Ridryder 911

Wow ! Who made you God? I did not realize blood was in that short of demand since everyone makes it every second of their lives.. I guess I could say that maybe we should start discussing younger people involved in trauma should not be worked upon. Since they are taking up "blood supplies" and as well hold higher non-insurable ratios, causing increasing hospital and medical rates. Same irrational madness... Yes, there should be considerations on whom receives organ's ... and this should involve criteria for the young as well. The junkie that screwed up their liver and heart with drugs and alcohol, etc... Should they get blood or organs as well? Again, there are times blood maybe in need of supply. As of yet, I have not heard any alarms and warnings that there is any major shortage. Summer is always the highest month with trauma, etc..

Well here we go again. All I can say is thank God, EMS providers are not responsible for the majority of medical education in U.S. If that was the case we would have Vo-Tech physicians and chiropractors would be working in trauma centers. Skills versus knowledge. Yet, again it is usually the those that do not really have a formal education to make such claims. All we need is a few more Jethro Bodine's out there...

According to American Burn Association, you are to only stop the "burning process", this does not mean to "flood or irrigate" to produce hypothermia. Sterile water, saline both or either can be used, even clean "tap water" if that is the only fluid possible to "stop the burning process". Saline usually feels "cold" to burn patients instead of "stinging". R/r 911

Not to be condescending, but I doubt this would be accurately answered on a EMS forum. I would suggest talking to her neurologist and PCP's on what measures they suggest. Since the hypothalamus is responsible for heat and temperature regulation control this would be geared more to their expert opinion. Coolants such as cooling pads (gel filled), or any other external devices that can provide externally cool environment. Good luck, R/r 911

I personally placed adhesive shelf paper or contact paper on the window, then use the punch.. the glass can be pulled out as a unit, or know it all into the door.. be sure there are no shrouds. R/r 911

I agree SSM sitting a truck for 12 hours sucks! Sorry, more and more studies are showing if you can get a nap in the better, the medic will be. The problem with posts is the constant rotation and movement, just to sit and then haul butt from where you came from. I personally like station houses. All the places I have worked at either had multiple crews or a main HQ, where everyone met and re-stocked or even had dinner (if possible) together. Twenty four shifts, is okay as long as you are not too busy. I much rather work ten/24 hours than four/12 hrs (usually split up) and never have a constant schedule. At least for now, I know what days I will be working five to ten years now! R/r 911

It all depends. Is it an isolated respiratory call? Does this patient have a cardiac history or other underlying possible other potential problems? I agree capnography is just as valuable. R/r 911

Contact Kaye Hollingsworth or Eddie Manley at OSDH, (405) 271-4027 after you discuss this with your instructor. Your instructor or school has to give information for the CAT (computer assisted testing) i.e course number (CAN #), verify passing, etc.. This should had been done after your completion of the skills test. R/r 911

It all depends, if some of those questions were heavy based type or an easier type. That is why, no one really knows until they receive their results. With that statement, yes- logically to assume if you went up to the number of questions required, one probably failed. R/r 911

Sorry, but to even think that family, child, etc is able to recognize potential risks during the event of the crisis is not even negotiable. As well, we teach during kinematics of trauma (per PHTLS, ITLS, ATLS, etc) to hold a child during impact is impossible. It would be hard press to defend one self, when 3 of our own national organizations, discuss this in the national education courses and teaches the hazards of such. Sorry parents, either need to be restrained in the front seat or my preferred method is per another vehicle (except epilgottits cases). Definitely, never in the arms of the parent or even the medic. I did a 2 year study on pediatric restraints or lack of, enough to write a Federal grant to purchase every EMS truck in my state a child restraint/carrier for the trucks. I was amazed on how EMS, Police, and FD were exempted, assuming they were safer... which we know they are not. R/r 911

As speedy described the test questions are not point based, rather they are weight based. Computer assisted test (CAT) use varying degree of hardness of questions per segment, not all test questions are based upon the same point system. There maybe some worth 5 points then others worth 1/2 point. That is why some can pass with 70 questions and some may pass with a 100 etc.... Usually weight based questions per CAT administers the hardest until you either get enough points right or you miss one. Then an easier level question is given, and so on. One can no longer "prep" for potential or exact questions, since the test bank has several thousand questions and they are randomly given. R/r 911

After ignoring and not reading latest posts here is a question. Q: What do you call an EMT that does not utilize straps, to secure patients to LSB, stretchers; as taught and recognized in the national curriculum? A: Defendant ... Period

Congrat's on your call. You mean codes actually become "saved"? Sorry, it has been so long since any of my arrests even had a squiggly line......I forgot. R/r 911

Wow! A pyxis for EMS. I agree, it is much cheaper to have that "bad back" EMT to re-stock or hey do it yourself! R/r 911

Personally, I hate Nancy Caroline's text (may she RIP) the Sydney Sinus makes me wonder about the role of medicine. As others will discuss a good basic background in science first will expand one's knowledge base and develop an understanding of medicine. R/r 911

I do understand that there is some problems, good press would help. Aleit, I believe in "glory hounds", but there is places that do not have EMS or is in terrible shape. Selfish, maybe but I believe EMS deserves a piece of the pie as well as anybody. I heard today Bush promising africa $4 Billlion dollars a year for treating AIDS patients. Yes, it is nice to help third world countries, but let's start charity at home. Four Billion (with a would definitely go a long way in EMS and developing education and loans to establish services. True, many other health care professionals do not have "public image", however; thinking about this, they are dependent upon the hospital (which probably has a full time image/PR consultant ) and not dependent on the individual communty opinion (be it taxes, private, etc). I do agree, we need to clean up our image. Maybe, a little positive image would give others a goal to be set. Hey, anything is better than what we have now! R/r 911

Let me know what hospital you work at & I will avoid it. Never seen a patient with a fever? Tympanic (not temporal) temps are considered inaccurate and worthless, especially in those that are febrile. All patients with possible sepsis, hyper/hypothermia should have baseline rectal core temps. They are called core temps for a reason. I suggest your ER and clinical manager do some investigation on core temps and policies. Emergency Nurses Association as well ACEP has some recommendations. There is some great literature and studies out there. R/r 911

I do understand you point. What I find ironic is that within the past 15 years our local medical school has yet filled their numbers, and the D.O. program has more applicants than the M.D choosing D.O. over M.D. programs. Maybe it is a local perception, but I know of many that has refused the M.D. and rather go into the D.O. program. As well it appears the perception has changed (at least in the Midwest) of the D.O. now the emergency residency is now directed by D.O.'s in my state. Most have completed dual residencies, this is totally different aspect than 20 years ago, when a D.O. was not allowed to work in the E.D. R/r 911

I don't think we need a publicity agent, nor an attorney to change things. We need EMT's that have a goal for EMS to be a profession. This means legislation, issuance of license, and requirements of having a formal education. (Hmm, have we heard this before? )Then after all of this occurs, we will see a positive image, because it will be there. Unfortunately, majority of EMT's are lazy in their professional development. They could care less, what goes on in the public, or for that goes in their own profession, as long as that last pay check clears. Most EMT's love to whine and complain, but very few take action to ever change things. It would not matter if we had the best attorney's available, they don't have much to work with. Don't believe me, just read or attempt to read posts on different EMS forums. It is shameful, and then when one points out the disgrace of poor thought pattern or writing skills, they are the ones criticized.... makes sense? Do you really want a film crew following most of the EMS out there? Uniforms that are thread worn, and shirt tails hanging out, but alas everyone usually will have a baseball cap on. Compare services out there do we really want the public to see such, maybe it is a good thing to be hidden until we clean up our own act. R/r 911

I wonder if your boss appreciates paying for the glucose strips on all those patients? They are not cheap and if you passing the costs onto the patient shame on you! That would be like placing an ECG on an isolated neck pain. Personally, I treat the patient as an individual. If they present symptoms as such as altered LOC, DKA, or have a history of DM then yes I will perform a FSBS. Personally, I prefer capillary stick since venous from IV caths have been found to be inaccurate (according to Nat'l Scientific Laboratories) to use in glucometers and why so many ER's use capillary samples. R/r 911

Not all patients require temp.'s taken but that those that do will get their temp taken rectally. As far as privacy, a well properly placed sheet and covering will surpass that requirement, not anymore demeaning than XII leads, and other exposures. Yes, I have taken rectal temps on geriatrics and pediatric patients, then again these are those that present a unique febrile symptoms. Usually, I will describe the patient as febrile. So not on all patients that require an temp., just like anything else.. usually there is never an always in EMS. R/r 911

Thus the problems of EMS. EMS is not considered a necessity rather a luxury. I know of many areas without EMS and then some only having a 1'st responder type system, but they will have LEO and F.D. again for safety and ISO ratings. Until we have an authoritative regulation requiring EMS and the components we will never progress, because there is no reason to do so. Without a regulatory watch dog such as JCAHO for hospitals, management will do what it can to get by and payers such as Medicare and Insurance Corporations will pay the nominal fee's understandably. R/r 911

All good points as well we are probably not going tot treat the fever as be concerned as much as the etiology of why they have the fever. At a BLS level provide a light sheet and obtaining an accurate history as much as possible would my best suggestion. R/r 911

Kinda hard to get "informed" consent when patients are critically ill. Without such research, emergency medicine would never progress. R/r 911

Obviously, you have never seen many right sided AMI's! So you much rather compromise or potentialy increase the AMI size in lieu of waiting thirty seconds obtaining a XII lead prior to NTG? As an educated Paramedic, one should be able to determine if right side involvement, and then the decision to withold or administer NTG is indicated. Why chance increasing the AMI size, workload for the additional thirty seconds to make such interpertation. R/r 911