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Showing content with the highest reputation since 09/02/2009 in Posts

  1. Mazrin, Exceptional first post! Welcome to the City! I noticed that you're not naive about the whole 'glory and teary eyed thank yous' that is so commonly associated with entry level EMS people. Since you appear to have your feet on the ground, let's get right down to 'brass tacks': EMS can be a rewarding career. It's got its 'up sides' and its 'down sides'. A lot of people aren't burned out on the helping people aspect as much as they are on the bullshit that's associated. Depending on the service you're with, you've got: 1. Small vollie politics and ass kissing to get ahe
    12 points
  2. Dust forwarded this video. IT IS SHEER GENIUS. What a great way to vent frustration and identify an issue. I have told everybody to boycott the trauma show and A.J at JEMS is doing the same. I have emailed the link to everybody I know and they love it. I could not resist the chance to send the link to Randolph Mantooth. He'll laugh his ass off. I'll let you know what he says (he loves this kind of stuff). Again, sheer genius lurks somewhere in the confines of this list. Thanks for letting me in on it. Bryan Bledsoe, DO, FACEP P.S. There is an "E" at the end of "Bledsoe" (e.g., Drew
    12 points
  3. I sent the memo to two of the EMS agencies (fire based, as are most around here) where I work. We are attempting to effect a cultural shift for the benefit of our patients. I guess we will see if it takes hold. There is no question that spinal immobilization is painful and anxiety provoking for nearly everyone. Patients often have back pain induced solely by lying on the backboard, pain which resolves not long after removal of the board, but which may prompt imaging in the ED due to pain and tenderness caused not by the presenting injury but by the backboard. We have seen ha
    11 points
  4. Does anyone else find it ironic that we are telling the OP not to believe everything he reads on the internet, on an anonymous Internet forum?
    9 points
  5. It seems like we've been seeing a lot of new faces lately, and from them gaining a lot of strong, smart new members. In the spirit of the City I thought maybe we could throw out some ideas on how to be successful here? Here are a few of mine.. 1) Welcome. We're glad to have you no matter what your certification level, experience, education or what type of service you happen to work at. The fact that we're glad to have you doesn't mean we don't argue these points, it simply means that we value thoughts, and the people brave and kind enough to share them, from every point on the compass and po
    9 points
  6. It had to happen sooner or later....................... Blonde Men! A friend told the blond man: "Christmas is on a Friday this year." The blond man then said, "Let's hope it's not the 13th." ------------------------------------ Two blond men find three grenades, and they decide to take them to a police station. One asked: "What if one explodes before we get there?" The other says: "We'll lie and say we only found two." ------------------------------------ A woman phoned her blonde neighbor man and said: "Close your curtains the next time you & your wife are having sex. The whole
    8 points
  7. Greetings, Comrades. Rumours of my demise have been greatly exaggerated. I can't believe some of you actually bet money I was dead. If you did, may all your children be born naked! Anyhow, I'm down, but not completely out yet. Don't pull your bets yet, because they will most likely pay off this year. I took a long hiatus to avoid creating [more] drama here and distracting from the forum. I didn't want to start a pity party, but as some of you know, I've had serious health issues since my injuries in Iraq. I certainly won't be returning to practice. Or walking. Or even wiping my own
    8 points
  8. After a very long and trying week with everything meeting me at the door each and every morning and demanding my undivided attention at once, it was nice this morning to get a phone call that I have never ever gotten before in my life~~ Ring~ Me~ "Hello" Female Voice~ "Is this Tami *****?" Me~"Ummm, yes?" Voice~ "Well, you don't know me, but you know my husband." OMGosh....little voices in my head are running in circles yelling at each other "What did YOU do? Nothing, what did YOU do? Nothing I tell you! I've been sober for twenty years and haven't touched another ladies man....ar
    7 points
  9. Alot of threads have been headed in this direction lately, and I personally have been questioning my own career longevity lately. Since I don't blog, I decided to write out my strategies to prolong my mental health, and career, and identify the problems we face as time goes by on the forum. I feel really passionate about this topic, and hope for alot of productive responses. First to identify the challenges: Although the number of years I have been in EMS is hitting double digits, the first time I was truly affected by a call was only about a year and a half ago. I was driving to my far
    7 points
  10. I am not trying to sound like a jerk, but I learned this lesson a long time ago: You decide what kind of day you will have every day. You can not let others control your life, which is what you do when your blood pressure goes up over what someone else said or did. The minute you show any emotion because of what someone else did, you have given them control of your day, it is like you are a puppet on a string. Example: If I said something mean about your momma right now, it could piss you off to the point of you punching me. But on the other hand, you could say "crotch does not know my
    7 points
  11. 1. I think part of a best friend’s job should be to immediately clear your browser history if you die. 2. Nothing sucks more than that moment during an argument when you realize you’re wrong. 3. I totally take back all those times I didn’t want to nap when I was younger. 4. There is great need for a sarcasm font. 5. How the hell are you supposed to fold a fitted sheet? 6. Was learning cursive really necessary? 7. Map Quest really needs to start their directions on # 5. I’m pretty sure I know how to get out of my neighborhood. 8. Obituaries would be a lot more in
    7 points
  12. Crotchity, in the original article, at the start of the second paragraph, it states “City Councilman Kenneth Stokes has threatened to reverse the contract American Medical Response has to serve in the area if the company doesn't send its workers into violent crime scenes, even before police arrive.” I think that makes the intent of Councilman Stokes’ comments very clear. As much as you want it to be, since you have brought it up in other threads, this Councilman is not basing his comments on race, and the replies from EMS are not either. It is a question of “is the scene violent? Yes
    7 points
  13. Just to add my 0.02. I don't think it is necessary for a woman to have an exam in the field under most circumstances. Obviously if she is giving birth then it might not be a bad idea to take a look. Heavy bleeding will be another reason, but should usually be obvious from the outside. In all other cases, you don't have the proper tools to do the proper exam, so why do it half assed? Does anyone carry a speculum on their ambulance? Has anyone been trained to do a bimanual exam? An exam by someone in the field will add very little (no, I do not mean that to put anyone down) to the pt's ca
    7 points
  14. How many of you carry printed Vial of Life papers to pass out to anyone who comes to your station, or stops your ambulance if you stage in different places. Theres so many people that dont know about these sheets that not only make our jobs easier but they can prevent possible mistakes from being made due to the pt being unable to speak for whatever reason, or a mother who is losing it and cant tell you what is wrong with her child. Something to think about. Get them printed and get them out there, its a free 1 page print of the vial of life website.
    7 points
  15. Hey guys, this is Franco Colon. Found this because I decided to Google myself. I just wanted to clarify some things. I had decided not to really say anything regarding this since I had planned on fighting this with my Union but the more time that passes by, the less I feel like drawing this out. First off, I was a Full Time EMT at LICH with no prior instances of ever getting in trouble. I've never banged out of a tour and I've always been comically early. As an EMT in NYC we don't have a station that we hang out at in between calls. We sit at our assigned locations in the ambulance and respond
    7 points
  16. Rookie Ease up on yourself. You'll thank yourself for it in time. EMS practitioners are by far, the worst offenders of being one's own worst enemy when it comes to looking back and wondering what could have been. After 21 yrs in EMS (17 + as an ALS practitioner and 18 as an EMS educator) this I know; trauma patients die. A lot. And mostly in spite of what we do. Five years ago on Memorial day weekend, my brother in law suffered a cardiac arrest in the driveway. He was 43. I was with him the day before when he was complaining of palpitations and like all of us would, strongly advised h
    7 points
  17. Sorry all, I only have a few minutes with internet so can't answer all of the questions... What I ended up doing is writing out my concerns, loss of leg, shock, loss of life, etc, etc. I had the manager on site witness while he read it out loud to his wife on the phone and then had him and the manager sign that it was read aloud and understood. Had the supervisor assign a worker to sit with him until his wife came with instructions to call if his mentation or physical condition seemed to change in any way, and left him there. I do understand that I could have forced him and later justi
    6 points
  18. Hey there Mike. That's a great question, and like the others have said, much of requirement for pacing requires a substantial foundation in education related to the topics Island had mentioned. That's the reason it's an ALS skill, if you were to learn everything there is to know about pacing, well, then you'd be able to do that skill, but you'd also be in school for much, much longer. EMT school curricula simply does not have the educational basis for many paramedic level skills. I believe that the biggest difference between the EMT level skill set and the Paramedic level skill set i
    6 points
  19. When I was a third year medical student on surgery rotation, we had a patient in his late 30s-early 40s with a large pleural effusion (fluid around the lung). He was doing okay on a NRB mask as long as he remained seated upright, but each time we laid him down, he would desaturate. He needed a chest tube to drain the fluid so he could breathe. As a med stud, I was eager to do the procedure. We were on a med-surg floor. I brought the appropriate gear, gowned up, and prepped appropriately. I thought through every step of the procedure: when to put on the sterile gloves, how to position him
    6 points
  20. You would be surprised at the amount of people that believe that God is in control of all things in their life.This is a very complicated theology for most Christians and most definitely for non believers to understand. It is rooted in a Biblical teaching that God is all powerful and sovereign in all things. We believe that His perfect will work all things together for the good of those who love Him. Therefore, nothing is impossible for God. I believe this theology. I have seen definite miracles but most often see circumstances develop through the normal administration of science and natural l
    6 points
  21. I am very dedicated to my work. I wear Paramedic/EMS shirts every day, even when I'm not on duty. The EMS station is my second home, and my second family. It often seems as if my life revolves around the EMS department, but it means nothing compared to my little girl. I am normally a very friendly person, but if you hurt my little girl you will make me mad. I know my little girl is growing up, even if I don't like it. She seems to like you, so I'll tolerate you dating her, but here are a few things for you to think about while you're with her: First of all, I go into hostile situations t
    6 points
  22. Signs and symptoms of PTSD have been documented in ancient literature from several hundred to several thousand years BC. Nothing new about it. However, the pejorative statements people make about PTSD patients are quite harmful and do little to describe the facts about this problem. Attached, is a link to a study on PTSD documentation in ancient literature, and this study was done outside of the United States, because I would not want to use anything from the "pharmaceutically" tainted literature in the States... http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990839/ Take care,
    6 points
  23. Crotchity, you truly are an asshole. I guess my father-in-law (Navy corpsman stationed in Vietnam with the USMC) was just pretending when he would hide under the covers every 4th of July because the fireworks made the flashbacks uncontrollable. It was even funnier when he couldn't take it any longer and overdosed, leaving behind a wife, 8 year old daughter and 5 year old son. Yup, must have been the pharmaceutical industry's fault, especially since he was on no meds. So how long until you make this thread about yourself and turn it into a racism thread? You truly are a worthless piece
    6 points
  24. Don't you EVER ask for a discount. EVER. If it's freely given, you may accept, circumstances depending (thanks for your story Squinty). To ask, or to be offended because one previously given is not extended, is churlish in the extreme, and reflects poorly on our profession. Just what is it that makes you so god damn special that somewhere you ate is OBLIGED to give away part of their profits to you? We get prodeals through my SAR team. If they stop being offered, which companies occasionally do, we don't say a word except thanks for the previous years of prodeals. Do we *ever* go into
    6 points
  25. What is it with people and the internet? You, "flaming", are not real. Here. You're a virtual name, a number. What is the forum judging? Your words and thoughts. I'm just gonna shoot from the hip here, and speak from my own mind. Although, I haven't given any "negative ratings", I could see why some would. Having never met you in person, we have a "screen name", and a character in words. So, if this were a book, you would just be like a character. Like, say, The Boxcar Children. AK would be Henry, you would be Benny. That was just for visual. If another user is judging someone, they're n
    6 points
  26. Man, Lone Star just killed your thread brother, as that is nearly a perfect post in my experience. There is no way to describe here what the job means and entails to everyone, but if you choose this path you will instantly recognize each and every point that he made. I'm going to highlight a few simply so that I can feel superior and believe if I've added something pertinent to the conversation... I never get tired of pts.in general. There are moments, but they are incredibly rare. My coworkers sometimes make fun of me, mostly in a good way, because I tell them that my theory is t
    6 points
  27. Of course it was me that gave you the negative. Normally you're whining and whatever nonsense you spout in the chat room keeps others feeling sorry for you and prevents them from doing so. But why do you assume that I'm a jerk for giving you a negative? Why can't you, like an adult, assume that I thought that your arguments were shallow, one dimensional, self serving, cookbook Basic level medicine and simply not good educational material on the board? Isn't that what the votes are for? To show others my opinion of your thoughts, either exceptionally good, or exceptionally bad? You continue
    6 points
  28. Ok, I guess it's 'confession time' here.... As an EMT, I looked at a lot of the medics I came in contact with as 'pompous asses' because of their attitudes toward the lower license levels. This thread has forced me to re-evaluate my position. As I climb through the license level ranks, I find more and more that there’s so much I DON’T know. I’m not the first EMT to come to this stark realization, and I know I won’t be the last to ‘figure it out’. Working my way through EMT, then EMT-I and eventually onto EMT-P, I find that when I was a ‘mere EMT’ I thought I knew it all. This feeli
    6 points
  29. I was with your train of thought, bro (because I know Airborne thinking patterns) until this last bit. Here, I think you dropped the ball, and you're going to catch a LOT of flack for it(not just from me, either I bet.) OK, I get the whole "balls to the walls" hero mentality... and I understand that combat medicine involves treating while under fire. WTF is wrong with you that you don't take the 15 seconds to protect yourself? How about popping a pair of nitriles on under your tactical gloves, so that you don't increase your chances of exposure to bloodborne pathogens? I know there's n
    6 points
  30. If you cut someone's property without an imminent medical need, you're really not thinking clearly and just being a douche. Sorry. You can dislike the "emo kid" and all his jelly bracelets... but unless you can't get them off without cutting, you have no right to destroy his property. What's wrong with you? If there's a medical need, you do as little damage as possible but do what needs to be done. If there's no medical need, and the original post doesn't really indicate whether or not there was, then keep your scissors to yourself. I'm actually really disgusted by this... is it OK to
    6 points
  31. I take no credit for writing this. I found it at: www.medicmadness.com If Chuck Norris was a Paramedic March 20, 2010 Posted by Sean If you have never heard of Chuck Norris, then you have been living under a rock with no daytime cable. From the “Delta Force” to “Walker Texas Ranger”, he has shown the world that he is one certified badass. Now today we are going to talk about what happens when you take Chuck Norris from the role of kicking ass to saving lives. So now the big question…… What kind of Paramedic would Chuck Norris be? Shifts Chuck Norris doesn’t work shifts. H
    6 points
  32. Actually hyperglycemia has been shown to contribute to morbidity and mortality in many acute conditions, MI and CVAs being 2 of them. Multiple studies have shown that it can reduce hospital survival rates and glucose levels are often looked at as predictors of outcomes. Pt's are started on insulin drips to strictly control the glucose levels even when they are only slightly elevated no matter what the cause of the hyperglycemia. There are plenty of studies out there and it the adverse effects of hyperglycemia with head injuries and sepsis is also well documented. Here are just a couple
    6 points
  33. Ive seen some local fire trucks around here at Subways, KFC, and the such. I wonder just how wrong, i.e. funny, it would be if one of these trucks pulled up at KFC with the PETA ad on the side...lol And I just have to say that meat is muder.................... Tastey, tastey murder. Yummmm *I wonder if I will start getting negative votes now lol
    6 points
  34. Wow. Just.... wow. It seems that there are at least three different questions here: Should abdominal palpation be done on this patient? Should it be done by an EMT or EMT student? Should it be taught to EMTs at all? Was the situation handled correctly by the OP? 1. Yes. Abd palpation is indeed indicated in the general examination of abd pain. However, it should be done at the proper time, by the proper person, utilising proper technique. And, of course, it should be deferred if the clinician determines a potential for exacerbation of the situation by the manoeuvre, or if it causes to
    6 points
  35. Everybody should make their own decision about the vaccine. I don't believe that any vaccine should be mandatory UNLESS failure to vaccinate puts the rest of the population at risk. I remember, as a grade schooler, going to my elementary school and getting the flu vaccine in the 1960s (it was mandatory). I am taking the shot as soon as I get to Las Vegas early next week. As a group of emergency physicians (at UNSOM), we decided not to take the nasal vaccine because it is a weakened (attenuated) form of the H1N1 virus and we were afraid that we would shed some of the virus which might adverse
    6 points
  36. This isn't about being careful with what you say, it's a valuable lesson in identifying pathological issues in someone who's supposed to be a patient advocate. I'm glad this guy's license has been revoked, at the very least. I'm surprised that it got this far, with allegations of roughness throughout his past... if that is the case, someone screwed up somewhere along the line and this guy should have been identified and yanked a long time ago. Scary stuff to be sure. Wendy CO EMT-B
    6 points
  37. **sneaks in the door, crawls over to the fireplace, grabs a wool blanket and sets a spell in the rocker** Hi all, I'm an old villager looking for a new home~~not sure I'm up to the "City Life" as I am truly a country hound.... but I will try to play nice with all my toys and be agreeable to disagree at times . I'm an EMS'r from the dinosaur years at times it seems, things I learned when I was brand spanking new in this world have gone away and somehow been reinvented and come back again... Truth be told, I started EMS in the early 80's and hit it hard for about fifteen years,
    5 points
  38. Did I mention you need to document? Otherwise, if it goes to court, you won't have leg to stand on.
    5 points
  39. UPDATE: We have implemented new policy on immobilizing patients, and I have copied the policy below. There is substantial room for EMT judgment. It went into effect about a month ago, so I thought I'd share the experience thus far. The director and AD of Trauma thought it looked good. Our trauma team is pretty good about getting patients off of the backboard during the secondary survey and before any CT scans. The medical director for our ER group liked it as well. We've had an internal ER policy in place for a year not where the medics and nurse get the patient off the board upon arriv
    5 points
  40. First, I think this suicide business needs to be put into context: The human body is a biological organism that is entirely built around survival. In fact, it's only been the past several thousand years where we had creatures on this planet that have been able to really think and ponder concepts that do not directly stem from "survival instinct" if you will. We in health care, who are also scientists in a sense should be keenly aware of just how important survival is. It's built into our nervous systems, we see in in the ability to clot, we recoginse it when we undergo physiological cha
    5 points
  41. Brother, let me break this down for you, and I'm not being shitty, as it can be hard to understand where people are coming from if you don't live/work in this field. You believe that you helped, that you showed that you care by leaving your home and showing up. Many others do the same, and like you, most often they harm people with their ignorance. Now, don't confuse the words ignorant and stupid. You can fix ignorance... The bent steering wheel is a huge deal to most of us here as it tells us that the pt, in one way or another, transferred a ton of energy from his body to the stearing
    5 points
  42. You rang? I'll start by saying that I think the OP is BS (either that or Dust is screwing with us from beyond. I wouldn't put anything past him. He's probably loving every minute of this). Assuming it's legit, let's start with the fact you practiced medicine without a license. Show an EMT book that says it is legal for an EMT to give nitro. I doubt any generic EMT book, such as Brady, will say what is and isn't legal when it is used in multiple jurisdictions. A protocol manual from a specific certifying agency might say it, but no general EMT book will do so without saying something lik
    5 points
  43. I had this conversation recently with another member here, and I'll tell you what I told them, right, wrong or indifferent. You are not part of the team. You are the leader of the team. You are not another cog in the wheel, you are the main gear. You can laugh and joke and have fun with the team, but in the end, this is YOUR call. You have chosen to step up to the plate and become a medic, you no longer have the right to share responsibility for your patients care. Your call, your patient, your team to use, including their knowledge when necessary, to solve problems, but not yours to shirk
    5 points
  44. For coral snakes native to the US it's "red on black, venom lack..." There are coral snake species from central and south America that do not follow this pattern. It's a misnomer that there is no available antivenom - the FDA extended the expiration date on the remaining stock until the fall of this year and there is available supply. Without antivenom, a severely envemomated patient might need prolonged ventilatory support. I caught this thread very late and am glad that the original poster did not have any problems, but I thought I'd comment about some of the practices some of the r
    5 points
  45. Actually, if they require it, they should provide proper training to fully utilize it, which includes knowing how to determine S3, S4, gallops, rubs, murmurs, etc. After all, what good is buying top of the line if you can't use it to its full potential?
    5 points
  46. This is why the ratings system is SO STUPID!! The guy asked a question. Just because you don't like the question doesn't mean you should hit him with a negative point!! It's supposed to be QUALITY OF POST... everything was spelled correctly, and this is a grand teachable moment if the idiots who knee-jerk would give us a little space and not goon it up... Please, anyone reading this, take a moment to give the kid some positive points to bring him back up to neutral rating... he's only got one post in here. Let's not run him off before he even gets started... Wendy CO EMT-B
    5 points
  47. It's not about the money. 1.6 million is a drop in the bucket for North Las Vegas, so this is certainly about politics and future financial maneuvering. It irritated me when he said something to the effect, "We just want to be able to get paid for what we already do..." C'mon, the reason fire started responding to all of the calls where they are seldom necessary is so that they could shore up their call numbers and get all of their fancy equipment...You're already seeing the benefit of "doing what you do" in your budget brother... It's a crazy world. I've come to be interested in the arg
    5 points
  48. Doctor Dave had slept with one of his patients and felt guilty all day long. No matter how much he tried to forget about it, he couldn't. The guilt and sense of betrayal were overwhelming. But every now and then he'd hear an internal reassuring voice in his head that said: "Dave, don't worry about it. You aren't the first medical practitioner to sleep with one of their patients and you won't be the last. And you're single. Just let it go." But invariably another voice in his head would bring him back to reality. Whispering...... Dave.......
    5 points
  49. Dude, I do truly hope your joking? You want to do Pediatric Critical Care Transport having JUST finished Paramedic SCHOOL? Short Answer = ABSOLUTELY NOT! I will tell you what, if you can tell me the pathophysiology of Tetralogy of Fallot without having to use GOOGLE, then I might be willing to listen to your argument. I really hate to sound like an A$$ here, BUT, there is NO way on this earth, any brand new paramedic is ready to do ANY type of CC transport. That included myself back in the day.....In fact, I have tons of CC experience, education, and when I took PNCCT last y
    5 points
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