Lone Star

Leave it to Fred to totally screw up following directions....it should have been a left at Pismo Beach and a right at Cucamonga.... Figures....I gotta explain EVERYTHING to you, over and over again..... How's the wife and 'linoleum lizard' doin?

During my time in Paramedic class, we were expected to know how to perform these BLS skills correctly. Since we were now required to look at things in a different light, obviously there were more 'advanced questions' being asked about these skills (for example, when I took my first BLS classes [all them years ago], I was told that when inserting the proper sized OPA, that I had the option of using either a 180º rotation or a 90º rotation). During the Medic class, this turned out to be an 'issue' with my instructor. I still don't know why using 180º rotation is better than only using a 'quarter turn'.....both will displace the tongue and open the airway; which is the ultimate goal of OPA insertion in the first place.

Don't forget to sample the local cuisine! When I went to New Orleans for Rita/Katrina, our crew was pretty much restricted to the 'campsite' (while management lived in hotels), so I wasn't able to get a good 'taste of the region'.....STILL want to try crawfish etouffee!!

As a kid, I dreamed of going where Neil Armstrong and the others had gone. Unfortunately, that was a dream that went unrealized. I was saddened by the news of his passing. Unfortunately, being where I am in this life, I'm seeing a lot of my heroes (on and off television) are passing away; unlike the generation of kids today who are watching their idols killing each other off...... "It suddenly struck me that that tiny pea, pretty and blue, was the Earth. I put up my thumb and shut one eye, and my thumb blotted out the planet Earth. I didn't feel like a giant. I felt very, very small." - Neil Armstrong

Chicago DOES have a 'gun ban' in place...for the law-abiding folks. Clearly, this is a case of 'outlaw guns and only outlaws will have guns' argument. I'm not going to get into the whole pro-gun vs. anti-gun debate, but it’s clear that SOMETHING has to be done in Chicago to bring gang violence and violent crimes like this back under control. Could stiffer prison sentences be the answer? Rather than catering to the prisoner’s misguided sense of entitlements (A right to cable television?), we should make the prisons more of a PUNISHMENT than they currently are.

I realize that the EMS system needs overhauling (especially in educational requirements), but compared to this job description, shows like Rescue Me and Third Watch (Turd Watch, Dust?) actually do us a favor rather than a disservice! The author of that 'article' needs to be sent back to school where hopefully this time, they will pay attention to the lesson plan!

First off, stop looking for problems where there are none! Second, it looks like you're already looking for 'shortcuts'. If you want to 'get a jump' on your classmates, take the A&P courses, Medical Terminology....better yet, go for the 'gusto' and get an associates degree (minimum) in Allied Health. The key to remember here is that you're trying to get into a position where the higher up the 'food chain' you go, the easier it's going to be to kill someone with your lack of knowledge. As an EMT-B, it's no major issue to get flustered, lose your place in your assessment/treatment routine and simply holler "Do over!" and pick up where you started to veer from the routine. Anything you might do wrong can usually be undone by an EMT-I or Medic. When you reach the EMT-I level, a Medic can still 'undo' your mistakes, but will have to work harder. As a Medic, you say 'Oops!" and someone potentially dies for your mistake...

Agusta National has been a 'male only' club since it's inception. It being a private organization, it's allowed to pick and choose it's potential members by any criteria it deems relevant. I realize this offends some of our younger members, who have been brought up in the 'kinder, gentler America' where everybody is included just because they showed up. Unfortunately, this has made this generation a little too 'thin skinned' for their own good. Nothing is said about other private organizations such as the Free Masons (no women allowed in the Masonic Lodge), they have their own offshoot organization (The Eastern Star). What about other organizations that are exclusionary based on race? Black Caucus, Black Mayors Association, Hispanic Mayors Association, Black Chamber of Commerce, Black Business Owners Association. How can they be allowed to exclude? Because they're PRIVATE ENTITIES. But no one faults them for what they do, or how they do it... The Masters is part of the PGA (read: MENS golf). If the women want a similar event let the LPGA come up with The Mistress' Cup! Just because the men have a golf course that they can call 'theirs', doesn't mean that they HAVE to admit women (or anyone else) just because the excluded scream "Not fair!" loud and long enough. I'm not against women doing what I do. If I were, I'd have made the old misogynic statements about "barefooted and pregnant in the kitchen". I really don't care if women want to do the same things we do or not....but don't expect men to just roll over and let women take over everything we've built! I hate to say it, but women will NEVER be equal to a man until they can walk down the street, balding and pot-bellied and still think they're 'sexy' while scratching their balls and belching.......

Romantic? Possibly Wasteful? Yes Hazardous to equipment and manpower? Possibly I'm sure that there were better ways to propose that didn't include misuse of department equipment and personnel, that would have been more romantic and sentimental. I've never understood why people only focus on one or two facets of their lives as if thats the ONLY defining factor that makes them who/what they are. This also applies to the NASCAR weddings, the ones that just HAVE to take place in the bar that the couple met in....you get the idea... Yes, firefighting is a profession, just as being an EMT; just as being a CEO for Bank of America, Wells Fargo or Avis Car Rental. How many weddings do you see that are themed with Dollar General or Family Dollar? How about one with a Walmart theme, because the couple crashed their carts into each other in the dairy section? Yes, I was a firefighter, I'm also an EMT; but I absolutely REFUSE to let either be the central focus of my life (where I can only eat, drink, breathe, sleep Fire Department or EMS)... As far as misuse of the department's equipment and personnel, I think that sanctions should be levied and disciplinary action persued over the incident.

If you're gonna do that, the very least you can do is wait until after 'pudding time' here at Shady Pines! Not only that, but the red button causes the 'Go, go Gadget bed" to fold up into a really hot sports car......

This thread has given me so much room to comment...... Doc, the bestyou can co is TRY to teach him the secret handshake and password....you know how he is. Remember, you can't teacch an old dog new tricks, and you can't teach THAT kiwi anything!! Fist off, you spelled that word wrong....its proper spelling is "B-U-Y-S-E-X-U-A-L". By your own admissions, the only time you are able to get sex, you have to buy it; and the usual outcome is that even the 'previously enjoyed companions' that you employ tend to refuse service to you.... We don't have to say anything, you're doing a bang up job of accomplishing that goal all by yourself. It's clear you don't need our help! Remember Arctickat, this IS the same guy who cites Wikipedia as a credible source (when he's not referring to it as an 'absolute authority'....

Either a pillow between the arm and the body, or a nicely folded blanket or two. This helps keep the extremity in a 'position of function' as well as cushion it from bumps and jars incurred during transport. Another consideration would be that we shouldn't be 'stingy' with pain management techniques, as letting our patient suffer simply because we don't agree that their 'owie' hurts as much as they say it does; is abusive and inexcusable...

Where were you when I had my aneurysm to deal with?

During my clinical rotation in the E/R on Friday night, a patient was brought in by EMS. The patient had an OBNIOUS GSW to the left temple. In this cse, it was a small caliber round and it never penetrated the cranial vault. This patient had been tubed and was being 'bagged' as they rolled through the doors. Had this patient suffered a cardiac event that left him pulseless, would it have been a different story; or should the responding crew just chosen to withhold recuscitation based on the fact that there was that damn "OBVIOUS GSW"? As far as 'corroborating signs', how about some of the ones we use in other cases: DeapitationDismemberment Decomposition Gross lividity Rigor/liver mortise Significant loss of blood volume, as to be incompatible with life functions Exposed brain matter?

It's not a matter of whether or not I think my local protocols are the end all/be all of how things are done, nor do I have a problem 'thinking outside of the box'; I can't even chalk this one off to 'reading too much into the question. The issue I'm having is that there's the PHTLS way, the BTLS way, the Mosby way, the NAEMT way, the NREMT way....ad infinitum. Let's all get on the same page here and come up with a single way of doing things, answering questions and treating our patients based on the evidence that we uncover during our exams (be it trauma/medical/focused/rapid etc). Answering test questions based on the idea of trying to figure out just what the producer of the exam wants to hear equates in my mind to nothing more than 'cookbook medicine'. To me, having certain criteria that has to be met before we can just "call 'em dead" is the only logical method I can think of. When we come to the scene of a cardiac event, do we simply pronounce the patient 'dead' because we can't get a pulse or because the monitor shows asystole in only one lead? Absolutely not! We look further int the situation (asystole confirmed in at least 2 leads). Even then, it's not a guaranteed fact that the patient is dead and thereby negating any attempts to resuscitate. What got my dander up is the way it was dismissed with the statement "It's the PHTLS answer". Yes, in my opinion, it SHOULD have been handled better, and at least offered WHY this was the correct answer. My local protocols; hell, even the STATE protocols are FAR from what I would consider the model for a national scope of practice, s there's no 'disappointment' involved. If the course material is going to overlap from several different general categories, (ACLS, PALS, GEMS, PHTLS, etc), shouldn't the modalities of treatment also be overlapping? Or do you advocate treating the patient based on whatever modality you choose at the moment? If so, then by what criteria would you base that decision on?

Just took the PHTLS 'final' after a two day lecture...not enough time to adequately cover the 'high points', let alone the nuances involved. One of the questions was "You and your partner arrive to a patient who has an obvious GSW to the left temple and is apnic and pulseless. What do you do? One of the answers was "Pronounce them dead immediately", another was "Immediately begin CPR". Nothing was mentioned about signs incompatible with life functions, nothing was mentioned about exposed brain matter, decapitation/dismemberment or any of the other obvious signs of death (gross lividity, decomposition; etc). Here in GA, we've been taught that unless those criteria are met or the patient has a DNR order...we immediately begin CPR. The PHTLS instructor simply said "This is the PHTLS test, and that is the PHTLS answer". It's rather disheartening to see how a situation like this flies in the face of what is being taught in 'regular class lectures"! And people want to fight a national scope of practice.....it truly boggles the mind.

When I rate a post, I tend to look at things like: 1. How well was the post written? 2. How well did the poster present their ideas/response? 3. If presenting fact, can they back their position with references/logic? 4. If presenting a rebuttal, is their position backed with logic, or is it a 'knee-jerk reaction'? I've posted some things on this forum over the years that weren't very popular, I've posted from that 'knee-jerk emotional reaction' place and have been smacked square between the eyes for it. I'd like to think that I"ve learned a lesson from that. I 'don't believe in candy coating things just to make them more palatable, but I don't believe in beating someone down because their viewpoint is different than mine. I don't simply '+1' a post because they're a friend of mine, nor do I simply '-1' a post because I don't like the poster. I'd really like to believe that I'm judicious in my ratings, and that the poster has actually earned the rating I've given. I would also like to think that I've given far more 'positives' than I have 'negatives' in the process. No, not everything I say is going to be well received, nor is it automatically giong to be automatically dismissed as nothing more than drivel cluttering up the forums. As far as posting a rating to negate another person's rank; that's akin to telling the 'rater' that they really don't feel that way about the post. My criteria for an automatic 'negative' is about as simple as the 'positive criteria' is: 1. Is the poster INTENTIONALLY trying to cause drama, discord or incite an argument? 2. Is the poster INTENTIONALLY refusing to listen to a loical argument against their position? 3. Is the poster INTENTIONALY avoiding ignoring requests for references to support their position? 4. Is the poster INTENTIONALLY being obtuse to cause discontent and discord (trolling)? I've recieved far more 'positives' in my 'reputation' around here, but I've also had my share of 'negatives' along the way. I'm pretty sure I've earned the majority of the positives and negatives based on the QUALITY of my postings, as opposed to being 'gifted' them simply beause the person was either being kind or because the rater considers me a friend....

My sincere condolences to Mike's family and friends. This is an especially difficult time of year to lose a someone. I pray that they can find peace and some measure of comfort.

So I guess this means that the OP didn't even pass "Operations"...which means that they've COMPLETELY failed......am I correct in my logic?

This is why I believe that the NREMT needs to stop catering to the lowest common denominator, or at least raise the level of said denominator! EMT-B isn't rocket science, and it's amazing how many people are having so much trouble with the mere basics of life support.... What I find frightening, is these people who bomb out on the NREMT exams ALWAYS want to blame 'the test'; rather than place the blame precisely where it belongs....on THEIR own shoulders. How LONG you study isn’t the issue here, its HOW you study that seems to be the issue. If reading and comprehension is where the issue lies, then by all means, enroll in a remedial reading/English/language course and bring that skill level up to par before you try to get into a technical field where knowledge is obtained from reading, along with critical thinking. EMS is NEVER about ‘the book says’, nor is it regurgitation of information on command. EMS is a dynamic field that REQUIRES it’s practitioners to be able to think on their feet and be able to use critical thinking skills to reach an accurate differential diagnosis at the patient’s side. The EMS clinician must be dedicated more to patient care than they are concerned about bopping around in a big shiny truck with flashy lights and a really loud noise maker, or how cool they look with a stethoscope draped around their neck. People’s lives are in your hands, and you OWE it to them AND yourself to either make the grade, take the blame when you don’t or get out of the field. This field is loaded with ‘glory hounds’ and ‘wannabes’, and all it does is make it more difficult for those ‘rock-star clinicians’ that are trying to make a real difference; not only in their patients lives, but in the field of EMS in general. Just what is 'near passing'? Does that mean you 'just made the minimum passing grade' or that you 'missed it by |_____| that much'? * Edited to include quote and comments associated with it