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A comment posted on CBC. Squinting I am a survivor of PTS or OSD (38 year .. A Domestic Veteran) so I speak with a bit of knowledge on this topic as 3 years ago I too was looking 6 feet down I asked for help and was treated as a criminal ...this despite the recent well intended legislation of AB Bill 1. PTSD is presumptive in First responders, Law enforcement, Corrections, Medics and our Fire Fighters RIP BRAD ! I have good days and not so good days, yesterday was not a good day as I knew with the media releases "innuendo" and links connected the dots ... no sleep, calls to non governmental supporters and advocates . I can say without hesitation that not only the EMS/LEO/FF culture of "suck it up princess attitude" is partially to blame, so if one comes out of the closet (so to speak) ones career is simply over. Yet hose in high places are and continue to contort the intent of this important legislation with deny, delay, and when at ones weakest bombard with useless paperwork tactics insisting that many multiple "psychological assessments" be done to attempt to 'disprove' a false claim. At your wish CBC I will present 11 pounds of paperwork and be interviewed as to the literal psychological torture endured by myself at the hands of those intended to help me ? Tomorrow is Mental Health awareness day, so I ask, when the first responders are suiciding .. just what does this say about the supposed HELP that governments purport to be doing about this national traged ? Not a Damn Thing ! I will make note that 3 survivors (2 places in Canada) at their own expense, attempting to set up a "respite" a place to go and spend time with trusted "been there done that type guys" in confidence and respect for the duty they have provided to all Canadians.

The "code of conduct/silence" must be broken, I suspect it comes from ACoP or AHS, but not criminal by OH+S, links to help lines and facebook link is broken ? HUH ? We HAVE to change the culture EMS to help our brothers and sisters.

My bad ? Nope it would NOT work out, $$$$$$$$$$ just the idea of travel to another country would be unworkable. That Said: I live (as do you) live in one of the most beautiful places in the world .. YES the concept is excellent in my purview... For example, my ex Flight Paramedic Brother PTSI partner, becomes nauseated just at the smell of JP4 (jet fuel) for very good reason. (a Long, very Sad Story)

I sincerely thank you for your support .. but Man, I have a difficult time just getting out of my G-damn house these days, just to get food, my new canine girlfriend, got me out to walk short distances almost daily, and tolerates me when I just cant go for a walk and she will not eat until I have finished. hence my lack of interest in food and not caring for myself, dropping from 200 lbs to 152 !... she is just a dog) but once again the focus in your link is on military not EMS. Somedays I believe that Front Line First responders are "a dime a dozen" or "disposable medics" .. as when I asked for help .. I went from HERO to ZERO in 24 hours. I believe that PTSD should be changed to PTSI ... Post Traumatic Stress Injury, as does the homeward bound telethon show on PBS for the US War Vets, that suggested NOT to clump this in DSM criteria as a purely mental disorder, they call it PTS/TBI ... this square peg in a round hole that phyciatrists enjoy so much to attempt to classify (i.e. protocol/ criteria shrink monkeys) curiously enough and perhaps remove some of the negative stigma of a "mental disorder" or a nut bar mentality by the public at large. As we learned from Dust's teachings that following a recipe make's one a COOK, NOT a CHEF... rings true again. Rob had soo much inner strength it was, well (fill in the blank) I just can not think of any word to describe him to do him true justice. I will confide that just yesterday, my Son, whom is the genetic spitting mirror image of myself, @ just 21 years old is a better man than I am ! This after over 3 years of absolutely zero contact he reached out to his Father to help him ! and HE visited me ! We talked for hours and hours.. not Father and Son just close friends .. it was True Life Changing event for me, as prior to this I could not bring myself to contact him, possibly to shield him from my pain ? I cannot explain my actions better "inaction" clearly this minute. As some may know that PTSI seriously affects relationships very deeply that of loved ones. Finding that my son and my adult male nephews (5) think I am one very cool dood ? WTF over ?? and do want to hang with me .. well, I am still gobsmacked beyond words. cheers

Et all: I would like to report in my latest research intel. First off the original topic, very sadly Kate has had some very bad PR (Sun Media) and in the Culture of the Canadian Military just does not understand, or are unwilling to even acknowledge this disorder (as much as I am not shocked, she was booed when walking by Gagetown a CAF base) WHAT ???? YES: in EMS we too are guilty of this attitude as well, I know I was ignorant with my best man (at my now dissolved marriage) a now retired Paramedic/FF/Captian and has been misdiagnosed as Bipolar .. very typical of the majority of Shrinks lack of knowledge. Point being under DSM criteria the Shrinks attempt to: and to coin a phrase "trying to put a square peg in a round hole" . In our struggle to help ourselves understand what is going on, a few colleagues are attempting to locate MODERN DAY research that is applicable to EMS FrontLine providers. To that end I present a link to a VERY enlightening study. I am going to entitle this helpful link to a study that was sent too myself " It not just psychological it is physiological" as every other "disorder" i.e. OCD, Schizophrenia, BiPolar Disorder ++ the root cause in vast majority of case can be linked to genetics or organic causes whereas PTSD is not, it is the only exception. I believe that this "EXPOSURE THERAPY" does more harm. http://www.allostatix.com/Portals/34/docs/Cardiovascular%20Manifestations%20of%20PTSD.pdf In addition: In the process of following up on biological markers for PTSD, I found an interesting mechanism that I had not seen explained before. While the symptoms that I am about to account for are common in PTSD, I have not heard a satisfactory reason for *why* they are present beyond simply being part of the symptom spectrum. More to follow to address this, with the prime directive of: That, PTSD in EMS can hopefully be "prevented" or at least "minimally addressed" for the newer Practitioners during the initial education process, unfortunately ALL of the research is Based on Combat Veterans, completely ignoring that Front Line EMS provider's that are at extremely high risk based on the extended length of time we are exposed, to the worst of the worst. Just because this is not an official War (and our lives are not placed on the line) no wait a second ... our LIVES ARE on the line .. as more persons are killed on the highways in north america than in war zones ! OR perhaps working in Chicago or Washington DC where more homicides were reported during the same time frame as the Iraq war of KIA or seriously injured. I guess its up to we EMS providers to help our own, but now very some good news, a good friend, a past Critical Care Paramedic (PTSD) with world wide experience has purchased 55 acres of Raw Remote (no triggers even close) this in order to set up a retreat on the east coast of Canada, perhaps when I am more capable. I too will attempt to set up a sister "retreat" in Western Canada .... a not for profit / non governmental (although funded by Canadian Government and ps they don't know what is coming, quite yet ) For those to get out of Dodge so to speak and get back to basics of life, for the entire families of affected EMS providers. Now that I have a new purpose in life, as opposed to being house bound struggling to leave my home .. I do not wish this to happen to any of my brothers and sisters.. or my enemies. heck even Dwayne ! ... oops I fear incoming ! If this post seams a bit tangential, or my composition in making my points is poor, my sincerest apologies ... I am just trying my best to work though this for myself .

Kiwi: Did you forget to mention me force feeding you to put maple syrup (tree sap) on your waffles ? It would have been far easier on you on the "hunting trip" when you put the snowshoes on facing the right direction <sheesh Kiwi !> and the RCMP horse just needed a translator to understand your ramblings ... THE END ........ of THIS work of fiction . Word of caution, Alberta Health Care Mental Health is non existent and the system is a broken system now... and besides no health care is free, its just part of our VERY high taxes, just too bad we the taxpayers have zero control over where our money goes. cheers and pass the beers eh !

Yike's K you ARE the Dog Whisperer. Well she's not really snuggly (in that sense) BUT when she wants something, a complete suck up, just a typical bitch ... Squint looks for bunker for he hears/fears incoming I take a few of the local Shepherd crosses, Labs, and one Bluenose Pitty .. oh yes I forgot a Bermese (sp) Mountain Dog (he's bloody huge) for walks, many owners around my place should be "put down" for the lack of exercise they provide, for many dogs in yards or kennels and never get to run free, hence they become more aggressive. So I took it upon myself to run them all together .. Chewy will return when called in the bush, and I use a E collar (mostly for the beep beep sound) nah it does hurt I tried it on myself FIRST (it does wake you up although) my dog returns and the others follow, again she's a female .. LOL. ps Note to self: when walking a pack in winter ALWAYS wear cleats and take the mass total weights and divide by 2 .. BEFORE one ties in .. as last summer I got dragged about a full block with 4 large breeds and a cat scooted out and across the road, Tuck, Duck, and Roll .. lots of road rash, should have been on U tube, I would be famous This is Lily and Chewy playing, unfortunatly she was put up for relocation, as the owner (a friend) could just not control the Shepard cross, I could not take her as she was not house trained and barking issues, Chewy: when I say Lily's name, it is sunonumus with Party Down dawg style. cheers Edit for double post.

ER Doc: could you define "lucky" to observe purulent urine .. Doc I think we have to talk LOL.

Chewy: named because she ate a $400.00 seatbelt the hour after I adopted her, (everything is tied down in my rig !) she was "confiscated ???" by SPCA @ 2 years of age. I believe from her behaviours that she was raised in a basement or apartment, she will not go into a small kennel, then again neither will I ! Her original name was Chloe .. which according to the (RedNose Pitbull Relocation Program Policy) name change is a mandated requirement ... LOL . Short Hair minimal shedding, House trained, zilch to little "dawgy smell" and the only chewing/damage she has done was webbing on a hunting back pack, and BA carrier .. oh well, I will not need that any more anyway. Curious as she is not a "trained" as PTSD dog, but she got me eating again, as she "knows" she is a subordinate in my pack, and she will not eat until after I do. I always said I would never allow a dawg in my bed .. Hmmmm ahem.... Well ... she cuddles so close (at 44lbs rock solid muscle) that I can NOT move and thrash in bed .injuring myself, as I have shoulder injuries and during nightmares stops she me from beating myself up. She awakens me when night diaphoresis soaking the bed sheets and is a real problem, she gently wakes me up licking the sweat off me .... BUT if its outside she MUST go .. well whole different story a deep BARK BARK BARK .. no political dog correctness when she needs to wizz. High demands for exercise (and she lets me know) rain, snow, or heat just doesn't matter .. instead of sitting watching TV .. hence my physical conditioning is better. The problem is that my WCB caseworker calls "PTSD Dogs" experimental <cough> therefore I have no funding, I asked for $15.00 a month for pet health care an was denied BASED on her BAD forefathers reputation's, In passing the Red Nose Pit Bull is one of the best drug and EOD detecting dogs, even @ the twin towers the Pit Bull SAR dogs were used to great results, as they can work in heat whereas the many other breeds overheat. POWER, AGILITY, but Dumb as as a post, as a duck/goose hunter she's absolutely useless, she forgets what she "supposed to retrieve" LOL .. she can swim, but hates water and honestly that's OK with me .. I had a Lab and that thing would, if released come back in the Sahara desert WET and stinky. Yes Large Breed Terriers are stubborn, Awesome with Kids, BUT she (if allowed) would eat cats and small noisy fluffy dogs (they are after all destroyers of vermin, rats, coyotes +++ ) .. She plays great with big dogs and 4 other Pit Bulls in my "hood" have playdays really rough but never bare teeth. I do go to a Master Certified Trainer, point being that I am not a trainer or dog behaviourist (i.e.) Cesar Millan I am not but his methods are working well. ps BTW is my first beard, I was ALWAYS clean shaven when I was working, now pfft who cares. cheers

Thank you for the more than kind offer, but until the "mobster" gets back to the thread I will hold off ... I would not want to destroy scientific evidence.. Hows that for evading the question ?

Ok Ok .. I got this. Top sample: is orange juice. The Bottom: Rum and Coke, no ice.

I have used this "spinal system" method frequently in fact at one time it was SOP for any suspected spinals for AAA and it it is superior, not only increase bed sores, and decrease amounts of sedation required but can reduce the incidents of stress ileus .. mobey I have little idea about the milkshake coloured urine , if I were to guess, perhaps an intra urinary polyps ... did it look white as in purulent ? Was pt running a temp ? Another idea off the top of my head, you mentioned that ETOH on board .. perhaps pt had a preexisting infection and initially diluted with mega volume's ... just saying. More queries: 1- Was there a demarcated level present in the urine bag ? am looking for a change of Specific Gravity 2- did you increase IV fluids gtts rate ? thinking, if this is Rhabdo then flush flush flush, well in any crush injury suspect really not a bad idea. cheers

Most seriously, I just do not know what to say with these posts (very atypical) ..but accept to say thank you all for firstly sharing your stories/ lives and being honest with yourselves .. Joker21 .. I will never forget the day I met you at Junior Forest Rangers, your enthusiasm for learning AND better understanding of physiology and comprehention of the Rx interactions was in top 98% of EMTs and you were still in high school ! I so wish you could have met Rob Davis (Dustdevil) he would have loved you as his lil sister as do I. btw Dustdevil spelt it "Shyte" .... this type doest wash off unfortunately. For me know being "retired" unexpectedly I am really quite lost .. hey got a ton of medical/ climbing gear I have no idea what I will do with now. chbare stated it best (mildly plagiarizing him) : .................. Just hope to have more good days than bad. I started this thread (not expecting so much personal support) it has really floored me .. my short term goal is to help Kate walking from Canso causeway .. to OTTAWA , we have, through my many contacts, well she is a bit more at ease with the financial aspect .. she's doing amazingly well .. full ruc and bleeding feet to bring the message home. cheers Squint ps you know how to get a hold of me, visit anytime could use the company .. just don't kick my raggedy old ass ..OK ?

chbare thank you very much brother, you are one of the most non judgmental, brilliant and kind man I have ever had the pleasure to disagree with, but you just made me cry again. ps Don't tell Dwayne I said that !

Thanks island .. the culture of EMS is oblivious .. better said, hides behind the "suck it up princess syndrome" we are just humans and after all the pain/suffering and cruel deaths we are subjected to0, its no wonder really, we are not superhuman but are expected to be, by employers. So 4 different experiments with SSRIs .. they did not help they made it worse, a pill does not take the years of memory away or make one feel "less depressed" I believe after all the research I have done is that constant bombardment with endogenous catecholamines, the crappy shifts, long hours without sleep (I believe now this adrenal rush we get) well it eventually screws up synapses between Cerebral Cortex and Amygdala ..well that's my theorem and like hell im taking any more meds other than anti anxiety and pain rx (my shoulder needs a new plastic one) lifting so many phat people under major stress situations wore it out prematurely. This Kate gal s doing her damnedest (last year she made a Guinness world record .. see the links) I feel so compelled to support her as she has more physical strength and moral fortitude strength than I do .. its the least I can type a few emails and give her a few pesos ... I know this sounds strange (ps I do not believe in any god) but I do believe in Karma .. I keep thinking, did I screw up and kill someone in error and now being punished ? I dunno .. realistically with chance vs anti chance in over 12 + 40 years its more than likely (like your very rational fear).. maybe I deserve this and I should have been a Plumber instead ? I would not wish this on my worst enemy .. some days death seams the only escape .. I now understand why regular folks do themselves in .. I now understand that Mental Pain can worse than Physical, that said living with both is very difficult .. Rob and I talked about this a lot, frankly I thought Rob knowing in depth about his disease would take this route, if there was a God .. WHY oh Why would s/he invent such suffering ? ps I will not respond to I will pray for you crap. The one thing that keeps me going (is my new rescued red nose pit bull) YES they are not all monsters .. and my Grandfather who was a POW in France in WW1, he lived to be 96 and enjoyed every day and sharp as a tack till the end .. well, I just can't comprehend the atrocities he saw and how he was treated .. it gives me solstice, well ... some days . Oddly enough we can help many many others in this life but I think we forget just how to help ourselves. OLD ? well f u ! ... dinos wtf ? LMAO ! Dwayne your a prick but I still love you man and btw Dwayne is a Cool Name !

Greetings ALL . Ok so no fear any more no hiding from the world .. I have not posted for a LONG time ... sorry all. So WHY ? .. well 37 years as a REMT-P and 12 years on top of that, in ICU ... Well it caught up with me, PTSD axis 1 cluster B . Robs and a non member of EMT city Peter Mitchell in the UK (took his life) well these deaths death hit me so very very hard ... so anyway I have a new hero. http://www.youtube.com/watch?v=6JwoqUl90BM http://www.youtube.com/watch?v=odXWyEk2O00 https://www.facebook.com/Thelongwayhomemm?ref=stream If anyone is on facebook please give Kate a holler minimum ... if you can spare a couple of bucks well she really needs it. Kate was "saved" and god I hate that word BUT a civy Paramedic made a huge difference in her life, she's running for all of us that wake up at night in a cold sweat. Because once that zip file you THINK is closed in your head opens up .. the Operating system runs amuck . cheers Squint

The supervisors white shirt in Hamilton was a complete set up ! Rob was doing a walkabout and was visiting his friend (Hammerpcp) when a topic came up to do a spoof on, cant remember the thread, sorry, but see your pm I have all photos of Rob @ EMStock on Blesoe's ranch.

Hmmm ... I thought Mark Twain was a redneck hick ? I could be wrong or perhaps or a rare event "stand corrected" .. no matter, I believe I made my point based on Historical EMT City files.

OMFG .. if rob were alive I just can imagine what he would say on this topic . Yes that is correct 'I" am still alive despite the rumours of my demise. ps quoting that Shakespeare guy

http://teespring.com/7793 Oh! I have slipped the surly bonds of earth And danced the skies on laughter-silvered wings; Sunward I've climbed, and joined the tumbling mirth Of sun-split clouds - and done a hundred things You have not dreamed of - wheeled and soared and swung High in the sunlit silence. Hov'ring there I've chased the shouting wind along, and flung My eager craft through footless halls of air. Up, up the long delirious, burning blue, I've topped the windswept heights with easy grace Where never lark, or even eagle flew - And, while with silent lifting mind I've trod The high untresspassed sanctity of space, Put out my hand and touched the face of God. Pilot Officer Gillespie Magee No 412 squadron, RCAF Killed 11 December 1941

Curiously enough the chosen keynote speaker for this year's AGM is none other than Fred Horne the Minister of Health??? Could this be called campaigning before an election is called? I certainly hope that representatives from the other side of the house will be present, to hear the grand announcement that we've finally been accepted under HPA, or is Mr. Horne going to be present to extinguish the possible fires generated by the "grand scheme of things being the big takeover" I hope someone is present at the AGM to ask this very important question ?…… Just How much has this cost the Alberta taxpayer, with no improvement in services, or response times provincially. Just what political process will be put in place to replace the CEO ? Will this be just a political conservative appointment appointment or will this position be posted nationally. If I can recall Paramedic Tim Essington is a member of the Wildrose Party ? Now If memory serves me correct, the last time there was replacement of the of the CEO, Donna LeFergy (sp) 2 public forums were used last time, for two weeks posted in the careers section of the Edmonton Journal and the Calgary Herald. Just me thinking outside the box; why not have the possible candidates for replacement of CEO present their resumes "as is the tradition seeking a position on the board". Then a vote online to choose the new CEO…… Only fair isn't it, or maybe the word's I'm am looking for is a self-governing body is a democratic process only 68 members present at the last annual general meeting out of 9500…… ??? Medic North there is only one way to do any change at ACP, that is proposed bylaw changes and to go back to an Association that truly represents the profession, that actually provides educational sessions so that the requirements under HPA would be far easier to accomplish than "I read page 214 two 218 of a Brady book." A really good start for the new CEO would be scratch that foolish waste of time, proved nothing CISM, outdated software program that was originally designed to establish provincial and national based competency objectives, My personal review is that after the new election we will have a voice . My suggestion is vote Wild Rose, Alberta Party, Alberta Liberal, NDP not necessarily in any order but as you know, I support Raj (he's my folk hero) because without his strength and getting booted out of conservative caucus nothing would've changed but today I believe we have new hope for democracy in Alberta. Cheers

Bada Boom Bada Bing ... its the the innominate artery and comes right off the aorta, I sure hope that ninja is a cardiac surgeon as the fix is crack the chest, honestly never thought of transensemic acid ? <insert head scratching smiley> Realistically pre-hospitally a real rarity i would hope of erosion, more so in chronic ventilated fragile patients. I would think more so from a rupture from of a congenital malformation in the field. But it does put a sober thought when slamming a "prescribed volume" of air in a cuff, doesn't it ? The mortality morbidity of innominate rupture is about 99.99 % even if your in an ICU and close to an OR. Permission to tell a war story ? I have had one Inferior thyroid artery erode, I pretended to play the little Dutch boy and plug it with my finger, it was a big stoma, the blood squirting on the curtains was a dead give away. The intensivist had me plug the hole for about 2 hours "talk about cramped fingers !" and of course in the middle of the night the unwritten rule I do believe. Cautery solved that problem Surgeons quote: "the scorched earth policy" the patient had 2 units packed cells and synthyroid after that bloodbath. Far more of a risk with real tracheostomy long term in situ as if you ALL haven't had occasion to transport a pt with a trach and watch the trach tube pulsate with every heartbeat, puts a different spin on things as the term ass puckering comes to mind for me now. Interesting thoughts, I like the way you think although diagnosing this in the field may be a bit of a challenge, if I had a lot of frank bright red blood up a ETT .... I think??? I might try doing a Right Mainstem or Left Mainstem (harder) and isolate a lung as cracking a chest is not quite in my scope of practice . Sorry Mobster for going off topic .. cheers Mobsters Homework LOL. See exercise #2 <edit> page 148 http://books.google....ressure&f=false

You did hit a home run ... besides I love busting your balls ... hey when are you dropping in for CXRay in service ... ? Still awaiting systemet to answer the question posed ... te he.

Do you know how to calculate Mean Airway Pressure in PPV, ah my first guess is no but thanks for playing ... so what was your RR, your Ti, Te, PIP and VT, and MV ? ps I use the little MAP microprocessor LED readout on a real ventilator. <cough> this was an in hospital study ... what if your PIP is 40 cm H20 do you keep your 20 to 30 cmh20 of cuff pressure, so are you ventilating effectively with a closed system ?

MOV aka "minimal occluding volume" stethoscope over trachea, then a positive pressure breath slowly increasing cuff pressure. until the leak goes away on inspiration.