Ridryder 911

Might want to get that flurostained to be sure you did not get a cornea burn.... those so hurt!....

Ha.. Ha!... Yeah, an old bearded man came down from a mountain with some sort of tree blazing and gave us the first set of protocols..... to me and Harvey and Brent......and yes our first unit was a 2 wheeler with real horse power... :wink: R/r 911

I remember when I was in Paramedic school, feeling overwhelmed. My professor informed us... "You should feel like I am feeding you knowledge through an NG tube in your brain"... if you don't feel overwhelmed, then I am not doing my job!..he was right.. as well as he described the light will turn on ... it will make sense!... No one knows when or where... but suddenly, when you have about given up hope..... it clicks... things begin to make sense!... Of course, you are excited and want everyone else to know... of course, they hopefully have been through it too. So yes, you will feel overwhelmed... it is normal. Yes, the more you learn, the least intelligent ones feels. I know I do.. I have been a medic for nearly 30 years, and a RN for 17.. and now realizing if I write a prescript.. and someone dies, or I misread or miss something on an x-ray..and was not referred to surgery....it's my fault.. now that's scary!...So yes, the more you know, the more you realize, you need to know more..... R/r 911

Most anatomy classes do not use human cadavers unless you take such a gross anatomy or cadaver anatomy, etc.. it is very costly and mostly used in a university setting. I did this for my own personal growth.. I already had Anatomy I & II, and human physiology. I personally have been through a cadaver lab, and had to go to another school to do so. It was worth the money, but again it can be costly... and smelly as well. I do not suggest it for those that are weak .. lot of formaldehyde, and I had to keep inflating his eyes.. Yes, many other animals have similar organs.. sheep=brains, I've dissected monkeys, fetal pigs. monkeys, cats, all have similar human parts... Good luck in your studies. R/r 911

The queasy feeling might be just short term, and a lot of the time it passes with exposure and deeper education, sometimes it does not though. But I am concerned if the "book" and some basic scenarios over whelms you. P.A. is much definitely much harder and although, the likelihood of "gore" is potentially there, there is much more you will exposed to... pelvics, rectal abscesses comes in to mine that I see P.A.'s get to take care of.. usually whatever the physician does not want to deal with. Definitely not trying to discourage you by any means but have you completed your cadaver anatomy, or some other basic sciences yet? As well, do you fully understand the general role of the P.A., especially in the emergency department? Have you discussed the career with an active P.A. as well ? I would suggest doing so before going any deeper into studies. I wish you the best of luck, R/r 911

Just a sidebar note.... according to OSHA pregnant females, are not to be exposed to loud and high decibels and frequency.. sorry, cannot recall the exact decibels. So those in EMS, that are pregnant and still working in the field are not really supposed to be exposed to such loud noise. I agree, this is one area we are very poor in preventing. I know I have lost much of the years of exposed siren and being in helo's.. R/r 911

Timmy, your actions by posting and then replying in a dramatic way, then re-posting (I believe I have counted at least twice now) that you will no longer post, is exactly the reason of why many feel age and maturity go hand in hand. Yes, thanks Timmy you have just proven the point. Amazing, this discussion and similar topics (should minor drive emergency vehicles) has been made here and many other EMS forums only to end up in the same way. There pointless... it does not matter as well within a few years youth will be removed from the field altogether. Compare what the number was from 10 years ago and now. Liability, entry level requirements. potential litigation as well patient expectation and professional requirements will require entry level to be of at least legal age. I know in my state that only a few services allow anyone under the age of 21 to drive, at my EMS one has to be at least the age of 23 to apply due to insurance coverage. There is a reason for such.. period. Again, this thread is like the topic.... dead. R/r 911

Might want to read the current literature on the myths of CISD, that is on another thread. Admin.. looks like this thread needs to die... it has outlived its purpose. R/r 911

That was way too much information .. for latex fetishes. R/r911

Racemic epi has been around for several decades. I have used it in the past before the use of many of the newer treatments were invented. There is so many less harmful products out there.... with less side effects. I use epi as a last resort and only then. Of course tachycardia, irritation and nervousness, shaking can occur, as well because of the tachycardia many of the other neb's cannot be used in conjunction. R/r 911

Around here, the only way we like our squirrel dressed up is a coat of batter and deep fat fried....LO, R/r 911

My local EMS contracts with the employee health division of the local hospital to maintain personnel up to date on immunizations. We are converting over to a program where I will assist in this as well, and will maintain immunizations up to date, in house. Employees are required to receive the usual preventive immunizations (unless, employee refuse and signs release statement). We also provide flu immunizations as well. Exposure control is still and will be handled through the infection control and employee health. We require bi-annual ( minimum twice a year) ppd, and as well after exposure, since we have several reported active cases of Tb. It is are state requirement as a health employee, ( I understood it to be a NIOSH requirement) Students are requires to have the usual vaccine and immunization(s) prior to any clinical and patient exposure. Our local hospital requires more than the usual vaccines, and we have a label system to make sure that all students have their immunizations, prior to any clinical activities R/r 911

Three of those physician's are professional acquaintances of mine. They used to hate to see me attend their lecture debunking the PASG. Mainly due to the poor study that was performed such as "inflating the PASG until the "pop off valves are initiated" .. I have yet not been able to perform this, as well as the TRISS level of patent's severity score, bad so severe that if you had trauma surgeon standing beside the patient, there would be no change in outcome... A .357 GSW to the chest over the pericardial area, will cause death.. no matter what instruments is used. Again a bias report was made... it demonstrated that PASG did not change outcomes..... but, what it did not emphasize was that it did not boast, was it did not increase morbidity as well... so basically a neutral study. But so many knee jerked after the first study, it was too late. Propaganda and false implications occurred. I agree, PASG was never designed or can be used in the "total treatment of shock" and definitely needed to be studied. As well, inappropriate use was being used at that time. Increasing BP can actually be bad for trauma patients... duh!.. And here I debate them as well.... they (some of the researchers) are concerned of coronary circulation, where as I am concerned about coronary and cerebral... if you do not perfuse the brain, what use is it?... I highly respect these physicians, and if you do some research you will still find them successful in EMS and Emergency Medicine research.....i.e Pep`e, Bickell, Meningus, etc.. In fact, Dr. Bickell, (many from Tulsa will recognize these names) performed a very in-depth research on fluid resuscitation myth. Very interesting as per discussing, "permissive hypotension". Again as I and so many others have pointed out, research is essential to move forward, but we need to able to interpret those findings, by knowing how to properly read these studies. R/r 911 .

Can you take your own advice ? You continue to post in this thread... R/r 911

I agree, but as a person interested in this field, one should be aware it is not the "gross" things that apparently have the long lasting or emotional impact. True, curiosity is understandable and allowed. R/r 911

Okay, yeah they are getting paid well, but we had the ball and dropped it. It is our own fault.... period. We did not have the stamina (or other definition of anatomy) to be able to fill the void. I remember in the early 90's of ACEP, FACS, ACS attempting and promoting EMS to "fill the void" to expand their horizon, but hell no!..We have to have lights and sirens, blood and guts, to be in business.. Thinking that EMS should be strictly for emergencies only. Not, that I totally disagree, and that would be nice, but for EMS to survive budget crunches, and for medics to make a decent salary, we will have to respond to more than MVA's, chest pains, and GSW's. Ironically, I have seen very few GSW's that have Blue Cross and Blue Shield in their back pocket... yet, again Medics feel that they should be paid equivalently (rightfully) but the old saying what comes in = what can go out. Yes, EMS is a business, and that business is to save lives. But it is still a business.. Medicare and insurance companies are getting tired of expensive EMS taxi cab rides.. period. Okay, now the Doc will go see that patient and do some simplistic tests, as noted in the article and possibly prevent this patient from being admitted, saving the minimal of $3,000-15,000 initial admission. Now, do this several times a day at a couple of thousand places and you have saved the Insurance + Medicare $millions.... so do we see how insurance companies are happy? Can you say HMO?.. and a healthy bonus check for that Doc that did not order excess tests, and admission ... ching.. ching!!!! The same is true, as hospitals are full.. thus decreasing the load as well. Now, we had the chance.... and we blew it!!! We cowardly lowered ourselves to small interest groups of the volunteers and rural areas!!! Yes, they killed the National EMS Scope of Practice Act as it was initially written to allow Paramedic Practitioners and widen the Scope of Practice. Crying and whining it would put them out of business!! In reality, it would had provided better and more advanced care, where it is really needed the most. Yet, again most was only seeing things for themselves. When performing and advancing to this level would had increased care, and income for EMS, as well as professional standing and pay for Advanced Level Paramedics. (Imagine Paramedics only having to work 1 job.. .shock & dismay!) So now, we see the Doc's are doing it ... and yes, making some $$$ .. it's not their fault. Who's fault is it really...? R/r 911 R/r 911

Do you really think that you want to be there? Here is a long, graphic documentary video about an U.S. Army Field ER. Each time I view it, make me have more respect and honor our true fallen hero's... for or against the war, I honor those that have given the ultimate http://video.google.com/videoplay?docid=-3...mp;q=Baghdad+ER R/r 911

Aww... the usual "What is .... tell me ?.. Question After nearly 30 years in EMS (ground/air) and 16 of those also working in ER and Level I Trauma, ICU, 2 years at a large Burn Center. even worked part time as a Field Investigator for the State M.E..etc.. there are multiple gross things, one can say I saw. After many years of being exposed of "gross things" ; I have learned that it is all in the interpretation of what "gross" is ? It is all in the individual and personal interpertation. Yes, I have seen everything from live maggots eating on live people, retrieved floaters, decomps, literally picked up parts of people, worked disasters of nature and man-made both. Yes, some would make one queasy and the smell or fluids getting on you, or your clothes to smell would make you see your last meal again. I believe the most graphic and rememberable things are the screams of the mother as you tell them their child has been killed, the emptiness and hollow look as you are informing that their spouse they have loved and been attached to for 60+ years, has died in their sleep, or the look of informing a young women she has stage IV breast cancer...incidences like those are the most graphic and make me "uneasy" and memorable. The gross dissections, GSW's, decap's, etc.. I will occasionally recall, but the true "uneasy" are the ones that I described, those are the things I have nightmares about and can recall. I guess it comes with experience and exposure. Yes, one can become calloused or at least attempt to use that as a shield for our own personal psyche, and protection. Many become "displaced" so they can handle such calls. So to all the new EMS members be careful not to ever be too "immune". Sorry for the rant... R/r 911

Appearantly you did not see were I am from...Oklahoma (means: land of the Red Man) .. :wink: LOL.. R/r 911

Here is a simple suggestion, perform a scenario of an pediatric arrest. Now, use your old system and assemble some pediatric arrest as in Broselow groupings. Then ask for supplies as in a code situation ETT size, IV needle, Ped bi-carb, etc.. , see how fast and proficient it is. IMHO Broselow is the only safest, and easiest way. Especially if you only periodically have pediatric arrest. one can make their own kit using colored bags or inserts using the Broselow tape as well. Good luck, R/r 911

Just wondering .... How this is an EMS Discussion?.. Oh, by the way Google is your friend... Here is your answer : No, it's Amis (Taiwan).. http://en.wikipedia.org/wiki/Return_to_Innocence R/r 911

I don't know which is more stupid, me taking time to read that or one that has obviously too much time to write and actually theorize this. Although, it is true in statements. R/r 911

Yes, as said .. google and So basically, if you do not know understand the above it is basically PASG Proven not to increase survivor rates or morbidity either.. thus no clinical indications to use them. As well, can potential cause further harm with delay of deflation procedures and increasing. Anecdotal reports have shown them to be successful in some situations, such as use in rural areas, with long transport times. Studies: Many of the studies have been demonstrated to be flawed in that procedures of application, and use. As well, the level of trauma that was evaluated outcomes would had been poor to dismal, no matter what the treatment would be. I highly recommend, for everyone to study recent studies and shock theories such as..... "permissive hypotension" and " no fluid resuscitation".. this is the current methodology that is being researched and studies as well as hypertonic saline, and initial synthetic blood or oxygen carrying fluids. Again, the Google button is your friend. R/r 911

I see you got my response on another forum.. good luck ! R/r 911

Palpated blood pressures are just an estimation, not a true validation of a blood pressure. Since you are only getting the systolic pressure or guessamation of one. The same is true estimating blood pressure by radial pulse, caratoid, femoral and trying to guess a pressure, since you have a pulse located in these areas, as well has been proven a myth. R/r 911