Using 12 Lead to Rule Out MI: A bad move?

[DwayneEMTP]

:? Man, here we go again...

You know, my new "watch out for the n00bs" philosophy is being tried and brutalizied...

Jinketsu, welcome to the City.

-5 for the most idiotic, immature, uneducated post we've seen here in quite a while.

Perhaps you and your volly buddies can have a good laugh about this stupidity later, but until you learn to think like a professional, and get some type of education, you'll never understand the level of conversation we often have here...

Good luck to you though...

Dwayne

[JPINFV]

I'll formulate a response when his post count reaches 4.

[Jinketsu]

i am truly tired of being put down because im am an emt-b.just because i am not authorized to run a line doesnt mean that i am not a good ems provider,there are more bls than als so of course they are going to send the ones they can spare the most first and then IF we need the back up then we call for it

[Miz Black Crow]

Jinketsu, not all systems are the same. In some cases, it really does take 20+ minutes to get to the nearest facility, which may not even be a definitive care center. You're saying you have a short average transport time, and that's great. That means that in your particular system, BLS can be a little more independent and slightly less reliant on their ALS backup, because the ER is never more than 10 minutes away (I'm guessing; I don't know your system).

Some people don't have that option. Triple the transport time; in that case, are you REALLY comfortable with that patient who's in chest pain? What about if their blood pressure starts dropping a little? I know I wouldn't be. That aspirin may help a little, and that nitro may reduce a little of the pain for now, but that's nowhere NEAR the care that can be given by ALS providers. I ALWAYS ask for medics for anyone complaining of chest pain, because if nothing else I trust my medics. I want to be dead sure that my patient is getting the care that they need. Also, even if your transport may be 10 minutes, what about triage time? Your urban EMS system most likely has waiting times before you even hit triage; even then, they have to run the EKG, tap the vein, run the line. How long have you stood waiting in the ER, when you could have gotten ALS to do the same thing, covered your own butt in case the pt deteriorates during txp, and have a better diagnosis than ROMI?

Are some ALS providers arrogant? Of course they are. Some EMTs are too--you made a fairly arrogant statement yourself. Don't mistake an ability to provide a better diagnosis and better prehospital care for arrogance. Not every system is made on a cookie-cutter; the needs of the community dictate the EMS system (or at least in an ideal world they do). Your protocols may be different from mine, but I don't mess around with feeling like I can run a cardiac call by myself. I know better.

~Miz Black Crow

(edited for clarity)

[JPINFV]

First off, thank you for making post number 4. Far too many people make 3 posts, check out the chat room, and leave never to be seen again. So, sorry for my earlier post.

I think the problem that you have is that you take any criticism personally. People, especially here, tend to criticize the EMT-B level because we feel that it doesn't require enough training and education ["how" and "why" are two separate things]. That is a critique of the level itself, not a critique of individual providers. The same charge has be levied again EMT-Paramedic programs as well, so the criticism isn't just against EMT-Basics.

As far as you being a good provider in discussions like this is irrelevant. It doesn't matter how good you are if your treatment options are limited by a lack of education in the level. This is especially true because protocols and procedures are set for the lowest common denominator, not the top level provider. The hard truth, though, is that if a patient does need cardiac medication, then any EMT-Basic provider is inadequate. An unfortunate side effect, though, of limited education is that most EMT-Basics simply are not required to know enough to determine which calls need paramedics and which don't. Hence why all patients should have a paramedic.

[DwayneEMTP]

i am truly tired of being put down because im am an emt-b.just because i am not authorized to run a line doesnt mean that i am not a good ems provider,there are more bls than als so of course they are going to send the ones they can spare the most first and then IF we need the back up then we call for it

If you normally conduct yourself the way you have here, then my guess would be that you are being put down because of who you are, not what you are.

In your few posts you shown yourself to be too ignorant to spell, unable to master even 5th grade grammar, unwilling to take a chance on paragraphs, have attacked people you know nothing about, and proven you have little to no grasp of, at the minimum, cardiac patient care.

What part of that do you find deserving of respect?

You can get respect here being ignorant but teachable, arrogant but smart, intelligent but quiet, loud/funny/educated....and on and on...but a word of advice...?

loud and dumb just aint gonna get it done. (This last typed in the style of your superior EMS system for clarity)

And truly, in the spirit of my new role as defender of the new folks here...please don't humiliate yourself further with the argument that "I don't need all that stupid book lernin' to be a great EMT!"

Just sayin'...

Dwayne

[Miz Black Crow]

...in the spirit of my new role as defender of the new folks here...

We love you Dwayne!

i am truly tired of being put down because im am an emt-b.just because i am not authorized to run a line doesnt mean that i am not a good ems provider,there are more bls than als so of course they are going to send the ones they can spare the most first and then IF we need the back up then we call for it

Jinketsu, I agree that the EMT-B is a good and useful level that has its place, especially in inner-city areas with high trauma rates and fast transport times. But you have to acknowledge the (sometimes exceedingly short) limitations of our training and education. I don't understand a HUGE amount of what gets discussed on this forum; that's half of why I read it. It's also why, when I have even the slightest doubt about a patient's stability, I get on the radio and ask for some medics, even if it turns out I didn't need them and they do no interventions on my patient at all.

Knowing your skills doesn't make you a great provider, it makes you a great drone. Ask yourself WHY the medics' assessments takes "twice as long" as yours; they're probably asking things that you didn't or covering things that you missed. I know I always wince and go "why didn't I ask that?" when ALS assesses one of my patients. Be willing to learn from those who know more than you. It will make you a better provider. Guaranteed.

~Miz Black Crow

[Scaramedic]

i am truly tired of being put down because im am an emt-b.just because i am not authorized to run a line doesnt mean that i am not a good ems provider,there are more bls than als so of course they are going to send the ones they can spare the most first and then IF we need the back up then we call for it

Well there goes the whole 'nice ALS' debate, once again shot to hell by a noob with a tude.

[tniuqs]

Just saying ..... love that Dwayne and I commend you for defender of the I hope "open minded noobs" like Miz Black Crow but please implement some triage techniques, thanks in advance.

I too like to encourage and try to support the new comers to this professional site, but when the topic of discussion is so obviously NOT a BLS subject. ie Using a 12 lead to rule to out MI, is there not enough threads already active for blowing smoke up ones own ass ? Then why, oh why would a such a silly and I do mean bloody silly post based on a very nothing other than "hey we are faster theorem" I have no guilt feelings to advocate a most serious mental thumping be implemented and should be the order of the day, this "poser" I have no doubt will only continue to be a disruption ONLY.

Respecting the others that take a great deal of time to post intelligently and positive input, after all this site is BASED on VOLUNTEERS time and serious efforts for an informed debate and issues that may positively affect advancement for EMS. Commenting in this manner, and completely off topic is comparable to a Paramedic walking into trauma/ cardiac/ neurosurgical rounds and telling the surgeons and inform them that s/he delivered a baby ... sheesh, give me strength to be the good Shepard, oddly every thread of my soul wants to put a cap into this guys arse, are you getting the drift here door knob, ps door knobs are used to open the door and are useless after the door is open, looks like total lack of "situational awareness" quoting "zilla" becomes apparent once again. Bottom line is this Jinketsu is walking into an "unsafe" or "unsecured scene" .... bang bang You FAIL, Your DEAD ! simple.

So just when will the day come that the media stops reporting "The victim was rushed to the Hospital" instead of "The Paramedics rush to the scene where the Victim was Stabilized and Transported" ? I am beginning to believe that it will not happen in my life time very sadly, no matter what we try do and very disappointing. Well at least we have Miz Black Crow, thumbs up little lady :!:

tOTALLY oFF tOpic YEA dOOD jus LIK aGiN ....

(bit of a subliminal message think anyone will pick up what I am laying down, this isn't my 12 y/o kid TEXT messaging ! blimy)

I do enjoy the EMT/Paramedic team model as it fosters a positive a collaboration model for a positive future, yet very obviously NOT the case here in that regard. It is quite obvious that this is not the situation at hand, asa can't hurt you ?????????.... just 2 weeks ago I had a patient that reacted adversely to ASA and very seriously complicated his outcome, (yes, quite rare) but this was treated effectively and just WHY, yes because I can as a ALS provider recognise and take appropriate action ..... that said ASA is NOT the frigging TOPIC !

So I leave you with this:

If you continue to think the way you have always though, you will continue to get what you have always got.

IS IT ENOUGH :?:

ps Admin PLEASE could you add a "vaporize" button next to "report" post sure would save a lot of My time ! :evil:

[Dustdevil]

...asa can't hurt you ?????????.... just 2 weeks ago I had a patient that reacted adversely to ASA and very seriously complicated his outcome, (yes, quite rare) but this was treated effectively and just WHY, yes because I can as a ALS provider recognise and take appropriate action

yes but are basics can give epi so we dont need no paragods!!!!11

[/sarcasm]