Lone Star

You have to sit through almost 4 minutes to get to what Richard's talking about:

It's no secret (especially among those that I chat with on even a semi-regular basis; I'm going through the EMT program again to get my license back after it expired. (The whole reason it expired is irrelevant). Ultimately, I had to do clinical runs over again. The crews that I've been working with have been outstanding! I had one patient that expressed concern over the fact that my 'uniform shirt' had "EMT STUDENT" embroidered on it. The EMT-I and Medic I worked with did everything in their power to put the patient at ease, and explain that this wasn't my first time attending to patients. (One EMT-I explained that I started in EMS about the time that Moses started wearing dry shoes). THAT is how it should have been handled! NEVER degrade your partner in front of the patient! Ultimately, we have to instill at least minimal confidence in our patients that we are going to take care of them. We cannot instil that confidence by downgrading, insulting or bereting our partners in front of the patient. If I make a mistake (which is enirely possible), then talk to me AFTER we transfer the patient's care to the recieving facility. If it's something that endangers the patient, then by all means step up; but save the 'browbeating' until we're alone!! The 'anxious' patient is harder to treat. If we have to 'discuss the call' after we're alone, talk to me like an adult; not like I'm some idiot! That's a sure fire way to communication breakdown. Once that happens, all attempts to teach/learn are gone. On the other hand, if I DO make a mistake that has to be 'discussed later', it's MY responsibility to try to learn from any mistake I may have made. I can't do that if I'm going to immediately get defensive and hostile.

The only reason I didn't go for the corporal punishment is knowing MY luck, they'd enjoy it and it wouldn't correct the abherent behavior....roflmao

Having read Richard's post several times, I don't see where he said that he made the patient wait. I believe he said he COULD have, but would have gotten in trouble for it. Read #3 again, as you can CLEARLY see, he stated that it took him 4 years to actually get to see that particular episode in it's entirety. Since you insist on 'stirring the pot', I suggest you follow your own admonishment, and hang your head in shame! Amazingly, in a matter of 12 posts, you've severly damaged your credibility and established a 'reputation' as a trouble maker. Congratulations! I dont think I've ever seen anyone accomplish that in so few posts! Now go to your room, you're grounded! Maybe next time you'll read ALL of the post, put your brain in gear BEFORE opening your mouth!

A widow was overheard at her husband's funeral: "You know, I was married 3 times. The first was a gynocologist, and all he wanted to do was look at it. My second husband was an entrepaneur, and all he did was talk about it. My third husband (the one in the coffin) was a stamp collector, and all he did was.....God, I'm gonna miss him!!"

As far as the 'altered mental status'; by jumping out of the car while it was in motion, the patient could have thumped his coconut on the pavement and injuries from contusion to concussion to coup contra coup injuries may or may not be present. I'm not sure if vehicle speed would play a big factor here (ie: would the speed of the vehicle negate a concussion and only inflict coup contra coup injuries?). In this case; I would write up a RMA and have it signed by the officer on scene, as a witness to the fact that the patient refused treatment and walked off before you could get him to sign the document.

Richard, I wouldn't sweat missing that statement. I went back and had a bit of difficulty locating it, and I knew what I was looking for!

Whoa! Stop! Hit the 'rewind button'! Am I the only one that's having a 'problem' with that line? Married for 3 years AND divorced while in high school??? How old were you when you got married; 14 or 15?

Your personal fellings about Fire or vollies is irrelevant here mate. I agree with examining the mentality of BOTH services. There is no room in emergency services for that 'hot dog' or 'cowboy' mentality! It's that mentality that usually ends up getting people hurt or killed, because of rushing blindly into situations, or as demonstrated here; that 'balls to the wall' response mentality.

The emancipated minor must take care of his or her own financial affairs and prove he or she has the ability to support himself or herself. The emancipated minor is still obligated to attend school and still cannot marry without parental consent. In a nutshell, this means that at 15 years old, you'll have to get a job, find a place to live, and be able to support yourself. You're not able to have mom & dad 'foot the bill' and take care of you from the point of emancipation forward. In most cases, this strains or destroys the relationship between parent and child. Are you REALLY ready for this type of 'fallout'?

What 'paid EMS employees'? Both agencies were volunteer.....

Yes, our little Spenac is all growed up now! Why it seems just like yesterday he was a 'lowly EMT-B student' himself! they just grow up so fast these days!! As far as Spenac being your piñata, I've got a couple other 'ideas' to be considered for a use for the King Taxi Driver.....

Unfortunately, you see this all too often in volunteer companies/departments, especially if they have a relatively low call volume. Everyone gets all 'amped up' and want's to be the first one on scene... There was absolutely no reason to be driving so recklessly, and if it WAS a deliberate attempt to beat the ambulance to the scene, then I hope that the driver of the fire aparatus faces the appropriate criminal charges.

As Katie said, if they're of 'sound mind' and are legally able to make those informed decisions. If they're stoned or drunk, obviously they're not in full grasp of their faculties, and are not 'of sound mind'. In GA however, a female child MAY be considered 'emacipated' until she gives birth, then she's not 'emancipated' (if she's not got the legal documents to prove emancipation.) She IS however, allowed to make decisions regarding her child. Katie also raised another 'good point', and that is check with your local protocols and see whats said there. That will ultimately be your 'guide'.

What I think is odd, is the guy's lawyer says "He's not a cold blooded murderer, he treated them.", he IS a 'cold blooded murderer' because HE SHOT THEM! I don't care what axe he had to grind with the family members. He was asked to leave the gathering, and he did. He should have 'stayed gone', and not come back with a gun. Because he couldn't leave well enough alone, two people are in the hospital, and he's probably going to jail for a long time.... I can only hope that what he's losing was more than worth what he did.

I may be way off base here, but I'm thinking that there's more than just uterine contractions involved in child birth. (I cant say for sure, since I've never been pregnant!). Wouldn't these contractions cause adverse effects on the second child (the one that's not ready to be born yet), and would there be a second amniotic sac involved in a situation like this? (Refer to original post) So many questions....no answers yet....

We've all heard, and some of us have said "You can't get any more pregnant" to a pregnant woman. I know I have... Well, I came across an article that makes me want to reconsider that entire thought process: Woman gets pregnant — while pregnant Arkansas woman conceives two babies weeks apart, according to reports Arkansas couple Todd and Julia Grovenburg found out that they were having a baby and then discovered they were having two bundles of joy — but the babies aren't twins. An ultrasound revealed that a male fetus was conceived a full two-and-a-half weeks after the woman became pregnant with a baby girl, according to reports from local media. The Grovenburgs' obstetrician confirmed the case to Arkansas television station KFSM-TV. The pregnancy is believed to be a case of a rare condition known as superfetation, or conceiving while pregnant. The pregnancy may sound weird, but it is possible, according to NBC's Dr. Nancy Snyderman. "Here's how it happens — egg and sperm, implant. Of course, that's your first pregnancy. But if you ovulate more than one time a month — and women do — and a sperm happens to meet that egg and they, too, implant, guess what, you get a second fetus," Snyderman said during MSNBC's “Dr. Nancy” Thursday. "You just have to hope it happens within that early window." Due dates for the babies are the end of 2009 and early 2010, reports say. My bigggest question at this point would be; would the delivery of the first fetus endanger the condition of the second one? What would the chances be that the first delivery would cause a premature birth of the second fetus?

When I was working in Detroit, about the only time we saw the inside of our station was at the begining and the end of our shift (and the end of our shift was well past our 'go home' time).

After all the nonsense you posted in the thread "Responding with lights and siren", you post a story like that??? All you've REALLY done is reinforce our general consensus that you should never be behind the wheel of ANY motor vehicle, let alone an 'emergency vehicle'! Put the keys down, and step from the drivers side of the vehicle; and no one will get hurt!

Easy there tniuqs! I didn't realize that 'cowboy talk' would frighten you like that! I'll try to 'tone it down' in the future, so you're not having to hide under your desk!

Whoa, Nellie! I'm not even sure where to start with this one! I'm not sure just what 'neck of the woods' you live in, son; but here in the 'backwoods State of Georgia', we DO have protocols in place where it DOES matter if they're 'loopy', or 'living in a shit hole'! If the patient isn't in full control of their mental faculties, we DO have the right to 'transport against their will' based on implied consent. Our protocols are: PATIENT REFUSES TREATMENT We recognize that patient refusals represent a difficult, almost impossible, medical – legal paradox. An appropriate policy must allow refusal of treatment by obviously lucid and rational individuals. However, we must be vigilant for those individuals who are incapacitated by means of substance abuse (i.e., drugs, and/or alcohol), medical condition (i.e., hypoglycemia), or trauma (i.e., head injury). We recognize that, if a patient refuses and therefore is not given an appropriate screening evaluation/examination, it may be impossible to uncover incapacitation in seemingly “normal” appearing persons. This leaves open the possibility that a person needing treatment will refuse treatment. The purpose of this policy is to provide a baseline for the EMS agency and its evaluators that recognizes the delicate balance between individual’s rights and appropriate EMS response. Adult patients who are in full command of their mental faculties have the right to refuse treatment even when the refusal is imprudent by accepted medical standards. This only applies to patients who are mentally competent and capable of deciding for themselves. This is not the case with the patient who is neurologically depressed, mentally unstable (either chronically or acutely), or is gravely disabled, which means that he/she is unable to provide for the basic needs of life. In situations of a mentally competent adult refusal, the following steps should be taken: 1. Explain in comprehensible terms the need for treatment and the consequences to the patient of declining treatment, (i.e., you may die; you may never walk again, etc.). Explain to the patient what treatment is to be done per protocol (such as Oxygen, IV’s, and backboard, etc.). Also, explain to the patient what treatment may be done at the hospital such as x-rays, ECG, blood test and physician evaluation. 2. Sometimes other steps can help in getting a patient’s acceptance of treatment: A. Removing a patient from the public or embarrassing scene. B. Involving family members or friends as needed or requesting that the patient be allowed to respond to questions privately. 3. If the patient still declines care, meticulously document what you advised the patient (i.e., you may die, you may never walk again, etc.) and all indications of the patient’s alertness, full orientation and capacity to repeat back the explanation given. Have the patient do this in front of another person, preferably in the presence of a police officer or ambulance crew personnel and document the results of that request and the name of the person who witnessed the event of the refusal. 4. If the patient should deteriorate or lapse into unconsciousness, the pre-hospital provider may render any treatment deemed appropriate. Note: Whenever possible contact medical control for cases in which patient refuses treatment/transport. As far as 'keeping the sentimental compassion to yourself', what do you REALLY think we're in this 'business' for? Dwayne, I've got no clue what your protocols provide for in this situation; but from trying to apply your postion based on the above state protocols, I can't see where you've committed any 'sin', and have only acted in the best interest of your patient. Again, applying MY protocols to your situation, you appear to have been well within your 'boundaries' (at least as far as the State of Georgia is concerned) and I commend you on stepping up as a patient advocate!

Congratulations, Ruffles!! If you need pictures resized, send me an email, and I'll do them for you LS

My response is about half way down on the page marked 51-100.

Because of last year's 'birthday incident': Wwe've decided to put the entire county on alert! Happy Birthday, AK!!!

That's the kind of attitude that would have me considering which side of the clipboard to whack you with first!