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Isn't a bus a large awkward vehicle to respond in ?

<edit> One of the old Guard in EMT City and some of the stories are actually TRUE ! LOL. Richard brings us all back to our EMT roots and will not steer you wrong.

Welcome TEXAS !

Dear Ed: Some days "sorry for your loss" just doesn't cut it. Deeply Saddened. http://civiliancontractors.wordpress.com/2011/07/10/retired-state-trooper-paul-protzenko-killed-in-afghanistan/ http://www.courant.com/news/connecticut/hc-reitred-trooper-dies-in-afghanista20110710,0,1378556.story

Still awaiting if DwayneEMTP carries Winter or Summer windshield washer fluid, because in the right hands a spray bottle with the winter stuff is a well know to be a deadly deterrent to all cape wearing crime busters. <shush its a secret> cheers

The comments section is hilarious: I think the police should start interviewing the bears------the death seems a little grizzly. How emBEARasing ? The safe word is, 'picnic basket'. Too bad the assistant only heard, "Mmmmmbbbbblllllmmmmm" More proof that stoopid is a disease that only has one "cure"

Agreed Timmy, but you forgot quote: "people EMT" there is something phishy here the focus of these posts, perhaps SD you would best be served by MALLCOP City, the justification for the use of spray or tazers with a professional EMS provider's is preposterous this is why SAFE SCENE is taught just don't go in and run away is perfectly accepable form of self preservation besides the FACT "everyone has the right to refuse unsafe work" call the real authorities the have more than a 8 hour course on civilian arrest that course SHOULD have informed you of how much "shaky legal ground" that you are walking. Low and behold .. an uncontrolled scene .. STAY in your TRUCK and wait for the authorities your not Ricky Rescue, or maybe I am incorrect ? Tazer is safer than OC .. wrong wrong wrong ! Tazers are Safer than implementing Lethal Force, I would agree. The local RCMP here are not using tazers near as much or even carrying them these days because of the poor publicity and more paperwork than in a fatal shooting and good I say, just to many maggots on the streets anyway. http://truthnottasers.blogspot.com/2008/04/what-follows-are-names-where-known.html OC is safer or more effective ? incorrect again and OC is considered an "offensive / control" weapon with most Law enforcement agencies, in the continuum of force. https://www.ncjrs.gov/pdffiles1/nij/grants/204029.pdf http://www.nopepperspray.org/health_hazards_of_pepper_spray_ncjm.htm ASTHMATIC patients do NOT fair well, anyone with knowledge in animal control will tell you that a "goal focused animal" (including dogs/bears) will not be stopped. I use a shotgun when I am in high risk environments then again I have a LICENCE a 3 month mentor-ship in National Parks, a 300 lbs angry Black Bear in full charge is ass puckering and if the can of OC is used at that point its just to flavour the meat. A Lovely story but had you recognised that you were dealing with a domestic (Hatfield and McCoy) and the weapon was a dog. (ps an unsafe scene)You Sir Shock Doctor made an error in judgement, I predict that if your focus remains in the current tenor re: control of your rowdy patients you will become front page on newspapers. What I do enjoy in this thread is the serious lack of recognition in understanding of the term satire, now back to my TV and more "COPS" and "Serve and Protect", and Worlds most scary Police chases .. got to get my FIX ! Late edit .. now a Martial Artist, 8 hour civilian arrest course, 100 hours of "Combat Training" an EMT B, packing OC and handcuffs working as a volly leader (with a hero complex) for a Church Group First Aid Outreach. Priceless !

This just gets funnier and funnier.

Looking for a new job Scotty ? LOL.

Bhwaa Haa Ha ... Ak. hillbillyemt: Try the search engine ... and welcome .

Ok "calm" the heart ? http://circ.ahajournals.org/content/112/24_suppl/IV-58.full.pdf This from the "bible" here they have removed lydocaine in its entirety .. and man this stuff is expensive I should have bought shares. Antiarrhythmics VF and Pulseless VT Amiodarone

On the other side of the coin ... just for debates sake is this a hard-fast rule ? No one here has ever removed a sliver, a fish hook or a the like as technically these are FO. The principle behind this EMS cook book rule is that the foreign object is more or less to tamponade (ing) the hemmorage, removal of large bits and pieces of car, glass or a Klingon knife can and likely would result in more damage or immediate death .. So what if you can not control the bleeding ? then when transport "in of itself" can result in dislodging the FO. In some circumstances patient risk of further injury MAY be best facilitated by <gasp> removal (this is a judgement deal with MD involvement) that said in our Alberta "medic" rules of engagement" we have the added scope of practice to suture, tie off bleeders and pack out a wound's and from personal experience I may have done this myself when in an King Air 200 and a 300 kms trip to a facility with actual surgical capabilities. For every rule there are exception's, anecdotally I watched an RN in a trauma room one day (years ago) gently push a knife BACK into a wound, well I was gobsmacked and she looked at me and quoted the "Do Not Remove Rule" .. say what ? (it was pulsating as it was very close to patients heart) this pulsation eventually pushed the knife out .. so what's the rule when a F.O. migrates out on its own accord ... put it back in ? Dear Richard .. sorry just hard to swallow that a hack saw was not available (back in the day) yes labour intensive but that is what FF are for. cheers <edit for proof reading and corrections> it just doest read the same in preview.

heerspinkb: Maybe its just me but just what is the point your making ?

A good thing I had that L scope handy on my belt .. that sucker was fast. Oh wait mums the word mate those Robber crab's were an endangered species .. oh well waste not want not.

It remind's me of the time we were on Christmas island, you remember when we did that HALO drop with Oz Special Ops for a little recon and then that crab stole your shoe ... ah the memories. cheers

Ok just a dumb question: Could they have cut a bigger piece of fence to transport ? No hack saws or chain "snippers" in NYC ? Why would someone use a gas axe is beyond me.

Ummm ... Oh never mind.

Ok yet another New Improved Way to OD ? This is new to me anyone have any experience with this ? http://en.wikipedia.org/wiki/Mephedrone http://www.wane.com/dpp/news/doctors%3A-bath-salt-overdoses-increasing How does one treat this besides the standard ABCs ? Benzos ? cheers

It appears you answered your own question .

I go commando .... opps wrong thread. Ok .. Fuck it have hit my max tolerance for SAVING LIVES threshold Bull Crap. - 5 on the dustdevil scale, cant use wanker and saving lives in the same sentence ... its a new rule in the City. So here is the realistic rationalist perspective of an experienced EMS provider / er old intolerant bastard ... just how many people that fall under your care that can actually speak are critical ? hint ZERO. <late edit> A highly trained road warrior ROFLMAO, is that winter or summer washer fluid ?

To answer the Question: Has the world gone crazy ? short answer: YES. and OJ is innocent too, good grief.

To Batman: Look forward to the versed ... I did and I wasn't disappointed. From Robin.

Interesting yet another supraglotic vs ETT with / without RSI and an airway question. Well the bottom line is that ALL these procedures can and will cause noxious stimuli this "can" cause increased ICP, heck moving a patient from bed to cot patient can as well. Why, Oh Why, do we focus on these things when we KNOW that RSI or facilitated intubation is "gold standard" although I do believe etomidate has been studied and proven, just how, well I have no clue. http://scholar.google.ca/scholarq=etomidate+mechanism+of+action+in+ICP&hl=en&as_sdt=0&as_vis=1&oi=scholart I can go into more detail about a study I was personally involved in ICU and guess what, 50 ugs of Fentanyl and 50 mgs of Lydocaine IV proved that prior to suctioning and nursing procedures this was effective not incure spikes in ICP (provided the probe was not to open to drain because you could not monitor) I will look for the published study when I get a minute for the non believers. Thing is the ONLY way that one can prove increases in ICP is buy monitoring ICP with a probe in place and this requires some form of anesthetic to be administered to actually secure an AIRWAY and BEFORE a hole in the skull can be drilled, my point being its really a mute point if you need to protect an compromised airway or non effective breathing, JUST DO IT. If your an basic life support trained provider and licensed and you have a supraglotic airway you use it, if your an advanced life support trained and licensed provider then ETT, because its superior overall, nuff said. So is a supraglotic airway more or less stimuli than ETT or OPA or NPT airway ? .. my personal opinion would be YES its just common sense really, more area's of pressure = more uncomfortable, tis highly unlikely this type of airway would even be considered in modern day medical practice in any hospital prior to ICP probe insertion or even bother do undertake any research to that end. Are you going to treat high suspected ICP in the field, well not any more as the whole topic is quite a bees nest these days, Neuro ICU post CT only ... well in my hood. Hyperventilating is a thing of the past proven to decrease positive outcomes, accept when your patient is coneing and you have nothing better to go. For the statement in a prior post, ETCO2 is equal to PaCO2 in the normal lung this is absolutely false ! .. Vd/Vt = PaCO2 - PetCO2/PaCO2. On to RSI in E(can I say M?)S, just how can we prove or disprove this with the trend based on a few studies in US suggesting it is not beneficial ... well I have these drugs and I use them, and would prefer to decease the WOB / pre arrest in the circling the drain demographic, and have been quite lucky so far.

As would I ... BUT just what producer of all these airways would take the financial risk undertaking such a study and in a passing comparison (what came first the chicken or the egg, aspiration debate) Did the patient aspirate prior to arrival or post compressions, some things in fact just cannot be studied. In a hospital arrest the ETT is the golden standard so why should the field be any different like really ? I see a very disconcerting "trend" in EMS these days (perhaps I am getting old a dogmatic in my perspective) but using "techno-wizardry" to solve problems instead of education, ongoing and realistic con-ed and practice of procedures. I was most literally one of the first in my hood to be permitted to intubate and loosing that accepted standard of care is a huge step backwards this is of great consternation to me personally. Very seriously I became a Paramedic to: 1- Definitively Protect Airways. (after the EOA was pulled because of the perceived complications of oesophageal varices ) 2- Take away the pain. I became an RRT to take some of the tubes OUT and a far more difficult a job overall. You know the thread is concluded when Dwayne goes to the sex place. Is this code for "getting naked and sweaty at home with the better half ? " .... my bad ? cheers