Ridryder 911

Sorry, it was on some investigative news report dealing with the surge of "teachers and teenage boys". What the description was that the current upsurge of women being investigated, charged and convicted. Once only thought more a male dominated crime. They proposed many of the crimes goes unreported because of the misconception of being a male fantasy for an older woman, younger male situation. I believe it was either on MSNBC or Frontline? I was even surprised the number of convicted females even in my conservative area. I would like to see the conviction and penalty versus male counterparts ratio. R/r 911

I checked a few months ago, and was shocked to find out my neighbor was one (fortunately, I live in the country). What is even more surprising is there is so many women now being found out to be as guilty of this horrible crime. Albeit, they are not prosecuted and convicted in the same manner and outcomes as their counterparts. The results are the same in the long term effects. R/r 911

I have seen a few aortic tears secondary from trauma, one was unique enough that when we laid him down he immediately went out, by instinct we immediately raised him up and was able to tamponade it off enough to say good bye to his spouse... I have yet seen one live. AAA used to have a high percent of mortality as well, but with recent improved surgical repairs the survival rates are increasing. In regards to MAST, I definitely would not use. Even though the tamponade theory might seem applausal, we used to use them for such and again, never seen a survivor. Raising the blood pressure or increasing pressure on the aneurysm itself by pushing on it I would suggest be detrimental. Like another post described, lowering stress and the blood pressure is the key, as well as immediate evaluation and surgical repair. R/r 911

As Ruff described, you need to check local and state laws. As well, be sure they have a specific job description written at your level on what is allowed at your certification and license level. This will also help clarify things up to others as well. R/r 911

Aww Doc it appears he has a B.S. degree from Google, or he has to go run to his partner on how to answer. Say a prayer for his crew and especially for his patient's sake....The same reason he keeps flip flopping is because he does not understand simplistic cardiac physiology or cardiac care more than what is on a ACLS card. Thus the reason of avoidance of credentials as well. This is would be quite humorous, but I am afraid ths person is serious. Here F/f 523 this book might assist you : [web:b9d642b0b2]http://www.amazon.com/Cardiology-Explained-Remedica/dp/1901346226[/web:b9d642b0b2]

Yeah, just give me the lights and sirens and get the hell out of my way...no need in that fancy medicine stuff!... Gettrrr done .. yooo weeee! and just to think why we are still called ambulance drivers? R/r 911

Here I'll sum it up.. wannabe! Period. As ERdoc discussed, those with clinical knowledge realizes there was more tan one correct way to treat this scenario all dependent on the patient clinical findings at the time. Those that have any experience and know more than the typical watered down ACLS realizes this. This is why the more experience providers avoided this thread. R/r 911

I have never seen Nitrendipine used in ED, I agree the best resource appears to be Valium to relax, many will produce into a coronary spasm AMI R/r 911

AAS- Paramedic ADN- Nursing B.S. - Science BSN- Nursing MSN- currently in pursuit of nurse practitioner R/r 911

Does this not answer your question on how long they have been in the field ? How many season medics refer to mnemonics ? They are a good training device for a test and I guess those that need a mnemonic device to refer to remember steps. I do smell this thread being locked soon though... R/r 911

Thus is the circle of problems, thank God nursing had enough foresight and professionals on knowing to demand education thus increasing demand and then requiring payment source to increase salaries to meet demands. Whenever we (EMS) quit having excuses on not obtaining a real education and thus not allowing administrators and payers of not having the obligation of paying services and salaries. Compare this with other medical professions such as physical therapist, nursing, etc.. Why is it such a drastic event for those that want to really become a Paramedic to do like any other medical profession and obtain a student loan, work part time, or whatever it takes to go to college? Sorry, don't want to hear excuses.. just like any other profession every body else had to. AAS- EMS ADN-Nursing B.S.- Science and BSN- Nursing pursing - Masters.. R/r 911

Debated this issue from another EMS forum, the problem is as discussed no one usually has a USB port, as well even in ER and field EMS most prohibit any insertion or reading from another drive. In my hospital we have plenty of PC, but again the worry of viruses and hacking, there is a strict policy of placing any non-regulated device into any computer of the hospital. Far as "if they lost their wallet" scenario, I never check ID in the field for a medic alert, etc.. If they want me to know about their PMHX they better have a bracelet or necklace on. I will open wallets in ER when witnessed and able to place to security and sign etc.. real life, I have yet seen anyone examine for a medic alert info from a wallet or purse. It would be much easier to invent a web site with their information on it. For example, have the ID attached to the license with an ID number to validate it and only be licensed to an approved EMS and hospital provider. With approval, attachments of recent HX., copies of ECG etc.. could be done....Hmm maybe I should get a patent :wink: R/r 911

The only reason for stating such is because over the years of experience, (beginning when you were in diapers) is I have seen many of your type come and go (mainly go). As an educated person, I will not attempt to debate cardio pathophysiology with you or medical ethics and legal implications, as demonstrated from your posts you are not able to comprehend or digest such statements. This is part of the problems of EMS and prime example of some our products produced by our current "training" methods and not being able to comprehend basic medicine and the diversity associated with it. We have attempted to understand your implications from your posts and even agreed within special circumstances for allowance, however; those with apparent higher credentials, education and yes... even far more clinical experience was attempting to illustrate in basic terms to you is implications of care is not always black and white, and as well there are areas ...(gasp!) that might not be covered in the text you studied from, that might not have covered in depth and as well as should had been covered. This is the reason for forums is to attempt broaden education and mind sets that might be thought previously as gospel. The debate of something over something this simple is ridiculous and if EMS really produced in depth practitioners, eight pages of debate would never had occurred. R/r 911

I guess beauty is in the beholder.. however, you did post it in the right category... "funny stuff"... EMS has an occupational fatality rate of 9.6 per 100,000 workers per year in deaths, compared with 6.3 for police and 4.5 for firefighters... hmm which is braver ? R/r 911

Try google etc.. under pics and you might find non-copyright material.. or www.traum.org Good luck ! R/r 911

Both can be used in either, the difference is in RSI one uses a paralytic agent, after the sedative agent. Pharmacologically induced is used without the paralytics and part of the problem is laryngospasms, as well the ability to arouse and have movements. R/r 911

I suggest you read what is called " patient rights statement" as well take some cardiology courses. Patient rights describes that you are legally bound to offer the choice and option. Yes, emergency conditions may indicate to take action on the best behalf of the patient when the patient is unable to make such decisions. As ER doc described, there was no indication not to inform the patient. Actions like those help keep my second income as an expert witness profitable. Second, I don't hope.. I much rather have educational knowledge of outcomes. A-fib with RVR is seldom needed for cardioversion.. Yes, I see and deal with it much more than those than usually in the field.. before you describe "stable environment" B.S., I work in the field full time as well for the past 30 years. Look at the whole forest not the tree.... R/r 911

We do not hire anyone less than age 23 due to insurance reasons. R/r 911

I believe the current CEU system is a farce, and should be eliminated. Yes, we are one of the few health services that require CEU's for license or certification and see what the results are? Obviously, the system we have is not working. So increasing CEU's is not the answer. Even though nurses 'technically" are not required to have CEU's for relicensure, JCAHO, Magnet Status, Medicare, etc.. requires about the same number or maybe even more in-house CEU's than the usual EMT or Paramedic CEU requirements. Maybe CEU's that meet educational standards and that are only presented by a true educational facility or sanctioned by one, would have more credibility and legitimacy. Most refreshers and CEU's are a joke, and anyone in EMS can attest many are written off due to repeat mundane "read the slide" lectures. Even worse, the new ACLS and other associated courses have become so watered down, one cannot lead credibility to those courses anymore as well. If we did require formal education at least the associate degree level, then maybe we can install a basic general education and professionalism with the understanding of the need of on-going education and professional development. Yes, I would love to see a baccalaureate degree be required, however; I much rather be realistic and have at least some formal education than none at all. R/r 911

F.Y.I. ... Thom Dick is not his real name, rather his pseudonym he uses for writing, albeit for many years in EMS rags... R/r 911

I feel faint, but I have to agree with V.S. EH on this one!.. gasp.. !.. But, I feel there is more than to just having to have an associate degree or two years of Paramedic education. In reality, two years is the most any receive in the Paramedic curriculum, albeit 4 yr 2 yr etc.. The current scope really does not need much more than this.... but the main point in differential is the education backing up and along with the general sciences that make the Paramedic curriculum more relevant and can be taught more in-depth. I know many assume a 9 month program is the same as a two year program, but let's compare at a teaching angle. In the general paramedic class an instructor would have to spend an hour on A & P , then assessment, then treatment, then lab/simulation. Now, let's review a collegiate level A & P review 15 minutes, assessment review, treatment, lab/simulation. The additional half hour to hour could be spending time on practicing, more in depth discussion and possibly advance treatment. Additional studies could be assigned to students that have a higher level of reading and comprehension. Such studies as in detail physiology, additional studies in emergency medicine so a higher level of knowledge can be obtained. Anyone can not dispute a more in-depth course, better prepared students both academically and clinically is not better for patient care. R/r 911

Okay, I can say I have seen it all... I bet there will be someone actually buy these!..Maybe playing the theme song of... "Mother, Jugs & Speed"...as they exit. [web:1fa42984f0]http://cgi.ebay.com/EMT-EMERGENCY-MEDICAL-TECHNICIAN-WEDDING-CAKE-TOPPER_W0QQitemZ280083060697QQihZ018QQcategoryZ20935QQrdZ1QQcmdZViewItem[/web:1fa42984f0]

Couple of things comes into mind. Wow! Talk about unprofessionalism. If you had been on my EMS unit, I would have requested immediate termination due to unprofessional conduct. Now, I know why most nurses call us ambulance drivers.. Remember, that CNA might be a RN someday and one wonders why she/he will have such an arrogant attitude towards EMT's. What goes around comes around.... Now, after we can stop beating our chest and screaming how great we are, we should start consider the "whole picture". Typical Randy Rescuers assume that "they" can only provide and know what is best. In my thirty years in the field, I rarely accept interference with care or allow much help, however; I NEVER embarrass or degrade anyone! If it is nothing more than to hold an unattached IV bag or an end of a rope (not attached to anything) I will always appreciate and thank them (even if they did nothing). I even thank Basic EMT's for the care and help (even though majority of the time, they do nothing but get in my way). I have found it is much easier to attract flies with honey than with vinegar. Customer service goes much farther than just with the immediate patient, remember many others are watching your demeanor, behavior and how you handle people. Remember, you control the scene, not let the scene control you. By acting as an arse, you have demonstrated you lack the ability to perform or have the knowledge to do so. I have had many confrontations by multiple levels, and even had one arrested but I did so in a professional and non-demeaning way. Usually by ignoring them they will get the hint.. (ever seen this in an ER to EMS crew?) Another point is one better have a license to practice medicine on their own or to be placed in a "never off duty" protocols by their licensed physician, if they establish any ALS care before I arrive. In the U.S. it is prohibited by Federal Law to carry IV solutions, ET tubes, etc.. without a physicians authorization (prescription) ... read the IV bag, if you don't believe me. Remember we represent more than ourselves on calls and how we handle the scenario may be what our whole profession is judged upon. R/r 911

I have used nebulized medications of various types for years. It is just another route. The effectiveness is so variable though.. all dependent on the ability to cross the membrane and circulation. Personally, I like nebulized steroids (such as Decadron) etc.. for those with stridor, inflammatory upper airway problems. It appears to work effective, the same way as some opioid med.'s such s Morphine etc.. I have used Lasix in neb form , but found the time of absorption was to be prolonged as it appeared to take more time to cross the membrane. R/r 911