Lone Star

Congrats Mario! I just wish I could have been here to be of some assistance.....at least you didn't have to have me putting my boot to your backside to study and do your homework...!

Good on you, Bushman! Glad to hear you're still a dezinen of the alive and kicking. Congrats on your selection.....no go forth and give the instructors hell (it's a blast when you can challenge them from an intellectual position)!

The Pilates classes in the Batcave ain't hurting either......

Not in class right now. Trying to assess if I have 'enough left in the tank' for a third run at it. Currently working in Industrial EMS for a sugar refinery. The company I work for is a security company and is a joke! It's one of those places that ranks right up there with AMR for the "I wish I'd never heard of this place" title....

It's been said by the Cap'n and Dwayne, so there's no real reason for me to reiterated. Listening is just far too important in this field, and if he's deficient in this area, then he's providing inferior patient care. When you can't hear the little nuances in things like lung sounds, how can you properly assess the patient? If you can't hear the subleties in a blood pressure, then how can you properly treat the patients condition and needs? Not all patients will be able to communicate whats wrong, and in the case of the unconscious patient, you need to be able to hear what the body is trying to tell you. Yeah, the guy's got a set of 'brass ones', but is it REALLY a good idea to have him in a position of patient assessment and autonomous patient care (within the boundaries of protocols)?

Sexual incompatibility? Nah, I would have to list one of the major causes as sexual infidelity. My ex wife turned out to be a lot like Will Rogers....you know, never met a man she didn't like. The biggest problem with that is that she 'liked' them even more when I wasn't home. I never 'strayed' while I was married, and was working double shifts as often as physically possible to keep her 'in the money'. Unfortunately, I wasn't home as much. When I would lay off the doubles, then she'd complain and nag because we didn't have as much money as when I was out busting ass on the doubles......just can't win for losing,I guess. There are far too many people out there who are in love with the idea of being 'in love' that they tend to forget that ANY relationship takes work to make it work. Nothing of any value in this life comes 'free' and you're going to pay for it one way or another.

I don't mean to bust anyone's balls here, but if you're not 100% committed to studying to pass the NREMT (I passed NREMT-I first time), then it really sends up flags as to what kind of provider you're going to eventually become. This field is oversaturated wtih mediocre providers, followed up by those that do just enough to get by and get themselves in over their heads (seen it too many times to be told differently). EMS as a whole needs to stop catering to the 'lowest common denominator' and really become more selective about who it lets into the classroom....

Just because someone is diagnosed with epsilepsy, doesn't mean that they are automatically excluded from professions like EMS and Fire (or police, etc). As long as it's under control, there isn't any reason that they should be excluded. This also appliess to diabetes, CAD, arteriosclerosis, HTN and other 'disabilities'!

Too bad it didn't happen on 12/31 at 2355...then they could have said they called you last year!

Little Johnny and Suzie were always in competition to see who had the best toys. They would meet on the street corner and compare. Johnny came out with a new Louisville Slugger baseball bat, and Suzie brought out a brand new Easton aluminum bat. Suzie came out with a 10 speed bicycle and Johnny had an 18 speed mountain bike. Johnny came out the next morning with a Red Rider wagon, but Suzie had one that practically pushed itself.....you get the idea here. One day, Johnny is standing on the corner with nothing that Suzie could see. He looked at Suzie and said "I've got something you'll NEVER have!" When Suzie asked what that might be, Johnnie dropped his britches, pointed to his crotch and said "I've got one of these!" Poor little Suzie went home in tears. The next day, Johnny is standing on the corner when Suzie arrives. He tells Suzie "I've still got something you'll NEVER have!". Suzie again inquires to that this might be. Johnny again drops his britches, points to his crotch and says "I've got one of these.". Little suzie pulls up the front of her skirt, points to her crotch and says "My mom told me that with one of these I can have all of those I want!" Never try to out-think a girl!

I've worked for a couple companies like that... It's hell when you're labeled the 'company screw-up' simply because the boss is a jackass and they've got nothing better to do than to hunt for problems where there are none. I've tried the "What can we do to make this working relationship better' route, only to find that the supervisor I was talking to (and honestly trying to make things smoother) wasn't holding up his/her end of the bargain. I've been praised by ER Docs in Detroit for my work, I've been remembered by Medical Directors for my knowledge (3 years after the class he taught when I was taking EMT-B for the first time). I really cannot be that much of a f*ck up! It's also statistically impossible for one person to be right all the time (conversely, it's statistically impossible for one person to be wrong all the time). It sounds like the best thing you can do for yourself (and your sanity) is to start looking into other companies in your area and get away from these anal-retentive jerks!

I agree that the posting was as far away from 'good taste' as it could possibly get, and I can see the case being dropped by the court system under the first amendment protections of free speech. Since the article states that neither department nor the city has a written policy against this type of behavior, any punishments being meted out are in error. How can you punish someone for breaking a rule that you haven't enacted? If that were the case, then maybe we should start locking people in prison just after birth, since some of them will end up there anyway! *NOTE: The previous statement is NOT a reflection on any particular group/gender/race/color/creed/religion or lovers of any vegetable, whether specified or unspecified!

Let's not forget the drug seeking frequent flyer, who's been in your company's trucks so often, that they can tell you how to fill out your paperwork (and know all the 'right things to put on the line for "Reason For Call" so that medicare/medicaid will pay for it). Then there's the ones that no matter what you can do (either by patient condition or limited by scope of practice) it will NEVER bee enough, good enough or they'll try to twist it into some form of malpractice, and won't be satisfied until you're castrated and they're using your 'parts' as earrings! Then you have the 'adrenaline junkies' that would NEVER be caught dead doing any of those 'routine IFT's, simply because it's beneath them do do it). No, EMS isn't always blood, guts and glory; but if you spend any serious amount of time in the field, you'll be surprised at how a simple "Thank you" can send you off to that 'feel good place'...

I've taken online courses and the traditional 'brick and mortar' classes, and find that when I have questions, I want immediate feedback/answers/direction rather than having to wait (sometimes up to a week or more) for a response from the instructor. I also found that with the traditional classes, when we were doing the 'hands on stuff', it was easier to have my skills evaluated/corrected. How long would the wait be for the next class to start? Since it's only the second semester of the course, would you have to restart at the begining again? I don't see this as a 'problem', since it gives you a chance to hit the 'problem areas' from the first semester and help you retain the knowledge.

How many of those 'EMS burnouts' are guilty of making EMS their entire life (Live, eat, breathe and sleep EMS)? You know the type, EVERYTHING they own is marked in some way with SOMETHING EMS related (from ink pens to coffee cups to decals/stickers in the window of their POV, and lets not forget the ever popular EMT license plates! As with anything in life, there must be a balance between EMS (or whatever career you're passionate about) and 'the rest of the stuff life offers.

When I worked EMS in Detroit, another service would brag and laugh about pulling up behind cars that were observed with certain ethnic groups in them, and then "light 'em up" just to watch the occupants 'freak out' because of the flashing lights in their rearview mirrors and the sirens blaring.... Is THIS the kind of mentality that you'll want running around with loaded firearms on them? (That company had at least one ambulance that had 7 rounds from a shotgun blow through the patient compartment) I've carried concealed for years (the only reason I'm not licensed in the state I'm currently in, is because I haven't been able to afford the licensing fees). I'm not saying that ALL of the people in EMS would behave in this manner, but as it's been said many times before: "you've got to gear this toward the lowest common denominator" Like I said in my earlier post, I've seen too many cases of "The Blue Knight Syndrome" where a security officer gets his weapons card and suddenly thinks they're some sort of 'super cop' and can take on any and all 'bad guys'. EMS isn't about apprehension of criminals, nor does it include the use of deadly force in the day to day duties of the job. Not all can or will make that distinction. Our job is dangerous enough without the added dangers inherent with the carrying of firearms. Additionally, there are so many in EMS that 'need' to have that shiny badge on their chest, as if it were some sort of talisman that will automatically make the general public bow and grovel at their feet with undying love, loyalty and ulitmate respect. Sorry kids, it just doesn't work that way. That shiny thing on the left chest of your uniform usually makes you look like a cop; and we KNOW how loved our local law enforcement officers are these days! On top of all that, that shiny badge (and possibly a firearm) isn't going to get your patients to want to open up to you about whatever they've done, taken or done to someone else (whether on purpose or by accident). It's only going to make your job that much more difficult because your patients are going to be less than forthcoming for fear that you (looking like a police officer) are going to arrest them.

This doesn't sit too well with me... With as many of the 'glory hounds' that seem to infiltrate our ranks on a daily basis, putting a loaded firearm in their hands would only encourage a spike of 'The Blue Knight Syndrome' where these armed chuckleheads are going to go out and try to save the world by themselves. I've seen this type of behavior in security companies, and in some new police officers. We DON'T need it in EMS as well! We can't get these 'Ricky Rescue' types to drive slow enough to keep from destroying their rigs (and injuring/killing themselves and others), can we REALLY trust these people to keep a level head with a loaded firearm?

I find it difficult for this illiterate speed reader to be taken seriously enough to GET published.......*sighs heavily*

What's the big deal about sorting your laundry by colors? Segregation has been deemed unconstitutional.... I think we should just put all the clothes in the washer and let them learn from their cultural differences!!!

I came late to the party, and unfortunately was exposed to the diagnosis before I could step in with questions. The first thing I wanted to know was the type of delivery of the most recent child. With C-section, could it be possible that a sponge/clamp/other foreign object was left behind? I was also thinking possibly diverticulosis/diverticulitis in the ascending/transverse colon... I was considering 2-5mg MSO4 for pain management, but since there was no respiration rates given in the initial vitals, I would have inquired about that as well.....

If you'd like to learn more, then by all means enroll in a college level Anatomy & Physiology course. Thats good for starters. Additional reading would be things like this: http://www.emergency...com/default.cfm Neither will qualify you for performing open heart surgery, but it will give you a better understanding of how your 'ticker' works and WHY it works the way it does. One of the reasons that EKG interpretation, pacing and manual defibrillation are not taught at the lower license levels is because the rest of your scope of practice will not allow the mitigation of the problems you will potentially face (ie: pharmacological interventions, IV therapy). Right now, you have no clue what you don't know (this is a phrase you're going to hear frequently, and will drive you bat-shit crazy!). As an EMT-B, you're barely scratching the surface of emergency medicine at the prehospital level. You're going to hear MANY people advocating pressing for a degree, and you're going to hear people talking about not needing one to be an effective provider. I used to be one of those that argued against the degree (although, to my credit, I NEVER mentioned 'Basketweaving 101'). Since I actually shut my mouth and pushed toward my degree, I found out that it is ESSENTIAL, not only to become a better provider, but to be able to provide better care for any patient I come in contact with.

Island seems to have hit the nail on the head here.... As an EMT-B, your main focus is learning everything that the course can teach you, and learning it inside and out. EMT-B isn't rocket science, and you'll be qualified to put band-aids on boo-boos. (I can say that with authority, since I was an EMT-B for 12 years) Don't fret over what you can't do, (but the other license levels can). This will only get you into trouble at your level. If you want to be able to play with all the 'cool toys' like the Intermediates and the Medics do, then by all means enroll your bad self into your local college and get with the educational program! EMT-B is the very BASIC building blocks that the other license levels are built upon. Another tidbit of advice (at least as how I see it): Just because that 'cool medic' you work with allows you to do things that are outside of your scope of practice, doesn't mean that you should be doing it! I know what's in the EMT-B course, the Intermediate Course AND all but the last semester of the Medic course; and I can tell you that as an EMT-B, you've got NO qualifications to be working with the defibrillator, reaching into the drug bag, starting IV's or touching a laryngoscope!

Each spring, the United States Coast Guard has to rescue a growing number of ice fishermen (and women?) because they can't seem to follow simple instructions and get their shanties off the ice in Saginaw Bay when the ice gets too thin to safely support it, them or their vehicles. I don't see how this couple who were a victim of the weather (not because they weren't prepared) should have to be charged anything. It's a simple matter of they got caught in circumstances that they couldn't negotiate. That IS what the whole rescue thing is all about. Unlike the ice fishermen/women that were mentioned in the begining of this post, who have been told to get their equipment off the ice because it was deemed unsafe in the first place. THIS is a 'chargeable offense' and from what I remember, it's $1,500.00 minimum.

I don't believe in lying to a patient, but in the scenario presented by BEorP, I think i would have to intentionally withhold information from the inquisitor. I could cite HIPAA rules and regulations to have a way out of explaining to them that they've just killed someone because they chose to drive drunk, or I could just tell them that I'm focused on treating them and the patient they're asking about is being seen by another crew. In the event that the patient being asked about is a family member, that opens up a whole new barrel of connundrums. Will breaking this news to my patient complicate my ability to be able to treat them? Will this end up in a life threatening situation for me/my partner because they've decided to do a 'murder/suicide'? Will I/my partner become the next victim(s) because I/we weren't able to save that family member?

Ah yes, another chance to land a few more blows to the dead carcass of the "This is why you shouldn't go racing to a scene/drive with due regard for public safety" horse. According to the article, it's clearly evident that if the woman had been driving slower (read: exercising due regard for public safety),this wouldn't have happened.... Do we REALLY need to go there again? Not to mention this opens the whole "women drivers" line of jokes as well.....just sayin'...