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A very complex subject overall and as Dust suggests highly political, the media / sensationalism does not represented in the correct light and with very clear safeguards in place The fall out could be disastrous for EMS overall, an EMS provider KIA or a bystander injured in a cross fire. Bottom line its really risky, all badness not being a truly deputized or LEO. I am an advocate of lethal self defence for the properly educated and practised providers, those officially attached to an ERT. My argument(s) would be based as a result of current trends, very unfortunately the very serious alarming copy cat type of school shooting's or political rally's to increase gun control it just aint working and a very ironic and tragic situation with the Gabrielle Gifford shooting. It s my understanding current practice has changed that in such situations the RCMP and armed LEO in major cities is NOT to contain and control off area's to prevent escape but any member's (typically 3) upon arrival,immediately enter and eliminate the hazard at all costs. I can not recall the specific details of the highly publicised "church shooting" where an off duty security woman who according to "media" reports did stop a potential massacre. Can I realistically see this concept implemented in Canada, Australia, New Zealand or the UK, absolutely NOT in my lifetime, heck our new Sherrif's in Alberta are unarmed that is just dumb IMHO. We too have observed as in the US an escalating problem, meth driven armed robbery and gang violence. I can say from experience in EMS that if I am requested to enter such a situation as a known shooting with injuries and if a Tac Team member is not escorting and standing over with myself and my partner, well good luck with that. I have a every right to "refuse unsafe work" better to be a live coward than a dead attempt at heroism, and no matter what level of body armour I am issued.

If one can't start a line on it or Defb it ... I would use a call out so that I don't break it even more. btw I am no longer permitted to touch photocopy machines either, I am convinced they are possessed by evil gremlins that hate me. cheers and good luck.

That is why soap was invented, so just how old are you GOOD SAM as this is covered in middle school, your first question was good, but got to call you on this.

Good AM, GDay or Guten Morgen ... et all. Lets do a bit of a statistical "tally" at this part of the movie shall we ? So far and based on the scenario provided by the good Doctor, firstly some support for his initial question progressing to gentle advice then more suggestive advice, morphing into (and missed) satire and (windshiel washer fluid LOL Dwayne) then an intent go completely off topic and ridecule you that you Sir SD did not pick up. Counting: A couple of Aussies, a Kanukistanian or 2, multiple truly respected veteran members of EMT City, those with thousands of intelligent posts on the topic of Pre Hospital Care Medicine and some old enough they are retired from some of the busiest and most dangerous stations in the free world. This cross section covers all the way from Coonassville to the Yonkers to the Midwest, in passing your own countrymen. I suspect that the Hitler reference did not go over well with our German / Bavarian friends, just saying. But that's not all: Called OUT by a highly respected ER MD, may god have mercy on your soul if zilla "Tactical MD" (he has spanked my bare ass in past) or if Dust wanders across this thread. A couple of the above have spent a few vacations in the sandbox, some deployed there today besides some other "austere" hostile settings that would you sir SD would make you shit in your Diaper's. In of the few Rez's I have worked pepper spraying an angry man with a dog would result in a dog pile style beating from bystanders, hell just packing a "puppy the bounty hunter canister or cuffs" on your bat belt would mark you as a ROOKIE just looking for a "tune up". Then a "BUS" a "RA" a Rescue Ambulance, come on bro, this is jargon used by posers ONLY, take the hint it's not too late to pull up your boots straps. I will sheepishly / openly admit and in the words of Charlie Sheen: It has amused ME. Yes, I have baited you because you are a reflexive poster and with some glee (my bad ?) just to see just how far you will dig a hole. Its a hole that you should stop digging as Dwayne has suggested as he supported but politely used the back side of an axe right between your eyes, you still didn't pick it up. <sheesh> The common denominator is that WE as a collective and as a community of professionals are attempting to inform you that your attitude (on -line) is either going to get you in G-Damn serious trouble, lose your practice permit or WORSE. So now .... its now your call .... respect or disgrace.

Hey hold on now, 30 is the "new" 20 !

A pioneer in EMS Industry, most curious, so just what cause(s) have you championed ? As Dwayne stated you express yourself well, have you authored or published something that would enlighten this group ? The biggest question for me being from "down under" remains just where do you practice and serve your community, what state or territory are you so highly respected ?

Actually there is no slang used only accepted medical acronyms and the "advances in Intubation" that you refer there are many serious and life threatening complications that arise from committing an Individual to Life Support, never to be taken lightly. But the link to the acronyms that one should NOT use on a PCR ... most worth while.

Agreed Mike .. a few other Laws as well ... just where is the Dust ? I suspect that the Laws of the Double Barrel shotgun will soon be applied. I am looking for a bunker myself and make some popcorn at this point in the movie ... ROFLMAO !. What frankly amazes me in this thread that Level 4 A body armour has yet to be discussed, curious and perhaps a needed piece of kit required in this ones POV as well ? just saying.

I think a excellent start for Good Sam in observation alone and great question for first post .. the point of resistance allows for a teaching point both in secretions and affecting pressures when squeezing a BVM, the hows and whys of the pressures are generated. Maybe a bio person that we can recruit to the dark side of Respiratory Therapy ? Pulmonary Mechanics is really not dealt with in the detail that it should in EMS especially the negative pressure effects on the heart.

Short answer YES. Almost a mute point but ETI will actually decrease physiological deadspace, if one looks comparably at the volume in the upper airway, it quite easy to observe that the "volume contained in the ETT" itself is markedly less. This can effect End Tidal CO2 readings/levels but minimally, when ventilating and taking away WOB (the intent of ETI) the "mechanical" deadspace becomes more of a factor as the circuits used generally add more deadspace, an artificial nose or "humidivent" "bacterial filters" also increases mechanical deadspace (the portion of a tidal volume "i.e. a single breath" that does not undergo alveolar gas exchange) spacers for medications or tape flex additions also add Vd/Vt. I don't think getting into "effective" MV vs "set" MV discussions and loss of volume to tubing compliance is or of value at this juncture, but should be mentioned in passing as "a couple years of Lung School" is essential to clearly understand pulmonary mechanics, as well as years of experience to put these concepts into actual practice. Good Samaritan: Your observation of "goo/secretions" and increasing resistance to airflow is most excellent and reflected on a gauge called "Peak Inspiratory Pressure" (IMHO they should have one in-line on ALL Manuel Resuscitators as well in EMS to prevent inadvertent "overpressure") This number is measured on a ventilator moreover a very serious complication in longer term ventilation or with pneumonias (due to the increased volume of secretion production) The ETT is guide for a suction catheter to remove said "goo" in the spontaneously breathing patient the "cough" is the mechanism to eliminate the goo, well until the patient "craps out" and fails. Yet again you are correct if one was just breathing though a "straw" on their own .. this would add an increased WOB or work of breathing. .. Try it to see for yourself in ten minutes it becomes very apparent. chbare brings up a good physics point with Poiseuille's Law .. A clinical bedside formula I use teaching Paramedics is that if one decreases an inner diameter by half this increases resistance to flow 16 TIMES .. so not to be taken lightly especially when using one "mode" of ventilation called Pressure Control, best left for pros to use. Another "rule of thumb" I use is that with set average flows set on a transport ventilator are 40 to 60 cm H20 per liter per second, so with an "average" resistance with a # 8 mm tube your looking on the Peak Pressure Gauge of a factor of 8 cmH20, even before looking at overcoming the resistance, compliance and elastic recoil of the chest wall. Yes its eyeball but when setting up a Ventilator on a patient the resultant sequelea of ARDS (adult respiratory distress syndrome) and adverse effects of barotrauma are of very serious concern's especially longer term for survival of those committed to Life Support. cheers

In summation of quals: By day mild mannered Paramedic deployed on a Rescue Ambulance er bus. By night a Trainer on a Church group First Aid out reach program. Combat Trained and a Martial Arts Expert, courses in how to arrest. L + S on a "Nissan" with a You tube video. I wonder if Dust has seen this thread ?

No worries I wasn't clear ... and I personally wonder if elimination of Lydocaine based on current research warrants removal from AHS EMS protocols, it does limit options . ps Besides its really hard to offend a Turnip .

You mean that Turnip@freezeyourassoff.ca is unacceptable .. Seriously AK a very good point.

LOL @ Dust, but he is right YOU have good health. Well I took the time to read it, read it over yourself and just LOOK at the Mountain you have already climbed. Maybe print this out and give it to the Judge on the red light infraction .. it couldn't hurt, some judges do have a heart. Keep plugging along and set your targets higher than a a Denver Job its a big world out there, full of opportunities. ps It could be worse, getting booted out of the significant others with no real warning and sleeping in a truck for 2 months is way worse .. been there have the torn "T" shirt !

Last time I was out there on the east coast NYC was thinking of calling themselves a city .. yup I am that old ...

. Dear Mike I would agree that the Wilderness EMT would be far more suitable prep from the OP's request for information but I would tend to disagree based the Haiti / Katrina / now presently the Libya experience, the EMT B does very little to prepare one for these catastrophic events, realistically. If one truely wants to be prepared in event of a natural disaster as in a massive quake or hurricane or civil insurrection. When infrastructure is so damaged as to be absolutely ineffective and overwhelmed one should look far deeper than slap on a dressing or give O2 and boogie to like where? ... this when roads are impassable for weeks. Is an EMT B a good place to start no argument but if I am reading the intent of the request from a sponge well here is my 1.4 cents. The immediate concerns are obtaining the essentials such as clean drinking water, shelter, broad spectrum antibiotic therapy and pain medication and again from Haiti experience, yes, how to amputate crushed limbs (when its black and smells like Blue Cheese) The biggest problem is actually locating ones zombie pack in the piles of debris so improvisation is a key factor in survival, I suspect that a Marine would have these skills already to some degree ingrained. IMHO (speaking from a position of some experience in these humanitarian crisis's) the problem that always raises its very ugly head and the first thing that occurs is zero law and order (the Japan quake being the exception possibly due to hundreds of years of cultural conditioning ) BUT "Might does makes Right" hence my most serious reflection about the real Zombies because when the Military or a FEMA or UN gets involved is that its very late, and during my holiday in Louisiana this was proved that in spades. Most seriously Walmart had superior skills in logistics and resupply and oddly enough NGO's get on the ground way faster than activating huge ops like Red Cross, UN or military.

I sensed you actually ate those Roo's, your breath gave it away and Yall's PLEASE keep that FREAK Celion Dion in Lost Wages, she's worse than a flying rat (Canadian Taliban Geese) every fall we send her down and she flys back in the spring <sheesh> Don't get me on a roll about the those "franco phones" that's why we invented the Ross in the first place, but we should have made it full auto ! I heard drift that in DC the smokies are going to be used to ward off gangsta homies and hey the down side is what again ? A charged line and an axe are effective weapon in the hands of a highly trained professional. Now back to the regular scheduled programming and quoting LS: common sense, courtesy, logic, compassion and an over active ability to pay attention to my surroundings or as we say in the "hood" keep your stick on the ice.

I stand corrected, thanks Doc.

Eh would be correct ! Ok a little EMT City history rule's of engagement, the term "bus" can only be used within the city limits and 5 boroughs of NYC, any Unauthorised use of this term other than in 1. Manhattan 2. Brooklyn 3. Queens 4. The Bronx 5. Staten Island is punishable with a minus 5 on the Dustdevil scale under the very clearly defined term whackerism . The exception being an MCI Bus

Yup good advice. Join a local Volly SAR group, a ski patrol or a life guard First Aid also may be a consideration, gratus training, if you don't wish to go official EMT courses route as they prepare one for working on a rig not when the Zombies come. ps Always a double tap ! My back country bible is by Wilkerson "Medicine for Mountaineering" is a good resource with kits lists in the back. http://ebookee.org/James-Wilkerson-Medicine-for-Mountaineering-amp-Other-Wilderness-Activities_722226.html

And with this from respected LS: Dear Admin or AK: If I could be so bold, could you move this from general discussion to "Funny Stuff" because its is more fitting as this thread progresses.

Yeah was going to say something about the correct Continent, let alone the correct "colonies" but apparently the red maple leaf in my avatar is not "understood" go figure, psst look north not turn upside down ! Hey you can keep those suicidal grasshoppers, child eating dingos, poisonous snakes, killer insects, cane toads and of course those harmless pet "Salties" on your very safe OZ "back country roads". I will be most happy to keep Swamp Donkeys, Bears, Wolves and Cougars (especially those will cell phone numbers) and we have more than enough suicidal 4 legged ungulates but thanks for the offer,I dont think they would fair well at - 40 C .. From a First Aider Outreach Church program (working with no education volunteers) to a EMT on a Rescue Ambulance "Bus" with Combat Training, a martial arts expert with OC certification and licence to pack handcuffs, and now an EMT-P this all in one thread about what do you wear on your person .. WOW I am impressed beyond words. I guess I need to get more crap for my belt to keep up with this ..

I should have been more clear, in Alberta Canada the Alberta Health Services as removed Lydocaine has from protocols using Canadian Prehospital Evidence Based Protocols, some privately run operations still retain Lydocaine in their protocols. Here is a link to a multitude of experts opinions and Canadian Prehospital Evidence Based Protocols. http://emergency.medicine.dal.ca/ehsprotocols/protocols/toc.cfm