nypamedic43

You're right Dwayne. I shouldnt have let his idiocy get to me. I have read his posts before and have ignored them for the most part but this time he crawled under my skin and I just had to reply. *slapping paddies for giving him what he wanted*

There are times when an ignore button would be a fantastic thing to have on the forums. Mercury, aluminum, Thermerisol...the fact of the matter is that none of these have been proven to be the cause of Autism. Hmmm...maybe thats why the Autism symbol is a multi-colored puzzle. Because NOBODY knows why its so prevalent. SHOW me your proof and maybe ..and I emphasize the maybe..you will gain some credibility Mr. Crotchity. OR, heres an even better suggestion, dont comment on a thread, if you cant add something that hasnt already been beaten to death.

CPhT...perhaps...instead of reading the first and last pages..you should read all the ones in the middle. I didnt put my son on Concerta to help control him. I put him on a medicine to help him slow down and concentrate in school. They were using weighted vests, quiet rooms and one on one aides to help keep him on task. I didnt make the decision to put him on a medicine lightly..I weighed ALL the pro's and con's before I made that decision. I didnt WANT to medicate him. Luckily the Concerta is time release and wears off in 8 - 10 hours. If you dont have a child with special needs, you cant possibly understand what we, as parents of one, go through on a daily basis. So what you may think is "throwing the Autism and AD/HD diagnosis" around, just may be all we have to understand our kids..dont judge us until you've walked a mile in our shoes.

Dwayne I read this and actually snorted milk out of my nose!!! Ok it was coffee but same pain in the sinus. Ok...#5. unfolded fitted sheets drive me IN--sane. I found a video on how to do it. I will find it for you. # 15- I hate that as well. And yes they did drop the phone and run away. # 17- I do that too lol

NYS will grant reciprocity one time. You fill out the paperwork and send it in, along with a $25 money order. They will send you a packet that needs to be forwarded to the DOH in Florida along with a self addressed stamped envelope. Once you hear back from Florida( they will send you the papers in that envelope) you then forward the envelope from florida to the NYS DOH. Its a lot of jumping through hoops, but they will grant it one time. Thats what I had to do to get reciprocity from PA. Good luck

First I want to say HI BABS!! It's very nice to "meet" you Second I want to share this lnk. I was watching some youtube videos and I noticed it on one of the Autism videos. I havent had a chance to check out alot of it but from the topic list, I think it merits further perusal just to see what information is there. www. neurodiversity.com It may prove to be something that I won't be interested in after reading a few articles, but I thought I would share it.

When my son was diagnosed, we saw a psychologist and a pediatrician at Golisano Childrens Hospital at Strong in Roch NY. Both of the people that we saw, specialized in PDD's and the Autism umbrella. When the pediatrician was interacting with Jayse, she noticed some things about him physically. 1. His fingers are squared on the ends, not rounded. 2. He has 3 "cowlicks". 2 go clockwise and 1 goes counter clock wise. 3. His earlobes are much bigger than normal and the creases in his ear are very narrow, as is his ear canal. 4. He was born with a severe clubfoot. 5. He has 3 birthmarks. 1 thats comes over his eye, from eyebrow to cheekbone. 1 at the base of his head and 1 at his tailbone. 6. An atrial-septal defect which produced a murmer. That closed on its own at the age of 6 months. 7. peanut allergy I filled out questionaires and paperwork that would choke a horse. In the end, he was prescribed Ritalin 5 mg twice a day. ( What a nightmare) With the Ritalin, he wouldn't eat and he wouldn't sleep. So we changed him to Concerta 27 mg once a day. He got his appetite back and he started sleeping through the night. Imagine being scared to death that your child is going to get up in the middle of the night, not wake you, and wonder off into the night. It happened to us on 2 occassions. It was terrifying and we put alarms on the doors. Through trial and error I figured out what kind of diet works for him. We avoid red dye like the plague. I have to peel him off the ceiling if he gets anything with red dye in it. We avoid most sugars, so there isnt alot of candy or sweets in the house. Lots of fresh fruits and veggies and chicken. He doesnt really like red meat and prefers chicken and fish occasionally. We go through cycles of him not liking anything and will only eat, say, spaghettios, for every meal except breakfast, sometimes for days. The biggest problem with Autism, is that every child is different in thier symptoms and problems. While my son is high functioning, reads well etc. he has a problem with socializing and reading into what people are trying to say. If he's made me angry for some reason, he knows I am angry but doesnt understand WHY I am angry even after I tell him why. The W questions, who, where, why, when and what pose HUGE problems for him. He knows what is being asked of him and can't communicate it in a way that is understood universally. So, sometimes when asked a question, he will answer with a totally off the wall answer. He knows the question needs an answer but cant put the idea of the answer into words, hence the off the wall answer to the question. ie: The question could be...why is the sky blue? and his answer may be something like "Because Thomas is blue" The biggest frustration for me, after he was diagnosed, say 6 or so, was being in a store and he wanted a toy. I told him maybe after we got what we needed and he melted down right there in the aisle. people going by us looking at him like he is possessed and looking at me like "Geesh lady cant you control your kid?" It finally happened one too many times and I looked at the woman and said " He's autistic..whats your excuse?" She humppffed off down the aisle. People who do not have a child with special needs and problems dont understand what, we that do, go through...on a daily basis. Schedules and ritual and repetiveness. The blaming of ourselves..is the reason that he is like this my fault somehow? The one step forwards and the 2 steps backwards. It is maddening and frustrating and stressful. And it seems that there are no answers, so some, not all, parents grab onto an idea and believe it and live it. Even if the idea holds absolutely no merit. Desperation for answers drive people to do crazy things. Yes I would like to know WHY my son is autistic BUT I want hard fact..science based fact and then given the opportunity to peruse it, form a conclusion and then choose a course of action. My course of action may not be the same as the next person's. I would just like the opportunity...to help my son understand things better, to be able to express himself better...to know that when my life is over, that he will be ok in this world. That what I have taught him will be enough and that he will be a productive member of a society that probably wont even begin to understand him. That's my hope anyway.

Dwayne, I cant tell you how hard I try to live in that magical place. Some days I achieve it and some days I dont. I guess, for me anyway, I try to learn something from every call. I reevaluate constantly. I dont second guess myself though. I think of ways I can do it better...until I cant get it wrong

My son is autistic. He is 10 and was diagnosed at the age of 5. Since when does vaginal flora come from the bowel??! In my experience, bowel flora causes HUGE vaginal infections. Just sayin....and no I'm not going to elaborate lol. I have heard the vaccination argument and it really has no merit. I even had my son tested for Mercury and nothing. There is no cure for Autism and with 110 children diagnosed everyday...some pure fact based, tried and retried and retried again, science would be awesome news. Freakin crackpots anyway. The next test to come is the genetic testing, to see if there is a "flaw" in the DNA strand. There are some that say mutation of the 23rd chromosome may be the cause of Autism. Who knows..all I do know that, to me, my son is normal. Autism and AD/HD are all we know. So if you have a "normal" child, count your blessings, because you many.

They never taught that if you sit a symptomatic bradycardia patient up that they would get even more symptomatic( they only taught us to pace) and that if you lay a symptomatic CHF patient (flash pulmonary edema etc) down that they respiratory arrest on you....helpful info to have BEFORE you make those mistakes edited for spelling :/ oh oh...just thought of another one lol pushing Narcan too fast will get you punched and puked on...been there done that thanks to my "senior" partner :/

Paramedic??? online...I'm pretty sure that wont happen. There are triple the amount of clincals and class time to go from a basic EMT to a paramedic. You're best bet might be going to school for Emergency Services Management if your goal is to truly help initiate change to the infrastructure and maybe implement change to the levels of EMT through education. Just a thought

I have to agree with all the above Ash. I carry a roll of tape, pens,my stethoscope and trauma shears with me but I also carry my protocol book. The company I work for provided us with a pocket size version for us to carry with us. I read them through about once a week, just so that when I am dispatched to a call, say for allergic reaction, I am refreshed in what I need to do ie: .03 epi 1:1000 SQ, albuterol if needed and to call for 50 of benadryl etc etc. along with all the reg ALS, monitor,, oxygen and IV. You will find what works best for you through trial and error. It's a learning curve that we all go through. I just want to say again: YAY!!! for Ash!! I am so very very proud of you and you are gonna be awesome

Washing a cut with water isn't going to hurt you. Most city water is chlorinated these days. OR you could let your dog lick your wound...they heal thiers just fine....just sayin

EMS is a tough job and every call puts everything you are and everything you own on the line as well as your boss and partner. That being said, if your goal is truly to help people and to make a difference...then ALL of the above advice needs to be taken. You will also realize very early on, once you get your EMT, that you cant save everyone and neither can your Paramedic partner. Here in NY, the biggest thing for you would be the insurance company. If you cant be insured, then you cant drive, not even from the hospital to the station, and driving is half the job. Volunteering is a great way to get patient contact, to see the way things are and the way things should be done. We all started as basics, we all started where you are now. We all asked for advice from different people. It took me 15 years to decide that being a basic EMT was no longer enough for me and I went to school, got my paramedic and my AAS degree AND got hired by the compeny I now work for right out of school. I didnt even have my card...all I had was my score from the testing facility and then my letter from the state. EMS is physically demanding, anyone who has been in an upside down vehicle for an hour while fire decides the best way to get the patient out or trekked a mile into the woods to carry a 200 lb man out on a backboard after he's fallen out of his tree stand will tell you this job isnt for wimps. The emotional toll can be just as great, anyone who has watched someone die because you cant get to them or did everything they could for the 6 month old in status seizure and they still dont make it, will tell you that you have to get tough....quick. If you dont, you will burn out in about 6 months. But not so tough that you no longer have empathy for the patients you may have tomorrow. I do this job 5 days a week...as of July 1 we were at 8000 calls. and my body aches and my brain is tired but I will get up tomorrow morning, put my uniform on and know that no matter what the day brings me, my patients will get the best that I can give them. Take the advice that the others have given you, get the education, get the experience. If this is truly your calling all of this will be nothing to you if you are going to do what it takes. Good luck to you

I dont ever remember you really pissing me off but I do remember you making me think about things, even as a basic. Being pushed to think about things, made me realize just how limited I was, as a basic in this profession. I am loving being a medic and my favorite calls are unresponsive diabetics. I like being able to see, right now, that what I do does make a difference. I dont wish bad on diabetics at all but they are my favorite. We have new protocols and procedures coming June 1 and I will probably pick your brain lol pericardial centesis and facilitated intubation and everything that comes with them is making me more than a little stressed and apprehensive. I look forward to chatting about calls and all this new stuff. I havent ever stopped learning but the new protocols make me feel like a new medic student again. Hugs Nymphette

I took a long hiatus as well Rob. I am very happy to hear that you are alive. I had no idea that anything had happened to you and I am distressed by that. We dont expect anyone we "know" to be injured. I guess I've been away longer than I thought. Gosh now that I really think about it, it's been 3 years. I was in medic school and I am recerting now. Wow! I am off to sleep now. Hope to see you lots Love and Light, Nymphette ( couldnt resist)

Chris I only used that quote to push home the fact that Medics need to remember their basic ABC's before advanced interventions are done. I am quite familiar with the area that you are in and am aware of the ability to get ALS from Memorial or Western and a helicopter if needed. As far as I am concerned strong BLS makes my job a little easier. It was in no way meant to imply that the EMT's in your area cant take care of a patient or that people's lives haven't been saved because your squad was there and did what was necessary.

I've been thumbing through my job description, wondering where the section is that I became a public safety person in. The last time I looked at the patch on my sleeve is said Paramedic, not Police or Officer or Detective or Investigator. But I digress. :/ I don't come to work everyday thinking that my job is to enforce the laws of the city, county and state. Mandated reporting pertains to child abuse and neglect and elder abuse. It isnt my job to blow someone in to the local PD while they are having a "crisis", that MIGHT have been caused by ilicit drugs. I would be concerned about leaving the drugs in plain sight if there might be a child present, in that case I would ask the patient to please put it away. I'm there to take care of the patient. Period. In the case of the 2 minors having sex. Again I'm not going to "tell mommy and daddy". Teenagers are tricky to put it mildly. It takes alot to get them to open up to you and trust you enough to tell you whats going on. If their parents arent around, I am their biggest advocate. I might not agree with the kids having sex but it's my job to make sure they are ok and unhurt before I would consider signing them off. And I would talk to BOTH of them and to do that you have to have a repoir built with 1 of them to get them to talk. I'm not condoning teenage sex but they are going to experiment. It's part of growing up and you aren't going to stop them. So my answer to the OP's questions: #1 no #2 it depends

Chris's nearest medic is 30 miles away because he lives in a very rural area. BLS there usually transports towards the hospital and intercepts with an ALS unit if its needed. To be honest there are ALOT of rural areas in PA where it just isnt feasible for volunteer BLS units to staff a paid medic. Lets be honest there are very few of us medics that WANT to volunteer their time, we want to be paid. They dont have the means to pay them or the call volumes to warrent a paid medic and all of our bags of tricks and equipment. Personally I am all for allowing basics to do blood sugars... the general public can..why cant basic's? It's not like they are cannulating a vein...it's a finger stick. I am also for giving them the skill of non-visualized airways such as a combitube, especially in very rural areas. As long as its positioned correctly and they are taught to use the correct tube to do ventilations. I know I am going to get backlash from the above statements..but I really am unconcerned about that. I havent yet read the new PA protocols but it seems to me that maybe PA ought to up their recert requirements for medics....our cards never expire and we only need 18 hours a year. Considering the responsibility and liability that we have, I think they should require more...and not just classified as medical and trauma. It needs to be specific core knowledge. Right now I can do a PALS, an ACLS and a driving class and be done for the year. But in NY, I have to do 72 hours, in specific core classes to recert, done in the last year before my card expires. Pretty big difference. Sorry if I ruffle feathers but I guess I see things a little differently. And I am unconcerned with the whole "I am a paramedic, I am the only one that can help a patient cuz I got drugs" mentality. BLS providers are a huge link in the chain of survival and without them getting there first in some cases, mortality rates in rural areas would be bigger than they are now. The old saying of "Paramedics save lives, EMT's save Paramedics" cant be truer because unless we remember where we started at? all the drugs and IV's and C-PAP and cardiac monitoring wont save a patient if we dont have the very basic skill of opening an airway. Just my $.02 worth

sorry to hear about your cousin.

our first in bag contains: front pouch: 3 different sizes of BP cuffs and a stethoscope right hand end pouch: all manner of bandaging supplies left hand end pouch: intubation: 2 each size of ET tube, 1 each size mac and miller blades and the handle, 1 each size combitube, secondary checks and tube holders, magills, safety glasses. center compartment: in the lid: 3 sizes OPA, bite stick, oral glucose. main: small sharps container, small flashlight, occlusive dressings, BVM, 1 complete IV set up, 5 epi, 3 atropine, 1 lidocaine bolus, 1 dopamine bolus, glucometer and assorted paraphenalia, 1 drug box with 1 6mg and 2 12 mg adenosine, phenergan, zofran, extra nitro, aspirin, epi 1:1,000, albuterol, atrovent, mag sulphate, benedryl, glucagon and assorted syringes and filter needles.

you did very well. 1) assisted ventilations can be stopped if the patients respiratory drive kicks in and they start breathing better. If thier respirations become adequate 100% O2 by NRM is fine, but watch them carefully. 2) jaw thrust is correct because of the unknown trauma. 3)suctioning and repositioning is correct. oropharyngeal if no gag reflex. BVM with 100% O2 to assist. listen to lung sounds...it may be an exacerbation of the COPD or unresolved pneumonia. you also have a change in mental status out of the norm for this patient. seriously consider ALS intercept if your partner isnt an ALS provider. You didnt kill your patient...hope you are enjoying the class

American Heart and Red Cross both teach the 30/2 or 100/min. If you do that, then you have done your job. Unfortunately, once you turn care over, you cant direct how ED staff care for them or continue or discontinue efforts. Once a person is intubated the 30/2 goes out the window and the 100 compressions/min and breaths of 10-12/min comes into play. I understand that you want as much info as you can get, but busy ED staff will probably not see it that way. Doing the best that you can do for your patient while they are in your care is really all you can do. If you can walk away from the ED, knowing that, then questioning ED staff about why they do it differently should be a non-issue.

I would no have. We have protocol for adenosine for SVT. In the long run, with this patient, the adnosine only slowed him down by 27 beats. The other thing that bothers me is the adenosine for an atrial rhythm. Because of the clotting issue of the atria, if its a new onset, I would have questioned the Doc as to his reasons why the adenosine. If anything I would have cardioverted but, as I said before, the rate isnt horribly high. Was the patient short of breath? nauseated? lightheaded? Without seeing a strip, it's hard for me to say what I would do....but I wouldnt ask for adenosine with an atrial rhythm.