NREMT-Basic

Why on earth would you say medics arent licensed. Im not totally up on EMS law but I dont think an EMT or Medic can practice without a DOPH license in any state. Why do you think we all take those tests. The single organizing (if we can go so far as to call it that) among EMS providers in the NREMT. The best thing that could happen to EMS is that all state tests and licensures are done away with and the NREMT standards and "protocols" are revised, made more rigorous and we all get our licenses that way. It would eliminate the need for reciprocity agreements, establish parody among the states and within them and I truly believe it would raise the standard of those working the streets. I rarely work street EMS these days having shifted to Disaster Medicine, but we even have discrepancies in IMERT because some of us that are BLS have broader protocols than our partners from different EMS regions. I can start a combitube and give push glucagon, other members from other regions cannot. If the NREMT is the nexis of a conspiracy, its one I would be in favor of.

Right now, the whiners, and the rest of us, have two options. Either do what you think is a ridiculous amount of CEUs which you say there is no way you can complete, or, in the alternative that the NREMT has offered you, you may simply re-test for re-registry. I think the same people would piss and moan if they said "all you have to do to re-up is show that you are currently working in the EMS field and we will give you a new, year specific patch." Quit whining for Gods sake. Do your CEUs, which you should have been doing anyway, or take the test. I have been taking CEUs but havent gotten enough to meet the NR standard so will be testing. Whats the big freakin deal. For those of you who are not re-registering as some sort of protest, go for it. But if you move to another state, and want reciprocity, you may find it difficult without NR. Wisconsin requires NR currency to reciprocity from Illinois. Basic what those of you that are whining are saying is I dont want to do anything to have to re-register. I just want them to give it to me. i dont want to do my CEUs and I dont want to take a test. Typical something for nothing mentality. Tuck it in and do what you have to...otherwise, I hear they are taking applications at your local Walmart.

Or there is the simple answer/best answer Ockums razor explanation that Dust gave. Never hear horses and think zebras.

Whats great about the state team Im on now is that since we are responding the MCIs either on a state or federal level, we had lead sedation available at all times. On top of each one of our trailers is an elevated and reinforced "gunner's platform" which is almost always manned by a National Guardsman or State Police Trooper. Their job is to make their presence very well known as a patient is brought to us. There are usually several more NG's or LEO in our medical compound (a civlian MASH basically) with riot gear, shot guns, etc. I dont believe we do, but some MERT, DMAT teams employ snipers and their military escorts and MPs, . We also use MPs and state guard troops when we are out of state. We use versed and benedryl chemically and out med director has left that as a standing order for EDP care. I guess this also brings about the question of EMS provider safety. Should we be allowed to carry something to defend ourselves with. Pepper spray not good for obvious reason and ASPs can get way too deadly in the hand of an amped up EMT or medic who is being attacked. What about kubatons, etc? I know this aspect has been discussed previously, but it seems that now more than ever we need to address defensive tactics. I have been attacked twice so far, both time by tweeks. Fortuately I had some empty hand techniques which helped to mitigate. Maybe someone would like to start a thread on EMS Self-defense...I think I remember reading about it here before but cant find the thread.

And no more pseudo-Euro spellings either, Dust! Honestly though, the reaction you had was natural whether you are a surgeon or a first responder. During my ill-fated year in Med school, I attended several autopsies and cadaver labs, even those where the ME handed me the scalpel and said "see what you find. For IMERT, we hold cadaver labs regularly. In the line of EMS in am now in (ie Diaster Medicine) you can imagine that we see some pretty gut wrenching stuff. We still have folks that came back from Katrina and say they cant yet get those images out of their heads. If its still upsetting you, perhaps a CISD is in order. I know it would be mandatory for IMERT. My very first trauma was a skull crush/basilar fracture. She was brought in by helo and I was standing ready with the trauma team. WHen they brought her in to the room, I nearly passed out. I actually stepped into the next room once things were as"under control" as they were going to get for awhile and asked a doc if I could a few liters of oxygen by nasal canula. That helped alot but of course is not alway an available option. We are used to seeing the outsides of people. Your reaction as "logical" given the scene you describe. "Scalpings" can be pretty damn scary. Have only had one myself. But then I reminded myself this is the same skull I played with in med school and just sort of looked at the blood like training day mulage. If this is our chosen field, as my mentor always says "THese are the times when you have to lock it in for the good of your patient." Another lesson is always be ready for what you will see when that bandage comes off. Likely the fire dept put it there so they didnt have to see it. The trick is, if you cant immediately know without removing it why that bandage is where it is, figure that something that shouldnt be showing is. I think the cadaver lab/morgue is a brilliant thing. I have spend lots of time in morgues observing and helping out. After about 5 times or so, you start to be able to pull the focus back a little ( or tighten it) however you want to look at it. In IMERT where we only respond to disasters (and not little ones) we all see things we wish we hadnt seen. Maybe even going back and looking at training slides would help. Focus your patient, because in times like you describe, taking time to pull it together isnt alway an option. I commend you though for being so forthright and willing to be vulnerable in relating your story. That is a combination that will cause you to learn and grow into a Grade A EMS provider. Bravo Zulu.

:dontknow:

Never argue with one patient when others might be dying. Never argue with a patient. Have a LEO witness the refusal and let her crump. She's either severely altered or s*** stupid. Move on to someone who might grow up to have an IQ over 60.

1. Even if you are 18, if you are in HS, you follow their rules which usually say no leaving campus without permission. Just because you have reached the age of majority, doesnt mean you dont abide by the rules that govern educational institutions in your state. 2. No person under the age of 18 (and for me thats stretching. Im a fan of 21 myself) has any business on any emergency crew of any kind, be it fire, EMS, CERT, etc. Im gonna get hosed here, but teenagers just should not be trusted to manage emergency situations. And no, I dont believe they should be in the military either. Flame away. Im starting as a fire fighter the first of next year and I dont want a teenager anywhere near any scene I am working either as an EMT or FF or combination thereof. My reasons are my own and yes, its a blanket generalization about my feelings about teenagers and yes I will get hate mail. The only time a teenager should be on an emergency scene is after its over cleaning up glass after an MVC or shoveling the remnants of what used to be a house into a dumpster. Yes, I am probably contradicting some posts I wrote in my early days here at the City. Big Deal. Im now on a team that is responding to emergencies at the federal and soon possibly an international level. Im not gonna work along side any teenager so long as part of my gear is a CBRNE exposure badge. So for me, the pager thing is really moot. In Illinois, students must be allowed to carry their cell phones to be able to make outgoing calls only in the event of some type of disaster. They must be worn stowed and not on your belt or in your hand and they must be turned off. I shudder when I hear about 16 year old EMTs and 18 year old medics or FFs. It wouldnt happen on any service or team I commanded. Im also a firm believer in curfews, signed homework, parental accountability and feeding children through a hole in a barrel until they are 16 and then plugging the hole. So shoot me.

Though I like my Blackhawk and my STOMP, Im liking the new gig where the logistics and transport teams haul our gear, set up our compound into triage, de-con, BLS and ALS treatment, field surgery hootch and commo bunker and all I have to worry about is my personal gear which I carry in either a CamelBak BFM 72-Hour ruck or a CFP-90 depending on where we are headed. We ran a MCI drill this weekend and it was nice not to have to ruck everything. Plus, our "packs" are fully heated and/or air-conditioned and big enough to sleep in and use some of them as post-op and rehab wards. Gotta love pre-fab field hospitals.

While I appreciate the kudos for laying the smack down as it were, that was not my intent as the link to my original posts will clearly show. I lost friends at WTC and in NOLA, one of whom has never been found, and in that shite hole with those poor people for a couple of weeks after the whole thing hit the fan. As I said to certain parties concerned since my original post, if someone wants to play a game that gets them chicks or makes them feel better about living in their parents basement and being an advanced dungeon master, go 'head on wit' ya' self. But when you begin to defame the people who do the real job, who actually stand in the gap you have crossed a line over which there is no return. I let SOMEDIC know that after my MS degree is finished that I will be "enlisting" in the Commissioned Officers Corps of the USPHS and deploying to whatever mosquito infested backwater they send me with a hearty "Yes Sir, How High?" He mocked the USPHS as not being real military. Tell that to the thousands of Native Americans taken care of by the Officers Corps, the 100s of thousands who receive free inoculations and the crews on three month tours in the God forsaken waters sailed by the USS Pililaau, the USNS Mercy or the USS Boxer, the last two of which my step-brother actually served on, first as a Navy Hospital Corpsman and then as a Nurse, LtJG. He is now medically discharged after being injured on the deck of the Mercy. Here's my problem, among others (twitch twitch): Perhaps SOMEDIC has served in the ANG in his home state. But his "expressions of knowledge" about black and special ops could be had off the internet and while sipping a half-caf, no foam latte at Barnes and Noble. Through in a little History Channel and you have yourself an alternate personality complete with deployments you've never seen, countries you've never been to and most likely some bilge-water bragging about decorations and honors never earned. I have gone back and read most of his posts and each time a little more of my dinner finds its way into my throat. Serving in combat oriented units has never been an option for me largely because I started trying once I was too old. Even my beloved USCG turned me down. I found the USPHS by accident and will be joining then once the MS degree in Disaster Med is done. I may not "travel to exotic lands, meet beautiful people and kill them" but I would like to think that my civilian experience and education might make life a little better for those among us who do not have the privilege of sitting at the computer, surfing the net, drinking a tall, cold one and telling lies about the good old days, which in this case, never occurred. A confession thread has been mentioned. Perhaps the PhotoShop savvy among us need to design a Congressional Medal of Dishonor and its first recipient walks among us. I will present it to him myself. SOMEDIC finds my service in IMERT funny. But, when I go to my training day tomorrow a receive the patches that I have earned and insignia won through training and hard work, I will wear them with pride, knowing that no lies were involved in getting them. As for SOMEDIC's true black ops, anyone with an ounce of computer savvy and internet access to public records knows what they are. The problem is, they don't give medals for the operations he has conducted...unless you count making license plates. I feel sorry for you SOMEDIC, I really do. I put myself through college studying folks like yourself. I have shared no details not already known or easily found. My honor was attacked by you not once, but numerous times in numerous threads, from the most recent, going back to when I first joined the City. It would seem that hobby of yours has come to and end and no one else here in the City need fear your cyber lashings because they dare say what they really do. Tomorrow, I attend IMERT "Boot Day." I've been preparing for months and am ready to go. Im really sorry if that doesn't meet your high standards for un-accomplishment. But when I stand in the gap with the members of my new team, I will stand, as my grandfather (may he rest in peace) always told me to do: On my honor. Even the most heinous individuals can still stand on their honor when they "man up" to what they have done. What a shame that you seem to have so much to offer, but we will never hear it as you stand on your honor. Because over a lifetime, it would seem, your honor has been eroded (or at least during your time on the City) to the point where it is no longer useful. Those among us...inhabitants of the City, know what you're about now. We need no longer fear expressing ourselves for fear that you may come out of the woodwork after returning from a "deployment" (I wonder how many definitions that word has) simply to bash the rest of us with credentials you simply do not have. I have said before and I say again: Shame on your sir. The only good thing to come of all of this perhaps is that, like roaches, when the light of honor and dignity and extraordinary service, those to who the word honor has never applied, or from whose grace certain individuals have fallen, they scatter, either in fear or disgrace to harm no one ever again. I hope that you can find the help you need and the happiness which will no longer require you to fabricate a life for yourself. I for one, am simply happy that the curtain of lies and dishonor has finally been pulled back and those who have earned what you have only claimed no longer have to be ashamed to be what they are...true heroes. Whether they are in the USCG, Army, Marines, Navy, Air Force or my soon to be home of the USPHS, they can claim what they have earned without it being sullied by those whose lives are so pathetic that the only way that they can be perceived to have honor is to steal it from others who have earned it with their last full measure. NREMT-Basic Sends. "Sciencia Vera Cum Fide Pura"

OooooooooooooohRaaaaaaaaaaaaaaaaaah!

So am I but not for the same reasons. Its all about the info, friend. "A wise warrior does not retreat when he is losing. He retreats when he is winning, knowing that his enemy will give chase and exhaust himself and in doing so make a fatal error. It will then not be necessary for that warrior to dispatch his foe because he will fall upon his own sword and spill his intestines on the field where they will become food for the vultures. A wise warrior needs no weapon in his hand. He needs only to know how to let his opponent slay himself. A wise warrior fights with information not steel...for knowledge is truly the tip of the spear." --Me ---NREMT-Basic Stands Down.

Heres the thing. If anyone else had said that, Id eat their liver. Dust has earned the right to say it because he has has been around long enough to know that by and large it is true. But if youre an EMT-B and your pulse still thrills to the sound of the Velcro on your Galls trousers, youre who he's talking to. Dust and I have had this converation personally, one on one. As I understand his position, EMS is not held down by EMTs who know their place. Its held down by those who think they are mini-medics. If you listen to what he says about Basics you will here him say that those that work around him crike patients, tube em, put in chest tubes, etc. Thats because they are 68Whiskeys who come in as Basics and are uptrained to the level that they can kick the ass of most civilian Medics. When I came to this board I was a cocky EMT who needed to be put in my place. I have since lost patients, been hurt my amped up meth heads and generally slammed around by the profession. I get hurt alot less now that I know my limitations and I have people like Dust to thank for it. I know what I know but more importantly know what I dont know and when to get the hell out of the way. EMT mills dont teach it and EMT "schools" dont teach it. Only working with people who are better than you can ever hope to be will you come to see your limitations. I pride myself that I work right at the edge of mine, but I can do that because I have been taught and know where they are. You cant teach that, you can only learn it.

PS- If you have friends in IMERT, you know that what it takes is a request from a governor who has declared a state of emergency and a memorandum of understanding (MOU) with his states department of health and we will go to his state. Before I joined the team, they went to NOLA. WHen they get called to that kind of situation again, Ill be going with them. How better would you suggest that I serve my country? Oh and by the way, I am enlisting. As soon as my MS degree is finished, I will be signing on with the USPHS with the intent to put in 20 years of AD. Can I help you with anything else? And before you go there, you can save your next tirade and explain to the LT. Cmndr. who is working with my recruiting process that the USPHS Commissioned Officers Corps isnt military. You can thank him for the PPE and drugs you take before and during one of your deployments. Unless of course you ARE with BlackWater USA and then, well then I suppose you buy yours meds from some other country. Watch out for the Mexican Quinine...Ive heard its a real killer.

Oh Somedic, you poor, lonely thing. The last thing I am going to do is get into a contest with you here. Im a little worried if you are truly "black ops" or Blackwater or whatever it is you claim to be because it seems you wouldnt be able to read enough to know which side of a claymore says "this side toward enemy." The reason that IMERT folks may not know who I am yet is because, as I said, "Boot Camp" is this upcoming weekend. The ironic part about you saying they had no idea who I was is that other than that I am from Illinois and my name is Steven, you have no idea who I am. The 700 or so folks that make up IMERT are spread from one end of the state to the other. Some of us will never meet each other. Sorry bro, that one dont wash. Do you want my CRIS number? Do ya know what a CRIS number is? If ya did and have been privileged to get one, you can use your brain (for something other than a seat cushion) and find me at anytime. Ill be waiting to hear from you. The work we do doesnt require us to pretend to be secret squirrels. For obvious reasons, I dont post my entire life's worth of personal information on line and in the clear. Pull your pants back up buddy...your ignorance is showing. As for high speed, I dont need it. Been there, done that, have the T-shirt. As for your advice to me to get in shape and quit whining, Ive lost 45 pounds in the last 18 months in the process of recovering from an accident that almost landed me in the LODD list. As for me getting in shape, I will meet you, at the time of your choosing, at the bottom of Sandia Crest in New Mexico. Ill give you the "jump start" of supplemental oxygen cause we're gonna be starting at 6,000 ft. Then when the 70 pounds packs are on, we'll go unassisted to 11,000 ft, crack a beer and come back down again. Same day, no campy stops or poddy breaks. Or if thats not high speed enough for YOU, we can go to 13k and have two beers, though I better put in for two tanks of oxygen for ya cause Im not in the mood to have to carry your sorry back side back down a mountain. Any day, any time and the plane tickets are on me. It would seem that you have a great many talents in life and unlike you, I am not going to question your honor by questioning who you are, the validity of what you say or the veracity of what you do. Men of true honor dont ask those kinds of questions. They dont check each others credentials. Come of the playground little boy cause once again youre all wet. If you cant play with the big dogs, Im sorry. If you wont save a life without a paycheck, Im even sorrier for you. If you attack me in public again, youre dumber than you have already shown yourself to be. So far, two individuals have responded to what I posted. One of them is a man for whom I have learned great respect. Whose credentials I dont question and who doesnt question mine by talking to friends he supposedly has in my outfit. Ive got a friend who has been with IMERT since 1999, and he has never heard of you, so...what does that prove. He is a former special operations medic, he has still never heard of you.....so...what does that prove? He was a SWAT medic and he DID wear black....what does that prove. Ill leave the face paint and your perverted version of the warrior ethos to you. You seem to need it. It would seem that it identifies you more than any driver's license or other ID ever could. Special Operations Medic. Bravo Zulu to you. Id rather draw my gear with men like DustDevil. He would bust a gut to save a life. I dont think you would even break a sweat unless you knew there was a medal or commendation coming out of it. Maybe you are willing to do your job and take the flag off and stick it in your pocket when its important that the rules of engagement dont apply. For me the rules of engagement are that if the people that I work with and I dont keep our word, people die. The flag I wear is on my sleeve in full color for all to see...permanent....unquestionable and unremoveable. Come out of the BlackWater, my tired brother. You're in way over your head.

Sorry you feel that way my cold and misinformed brother. Its also clear you cant read very well. Look at the profile under my name. What do you suppose I do? What do you suppose a member of a team called Illinois MEDICAL Emergency Response Team does. I dont drive our trucks and I dont fly our planes. I dont man commo posts and Im not a member of our safety staff. Hmmmm. I wonder whats left? Medical Staff ya think? Fortunately for you, there are people like those 700 I mentioned willing to do disaster medicine so you can wear black nylon with velcro all over it and run around and play flash bangy. I dont know if you didnt have your ticket or if you were napping, but you sure missed this bus. But if you are a medic, I love ya anyhow, no matter how crass, boorish and thoughtless ya are. Stay safe

The highest-speed TacMedicos among you may wonder why I am posting this here. I hope by the end you will understand why I chose to write it where I have. 9/11 has come and gone for another year. Some of us shed tears (like me) and spent a lot of quality time checking and re-checking our cell phones and pagers to see if the call would come to once again clean up and do our best to heal the damage that only the most cowardly human beings can create. They day came. The day went. My cell didn't ring, my pager didn't direct me to my rally point And life was, as much as it has been since that awful day 6 years ago, pretty much normal. Except for a crying spell brought on by feelings I didn't know I had. About a month ago, I was informed that I had been accepted as a Basic Life Support Specialist with what is arguably the best medical emergency response team in the country and certainly, the first of its kind. IMERT. Illinois Medical Emergency Response Team. Founded in 1999 by a group of emergency medical personnel of all stripes, current and retired military medical staff, computer wizards, logistics technicians, administrators and about a hundred other kinds of volunteers, IMERT is one hell of a dedicated group of people, about 700 strong who have decided that when things are blown up by those that hate us, or nature decides she has been pushed to far and pushes back to remind us of who is really in charge, they would take leave from their day jobs and as so many regulars to this site do, walk into hell when everyone else was running out. Today, I am sitting in bed with strep throat and not much voice left (a blessing to those whose ears I usually chew off) and complete ICS 100 and 200 and Intro to WMD so that I can go to my first training exercise next weekend at the training facility own by Advanced Medical Transport of Peoria, Illinois. Basically our day will consist of familiarizing ourselves with the team's protocol, and then erecting, evaluating and dis-assembling the tents of what many have called a civilian MASH. So, as a wise man once told me, thus ends theory, let us begin the fact. I'm not only feeling something I didnt expect to feel, but also something I have never felt before. I don't know a single word which can express it, so I hope you will bear with me for a few more paragraphs. When I go to what is affectionately called "Boot Camp" next weekend, I will be given alot of information, three black t-shirts and a windbreaker, all emblazoned with the bright blue acronym "IMERT." Ill be told to buy three sets of the best quality khaki BDU's I can get, a new pair of steel toes, a boonie and a patrol cap. Ill be handed the teams signature logo patch, the insignia patch of the US Depart of Homeland Security, of the Illinois Terrorism Task Force and a rocker that says "BLS Specialist." I can hear DustDevil laughing at my new title and wondering what the hell it could possibly mean. Oh and that reminds me my brother, your package is still on the way. Money has been tight, but it will be worth the wait. Lots of extra goodies. Then there is that last patch. The one I will wear by itself on my right shoulder. By itself, clear of any other clutter or bling. The "stars forward" American flag. The other patches are getting sewn on by the local uniform shop's tailor when I buy my uniforms. The flag...the flag I will bring home and use my own poor sewing to stitch to my uniform myself. I'll probably spend an insane amount of time sewing measuring where she goes and getting her just so before I set to stitching her to my "arm" by hand with needle and thread. It seems the least I can do for her. Though I don't always agree with the policies of the people chosen to represent her, she has come to symbolize for me feelings and a way of being that I never knew I was capable of. These days for reasons that I dont entirely understand, the sight of her makes me stand up a little straighter...steel myself to push just a little harder to do things I didnt know I could do. She reminds me that so many have gone before me without snazzy sounding titles to do more than I can possible conceive. She has been on the arms of so many countless heroes who have truly given their last full measure so that I can say what I mean. But now she reminds me of something even more important than the fact that I have the right to say what I mean. She reminds me that I have to responsibility to always mean what I say. That if I tell someone they aren't going to die, that what I am really saying is that I will bust a gut and whatever else is necessary to do my best to keep them from dying. That if I say I am going to help them, I don't delegate that job to someone else. That if I leave their side with a "I promise I will be right back" that I keep my word so that their already stomach turning fear and uncertainty isn't deepened by someone who can't be bother to hustle just because the trauma hasn't been inflicted on my body. That if I say "Hi there, my name is Steven and Im going to take care of you" that it doesnt mean that I due the bare minimum listed in my assignment description. But that come blood, sweat or tears, I treat them as I would want to be treated myself. I turn 34 in November of this year. Ive never served a day in the military. Im overweight and out of shape and probably drink way too much coffee. I don't know if I could hit the side of a barn with an M-16 and though I'd like to think I would throw myself on a grenade to save my comrades, Im quietly but intensely relieved that I wont ever have to find out because of the men and women who have worn that flag and gone before me. The soldiers, airman, marines, and sailors. The fire fighters and EMTs. The civilian medics and the 68 Whiskeys and Hospital Corpsman, like the man who taught me everything I know that is worth knowing about EMS. Like our buddy DustDevil who volunteered to not only serve his country, but to do a job most people can't even imagine. So that's where those tears I mentioned come from these days. I feel others' pain a little more closely like my own lately. I can empathize with the rough days experienced by the little special ed fella I follow everywhere he goes in my day job as he struggles just to pay attention. I worry about the folks in my home town who dont have enough food or a roof over their heads a little more than I used to now. That flag means something different to me now than she used to. I hope I can live up to what I told her I would do.

I am honestly not sure how our protocol runs on this. I am with IMERT so we are usually responding to MCIs, since that is really what we are set up to do. My understanding based on situations like Katrina is that during the triage process (which is pretty much ongoing) black tags are confirmed with Medical Command Officer (a trauma doc) and then we call a local service to transport to wherever the morgue has been set up, which is usually a gymnasium, or some place else cool to slow decomp. From the people from the IMERT team I have talked to about Katrina dealing with DOAs was kind of a constant process and I imagine the environmental conditions didnt help the condition of the bodies. Again, since I just recently started with them, I am not entirely sure what they do. If I find out at training on Sept 22, I will post it. I know some DMAT teams in other states have a morgue detail. In other services I have worked with its have both crew members confirm death, contact coroner who comes out whether or not cause is natural and then we leave the deceased with her and the local PD. Ive never been with a service that transports corpses, partly because it should technically involved de-con of the rig.

As for the color green, green is the "international color" for medical aide. Most Canadian and Euro uniforms I have seen are some combination of green yellow and white.

Code with no valid DNR: 1. Initiate "Code Protocol" and work the code 2. Contact MedCon 3. If advised to cease working code, do so. Offer condolences to family. 4. Write PCR 5. Purchase double espresso and smoke a cowboy killer

So Dust- by saying that replacing all EMTs with Medics (which was recently done by a service in my hometown and the screw up rate has sky rocketed) are you saying that its the EMTs that are the problem or if you eliminate them you can tell if its really the medics that dont know what they are doing? Or both?

I use the notebooks (shirt pocket size) carried by a company called Triple Nickel and also some others. Lots of room for vital stats, mutiple sets of vitals, meds, docs, etc as well as a space on the back of each page to kind of scribble a draft of your PCR. The notebook is called "EMS Vital Stats Notebook" and is put out by a company called "Rite in the Rain" which makes lots of responder notebooks that wont run if they get wet in the rain, or other liquids. Hope this helps.

The closest I have come to "tough love" so far was telling our frequent flier-three pint a day jack daniels drinker that, when he started man handling my partner in the rig, that he could either settle down, we would start an IV and let him sleep it off in a SNU room, or he could get back out of the rig, go back in handcuffs and sleep it off at the Striped Light Hilton for a night before being arraigned on charges of public intox, D and D and assaulting emergency medical personnel, a class 3 felony. He chose to go to sleep. I save my love for 4 year old burn victims and old ladies. I doubt the guy that passes out in the same parking stall in the same grocery store parking every frigging night lot gives a flying flip what I have to say and that anything I could say is not about to bring about his one and only moment of clarity before his liver falls out. I try to be kind and compassionate to my patients, especially those that have just been assaulted, etc... But my "drinking buddies" arent likely to give a flip after all. They will get all their tough love from their friends of Bill.

Perhaps before you set to bashing others for the use of the English language in their posts, you should re-check your own before posting. As a former teacher, I found no fewer than 5 mistakes in your response. Thanks to others for actually staying on topic.

As a new member of a state medical emergency response team ( we primarily respond disaster mass casualties, man made and act of "God" type). I will be taking my teams course in technical rescues which will include extrication, disentanglement, cribbing, high angle, confined space, etc. Is there room for EMTs and Medics in the world of rescue or should they remain sort of separate entities with no cross over. I know what as an EMT, I have started the extrication process with a crash ax on more than on occasion before fire arrived. What say you all?