JPINFV

Someone said castration?

[me looks at poll] Hmm... interesting. None in the city I currently live in, but there are quite a few living in the city I grew up in, including one that lives in the other half of the block I grew up in (the block is split east-west with a small flood control channel) that has been ruled insane.

http://www.snopes.com/college/homework/foundcar.asp read the entire thing...

Sir, I do believe that you missed this post...

Finished with my BS in Bio. Sci. [bS in BS?] after this quarter (plus a minor in Poli Sci after next). Currently applying to special masters programs.

Just because a patient has a finding that would fall under AEIOU TIPS does not mean the patient is altered. If the patient IS altered, then there is a good chance that it falls under AEIOU TIPS. It is not a two way road.

^ I'll give him benefit of the doubt and say he meant patient education. Unfortunately that's a slight problem where you're only slightly more educated than the patient to begin with.

:roll: I can't believe I'm doing this. VS. Dude, why does this remind me of affirmative action threads on my college's student ran forum? The regulars have hashed this out so many times that they've come as close to a consensus as they will, the noobs aren't up to speed enough to say anything remotely intelligent [see below], and it just ends up becoming a farked up thread. Besides, how many of these threads have you made? Honestly, we get it. American EMS education sucks compared to Canadian. Honestly, here's a gold star for ya. In fact, let's make it a whole page of gold stars. There ya go. Besides, if Canada is having that many people drop out of their PCP programs, than apparently there's still too many stupid people trying to get in. When you have that many stupids trying, some will get through. Not that American BLS is anything to be proud of. Now onto this. Why not? How would you like to have more of that 'edumacation junk' than someone else but see a foreigner doing more. Would you accept a foreign doctor that didn't pass the USMLE and wasn't educated to our standards because, well, he could be a doctor in his home country? Would you accept that for your family? Are paramedic's doctors? No, but they are a type of physician extender [like PAs and NPs, except with out the education and scope] and need to be able to act at least somewhat like a doctor. See above about being able to perform skills with less education. Once you can do something, I'm not so much convinced that more education vs. practice on the job is really much help.

The idea was if you had a laptop or a tablet PC. I know at least one IFT company in the LA [i saw them in South LA county area) county use tablets for their PCRs.

If I was a medic: 1. Taxes 2. Cold weather sucks 3. Joking, but am I? 4. Taxes 5. Do I get credit for the college courses I've already taken?

Because MDs don't make mistakes? [full disclosure] I honestly don't care too much about the differences between MD education and DO education. I'd take either.[/full disclosure]

only problem I see is the cost. Medic tag costs almost $40. I can pick up a USB drive that has a keychain mount for less than $10 (http://www.superwarehouse.com/p.cfm?p=1489177&CMP=KAC-Froogle). A sharpie, Microsoft Word, and 5 minutes with my doctor and I have the same thing at 1/4 of the cost.

^ Since the edit option gets locked after a period of time... www.trauma.com Unfortunately, looking at it, the site appears to be down. It might just be a hiccup...

Quick question for ya. Besides requesting a little first aid for the cut, was the patient refusing/declining transport?

:Looks at thread: :looks at his posts: :looks at thread: :looks at posts again regarding local protocols that differs from what the "class/book" states: :looks back at thread, shrugs, and gives up: At least in California, the physician signature is stating that there is no condition that the patient has that might change the patient's opinion. It is more of an informed concent than a competence (if the patient is not competent, then a family member can make such decisions).

Of course the question then is, "What is a valid DNR?"

^ Where is that?

It depends on location, type (911 vs IFT vs combined, dual basic vs basic/medic, volly vs paid), and need (how many basics do we need, this ties into type) mostly. You need to be 21 at most companies to drive and most good companies won't hire basics till they can drive.

Of course this entire conversation is even more of a moot point when you stop and realize that must manual cuffs have a margin of error of +/- 3 mmHg anyways. This means that your blood pressure can be anywhere in a 7 mm range (3 in each direction plus the number you got). It gets even worse when looking at a change in BP because that change would have to change more than 6 mm in a single direction (example, starting with a BP of 100, a new BP at 106 is not significant because 103 is within both margins of error. This is an extreme example).

If my company's training department had an ACLS manual in it then I would have picked that one up instead of the ACLS for EMT-Basics book.

Err, so again, are we talking about room air oxygen (i.e. not a drug) or supplemental oxygen (i.e. a drug)? Yes, if you are dead then the drugs probably won't work (i.e. cardiac arrest + ACLS drugs), but the vast majority of the world's population does not need supplemental oxygen to survive. We can survive just well on room air oxygen.

But is there conclusive proof that it works?

Are you putting forth that without supplemental O2, then your epi, lasix, morphine, and any other drug you have will not work?

Yes. Most nursing homes have their own DNR form and there is a prehospital form. It clearly states down at the bottom in the physician's order section link: http://www.kaisersantaclara.org/images/Pre...uest%20Form.pdf The quality of the nursing home's DNR varies from listing out specific interventions (both emergent (transfer to acute care hospital, CPR, intubation, etc) and long term (antibiotics, IV fluids, etc) care). All forms must be signed by a doctor to be valid. Personally, it appears that my county is different from mosts, and I like how it is. EMS [1 med. director, 1 set of policies/protocols/scope county wide] can accept a form DNR (preference for the state prehospital form, but SNF forms are ok too), a written and signed DNR order from the chart [personal policy is to transport with a copy of it, but all we have to do is note the order, date, and physician who wrote it], or accept a "verbal request to withdraw or withhold resuscitation measures" from a family member (spouse, adult children, parents, domestic partners). DNRs can be revoked by any family member or the patient and if there is question to the legitimacy of a DNR order or disagreement in regard to the DNR from the family members then the patient is to be worked pending on-line medical control orders. I feel that a patient has a right to control their medical care through advanced directives. If the patient wants to die naturally than that is their choice. I, as a provider, is both ethically, morally, and legally required to respect their wishes. Furthermore, I agree that family should be able to direct medical care if the patient is in an altered mental state. There is no reason to transport code 3 while diverting to the closest facility only to get there and have the family get the EMP to sign a DNR on the patient. The only problem I have is that the division of my company that I work in operates in two different counties. The main county follows the policy I laid out above regarding family members, the other county does not.