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SALIENT POINT. I just may have knowledge of whom that employeer(s) may be , actually their is a couple that hide behind a loophole that will be soon changed, when we eventually get accepted under HPA that 200 dollar fine will change markedly and may result in loss of Practice Permit in your own hood. Thier are no "inspectors'" as of yet but rest assured if you doing something "under the radar" you will get balls busted one way or another.

Well I might have a bite on that ! Don't you mean the "precedent" set by scum sucking Lawyers because of a loop hole ? I have been to court way to many times to see a slap on the wrist when a drunk guy kills a father of 4 in an MVC. A bastard that smothered a 19 month old child and got 2 years, or a meth head get off because he had a drug problem and assaulting a Peace Office charge because he was not aware of what he was doing? ps I was the witness. Oh dear North "opinion" is exactly what the judge uses in his/her judgement, we are way to light, 9 times out of 10, bring back the guillotine and public hangings for horse thieves too. cheers

I am with you 2c4 typically we get zip in my hood too, well pretty much, I do have a theory it your case. Could it be because your ass glows ??? .. just saying . I don't think I could ever get up the gumption up to demand a discount, that said it does depend in the situation as many ma and pa shows like to have any uniforms frequenting their establishment, its a free security and promotes good will in the community, nuff said. We do get "staph" breaks when doing standby at a large arena, Pro hockey, Rodeos and Concerts and the like as we are employed by the "operator" and carry have staff ID. Thing is that "concert" food is a freaken bio hazard, don't believe I have ever taken advantage. My RN flight partner and I will working out of Ft. Mac, we stopped by really nice steak place, a 4 star spot. We were recognised by the owner and rumour has it he is Hells Angels. He insisted on picking up the tab as we had flown his 14 y/o daughter out to ICU in EDM with meningitis just the week before, so just what do you do ? Offend the biker guy ? We can't accept tips here its in our code of ethics, so we politely informed him that we expected nothing for taking care of his girl, just doing our job Mr. "GRIZ". So in order to save face and not get knee caps broken both of us insisted on tipping the waitress (just slightly less than the bill) it WAS excellent service and avoiding a rather sticky situation, so he gave us a receipt so we could claim company "expenses",yeah right with a strip joint attached THAT would have gone over great ... NOT ! cheers

I do not think they would fit .. they got put away wet and are shrunk a tad.

Shush you .. I am trying to sell a sightly used White Ford Bronco !

HAY ...Hold urine horses .. don't put me in the middle of a two way shooting range with North and Dust. I would just be Dust's collateral damage

I have to agree about the term "provoke" I would go so far as to say "thought provoking" but this politically correct term we toss about that of "tolerance" of others societies that are not based upon our western values. Those that tolerate "mercy killings" those that tolerate "stoning for infidelity" those that tolerate "permanently disabling a child's arm" because s/he was caught stealing bread or those that tolerate "females hiding their faces in public" . I am of the opinion that this is simply oppression and does not comply to my western ethical beliefs of fairness, the problem if one actually reads the history books of the religions in this case the "building of a mosque" is a monument to a vanquished enemy, i.e. "Wailing Wall" by European observers because for centuries Jews have gathered here to lament the loss of their temple. This is a more than clear intolerance of that group, the last sentence in the OP without doubt does have some validity. Lets look to the "humorists" in our western society (as presented in links prior) if one can not see based on colour or ethnicity their is a double standard well best remove head from a very dark place. Question is: Just how far does one "tolerate" all the religious minorities ? When the demographics of population change to a majority ? Perhaps take a look at current events in France or Austria to bring a more worldly perspective, are you prepared to sit in traffic bringing all business to a full stop because of one groups prayer "time(s)" and not in a counties unofficial language being broadcast from towers .. may I remind all that we do have laws about loud noise, loud music, its my right to peace and quiet and not be restricted for my freedom of travel, based on a now close to a majority group, in France. Should one ignore that "ethic related gang warfare" is not in your present community, well we have 28 identifiable "gangs" in my hood. My son will not go to a "high school house party" because when the "Browns" show up the fights start and someone gets "shived" this is not an opinion it is a fact and if one looks under human rights were I live its a very one way street, charges are laid when its a brown guy stabbing a white kid, but never the other way around. The Math: Presently their are 7 billion two legged rats walking the planet (called over population in my book) I the Horn of Africa we as observing this very tragic event unfold and the western world could stop this in a heartbeat but nope we are far too focused maintaining the current wars with other idealistic societies. In the last decade we have seen an mass exodus from areas of conflict to a better life but firmly retaining the legal aspects of their homeland, this is not tolerance either. This despite swearing allegiance to the flag or (I, [name], do swear that I will be faithful and bear true allegiance to Her Majesty Queen Elizabeth the Second, Queen of Canada, Her Heirs and Successors. So help me God) Its just a matter of time before the "request or complaint under human rights commission" that GOD be changed to and Allah based on the philosophy of "western tolerance". We have witnessed this in schools and some groups actually having Christmas Carols be stopped, protesting Christian prayer time, or for over a century wishes of "Merry Christmas" be changed to "Seasons Greetings ?" is this tolerance or dominance ? In fact forcing non official language be taught when a majority in a community has been accomplished, curious is it not ? Another Question must be asked from an "economic standpoint" are you personally prepared to hugely lower your standard of living that the Western World has become so accustomed ? We do take 80% of the worlds resources so tell me if this "standard of living changes" that you will just stand back and be tolerant I will call you without hesitation a hypocrite. Even the most tragic events in Norway, with this event ignoring that their are very fringe groups out there that believe that "multiculturalism" does not and will not work, well minus the insanity of it all, have not and will not read that "manifesto" one screwed up dood their believing that using violence against his own countrymen ... that is fucked up. So I challenge ANYONE to tell me in the History of "Tribal Man" that this utopia idealism has in fact been successful anywhere on the planet? the Romans, Greeks, the Mayan, Bosnia, South Africa, Somalia, Rwanda, Chechnya, Arizona, Quebec the list of cultural conflicts goes as far back as Wouldn't it be great for everyone on the planet "to tolerate each other" ABSOLUTELY I am all for it, count me in ! Will it ever happen ? A realist or historian will tell you not a hope in hades. Homo Sapiens have just not progressed up the the ladder of evolution, we enjoy killing each other, we enjoy being territorial, we love being tribalistic, we are overly judgemental, we will not share when our survival is on the line. Tolerance Defined: 1. the state or quality of being tolerant 2. capacity to endure something, esp pain or hardship 3. the permitted variation in some measurement or other characteristic of an object or workpiece 4. the capacity of an organism to endure the effects of a poison or other substance, esp after it has been taken over a prolonged period NB: this is a definition and not my words but those of scholars. Personal Conclusion: If you want to see tolerance from me, well best one demonstrates that you will meet me half way, that's called cultural fairness.

Ok as the female side of the house tripp what are you thinking "ahem" means ?

Quake, do you carry many large bowls in your Ambulance ? We do in industry but that's for puking into or great for a nice foot bath, OH+S regs, and don't get me going on that rant . I would file that "I heard" in the G section of data banks along with MAST Garment, Leaches and Butter on burns ++++++ just saying ...

Just an idea but check in the couch for some change, your best girl deserves a bit more than a $10.00 gift. If your broke then do something special, like a card for "free cloths wash for a week" "coupon for special (ahem) favour" or "prepare a meal of her choice" she busted a hump getting her ticket YOU SHOULD TOO if you want to keep her as your GF. I got a pen with my initials on it from my ex (we were broke too she saved up for months before) ... after 30 + years I still have and use it. To bad I still don't have her .

Thanks guy and gal ... within a day or 2 after this query the NEWS ROBOT edjumicated me . http://www.emtcity.com/index.php/topic/20380-podcast-bath-salt-abuse-ems-garage-episode-140/page__p__261247__hl__podcast__fromsearch__1#entry261247

One of my favourites:

The questions I posed in a post prior, in light of very recent events in Norway. I have often thought just what would "I" do if this happened in my community, clearly not from a Hero Headline grab. I am not a HERO in fact I have a yellow strip permanently tattooed up my back. But a very realistic position in my community the LEO are far, far , far away. It will be over before they can even get dispatched. SO if I had knowledge of a similar situation, do I risk getting riddled with Tac Team lead and causing more of a complication, OR grab a hunting rifle and go and eliminate the fucking vermin myself ? Seriously these mass shootings of the innocents make me just fucking furious, killing innocent kids proves what ? just what in their heads ? do they think they can accomplish anything positive ? Norway needs the death penalty reinstituted as does Canada IMHO not as a deterant just a cost effective means of eliminating a cancer from society, hanged criminals just do not make a lot of headlines when they are ded. These acts define INSANITY quite clearly, in fact the "goal" of these cold blooded murderers most typically polarizes against the supposed goal. The police (generally speaking) and in this Norway incident are clearly not prepared nor can they predict or even identify these loon's. Is it time to go back to wild west vigilantism ? That said and at the risk of being on another "Watch List" (well just another one ) Sorry zilla this is a bit off topic but I am one that truely believes that multiculturalism is a huge failure (with present immigration laws and tolerance that is only one sided) the proof is rather clear I believe. I live just north of a huge First Nations community the segregation I observe daily and based on "Special Rights" will continue to contribute to the violence, crime, gang warfare, drug abuse this observation is based on decades of interactions IMHO. My morphing philosophy in this: That man has not progressed enough we are delusional to believe that we are little more than naked ape's, like it or not we are extremely "tribal" and the fact organised religions are the root of all evil, IMHO, proven over and over. Would it be great if we could get along without killing each other ah utopia what a concept, but its just not the reality. cheers

Interesting topic's and quite dear to my heart, actually discussed in great depth before, not "have you ever used one" request for war stories but the EBM is: http://www.dtic.mil/cgi-bin/GetTRDoc?Location=U2&doc=GetTRDoc.pdf&AD=ADA480277 NB: The study is protected from reproduction therefore I highly suggest that one reads the full meal deal, noting the conclusions, it pretty clearly smashes the old school F.A. myths of: 1- It should only be considered "last ditch" 2- That it causes damage. 3- That it can be taught in a 16 hour First Aid course. Conclusion: Tourniquet use before shock onset saves more lives than after shock; use them before extraction or transport. Logically the idea of placing secondary Pressure Dressing over a Pressure Dressing that has not arrested life threatening bleeding (the theory being that it will dislodge clots) is false, akin to the idea of putting another diaper on a child that has pooped in the first diaper. In passing in one post it appears the Student has now become the Teacher. Forgive the extensive data I provide concerning Trandelenberg and the associated EBM studies, but it become fairly clear that the 16 hour first aid course or EMT or Paramedic programs still stuck in the paradigm are not doing anyone any favours. Db=pubmed&Cmd=ShowDetailView&TermToSearch=16120887&ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum The Neurointensive Care Unit, Vanderbilt University Medical Center, Nashville, TN, USA. OBJECTIVE: To review the literature on use of the Trendelenburg position as a position for resuscitation of patients who are hypotensive. METHODS: PubMed online, cited bibliographies, critical care textbooks, and Advanced Cardiac Life Support guidelines were searched for information on the position used for resuscitation. Because of the heterogeneity of the data, only pertinent articles and chapters were summarized. RESULTS: Eight peer-reviewed publications on the position used for resuscitation were found. Pertinent information from 2 critical care textbooks and from the Advanced Cardiac Life Support guidelines was included in the review. Literature on the position was scarce, lacked strength, and seemed to be guided by "expert opinion." CONCLUSION: The general "slant" of the available data seems to indicate that the Trendelenburg position is probably not a good position for resuscitation of patients who are hypotensive. Further clinical studies are needed to determine the optimal position for resuscitation. PMID: 16120887 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=7762369&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus Martin JT. The steep head down tilt surgical posture, popularized in the 1870s by Trendelenburg as a means of improving access to pelvic pathology and espoused by the American physiologist, Walter Cannon, during World War I as a resuscitative position with which to treat shock, has a history of widespread, ritualistic acceptance. An awake patient placed in steep head down tilt usually objects to the posture after only a short time. Now recognized as potentially harmful in the presence of cardiac, pulmonary, ocular, and central nervous system pathology and essentially useless for vascular resuscitation, steep tilt should be limited to selected circumstances in which alternatives are unacceptable. Shallow head down tilt, a more recent variety, also offers serious questions about its surgical usefulness as well as its applicability for patients with diseased hearts, lungs, and heads. As an aid to resuscitative procedures, the contoured supine position offers assets that merit serious consideration. Means of restraining a tilted patient on an operating table include wristlets, shoulder braces, and bent knees with ankle restraints. Considerations that aid in the selection of head down tilt are presented, as is a plea for the abandonment of the Trendelenburg eponym and a suggestion for future investigation. PMID: 7762369 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8135435&ordinalpos=17&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Department of Surgery, Graduate Hospital, Philadelphia. STUDY OBJECTIVE: To evaluate the effect of the Trendelenburg position on oxygen transport in hypovolemic patients. DESIGN: A prospective, self-controlled sequential design. INTERVENTIONS: All patients had indwelling pulmonary artery catheters, and hypovolemia was confirmed by a pulmonary artery wedge pressure of 6 mm Hg or less. Hemodynamic and oxygen transport variables were measured with the patient supine and again ten minutes after placing the patient in the Trendelenburg position. SETTING: University-affiliated tertiary care surgical ICU. TYPE OF PARTICIPANTS: Eight postoperative adults. RESULTS: Mean arterial blood pressure increased from 64.9 +/- 4.9 to 75.6 +/- 3.5 mm Hg (P < .05), pulmonary artery wedge pressure increased from 4.6 +/- 1.1 to 7.9 +/- 0.8 mm Hg (P < .05), and the systemic vascular resistance rose to 2,965 +/- 210 from 2,302 +/- 199 dyne.sec/cm5 (P < .05). There was no significant change in cardiac index, oxygen delivery, oxygen consumption, or oxygen extraction ratio. CONCLUSION: The increase in blood pressure from Trendelenburg position is not associated with an improvement in blood flow or tissue oxygenation. http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8000462&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus Ostrow CL, Hupp E, Topjian D. West Virginia University School of Nursing, Morgantown 26506. BACKGROUND: Although we have insufficient knowledge about the effects of Trendelenburg positions on various hemodynamic parameters, these positions are frequently used to influence cardiac output and blood pressure in critically ill patients. OBJECTIVES: To determine the effect of Trendelenburg and modified Trendelenburg positions on five dependent variables: cardiac output, cardiac index, mean arterial pressure, systemic vascular resistance, and oxygenation in critically ill patients. METHODS: In this preliminary study subjects were 23 cardiac surgery patients (mean age, 55; SD, 8.09) who had a pulmonary artery catheter for cardiac output determination and who were clinically stable, normovolemic and normotensive. Baseline measurements of the dependent variables were taken in the supine position. Patients were then placed in 10 degrees Trendelenburg or 30 degrees modified Trendelenburg position. The dependent variables were measured after 10 minutes in each position. A 2-period, 2-treatment crossover design with a preliminary baseline measurement was used. RESULTS: Five subjects were unable to tolerate Trendelenburg position because of nausea or pain in the sternal incision. In the 18 who were able to tolerate both position changes, no statistically significant changes were found in the five dependent variables. Changes in systemic vascular resistance over time approached statistical significance and warrant further study. CONCLUSIONS: This preliminary study does not provide support for Trendelenburg positions as a means to influence hemodynamic parameters such as cardiac output and blood pressure in normovolemic and normotensive patients. PMID: 8000462 [PubMed - indexed for MEDLINE] cheers edit to add personal conclusion.

So would the medics primary role be an active operator or just defensive back up ? Have you adopted the "rush" the shooter the 3 man approach or remain with containment in a mass cas event ? Later entry: Would for a rapid response, the Ambulance have a firearm on board or have to be issued on scene ?

Do you have 411 down south ? Most of our EMS dispatch do have a Non-Emerge line, one just has to ask the operator, for 50 cents they will actually connect you. cheers

So Dust are you a proponent that every EMT and Paramedic should be armed ? Maybe your missing the fact that with North's legendary cat like ninja skills, I suspect he would have them crying uncle in a heartbeat, or subdued with his combat walker ... you choose ! <insert haunting evil laughter> Now would that be sidearm or a 12 ga (my personal preference, well if I could just find a holster for my bat belt) for our "Furry Black Taliban" or Cougar (without a cell phone number) a far higher risk assessment were North lives than any pistol packing "gangsta" in Red Earth AB. In passing with our Bruno's even a .40 cal would just piss em off worse, and on the Rez, well if they want to shoot you it would be from distance a 30-30 or a .303 Le Enfield its standard issue in every cabin. cheers

Dear nah2323: I like that line, just who doesn't like mildly bonkers Charlie Sheen and please pass the Tigers Blood. After a bit of a "rocky" start a hearty Welcome to EMTCity, straight up Paramedics and EMTs are actually some of the worst for the use of acronyms and mnemonics, even worst are the Military Medics hence my jab at Maverick56, but all in good fun. I got my start as a Pro Patroller stepping into Emergency Medicine area, (NB: I didn't say up) in my opinion and yes even inclusive of the Turkey Patroller's. Those with a Ski Patrol and/or Surf Lifeguard background make some of the best EMT's and Paramedics, packaging patients in these environments and transporting off a rock or beach is not an easy task, one learns in a hurry what or what doesn't work, no hose monkeys around to lift the heavy things. Just my 2 cents but if your looking for a one plus one equals 3, why do you not take an W-EMT program ? I see that SOLO is in Colorado and offer many courses that could enhance anyone's background skills, especially splinting of twisted out of shape limbs with what is at hand, just like getting more blades or a fancier model Swiss Army Knife that already you have. btw: Don't mess with Maverick, I believe she uses a Ka Bar, and the Germans are not the only ones that have good steel. Here is a link to another Wilderness EMT program and IDM the "Independent Duty Medic" program that I can highly recommend as Dr. Jonathan Busko the medical director is one of the best in the biz, well so he tells me. http://www.cdsoutdoor.org/index.php cheers

Top Hut Duty .. yes same here, TP Turkey Patrol is the predominate phraseology. Hey wait when did Michigan get mountains and do you still have "Loud Powder" out east ?

Ahem .. you mean the Queens English do you not ? cheers

Just an FYI (that's: for your information) this site has a membership world wide , yall think an OZ, Kiwi, Canadian, Israeli or German or even a dood from Louisiana would have one clue of what your yittering aboot ? Thanks Maverick "the queen of the acronym" to explain to we lower IQ members of WTF buddy is actually asking. My question would be that your National Ski Patrol medical background is half as much info as an EMT B, curious. In western Canada, Lake Lousy, NoShine and Marmot Glulch most Pro Patrollers at minimum are EMT / PCP with many Canadian Ski Patrol System Trainers are REMT-P, a good thing because we have some pretty big rocks here. cheers

Oh I get it now .. the Kanukistanian translation would be: CSPS + EMR = PP . NFW !

Hot or Cold load .. an interesting topic. In BC there are only 4 contracted helos and vast majority of Helo use "out of the bush" is done by the closest bird, typically the A-STAR, or the Bell 206 Longranger which suck as medivac platforms and when medivac is done by "hit an miss" operators and PCP the attendant. So the COLD Load is the safest options IMHO. STARS in AB does HOT LOADS with BK 117 clam shell doors, policy is first officer is safety man so no one walks into tail rotor .. the real show stopper. In this situation a fellow had a fall from height while pruning trees, packaging could have been the reason for cold load but I wasn't on scene, in the news many couch pilots commenting but the vid speaks for itself quite clearly. The fact that BCAS has no "crew chief" training with "head on a swivel" and door open on departure, thing is wire strikes are a huge killer with helo ops. NB: That S 78 doesn't even have line strike protection ... folly in any HEMS show. That said: In Canada with twin pilot IFR, twin engine, mission uninformed all mandatory in the RFP for the HEMS contracts, but the safety record's speak for themselves, in the USA also speak for themselves. I can only recall of 2 wrecks (in 15 years) ORNGE in Ontario put one in the bush on very short final with injuries but BOTH birds were S 76. This bird in my personal evaluation is old, underpowered, was never designed for HEMS, it was designed for offshore for crew change out. The awarding of the contract in BC is VERY controversial, the so called "non-profits" whining (but look at the breakdowns in operational budgets) is also rather reviling. Funny how a thread started on blood products in HEMS (media poorly researched sensationalizing) morphs into something completely different, oh and it is my fault taking a poke at BCAS (look something shiney ) But wouldn't it be nice that a Health Minister would actually read the free unsolicited comments to open their eyes ? cheers