. Doesn't mean I'm oriented. It isn't anything official.. just my way of phrasing that and I do apologize for any confusion.. Wendy CO EMT-B MI EMT-B EDIT: Do I really have freakishly large frontal lobes? I don't intend to come off that way....

Here's a shot in the dark... could they have OD'd on Ketamine? By any chance? It's an anesthetic abused by the "party club crowd", and can be snorted as a white powder. Something still seems rather funky about all this, however. I really want to know the AAOx? of our patients and how they're tracking per a full orientation questionnaire... Let's call them patients A B C and D, with A and B being our two that have *already* passed out on us. Orientation level of A? Orientation level of B? Orientation level of C? Orientation level of D? Can we get full 12 leads on all of them, both our pre- and post- blackout folks? Can we get the vitals from the charge nurse on the 2 non-conkers as a comparison? How about breath sounds and general physical appearance on all? I think a comparison between A, B and C, D might help with figuring this puzzle out... because two have conked and two have not. Unless C and D are lying and they didn't touch the powder. Which is something I want to know ASAP. Has anyone tried to convince these folks that it's a very possible life and death deal for all of them and that the repercussions are going to be the same whether they talk or not, and that talking might just mean they make it to tomorrow? And hey, do we have parental consent for treatment on all these guys? Contact with parents RE medical histories? Where did they meet the mystery powder man? What were they doing? How long ago did they inhale, ingest, or otherwise introduce the mystery powder into their systems? Any evidence of powder in their nares? Wendy CO EMT-B MI EMT-B

Let's fix what you can first and get some dextrose going. Does the kid respond in any fashion to any of your stimuli? Does he show any signs of recognition to verbal stimuli? Any trauma other than the gentle slump to the ground? What's his muscle tension like? Does he take any meds from the school murse? Head to to exam reveals: ? Got any parent info forthcoming? Siblings that could be of assistance? Prior history of anything like autism, developmental disabilities, ADHD, etc? Did I miss it... BP? Wendy CO EMT-B MI EMT-B

Actually, Marty, salamander genetics and procreation are a very viable biological study, haha! You don't want to know what they're teaching us here... The voluntary castration is a lifestyle that some endorse. I just threw it in here to see how folks would react to it! I swear, I haven't been totally corrupted, lol! Wendy

Hey, NREMT-Basic... I completely agree that we often overlook those issues most important to us as medics (I use the term as referring to medical professionals, not just paramedics...) I wasn't even aware of the Medtronic Lifepak deal. But, if you would be so kind to look at the header on this thread and where it is situated.... "NON EMS DISCUSSION". Therefore, anything, including but not limited to the weather, politics, Chinese food, salamander procreation, the Dewey decimal system, how to effectively make spit wads and voluntary castration as a lifestyle may be discussed in this area. We're medical professionals, yes, and this site was created specifically to cater to that need. But we are also humans with varied interests and perspectives. That's what makes this forum so great. You can post EKG strips and archaic terminology and have pertinent, wonderful, educational discussion on them. You can ask a dumb question and get a good answer, usually involving "use the search function, stoopid". But you can also discuss other things that are important to you. That is why this forum area exists. I return to what I said earlier today... no likee? No clickee! NO READEE! PRPG, I see where you are coming from and Dwayne, I don't think he was going where you thought he was going. I didn't read it that way, to be sure. He wasn't defending the content of vs-eh?'s latest productions... just his sovereign right to create them and the fact that creating them is to be allowed or even encouraged. vs-eh?, we are still waiting to see what makes the typing flow... in the words of any 3 year old... "But WHY does it do that?" Wendy CO EMT-B MI EMT-B

How fitting that I just came off the latest vs-eh thread to see the arguing on the internet special olympics quote.... haha! Wendy CO EMT-B MI EMT-B

There is a very fine line between discussion and ranting without listening. I think (personally) that this thread as well as many others that vs-eh has started begin with discussion and inevitably end up as ranting. I'm still not quite sure how that happens! But, we all participate time after time, do we not? No likee, no clickee, no postee. Easy as that. You *know* there's always going to be someone with a different opinion than yours posting and that, from your view, they are WRONG as wrong can be. Don't let it get to you on a personal level and for goodness sake, don't let it be another stressor in your life. We as EMS deal with enough stress... places like this are where we come to relieve some of that and engage on an interpersonal and intellectual level. I learn something every time I read a long forum thread like this one. Doesn't mean it's the something that any particular person wants me to learn. Anybody else learn anything new this time (and vs-eh is an @r$e!0^e doesn't count!)? I also am curious. Vs-eh, we all have things that drive us crazy and that we passionately engage in discussion or ranting about. Why, good soul, is this one yours? It always helps to know where someone's coming from- not in the sense that it helps you destroy them or break down their arguments, but in the sense that perspective and "walking in the other person's shoes" helps you to more fully evaluate your own position and integrate it into a larger context. Wendy CO EMT-B MI EMT-B

BP, R, P? If he's hyperventilating, he could have the mouth/hand numbness and the hand contractions that go along with it in severe cases... maybe worried about proposing to someone, lol? Agreed with the question about allergies, occupation, meds, what he was doing immediately prior to the meal and what he's been eating drinking recently. What's his orientation status? General appearance? Pupils? Family HX? Numbness anywhere else? That'll do for starters. Wendy CO EMT-B MI EMT-B

It is very true that the links to genetic basis have not been yet completely proven but they are solid enough for this skeptical biology major to go ahead and chalk that one into the "Ok, I'll buy it for now" category until more information comes along. But the link between maternal hormones in utero is a definitely proven phenomenon. I'll try to get the articles for you if you so desire. And notice that I said the RESPONSE is the choice? The orientation might not be. Whether or not a person decides to act on their sexuality IS a choice. No? Rid, I completely see where you're coming from. The only thing I've come down to is what I said before... I leave the judgement up to God. Personally, I like the reservation of MARRIAGE for a hetero couple... but civil unions wouldn't necessarily be a bad thing for committed homosexual couples. I look at it this way... there's a couple who've been together for 20 years, they're good for each other... say one of them ends up in the ER. Their partner should have the right to make care decisions for them. Only makes sense. Now, if they're smart, they've drawn up legal, medical and financial power of attorney forms naming the other which they have a in a file, ready to use should it be necessary. But a civil union wouldn't be a bad thing, in my honest opinion. Just my (slightly more liberal than it used to be) opinion. Wendy CO EMT-B MI EMT-B

Funny this thread should come up. I had a good friend come out of the closet over my spring break, much to my surprise. I was really worried- about how I could reassure him that I didn't think of him any differently and that I wouldn't turn away from him or judge him. I wanted to be as supportive as humanly possible; because there's still so much misunderstanding and blanket prejudice, coming out of the closet is still a real emotional and possibly physical challenge, depending on whether or not people who are radically homophobic are near you and decide to threaten you or injure you based on your sexuality. Homosexuality is largely genetic. That's something that science has proven in many species, including our own Homo sapiens. It has to do with exposure to different hormonal levels in utero. How people choose to express this sexuality is the choice... there are flamboyantly annoying gay people, just like there are really freaky swingers or straight folks with devious desires. Some are really in your face about it and others keep bedroom business to themselves. Personally, I don't want to hear about your normal hetero goings on any more than your freaky hetero or normal homo/freaky homo. Keep it to yerselves! Not something I'm interested in sharing. If you are and have friends who are cool with it, more power to you. As for the religious condemnation of homosexuality... heterosexual marriage is extolled as a sacrament because it involves the creation of a new life, the closest that one can get to being God (as taken from some theological viewpoints). Therefore any union where this is impossible is not desirable. Not saying this is what I believe... just adding some extra dimensions to the "WHY" of it all. As a religious Roman Catholic, I personally believe that it is up to God to judge every person, and therefore not my place. I might not like something... but that doesn't mean I can tell someone they're going to hell. In the end it comes down to that person and the higher power. Therefore, I will keep myself out of it and interact with the person, avoiding judging as much as possible, because hey, I'm as messed up as the next guy. I try to aim for being as supportive as possible... life is rough, and doubly so if you are conflicted about something as basic as your sexuality, or have to fight to express your natural sexual inclination for fear of repercussion. Paedophilia is a different matter entirely. That is a crime, because a child does not have full understanding of the psychological and physical aspects of sexuality, and cannot give legal consent (rightfully so). Anyone who takes advantage of a child is a depraved individual deserving confinement at the least and death at the most extreme. (I am VERY defensive of children). Any points where it's unclear how I feel on this issue? Wendy CO EMT-B MI EMT-B

I just describe what's going on with my patient using verbal descriptors, especially if the situation is not one that lends itself to the AAOX __ situation. I find that it makes a lot more sense to me and I can give a much better picture if I actually write things out completely in trip reports with the exception of BP, P, RR. I actually use whole words describing it verbally to the doc- why wouldn't I just write it out completely so the quality control review and the possible future lawyers can also understand it? Back on topic a bit I use X4 but used to confuse this with the AVPU scale. Which is why I now just completely describe their awareness level vs using the abbreviation. Wendy CO EMT-B MI EMT-B

Feel moved to pray with the patient? Do so. Feel moved to pray without the patient? See Dust's quote above. Prayer not something you do? Don't. I completely agree that our care lacks that element... it doesn't necessarily mean making yourself more vulnerable, the way I look at it. You're tapping into another source of strength, that is, the strength that connecting with the Higher Power as you understand it gives you and your patient. All of a sudden, it's not just you and the patient in the back of the rig... which eases the burden some. I have no problem praying with anyone. I pray before I go out on every call. I pray for my partners' and my protection, and for the safety of those we encounter, and for the well being of the patient and those who care about them and for them. It takes about 10 seconds and can be done silently... "God be with us, keep us safe, help us to do our duty and to help those who need us most now. Protect those with us and around us, and grant us Your grace. In the name of the Father, Son, and Holy Spirit, Amen". Ruff, I gotta say.. you need to PM me about something that happened recently with me. I think you'll understand it and get a kick out of it. Wendy CO EMT-B MI EMT-B Roman Catholic

Kudos to hanging in here, Pro... it takes a while to get fluent at "forumspeak". A lot of what you're trying to say can get lost in the context. I am also curious... how's the job hunt going? Wendy CO EMT-B MI EMT-B

EMS has taught me how to be a lot more level headed. It has taught me to subconsciously keep an eye on everyone around me... because you never know who's going to puke on you or fall over or a myriad of other wonderful things. EMS has taught me that awful things happen to everyone- those who deserve it and those who surely don't. EMS has taught me that not everything falls into a neat flip-chart order... and that you better be able to flex or you're going to be standing in front of everyone including possibly a judge, explaining why you're such an idiot. EMS has taught me to continually pursue my education... because there's so much out there that I still need to learn to benefit myself and my patients. EMS has taught me to call for backup when I need it... in both my professional and personal life. EMS has taught me to tell the ones I love how much they mean to me at every possible opportunity, because it has shown me how fleeting and fragile our lives really are. For all I know, I could die before hitting the submit button, and no one will ever see this.. but so could you. I have learned to appreciate what I have in my life, because I know it could always be worse. Doesn't mean I'm a pollyanna... I still struggle with things in my life like the rest of us... but I feel like I've got better perspective now than I did when I was younger. EMS has taught me always to knock on wood, never say the Q word, and that bad $h!^ always comes in threes, no matter what! EMS has taught me that latex isn't my friend. I'm sure I'd have learned this one sooner or later... but I think my learning curve got accelerated a bit! EMS has taught me that I shouldn't judge a situation or a person without adequate information. I end up being wrong more often than not. EMS has taught me that it's not about the flashy lights and the adrenaline pumping serious situations... it's about comforting the kid with the broken arm, and calming down a distraught person who really just needs to learn to cope with panic attacks. Why get frustrated with the person you have in front of you? You're still getting paid. When did interacting with the PERSON, not the condition, get lost out here? EMS has taught me that my definition of an emergency doesn't necessarily cover it all, and that different cultures and people have different criteria for what an emergency really is. Sometimes, that definition is REALLY dumb. Sometimes it isn't. Every situation is one in which you can learn something. Might not be something really useful, especially if you're running with an Alzheimer's patient who was a whiz at answering Jeapordy in their 30's, but boy, it was interesting. I know some people might look at this list and go, yeah, she'll learn in a few years... and I'm sure there's a lot left out there for me to learn. But the day I don't care on some level about the PERSON in front of me is the day I unlace the boots and hang up my uniform. It's more than just the interventions you do. It's about how you do them. And that, in a nutshell, is what EMS has taught me- so far. Wendy CO EMT-B MI EMT-B

Benzonatate. Can be an oblong gelcap or the one with the T on it. It's a cough suppressant, overdose can cause seizures. Thought it looked familiar... friend of mine had to take it a while ago but it was the capsule w/o the T on it. Can someone go through the pharmacology of it and explain exactly what its mechanism is, what it does and why? Wendy CO EMT-B MI EMT-B

This is a shot in the dark. Are fungal infections associated with being febrile? If not... frat houses breed NASTY fungal strains that can cause REALLY strange problems. Yes? No? Maybe so? Seizures- does he have a wallet card or any medical ID on him? How 'bout meds in the jacket pocket? Do his buddies know any more about his condition? Do they have his mother's number by any chance or some other contact info that could give you the clue here? Is he complaining of any respiratory distress or obviously displaying such? Wendy CO EMT-B MI EMT-B

I'd take the running man out. Just put the radiating trefoil and the skull and crossbones. Or a flaming man. *sighs* Wendy CO EMT-B MI EMT-B

And yet again, I ponder... why can't basics give rectally administered glucose? Done in a sterile manner (which the Mrs. Butterworth's wouldn't be, yurck) it could pose little risk to the patient and give basics another option with that unconscious, unresponsive diabetic. What's the worst you could do at that point? If you know what you're doing you're not going to damage the patient.... and excess will naturally be disposed of later... Sorry, I know I've asked this one before. Just wondering why it hasn't been considered more. Makes sense to me, but then again, I'm not a doctor, just a basic... Wendy CO EMT-B MI EMT-B

Looks like your department did the best that they could given a really difficult situation, Asys. I commend you guys and hope that everyone is able to process this event well. Ok, someone clarify for me what the rights of news media are vs the rights of individuals who DO not desire to have their images in any way shape or form appear on the evening news. Is it assumed consent until denied? Why didn't the cop just say that the patients could not legally express an opinion regarding being filmed, especially the minors, and ask the cameraman to respect that and remember his OWN liability regarding this kind of deal? I know my photographer friend has to be VERY careful RE this kind of liability. Wendy CO EMT-B MI EMT-B

News flash. Kids are ridiculously stupid at times. That is what makes them fun (for the most part) and why I have a job at the summer camp I work at (yes, Batman jumped off a boulder again...) If kids didn't do stupid stuff, they'd never learn from it. Imaginative play, including socio-dramatic play and role playing, is crucial for children's social and intellectual development (at least according to Vygostky). Can you tell I have a developmental psych final coming up?! If you try to suppress this kind of play, you will end up with a lot more problems than a few broken wrists and bumped heads... Personally I'd rather see my campers play at being Batman than glued to their safe, if stagnating, Nintendo DS gizmos. I'll deal with the cuts, bruises and occasionally more serious injuries. I'll bet the kid who hopped out the window won't do that again, or if he does, he'll know a little bit more about grab points and balance.... Wendy CO EMT-B MI EMT-B

I, uh, think that one can definitely qualify as a "oholy itshay" moment! WOW. Lucky to be alive, that one. Wendy CO EMT-B MI EMT-B

Agreed with CD. I also wear a medic alert bracelet which I never take off... but I would hope that the medical providers caring for me should I become unconscious or otherwise unable to provide information about my condition would exercise good judgement and assessment skills. The downside of the USB keytag is that they can become damaged or corrupted. What if you're lying in a puddle of water and the USB drive gets drowned? What if you're in a wreck and it gets crunched along with everything else? That's a moderately expensive mistake... a stainless steel bracelet or dogtag with the basics is the much better option in my opinion. Now.. this reminds me.. time to update the emergency contact info card in my wallet! Stay safe out there! Wendy CO EMT-B MI EMT-B