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There is no quicker way to a loss of your sanity than to look for justifications for the actions of people- especially in our business. Not our place to ask those "why's". Why does it seem that too often, in a confrontation between a LEO and a bad guy, the LEO dies and the dirt bag lives? Why does it seem that we so often "save" an elderly, contracted, nursing home patient who is in a vegetative state yet may be unable to save an infant SIDS victim? Why would someone stab their own brother to death at the dinner table because they took the last pork chop? Why would someone sexually abuse and then murder their own infant child? Why would someone leave 6 children all under the age of 6 alone in an apartment so they could go out and score some dope and cigarettes, only to return after all those kids were killed in a fire? and, more globally... Why would someone justify killing innocent men, women, and children in the name of some religion? In your situation, like you said, clearly someone had come to the end of their rope- and for whatever reason, they could no longer cope with their problems. Unfortunately their "solution" did not work out as they planned it and they and their family must deal with the aftermath. Suicide- a permanent solution to an almost always temporary problem. When I first met my wife, I would relate some of the funnier events I would see, and for a long time, she would ask "why" would someone do what they did. I told her there is no "why"- it just IS. When I first started out in the business, I realized the best way to "understand" someone's rationale in insane situations was to say that there is a subset of people who look at life, morals, and right and wrong from a POV 180 degrees off mine. Their "right" was my "wrong", and nothing I could say or do would change that. We do the best we can- regardless of how futile or crazy it may seem- and let a "higher authority" decide on the outcome. Ultimately, there needs to be an internal drive to do our jobs to the best of our abilities- we cannot operate on immediate positive feedback or recognition, - we'd never last a week in this business. We do this because every so often, we get a thank you. We get an appreciative nod, hug, handshake, or occasionally a note from someone who's life we have touched in some way- be it a patient or a family member. Hang in there, Kaisu. I know it's frustrating at times.

Greetings from the uncivilized part of the country. It was another one of those killer shifts. Three crews of 1 EMT and 1 medic each ran 37 calls in the first 24 of our 48. I finally got 5 hours of sleep at 9:30 the following morning when a supervisor called in a crew from the substation to get each of us some down time on the second day. The second half of the 48 was almost as bad. We went through 4 rotations after midnight. The angel of death rode with us this shift. I personally had 2 die on me, and one (details to follow) lived despite our efforts to kill him. This is the one that bothers me this morning, a full three days later, so as is my wont, I am writing to expunge it and appreciate comments from all. I had just returned from a call to the state prison, where a 25 year old inmate had shot himself up with a lot of heroin. CPR had been in progress. Long transport time, but this one is going to live. We get toned out for a gunshot wound in BF nowhere. This location is 40 minutes from our station down I-40, locale for desert rats and lean-tos. In this area, I have seen garbage piles that pass for residences, ran on patients with maggots infesting open wounds and 14 year olds beating up their grandmothers. Dispatch states “gunshot wound to the neck - the weapon has been secured.” That’s it - that’s all I get. We go enroute and I launch a rotor. 15 minutes into the run, I get an update from the BLS volunteer squad on the scene. There are a couple of new EMTs out there, which is a positive development because at least they still remember what they need to do, and are green enough to want to do it. I get “he’s got no nose, no tongue, and we can’t stop the bleeding.” I co-ordinate with DPS and BLS for landing the chopper, and it gets on scene about 10 minutes before I do. My EMT partner is tearing up the dirt road, he turns to me and says “I’m only doing this for you.” He knows I want to get there, and he is driving faster than he normally does. The dust from these dirt roads is infiltrating every nook and cranny in the cab and the patient compartment, and he is going to have hours of work to clean this thing up, if we ever get enough downtime to eat, let alone decon a rig. (Our “management”, 60 miles away, is based at a station that never runs on anything but pavement with half our call volume and 1 more rig, and writes us up when we turn over dirty rigs.) I get on scene. The flight crew has moved the patient on a gurney into the BLS rig. The patient is a 77 year old man. He is in tripod on the gurney. I see accessory muscle use, and labored breathing. There is a seeping clot where half his face used to be. I immediately flash to that infamous picture in the Brady Paramedic text of the patient with a shotgun blast to the face and whom my esteemed instructor referred to as the walrus. I also immediately recall his first rule of wing walking: “Never let go of one thing before getting a hold of something else.” This patient cannot be bagged because it’s pretty hard to get a seal on hamburger. I also figure that if I see no identifiable external landmarks, my odds of identifying internal landmarks are pretty slim. If it was my scene, I would hit the guy with some Versed and crice him. The flight crew is getting their RSI drugs ready. The flight crews around here are infamous for knocking down patients and then not being able to get tubes. I also note that there are no ACLS drugs in the rig (recall that it‘s a BLS rig). I turn around, go to my rig and get my drug box. On my way back, I note the patient’s son and granddaughter standing outside the rig. When I get back to the patient, they have given up on the tube and are cricing him. They get the tube in through a very nice hole in his throat and begin ventilations. The patient arrests. He is in a brady PEA. CPR begins and the flight RN is yelling at someone to get her ACLS drugs from the chopper. I draw up epi and pass it to her. As she is pushing that, I draw up the atropine. I hand that to her and she pushes it. I take over chest compressions. I get about 50 in and ask her to verify that she is getting a pulse with the compressions. She is. After about 2 minutes, we do a rhythm check. Patient has a pulse of 135 (um.. That would be the atropine) and a BP of 220/140 - um, that would be the epi. The Hs and Ts folks - when you cause hypoxia in a patient, if you correct that, you actually have a chance for ROSC from a brady PEA. I take over ventilations (and custody of the tube) from the flight medic. He is pumped because he just got his first field cric. My supervisor is on the scene. (He had come out in the supe vehicle) and he secures the tube. Does a fine job of it too. Patient is now stable. The EMTs and the flight medic begin organizing the move onto a spine board (why he wasn’t on it when they put him on the gurney is anybody’s guess). My supervisor grabs the yankauer and begins to suction the hole in the guys face. “leave that alone” I tell him - “it’s the clot”. He grins sheepishly and stops. A few minutes later, the RN picks up the suction and heads for the hole in the guy’s face. “leave that alone” I tell her - “it’s the clot”. Bottom line, the patient is loaded onto the chopper and off they go. They had debated taking him into Kingman and I chime in with “no - get him into definitive care in Vegas. That’s where he will need to be anyway”. They contact med control and get the OK to take the patient to Vegas. I am left on scene with my rig covered inside and out with dust, the BLS rig knee deep in trash and gore, and the patient’s family staring at me and my blood covered gloves, jacket and uniform. I remove the gloves and the jacket and go over to the family. “Is he gonna be OK?” I tell him the patient has done a lot of damage to himself. He wont’ be able to talk (no tongue), and I prepare them for the fact that he may lose one of his eyes and he has no nose. The son says “I wish I had known - if only… “ I stop him and say “It’s not your fault - there is nothing you could have done or not done.” The son collapses weeping into my arms. OK - so that’s the story. Now I’m going to tell you what had me up this morning thinking about it. This patient has shit for a life. He got to the point where he put a .38 under his chin and pulled the trigger. If he makes it, and I’m pretty sure he will, now he’s got shit for a life and no face. Tell me again why we do what we do. Thank you for listening.

We do it because it is our job. Very few people could or would do it. There is no shame in counseling sessions when you're at the breaking point. There is no shame in needing the occasional sleeping pill. There is no shame in needing a day off. There is no shame in asking for help. Figure out a fast way to deal with it. The more baggage you carry the heavier you are when you're trying to do your job and the less effective you become. You'll have to put these bad calls and shifts behind you and concentrate on continuing to do the very best job you can do. Good luck, and consider a vacation day or two to sharpen your blades.

We do this because we are good at what we do no matter what level we are. We do this because of the ending of all the ones that survive not the ones that die. We do this for our communities because with out us they would have no body to come and help when the need help. We do this because god or who ever you belive in knows that you can do it, and do it well. We do this because we are naturaly good people. And you do Kaisu because you trained hard at something that you really wanted to be, so take thought in all the good ending calls you have had and try to file away the bad. When you have time take a nice hot bath with bubbles, and crawl into a nice warm bed and have sweet dreams

what bout trauma

So... the moral of the story here, at least from what I'm seeing, is keep my politics and bluntness in the Army forums and stick to EMS around here. ;-)

Dear Santa can I please have a new fishing boat and better hunting rifle and while your at it a 4 wheeler and a couple a snow mobiles. If that's to much I will settle for a Klondike bar

My gut tells me this poster is trolling for an argument, however, 1. I agree that one cannot reasonably expect to " Get them all" BUT, 82% is pretty poor. 2. If you have never used a backup rescue airway, how did you manage those 5 airways you could not secure? 3. My personal limitation for Intubation on the aircraft are 2 attempts at DL, followed by 1 attempt by my partner, and then we switch to King, Combitube, LMA, Crich, etc...... 4. Any reasonable competent ER will not arbitrarily pull a rescue airway if it is providing oxygenation and ventilation until they have sufficient resources available. In my world, this means having an MDA or CRNA at the bedside ready to manage the airway. ER docs like to think they are the airway guru's but, when the SH$T hits the fan, who do they call? Anesthesia! 5. Having success with difficult intubations is all well and good, but the most important issue in my mind is being able to do a complete airway exam and recognize when things have the potential to get FUBAR. It is important to recognize when EGO is dictating the outcome and you as a competent provider must have the ability to say, just because I can, should I be doing this? Respectfully, JW

My only lash out was to someone who posted that i should find templates for a resume builder online, which is clearly evident that they did not read the original post. As far as Paramedic Experience, that is not what this thread is about. I plan on busting my ass in medic school and being the best medic that I can be. The post is about a medic resume and what 4 year degree would look best. Some people on here seem to think otherwise.

"unlike nursing which is standardised" ----- is that statement a joke. I have worked in both hospital based trauma services and prehospital ems since 1994. A blanket statement suggesting that U.S. or foreign trained nurses can hold a candle to an EMT is moronic. Unlike nurses many EMT basics in the united states are responsible for care of the patient door to door. Oftentimes the EMT basic is the only level that is able to care for even critically injured patients until more highly CERTIFIED professionals arrive. Based on my now 15 years experience with RN's; only about 25% could perform at the EMT level. Only about half of those 25% could perform at or above the skills of a decent EMT-Paramedic. Most nurses in the United States exit with a R.N. license after two(2) years of rudimentary nursing training. Of course most paramedics are trained for the same two(2) years OR more in ADVANCED LIFE SUPPORT. As far as other countries laughing at the EMT-B certification, I wouldn't know. I do know that few if any states accept foreign training in EMS. I also KNOW that the national registry does not recognise foreign trained Medics. On this disparity, there should be a national accreditation body. Still, to suggest that a medic in Britain is somehow more experienced or has thousands of more hours of training...well that just sounds like a pretty long stretch...And frankly the facts do not show this to be true. Typical US medics have well over 4000 hours of didactic and clinical training by the end of EMT-B through NR-EMT-P. Of course there is always the exception to the above facts. Besides who wants to go to Israel and get shot at when I can just stay here in lovely downtown detroit.

LMAO All I can say is..wow.

because you gave him the choice to have a shitty life back and he can change it. Also you do this so that son knows his dad is gonna get the best care and so he can cry on your chest. If you need more I will be there for your family member you be there for mine.

MARK YOUR CALENDAR FOR NEXT SATURDAY As you may already know, it is a sin for a Muslim male to see any woman other than his wife naked, and that he must commit suicide if he does. So next Saturday at 4 PM. Eastern Time all American women are asked to walk out of their house completely naked to help weed out any neighborhood terrorists. Circling your block for one hour is recommended for this anti-terrorist effort. All men are to position themselves in lawn chairs in front of their house to prove they are not Muslims, and to demonstrate they think it's okay to see nude women other than their wife and to show support for all American women. Since Islam also does not approve of alcohol, a cold 6-pack at your side is further proof of your anti-Muslim sentiment. The American government appreciates your efforts to root out terrorists and applauds your participation in this anti-terrorist activity. God bless America. It is your patriotic duty to pass this on. WAL-MART HAS LAWN CHAIRS ON SALE, PASS IT ON!