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Because God wills it. Next question.

He's a red puppet popularized on Sesame Street and is also a stuffed toy that was the must have toy during Christmas time. Oh wait, that's Elmo.

Even though I would make fun of it on the surface, I always kinda liked the Goth thing because it did have a certain kinda coolness and sexiness to it, you know, like Elvira, Mistress of the dark, The Crow, and Alice Cooper, yeah, they're cool. This Emo crap, man, just drop dead already you guys.

Yeah, but all of your politician's and businessmen's lawns are still looking pretty sharp and their kids all still seem to have private 'nannies', so maybe they need to pick up the pace a notch.

You know, I never even heard of Emo until like 2 weeks ago and now I see it everywhere. This is a parody of course. Too all you Emo kids out there, either kill yourselves or quit your damn whining. Life can always get worse.

Actually, as usual, EMS got shafted in the funding for Haz-mat gear as usual. While firefighters get to watch interactive videos on brand new plasma screen TV's, EMS still is using bootlegged DVD's on personnel bought projectors. Anyway, when members of the Taliban start getting caught with schematics of the Astrodome in their back pockets, then Texas can get all the blood money it wants. Until then, you're just going to have to rely on the Minutemen to have your back. How are those good ol' boys doing, anyhow?

Not that you haven't heard it, but yes, 7 years is far, far too long for a doctor to have taken action. Unfortunately, things such as this are becoming far to common in the modern health care world as HMO's squeeze more and more patients into less and less doctors. One day, the system will either collapse or wake up and see that medicine is not McDonald's, you can't streamline or make diagnosis faster without compromising quality.

1. Progressiveness. Free from the chains of tradition that plays havoc with the modernization of firefighting equipment, EMS changes and grows significantly every year. Compare a Lifepak 5 with a Lifepak 12 sometime. 2. Inclusiveness. EMS brings aboard a far more diverse work force than police or fire could ever hope too. 3. Flexibility. EMS gets it right in the modern field by being made up of pretty much autonomous units. On an MCI, if a fire chief is incapacitated, things can get ugly. On an MCI, no one listens to the EMS supervisors anyway so what happens to them doesn't matter. 4. Endurance. Spit on us, kick us, don't pay us, call us names and forget us later, someone will still be there when you have chest pains. 5. Review. We love to pick each other apart. No blue wall of silence here, you screw up, and by God everyone in the service will know it, and sometimes its a darn good thing too.

Broadly, the equipment for Hazardous materials decon is broken up into the ambulances which carry limited decon supplies (adapters, brushes, some levels of suits), while the heavy duty stuff is equipped in specialty units that respond when needed. Outfitting an entire ambulance with all of the equipment needed for even a small decon event would not be conducive to normal 911 duties, so limited equipment should be on the individual ambulances with the bulk of it on a specialty (non-transport) unit. My advice is to plan for the events you'll probably encounter, rather than spend all your time and money planning for 'the big one'. Do a study on the calls your department has responded to in the past couple of years, and try to determine how many could have needed hazmat resources. Remember, Hazmat response is not only necessary when there are actual hazmats present, but any time there is the potential for a hazardous situation. Any tanker truck MVA, actually, any MVA with significant fuel spill, an unconscious in a greenhouse or a warehouse, structure fires, the potential for hazardous materials release is really endless. My training was 10 (two weeks) 8 hour courses that encompased training in SCBA use, and scenarios in Level A, B, and C protection, didactics, and lectures. Some equipment we use are brushes, hydrant adapters, SKED's, garden hoses, Mark I kits, inflatable decon tents, and other various equipment. I'm sorry I can't be more in depth but the Department does like to keep a lot of what we do on the down low, mostly because it cost them a lot of money to teach us and god forbid someone should learn something for free. Best of luck to you in your endeavours.

It pays the rent.

1. Lights ain't bright enough 2. Ambulances ain't fast enough 3. Siren's ain't loud enough 4. Too many rules 5. Not enough TRAUMA!!! WOOOOOOOOOO!!!! That's what I'm talking about! YEAH!

One last thing to all the young EMS providers out there with self esteem issues. Remember, if a girl will fall all over herself fawning simply because a man is wearing big pants, boots, and suspenders, she's really not worth your time anyway, so don't get jealous. Yeah, you heard me, any girl who is willing to go out with a guy because he wears turn out gear is one you can give a miss. Keep being yourself and find someone decent.

Nurses are like any people, and you get the good ones and the bad ones. Don't confuse the cute ones with the good ones, its so easy to do. Try not to flirt too much, you're not God's gift to women, I talked to to him this morning and he assured me I'm the only one. Be friendly, if a nurse digs you, chat her up on your own time, and if you can't get her to go out with you without the uniform, you are very very lame. I like being friendly with the nurses, but I start to reach for the red bag when everyone is so buddy buddy chummy and stuff. I come to work to do my job, I don't go to work for social interaction. I've offered to do a food or coffee run here and there, but that's only because I have a truck and they're cooped up and I only think its courteous. Bringing chocolate sounds dangerously close to "Bribing the pretty girls so they'll talk to me" land, and again, don't be that guy. Professionally, bring a patient, have a decent report, do appropriate treatment and don't be a moron, and everything should go well. You'll have the Nurse Ratchet and the Nurseferatu types here and there, usually they have serious emotional problems that are easy to pick out and exploit if they give you a hard time. Ask them how they're ex-husband is doing now that he ran off with the cheerleader. They love that. Unless you work around me, at least your nurse will usually have a working command of the English language, so count yourself lucky. Nothing is more frustrating than trying to give a run down on a post cardiac arrest in pidgin English/Mandarin/Cantonese/Spanish/Urdu/Swahilli. The most drastic measure you can do if you are being ignored in triage is to break rank and find the attending physician. You really shouldn't do this unless its an absolute emergency (I.e., pt. turning blue, heart rate very low and getting lower or very high and getting higher), it gets you attention quickly, but it also makes the triage nurse look very bad and gets the doc mad at her, and we like peace and love and happy ER's, not docs yelling at nurses yelling at us ER's. That being said there have been one or two times I've actually had to do that.

This sounds like an urban legend, but its true, I actually made the call and confirmed it. Our stand by protocols for the annual West Indian Day parade dictate that crews should be equipped with soft body armor, not for its normal intended use, but because there have been cases of crews with (minor) chest discomfort and blunt force trauma effects from exposure to the endless parade of highly amplified bass music. Whether the soft body armor actually helps or not is debatable, but apparently it has been enough of a problem that someone decided to take a step by writing it into the protocols. No one has gotten a pneumothorax, mind you, but someone has described the feeling like being sore after a rough game of football. Hope that helps.

HURRRRK YOU DON'T KNOW YOUR BLS SKILLS!!! THE CRAVAT GOES THIS WAY NOT THAT WAY!!! HURRRKKK!!!! THAT'S NOT HOW YOU TAKE A BLOOD PRESSURE!!! YOU NEED A FEW MORE YEARS ON THE STREET DURRRRRRRRRR Seriously, man, a retarded monkey can figure out how to do BLS skills in about 3-6 weeks. Why do people get so caught up in them?

NREMT-Basic, lets say you have the authority to have people arrested. That's no different then professional courtesy from police officers. Exactly what are you going to do exercise your authority? Wave the gun around? Slap some cuffs on people? Without that ability, authority is just something to jerk off over at night.

Tracy, if you are really serious abotu doing your medic, repeating 30-40 hours of clinical time is a drop in the bucket. Yeah, its sucks to have to redo something you've already done, but to get my medic, I had to sit for two different state EMT-B tests, and now if I want to go anywhere else, I have to retest with the National Registry despite holding a degree in paramedicine. This is also why I suggest to anyone who is serious about working as a paramedic to forgo all the in between steps and get your medic as soon as possible.

I guess that's like my ultimate course for whackers, tactical underwater school bus extrication. For when a school bus is hijacked by terrorists and goes into the drink with kids trapped inside. I think my biggest pet peeve besides being a loud mouthed obnoxious dick with no sense of decency or tact is trying to help me make an ALS decision, or worse, the worse thing, questioning what I'm doing or having a better suggestion!!! Now, I'll clarify that, if its a suggestion like "I live around the block, and I know a short cut," or, "Let's not open that door, I saw a big dog go in a few minutes ago," fine, great, please, speak up. But if its "Are you sure you want to pace him? I saw on Discovery Health that initiation of transcutaenous pacing in the field overall raises mortality rates." (That's not actually true, I just made it up), then by God, I will not be pacing the patient but rather your skull instead. For whatever reason, on a scene, every single person automatically becomes a medical expert with a suggestion. Don't be one of them, or I will kill you. I mean it, too.

Sounds like a classic vasovagal reaction, she was in the bathroom, she vasovagaled, went down onto the floor, had a low BP initially which came back up when you got to the hospital. That would be my guess, but this definitely someone who you needs to be monitored for transport.

I guess my only question would be does this guy present as being septic for any reason? A prior similar instance leads me to still strongly suspect a stroke, or a new onset of seizures, though if the guy was postictal, he probably would have woken up by now. Okay, I want to know more about this guy's head injury. His blood pressure is low, but that doesn't mean the AMS/Bradycardia aren't signs of a whack on the noggin. At this point the EMT's semi should be stopping at a local truck stop before that long trip to Phoenix.

Dust, what exactly is a tactical flight medic? Somebody who lays down covering fire, lands the helicopter, and then treats an MI? In all honesty, the FDNY doesn't have flight medics. The FDNY doesn't even have a helicopter. Once in a while a medic gets to ride on a PD helicopter, but really medevacs within the five boroughs are fewer than chinese food places without health code violations.

I nearly crapped myself reading the 'translated' page of a little discussion about arrest protocols we had a while back. For some reason, Dustdevil's post struck me as particularly funny. http://sites.gizoogle.com/index2.php?url=h...php%3Fp%3D83768

As per the dextrose question I'd tell the EMT that an amp of D50 is equivalent to half a Snickers bar and the effect of dextrose on stroke and head injuries patients is still up in the air, so if he questions what I'm doing again I'll duct tape him to a semi-traveling to Phoenix. If its a bradycardia issue due to an overdose of a beta blocker, we could be cute and try a high dose of glucagon, but all of that will be while we are enroute, quickly, to a hospital because this guy is still probably stroking out. If it is a head injury/stroke, glucose will probably not do much difference but a good shot of atropine can increase ICP, so what is this guy's heart rate before we start going crazy go nuts with the anticholenergics? Who the hell is this EMT, anyway? We're going to have a good long talk after the call, that's for sure.

Strong suspicion of a stroke if the blood glucose is okay. Secure airway as necessary, initiated IV access with KVO, administer D50 25gm if needed, if no response, notification to stroke center, drive fast to hospital. Patient rates very high on the vegetable scale.

dang ol ay-rabs just you know nothing but sand that's all man like daytona no water though baboom watch that on cnn i'll tell you what