Asysin2leads

She had last eaten at school before coming home, her Lantus injection was iin the morning, and she had 8 units of Novolog at noon. Now that you mention it, it does seem that she was missing a meal. See, this why I don't get to play with the insulin. No, her sister wasn't hot, but her mom was definitely in the MILF range. Any tips you can give us about dealing with Lantus/Novolog patients, Dust?

No pill bottles to speak of. Sister agrees with everything mom says. Anyway, here's what we did. My biggest question was "Is this kid AMS, or just scared?" Given the mom's state, and the other bystander's state, it was really difficult to determine the child's mental status. The blood glucose wasn't reading abnormally low, and I am not for giving medications that aren't required because everyone in the room is panicking. The biggest tip off for me that she was indeed AMS was that she kept asking her sister "Is this really happening?" I took that to mean she was confused. 1 mg of glucagon calmed her down a little, enough for us to get an IV, and after 12.5 mg of D25, she became a calm, lucid, remarkably intelligent little girl. As the old adage says, if you hear hoofbeats, think horses, not zebras. Her blood sugar was low, she only had been diagnosed diabetes a year ago, and it seemed her Lantus injections needed to be adjusted.

Called for a altered mental status, 10 y/o female reported lethargic. Arrive to find a 10 y/o on bed in sister's arms, crying, obviously terrified. Mother and friend are runnig back and forth, mother is alternating between attempting to draw up Glucagon in a syringe and stating that the child is diabetic. After much cajoling, mother states that daughter is a diabetic, was found by brother slumped over while watching TV, drooling, was hard to arouse. Mother took blood glucose, which was 40, but now is at 80. Patient will not talk to you, is crying and only wants to be held by her sister. Patient does look at you, then at sister, and asks "Is this really going on?" Vitals are all good, BP 122/46, HR: 92, RR: 18. What is your plan? What else do you want to know? How else could you get this information as mother is far into hysterics land?

Hey! Hey! Hey! Over here, behind the firemonkeys, hello? Put down the EKG monitor and the Valium and the RSI kit and tell the firemonkeys to put the child down, slowly. Ummmm, you know, the biggest things otherwise healthy kids like to do is run around. Has this kid had a particularly rough time on the playground? Any signs of head injury? Given the risk of trauma in a pediatrics patient, even if there are no outward signs of injury, I still say full C-spine precautions on junior here. If its not trauma, the other biggest thing kids like to do is drink and take stuff they're not supposed to. Ask the parents if there are any medications missing from the cabinet, check the kid to see if he has any pills on him, and lets get him off to Mr. ER for a tox screen. Don't make me say BLS before ALS. I'll have to kill myself. In order of decreasing odds of probability, I'd say it would look something like this: 1. Fakin'. 2. Smack on the noggin. 3. Lack of child proof caps and Mr. Yuck stickers. 4. Mysterious sudden onset of hypoglycemia/seizures/brain tumor/Dr. Housemovieoftheweekitis/

I say cheat. Supportive care and bring 'em into the hospital. Let toxicology sort out the powder if they really care. Otherwise smack 'em around a little and send them on their merry way.

Mostly from straw buys in North Carolina, et al. Per capita, gun violence in New York is extremely low, probably the one of the lowest in any major city. Yeah, of course, shootings do happen, and yeah, you can't use it as a model for other parts of the country because few places can sustain the police presence. The United States does have a problem with guns, and as Dwayne pointed out, putting the genie back in the bottle is next to impossible. However, to bring this discussion back to where it started, I don't think giving people more excuses to shoot each other is good idea, which is what I was coming out against in the first place. Somehow we got on the topic of concealed weapons, which is a whole other ball of wax. Anyway, at the end of the day, this is my stance on guns. I don't think they're sexy. I think they're a tool, but they are not a means of self defense, they are means of applying deadly force. Thats why I'm against using guns as a deterrent, because guns aren't meant to be a deterrent, and their use as a deterrent is so abysmal that police departments don't even teach it anymore. We're never going to get guns completely out of American culture. Its not going to happen. However, if we do foster a better understanding of their uses and effects, maybe we'll be better off.

Actually, I don't live in a protected gated community, and yeah, I've had my share of run ins with guns. Somehow the grieving families of victims of gun violence and people who I've dealt with who have been shot usually are against gun proliferation, not for it. See, in my experience, usually the ones who are so for guns are the ones from the gated communities in the suburbs, and the ones in the boonies where the worst crime was someone parking on the grass, people who get the majority of their information about crime and violence from what they see on TV. These are the ones who believe in 'predators', which Dateline is always seemingly trying to catch, and the CSI devotees who wannabe like David Caruso and let the criminal know who's boss. So you can take the tough guy "you don't get it, man" approach to this, but the truth is, I have a lot of experience with crime, gun violence, and the like, and its from that that I draw my opinions. Seeing a six year old die because someone decided to have too many drinks at a birthday party is why I have such a dim outlook on firearms, why I see them for what they are, a means to kill, nothing more, and nothing less.

Nope, haven't gone, don't plan on going to one. You see, I do this as a job. My personal feelings and attachments stay at home. Besides, if you go to a patient's funeral in uniform, you're taking the attention off the deceased and placing it on yourself, which is just tacky.

http://www.texnews.com/texas97/corrupt092597.html I'm sorry, were you saying something? I was too busy reading about the Texas cops being hauled off to jail for drug charges. Smuggling reefer over the border, yeah, the cops look real terrified.

I said it before, I'll say it again, paranoia and gun proliferation, they just go hand in hand. Anyway, I'll just go ahead and put my trust in trained law enforcement professionals rather than Bob down the block with the sawed off, but that's just me. You know, while were at it, I never responded to I forget who's semi literate attempt at calling me out on a a point. I mentioned that if you whip out a firearm and scare the bejeezus out of somebody, you're guilty of the crime of menacing. To which the reply was something along the lines of "SURE...*SNORT* *SNORT* THEN THE RAPIST SAYS HE'S SCARED...HA HA HA". Now actually what I was really getting at is when Mr. Armed Champion of the 2nd admendment goes off and makes a mistake. Lets say you go and stop that rape in progress with your gun and then, oh crap, it wasn't a rape it was a boyfriend and girlfriend making out and you just pointed a gun at them, which, statistically, is a far more likely scenario than you, Smith, and Wesson saving the day. Now you're guilty of a crime, and you're going to jail. No one cares what your intentions are, once you started pointing a gun at people you open yourself up for a world of s**t. That's why we TRAIN police officers and hold them to STANDARDS, which in my opinion anyone who is armed and out there cleaning up the streets should be held too. Anyway, CB, if you really have that dim a view of the police and government in general, there's some nice men in a compound in Idaho who will sign you up. Until then, I'll trust you to stop driving on those nicely maintained interstates the government provides for you. (You see HDFF? This is exactly the type of person I'm talking about. )

Sorry, I'm going to have to go with Dust on this one. I wouldn't use an airlift unless I confirmed or had very high suspicion of major injury. Using helicopters due to "ruling out" trauma is not good medicine. You're telling me that if there is deformity +12 inches into the vehicle, even if the person is AOx3, asymptomatic, with stable vitals, they buy themselves a helicopter ride? I hope at least they have the option of RMAing. Secondly, and can someone please point me in the right direction for this one because its come up a few times, I was under the impression that flying stroke patients can be contraindicated due to changes in air pressure. Anyone know some place I can read up on this?

HDFF, I fully agree with you about the American Idol mentality, which is why I am against the masses being armed, at least in principle. A person is generally a rational, sane, level headed individual. People, on the other hand, are a bunch of mindless, reactive, fear addicted cattle who shouldn't be allowed near a sharpened lollipop stick. In the good old days of America, if you wanted to operate a firearm, you had to know proper cleaning, loading, and a good deal about chemistry and physics. Now, with a credit card, anyone with the IQ of a gnat can pretty much buy enough firepower to take out a block. Ending a life now, is as easy as turning the channel on the TV. You also make another point I was hinting at, too many people confuse their firearms with their penises. Most people, I believe, are not for carrying a firearm out of necessity, but because if they don't, it makes them feel less like a man.

Except the thing is, usually when the bible thumpers get up on the soap box and start telling us what God wants us to hear, they are quoting from Leviticus or the Old Testament. The prohibition against homosexuality, to the best of my knowledge, comes from Leviticus, which lays the kibosh on a whole host of activities that good Christians do everyday and don't hold rallies and form political platforms on. The New Testament doesn't say much (if anything, to my knowledge) about homosexuality. Its all about peace and love and tolerance and all that crappy stuff that would get you killed if you preached it in the bible belt.

Give me one Christian that follows every single word of Leviticus, and then I'll listen to the self righteous grandstanding. Until then, its just another case of someone trying to convince others that what they believe is the word of God.

The hiring page at nyc.gov gives you an estimate of the annual salary, based on base pay, average overtime, shift differential, etc.

First: THEN: Hate to break it to you Basic, but you just made an assertion based on anecdotal evidence, and not fact. Isn't it ironic, don't you think?

Me, personally, I don't care. I mean it. I really, really, don't care. I was for gay marriage, until a good friend pointed out that marriage is a religious, and not legal term. So, in that aspect, since I am such a firm believer in a seperation of church and state, the state has no right to dictate what a religion can and cannot accept. So, civil unions, yes, extend rights to partners. I don't think there is anyone who can really defend being against things like domestic partnerships without just being out and out bigots. I mean, people came down on my stance against shoot first laws by saying it restricts peoples freedoms. No one has ever died in the crossfire during gay sex, yet these same people like to but into other people's lives when comes to acts that are far more harmless. If you don't want people butting into your right to arm yourself, then what right do you have dictating what other people can and cannot do? The only thing worse than being a bigot is being a hypocritical one. Oh yeah, and being a natural redhead, redheads do get discrimnated against fairly often and are the subject of only partially true stereotypes.

Is it the same company? If it is is, yeah, that's the one headed by Steve "Whaddya mean Medicare wants their money back" Zakheim, who prior to Transcare, once told employees of his who were discussing wage increases and better benefits that he routinely carried a weapon, and has had at least two sexual harrassment suits against him. Ummm, I'm sure it has its benefits too.

Yeah, Democrats are all about slashing the federal government...oh wait, hang on a second... Know your political party people, please. Republicans = small government. Democrats = big government. Try again.

All right, pick an arguement, will you? First you say "more guns equals less crime". Then I show figures saying otherwise. Then the arguement switches too "okay, well, maybe not less crime, but see, the figures don't match up exactly so I'm right anyway. Yay guns." Its the same BS everytime. "Guns deter crime!" "Wait, basic firearm safety says that a gun is not to be used as a deterrent", "Errrr.... well, ummm.... cars and doctors kill people too..." "Yeah, but cars and doctors primary purpose isn't to kill things, a gun is. A gun isn't used for anything else except killing." I'm still waiting for the one about how if everyone was armed then we'd all be safer. Come on, let's here that one. It's my favorite.

Sorry, usually anyone who is blaming "the media conspiracy to keep guns out of our hands" has an autographed picture of Newt Gingrich somewhere. Once someone goes that route, I've already considered it devolved to a juvenile level.

Again, you are using the classic technique of arguing something different. Again, I will repeat, I never said relaxing laws on the use of firearms increases crime, I said that carrying a gun drastically increases your chances of getting shot, shooting a loved one, or going to jail. If you'd like to bring out facts to the contrary on that, please, show me. Until then, I'll look at these NUMBERS, which, at the end of the day, tell a lot more. Take the USA, Germany, Spain, Australia, and New Zealand, all industrialized, first world nations. In terms of numbers of homicides vs. 100,000 people, the numbers look like this: USA: 9.10 Germany: 1.65 Spain: 1.49 Australia: 1.88 New Zealand: 1.35 Adjusted for population, the United States has nine times as many homicides as the other countries. Now, why you may ask? Well, lets look at the percentage of those homicides that used a firearm: USA: 39.5% Germany: 28.57% Spain: 16.41% Australia: 16.34% New Zealand: 13.46% So...it seems, that while as I said before correlation is not causation, from these numbers, a lower amount of guns used in homicides coincides with a lower homicide rate. One interesting thing, as anyone might have seen, is the fact that Germany only has 11% less homicides that use a firearm but almost 6 times less homicides than the USA. Got to wonder why this is. Could it be that ambulances in Germany have physicians riding along?

More like a stomach felt feeling. Here's a t-shirt.

Rescue, here's the thing. I feel for your situation. I'm sure your department is top notch. It sounds well put together and well run. I myself have many times said that rural areas can utilize volunteers well in areas with low income levels and high coverage areas. However, I, and the others you speak of, have seen the ugly side of volunteering and do not pull any punches about it. Typically speaking, volunteer EMS attracts many of the wrong people, into doing the wrong things for the wrong reason. For every volunteer service out there who provides professional level service, there are 10 others that the term hit and miss is far from appropriate. So, when someone comes along stating "Fighting to keep it volunteer!", you'll have to excuse it when people assume its yet another starry eyed hero with a star of life T-shirt, three missing teeth and a couple of tattoos, which unfortunately, compromise a good bulk of volunteer services today.