Mateo_1387

It does not say what the gut feeling is, but maybe his gut feeling is that the patient is anemic due to hemorrhage. It also says that the EMT made the decision based on gut feeling and patient appearance Nobody ever said the EMT missed the signs and symptoms of shock (that is s/s according the just plain ol' medicine and not a 3 week first aid course). Again, nothing has shown that this was a BLS call. You have not shown anything to prove otherwise. To hash this out just a little more, there is medicine, and only medicine. Not ALS and BLS. Patients who call for an ambulance deserve a Paramedic who will give them a full evaluation. I liked spenac's quote which is "a complete exam is the best exam." This may include the use of the heart monitor, as well as using advanced exam techniques that should be taught in paramedic courses. EMT B's cannot provide these services. This patient should be transported by a Paramedic unit. Nothing less is acceptable. Again, the patient may have decided to drive herself to the hospital after the ambulance crew came and evaluated her. I would assume anyone who thinks someone needs to be seen at the emergency room would not talk them out of transport, but rather try and talk them into being transported by ambulance. Sometimes though, you just cannot change someone's mind. We just don't know the whole story.

:shock: Are you serious? Some reasons why I would think otherwise... Had she been vomiting blood, an NG tube may be in order, as well as possibly some fluid, and some nausea medication. I do not mean to come off as rude, just trying to get to the bottom of this. You leave no choice, but I have to question your intelligence. What makes this a "basic" call? Should you transport the patient against their wishes if the patient is of sound mind and able to make their own decisions?

Spen, I think he may be in reference to EMS49393's post. Seeing as he did not quote his source, I will not be 100% sure.

Any sources for this? I saw another thread where you mentioned this, and stated that police must be called. Do you think the police may be there for your safety?

Have fun down there in Jay-axonville ! Welcome to EMT City.

Haha Kaisu. I like you're attitude, as Dust says...go big or go home. In all honesty, the police probably could have waited to arrest the guy. He is probably grieving over his father's death, as well as the other people in attendance at the funeral. No respect for anyone. I guess that is because any guy who is accused by a significant/ex-significant other ends up guilty until proven otherwise. :roll:

Yeah, OK, my thoughts are almost certainly a bunch of crap. But I had to take my shot, despite the fact that [s:166bdd601b]Matty’s[/s:166bdd601b] Dwayne's thoughts make WAY more sense than mine. Its funny we were thinking the same things about each other's posts. :wink:

Ak, I enjoyed the story. Here is what I get out of it. I feel as if you were drawn back to your old ways and tendencies, such as coming down off the wall like you parents wished, yet they were not there to tell you to come down. The notion to come down off the wall seemed instilled in you. I got that you did not let that wall become a barrier to you. The consequences were worth the climb and excitement you got out of the wall. As your story goes through a time change, so does your thinking. As you grew older, the excitement of the unknown did not seem to phase you. What you seem to have wanted was the chance to relive the life of newfound excitement and fearlessness. As time went on though, you grew up, you realized just what life was about, and that silly crumbling wall was not magnificent as it used to be. Yet you are always drawn back to it, like a beacon. Some part of you was addicted to that wall. Nothing in the world could make you feel as excited, innocent, and positive as the wall did. No matter how much of a distraction though, reality always prevails. You still have your family to provide for, children to raise, jobs to attend to. Time is slipping by; you get older, as is the wall. Every time I go back and reread a paragraph or two, I find some other subtle meaning out of it. It is probably just me thinking too hard, but its ok, it is about what I get out of it. Pretty awesome!

I agree that we go to the hospital to see the voodoo that hospitals do so well.....but it is also to have extensive patient encounters, as well as see the course of care over several hours that patients receive, and to show you specialties such as Obstetrics that you may not see too often. Personally, I would not have minded working in a nursing home for a few rotations, There would be plenty for EMS folk to lean at nursing homes. One hospital nearby makes the nurses ride on an ambulance for a few shift during their orientation. I have to admit that I was impressed with the few I met, they were educated, professional, and very willing to learn what they could about what they are not familiar with.

Two things: 1) I think it is funny that most of the replies on this thread have so far been from men... 2) Regarding your post above, women are not the only ones who face sexism. Just one example that pertains to the health care field is the acceptance of male nurses. Just because Most* men do not face issues of sexism, does not mean that their opinion does not matter, which is what I think you imply from your post.

Wait a sec Dwayne........did you consider she may be talking about the Admi ? :love10:

Thyrotoxic Hypokalemic Periodic Paralysis

http://www.anaesthetist.com/icu/manage/dru...x.htm#index.htm Try this site.

The wages are per the fire department. Why should we let fire departments rule how much we are paid? We should be deciding our own pay, what we are worth. Not the FD. This statement just shows your ignorance. Who here said that most EMS systems are like you describe above? Not us. It is you bro. Some of the systems I am familiar with that use System Status Management for ambulances mostly work for fire departments. You have a point. That is why we try to spread the word of professionalism which begins education. That is the basis that will change everything in EMS. I work for a government based service. I do not know which is the best. I have seen some good hospital based systems, as well as some private systems, and some third agency systems. I have seen top notch systems under each.

Here is the deal. When paramedics can claim their own and govern themselves, without being under fire departments, we will excel far past the standards that the fire departments have set which hold us back. When EMS becomes solely a medical profession, we will be able to justify our own wages, our own shifts, our own standards. The tactics other medical professions (nursing, respiratory therapy, physical therapy, MD's and DO's) have used to raise their standards could be employed by EMS for positive change. As it stands, the volleys and FD's are what keep us down. The IAFF is not doing anything to make EMS medical, only to keep jobs and pay for firefighters.

Fixed that for you, ignorant fool. :wink:

We have a no transport policy for dead persons. So the answer is no.

Is anyone seeing a trend? There are systems that have been working codes on scene for a while now, plus they do not have to call for orders to terminate. I am just wondering why they are doing this article on the incomplete Los Angles experience and not other systems that have the research. I wonder if it is due to the aforementioned trend?

Jeeze Dude, Memphis must be something special. Just because your patient could go by personal vehicle does not mean that paramedic evaluation/treatment/monitoring will never be beneficial. I cannot count on my hands and feet the number of patients that have had the most obscure BS looking symptoms that ended up being something serious. Plenty of people can benefit from a competent paramedic. Without education and experience, it can be difficult to know which patients are truly sick and may benefit from being at least monitored. You should respect what you do not know.

:bs: This reminded me of Miss Cleo, the self proclaimed psychic who was on commercials in the late 90's. Even she could not predict her downfall, yet you can call ALS, BLS, and BS on almost all calls, based only on dispatch information. I doubt it. I know there are BS calls, I have ran them, but there are far more legit calls that require a doctor than ones that do not. Please do not be too full of yourself.

I had a patient having an anxiety attack and chest pains have this conversation with my partner: Patient- If something happens during the transport......I....um......I......I want you to let me die. Medic- You want me to just let you die? Patient- Yes, I have a DNR. Medic- Where is your DNR? Patient- It is in Jacksonville (Fl) with my son. Medic- So, if something happens during the transport, you don't want me to do anything? Patient- Well......you can breath for me, but that is all. Medic- So if your heart stops do you want me to try and give you some medication to start it back up? Patient- Yea, that is ok. Medic- Would you like to put a breathing tube in you to help you breath just in case? Patient- Yes, please do that. :roll: Some people just don't know what they really want in life....or death, in this case.

Why not focus on the good? In the case, everything seemed to have a positive outcome. Sure, the decision may not have been the best, but after the fact, it does not seem to matter so much. Had she screwed up and got herself or the bystander injured, then she would be criticized. As far as they occupant, they were as good as dead. She risked her life to save the man, who seemed to have a poor outcome, kudos to her. I have a problem with this mode of thinking. I think it is bad practice to just go through a situation by a set plan. When faced with situations, you should adjust to them, and be flexible. In defense of the medic, maybe the fire was small, and had potential. By your absolute, she should not enter, but by her adaptation, she faced the issue and had a great outcome. To me, the above statement is like following a protocol, which does not get us very far.

Shooting at someone only* knocking on the door is stupid. Someone trying to beat your door down, turning the knob viciously, and making an effort to gain entry into your home would be ample reason to shoot through the door. Identifying that you have a gun and you are going to shoot it is also key before they enter. Just opening fire would not be acceptable, especially for someone knocking on the door saying "trick-or-treat" on Halloween, while you porch light is on ! Some state laws (according to someone I know who had to take gun classes) allow one to shoot through the door if they feel threatened. As explained to me: (Scenario) You are at home *alone* when a would be rapist/robber/murderer is at your door trying to gain entry. They are beating the door down. You verbalize that you have a gun and are willing to shoot. The person keeps on beating down the door until they gain entry. You decide to wait until you see* the person to shoot so you can make sure to hit them, instead of taking blind aim. When the person enters you immediately shoot the person three times killing them on the spot. You call the police and they arrive at your home. The police find a man dead at your doorway. Dressed in regular clothes *without a gun*. In this scenario, you decided to wait until the person gained entry at you shot them right on the spot. You did not have time to assess if the person was armed and shot anyway. Once you shot and killed an unarmed visible person, you can have a good chance of being pinned as a murderer instead of acting in self defense. In the laws eyes, they will see that you shot and killed an unarmed person. Now, the scenario changes, you shot them through the door, after saying that you gave ample warning. Your actions would have a better chance to be seen as self defense. You shot not knowing if you were about to be killed by the person entering your house. They key in the scenario is that after they entered, the law views the shooting totally different.

Wendy, just buy one of these ! You won't put it in your mouth........I'm sure you don't want a reputation............ But in all seriousness, you would be forced to put it down instead of in you mouth. Just put a Gall's sticker on it and your pen will be the envy of everyone.