emtannie

Ok, a little more info. Heart sounds were never heard. Pulse was during CPR and without CPR. No known medical hx. This is coming from the nurse at the hospital that worked on the pt. I really don't know what to think either and everyone has told me its not possible.

Please remember I was not on this case and I am giving you the facts as presented to the class.

BoCat, I don't think anyone is directing their concerns at you - you are just telling us what you were told. Ashes is right - it is generating some interesting discussion though.

If you get a chance to talk to the nurse who worked on this patient again, maybe ask some additional questions to get more clarification:

- if you had a pulse without CPR, why did you do CPR?

- what medications did you give to this patient?

- what was the patient's GCS? Were they a GCS of 3? (I wonder, since previous informaiton had him sitting up between CPR cycles)

- did the patient have any appliances (pacemaker, internal defibrillator, other) to assist with heartbeat? Even though there is no known medical hx, doesn't mean there isn't one.

That's all I can think of off the top of my head for now.

Keep digging!

I agree with other posters that this scenario is hard to believe…

Ambulance service brings a mid-50 y.o.m. into the hospital. Found pt unresponsive, put pt on the monitor showing asystole. Crew checked a pulse, found a pulse in the carotid and brachial pulse. Pt cyanotic from nipple line up. HR ranged from 70-200, erratic. Pt had a BP or 110/70-200 systolic. Pupils dilated, nonreactive. Agonal resp, medics tubed the pt.

If a patient is truly asystole, they would be apneic and have no pulse. Since the patient had a BP and a pulse, why would you do CPR? If the patient had a BP and pulse, but wasn’t breathing effectively, you would assist ventilations, but you wouldn’t start CPR.

Cyanosis from the nipple line up? I am curious – was patient truly cyanotic from that point, or was that as far as the medics opened his shirt? (and before anyone gets mad at me, you know and I know, crap like this happens when someone doesn’t do a complete assessment)

Did the patient have any facial injuries? There have been cases of asystole or severe bradycardia upon stimulation of optic and trigeminal nerves, but this should have resolved with medications and compressions.

Pt placed on 3 different monitors, leads and pads changed with the monitor. I monitor on the back of the ambulance, 2 monitors in the hospital. Hospital staff continued to work the pt for an hour and a half, each time they stopped to pronounce him, he would sit up, look around and then lay back down. Has anyone ever heard of this happening or have any idea what may have caused this?

Again, if the patient had a pulse, not sure why the hospital staff would “work him.” Treat the patient, not the monitor.

I think I would like to know more about what the hospital staff did… were they doing CPR? If they were, someone needs to take them back through basic CPR criteria.

His pulse was between 70 – 200… If his pulse was at 200, did they cardiovert? If his pulse slowed significantly, did they pace him?

I seem to remember reading about something like this either on this site or on another site some time ago, but can’t find the link right now, where the discussion was on the remote possibility of the cyanosis being a dissecting aorta with complicating cardiac tamponade. If the aneurism ruptured into the pericardium, it could produce cardiac tamponade and the cyanosis from the nipple line up – very rare, supposedly. The patient should have the tamponade signs though – edema and JVD. I will keep looking for the link… D*** Google doesn’t find it when I want it to.

Ruff,

That is a milestone worth celebrating - congrats! But why don't we see pictures???

Very few children are blessed to be in a home as full of love and caring as yours - I hope that someday she will realize how lucky she is to have parents like you.

Quote from LV article: "But on Friday, Righthaven agreed to settle a case against the National Organization for the Reform of Marijuana Laws (NORML), based in Washington, D.C., for $2,185. That case involved an R-J story called "Marijuana as Medicine.""

So, they took NORML to court, and got $2,185. NORML will incur huge costs, since later in the article, it says they had 3 lawyers working on their defense. What did it cost LVR-J to work on this case? Is this really worth it? Or it is a form of newspaper terrorism, where the goal is to disrupt the regular business of other websites by involving these other people and businesses in these lawsuits when there were other means to inform them of their breach?

It seems like a petty tactic to me.

I think some of my scariest calls weren't even calls that endangered me personally. They were more emotional calls.

Two stand out for me. Although I work for a city service, I also work for a rural service in the small town I live in, and most of my patients are people I know when I go on calls there.

We were toned for a 7 month old female seizing. The address was one I recognised, as it was a couple who are two of my best friends. Their youngest daughter was having a generalized seizure. We arrived on scene, they were panicked, I took the infant, and carried her to our rig. Thinking it was just a febrile seizure as I knew she hadn't been feeling well the last few days, I left the back doors of the unit open while waiting for my partner, and pulled the baby's clothes off to cool her. Her seizure didn't stop (she was running a fever of 39C). I tried to cool her with cool towels... her seizure didn't stop... As I was in a BLS unit (and haven't finished my medic yet) I couldn't give her any medications, and we were 30 minutes from the closest hospital. I called for ALS backup, which was unavailable. We raced for the hospital, with the little one seizing the entire way. Several times she quit breathing and then went into cardiac arrest... I did CPR for a minute or two, and she would revive, and begin seizing again. We got her to hospital, and the ER doc gave her the maximum allowable dosage of ativan and phenobarb, and the seizures didn't stop. We transported the child to a higher level hospital, 40 more minutes away, with her still seizing, and the doc on the phone with a peds specialist, giving more meds. That little one seized for over 2 hours.... all I could think of was that the infant of some of my best friends was going to die, and there was nothing I could do to stop it. THAT was scary. (after many more seizures over the next few months, she was finally diagnosed with a rare seizure disorder called Dravet Syndrome).

The second one was an mvc call. We were called to a 3 car mvc on a highway, poor winter road conditions. One of my best friends had told me that morning she was going to head to the city to run errands, and when we arrived on the scene, one of the vehicles looked EXACTLY like hers. I thought it was her van. I had a moment of panic as I thought she was one of our patients. I took a deep breath, and headed for the vehicle. It wasn't her van, but it was someone else I knew. Two of the 3 drivers involved died, and I knew all three people involved. I can generally deal with that, but I still remember the first few seconds when we got on scene, and I thought "OMG, it's her..."

daedalus,

I am addressing you because of your comments, however this is for all who want to drag the bible into this.

The Bible is a historical document. It was written partly from dreams, partly from eyewitness accounts, partly plagerised (generally accepted of the gospels). There are also more books of the bible that are not included.

Many of the laws that were taught in the Old Testement are still enforced in some countries. An eye for an eye is the first that comes to mind. Many of our laws are based on the 10 Commandments. However, what you need to consider is that the bible, as a document, was written for the Israelite people 2000+ years ago.

Fundamentalist christians believe, for example, that God created the world in 7 literal days. Are they right or wrong? The Bible says that when Noah built the Ark it rained for 40 days & 40 nights, but Noah lived to be hundreds of years old, so how long did it rain for? (At the time of Christ it is believed the average lifespan was 30-40 for a male).

Literal interperitations are at your peril.

In the New Testament Jesus endorsed many of the Old Testament laws, as well as explaining some & modifying others to suit. The problem we have now is that after 2000 years, there have been many 'scholars' who have added their twists & interperetations that have been accepted as fact.

A Devils advocate question is to ask why is Christianity the right religion to follow. It is also right not to label all muslims as terrorists, as it is not right to say all christians are good, loving, wholesome people.(Jim & Tammy Bakker come to mind, although he loved prostitutes & was just trying to spread the gospel to them )

This proposal is a couple of blocks from the site. I don't see the problem. Would the same be said if it was a Pentecostal church that wanted to build right next door, how about a Hindu temple, or even the Church of Scientology? I am sure those religions had representatives who lost their lives that day as well. I believe there should be a non denominational chapel for people of all religions built on or near the site for those who survived & their families, as well as the families of those who lost loved ones to reflect of what happenned & to move forward.

Quakefire to ban any religion will have the samme effect as trying to ban alcohol, ask the communists. Many of the churches had more sucess in increasing membership in those countries that banned their right to worship than anywhere else. Prohibition doesnt work.

What happened on that fateful day was the result of extremists. Extreemists who had been brainwashed. What does not get reported is the fact that there are millions of muslims in the world who seek peace. They do not condone terrorism. The do not condone the actions of the extreemists. Acceptance is the key.

Is this being built in the wrong place. Who knows. I will ask though, if you think it is, then how far away is an acceptable distance & should that apply to all churches?

I love you Phil...

I was trying to come up with a response to daedalus that wouldn't sidetrack this thread into a discussion of Old vs New testament theology, and why Christians believe what they do. This thread isn't about that. One of the points I was trying to make, and have obviously done a very poor job, is that there is a difference between tolerance and being walked all over, and a difference between forgiving a wrong and just ignoring it and allowing it to continue.

I don't know if there are other religious buildings on the Ground Zero site. I think it should be straight forward to zone all properties within a certain radios of the site to be commercial and non-denominational. How close is too close? I think any facilties within sight of Ground Zero should be non-denominational.

tniuqs, how about you reply to the topic at hand, not run me down on my opinions

Ummm... turnip prefaced his post with "To play the devils advocate and not politically correct."

He was disagreeing, not to run you down, but to generate discussion... which is why he started his post with that comment.

While I agree that as a whole, the Islamic religion does not represent the views of extremists, it irks me that a mosque (a representation of Islam) is being built at the foot of two amazing structures destroyed by muslim extremism. Some of you here might argue that it was actually socioeconomic and political factors that gave rise to Muslim extremism that took countless lives on 9/11, but you would be wrong. Most of the conspirators including the pilots in the 9/11 plot had PhDs, and were from wealthy backgrounds. Recent psychological research into religious extremism finds that even after you correct for poverty, lack of economic opportunity, etc, extremist views in the middle east actually increase.

"Go forth in Jihad... [9.39] If you do not go forth in Jihad, He will chastise you with a painful chastisement and bring in your place a people other than you [to go on Jihad]"...

Um, have you read the Old Testament? Yahweh of the old testament is perhaps one of the most unpleasant, cruel, jealous characters ever to be written about in any book.

I agree - Old Testament is filled with extreme characters; however, New Testament writings are focused more on grace, strength, love, and forgiveness, based on the life and teachings of Jesus, as written by his disciples. Like any religious beliefs, there are extremists within Christianity as well.

JPINFV quote “I'm sorry... you lost me here. Are you saying that Christian religions aren't homophobic or contain scriptures that consider any non-Christian religion as being sinful? Also, there's a very large difference between not ignoring a child who hits other people and blaming an entire religion for the acts of a few, regardless of what that few claim that their actions are for.”

Sorry, JP, I fear I may not have explained myself very well.

I am not saying that Christian religions aren’t homophobic. I am also not saying that non-Christian religions are sinful. I am saying true Christianity (regardless of denomination) focuses on living a life of love and forgiveness, and trying not to sin.

I am not blaming an entire religion for the acts of a few; however, I do feel that that religion has an obligation to curb the activities of those few, just like a parent is obligated to curb the tantrum of their child.

JPIFNV quote: "Any response to this conversation being turned around? ..and, for the record, child molestation is not an issue unique to the Catholic Church. Example, those crazy Baptists who blamed a girl for getting pregnant after being raped. No more Baptist churches with in 1000 feet of a playground or school?

http://www.concordmo...-then-relocated “

It doesn’t matter if the conversation is turned around. If a group of people within a specified group have intentionally caused harm, it is up to the members of that group to curb their activities. Other groups do not have to tolerate those activities.

I feel it is up to the Muslim community to curb the terrorist actions of the few; I believe it is up to the Catholic church to curb the child abuse actions of certain priests; I believe it is up to the Baptist community to step in and help the girl who was raped. If these groups do not, it is up to the surrounding community to protect themselves from these actions, and if that means that a certain group is not allowed to build a building to gather in, regardless of name (church, mosque, meeting hall), then they should not be allowed to.

The Catholic Church has been attempting to stop the actions of those priests who abused children. There have been numerous cases which have been investigated internally, and with the help of law enforcement to bring those perpetrators to justice. I am not sure about the Baptist one - I will have to look into that more. I am curious - what has the Muslim community done to help bring those who attacked the World Trade Centre to justice? I am not just asking this to be obtuse - I am asking because I truly haven't seen any news articles, documentaries, or other information showing that the Muslim community truly has put significant effort into catching those responsible, and working to ensure further terrorist attacks don't occur.

Here's the deal. No, all Muslims do not believe the extreme lunacy of radical Islam, just as all Christians do not agree with white supremacist's bastardization of Christianity. Does that mean we should allow the KKK to set up a few burning crosses in the middle of an area of a city that is predominantly black?

Herbie, that is an excellent analogy!

I do think that there are times when political correctness goes too far, and the wishes of a few outweigh the wishes of the many.

This mosque is going to be offensive to many who travel to Ground Zero.

Although Christianity has its bizarre splinter groups, overall, Christianity focuses on leading a life free of sin, including avoiding sinning against others. Leading a sin free life includes treating others well, and forgiving those who do ill to you, and loving all people.

Forgiving sins is not the same as ignoring sins. Christianity does not tell people to ignore the sins of others. The Bible says to “turn the other cheek” but it does not tell its followers to ignore abuse.

We do not ignore a child who continually hits others. We do not ignore a person who abuses others. We do not say “oh, it is their belief and so we must tolerate their behaviors.” Some religions teach their followers to actively discriminate on the basis of race, gender, sexual orientation, or nationality. So why then, do we ignore the beliefs of certain religious groups, who teach racism, sexism, homophobia, hatred of other religions, etc., in the name of tolerance?

Yes, there are members of the Muslim community who are not terrorists, and are kind, compassionate members of society. Perhaps we should expect them to control their own members, much as we expect a parent to control their screaming child. By not allowing this mosque to be built, we are sending the message “we will not accept your religion in this area, due to the damage, pain and suffering some members of your religion have caused to those in this area.” Why is that a bad thing? By showing members of the Muslim community that they have to control their own members in order to be welcome in America, we are not being intolerant – we are protecting our own innocent members of our society.

I'm calling bullshit for a couple of reasons..

First, I believe that they should have to publicly justify their already boated budget before being considered for more money...

Second, who is to represent the drivers in this scenario? This is a bullshit idea as it allows the FD to hold out of state drivers hostage...

……..

If a tax is prudent, it is only prudent if those that will not benefit from the tax are in charge of assessing it.

Dwayne, as usual, you have effectively already voiced what I am sure many of us are thinking.

I tried to go to the Denver Fire Department site, but I kept getting a “Server is too busy” message. I wanted to see if there was any budgetary information to see where they are spending their money.

I like the part of the article that states that insurance companies feel this is a hidden, backdoor tax. All this will do is cause higher premiums for consumers to cover the cost of this fee.

Unfortunately, firefighting seems to be one of those sacred cows that municipalities are all too often willing to throw money at, regardless of fiscal responsibility.

I have to agree with other posters who said that it is within the care owner’s rights to refuse service to anyone they choose.

In this case, there was something that caught my eye..

“So, he popped into the Red & Black cafe on Southeast 12th Avenue near Oak Street, bought a coffee and was heading out…..”

It was while he was talking to the other customer that the owner asked him to leave… if he had left without speaking to anyone, would the owner have said anything?

Yes, some people have negative opinions of the police, and interpret their actions as abusive and hostile, when they are performing their duties. Unfortunately, there are bad apples in every crate, and the police service is no different. There is always one who pushes too far, and is too aggressive, and those shed a bad light on others (very similar to those EMT’s and medics who treat their patients poorly, don’t respect them as humans, and handle their patients roughly or without due care).

In the event that this café does get vandalized, I am certain that the owner will call the police. I hope that he, and the police officers, handle it as professionally as they did this incident – no voices were raised, he made a request, the officer complied. I would hope that those who tend to be offended by having a uniformed officer at the café would remember that this officer respected their wishes.

Ruff, your post caught my eye… and I would like to add my opinions on why things aren’t going right in EMS. I hope I am following your train of thought in your OP.

Although I agree that the patient (customer/client) is your primary concern, the very first area that EMS breaks down is in educating the public.

Many don’t know what the role of EMS is, and in a lot of ways, I don’t think we know either. Yes, we really shouldn’t be using resources to take the “my baby toe hurts” patient to the ER, so how do we ensure we educate people so they know that? Not every patient is truly our primary concern. Some should be re-routed to other medical departments to get care, other than using EMS. In some areas, EMS provides a number of roles, from working on the ambulance, to working in the ER, to working as transport services. Once we take the “emergency” out of our duties, what are we really?

The second area that EMS breaks down is in your second point – the crews. I agree that the crews are important – after all, they are the front line, and doing the dirty work. Why then, are so many not paid a competitive wage for the responsibility they have? Given the education and skills they have, why aren’t they seen as being valuable enough to pay more to? We can get into the whole volley vs paid thing here, but some have told me on this site the wages that they make, even though they are in an area without EMS volunteers, and I cringe at the poor wages and benefits they get.

Administrators have a very difficult job, and they have to juggle the cost of providing care vs the bottom line of making enough money to provide those services. Too often they get bonuses based on saving money, rather than showing that they improved patient outcomes with their management of resources. Going back to the crews, many crews don’t feel that administration hears their concerns, and if solving their concern is going to cost money, they know that it won’t happen. As well, too many times, administration is just the person who has been around long enough to get put into a senior position, without having the education or management skills to actually perform that job effectively.

So, how do we solve this? Well, again, this is only my opinion, which is of course worth what you paid for it.

We need to improve education criteria and certification – we need to make paramedic a degree program, partly for the “prestige” and respect a degree gets, and partly to show that our educations are truly that difficult and in depth that they deserve degree status. If we decide that we still require EMT-B’s, EMT-I’s, and medics, build that into the program – at the end of the first year, you are an EMT-B… at the end of year 2, you are an EMT-I.. at the end of year 4, you are a medic… build management and supervisory, financial and accounting courses into the curriculum, so that those students eventually have the education and skills to move into management positions with more education and skills than just hanging in there long enough to be the senior person.

We need to be united, not just regionally, but nationally, so that our voice has more effect. We can then push for and work towards national public service announcements regarding EMS, and have a larger voice in fighting for quality wages and work environments. This will also help in educating the public in teaching them what we do.

We need to be part of health care, not part of the fire department. We will never be taken seriously as medical professionals as long as we are firefighters first, and medical professionals second.

EMS is a young profession – we have a long way to go… and lots of changes to make.

I had spoken with Bill (Retread) a few weeks ago, and he said then he wasn't doing very well. He had CHF, and was on leave from work as his health was deteriorating.

My condolences and prayers to his family, and his many friends.

Obituary from http://www.pennlive.com/perry-county-times/index.ssf/2010/05/obituaries_-_27_may_2010.html

WILLIAM H. GRINDLE II

William H. “Bill” Grindle II, 65, of W. Main Street, New Bloomfield, died Tuesday, May 18, 2010 in Holy Spirit Hospital, Camp Hill.

He was born Sept. 1, 1944 in Elizabeth, N.J., to the late William H. Sr. and Marie Agnes (Flaherty) Grindle.

He was employed as a park ranger at Colonel Denning State Park, Newville, a retired teacher with the Harrisburg School District and a former deputy game protector; a Vietnam-era Army veteran; and a member of New Bloomfield Fire Company and Ambulance for many years.

Surviving are his wife, Diane (Pugliese) Grindle; four daughters, Meghan Weaver of Mt. Pleasant Mills, Jessica Grindle, at home, Marie Catherine Marquez of Turbotville and Angela Stoner of Duncannon; three grandchildren, Olivia Weaver, Jack Weaver and Aliyah Marquez; a brother, John R.; and a niece and nephew, Heather Grindle Platt and Scott Grindle.

Services were held May 23 in Boyer Funeral Home, New Bloomfield, with the Rev. James Gold officiating. Burial, with military honors by New Bloomfield VFW Post 7463, was in Indiantown Gap National Cemetery, Annville.

Where is turnip when we need him? I know he was there.... he could give us the uncensored version....

Wendy, great post.

I am in agreement with all posters who have said that if it compromises patient care, it goes.

I don't agree with cutting clothing items unless there is a medical need for it.

I have had patients who didn't want clothing cut (anyone ever cut cowboy boots off a bull rider?). Most of the time, it only take a minute to explain the reason why you need to do a certain intervention, including giving an IV, and the alternatives if they choose to refuse that intervention. Usually, after the explanation, the patient is cooperative.

Part of patient care is dealing with their personal space in a professional manner, and dealing with their emotional care as well as their physical care. If we get to the point where we are rude to a patient just because we can be in our position of authority at that moment, it is time to consider stepping back and taking a break from the profession for a bit. Yes, we all have our days where we have had more than our share of idiot patients and we have ended our shift with extreme frustration.. it happens... but when we can't put that behind us and treat the next patient with professionalism, it is time to go.

Honestly, I have little use for splints in the sand box or otherwise. Minor stuff can be self splinted until I can do a proper immobilisation job in the ER. Major stuff will go on a vacuum mattress, scoop or both and everything is pretty much immobilised. For some of the facility transports I will use whatever the sending facility has, I'm not picky.

Take care,

chbare.

I so agree. I don't splint a lot in the field. If it can be self-splinted, I find that is the best - I can make it all pretty and splint the injury, and the doc is going to take it all off at the ER anyways. I like the yellow speed splints, not for splinting, but cut down a bit and used for keeping an arm straight after I have an IV in AC. It works well for those patients who are head injured, or otherwise refuse to keep the arm straight or still.

I don't see it.

I have yet to see Nurses, Lab tech's, lawyers, Vetinarians, or any other profession doing rap video's on youtube to advance thier profession.

As far as the music scene goes.... Rap really is one of the lowest denominators out there, (OK Justin Bieber may be worse).

It is my opinion that rap is associated with violence..... not health care.

Ok, maybe these don't "advance" the profession, but they still show the professions in a similar artistic light. I, like others, am not a fan of rap/hip hop... and for those who like a little more harmony, check out the "Breathe" video...

It could be worse.... I wonder how many kids grew up wanting to be big rig truckers after the song "Convoy" came out....

The one thing we seem to go through a lot faster than they get restockedd, is the peds SpO2 attachments (the 'bandaid' type that you can wrap around a little one's finger or toe). I love them, since I can put one on a peds' toe and they generally don't notice, but we never seem to carry enopugh in stock.

Mobey, are you guys going direct delivery, or are you still AHS contract? I can send you a list of the meds we carry, and a supply list from our unit. PM me your email, and I can send you some lists.

We use the Pacific Emergency Products trauma bags for now, but since they went belly up, I don't know what our replacements will be when that time comes. I like the Pelican idea.

Mario,

It does appear that you do need to study more. I agree with Siff, that in several conversations with you in chat, the depth of your knowledge needs some work.

That having been said, you did comment that so far, only 8 of your classmates have passed the exam so far. There are bad programs, and bad instructors, and despite that, some students will still always excel. Even with a poor instructor, it is still up to the student to ensure that all the material is getting covered, and that you understand the material. EMS classes are not spoon-fed classes. There is a lot of homework, and outside research to be done.

As Siff said, it is easy to recite from a book. Knowing the WHY of things is the hard part, and I suspect that is the part that you have difficulty with. If you know why certain things happen (for example, knowing what vital signs are when a person is in shock is not as useful as knowing WHY those vital signs are what they are) it will be much easier for you to be able to recognise these items in a question on an exam, in a scenario, or when you get to the street.

You failed your first NREMT attempt – it is not the end of the world. You have two choices. You can give up, or you can really put your mind to it, study hard, and try again. Write out your notes in detail. Work through your text, and ensure that if there are chapter objectives for each chapter, that you can answer all the objectives. If there are review questions in each chapter, do those. Take advantage of sites like www.emtb.com and use the reviews there.

Passing an EMS exam shouldn’t be easy… we carry a lot of responsibility. Do you want the person who barely passed their course to work on you or your family? Probably not. You want the one who excelled in their class – it is up to you to be that person – be the one who excels, and can give the best care to someone else’s family member.

I am a Red Cross instructor in Canada, but I suspect that the American Red Cross is the same. The following are the guidelines I have to follow:

To be an instructor, I had to take the instructor course, which was over 2 weekends. I don't know what the cost it there, but here it was $550 including the course materials (and that was a number of years ago).

To be able to teach on your own, you have to prove you carry insurance. Or, you can teach under another instructor, who carries insurance.

Your supplies have to be purchased from Red Cross. To do otherwise undermines the work that Red Cross is involved in to ensure that their programs are standardized through the region, and the work they do on your behalf to develop materials for you to use, and being involved in first aid and CPR research.

I realize that you want to save money, but before you get into instructing, do your homework. There are a lot of potential expenses in starting to instruct - are you going to buy or rent manikins and AED trainers? Where will you get splinting and bandaging supplies? If you teach in a larger centre, do they require a business license? Talk to the rep, and find out if there are instructors who are running classes where they need a second instructor; there are class size limits per instructor. Are there colleges in your area that you could instruct at? If you can get on staff with a local college, they would already have the supplies, and you could work under their insurance and use their classroom.

Red Cross can audit your classes at any time, and if they find that you have been having classes without purchasing materials from them, including photocopying cards to use in your class, they can pull your instructor certification.

Make a list of questions - your rep will be able to help a lot, and can get you in contact with people to help you do this.

What I find scary about this is that if it is happening in EMS, where else is it happening in the medical field? Nurses? Doctors? Lab techs? How many medical staff are actually out there with bogus certs?

I agree that all involved should be fired.

I realize that the PR machine of some unions may have the strength to push this under the rug and make their employees out to be the victims, which is very sad. Those employees who chose to not complete their continuing education should not be protected by the union. I do not want those practitioners coming to take care of me or my family members - maybe they should become the personal EMS attendants of the union reps....

If everybody is there being in the picture, WHO IS MINDING THE STORE?

HAHAHA - I thought that too! Right after I thought "Very cool pic - I wish my service would do that.." and then I thought "If there was an MCI a mile away, right at this momemt, wow the response time would be great..."

If I am replying with a number of quotes, I tend to build my posts in Word, and copy and paste the start and end quote information several times, then deleting what I don't want from each part. Cumbersome, yes, but then I find that it does my spell check and I can move stuff around easier than with using the multi-quote inside the city. Then when I copy and paste it into my reply, it keeps the correct formatting to show as quotes.

Sometimes, my internet service sucks, so I will type a long post, and then when I submit, it gives me the dreaded "cannot display this page" message - when I compile my post in Word, I don't swear nearly as much because I don't have to re-type it again and again.

Unfortunately Dwayne, I think you need to find a 14 year old computer geek, who will take 10 seconds, look at your situation, and hit 3 keystrokes to correct it.

I'm sure the link from the UN will be popular.

Thanks for the links – I looked through them, and had trouble finding the scientific studies that they were based on. The UN link did not work, nor did the biodiversity one (the last one) but I will assume that they were more graphs without the study literature.

I tried to cut and past the UN link into a new window, and just go to the UN.org site, but it would not let me into the news articles/press releases either.

However, when I googled it, I got this hit:

http://www.foxnews.com/scitech/2010/01/28/save-rainforest-climate-change-scandal-chopped-facts/

It would appear that the UN is basing their stance on some flawed science.

OK, Matt – I will quit derailing your thread (but can I have Dwayne’s goth Barbie?)

There are those who may feel that a belief in God, and God being the reason we are here is not a valid argument. Although there may not be peer-reviewed scientific studies to show that God exists (sorry, didn't google that one), and is the reason for our being, I prefer to think that the belief in God can be meshed with the evolution theory. There are so many things that have happened in the evolution of man and earth, that cannot be specifically scientifically explained. It reminds me of the Far Side cartoon of the scientist with the blackboard full of chemistry calculations, and in the middle it says "an a miracle occurs" and then he continues rto his final answer.

So, while we are here, regardless of why we think we are here, so far that majority of posters have agreed on one thinng - we should be doing what we can to make someone's life better.

Dang - now I am late for work....

http://www.huffingtonpost.com/2010/05/03/gulf-oil-spill-photos-ani_n_560813.html

And, you know what? I am sick of people who work in science completely rejecting science!!! How can you even justify interfering in this "God-planned circle" as an EMT? Obviously God planned for that person to die, how can you possibly interfere with his will?!?!? Global warming is a theory in the same respect that gravity is "just a theory."

You completely missed my point. Without getting into pages of detail, I stated that I believe a higher being controls more than we humans do, and we are pretty arrogant to think that we have so much impact and control. Yeah, you can post lots on the latest oil spill and how we are all going to fry for that. (remember the Exxon Valdez? That sure doesn't make the news much anymore. What about the ice age? Man didn't cause that. Species have been going extinct and new ones evolving long before man arrived on the scene, so to think that man is interfering and is completely responsible for destroying biodiversity is truly arrogant.

As for "completely rejecting science," I prefer to think that I am open to suggestions that there are sometimes things that science cannot explain. I am sure you have seen things in your medical career that did not fit the scientific mold - patients who, according to science, should not have lived, but did; patients who should have lived, but did not. Maybe in 5 or 10 or 50 years we will be better able to explain some of those things.... oh wait - that would be interfering....

Working in the medical industry, I do not believe I am "interfering." We were given brains for a reason - to choose to use it to learn, to try to help others, is not a bad thing, but you prefer to twist that into "interfering." I suspect you are looking for an argument here, and feel free to try to beat your opinions into me - I do not have to agree with you, nor do you have to agree with me.

I did not disagree with your entire first post - I chose to disagree with a portion of it, and gave my reasons. That is one of the great things about this site - we get to see the varied ideas and opinions. It doesn't mean we have to agree with them.

Matt - good thread -