Ridryder 911

Ak...please remain safe, and careful. Please keep in touch, and take plenty of photos... hope to see you, when you get back! R/r 911

What are "ribbons"?.. Is that those placard looking device, some officers wear?.. for what distinction except to each other do they mean anything? Are you military? R/r 911

Window punch 5 straight times... hmm I smell something here. ! Might want to read my credibly post.. R/r 911

One might want to explore more than the term when looking up and researching a procedure and physiological response. The term is orthostatic.. NOT orthostasis. Please, when addressing a physician on discussing, one might want to pronounce and discuss it properly, than to look very foolish. R/r 911

You brought up a very good point,, even Dr. Bledsoe addressed one time. He was discussing how one Paramedic was blasting a new RN on not recognizing an AMI on a XII lead, and the discussion somehow lead to the patients creatinine and BUN level, which the nurse noted and asked if the patient was in ARF. Noting the Paramedic had that "deer looking in the headlight look".. he then realized how ignorant, most EMS providers were of laboratory values. This is why their is a dedicated section on the Critical Care Paramedic book on some basic understandings of laboratory tests, and values.. R/r 911

Apparently, there are plenty don't think they are credible that participate here.. I won't disagree.. I guess this subject is to deep, I have to remember the difficult questions in life like : EMT pants, badges for whackers, and lights sirens.. oh yeah, can your Basic intubate R/r 911

True it does, but there is nothing else prehospital personal can do.. like paddling up stream with the use of one hand. Most of these patients require balloon pump therapy.. and that has not been approved in EMS (U.S.) Few of us oldies might remember that in Ireland (I believe) they were using a similar counterpulsation device connecting to the descending/femoral artery in the field, about 20 years ago or s.... appeared to be successful, but have not seen any more literature on it though. R/r 911

Yeah, kids don't know much about attorneys yet!... but, they are learning

Now that is bragging!... This reminds of the old statements of James Bond movies...

I just am finishing up a thesis on abuse of E.R. Call it what you like "state insurance" etc.. is just medicaid contracted out to another insurance company, no difference in reimbursement pay. There are multi problems with abuse in the ER. Some from being uneducated, partly from physicians using it as a "dumping ground" in lieu of seeing their patients, to those that want a quick tx. for their ailment.. covered or not. ER patients have drastically changed in the past 15 years, they are not the same we used to see. More demanding, non life threatening, and have higher expectations of treatment. So many patients expect and demand treatment like a drive through at McDonald's, and if inappropriate treated, will be the first to seek litigation. That is why so many ER's are placing non-urgent centers in the ER. Basically, a clinic inside the ER, because people are either lazy, don't have a Doc, or the Doc over books himself as an HMO provider and can not see them for 6 months. Which is a whole different rant... Remember, only and if only that patient has a true life threatening emergency, will that ER get reimburse from Medicaid, if they do not most state has a cap level of payment.. usually $30-50, which basically, doesn't pay for squat. Now, you see why hospitals would love to dump the ER business? Yes, if there was not a law making the hospital to see everyone, there wold be a lot less ER's and as well a lot less patient's to. Many patients are quite aware of the EMTAL rule, and use it to their advantage. We have just reached the tip of the iceberg, on this problem.. wait another 5 years, when experts predict the ER visits to triple in number.... R/r911

True, if you are going to do that why not give 10 mg IM?... I much prefer to give 4-10 IV then 10mg Sub-q.. the inital takes the edge off, then MS in the sub-q allows a time duration... R/r 911

That's interesting, when is your indication to use Dopamine, if it is not cardiogenic shock? As well, Atropine is great, unless they have a block of second degree or higher.. then, you can stand back and watch the infarct size increase. If it is not reflex bradycardia, I much rather pace.. R/r 911

I always though it should be : Bowel Brown Urine yellow Bile green Fatty yellow decomp... a mixture of green, red, blue and black R/r 911

Don't get your feathers in a ruffle, because you so happen you can perform what you are suppose to do. Yes, Dust is right .. as we have discussed many times and as posters have asked numerous, numerous, times on this forum and others.. "how do I take blood pressure?". Just, because you attended a little over hundred hour night time course, does not make one an authority in EMS. Hell, even the pedicurist that does my girlfriend nails had to go to school longer than a basic EMT, in comparison for their job.. and if you truly believe someone taking a blood pressure is going to make me feel threatened, you are very naive to medicine. Like Dust, I don't care who takes the bood pressure as long as it is correct.. and please don't give me odd number readings when performing a manual B/P.. it does remove all creditiblity. Glad you can perform your job, you should that's what EMT's are trained, not educated to do.. perform tasks. R/r 911

I am really glad, that he received the help he needed, hopefully he is on the road to recovery. Hammerpcp, I assume you were joking. . The reason I made such statement(s), is it hit home . Several years ago, I had worked part time at a service, that had a very similar case and being the "staunch" medics they thought "he could tough it out", his crew and partners ignored the repeated cries for help... Thinking, he could take care of it on his own, and really it was none of their business... and never taking or truly listening to what was really said. This story, however; did not end in a happy ending as the original poster. He went home after his 24 hr shift and called 911, then blew his brains out with a 357 magnum.. unfortunately this affected not only the medics on duty, but the whole service as well. Some good medics left this profession and many others had to seek counseling for themselves.. Yes, there are times one cannot prevent anyone's action and then there are times they are crying out for help... be it medics or your patient. It is our job to listen and acknowledge these cries, albeit your patient or partner, be a true friend and care giver, be sure they get the right help. I much rather loose a friendship and have them alive, then loose them permanently Again, glad you were there for them, being concern and a friend, hopefully, their future will be great. R/r 911

Subject: MATH TEACHER ARRESTED NEW YORK -- A public school teacher was arrested today at John F. Kennedy International Airport as he attempted to board a flight while in possession of a compass, a ruler, a protractor, and a calculator. At a morning press conference, Attorney General Alberto Gonzales said he believes the man is a member of the notorious Al-gebra movement. He did not identify the man, who has been charged by the FBI with carrying weapons of math instruction. "Al-gebra is a problem for us," Gonzales said. "They desire solutions by means and extremes, and sometimes go off on tangents in search of absolute values. They use secret code names like 'x' and 'y' and refer to themselves as 'unknowns', but we have determined they belong to a common denominator of the axis of eval with coordinates in every country. As the Greek philanderer Isosceles used to say, 'There are 3 sides to every triangle'." When asked to comment on the arrest, President Bush said, "If God had wanted us to have better weapons of math instruction, he would have given us more fingers and toes." White House aides told reporters they could not recall a more intelligent or profound statement by the president R/r 911

I agree, it is amazing that it does not take intelligence to reproduce... one thing for certain.. We never have to worry about being out of business, there are enough stupid people, to maintain and increase our profession. R/r 911

Good point! Here is one of the best definitons, I found from Winkipedia: Integrity comprises the personal inner sense of "wholeness" deriving from honesty and consistent uprightness of character. The etymology of the word relates it to the Latin adjective integer (whole, complete). Evaluators, of course, usually assess integrity from some point of view, such as that of a given ethical tradition or in the context of an ethical relationship. People who for instance said bad things about their own grandmother might appear to lack a form of integrity. Actually, I believe the two compliment each other and is hard to have one without the other. I do think it is a shame, that many have not responded to this question. Ironically, those that so far have answered is the ones', that I predicted would and believe have credibly. It is for some of those that did not answer, I posed the question in the beginning. Apparently, they have answered by default....unless, they would like to rebut. R/r 911

Your right that is scary that law enforcement is just as screwed up as EMS. I agree, with Mike, one should have formal training in the profession they do, way before they place the uniform on and have duties of such.... paid or volunteer. Usually, assailants don't ask which is reserve and which has been through formal academy, but the courts do as a representative of it. I have worked in a large Police EMS system, a Tactical Medic on the State Narcotic Assault Team, and even as Reservist for our County S.O. to maintain my commission, so yes, I am familiar there are some places, that will use anything with a pulse and a ego to wear a badge. This is what is so scary, when I see ones wearing garb and looking like a Gall's magazine. What concerns me as well, if the paid officer really needs assistance such as officer down... (usually the reason for reservist, except to direct traffic) would you not want one able to use the full force? As well, what does working in an prison, or penitentiary have to do with patrol and LEO, and investigational duties? Most officers, I know never have ever worked in prison systems, other than to process them. Well, I guess in Rome, one has to do as Romans do.. just wish the best of success and safety to you R/r 911.

Sorry, I did not find being an idiot funny or humorous. Foreign reality t.v, oh.. boy, they will putting on one just like here in the U.S., just like the show Fear Factor. eating horse colon.. no, not afraid..just smart that I don't want horse sh*t and E.coli for breakfast.. hopefully, people will get fed up with reality television. R/r 911

Welcome BW, from another Oklahoman. There are a few of us on here. I feel, EMS is composed like most of America.. mainly, down the middle. I do feel, that majority of the people are very uneducated in their political reasoning, and choices. I am concerned most are to the left, when right promotes capitalism. As mentioned most are ill informed on their party stand platforms and as well what PAC has donated to them the most, to pay off favors. So many place emphasis on the Presidency, when really that position (humbly, respected position) has very little in performance with day to day living. Most are unaware most programs, are not initiated or started way until that person has left office.... so if it is screwed up, you should blame the President 4 to 8 years prior. Sure, I would want to have my candidate be supportive of EMS, but in my nearly 30 years of EMS, I have yet met a "real" Paramedic, that I would see be able to hold such an office or even want to. Most EMS personnel are very ignorant on generalized health care, and especially at a large and global arena. Yes, day by day treatment.. but, nationally involving HMO, Medicare, WHO, etc.. I doubt most Paramedics understand such, & unfortunately cares...This is truly unfortunate. I do remember the Clinton's fiasco and their plan of health-care... (the origin of HIPPA came from). Many, are for standardized health care, but no one wants to pay the price tag... (Can you tell, I am in a health economics class ? ) Again, many do not investigate all the potential consequences and long term effects...so many do not understand you will never cut the fat.. they will always take care of themselves. I stress to all co-workers to become really informed voters, check out their voting record, participation and voting in committees, as well as spending history. Not, just what they say.. or what the public wants to hear...but their perfomance. R/r 911

So true Mike! You know they say men think about sex every 3-4 seconds, I thought it was funny that research has shown over half of the men purchase an item for their car during Valentines, but less than that purchase for their wife!. R/r 911

Yes, I like animals, (especially medium well done..LOL) and yes, I will offer treatment if there is no human injuries.. etc. I do have a big heart for injured animals, because they are innocent, not like the humans that usually cause events. But, to spend basically $50 for masks is ridiculous! I bet if you were to check that EMS unit, you would find it was lacking in equipment for pediatric supplies or even adult equipment! I wonder how much money would be raised to purchase I/O needles or even pediatric masks or laryngscope blades?... R/r 911

Thanks for your replies, interesting and insightful. This has been discussed lately among veterans and new ones. With many of the new and younger Paramedics describing their is no such thing as credibility in EMS. The profession has not matured yet to have such measurements. I don't believe one has to work MCI, etc.. to have such, this was just an example of someone that has probably been in the field long enough to see almost everything once or twice, yet realize each and every emergency is different and especially unique to the patient. Even here on the forum, I believe we are loosing credibility. I chuckle, lately when I read posts from those that offer advice or make recommendations that..."there is more than one way".... etc. and then only later to read they have not yet completed a Paramedic or RN program (highest level of EMS), or completed any true accredited education level (degree of education, BS, MS, PhD, EdD), and much more humorous is they have never worked in this field or could be considered at the rookie level (<5 years) yet they are spouting and offering advice as an expert in this profession. I doubt they will read this post or respond not really understanding true professional development and education. Although, I highly encourage discussion, I do believe there should be some form of credibility to those that offer advice or some form of disclaimer "Not all that participate in this forum, actually know what they are talking about, take advice and recommendations at risks"... Unfortunately, many naive readers believe that majority of the posters actually really know what they are talking about. I know I receive personal IM mail continuously about professional development, education, patient care, etc.. and I am honored that one would do so. I do research and sometimes ask others with more speciality than me for advice for them, to be sure accurate and true information is dispersed. Now, back to the main topic.. how can we promote more credibility in our profession.. do we even see that this is a problem? I do, I believe this is some of the reasons we have major problems in this profession. EMS receives poor to low pay, poor working hours, and poor benefits if any. The public does not include us as an essential item, and make sure each community has not just an EMS, but ALS response. Is this poor perceptions) our fault and what can be done about it? R/r 911

Ditto.. If you mean pericardiocentesis (commonly slang is T-needle) no..not on a live pediatric.. I agree, we need more definition. R/r 911