Asysin2leads

dang man that thar aerosol it like bababoom dang ol fuel air explosion i tell you what and them guys with the gas it like too much gas man booooom heh big ol fireball can see it from the space station or something and them arab guys dang ol cant even drive them thar ambulances like they need some ol NASCAR drivers over there I'll tell you what

Yeah, and I have basic skills like tying my shoe laces and brushing my teeth. No one makes a T-shirt about doing that, although with some EMT's I have met, dental hygiene should be reinforced about as much as basic skills should.

The EMS academy out at Fort Totten has a small 'museum" of sorts with equipment from EMS from all sorts of periods, from Lifepak 5's, to old METAL opa's, to some pictures of the ambulance wagons from the 1800's. Some really interesting stuff there. My favorite is an article written by a female ambulance worker, talking about "Treating intoxicated people in the Bowery, having to deal with the filth and trash and having rocks thrown occasionally." The funny thing was she was writing from 1896. My, how times have changed, right?

A funny video for those of us who stupidly get the dog out too...

Here's what I know about doing a 12 lead, besides put the leads here, here, and here and push the button. In 12 lead mode, the monitor (for sake of arguement I use a Lifepak 12), uses more sensitive filters than in a 3 lead, that's why often it bitches at you that there is "noisy data", because artifacts it doesn't pick up in 3 lead mode it does pick up in 12 lead mode. So, the 12 lead mode not only gives you more views of the heart but it also gives you a more accurate, and some would call "diagnostic" views of the electrical activity of the heart. To be perfectly frank, however, no cardiologist in his right mind would use a field 12 lead to make a positive diagnosis. I guess you could call the 12 lead mode a "presumptive diagnostic mode." I can say, from a couple of experiences, there is a notable difference between the 3 and 12 lead mode. If you have the 12 lead hooked up, on a lifepak 12, you can still look at V1,V2,V3,V4 etc. by adjusting the lead setting in 3 lead mode, which is useful if you want to track a change in anyone of those leads. However, because it is not using the filters of the 12 lead mode, it does not give you a fully accurate depiction of the lead it is displaying. A couple of cardiac patients I have had hooked up to the monitor showed 'ugly' ST elevations in various leads in 3 lead mode that would not appear when a proper 12 lead was done. I've saved a couple of them and I'm going to see if I can harrass a cardiologist or other 12 lead know it all about the nuts and bolts of why this is, I'll give you an update when I get one. Hope this helps.

Protocols are nothing more than what they use to hang you when the you know what hits the fan.

Welcome to our fight for excellence in prehospital care. Always glad to have new member. Its a dirty war and no one will like you for engaging in it, but its a good fight.

I agree with Rid, I really don't view things in terms of BLS or ALS I view them in terms of what is appropriate for the patient. As mentioned above, this starts with the least invasive procedure working up to the most invasive procedure. BLS before ALS, EMT's save paramedics, two of my least favorite phrases.

For a while we thought the best thing for VF patients was to stop everything and immediately defibrillate them. Now they want 2 minutes of CPR prior to defibrillation. Next, apparently, its waiting for the body to cool before defibrillation. After we do all that, do you think that maybe, ummmmm, we could get around to, like, shocking them?

Eh, fire brigade isn't so bad. At least when they screw up, innocent patients usually don't suffer. It takes a lot more brains, maturity, and experience to do an EMS call well than it does a fire call, at the firefighter level. Wet stuff goes on red stuff, break things when told. Emergency medicine is a bit more tricky than that.

25 divided by 5 is 14. You can't argue about it.

Oh Dust, why would EMS sit down and consider all of the uses of a specific piece of equipment. Something either saves lives and is a miracle worker or kills people and is a hazard to all that even looks at it, you know that. Grey areas are for pussies.

And, gain, you'll be wearing said shirts in public with the general populace who pays our bills reading them with a big star of life on them. Great, only sets us back like 15 or 20 years or so.

Ummmm.... yes... I'll have the anchovies? I don't follow ya, Mike

Yeah, actually, we do mind. Really bad, cliched, self glorifying pity me fireman poetry isn't what this site is about. At least it wasn't as bad as "I wish you could" or "The littlest firefighter." Those were awful. Everytime I read them I want to do my job just a little bit less. Randall Jarrell, author of the famous poem "Death of the Ball Turret Gunner", about the realities of the glorified deaths of air crews, wrote a piece about bad poetry. Here it is. "Bad Poets" by Randall Jarrell Someties it is hard to criticize, one wants only to chronicle. The good and mediocre books come in from week to week, and I put them aside and read them and think of what to say; but the "worthless" books come in day after day, like the cries and truck sounds from the street, and there is nothing that anyone could think of that is good enough for them. In the bad type of thin pamphlets, in hand-set lines on imported paper, people's hard lives and hopeless ambitions have expressed themselves more directly and heartbreakingly than they have ever expressed in any work of art: it is as if the writers had sent you their ripped-out arms and legs, with "This is a poem" scrawled on them in lipstick. After a while one is embarrassed not so much for them as for poetry, which is for these poor poets one more of the openings against which everyone in the end beats his brains out; and one finds it unbearable that poetry should be so hard to write - a game of Pin the Tail on the Donkey in which there is for most of the players no tail, no donkey, not even a booby prize. If there were only some mechanism (like Seurat's proposed system of painting, or the projected Universal Algebra that Gödel believes Leibnitz to have perfected and mislaid) for reasonably and systematically converting into poetry what we see and feel and are! When one reads the verse of people who cannot write poems - people who sometimes have more intelligence, sensibility, and moral discrimination than most of the poets - it is hard not to regard the Muse as a sort of fairy godmother who says to the poet, after her colleagues have showered on him the most disconcerting and ambiguous gifts, "Well, never mind. You're still the only one that can write poetry." It seems a detestable joke that the national poet of the Ukraine - kept a private in the army for ten years, and forbidden by the Czar to read, to draw, or ever to write a letter - should not have for his pain one decent poem. A poor Air Corpse sergeant spends two and a half years on Attu and Kiska, and at the end of the time his verse about the war is indistinguishable from Browder's brother's parrot's. How cruel that a cardinal - for one of these book is a cardinal's - should write verse worse than his youngest choir-boy's! But in this universe of bad poetry everyone is compelled by the decrees of an unarguable Necessity to murder his mother and marry his father, to turn somersaults widdershins around his own funeral, to do everything that his worst and most imaginative enemy could wish. It would be a hard heart and a dull head that could condemn, except with a sort of sacred awe, such poets for anything that they have done - or rather, for anything that has been done to them: for they have never made anything, they have suffered their poetry as helplessly as they have anything else; so that it is neither the imitation of life nor a slice of life but life itself - beyond good, beyond evil, and certainly beyond reviewing. Okay, there lesson over. Bad poetry is bad, and death is bad, and such. Class dismissed.

Nice post Bushy. I'll concede that while I am against young people on ambulances in principle, and I don't think anything will sway that fact, there is a big difference between a formal cadet program and a volunteer service that allows 14 year old ride alongs and 15, 16, or 17 year old EMT's. If you want to make a program, train teens in first aid, get them interested in the field, fine. I'd say if you want to take them out at the very end of the program and let them do a ride along or two after they have succesfully proved themselves in class and are with a mentor, I'd say okay. But that is a far cry from 16 and 17 year olds responding to their vollie squad building to go out on whatever call comes in through 911, and really, that is where I have the problem.

Uh oh... Time for Wapner... Charlie...Charlie Babbit

I understood the post perfectly. The cardiac arrest protocol is called the 'AED protocol', because fire engines are so equipped. Now, while an AED isn't exactly useful in a situation like this, the things that come with it, a supervisor (although I'm a little dubious on their usefulness), and the large men on the engine are useful. So, real slowly, just because you use something known as "The AED protocol", doesn't necessarily mean that you need an AED. Jeez, its like dealing with Rainman sometimes. "Don't need an AED, we have a LP 12, LP 12 definitely better than an AED, definitely... No, Raymond, we're just using the AED protocol, not an AED... Course, a LP 12, definitely better than an AED, yeah, definitely better... No Raymond..."

I'm not sure why this has to be reiterated time and time again. Being against explorers and cadets isn't about bad apples or good apples or anything of the sort. The problem is that while I have no problem seeing it from your point of view, you just can't see it from mine. I have spent a great deal of my life to be able to do what I do, and work very hard to make a living doing it. The problem is that people assume everybody who pops out of the ambulance is all on the same level. Now, that might be a cool little thrill that people think you're a paramedic, but for us paramedics, it maks us look no better than high school kids. What really burns my candle is when you guys take something some of the older and experienced members say and rather than stopping and considering it, you just put your own teenage spin on it. "Oh, its just a few bad apples," "Oh, its because you're arrogant," etc etc, maybe, just maybe, if someone who has been doing this job says "Hey, an ambulance is no place for a teenager to be," they say it because they are basing it on their own experiences and knowledge. The other day I did a call on a 20 month old with 2nd degree burns to 30% of his body after an accident with a pot of macaroni, and to be perfectly honest, I had to do some serious lower lip chewing on that call to keep my own emotions at bay. Now, I ask you, are those the calls that teenage cadets really belong on? Are those the images you really want to have ingrained in your memory while you're still forming your own personality and growing? I say no way jose.

I'm not sure why this has to be reiterated time and time again. Being against explorers and cadets isn't about bad apples or good apples or anything of the sort. The problem is that while I have no problem seeing it from your point of view, you just can't see it from mine. I have spent a great deal of my life to be able to do what I do, and work very hard to make a living doing it. The problem is that people assume everybody who pops out of the ambulance is all on the same level. Now, that might be a cool little thrill that people think you're a paramedic, but for us paramedics, it maks us look no better than high school kids. What really burns my candle is when you guys take something some of the older and experienced members say and rather than stopping and considering it, you just put your own teenage spin on it. "Oh, its just a few bad apples," "Oh, its because you're arrogant," etc etc, maybe, just maybe, if someone who has been doing this job says "Hey, an ambulance is no place for a teenager to be," they say it because they are basing it on their own experiences and knowledge. The other day I did a call on a 20 month old with 2nd degree burns to 30% of his body after an accident with a pot of macaroni, and to be perfectly honest, I had to do some serious lower lip chewing on that call to keep my own emotions at bay. Now, I ask you, are those the calls that teenage cadets really belong on? Are those the images you really want to have ingrained in your memory while you're still forming your own personality and growing? I say no way jose.

Dammit, I just can't let things go. Okay, look, blueangel, I'm sure you're not a bad guy even though you're from Jersey. I'm telling you this not because I have anything against teenagers, in fact, the judge says if I'm caught with anymore of them I'll be in serious trouble. I'm telling you this because its true. No one else on your squad will tell you this, but volunteer first aid squads are a detriment to both the people who work for them and the patients that are cared for by them. They will not further you anywhere in your career. The paid EMS spots in NJ are few and far between, and no professional training course, paramedic, RN, MD, PhD, PA, or CCCP, really gives a damn about how much time you have spent 'on squad'. You only risk embroiling yourself in a legal situation or becoming ill or injured with little to no compensation for your actions. Your actions volunteering also serve to lower the salary for paid EMS providers, and prevent appropriate resources from reaching appropriate patients. I say this as a paid professional paramedic, who has numerous friends in the field of medicine, at all levels, and family members in various positions in the health care and public safety sector. So, when I say "Stop playing hero and go back to English class", I mean it because if you really want to seriously pursue a career in medicine or public safety, its really, truly, the most sound advice you'll get. Oh yeah, and you used 'descent' in place of 'decent' twice, and given that they are homonyms, I am led to believe it is a serious error in spelling rather than a typo. This is a trpo. This is a messpeling. See the difference? Oh, and just very last thing, I did 50 calls last month alone, just for some perspective.

You know, JP, I am giving serious consideration to changing my longheld to sig to "There is no reason to suck at your job" in your honor. =D> Here's my thing about BLS/ALS, QLS, etc. etc. I really don't see things in terms of ALS or BLS, I see things in terms of patients who need to be treated. What really saddened me when I graduated paramedic class was that I realized in how much better a position I was to really treat a patient, even one with let's say a minor injury, and I thought, 'Jeez man, what the hell have I been doing up to this point?' As JP said, a lot of things that people consider to be 'BLS' calls would benefit with someone who has more than 120 hours of training. Given the weird wild world of the human body, abdominal pain can be a heart attack, or it can be a bad enchilada, and telling the difference may not necessarily be the difference between life and death but it can mean the difference between having 40% heart function and 95% heart function. I won't pretend I'm paramedic Gregory House and can diagnose everything in the field, but I do honestly believe that after spending 3000+ hours with paramedics, RN's, respiratory therapists, cardiologists, neurologists, anesthesiologists, pediatricians and a whole host of patients, I did come out with a pretty good understanding of what to look for and why, at least a lot better than when I was an EMT. Its for this reason that I take the stand that I do against local volunteers and cadets and all that, because I believe that EMS can be an immensely important factor in determining a patient's outcome, and it should be treated as such and held to the same standards as the rest of the medical profession, and for better or worse, when you enter in the ER, you don't have 25 underage well meaning volunteers descend on you. You might have a few underage interns and residents, but at least they went to college, lol. We are also still a profession fighting for recognition. I have busted my ass to become good at what I do, and I am fully aware that 20 professionally presented and treated patients by me does less for our image than 1 bunch of 17 year olds in uniform goofing around in the ER. That's why I don't think underage kids in this field is a good idea, and really, I can't say anymore on the subject.

Well writ, Nate, cept you left out the part where you do another shot of whiskey and bellow "AND ANOTHER THING THAT PISSES ME OFF!!!", lol.

>Many EMT's and many are pretty good ones with descent experiance and knowledge. Main Entry: de·scent Pronunciation: di-'sent Function: noun Etymology: Middle English, from Anglo-French descente, from Anglo-French descendre 1 a : derivation from an ancestor : BIRTH, LINEAGE <of French descent> b : transmission or devolution of an estate by inheritance usually in the descending line c : the fact or process of originating from an ancestral stock d : the shaping or development in nature and character by transmission from a source : DERIVATION 2 : the act or process of descending 3 : a step downward in a scale of gradation; specifically : one generation in an ancestral line or genealogical scale 4 a : an inclination downward : SLOPE b : a descending way (as a downgrade or stairway) c obsolete : the lowest part 5 a : ATTACK, INVASION b : a sudden disconcerting appearance (as for a visit) 6 : a downward step (as in station or value) : DECLINE <descent of the family to actual poverty> A little more time in English class, a little less time on Ye Olde First Aid Squade, trooper, you'll be in a lot better shape. Whether you get paid or not is moot, we were talking about maturity and responsibility to the patient's and to our profession. If you really want to benefit the public, study hard, quit playing hero with the First Aid Squad, and become a politician and fight for modern EMS to come into your state. You'll help a great number of people.

And you wonder why Oklahoma gets no respect, lol. Actually, we have people eating squirrels here too. Except we usually drag 'em in to the psych ward.