akflightmedic

After a discussion in chat, a fellow EmtCity'er was wondering the best way to discuss your weaknesses during an interview. I did give some advice from personal experience, however here is a great link for detailed information and examples of how to handle these types of questions. http://www.wikihow.com/Communicate-Your-Weaknesses

Sorry was not my intent. By no means does one have to be inadequate to make mistakes, I have done my fair share. I am tired of the frame of thought that "I saved them cause I am BLS and they were focusing on ALS". I worked for years in an all ALS system, does this mean we screwed up a lot cause there were no Basics to save us? Possibly since there were no basics around to tell us and report it and obviously we would not know ourselves...lol. This is what I was trying to imply. Anyone could of made that statement, it was not made only because a lower level provider was on scene.

First, I simply wish to respond to create more discussion. These are not cheap shots and are legitimate questions and observations. Could you please provide an example to explain the passage I bolded above? I would like to know if this mistake you prevented was due to inadequacy on the medics part or a perceived notion on the EMTs part, as well as whether or not this mistake would have been caught by another medic or only by the eyes of a highly trained EMT. If you will reread your entire post, you will notice two things. 1. It is overwrought with emotion, which clouds one's ability to step back and logically rationalize or debate. It prevents one from seeing the larger picture, does not allow you to remain objective and make informed decisions based on fact. 2. Your entire post is "you, you, you". You are taking this way too personally. You may be the exception to the rule as there always are and there are others like you. However, the few exceptions out of the thousands does not help the cause. There are some Basics on here who have been able to step back, analyze the information and say, wow that IS a good point and I never realized due to...xyz. Those basics realize how faulty the system is, how inadequate the education is and for the most part how it is wrong to continue to perpetuate the myth of EMTs are all a community or patient really needs and EMTs save medics. These individuals also are doing what they can to further the standards and to make it better for those that follow behind us. They are the ones who deserve respect because they realize what they are sowing today will not reap the rewards until many years from now for all those coming up behind. They realize the rewards to be reaped may have no baring on them and may not benefit them personally, yet they push for higher standards anyways. They are not considering what is in it for them, only what is best for the patient and for the EMS profession. As for the whole "down on basics" issue, it is more out of a frustration by the ones who continuously talk about it. Grass roots campaign if you will, we have to start somewhere. To make changes you have to present the ideas to the masses and this is a great place to do it. They want the system to be better and there is a way to make it better. We have a plan. Do you? Can you present a plan that logically justifies leaving the system as is? Can you share a plan that explains how this is the best thing for all and justify the ramifications of such? If not, then strive for improvement. Your comments about how if it were not needed, it wouldn't exist are not entirely accurate. Imagine if we had done it right from the beginning, never created the multiple levels? Oh wait, that is how we did it. Then politicians and fire departments got involved and wanted more for less or even for free. So then we started dumbing down the curriculum and creating different levels and basically cheating the patients. Everyone patted each other on the back about how they are saving the community money,etc but at what expense? What is the cost? These are the types of people that stand by the old famous quote "Nothing is too good for our boys, so nothing is what they will get". The cost is less than 40 years later we are left with a fragmented, woefully inadequate system with much dissension among the ranks. The patients suffer, the EMTs and Medics suffer, and the RESPECT for our PROFESSION suffers. We are still young (EMS), and now is the time to make changes. We do not need to continue as is, just cause that is what we have always done. We need to make changes and fix it now while we are young and make those changes last. If we are going to do it, then we need to do it right. That is what this entire "debate" or desire to change is all about. Change is hard and met with resistance, that is nothing new; however, if you are passionate about EMS and delivering the best care with the best educated provider every time to the members in your community, then get on board and lets make it happen. Do not worry about the "what ifs" of I will lose my job or be unable to meet the new standards I championed for. Nothing is going to happen that fast but the time to start is now. And eventually when that day does arrive, it will be the best for all. You will be able to sit back in the knowing satisfaction that you helped make the system better and improved overall care for people in your community. Altruism at its finest... For the ones who continue to take this so personally, you need to realize this is not a EMT vs Medic thing. This is not medics being scared cause ALS skills are being given away. This is about patient care, what is best for them. It is also about gaining respect for our profession, not diluting it to the point where we are viewed as nothing more than protocol monkeys and taxi drivers. More to follow when I stop getting interrupted, hope my thoughts are decipherable.

What squint said..... We used to use these in Alaska to pre heat our aircraft.

His record has NO reference to DUI or what percentage his ETOH was. He has a reckless driving, thats it. That could mean many different things. Having said that, it still varies company by company, and is based on their insurance companie's policy or if they are self-insured whether or not they want you on th epolicy.

What medicines was your patient on? Here is a great article for your reading pleasure. By the way, OJ fell out of favor a few years ago; another medical urban legend dis proven with solid science. I am trying to find that article for you as well. Other juices are preferred over OJ, something to do with the acids slowing absorption rates and the end result being less than that of other juices or tablets, etc. http://archinte.ama-assn.org/cgi/content/abstract/150/3/589 Can any of the others weigh in on this or provide some more info???

That statement is full of untruth. I lived and worked in FL and SC through many hurricaines, everything from Hugo to Floyd. I also worked for privates and for the county or city during several of those. ALL of the services have a cutoff point. We are NOT required to respond when it is a life safety threat. We are required to respond as soon as possible in those situations. This is why post landfall, we have calls stacked and prioritized awaiting us to respond. Same thing happened when I was in Lousiana after Katrina and during Rita. In FL, when the winds reached 60mph, we no longer responded. ALL public safety vehicles were pulled from the roads and reported to their assigned shelters. People that were still out there and needing assistance were on their own as they all had plenty of time and adequate warnings especially during the mandatory evacuations. When the winds were 50mph we quit responding over the bridge/causeway to get to the barrier islands. Those people should already have been gone. As the saying goes, 'A failure on your part to make plans for an emergency does not constitute an emergency on my part.' Yes we are considered "public safety" during this time for some reason, however no city, county or private employer is going to force their employees into being heros, if for no other reason than not damaging the apparatus. We report to the shelter, ride it out and then resume service.

This poster is on 3 sites that I have seen and has received all the answers he needs. I see no reason for this thread to continue any more.

Great topic brother! I truly appreciate your postings and can say without a doubt that there has been significant change with you since your first day. Growing, changing, broadening our minds is a lifelong process that we must never stop persuing. Life is NOT short, as it is the longest thing any of us will ever do. So soak it up and continue to learn and develop the skill to step back and analyze everything you do. Ask yourself why you do something, how you do it and can you do it better? Thanks for the credit on the quote, however I stole it from someone/somehwere else and can not recall exactly in order to give proper recognition. As for things I have learned, the list is endless. There have been so many different members that have changed my thoughts on so many different subjects. I love this topic because it is a chance for members here who are brave enough to let others know they have had an influence upon them. Many of those responsible for the influencing are not even aware of the impact they may have had on your life personally so here is a chance to do it. My list is endless and yes I admit there are many names I have forgotten, but I have been influenced by them regardless. Top of my list always is Michael. Although he is non-EMS, he has influenced me personally in many different areas outside of EMS. Ironically, some of the things he has shown to me are things I can apply to EMS or myself in order to improve myself. I enjoy his postings and his PMs have provoked some serious inner thought. I have looked within myself on many occassions and examined how I could better myself. Whether or not I do change or improve as a result of this, I still look and see if I can. I am rambling, as the point was not to name names ( I think), so the lesson learned is: Do not be scared to look within. Always evaluate and reevaluate yourself and why you stand for what you stand for, then apply lessons to yourself for improvement. VS-eh, notvsa,(King of 10+ page threads) here are his lessons: 1. Do not be scared to start or comment on topics that are sensitive. However, do be prepared to logically present your side without it being based on emotion or "just beacuse thats the way it always been". 2. Google the rules of debating and try to follow them when engaged. (yes there are proper rules) 3. Be PERSISTENT, RELENTLESS, and PASSIONATE if it is something you feel strongly about. Rid with 500 certifications behind his name: 1. Never stop learning or going to school. There are not that many 80 year old men pursuing a NP after all the other education already obtained, so kudos to him. 2. Know when to disengage from a situation. Say what you need to say, if at all and then disengage. This is not retreating and does not make one a lesser man, it is the opposite. It shows maturity and wisdom, the old adage of "picking your battles". 3. Passion for life in general, but mostly passion for the betterment of EMS. Dust...ummm Dust... 1. Wow, umm yeh. I think he speaks for himself...lol. 2. Ok, seriously he has made me see things from a totally different perspective that I never realized before. Definitely has changed my opinion on many, many EMS related topics. He did this by being able to explain WHY it should change by using LOGIC and FACT, not just heresay or theory. Asys 1. Keep it real. 2. While coming off more cynical than Dust sometimes, again his perspective is matter of fact and "keeping it real". I love the straight forward, no nonsense approach and do wish I used it more sometimes. Dwayne: 1. ALWAYS remain a student 2. ALWAYS ask why or how and do not be afraid of looking the fool. 3. Pursue your goals or passions, no matter how far in lilfe you have already traveled. ( I love Dwaynes adult perspective on this paramedic journey of his). AK: 1. DO not get so bent out of shape over anything that happens in the forums or the chat room. It is an internet site that has no bearing on your day to day life UNLESS you are applying some of the lessons learned from others to improve yourself or EMS. 2. Ask yourself, why are you getting so torqued over things said or asked...is it because what was said IS causing you to look inward and reflect and you do not like what you see? Anyways, as I said this is a FANTASTIC thread. It caused me to look back and think and then try to put it all into words to show proper respect to those I mentioned. The list I started, which I may add onto later, is in no way a complete all-inclusive list. I did not even write half the stuff I thought of for the names I did mention and there are so many more that deserve recognition for the lessons they bring to the table on a regular basis and share with us. I am hoping others will step up and list some of the lessons learned and if comfortable, explain who you learned them from. Finally, lesson learned from EmtCityAdmin: 1. If you believe in it, it will come to be. (Look at how this site has grown over the years) 2. Dont be afraid to stick your neck out for what you believe in. (By this I mean $$$) 3. Do not be a dictator and shut down creative thinking or processes. Allow the ideas to free flow and see how they shape/reshape the dynamics of the site or yourself (if applying this lesson personally). oh well...ramble over for now

I think I found my next job ! ! ! http://www.sun-sentinel.com/news/local/bro...0,7338071.story By Sallie James | South Florida Sun-Sentinel February 17, 2008 FORT LAUDERDALE - Ken DeSantis looks like a traffic cop whizzing down Interstate 595 on his Harley-Davidson Road King. But DeSantis doesn't write tickets, and he only targets speeders if they're hurt. Instead of handcuffs and citation books, the 22-year veteran firefighter/paramedic packs medication and bandages for saving lives. DeSantis, 42, of Wellington, is a motormedic whose mission is to get to crashes fast — even faster than your typical ambulance. "People think we're cops until we bring out all the gear and start asking medical questions," chuckled DeSantis, part of a new, two-person motorcycle rescue team stationed at Port Everglades to reduce response times at the congested seaport. The Broward Sheriff Fire Rescue division started the pilot program six months ago, modeling it after a successful one created by Miami-Dade Fire Rescue. "We cut response times to life-threatening calls by more than 58 percent," said Miami-Dade Fire Rescue Capt. Roman Bas, who started his agency's team in 2002 and hopes to help train Broward team members. "We have an average of a three-minute response time. You look at the statistics and it definitely works." Using 10 donated motorcycles formerly used by the California Highway Patrol, Bas created his team. Today, rescue workers staff the motorcycles five days a week, 12 hours a day. "We would love to see this program implemented around the country," Bas said. "We are pleased to see our neighboring fire department in Broward starting their own." At Port Everglades, the motormedics roll on everything from traffic crashes to stalled elevators. "There's lots of cruise ship traffic; there are traffic issues and [the port is] close to Interstate 95," said Mike Jachles, agency spokesman. "They can be anywhere quickly because it's centrally located." DeSantis and firefighter/paramedic Tim Riggs were selected for the job in Fort Lauderdale based on seniority and medical experience. Both had to complete the same 80-hour motorman course required of police. Key to the unit's value is the riders' ability to weave through gridlock and arrive at crash scenes well before their co-workers pull up with a fully-equipped rescue truck. Daily crowds at the five-square-mile port often reach 46,000, but the maneuverability and speed of the motorcyclists make it easy to navigate. On busy days, they sometimes run as many as 15 calls, DeSantis said. "On the average, [there's] at least a two- to three-minute decrease in response times," DeSantis said. "Traffic in the port is so congested that the rescues cannot get in ... they have a good eight- to 10-minute delay with taxis and 18-wheelers, and the bike is able to weave in and out." The paramedics can stabilize injured patients, check sounding alarms or begin evacuating people from a burning ship when they arrive at a scene. If the call is a working fire, they can change into traditional bunker gear and battle the blaze with their co-workers once the firefighting apparatus arrives. "It's not to take the place of a rescue, but to supplement it," said Broward Sheriff Fire Rescue Lt. Tom Lord. Sallie James can be reached at sjames@sun-sentinel.com or 954-572-2019.

Very creative Michael. I like it!

Michael, most of the older stretchers are rated up to 450 lbs and are narrow, which means a lot of rolls hang over or feet extend off the stretcher. The newer stretchers have a few extra inches added in width and are rated up to 600lbs, but again it is a challenge actually getting these patients on the stretcher and then getting the rails up and we have yet to begin the lifting process. When this amount of weight is on the stretcher, obviously they are very top heavy, so they should not be lifted to a pushable height. This means the providers must be stooped over pushing a heavy load until the fun part of lifting into the transport vehicle. Now there are new stretchers designed for this particular type patient however they are not entirely common as of yet. Since these stretchers are much larger. they also require a larger ambulance which itself sometimes has an automatic electric lift so no one gets injured. For the uninformed, we never take a patient down flights of stairs as this is dangerous for all involved. A few steps yes, a few flights, no. We like to use a stair chair for this purpose, however this patient definitely exceeds the weight for that device as well, not to mention how awkward it would be to use if he were able to get on it. Now the task fell upon 10 FFs to figure out how to extricate this patient. It seems they chose a workable scheme however they failed or were unable to secure him to the improvised board. I do not have any further details and dont know anyone who was involved, so it is hard for me to even imagine what they came up with and why it did not work. This is purely speculation on a possible scenario, but is something that has happened with me personally many times. It could be possible that the patient shifted his weight and caused them to drop him. This has occurred many times when loading and unloading patients in the ambulance, so I see how it could occur if they were toting him on a sheet of plywood. Despite warning patients about the loading and unloading process and assuring them we have them and will not drop them, so many of them flail about and shift their weight which does indeed cause us to sometimes dip the stretcher or turn at an angle. They even like to grab the doors as they roll past which again causes drag on us and has potential to harm us. I could see how this large man having to be extricated during an emergency situation where anxiety/stress is already present may also have been embarrassed at the great effort it was taking on everyones part to do so. I can imagine him trying to assist or even grabbing out during some of the shaky parts causing weight shifting. Since we do not know all the details, I can only speculate but this is a very plausible scenario.

Same thing with Florida. Can find them any day of the week or on the spot for the right amount of $$$. Can't you do ACLS online and then do the practical portion with a training center? What other classes besides PHTLS and ACLS are you looking for?

WoW! I wonder if they will ever make it to this side of the pond and how they would sell? http://en.wikipedia.org/wiki/Rice_krispies http://www.ricekrispiestreats.com/The_Tale.aspx

This topic has been very productive, lot of good points have been addressed. However, I think we will give it a 24 hour rest or so then see what happens. If it continues to go south, then it will get a permanent rest.

The New York Sun A 500-pound man who dropped down a flight of stairs during an emergency evacuation is suing the New York City Fire Department for $5 million in damages. James Maietta called emergency services on November 23, 2006, with health complaints, and requested to be taken to the hospital, a member of the law firm representing Mr. Maietta, Kenneth Berman, said. Ten firemen rigged a pulley-operated plywood lift to carry Mr. Maietta down the staircase of his Midtown apartment, but failed to tie him down, Mr. Berman said. Mr. Maietta, who is now living at a Yonkers nursing home, suffered injuries to his neck, back, and legs, Mr. Berman said. The New York City Law Department could not comment last night because they had not yet received the legal documents.

Because that is how it is in every system I have worked...SC, LA, OR, AK, FL, Philippines, Afghanistan,etc. We hired our medical directors, they were employees of the service, city or county. Since they were our contract employees, we could hire or fire at our discretion if we had issues with them. Fortunately, it never really came down to that but it allowed us leeway as well when it came to certain procedures or treatments. If we could provide valid documentation and support for a new procedure, drug, or treatment, we could apply a little pressure to make it happen. Once again, it never really came down to that as we tried to select progressive docs that had or currently have emergency experience. Most of the docs were on board with the proposals, however a few were shot down as well and that was ok too.

Sikorsky S-76 helicopter, see link below for cool pics http://krisabel.ctv.ca/blog/_archives/2006/8/28/2273726.html Here is a snippet from the blog.. The fleet can reach any community in the province and picks up an average of 17,000 critical patients every year. It requires round-the-clock teams including 244 flight paramedics (not counting the pilots) who are specially trained for emergency medical care. Wow thats a lot of critical patients....!!!! What are they doing up there???

Yes I did call you "Sir". Sorry for giving the respect, my bad. Thanks again for pointing out my spelling error. As many of the regulars know, I am dyslexic and sometimes insert random letters as well. I refuse to utilize spell check as that is how I train myself by forcing myself to go back and reread, yet sometimes still am unable to catch my errors. I think context is being misinterpreted as often happens on a forum board because I specifically stated in one of my posts on this thread that I was not implying a holier than thou attitude. I do agree I was slightly condescending towards the end, but i never claimed to be perfect. I explained why I quoted your post and how it was interpreted and why I thought what was implied as I am sure others thought the same. And yes again it is tiring, yet true..."you do not know how much you do not know." This is a quote and I can not cite the source but it holds true for EVERYONE. This was not aimed at you, it was shared with you. There is much truth in it and it is not until you reach a certain stage in your life/education, etc that one comes to realize this and accept it. Unfortunately, the majority of the young and inexperienced, under educated do not posess it. Now, I was not arguing for different scopes depending on partner of the day. It was you who brought up how you work on ALS rig, therefore the problem can be "fixed" because a medic is there to do so. I am trying to stick to the OP in regards to BLS only and what should they do. The standard should be the same for all EMTs, so no, regardless of you being with a medic or not, you should not have this in your scope. In your rapid response, you also failed to address my last two paragraphs, so maybe that will come later. Again an example of not fully reading, digesting and composing a well thought out response. This is a debate. Do not allow your feelings to be hurt. Do not take it so personal. Instead, compose accurate, fact based suportive information and convince me otherwise. I am all ears/eyes and willing to hear what you have to say.

The electrode placement ONLY comment was directed to the tangent that you spun of working WITH ALS. I would never endorse this for a BLS crew as again there is nothing they can do about it. Sorry you got confused while reading, as so often happens here because one takes immediate offense and types a response instead of stepping back and fully comprehending what was just said. Please do not confuse the two entirely different scenarios of BLS only on scene and a mixed crew of ALS/BLS. I guess I should never had entertatined your tangent whereas to limit the confusion and address the original issue. Now these are your words, forgive the improper quoting: Gave her some orange juice (or oral glucose) and suddenly she feels fine and has no complaints. With a BLS crew that didn't have the option of checking BGL, their options would have been: Transport while twiddling thumbs saying "I don't know what's going on!", or request ALS so that ALS can do the exact same thing BLS would have done on scene if they had a glucometer. Is that really what's best for the patient? In this very statement where you said give OJ and all is well, that would indicate or imply the thought process of "everything is dandy and all it was is a low BGL, lets get a refusal now. Did anyone else here not think the same thing? Secondly, you stated ALS would do the exact same thing on scene as BLS. Hmmm, interesting theory but I beg to differ. I will allow you a chance to further support that ludicrous claim with something more tangible, fact related other than you just saying so. Also, you said BLS would be transporting, twiddling their thumbs saying "geez I dont know whats going on"? Once again, this implies that IF you knew this magic number, that you would know exactly what is going on and that is all there it is to it. Which as I and Ruff stated previously is incorrect, there could be so much more going on, yet once again the lack of knowledge is what prevents one from realizing that. So, in closing, I toss back at you sir, that it was you who implied the things you accused me of. You don't know how much you don't know...

You just demonstrated one major problem. You are assuming because all the signs are there for low BGL, that is all that is involved. You have no other tools or KNOWLEDGE to determine otherwise. Again this is "protocol learnin" or" rote checksheet mentality". WHY is her BGL low? Isn't she controlled? I would be very uncomfortable with a BLS crew making this diagnosis and giving the OJ treatment, then getting a refusal on my grandmother. Sorry, its just the way I feel and it is not what is best for the patient. As for freeing up the medic, again it is another lame argument. Most medics can handle everything in a systematic order for any call by prioritizing what is best and what is needed. By this statement, I do not mean to imply all medics are stellar and godlike, I am implying that most tasks are simple, easy and require minimal skill and time. No one has ever said skills are difficult (IV's intubating,etc); anyone can be taught to do these. As for you getting a BGL while I do an IV, guess what? I will have done an intial BGL myself while you get a BP and pulse, or on known diabteics that I have treated before, I may do an IV and BGL at the same time. Then while you are placing the electrodes (provided I have trained you and trust you know proper placement) I will be inserting an IV. Any subsequent BGLs will be done by me while you are driving me to the ER or while I am assessing whether or not to get a refusal for this particular patient. There are so many other ways you can assist as an EMT than worrying about a BGL. You can work on your assessment skills, interview the patient up to a certain point, set up for IV, monitor lead placement, prepare stretcher and give a smooth ride. You doing all of those are way more important and valuable to me than you being able to prick a finger. Ok, now can we leave the tangent of "what if" an EMT is working with a medic, cause that was not the point of this thread. The point was referencing BLS crews and what/how they should handle the knowledge of a number on a machine.

DD I already tried the tax deductible thing and CE benefit, but was informed this is for FUN only, NOT CEUs and evidently a lot of people here do not itemize. Regardless, if my schedule permits I will be at one of these events, still deciding but I am sure CEU and tax deduction will be my calling.

Again you are thinking of the exception, not the rule. Yes in the back of an ambo is fine but the scenario I described is very real and what occurs more often than not. You must keep an open mind and always cater to the lowest common denominator, which again is one of the largest problems with EMS.

Ok, did you not read my post where I made the point that it is a time waster and how I expanded on that fact with examples and even admitted doing it myself as a medic? It is not the fact that they can not be trained to use it, it is the fact that it will waste time on information that is unecessary for what they need to do and could potentially delay the patient transport. Remember the patient..the person who needs help? It is about them and what is best for them...NOT what is best or most cool for the EMT. I bolded the word "may" in your above post as that is exactly what it is. It MAY as in possibly speed their time. Now I say, no it does not. First, most labs are repeated almost immediately upon arrival, especially when you say you are responding with a AMS or unconcious patient. These are "critical" patients until certain tests are performed, so I do not see how a hospital report saying the pt is unconcious with BGL of 12 versus them saying an unconcious patient unknown BGL with delay their treatment at the ER. The triage process is going to be the same, they will get the same rapid care as this is an emergency situation and once again the end result is the same. What I am finding when a lot of people respond to these posts, they are thinking of the exception rather than the rule. They think of how they were personally as an EMT or think of the few exceptional ones that stood out with a thirst for knowledge and desire to advance and do what is best for the patient. However again, you must consider that when discussing treatments for EMTs and for medics, usually the skills, protocols, guidelines, whatever are geared for the lowest common denominator. Keeping that fact in mind, then apply it to a large portion of the country where rural volunteers exist and where call volumes and exposure to new experiences are limited and see how this applies to them. What is best for the patient is a transport without delay.

I do not believe anyone is debating the fact that they can be trained to use them as they are no more complicated than my universal remote. What they are debating and the point that several have missed, is why is it necessary for them to do so? Does knowing what their BGL is change the end result as a BLS crew? No, it does not. The treatment will be maintain airway and transport or call for ALS or ALS intercept if that is what happens in that area. What checking the BGL does do is waste time learning something that they can do nothing about. See? The end result is the same regardless of it being normal, low or high. You maintain and transport. Even if you administer oral glucose and "wake" them up, you should not be getting a refusal as a BLS crew, transport should still be required. Now my next statement is in no way representative of ALL BLS crews, however I have seen first hand what typically takes place. By the time they get through their rote memorization checklist of SAMPLE and all the other BS and do vitals and then consider "What can we do next" and remember a BGL, they have already wasted too much time; giving the oral glucose and waiting for improvement again is wasting time. Now consider how much time has been wasted for a number or treatment that in no way changes their end course of action. I am not saying withold the glucose if they are able to swallow, but time should not be wasted sitting on scene checking for numbers and administering a drug. As we all know, time gets away from us on scene. Many times I have been caught up myself and relaized I was on scene way longer than what I recalled. Dispatch times do not lie and I have been shocked and said "No way" many times...LOL. I witnessed a similar phenomenon when pulse oximeters first hit the streets. (Yes kids, there was a time we did not have that fancy gadget and I am not that old). I would come on scene and see a patient in obvious distress or even in mild distress and there would be no oxygen on the patient. When I ask why, I am told that the pulse oximeter reads 99 percent so the patient does not need it. See the correlation anyone? Our reliance on gadgets and numbers instead of solid education and thorough assessment based on our past knowledge is one of the pitfalls of EMS. Yes, they are handy but not always needed. As for the scenario of giving oral glucose to a patient with hemmoraghic stroke, I am going to claim ignorance in regards to whether or not would this make a significant difference. Is it enough to worsen the situation? I do not know. I do know I have given patients with low BGLs and presenting with CVA symptoms IV D50 many times, usually start with a half amp per med control. Out of the all the times I have done this, only one of them was actually having a CVA along with hypoglycemia. Did this make him worse? I do not know and can not say, however I did administer the D50 with online medical direction as I was conflicted on what to do in this particular case. (I passed the buck, so to say). Well, thats my ramblings for now, hope they made sense.