Scaramedic

Oi Vey!! Where to start? I think we all agree that hardcore porn has no place at the station. Besides being unprofessional its plain out creepy. If you want to sit around and watch porn with other men I suggest you try a local bathhouse. As far as rated "R" programming, were all adults in this biz. Please do not give me the "what if you had an explorer in quarters" excuse. With kids today I would probably be asking them "what position is that?" In case you haven't noticed kids today aren't exactly puritan virgins, they are exposed to things we can't imagine. So that leaves us with Basic Cable. Lets look at our choices.. Praise the Lord, 700 Club...some are offended by religion Lifetime, WE...some are offended by high estrogen levels History Channel...some are offended by images of war Disney...some are offended by large cooperation's ESPN...some are offended by high testosterone levels Home Shopping Network...greed PBS...they have those creepy Teletubbies Nick at Nite...runs "The Beverly Hillbillies"...stereotyping Fox News, CNN...Politics A&E...don't you just hate that "Inside the Actor's Studio" guy? FX, CBS, NBC, ABC, WB, USA, TBS, SPIKE...SEX SEX SEX So who gets to decide? Lets make it simple, if you don't like it leave the room. You and only you can control what you watch. If something offends you don't watch it. Like Sarge said, too easy. Whats next GA? Are you going to tell us we can't knock out a piece at work! Whats this country coming too? :wink: Peace, Marty :joker: P.S. I think its time for the dancing penis!!!

I think I can shed a little light on this study. The hospital they are talking about is Oregon Health Sciences University. Up until about 1998 they had one of the smallest ED's in Portland. It was nestled in the back of the facility and was inadequate for a level 1 trauma center. I am not saying they were a bad ED, in fact they were a damn good ED, it was just too small. Being small and rather old they spent a lot of time on ED divert. They had one part of the ED with no air conditioning so when it got hot and busy they would break out the fans, yeah it was that bad. So in 1998 (if I remember right) they opened a huge and beautiful ED and they spent a lot less time on divert. So if I had to guess I bet they were using numbers that were pre-98 and post-98 in their study. By the way OHSU has gone crazy with new construction. This is OHSU today.... Everything you see in that picture is OHSU. They have gotten so big they are building their Physicians buildings along the river and are building a sixty million dollar tram to connect the hospital to the new offices. Peace, Marty :joker:

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dripping with lard

I think I found the story on that... Peace, Marty :joker:

At the time of the headaches.. Whey protein Creatine Glutamine Hydroxycut Xenadrine It was the last two I cut down on, I took the hydroxycut for the fat burning and the Exandrine for an energy boost. Probably not the best combo, but Xenadrine gave me a nice energy boost for the rest of the day since I used to work out early AM before I went on shift. Peace, Marty :joker:

I was too tired to type, I had been working in the yard all day. Sorry. I mentioned effort HA because I use to have really bad headaches a few hours after working out. I was told they were exertion/effort headaches and to lay off the supplements I was taking, I did and the headaches stopped after a few weeks. Peace, Marty :joker:

I couldn't agree more Rid. The problem is that too many EMS personnel justify their interventions by "it's protocol." There are many threads on this very website where members justify treatment by that infamous phrase. Maybe it's because I went to Paramedic school a few years back and the program director was a very old school Paramedic, but we were taught to justify everything by how it affects the pt. It was pounded into our heads that any treatment, or lack of treatment was to go through a process like this in our head. 1. What is the problem? What is the physiological process or what is the injury that is affecting the pt? 2. What interventions are available? 3. How will it relieve/treat or support the patient? Not just "it will make the pt feel better," but what it does physiologically. 4. Is it necessary? Will it cause more harm than good? 5. What are the options with this care? 6.. What are the follow ups or other care I need to give and does this treatment affect those? Only then do I decide to use the intervention or not. It takes no more then 5-10 seconds to run this process thru my head. If I answer all these questions I am ready with answer if an MD asks why I did something. Also by following these guidelines I am not using my "toys" without reason. Peace, Marty :joker:

Peace, Marty :joker:

On a side note they had a nice dinner and took in a movie as soon as she made bail. Peace, Marty :joker:

No, whats V-Fib? Seriously I would have to see the pt, check the vitals, get more history and see whats happening on the monitor before I decided on this scenario. My gut feeling is to go ahead with a Lido drip to be on the safe side. As far as protocol I would not (nor have not) worked in a system that does not allow wiggle room in protocols. We are not robots, we are thinking machines that are capable of making informed and intelligent decisions. Peace, Marty :joker: P.S. 22.36 miles per hour.

](*,) :roll: Peace, Marty :joker:

We need to look into the etiology of an overdose before we pass judgments on Medics in the field. When an adult overdoses on a medication for the most part it is intentional. It is rare for an adult patient to accidentally ingest toxic levels of a medication or toxin, not impossible but unlikely. The intentional overdose patient then tends to wait until they are getting very sick before they call 911. Many times an hour has passed before we hit the doors and begin treatment. Yes I know that there are the patients that take a 100 acetaminophen, or drink some funky tea and immediately call 911, and yes they would benefit from AC if they agree to drink it or will accept an NG. Good luck trying to get them to accept either, keep in mind they are patients and have right of refusal. So back to the patient who waited an hour, you now have a patient with AMS and who has absorbed a large amount of the toxin into their system. Studies show that AC at this point is a toss up at best, so do we take the time on scene to drop an NG tube, draw up AC into a big syringe and take the ten minutes it takes to ram the charcoal thru an NG tube or do we just transport providing treatment to the effects of the toxicity? In my personal opinion it is best to transport and treat then waste my time on something that will probably not be effective. The pts that we will get called for who have just ingested meds/toxins are children. Once again this is a situation that AC would indicated, and yes I would place an NG tube and give AC in this case if the levels were potentially toxic. I do not consider three Flinstones chewable vitamins to be toxic. The problem with kids is that many systems do not have NG tubes in their protocols yet, so the only route available would be PO. On a side note, I used to have an old uniform shirt I would wear when working in the yard or working on my car. It was peppered with AC from a little one who weighed the benefits-risks of AC and found that it tasted "yucky" and spit it all over me. Getting a ped to accept AC is a tough proposition, trust me cherry flavored AC still tastes (and feels) nasty. My point is that yes AC will work in certain situations, but those situations are not as common as you believe they are. I do not believe AC is underutilized anymore than other interventions we carry on the units. Peace, Marty :joker:

No JanMarie I do not believe you were out of line in talking to the medic. Just make sure when you do address an issue do not come off accusatory, it then puts someone in a defensive mode and nothing is accomplished. As far as the pt it could have been several things. 1. Most obvious, he took too much insulin and his BS was low. Easily ruled out by a Glucometer or even a chemstrip. 2. When you said his pulse was irregular was it fast or slow. Many diabetic pts are put on Beta blockers, and you mentioned a BP medication in your scenario. Beta blockers can lead to decreased heart rates which then can lead to arrhythmia's since the heart itself is getting ischemic from lack of blood. 3. You can also get a mixture of points 1 & 2. Normally when a diabetics blood sugar decreases the heart increases to make up for poor energy use. Beta blockers will stop this increase making the pt even worse off then in a normal hypoglycemic episode. Beta blockers are your "olols" propanolol (Inderal), atenolol (Tenormin), and metoprolol (Lopressor, Toprol) in case you did not know. So in my humble opinion he should have ran an EKG and gotten a blood sugar double quick on arrival. If he failed to do this he was out of line. Peace, Marty :joker:

Let's add another one from a current thread that is going to hell real quick. Teens as EMT's. i.e. how young is too young, 16yo looking for an EMT program, etc. Peace, Marty :joker:

Good one Rid, I forgot about that one. I hereby pledge never to mention the above topics in any of my posts. :-# Peace, Marty :joker:

Y'all forgot a big one.. 1. Basics giving Glucagon. Peace, Marty :joker:

Hey Rid I would use the AHA ACLS for experienced providers as a blueprint. It tends to have more scenario based teaching that builds on the experience your crews already have. That model can be altered to fit any kind of training. Peace, Marty :joker:

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Here's a few local stories on it Rid... http://www.ohsu.edu/ohsuedu/newspub/releas...50206trauma.cfm http://www.ohsu.edu/emergency/roc/hypertonic.htm. http://www.uwmedicine.org/Facilities/Harbo...pertonicSaline/ ...and some national stories. http://www.medscape.com/viewarticle/493668 http://circ.ahajournals.org/cgi/content/fu...ha;108/18/e9047 http://www.touchcardiology.com/articles.cf...601&level=2 http://www.jems.com/medical-clinical/articles/104188/ http://www.defrance.org/artman/publish/article_1581.shtml Peace, Marty :joker:

drinking bandit who

I am ultimately responsible for any patient care I render. It is my duty to thoroughly understand all my treatment modalities and how they effect the patient. To say that it is Med controls job is a cop out, I should know if an order or a protocol is harmful to a patient. Granted medicine changes weekly, but I should make a concerted effort to keep up on the changes. My patients deserve the best I can give, and I can only give the best by keeping up with the changes in the standard of care. Peace, Marty :joker:

I am no stranger to ripping on our co-workers in Nomex, but in this case I am going to venture into the land of defending them. Let's take a look at some of the other photos from this scene. [align=center:6f5994669a] I am assuming this photo was taken prior to them bringing him out, notice the stokes basket arriving and the guys lined up on the pile of rubble. Notice the entry way the firefighters disappear into to, does not seems like a place I would want to spend a lot of time prepping the patient for photo ops. PHTLS would consider this a rapid extrication situation. Finally, no orange helmets visible in this photo, they must be holding EMS back.[/align:6f5994669a] [align=center:6f5994669a] Another photo after they get the patient out. I have to admit for some reason I find this photo funny. When I look at it I can hear all the firefighters saying "you hid the treasure where?" Just like the other photo it is obvious they have made some mistakes.[/align:6f5994669a] [align=center:6f5994669a] In this photo EMS is all over the patient. If you look closely you can see at least two Medical Director's on scene, and several other EMS personnel talking to the patient. Once again I have visions of "where did you hide the treasure?" In all honesty they are probably asking the questions you would expect in a situation like this. "Are you having trouble breathing?" "Do you know where your at?" "Are you a member of Al Queada?" "Where's Osama Bin Laden?" [/align:6f5994669a] [align=center:6f5994669a] In this photo they have the patient on the cot and are probably heading to the truck. They do have oxygen at the patients head but it is not on the patient. Once again an FDNY Medical Director is all over the patient, but yet no oxygen. At least the collar has been adjusted and his head is taped.[/align:6f5994669a] [align=center:6f5994669a] One last action photo of them rushing the patient to the truck. Asysin2leads are you in there somewhere?[/align:6f5994669a] When this story popped up on my computer my heart sank, I thought "here we go again." I cannot imagine what it was like for FDNY/EMS when they got this call. I am willing to give them a little slack on this one. Mistakes were made by both Fire and EMS personnel. No it was not picture perfect, but I am willing to bet there were times when we all did things that we wouldn't want on the cover of the New York Daily News. Peace, Marty :joker:

Point #1. Two words for you..President Cheney! :shock: Point #2. You mean our good buddies the Saudies, they have more connections than any other country in the world. Lucky for them they have oil. Peace, Marty :joker:

with nipple holes