chbare

Voluntary gun collocations with gift card handouts are the answer?

Unfortunately, this is often the pitfall of being a paramedic. It is hard to progress and sometimes make a living as a paramedic and I understand why we loose so many EMS providers to nursing, medicine and other allied health fields.

No, rhabdo is a different animal.

Here are a couple sources: http://www.osha.gov/dts/shib/shib032404.html http://m.jems.com/article/patient-care/dangerous-suspension-understan

I cannot answer that question bro. I do not have children and never wanted children. Was sterilised at a very young age, so I have no real concept of what it means to be a father. However, it's hard to look after your son if you are dead. Can you look at a private insurance plan? In the spirit of full disclosure, I developed severe right sided chest pain and dyspepsia intermittently when I'd lay down at night several months ago. I was working a few part time jobs without benefits and could not seem to get coverage due to pre-existing conditions (minor for myself). I took a chance and figured it was likely Gi and I waited. Currently doing quite well with a possible hiatel hernia with symptomology that is well controlled on a PPI.

I'd refuse to administer or draw up the atropine and state on scene if need be that atropine is not indicated for refractory ventricular fibrillation according to the current 2010 AHA recommendations. Then, report as necessary if needed.

Great topic btw. Rated highly. Thanks for the discussion Dwayne.

Dwayne, you dumb bastard! You are 50 years old and having cardiac complaints. You basically made every lay person mistake in the book, but you had the balls to come clean. Good on you. Good luck as you move foreword.

Treating life threatening hyperkalemia involves a three prong approach: 1) Stabilise the cell membrane potential 2) Shift Potassium into the cells 3) Eliminate the Potassium Membrane stabilisation is the immediate treatment in life threatening hyperkalaemia. Sodium bicarbonate is not necessarily the front line, stop-gap intervention. I am not completely sure that rhabdo is present in this guy, nor is it going to be present in every suspension type injury. Rhabdo is the result of massive tissue (muscle) damage leading to massive numbers of cells rupturing and releasing their contents, Potassium and myoglobin among the various substances. While acidosis alone will cause a K+/H+ exchange to occur, the Potassium imbalance of rhabdo has additional pathophysiology at play.

If we are really worried about hyperkalaemia and it's lethal cardiac effects, is Sodium bicarbonate the first medication we should be thinking about?

I do not want to give potential answers or discussion points away; however, it my be worth your time looking up the concepts of suspension syndrome and reflow syndrome. The pathophyisology of these concepts may have particular relevance to this scenario. Regarding sodium bicarbonate administration. One needs to be particularly careful. Administering Sodium bicarbonate can shift a certain chemical process to the left creating more Carbon dioxide. If a patient is not being ventilated effectively, this can create new problems.

What kind of safety setup was in place? Was there a setup capable of dynamically responding to loads or was it a simple static safety setup with static rope?

DFIB, as somebody who is highly libertarian in many ways, I agree. Personally, I think it is our duty to be skeptical of government, it's intentions and it's actions. Typically, the question I ask when faced with social issues is "can I help by allowing the people to have more freedom?" I think this applies to many things such as gay marriage and the drug war, but that is a conservation for another day. However, I cannot solve the current issue when performing gedanken experiments with the information available, by allowing more freedom as it pertains to having access to guns. The issue for me becomes another question: "Does mandating armed teachers and armed security in every classroom amount to increased personal freedom and liberty?" I am not necessarily saying outright ban; however, it looks like a majority of the population is pissed and they are mandating some sort of change. I think as a good libertarian and citizen, I have to recognise the concerns and will of the people. The concerns are valid and we have to discuss options including the possibility of some sort of ban and try to identify what can help and where does the constitution begin and end. Possibly, the issue could again end up on the doormat of the supreme court. Clearly, I have bias and ignorance about many of the complex issues, but as a citizen and as a teacher at a college, the topic is very important to me and I want to debate and consider the various options, but it is also my goal to try and eliminate hyperbolic speech as much as possible.

It's raw and emotional, much like the anti-gun victim stories that we hear. However, it's that very emotion and the notion that she needs to protect herself from the government that is not the important consideration or particularly helpful. I think she needed to grieve and say what she needed to say. Fair enough. However, we need to come up with reasonable solutions. Personally, people on the extreme ends of the debate really have nothing reasonable to add. To suggest that giving everybody a gun and mandating they learn how to carry and use it is as ridiculous as thinking we can go door to door and take all the evil guns away. These diametrically opposed camps assume a perfect world exists where everybody abides by the boundary conditions they set. That is not reality and not a helpful thought process. The United States will continue to have lots of guns and I don't see that changing significantly in my life time. Likewise, reasonable regulation regarding the acquisition and use of firearms is desperately needed. In addition, said regulation must be highly flexible and change as we should have robust methods for gathering data to see what works and what needs to change. You look at all the data pertaining to the 1994 ban, and I cannot make heads or tails of it, but I'm not sure of its overall efficacy. Unfortunately, much of the data is tainted by opinion and bias from both sides. Clearly, we need to change, but must do so in response to good data collection and analysis and not opinion. It's an incredibly tough challenge and I doubt everybody will be happy.

It's a slippery slope and full of stereotypes and I think it can lead to some real rights violations. However, if somebody has been institutionalised, fixing to be institutionalised or is a felon, do they need to be in an environment where they have access to guns even if said guns were obtained legally? I have no data and I'm not a mental health expert, but it's probably worth discussing.

If you want to call it that, yes. You fill out a form asking about criteria that could prevent you from obtaining a firearm when go to buy one, now we could extend the check to people living in the house where the firearm will be stored. We do that to some extent when considering the environment felons will live in following release.

However, can we not be more aggressive about limiting access to at risk individuals?

Regarding the first point, when looking at mass shootings specifically, legally obtained weapons often play a role. Regarding your second point, I'm not sure it's too much to ask about people who have mental problems and such living in the same area where weapons will exist. Could such a process have prevented the recent tragedy? I'm not sure, but it could be parted of a larger process aimed at dealing with mental illness in the United States.

Additionally, I can see expanding the vetting process to include an assessment of the prospective buyer's living situation to include identifying people who live at the residence and potentially have access to firearms.

DEFIB, people can easily get around the process by purchasing through a less than scrupulous seller at a gun show. The loop hole will likely need to be closed.

An ban was in place from 1994-2004. You can look up the details on how assault rifle was defined, but more or less a gun with a certain set of cosmetic features that could accept a certain set of attachments. Around 20 or so weapons met the criteria. In addition, magazines with a capacity of greater than 10 rounds were generally not allowed. Of course little could be done about pre-existing weapons and magazines. My opinion on background checks is yes. I cannot see these gun shows where anybody can buy a gun continuining to function. Everybody should go through a vetting process prior to purchasing a gun IMHO. My suspicion is that this provision is something many people can agree on and it will probably be part of any new legislation. Of course, I could be wrong.

https://www.nremt.org/nremt/about/emt_cand_state_offices.asp

Island, the 7.62x39 is not a particularly common hunting round. Also, the 7.62x63 is not used in the M60. The M60 fires the 7.62x51. The 7.62x63 is the common .30-06 hunting tound. While it may seem like hair splitting, we need to talk about things accurately and have a basic understanding of the information we post so we do not add to all of the inaccurate information being thrown around.

This topic is too important not to have a good understanding of terminology and definitions. Hair will have to be split and concrete decisions will have to occur. However, we all benefit from having a basic understanding of what we are talking about. As you pointed out in your definition, the cartridge type does not seem nearly as important as the gun and how the gun works. That is a critically important differentiation and clearly not splitting hairs IMHO.

However, with all we have talked about, does the bullet actually matter when we know much more devastating rounds can be used by hunters all day long? For example, I can take a bolt action, single shot rifle that fires the 5.56 mm "assault rifle bullet" and I dare say most people would not consider that gun an assault rifle. Therefore, I believe there are much better methods of defining what constitutes an "assault rifle."