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Define cheat. *********************************************************************************************** DAMN Kanukistan and all the stupid goofy rules, you can dart a moose in a city, but oh no .. the 2 legged Neanderthals you have to be politically correct and invite them for bloody tea and crumpet's. yet another retirement plan .... buzz killed.

Conversely: One must ask, if one is a *Christian. Do you want to be a brother or sister to this new Governor ? Is he sending a "hidden" message that you agree with or were these comments just a demonstration of his faith ? He is from Alabama and not well known as a progressive state in your union. * from one that believes that all organized religions are the root of evil.

Dear emsgirl911: It certainly sounds like you have had a rough day, yup everyone has them, sure sounds like you need a boost, beer or a rest. So will I fall into line with the politically correct crowd and blow smoke up your butt ? well NO FEN WAY, not this burnt out .. old dawg, I don't have "time" for frivolity. Paramedic Impression: Your last Post here is most articulate with intelligent observations, you speak from the heart without fear of judgement, you have used personal introspective then applied to yourself in a tangible logical "matter of fact" manner. (btw your not the typical 17 y/o noob that we see wanting things handed to them on a plate ;>) Thread's are just like life, different presentations require different approaches / tenor to accomplish a goal, some kinda like bad cop / bad cop ... did I get that wrong again ? dang. I sense strong will and the independence needed to do this job and do it WELL. Do I think you should continue your EMS, hell girl your already infected, there is no turning back now your a lifer already. Just remember the word's of my first mentor: Tony M. RIP 9/11 second tower. Working in EMS is like pissing in a dark pair of pants, you get that warm all over feeling but you hope no notices and don't expect a pat on the back ... after that sunk in for me, it was gravy, still is. I hate to agree with Dwayne, but he is absolutely right your hanging with the WRONG crowd, but hey don't run away, walk away smiling, they will never know what your up too. cheers

This is the exact situation for purchasing one of my (soon to be patented) Pigmy Blow Dart EMS delivery system devices that doubles as rape me whistle (hah I bet Dwayne getting sex into the thread !) nah nothing to add but interesting how the Kobayashi Maru is always introduced in class and what peoples solutions are in a hypothetically situation. cheers

Well I have been called stunned but a first for stunted, although that is something I will now look forward too in my old age. I am commonly called skeptical and actually enjoy that. I would like to point out in all these presentations (and 2 thumbs up for finding them, some interesting presentations here, but are all USA based and thing is in other countries they may be considered retarded I guess ? ALL these patient were extremely ill and the vast majority of the discussion/ presentations are "focused" on lung recruitment techniques, ventilation with HFO, Proneing and critical care ONLY. I still have yet to see or even hear of TUBE Clamping in my hood, but rest assured that I will be asking at next RT conference in Alberta after APRV and ECCMO presentations. There are things discussed in these studies as in determining "closing lung volumes" (why I do not know) either unless research data was to be obtained only, as this would result in lung de recruitment in itself and then dropping cuff pressure to allow for CO2 removal in the HFO patient and those are research level issues also, you have opend my eyes to this but I am yet to be convinced that TUBE CLAMPING is anywhere near proven or an acceptable practice. I commend you in your fact finding tour but I can not accept that and "especially" in EMS that clamping any ETT is advisable nor proven to be an effective in way of preventing lung de recruitment if it WERE then one should NEVER suction a patient as this would subject the patient to negative pressures of you see where I am going with this. This crowd COULD stand to improve the understanding of the effects of CPAP vs PEEP, (what patient demographic pathology would benifet in the EMS field) CPAP vs BI Level support, (controversy's) interpretation of ABGs, understanding O2 transport and what is ETCO2 and SPO2 really telling you or the interactions of different parameters changes in conventional ventilation, as a matter of priority ... oddly enough as soon as I make one "wordy" post on these topics ... the silence is overwhelming. cheers edit for quotes no contextual changes

EXACTLY ! If far fewer words that I would have used to explain, following that, one is forced to ask the question: Just who is responsible for educating and promoting this profession ? The media ? (rhetorical question) Regulatory bodies ? (although most are "too" busy regulating) The Government ? <gasp> or A professional association tied closely to a benevolent society as most unfortunately this venue is about the only time any media lip service is given and without union ties affiliation. For news reporting EMS or whatever .. it just does't matter because to me, they are still saying "Rushed the Patient to the Hospital" this is all the media knows, sensationalism and the shock and awe factor. When they start saying EMS rushed to the scene and stabilised the patient, then we will know then a positive change has taken place. cheers

From the article: I am afraid this information is incorrect and poorly researched, their is a problem with title protection in Canada and a bone of contention because as of yet there is not a consensus or a national registry. Even the Canadian commentators in JEM's do not understand the national picture, in fact the term EMR never came up and we are progressing back to that less than EMT-B equivalent in many places. I digress. That said everyone wants to be called PARAMEDIC but when you do in many cases you confuse the public as they are still in the mind set of Gage and Desoto, put PARAMEDIC on ever truck when your not getting 12 lead and drugs is deceptive / misleading, this when some "Paramedics" can't even take a B/P and some can start Central Lines and put in Chest Tubes. Just try to explain the difference to the public the terms of "primary care" "advanced care" "critical care" Paramedic and see where you get. Personally keep it EMT and Paramedic the public understands this. The point of the JEMS articulation is what the writer think the Media is to call us and frankly speaking they will call us what they wish to. the prose, puns play on words and rhyming of their story has more bearing. Oh and welcome and this topic has been discussed in detail but searching for the "thread" topic may be a bit of chore. cheers

From PNN: This is truly an honour that this world famous native artisan bestows, so bravo to Mr Vickers. I suggest that any member of EMT city if they get to Tofino, British Columbia Canada to visit Mr. Vickers Gallery its simply incredible, his respect for the land, the sky, the sea and all the people's his colours are simply indescribable. cheers

I believe the "survey" and the Con Ed were developed by one in the same monkey's. Con Ed takes longer to enter than the actual course took to attend and at the end of the day proves nothing in regards to competency. Yes agreed "puke proofing the practice card" would be a very start, my passport is water proof and it only cost 50 CND. I bet for 12 G they could get a real nice "lamination machine " then again this is Alberta where it is illegal to laminate ones "receipt" type Fishing Licence. I guess it never rains when your fishing in AB ?

Just an update U tube to see what is happening lately in the UK. cheers

Dwayne ... there was very prompt action taken to clearly demonstrate to the Canadian "tax funded censors" that the entire country (including the vast majority of gay and lesbians) that they were infringing on our rights of freedom speech, laughing I visited a local saloon just last night for a non "screech" beverage (ps even Dr. K. Westley calls it battery acid when I tried to pawn it off on him) But what was being played over and over the "old version" as soon as I walked into the pub http://www.q104.ca/blogs.asp?bloggerid=8 btw I have never been with a naked catholic girl / women but am willing to try Dear Richard .. agreed the "queens" English has taken on a regional flavour beyond belief in NL, actually beyond recognition. Can I still say Queen here ?

Well just me but I love this stuff and the bigger the better, yup a bit warped I guess. just 2 tiny piece's of advice as others have pretty much covered the main points. It is THEIR emergency not MINE, and WALK by the noisy ones as they are moving air. If a so called medic is giving me helpful ? advice ... ie Ah your right no collars can you get them on for me and what was your reg number again (ie accountability) You will find lots of weekend Paramedics out there but good ones will size things up walking in and actually help out or ask what they can do to help .. sounds like you found a prick, one in every crowd. My 3 questions of triage: 1- Take a deep breath ... (airway and breathing) 2- Where does it hurt ... (chief complaint) 3- What happened .... (LOC) cheers

I do not think the OP is asking for advice on how to study, although most helpful information to other student members of EMT City. She is asking for opinion on the information she provided.

Only if you can answer these questions correctly. 1-Have you ever "kissed the cod" and where do you kiss it ? 2-Have you been screeched in ? 2eh- What is another name for Neufie Speed bump ? ____E Translate this sentence in one word: Lord Thunderin Jesus, me mudder is me fadders sister, hey dar bouys. _______ ! One more query: If there is "No shore like dah Norff Shore" ... Where is the shore ? cheers and good luck.

The term procrastination used, failed "all" categories x 2 are very disconcerting just to start with. I understand you as a caring stepmother wanting the best for your daughter BUT a counter question must be posed. 1- Would you wish for any EMT to care for You or a Family Member that failed the basic exams x 2 ? This is not flipping burgers or doing someone's hair, by the way Hair Stylist Programs are in many places more extensive and longer didactic training than a EMT -B program ... scary eh ? 2- If one is motivated one would not have failed a second time. Is there enough time from mid January to May to study, know the material cold and do a work experience rides, this almost is 5 months ! I think this gal needs to revaluate her motives. Can this EMT qualification be accomplished, well as stated by the prior poster who adapted, persevered, and overcame, and that is the individual that I would want to treat me ... just saying. cheers

OMG do you know how socially offensive it is to call ALL east coasters Neuwfies ... <gasp> May your now worthless soul rest in peace ... LS it was nice knowing you.

Crotch: absolutely correct the autovent (most models) (carevent) another joke are limited to "control mode" as in a OR type ventilators so the breath rate is set / fixed, the tidal volume is set and you can suck back as hard as you want your ONLY getting what the machine rate is set for. Some autovent / carevent have an SIMV (synchronised intermittent mandatory ventilation mode) as in Control Mode the rate / tidal volume = minute volume is fixed. If one needs another breath this does not trigger a "free" breath at volume set, the trick in looking at vents is to look for a "sensitivity knob" this is the trigger value set for "assist control" this gives a "free" breath set to the volume of the controlled breath, when setting trigger values, and higher levels of PEEP well this can be problematic with auto cycle issues but I digress. The trick in Ventilating Patients that are awake is take their drive away (PaCO2) and keep them flat. SIMV allows the circuit to be "opened" and allow a breath from the base line or set PEEP .. a very old mode was used for weaning patients in the past but a crappy "Transport mode" unless a very stable long term patient ... SIMV will do some magic time window tracking so that it does NOT deliver the set breath when the patient has taken a breath from baseline (its a bit more complex but thats the idea in a nutshell) oddly enough from a nut ! Dave: The LTV is a awesome piece of kit and my choice for dang near every transport, the LTV (Lap Top Ventilator series) is a true ICU ventilator and is capable of ventilating most ARDS type patients (generally speaking) a great selection of modes, but the thing is sometimes the ARDS patients do not cooperate and die no matter how they are ventilated. Out of about 60 different Ventilators models that I have used on patients or bench tested this LTV is one of the best, although one has to fiddle with the pre programmed values for Ti% sometimes called slope for NIPPV that's a bit of a PITA. Honestly the best way to understand all these magic modes is put a mouth piece on a circuit and TRY breathing on them ... nothing like first hand experience. I will reiterate that clamping or crimping an ETT no matter what "therory" is ill advised by myself. cheers

Have been watching this tread ... interesting. I have operated a Bunell Jet / HFO and a Bird HFO vents in (NICU) and never have I "clamped" or occluded an ETT Tube, its NOT a common or even an advisable practice in my opinion EVER. I don't know where you observed this Dave but no NICU I have worked would this even consider this be an option. My old NICU Director Neil Finer now a Professor NICU in San Diego would have slapped me silly if I had ever done that and I would have ended up working in housekeeping. 1- Because of the nature of ETT plastic there is a memory, one could change flow characteristics if one used Kelly's to clamp (interior lumen would become OVAL) or crimping the ETT again not advisable, but especially in HFO as this would seriously affect the entire theory of HFO. besides and there is always a "back up" conventional breath to prevent collapse of alveoli in HFO with modern NICU vents. Even putting a thumb over the end of a ETT is folly in any paralysed patient and a huge stretch in a non-paralysed patient, as one cough and there is no high pressure blow off .. instant barotrauma. 2- IMHO this is a very poor practice, especially from one vent to another and I highly doubt from a HFO to a transport vent (maybe I read that wrong) but even if one believed that one was fast enough to do an "crimp" on inspiration occluding a tube manually,then to do an effective "inspiration hold" with an attempt to retain residual peep pressures volume ... well your actually kidding yourself. 3- If one had an ARDs patient that was that sick, and not ever in my experience ventilated with a HPO btw as a mode for ARDS (PC, PRVC and APRV yes) the current methods in treatment are varied, permissive hypercapniac ventilation, proning, perflurocarbon, but most seriously a discussion on ventilating the ARDS patient is a bit beyond this forum's readers. (no offence) if one is interested try the Respiratory Forums ... but a tad dry reading 4- OK sure Flash Pulmonary Oedema and loss of FRC and PEEP can and does occur, in fact every time one suctions and even with a closed system, so alveolar recruitment techniques can be helpful but again and most seriously if a patient is this so damn sick as to desat with a change over ... best not transport anywhere unless its to the donor table or the morgue, they are just not stable enough to be moved anywhere. I would highly recommend if there was any delay suspected before change over vent to vent ALWAYS have a BVM/ Manuel resuscitator available and appropriate O2 flows, and PEEP set before attempting to switch vents or any movement of patient. A sad side bar I know of an incident (a highly dependant 02 patient) was moved from an aircraft to ground unit .. the vent O2 supply was not pre checked (BVM and VENT same supply) ... short story an 8 y/o kid coded and promptly died, it took less than 3 minutes. I am open to discussion but this crimping / clamping of an ETT, but this is first time I have ever heard of this. cheers

Agreed Tyler he calls it the way he saw it. That said hindsight is 100 %.

YES glad you asked "Medicine" as in becoming an Medical Doctor, it is not boring in any way, its far more rewarding in more ways than one, you have your entire life before you, dont limit yourself to lateral type moves or even perspectives. Your comment "too much school" is a bit worrisome to me, you do realize how much schooling there is to becoming a EMT / Paramedic, AND it is life long learning. Emergency Medicine as you see it today will change drastically during your lifespan, this is not like learn as you go apprenticeship, as in the trades. You if you wish to proceed you will become part of the "new breed" where even more education will be required before you advance, more regulation, more legislation, more law. Ok ... Please remove all the thoughts out of your head NOW, believing that EMS or even being a Hose Monkey is anywhere near what is portrayed in TV or Hollywood movie's. Its just not a glorified life nor will you featured in "HERO magazine" that the straight poop! As they say in EMS 95 % boredom and 5 % panic. cheers ps search and read.

Zactly Richard: The old saying comes to light ... you can't please all of the people all of the time. Lets put things into perspective, Canada was one of the first Country's in the supposed FREE World to permit gay marriage, if you are gay in some countries in this "modern world" then you could be executed or tortured or live in fear or not even serve in your country's military ;>) But that's not good enough for the whiner from NL and this results, the banning of a song / accustical art form until "modification" of soundtrack is "approved". When did Canada become so, and it's the proper word - retarded ? Hell, even the organised gay rights groups are saying this song is not offensive. The big question is just where is the end point, and can you hear George Orwell laughing in the background ? One thing I do know that "Get Money for Nothing" should become the CBC theme song. cheers

Gosh I did not listen to that version because I was listning to to this new version: cheers