Lone Star

For those of y'all that know me, y'all know that I was wiped out on my motorcycle last November as I was on my way to a study group for my EMT-I finals. I spoke to the orthopedist that has been treating me since they found out that my right wrist was broken in 3 places (transecting fracture to the radial styloid, oblique fracture to the distal radius and and avulsed fracture to the ulna), and after steroid injections to the wrist didn't provide the intended results for the intended time, they're now talking about possibly doing arthroscopy on the wrist. I understand the concept of what they're proposing to do... a small incision and the insertion of a small camera and light to 'look around'. The concern I'm having is this: The last time I went in for a 'day procedure'...I ended up in ICU for 3 days with respiratory failure because when they removed the LMA they used, I ended up aspirating because the airway wasn't protected. I REALLY don't want to go through that again! Has anyone gone through this procedure? What can I expect (besides having another 'owie' to heal?

I know that by the tennets of my faith, I'm supposed to 'turn the other cheek' and forgive those who tresspass against me, so that I may be forgiven of my transgressions. I have a hard time bringing myself to that point... maybe in time, I can; but not at the moment. I'm intelligent enough to know that not all muslims are guilty of the actions of the few, and I personally could care less if you want to worship a cat, a cow or a tree, it's your faith; and if it brings you happiness and peace, then it's all on you for that. While this 'cultural center' will not directly impact my day to day life, I've expressed my thoughts and feelings on the other thread. I wish that I could be more 'understanding' about the whole concept....

The whole point of the matter is St. Nicholas Church already had a site (right across the street from the WTC). If the only 'roadblocks' were on from the Port Authority, then the church would have rebuilt on the same site it had originally stood. Just because the Port Authority offered to donate a new site (not the same site where it originally stood) means nothing. The church already had an 'original location' before the towers were knocked down. They should be able to rebuild right where they were. The community center was approved by the Financial District Committee of Community Board 1: The whole point is that the City of New York is wholeheartedly welcoming the community center, while ignoring the Christian church that was already there in the first place. Now, please explain to me why it's more 'appropriate' for the Financial District Committee of Community Board 1 to approve this community center and deny the Christian church to rebuild. The ONLY part that the Port Authority plays in this whole mess is that they offered to donate a patch of their property over top of an area that was used to screen vehicles coming into the WTC underground garage. The Port authority backed out of the deal when the church officials wanted to see the plans for this 'screening area'. Again, I will ask you to justify why the church HAS to accept any offer, when they already had a site of their own? This isn't some newly planned church...it was already established prior to 9/11. As far as you not liking the writing style of the source, I challenge you to find another source that contradicts it. Until then, it is what it is. As it stands, there are one set of 'rules' for the community center, and one for the church. This is NOT how 'tolerance and understanding' are fostered. If these restrictions are placed on the church because of it's proximity to the WTC memeorial, then the same restrictions should be placed on the community center as well! Since I have provided sources that support my original statement, I see no need to retract any statements I've made to this point. 1. http://www.humanevents.com/article.php?print=yes&id=38462 2. http://www.humanevents.com/article.php?print=yes&id=38462 3. http://www.nypost.com/p/news/national/mosque_madness_at_ground_zero_OQ34EB0MWS0lXuAnQau5uL/0#ixzz0x7ZjuYRG 4. http://www.humanevents.com/article.php?print=yes&id=38462

First off, nothing I've read shows that the Port Authority was REQUIRED to give anything to anyone. The Port Authority donated that land and money to relocate the Christian church. It has no say in the community center at all. From what I read, the Port Authority retracted the offer when the church wanted to look over plans for the 'vehicle screening area' that was to be located beneath the church. Explain to me (and others) WHY the Christian Church should be REQUIRED to move from it's original location to some place that they have to put in a 'special blastproof basement'! Explain to us why you think that it's alright for the 'muslim community center' to eclipse the height of the WTC monument, but the Christian church that was there before the WTC was felled can't. Explain why it's 'acceptable' for the community center to be as large as it wants, while the Christian church is limited in it's dimensions. It's not the Port Authority that has any say about the church OR the community center. The approving board from the City of New York is the one that has no authority in granting the zoning for the community center and/or ANY religious matters.

St Nicholas shouldn't have to be relocated for the simple fact that it was there BEFORE 9/11. The mosque is an addition AFTER the disaster. Secondly, no radical arm of the Greek Orthodox church was responsible for bringing down the World Trade Center. Third, The Greek Orthodox Church isn't stating their desire to convert the world to their religion. Additionally, I haven't seen any articles, comments or other forms of protest or disention about THAT house of worship being rebuilt where it originally was. Again, what I find 'odd' here is that the zoning board (or whatever municipal diety is responsible)is throwing every roadblock they can at the Christians, and yet are bending over backwards to accomodate the mosque (which can't even verify it's funding) in the name of 'tolerance and acceptance (and any other politically correct term you can think of). *Edited to correct grammatical error*

Great responses, guys and gals! I can only hope that when (if) I can get through the medic course, that I can remember all of these tidbits of advice! The rate things are going, algebra will be the bane of my existance! There's not much I can add from my BLS point of view!

Ok, here's the 'real deal'.... You've taken the NREMT and for whatever reason, you didn't pass it. This isn't the end of the world... What matters now is what your next step is. As I see it, you can do one of two things: 1. Sit back and lament about what a 'failure' you are and never put forth any effort on anything ever again (We don't want to set ourselves up to fail again, now do we?) 2. You can pick yourself up, dust yourself off and get back in the game. I'm going to echo armymedic here; many people have failed the test and still ended up being some really 'ace' providers. You've heard the age old saying that 'SH*t happens'? Guess what? This is just a pile of sh*t that you've stepped in. Time to scrape off the bottom of your boot, and keep on truckin! Most people that have trouble with the NREMT tend to overanalyze the questions, or worry about which number the test stopped on. The questions are designed to measure your cognitive skills, (how well you think about the scenario they present). They will give you all the information you need to 'solve it'...Do NOT start trying to 'guess' what they're getting at. The questions are straight-forward. Do NOT worry about your time (you'll have plenty of time if you stick to the task at hand and keep your head in the game). Don't worry about what question the test is on. This is NOT an indicator of how well you're doing/not doing! Take your time, (Remember the hare and the tortise? 'slow and steady wins the race'). Don't try to 'cram' the night before the next testing date, this will only get everything all twisted in your head. Get a good night's rest the night before. Eat a light snack before you go, and do NOT load up on water or other beverages, the need to pee is a bitch of a distraction! It's all up to you now....whatcha gonna do? If you have any questions, I'm sure that there are MANY people here that will guide you to the right answers. There's a wealth of knowledge here; take advantage of it! No one's here to bust your chops, we've all 'been there, done that', and some of us have 'been there, done that' so many times that we've designed the t-shirts you can get at the gift shop! Let us know how you plan to handle it, and how it turns out. Best of luck! LS

In my younger days, it was 'wine, women and song'.... Now it's "beer, the ol' lady and tv"....

Hey Zorro... You STILL haven't told me ... what's for dinner?

Didn't the church in question already have it's own parcel of land (where the original church stood)? Just because the Port Authority offered them land over top of a vehicle screening area, is the church actually REQUIRED to move to it? It appears that the negotiations fell apart when the Port Authority refused the church the opportunity to review plans for the screening area. This could have been for security/safety concerns of the church. Additionally, there are no restrictions on the mosque as far as size and height, but yet the church was limited and was being forced to 'downsize' it's plans. It appears that the Christian church is encountering all sorts of red tape and road blocks, but yet the board that approved the mosque (even though they have NO SAY in religious matters) is bending over backwards to 'green light' everything this mosque wants to do. Why are 'the powers that be' so accomodating to the mosque project, and taking such a hard line on a Christian church? If anything, it appears that the Christian church has grounds to claim 'discrimination' here....

OMG! Thats just TOO funny! I'll bet that gets better reactions than putting a single serving size bag of M&M's in layaway at Walmart!!

Well played! It's nice ot see that I'm not the only one that got caught sailfishing along until some new material came along! I took the bait, and got reeled in. I do take comfort that I'm only part of the grouper that got netted by this.... *Edited to correct a glaring spelling error*

I dont think that reccommendation was meant to insult you, but with the bare minimum of information being presented as the 'core building blocks' in the EMT-B course, the basic first aid course would have given you this very information.

Wouldn't the same concept apply with the B/P cuff as with a tourniquet? Inflate the cuff until the bleeding stops, irrespective of the systolic pressure? Maybe I'm misreading it, and the effects are the same....

The proper title would be Prehospital DDS

The 'new and improved' EMT education module doesn't teach about pressure points. Years ago, when I went through EMT-B for the first time; we were taught that it was direct pressure, elevation, ice and pressure points. Tourniquets were a 'last resort', due to the thinking that they should only be applied in cases of 'loss of life or limb'. In the arm, the brachial artery (just below the armpit) will control bleeding below that point. This can usually be accessed by pressing between the bicep and tricep muscles. In the leg, the femoral artery is what you would use. This is just below the groin, but you're going to have to 'dig deep' into the thigh muscles to be able to get to it. For the distal portion of the lower extremity, I think you might be able to use the Popliteal artery (in the back of the knee), and for the distal part of the uupper extremity, the distal end of the brachial artery (just prior to the bifurcation into the ulnar and radial arteries). Bleeding in the foot is controlled by the posterior tibialis and the pedis dorsalis arteries. The hand is controlled by the ulnar and radial arteries. The school of thought with pressure points is that you start as close to the site of bleeding as you can, and then work higher if it's not effective. The new curricula teaches that the application of a tourniquet approximately 2" wide placed 2-3 inches proximal to the bleed is advised. Only tighten the tourniquet to the point that the bleeding stops and 'lock it in place'. Note the time of application and location for the recieving ER staff. I have to agree with Fiznat on the point that the pressure points is an 'antiquated way of thinking'. This shows that the service is unwilling to accept the changes in curricula, and is trying to adhere to the 'this is the way we've always done things' mode of thinking, which is counterproductive to changes in patient care in the field.

I think we all go through the 'first time out anxieties', regardless of what level of license we hold. The thing to remember here is you've retained enough information to pass not only the class testing, but the NREMT as well. In a perfect world, the company should have put you with a Medic FTO (Field Training Officer) for a couple weeks while you 'got your feet wet'. This isn't the end of the world here, and if you rely on your education and training, follow your local protocols, you should be fine. But don't let your reliance on protocols keep you from thinking WHY you're treating your patient in the manner that you are. Protocols are 'guidelines' for treatment, and they spell out just what you can and cannot do, but they're not meant to negate the need to think about what you're doing and why you're doing it! Another thing to remember; just because you're out of school doesn't prevent you from opening your text books and 'brushing up' on things....

First off, before we start throwing our hands in the air and screaming about first amendment violations and religious persecution, let's look at a few things objectively. The NIMBY (Not In My Back Yard) principle has been a very effective tactic to date. Nowhere in the articles have I read anything about the resriction of religion or it's practices. I don't recal the approval of any other religious structure being approved in that area, specifically cited as a move toward 'unity'. With that in mind, even denying the mosque to be built in this area is not 'discriminatory'. Even if you want to try to cover this under freedom of speech, that protection will only get you so far, because there are case laws about 'inciting to riot', causing panic (shouting 'FIRE!' in a crowded theatre), etc. No one is restricting the right of the people to peaceably assemble either. Looking at the location, the type of building proposed and it's use; not to mention it's 'Grand Opening' date, one can conclude that this group has in fact excluded itself from the protections of the first amendment simply due to the fact that these actions are only meant to gloat, antagonize and rip open the wounds that were created on September 11th Apparently, The Financial District Committee of Community Board 1 seems to have overstepped their bounds here, which would probably negate any 'permissions' to build this mosque in the first place. 1http://caselaw.lp.findlaw.com/data/constitution/amendment01/ 2Read more: http://www.nypost.com/p/news/national/mosque_madness_at_ground_zero_OQ34EB0MWS0lXuAnQau5uL#ixzz0w1fbBIt0 3Read more: http://www.nypost.com/p/news/national/mosque_madness_at_ground_zero_OQ34EB0MWS0lXuAnQau5uL/1#ixzz0w1h5gQcL

And by your own admission, not the person treating as well!

The opening date shall live in infamy: Sept. 11, 2011. The 10th anniversary of the day a hole was punched in the city's heart. Read more: http://www.nypost.com/p/news/national/mosque_madness_at_ground_zero_OQ34EB0MWS0lXuAnQau5uL#ixzz0vs5tLNix

WHen I was in EMT-B school, the concept of 'The Golden Hour' was further reinforced with the 'Platinum Ten' for extrication. Not every patient will need 'rapid extrication', and not every patient will die because they haven't been delivered to the local E.D. within that 'golden hour'. While the concept is to reinforce that there are 'load and go situations' and other situations where time isn't so critical; we need to start basing our education on FACT rather than 'impressive anecdotes'. Yes, some patients (multiple system compromise) ARE 'time critical', if we continuously hear the ticking of that 'one hour clock' in our head, it's going to cause some (especially the new people in the field) to become obsessed with time as opposed to treating the patient's conditon. When this happens, mistakes will be made, and we know that 'mistakes' can end up doing more harm than good.

Any interview that I've been to that required a physical, usually involved a 'lift assessment' and a general physical. Bend over and touch your toes without bending your knees, blood pressure, lung sounds, vision assessment, etc. As far as the interview itself, I've had to face up to 3 people in the HR office, and in one job had to do a few 'scenarios' on patient packaging, patient assessment, and even had to take a written test for one company. The scenario based testing was very similar to what we all faced in the 'practicals' for school.

If what you say is true about the 'Grand Opening' being held on September 11, doesn't this show that the whole mosque thing at 'Ground Zero' was an intentional kick in the teeth to those that were slaughtered there and their families? Ripping open wounds that are starting to heal is NEVER a 'good thing', and to intentionally do it, just to inflict additional pain is counterproductive to the 'healing process', and just down right cruel. I haven't seen anything about the 'Grand Opening', but if it IS true, how can this be a step toward 'unity'?