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So in a HIPAA SAFE galaxy far far away.... I am taking care of this patient with an emergent but not critical condition, who has a history of subsance abuse, mental health disorders, and other related issues...on TOP of the current emerergency that involves an altered mentation. ....... In the middle of transport, the patient SCREAMS... "OH MY GOD , ITS A SPIDER..ITS CRAWLING RIGHT THERE..ITS GOING TO GET ME!" OK, to say I was doubtful is an understatement. I tried reassuring the patient, to no avail. The patient keeps screaming and pointing. Finally I look over my shoulder...and sure enough is a little cousin of a camel spider, rapelling down from the ceiling, gigggling I am sure at the chaos he caused. Now I dont know which is worse, trying to appologize to the patient or trying ot catch the spider that was swinging like a pendilum accross the ambulance toward my patient. Uggghhh... somedays I still feel like a rookie. Just had to share...

Google the Boss's name and find out any dirt you can use to coerce him into hiring you. Hire a PI to follow him/her around for a week or so and catch any compromising positions on film.

Thanks for the great and well thought out response, Systemet! I'll throw in my two cents on your final point, and hopefully one of our docs can correct me if I am mistaken. According to the AHA, the risk is about the same for electrical cardioversion as chemical cardioversion in non-anticoagulated patients IF there is a conversion from atrial fibrillation to a sinus rhythm. The primary issue (to my understanding) is when you get the atria effectively pumping again, in which case if there is a thrombus that has formed in the left atrial appendage, it may become dislodged as opposed to simple rate control where the patient remains in atrial fibrillation without rapid ventricular rate. However all forms of rate control carry the risk of converting atrial fibrillation into a sinus rhythm, as ERDoc pointed out. Also from the AHA, another little useful tidbit:

That dangling strap is going to get caught under the wheel causing the stretcher to jerk to a halt thus allowing the FF to accidentally dislodge the tube in which all blame will later be placed on the paramedic for improperly placing a tube.

The most important part of treating a snake bite is to bite the snake back. Otherwise, they never learn how it feels and will keep biting people. (To the idiots of the world, don't do this)

Last night we had a transfer out of the hospital where we took this patient. Just for curiosity sake, I stopped at registration and asked about her. They said she was transferred up to ICU later in the night that we brought her in. I slipped up to ICU as we still had a couple of minutes before our call was scheduled. The nurse at the ICU desk said the pt was take off feeding tube and ventilator at family request earlier in the morning and died shortly thereafter. Apparently, the pt had pretty significant neurological deficit, shown by some tests done by the neurologist. She never regained consciousness. Plus, the pt kept slipping into pulseless electrical activity. Temporary victories. The way I see it, at least the family got to say goodbye to a living relative, rather than a cold corpse. I'm not gonna lie though, I hugged my wife a little harder last night than normal, and may have been choking back a tear or two.

Well I was planning on being a real boy when I grow up someday but then the cops and various Federal agents busted Jepetto, apparently he is a paedo, oh well back to the toy box for me