Ridryder 911

Like Dust described, most of the time coordination will come; but, if if does not I would confront him and discuss it with him after an incident. Be firm, not argumentative. Inform him, WE almost .. dropped, or ran into the wall... etc.. Remind him, that it's a "we" thing, and you don't plan on getting hurt, hurting the patient, and plan on getting our act together. Enough is enough... Hopefully, this will awake him enough to remove his cephalic region.... R/r 911

I used the sternal F.A.S.T. for several years. It was an okay device, but I prefer the EZ I/O .. Actually, there is only one needle that is displaced, but a "bed of nails" 16 that encircles initially for delivery of needle. As well a mini tool is required to remove the needle from the sternum... R/r 911

That was good.... I bet he even laughed about it...! R/r 911

Heard nothing but praises about them... the only "bad" things I have heard is the abuse ind over use of them by Paramedics and of course the costs of them... R/r 911

I suggest taking either another pathophysiology, pharmacology class or maybe a writing class... This time quit "Googling" your answers after you get caught. ... Write what you mean then there would be NO confusion. By the way, my initial statement was not addressed about you. it was about a student that made that same asinine statement As I recall a physician that overheard him stated." What a dufass!"...point delivered. Dead myocardium cells cannot receive interpretation or impulses so their would be no receptor signals to be "numb"... You have nothing to prove here, we are all practitioners... so hostility, does not impress many of us and definitely does not display tact, education, and experience of being in the people business. R/r 911

:oops: ... Oops!!....Sorry!!!! With that dazzling smile, didn't even notice the cross... R/r 911

Actually most of the drug and urine samples products that will produce "negative" results are bogus. If the urine test is specific and if the laboratory is up to most of the national levels for being reputable, will detect all the B.S. to neutralize etc.. as well levels are caught way after a couple of weeks and as well detect second versus from sole service. Court mandated tests are very specific.. R/r 911

Ditto... Could care less, if I ever seen their symbol again. They told me that you have to be a RN associated with them that requires a BSN, to be a Red Cross Nurse. R/r 911

Actually, alcohol can be tested as well. It is all considered "substance abuse".. sorry, what you do on your day off is your business, but unfortunately not everybody stops before ahead of time, or allows it to get out of their system. Hence.. that is why there is documented mistakes, accidents, etc. on the work force r/t substance abuse. Many do not have random tests, because then they have to offer rehab. Most employers prefer to "witness" suspicious behavior, and request test. If a positive result returns then usually an automatic dismissal and then a possible hearing of license and certification in most states. R/r 911

Ever had a patient with the cuffs on behind them on a cot?.... nope it doesn't work .. Why he was in the ambulance was probably covering the Police arsess.... and pysch patient. Cuff each extremity the rail... and no Police rides with a weapon. I rather not get shot on the way, thank you!.... Taze them once and leave the barbs in... if they act up.. zappa a doo... dah! R/r 911

Well first you have to contradicting saying..... "You have no concerns as you have known him for years. But, you always have lingering doubts"..... If you really know him, then you either would have doubts or not... 1. I would NOT give a "heads up" If I really valued and like my new job...sorry, business is business, friends are friends. At the time he is an employee 2. Buddy or not ... He is RESPONSIBLE for his own action, if you did just so happen to warn him, then he should report himself and get help to save his job. This should be discussed in any company as a policy if they are to perform "random test". Remember your not his mother!! 3. As a true friend, he would not put you in the compromise situation as well to have to deal with this. Again, you are friends and did not "make him" do anything. Sorry, offer help to counseling, etc.. but, if it ends the friendship so be it.. then he is not a true friend to YOU! AK sounds like your are in an ethics class.... this is not a teleological but more a deontological theory... R/r 911

I think you are over rating your clinical preceptor. Most are not there to 'crucify" you and unfortunately could care less if you the sodium pump action versus calcium channel blocker potential functions. Be confident, not cocky, do procedures that are normal, ask to be watched and ask if permission to do something new to be observed. The time to screw up is on the clinicals not when you are by your self... they will not let you harm or kill anyone, it is their but as much yours. If they "drill" you, thank them and tell them you will seek the answers (bring essential books) and return to them..... if you can't find it, be honest and tell them. They only ask it probably because the were "burned" themselves one time on the same thing.... so goes the tradition. Chill out, be confident, keep ears, eyes, open pay attention.. be nice, but not to clingy or sucking up... Good luck let us know how it goes..... R/r 911

Piss of the medic.. you will be replaced, remember Basics are dime a dozen... they will even volunteer for your job for free. In 2-8 weeks there is a new crop..... Remember the medic is the one making the revenue... R/r 911

Congrat's and dittos to Dust's advice. Now, as in ER you will also see the "other" side of EMS and what some of the dilemma is as well. Now, you can really explore medicine and as Dust's describes all of it can be a learning experience.. good & bad.. but, you will find we are only the tip of the iceberg in medicine... Good luck ! R/r 911

You know I initally laughed, until I remembered a Paramedic student, I quizzed over Lidocaine who actually thought that Lidocaine actually did that !!!! R/r 911

Actually, I was informed it was higher than one would believe. Dr. Shea a neurosurgeon/trauma physician that was very pro-EMS and I believe was Chicago EMS Director for several years used to demonstrate this on cadavers. His statements was many of them were never published due legality/liability admitted and many was settled and not many wanted to publish such findings. Describing that trauma to facial/head was a direct contraindication of nasal intubation even from the ATLS course. It does make sense pushing a tube past the posterior pharynx, is sometimes difficult. I personally, would not perform it on trauma, rather use alternative measures or retrograde intubation or crich them. Anticoagulant therapy patients is definitely a concern, an even on non-trauma patients one can soon find out they are on Coumadin after attempting to place a NG or ETT in. But, in the case of trauma, chances are they will be already bleeding. R/r 911

I smell hungry attorneys that are scraping anything to settle out for... Although, I agree, why couldn't they temporary stock?...But if the truck was "designated" as a BLS, then it is a BLS truck.. period. It all comes down to policies, and level of care preformed. One cannot be prepared for everything and as long as care within the scope for that unit was given.. and ALS was either summoned or called for/ transferred to etc.. then no damage was done. R/r 911

Part of the other problem more so than Brady and ICP is actually penetrating through the cribiform palate, and entering the brain stem on patients that have trauma induced head injury. One cannot for certain detect a small La Forte fracture, or any fracture that may involve the ethmoid, sphenoid. It does not take much pressure to penetrate the palate. There are well documented radiology pics showing both pre-hospital and in hospital intubation of the brainstem.. the same reason a NG tube is placed as a OG and goes orally. Yes, nasal intubation is a routine procedure... I perform it routinely on non-traumatic patients or patients that have a respiratory drive present and does not to be RSI. R/r 911

I take the money from the drugs, that AK posted ... and buy her a new bauble... hey..1 wrong, 1 right. = out. Of course I would tell... fill out a I/R and report it.. character counts... R/r 911

Oh yes!!!... :oops: R/r 911

Atta..boy ! R/r 911

Okay... I have bit my lip long enough. I have worked with trained and re-trained more medics that was military and was applying traction splints when you were still in diapers and sucking down formula... so I am not impressed with your "12 years experience". As well, I cut my teeth with special force medics from the Vietnam era, and work with those from Desert Storm, Iraq etc.., so yes, I have a special place in my heart and respect for those that performed those actions. The first thing they taught me was never to have a pompous attitude. The other was they never liked one with a G.I. Joe attitude and blasting and disrespecting others. In fact they have always presented a respectful attitude, another thing I honored about them. As well "those college boys" that you appear to despise so badly, are the ones that tells you exactly what to do and how to perform care in EMS and in the military as well. Maybe, this is the source of your apparent anger issue. If you did read the corresponding reply I did state I was quite aware of the change and taught their standards at PHTLS courses, but this does not mean it is the sole "Gospel" it is only their recommendations and one should be able to discuss and follow local policies. No where was there a discussion of a pulseless extremity, as well it is very apparent the standard care is to attempt for realignment with traction for such. (You see, I know a little more than having read more than one text and attending one course on trauma). This same type of ignorance that presumes that the AHA ACLS treatment is Gospel as well.. it is only recommendations from that governing or sponsoring body/organization. As far as teaching, your damn right I am proud students question..'why & how come" we do things! You see that is there is a big difference between education and training. EMS is medicine and needs education not training... period! To take things on face value as in training is not only wrong but down right dangerous! I do NOT believe in training for civilian medics... there is a thing called differential diagnosis, responsibility of care to the patient, the profession, and yes a little thing called litigation. If I wanted to have a trained object, I'll get a monkey or a dog. I prefer a medic to understand different modes of treatment and the etiology of the treatment as well as what occurs in the body when a procedure is done or not done. For example for a treatment of a headache: Tylenol, Excedrin, Ibuprofen, or Aspirin... each one correct, only if you know what type of headache it is. Now, have you ever heard of evidenced medicine? Questioning of why, how come, and is it really beneficial to the patient? As well, do you still believe in the trendelenburg position ?... Do you even know or realize why PHTLS was developed? Why a group of us met in New Mexico to develop the curriculum? It was based upon questioning if what we were teaching at the time was adequate in real trauma care?.... And guess what, it was designed by a bunch of us "college boys".. and the course was primary designed to be placed in EMS schools to reduce the need of previous field experience. It was to cut out the time many needed to see how to do things in a real world situation. Part of this profession and being a professional is being able to play well with others at all education levels. I believe anyone can pass a Paramedic class & get a patch. It has been demonstrated well on these forums. Like I have said before.. it is too easy to become a Paramedic".. However; it is a different story, to be a damn good medic, patient advocate, good co-worker and a good employee. I have found those that fear questions, or to be challenged is probably those that are lacking in self confidence, otherwise there would be no problem in answering them and having an open objective mind. R/r 911

How ironic, I actually had a similar case 25+ years ago. The difference was instead of crank, it was a dealer that drove his auto into a river and he died from an mva, hypothermia and froze. As we were awaiting for LEO to arrive, we found a roll of money (about $7k) and a bag of 747's (Quaaludes) about $5k worth.... My partner and I looked at each other .. here it was Christmas time and we were making about $2.25 hr/for 16 out of 24 hr shift. My partner had a child <2 yr and his wife was pregnant now. So the dilemma... no one would know ..... cash.. more than 3 months salaries for us. After, a brief period of silence and chuckles.. then stating how unfair life was... we finally handed it over to LEO (which I wonder if it made it back to the station). But, we knew we did the right thing. We could enjoy the season with clear conscience, and we both did not want "dirty money".. the rewards of having principles and integrity is much more important than money. R/r 911

In the U.S. you do not have the "Duty to Act" or to respond off duty unless you want to. Some states do have a clause that if you display insignias (star of life, etc.) that one may be obligated to stop and render aid. I am not how successful that is. I personally prefer not to stop. I will call EMS, FD, etc. but usually I do not make contact, and if I did then I am stuck there until released. I have found out from previous experiences that I usually do not make a difference, and EMS will be responding shortly. ( I do not carry a kit off duty as well) R/r 911

Apparently, you have never worked with or met Jack Stout and his prodigal son.... a self proclaimed "EMS Guru".... Sure, for a few million I could tell you as well to either place EMS in third party, fire, or private.... duh. Now, let's compare the "so-called" success of the systems he initiated.... hmmm and he was still employed. Unfortunately, or maybe fortunately many seen through his smoke screen and propaganda. Yes, it sounded good and that was it. So did he do any good for humanity or more for himself. Yes, it is okay to make a respectable living as long as your not screwing anyone else ever.. (except prostitution ) .. If you are really considering a professional career as an EMS administrator or policy maker, I highly suggest you omit the name of him. Many are still feeling the bad taste he left ....and the empty pocket book. R/r 911