Lone Star

The reason I post the whole thing instead of giving a link, is because with MSN, the news is changing and links don't stay 'good' for very long'. Since this isn't something that's only being debated for a preset time period, why limit the time period to the information? Do you hang them upside down first, or am I the only one that does that? ROFLMAO

Well, I've found another topic for debate here folks! I know that people are begining to really hate when I read the news, but oh well! This was found on today's MSN news section. I'd be interested to find out what the general consensus is on this matter! Debate on lower drinking age bubbling up Proponents say current restriction drives teen alcohol use underground By Alex Johnson Reporter, MSNBC Updated: 7:41 p.m. ET Aug 14, 2007 Over the strong objection of federal safety officials, a quiet movement to lower the legal drinking age to 18 is taking root as advocates argue that teenagers who are allowed to vote and fight for their country should also be able to enjoy a beer or two. The proposal, which is the subject of a national petition drive by the National Youth Rights Association, has been studied in a handful of states in recent years, including Florida, Wisconsin, Vermont and Missouri, where supporters are pushing a ballot initiative. Opponents of the idea point to a reported rise in binge drinking as teenagers increasingly turn to hard liquor as proof that minors should not be allowed to drink, but proponents look at the same data and draw the opposite conclusion. “Raising the drinking age to 21 was passed with the very best of intentions, but it’s had the very worst of outcomes,” said David J. Hanson, an alcohol policy expert at the State University of New York-Potsdam. “Just like during national Prohibition, the law has pushed and forced underage drinking and youthful drinking underground, where we have no control over it.” But Mark Rosenker, chairman of the National Transportation Safety Board, countered: “Why would we repeal or weaken laws that save lives? It doesn’t make sense.” Different laws in different states As it happens, there is no such thing as a “federal legal drinking age.” Many states do not expressly prohibit minors from drinking alcohol, although most of those do set certain conditions, such as its use in a religious ceremony or in the presence of a parent or other guardian. The phrase refers instead to a patchwork of state laws adopted in the mid-1980s under pressure from Congress, which threatened in 1984 to withhold 10 percent of federal highway funds from states that did not prohibit selling alcohol to those under the age of 21. By 1988, 49 states had complied; after years of court fights, Louisiana joined the crowd in 1995. Libertarian groups and some conservative economic foundations, seeing the age limits as having been extorted by Washington, have long championed lowering the drinking age. But in recent years, many academics and non-partisan policy groups have joined their cause for a different reason: The age restriction does not work, they say. Drinking has gone on behind closed doors and underground, where responsible adults cannot keep an eye on it. “It does not reduce drinking. It has simply put young adults at greater risk,” said John M. McCardell, former president of Middlebury College in Vermont, who this year set up a non-profit organization called Choose Responsibility to push for a lower drinking age. McCardell offers what he calls a simple challenge: “The law was changed in 1984, and the law had a very specific purpose, and that was to prohibit drinking among those under the age of 21,” he said. “The only way to measure the success of that law is to ask ourselves whether, 23 years later, those under 21 are not drinking.” So are they? The federal government’s National Survey on Drug Use and Health found that in 2005, the most recent year for which complete figures are available, 85 percent of 20-year-old Americans reported that they had used alcohol. Two out of five said they had binged — that is, consumed five or more drinks at one time — within the previous month. “The evidence is very clear,” McCardell said. “It has had no effect.” James C. Fell, a former federal highway safety administrator who is a senior researcher on alcohol policy with the Pacific Institute for Research and Evaluation, acknowledged that “it’s not a perfect law. It doesn’t totally prevent underage drinking.” But Fell said the age restriction “does save lives. We have the evidence.” Lower death rates disputed The evidence, widely touted by Rosenker of the NTSB, Mothers Against Drunk Driving and other activist groups, rests in a study by the National Highway Traffic Safety Administration, or NHTSA, which estimated that from 1975 to 2003, higher drinking ages saved 22,798 lives on America’s roadways. “Twenty-five thousand lives is a lot of people to set aside when you’re looking at a current problem,” said Brian Demers, a 20-year-old student at the Massachusetts Institute of Technology who is a member of MADD’s board of directors. That figure is disputed by proponents of lowering the drinking age. They have questioned the NHTSA study, which did not explain how it arrived at its estimate. Moreover, it counted any accident as “alcohol-related” if any participant was legally drunk — including victims who may not have been responsible for the accident. “The methodology used has been widely criticized by scholars,” said Hanson, of SUNY-Potsdam, who called the report “really more of a guesstimate” that showed only a correlation of numbers, not a causal relationship. In fact, he said, alcohol-related traffic fatalities among minor drivers were already declining before 1984, when the drinking-age measure was passed. Barrett Seaman, author of “Binge: What Your College Student Won’t Tell You,” echoed Hanson’s assessment, saying, “Those statistics are a little suspicious.” Even so, Rosenker said Tuesday, alcohol is still the leading cause of death among teenagers in highway crashes. “The data show that when teens drink and drive they are highly unlikely to use seat belts,” he said. “These are the facts, and it would be a serious mistake and a national tragedy to weaken existing drinking age laws.” Adults ‘written out of the equation’ To McCardell, however, the real problem is that we are not teaching teenagers how to drink responsibly. Choose Responsibility proposes lowering the drinking age to 18, but only in conjunction with “drinking licenses,” similar to driver’s licenses, mandating alcohol education for those ages 18 to 21. “Education works,” McCardell said, but “it’s never been tried. Now it’s mandatory only after you’ve been convicted of DUI. That is not an act of genius.” Choose Responsibility and its allies face a tough task convincing the public. In a Gallup poll released last week, 77 percent of Americans opposed lowering the drinking age to 18. But Seaman argued that it was the wisdom of the drinker that mattered, not his or her age. “The problem we have is that since the 21-year-old age limit has been in effect, we have effectively written adults out of the equation, so that they really have nothing to do with young people who are drinking alcohol furtively, viewing alcohol as a forbidden fruit and drinking to excesses that I don’t think were evident back in the years before the law was passed,” said Seaman, who lived on the campuses of 12 U.S. and Canadian colleges while researching his book. “If you lower that drinking age — make drinking no longer a forbidden fruit but rather something that younger adults do with older adults who have learned how to handle alcohol responsibly — then you reduce those behaviors rather than increase them,” he said.

In Michigan (snow country) the motor vehicle code specifies: ...at least one rotating, flashing or oscillating light visible 360° at a distance of 500 feet under normal atmospheric conditions. The use of blue lights as 'emergency warning lights' are restricted to Law Enforcement only. The Fire Department may use any combination of red, white, green and amber lights, as long as they conform to the requirements stated above. The motor vehicle code goes further to state that the privately owned vehicles driven by Fire, EMS, and Law Enforcement (if used to respond from home to the station, or directly to the scene) are considered emergency response vehicles from the moment the tones are sounded, to the point in time that they return to their point of origin (usually considered 'home') while taking the shortest and most direct route. (No stopping at the local Wal-Mart on the way home from a call.) While Michigan allows the use of amber lights as warning lights, I've never had them in any lightbar that was on emergency vehicles. I have however, had emergency vehicles (both Fire trucks and ambulances) use a white oscillating light for traffic clearance. I was told there was a study done that shows the 'unusual pattern of movement' by the oscillating light caught the driver's attention faster than just using the flashers and lightbars alone.

Hey, I didn't design the bed, nor can I (a mere Basic) tell the paragods how to best do their jobs! I can only react to what the situation gives me to work with!

Ok, let's go back and read this as it was written. I used the multi-tool to remove the headboard of the bed that the patient was laying in. Nowhere was it stated that the multi-tool was used in the insertion of the ETT. The medic that benefitted from my having a 'tool' to deal with the situation followed all proper protocols. I just love having to spoon feed information to those that just can't seem to follow along!

It's not just the 'new people' that are getting offended by these types of comments. It's any EMT-B, Firefighter or combination of the two (like myself). It's no secret that I've worked EMS in metro Detroit (I'm rather proud of that fact). I too started carrying a 'batbelt' (it makes it easy to ditch all the equipment I've found I needed in day to day environment). I've actually used a 'multi-tool' to remove a headboard at a ECF, to help a MEDIC drop an ETT, because he couldnt get a good line of sight otherwise. Glove pouches for carrying more than one pair work well at multiple injury calls (again, talking about Detroit, go figure). And yes, I've even had call to use a window punch on an extrication call. Just because you work in an area that doesn't require that you carry more than your pen and a penlight, it's not cool to go around bashing those of us that actually have to do something! Obviously if you feel the need to bash those that haven't advanced to your 'level' (for what ever reason), then you've forgotten that you started at the bottom of the 'food chain' as well. As for bashing those that do a job that you either can't do or don't understand, only shows how small minded you truely are!

No, acceptance is the first step in the healing process. :coffee: :D/ =D> :laughing3: :coffee:

I'm sorry, I hate to be the one that breaks the bad news......at the C/A (Caffiene Anonymous, they only serve Kool-Aid. To get the 'good stuff', you have to start hanging out at the A/A meetings!

uh hi, my name is Lone Star....and *heavy sigh* I'm a caffiene addict.

Since you're not allowed to split crews (which would in effect give you two ALS trucks). The only problem is that how can a Paramedic (even if they're only working at BLS level) pass off a pt to a BLS crew? It's stated in my state protocols that patient care can only be transferred to someone of EQUAL OR HIGHER licensure. I notice that the parameters that govern the transfer of patient care do not specify or make allowances/exceptions for the level of care given at the time of transfer.

I agree Richard. While most companies/counties/states have an established set of protocols for their area, it's clearly going to be different from location to location. That being said, most protocols are written by the 'forward thinking' of the Medical Control, there are some areas (primarilly rural) that do not use such 'forward thinking' and cannot fathom such events occurring. Thus, most of the changes to medical protocols becomes a 'reactionary' move as opposed to a 'pre-emptive' one. These protocols are set forth for each area, in accordance to what the medical directors feel will best serve that area. What works in suburban St. Louis won't necessarilly apply as well in metro Detroit, or the backwoods of Kingman, IN. If we each take the time to learn our own local protocols, and follow them to the best of our abilities, (whether we agree with them or not), there should be no 'fallout' from our actions. Moral obligations and legal obligations will more often than not be in direct conflict. It is our responsibility as health care providers (regardless of level of licensure), to weigh the consequences of each, and try to decide what is best for the patient, while balancing this with the legal parameters that we have to work within. At best, we can only follow the established scope of practice and the local protocols that have been handed down from Med Control, and give the patient the best care that we can! Be safe....

It COULD be worse....just look at the name I got saddled with: [align=center:467f7b2c2b]Cap'n Carl Firecrotch[/align:467f7b2c2b] See? Life aint all that bad! Guess I should have watched how much fun I had in port!

If company policies and procedures don't cover this, then check your local protocols - set forth by the county medical control. They trump company policy any day of the week! If you don't get an answer there, then check your States protocols. If you STILL can't find a definative answer, then start asking questions at the local Medical Command level, then State. Someone somewhere has set forth a book of 'rules' that govern how you operate as an EMT in that state. If there is no protocols listed anywhere in the state, then its nothing but chaos, and lawsuits just BEGGING to be filed!

Don't know what its like to operate in urban EMS? I'm thinking you just put your foot in your mouth on this one! I for one have worked in the metro Detroit area for several years. That's about as 'urban EMS' as you can get! Granted, its not NYC, or DC...but it definately isnt Mayberry RFD either! Until you know all the facts, might be a good idea to refrain from making inane statements like that....unless you like the taste of shoe leather.....your call. Ultimately nc, it comes down to one fairly important word...PROTOCOL. If your protocol says that you're 'out of service' when you're transporting a pt (regardless of the 'severity' of the pt's condition)....then you have no business stopping! The protocols were put in place for more reasons than to just 'inconvenience' you! Your feelings are not a 'factor' on whether you follow them or not. Protocols were not adopted because you think they make sense or not..... The protocols were put there to establish an educated continuum of care, whether you agree with it or not.....whether you like it or not! Violations of protocol will result in disciplinary action up to and including loss of licensure and possible criminal charges. Secondly, since you don't know the etiology of the febrile seizures, it's not prudent to dismiss them as a 'minor problem'!

The problem I see here Ruff, is that as soon as you make pt contact, (ie ask the pt if they're hurt or need assisstance) you can't leave that pt, until another unit shows up (staffed by equal or higher licensure crew members). Meanwhile, your currrent pt on board gets medical care delayed. You cannot absolutely guarantee that the sz pt in the back of your rig is stable and the pts condition will not deteriorate. I realize that my protocols are different that alot of others out here, but in each post I've identified the protocols that I'm using. Since these are the only protocols I know, I can't see any way that anyone can convince me that stopping is a good idea.

"...how much they 'emerged"? Abandonment is measured in degrees of separation now? In my area, there's no 'justification' for abandonment, no 'free pass' In the article, it was stated that the driver had the attending stay back...which means they were in the process of abandoning the pt. In for a penny, in for a pound. Let's be realistic here if you robbed a bank, it wouldn't matter if you only took one dollar, or you took 500 million dollars; either way you're a bank robbing thief and you're going to jail! If you cease medical treatments without ensuring your patient is in the care of someone of equal or higher licensure, and prepare to leave the pt alone...you are committing abandonment. It doesn't provide that you only get a slap on the wrist if you have one foot out of the room, a kick in the shin if you have one entire leg out of the room......on up to the point that you get a 'time out for leaving the room by 5 feet, and a broken leg for leaving the room by 20 feet. It just doesnt work that way.

Ultimately, if the driver hadn't stopped (because his crew had a pt on board), he would have never gotten a gun stuck in his face, needed to retreat, needed to evacuate the ambulance....you get the point..... Irregardless of how 'bad the accident looked', your crew can only treat so many patients at one time. Thats why any company that's considered any amount of 'successful' has multiple ambulances and crews to man them. I'm sure that FDNY/EMS is no exception. To me, this screams of what I like to call the 'Johnny and Roy syndrome'; In law enforcement you have 'The Blue Knight Syndrome' (or for those of us old enough to remember, 'Bumper Morgan Complex'). In the fire service, we've all seen the 'Backdraft Complex' in full swing. From the article, it seems that the prudent thing to have done, would have been to continue on with your patient, and notify dispatch, so that another unit could be sent. It's been said in an earlier post that because of the pt on board, NY DOH rules specifficlally states that he wasn't supposed to stop. Now you can see why Im seeing the 'whacker meter' go off. This was clearly another case of the 'Johnny and Roy Syndrome' in full manifestation!

I'm thinking the 'whacker meter' is off the scale on this one!

there was enough of the 'story' to elicit the appropriate response. Until you started throwing the 'what ifs' in there!

Well said! The point that you're transporting a pt already, disqualifies you in 'rotation' for taking calls! Marconi came up with a really good invention, called the RADIO, use it!

Talk about 'overcomplicating the issue'! There are so many 'what ifs' in there that its not even the same situation at all! What if the gunman only killed the driver who stopped when he clearly had no reason to? What if the gunmans bullet actually went through the rig and hit the pt or the pts family member? Lets stick to the story as presented, and give feedback accordingly. Don't read into the scenario!

BRAVO!

Well stated, Dust! I don't think I could add anything to it, without becoming redundant, so I'll just agree with your assessment of the situation and go from there.

Based on Michigan protocols as they've been explained to me, I have several problems with this entire scenario: 1). They were transporting a pt (pediatric sz pt. 2). The attending EMT was getting out to help check for injuries. This would have left the pediatric pt alone, thereby constituting abandonment. 3). By virtue of the driver stopping, and knowing there was already a serious pt on board, he placed himself, his partner, the pt and the pts family in extreme danger. For this he should be fired on the spot (in my opinion) It was an unnecessary risk that should have NEVER been taken! Per Michigan protocols, if you're enroute to a nonemergent call, and you roll up on an accident, as long as there is no pt on board, you have a duty to stop and check for injuries. If you're flagged down by law enforcement, then you obviously have a duty to stop and treat the pt on scene. In the first stituation (enroute to a call), you would immediately notify dispatch, so that they can dispatch another unit to cover your original call. Once you have a pt on board, it doesn't matter if it's the president of the United States involved in that accident, you DON'T stop! If you're flagged down by law enforcement with a pt on board, you explain the situation to the flagging officer and offer to have a unit dispatched to their location, while you continue on to the recieving facility with your pt.

Happy Birthday T2! If you're worried about wrinkles, eat chocolate until you fluff out and the wrinkles will be 'filled out' and your skin will be smooth!