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

  1. 7 points
    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....are you sure?? Yes,"......(okay, well you get the picture) Me~"Okaaay?" Then the "voice" starts out with a quiet little laugh that came across with slight embarrassment and then says, "I guess I just don't know where to start but here goes...You met my husband outside of the casino a few weeks ago. He was the one laying on the ground....." The memory comes flooding back easily, I had stopped at the casino on my way home from a meeting and as I was walking towards the hallway I suddenly felt a female security guard grabbing at the back of my jacket and pleading for me to follow her back outside where they had "a medical" down on the ground. Looking around and seeing no-one else following her I reluctantly followed her as she half ran back to the front of the casino where I was confronted with the sight of an older male lying face down in a pool of blood and several people standing around watching as another older male was feeling for a pulse. When I got close he locked eyes with me and said "I'm glad your here ma'am, he doesn't have a pulse." I went thru the usual questions quickly as I felt for a pulse and gathered the important information that despite the fifty people standing around, not one of them knew him and no one knew what had happened....the gentleman kneeling next to him tho tells me that he is an EMT "from 100 years ago" so I quickly inform him that we are now partners and CPR hasn't changed much so we proceeded to flip the gentleman over and begin CPR while the casino First Responders ran and got us an AED and BVM while we waited for the ambulance (did I mention I used to work for this ambulance? awkward) arrive we performed CPR. We managed to get a pulse back after one shock and I assisted ventilations with a plain old BVM while we waited for the boo boo bus to arrive. Seemed like it was a couple of hours but turns out it was only eleven minutes.... Just as we got a c-collar on the gentleman and had him loaded unto the spine board he lost his pulse again so we quickly loaded him into the back of the rig, restarted CPR, shocked and got a pulse back again. Long story short, I rode along with the gentleman to the ED in the back of my former employers ambulance (did I say awkward before?) where they stabilized him and flew him out to a higher level of care within the hour and I went home to wonder the final outcome. I have to admit that I googled his name a few times in the following weeks thinking that I would see an obituary and finally just kind of put it out of my mind.... Then the voice started to break up and said, "I don't really know how to tell someone like you Thank you for giving me 45 more years with the love of my life. The doctors told me that if you hadn't of been there and done what you did, he would not have made it. How do I tell someone thank you for that?" With a few tears in my own voice I replied....."You just did." Turns out he had a defib/pacemaker implanted and is back to his old self again....
  2. 6 points
    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 justified it with his refusal being an obvious sign of altered mentation, but as mentioned above I'm a true believer that I am a patient advocate first. This guy understood the risks, he's just had a lifetime of experience of ignoring such risks and having things work out ok for him. I wasn't able to convince him in my limited time that his experience might not work this time. I left him on scene. About an hour and a half later I got a call from the site supervisor telling me that he'd decided to go to the hospital due to increasing pain. The employee had driven him instead of calling me back, which was faster anyway...I lost track of him after that... Thanks all for the discussion. I do find these types of cases sometimes more mentally challenging than some medical patients... One thing that I have come to believe, that trying to be morally and ethically sound with these types of patients seems to be becoming less and less popular. That the, "Screw it. Take him and tell them he was altered, no one will ever question that.." is more and more prevelant...That's a shame I think...
  3. 5 points
    Hey everyone! Glad I found you all, from what I've gathered from some brief browsing, this seems like a good place to get advice on the world of EMS! So, I'd thought I'd just directly ask this community some on my questions, as I'm a little on the fence about pursuing EMT and Paramedic Should I become an EMS student and eventually an EMT? Also, will my age hinder me greatly? What are the challenges of studying to be an EMT that I should be aware of? If you're concerned about the emotional and mental strain of the job, but know it is a challenge you want to try and overcome, should you think twice? Sorry for all the big questions, any answers or advice you could give me would really be appreciated! Thanks in advance!
  4. 5 points
    I'm really sorry for coming off as a completely ignorant teenager who's here to argue or something. I'm really not that guy. I said some things I regret and I'm truly sorry. I respect all of you no matter what you think of me for what you do. I hope you can all be a little more patient with me cause I don't have 10+ years in EMS, I have 0. I don't want to go into EMS for the glory or anything and I know it's gonna be tough but it's what I want to do because I enjoy helping people. I'm here to learn and I've already learnt a lot. So thanks for teaching me. There is no other job I want to do, this is it. And I'll listen to what you guys have to say because you know a hell of a lot more then I do. At the same time please understand I know my situation better then you do so before you judge at least let me explain it if I can. Thanks.
  5. 5 points
    Hi Caduceus, nice to meet you I'm going to be the one irresponsible adult in this bunch who walks over, shakes your hand, and hands you the code to access my ambulance shed door..... Then we are going to sit down together and have an in depth visit. In some of your previous posts you've alluded to having witnessed or possibly having been a part of some traumatic events, or maybe some medical events. I'm going to ask you further about them, what they were, what your part of them consisted of, how it affected you in the following days, weeks, etc. During our chat, I'm also going to give it to you straight. We see things in EMS that most people can't even begin to imagine. Things that we carry with us for the rest of our lives. I only have three decades in this business and I'm sure I haven't seen it all and there are probably more things I have yet to see, but honestly, I still have a few accident scenes and traumatically abused young patients come and visit me in my dreams.........but I also have some wonderful memories of being the first person to hold a newborn baby in my hands and can still feel the arms of a mother who's son we revived after he plunged into an ice cold lake hugging me and thanking me for not giving up on him. So we are going to talk about those things together. We are going to talk about the good, the bad, and the boring. We are going to talk about how a profession in EMS can either make or break a person. Then I'm going to ask you to go home and take 24 hours to really think about whether or not you want to come along with me in my ambulance. 24 hrs later...............you show up at my bay and say "I thought about it and I still want to do it." And then I'm going to give you a pager which you will carry with you at all times. He probably will be quiet for the first few days that you carry him and you'll probably push down on the little protruding button on the on/off knob a couple of times a day "just to be sure" it hasn't gone off and you've missed it...... And then finally, when we least expect it, (most likely at 0600 hours) Mr. Pager is going to scream/beep/tone at the top of his lungs to tell you that "Old Mr. Creeky Hips down the road has fallen and can't get up." and your going to jump out of your nice warm bed, throw on that set of clothing that you have had nicely laid out for just this occasion for three days now, wipe the sleep out of your eyes and try to calm your shaking hands while waiting for me to swing by and pick you up for the ride to the ambulance bay. I'm going to pick you up outside your house and on the way to the ambulance bay I'm going to coach you to slow down your breathing and shake out the tremors running thru your body and just relax. I'm going to calmly remind you that this is Mr. Creeky Hips emergency and not ours. And we're going to talk about what we might be heading into as we get to the bay and transfer into the ambulance with the rest of the crew. I'm also going to remind you that this is the time of day that heart attacks happen and that we can't always rely on what "Mr. Pager" tells us so we need to be mentally prepared for the "worst case" scenario as well as a simple fall. As we pull up to the front door of Mr. Creeky Hip's house I'm going to ask you again if you are ready and if you want to come in. If you don't, that's fine with me and I really won't mind if you decide to sit this one out in the front seat of the rig and just wait for my partner and I. I will not hold it against you either, so don't be afraid to tell me that you've changed your mind. I'd rather know now than have you come in against your better self judgement. But if you do decide to go in, then you need to know that I can't hold your hand. I can keep an eye on you and guide you if needed, but once we step foot into Mr. Creeky Hip's house, my focus and my attention need to be on him and what is happening with him. If we get in the house and it is a simple fall, great! We can do a rapid trauma assessment while we question Mr. Creeky Hip and try to find out what caused him to fall and get him all packaged up and ready to transport (if needed) or if he doesn't want to go in, do a thorough assessment both medical and trauma, call medical control then help him up off the floor and be on our merry way. Most likely the entire time I am going to be observing you and how you handle yourself, how you interact with Mr. Creeky Hips and his family, and how you interact with myself and my crew and hopefully you will be wonderful at it. But if we walk in the door and Mr. Creeky Hip is exhibiting agonal respirations and his family is hysterically screaming at us to "do something" then I may even forget for a few minutes that we brought you along because we will be in full "code" mode and you may have to fend for yourself for a few minutes until we get CPR started, the AED on, get IV's going, etc....so I hope you are okay with that and secretly I am probably hoping that you jump right in and ask if you can help with CPR. Whether I need you to help or not doesn't matter, but your offer to help will be immeasurable in the amount of faith I put into helping you continue along your chosen path should you choose it after this call. And when it is all said and done, and the call is over, we are going to talk about it. And we are going to talk about you. And should you decide you want to continue on this path I will urge you to first get your Emergency Medical Responder patch.... And I will probably give you my personal cell phone number and tell you that any time you want to talk about it to call me. Any time. I will be honest with you and tell you that I would much rather you get your EMR patch before your EMT patch because of your age. I'm not trying to downgrade you or say that you aren't ready for an EMT patch but rather just saying that "at your age" the logical step is to get an EMR patch which will allow you to ride on the rig but the ultimate responsibility for a patient's life will never lay in your hands. That's a huge responsibility to have at 15. As a side note, my son, who is 12, has his EMR patch and it might be a shock to some, but he is allowed to ride on the ambulance with me on certain calls. Granted he has grown up in EMS and has practically lived in an EMS classroom since he was about five years old, not to mention been witness to several car accidents that we have come upon while traveling and watched from afar as I've treated the patients. The last class that I taught he decided he wanted to take the State final and practicals..........and he passed......he passed all the skill stations and the written so "legally" he can practice as an EMR but legally and mentally are not always the same. I am fortunate that I work full time for a small service and I can pick and choose which calls I allow him to go on, but I always know in the back of my mind that at some point we could be called to something I know he shouldn't be involved in because it will be totally different on scene than what the call came out as. Thankfully my town is small enough that if he isn't able to stay in the rig, there will most likely be two or three extra people on scene that can take him home again and I can talk to him later about the call and why he wasn't allowed on scene. But in your case, it will be a totally different deal and I worry a little bit that you may get in over your head by mistake.....especially if you are running with a bunch of guys who maybe won't think twice about how something may or may not affect you....but on the other hand, I applaud you on the research that you have been doing and how you found this site. Your maturity level speaks to me of far older than 15 and I may be worrying for naught... Please keep us posted and let us know how you are doing....and never be afraid to talk to us about stuff..........good luck!!
  6. 5 points
    **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, then took a five or six year hiatus to try and make it in the "real world" but found that they didn't accept my way of thinking that sometimes, just sometimes (not always) you just have to just let natural selection run it's course and they forced me back into the world of EMS where I've been 'at home' ever since and will probably die doing this "job". Actually, I've never really considered this a job if I think about it, more of a way of life..... I've been known to be stubborn at times, but if forced with an appropriate and knowledgeable mallet, I may sometimes admit that I may have, or may not have, been wrong~~only time will tell if I can be housetrained for the "City Life" and I look forward to meeting and greeting all of you...I think I see a few "villagers" here so maybe they will accept me and still have one of my broken toys lying around somewhere and will allow me to sit in the corner and gnaw on them while the discussion goes on around me if I am contentious.... **waves at Kat and Ed** I am currently an Intermediate who is also an instructor~~soon I will be a thing of the past again and will be considered an AEMT and I'm really hoping that it's true what they've told me that my knowledge and wages will triple the minute I open the envelope that labels me as an AEMT...I think they also said something about "World Peace" happening as well... but I am excited about the national push to stabilize, equalize and verifize EMS across the board in the states and if it brings more uniformity and "togetherness" to the world of EMS to help us all grow up, then I am all for it~~yeah, like I said, "world peace" as well :0)~ I also work full time EMS, work at a local store on my off days to collect a pay check that makes up for what I don't make in EMS...lol, and run a rural volunteer ambulance service which has seen it's call volume almost double in the past year due to the "oil boom" in the western part of our fine state, and as the call volume doubled, the crew numbers decreased to half the size.... So as I said, I will try to play nice here in the "City" but I am a bit biased at times and if nothing else, have always been a strong advocate for my patients and what is and always will be right for them.... **sits back down in the rocker and sips her Rum and Coke and plays with her bloodhound SAR dog**
  7. 5 points
    I actually shelled out the $6.00 in order to be able to give a fair critique of this piece, and in the suspicion that in doing so I might be able to write a review for your work on Amazon that would save others their money in the future. 1. The name of your book is "A Professional Rescuers(sic) Guide to Behavioral First Aid Crisis Response". In spite of the title, there is an addendum at the end stating you make no claims to this book, and there are no credentials to be found anywhere in the book. At the end the author is listed as Steve J. Stevenson Jr. A quick google search turns up little to nothing, though on LinkedIn I found a Steve Stevenson who is a Fire Safety Supervisor at Oklahoma State University. Don't know if this is you, but if it is, I see no credentials on your page that demonstrate your competency in either emergency medical services, medical care, behavioral health, or any related fields. 2. Brevity of content... Reading your piece from my Kindle, Chapter one took up all of 5 pages. One chapter was only a single paragraph long! 3. Unscientific. The content seems to be purely derived from anecdote and what I can only surmise is your own poor understanding of the topic. There are no references, citations, or evidence of any kind that any of your analyses or suggestions have any scientific basis whatsoever. Finally, the explanations appear simplistic for the depth of the topics being discussed. 4. Grammar/Spelling Errors. Numerous grammatical errors and misspellings throughout the text. 5. Plagiarism? It appears you've taken some of your content from other sources without either adapting them to EMS and rephrasing them or citing them. I thought it was kind of fishy when you began recommending EMS providers use such phrases to patients as "would you like to continue our discussion calmly or would you prefer to stop now and talk tomorrow when things can be more relaxed?" A quick google search shows that this phrase is not novel... 6. Same as above... this book is increasingly starting to look like a copy and paste of other texts. 7. Unprofessional. Why does the font size change every chapter or so?! 8. Logo. Is that the 2011 National EMS Week logo?! Do you have permission by the American College of Emergency Physicians for its use? Anyway, your book took me all of 20 minutes to read... It was in my own personal, humble opinion, not worth the pixels that made it up (and I'm not even sure how much a pixel costs?). I would NOT recommend it to anyone, and I will be happy to share this review on Amazon and anywhere else it is sold. I hope this review has been helpful. Enjoy my six dollars.
  8. 5 points
    The patient may not always be right, but the patient always has a right to be wrong.
  9. 5 points
    Did I mention you need to document? Otherwise, if it goes to court, you won't have leg to stand on.
  10. 4 points
    Hi. Although politics are not for everyone, this area was designed for those that want to discuss politics and other items not EMS related. Many of the members here have other interests besides EMS and what better place to discuss them than with people you already know from other discussions. I welcome you to join in or perhaps find a different topics that you enjoy and post.
  11. 4 points
    go in with an open mind Ask in advance what they want you to do Ask what they will allow you to do ask many many questions make sure you help them with cleanup and changing cots DO NOT spend most of your time flirting with the nurses, talking or texting or playing games on yoru phone. Youare there to learn and not to text or talk on your phone. If I as a FTO/evaluator had my wish and ruled the world, I would not students to carry their cell phones on them when they were doing ride alongs or I would put them in the lock boxes and I would only allow them out during breaks and lunch. Bring your field guide or some book to let the medic know you are serious about learning. Do not offer to buy them lunch or dinner, that would set a bad precedent that you would be held to on your next ride and your next and again and again. You are there to learn, not to buy the crew food. I'm sure that there will be other stuff that others will add.
  12. 4 points
    Should I become an EMS student and eventually an EMT? As many discussed, what are your intentions? If you have to ask.. probably not. This is really tying to be a profession. My advice is to go to academic studies and obtain your general education. You will need them no matter what you decide to do. Also, will my age hinder me greatly? Yes!.. Most professional services require minimum of 21 years of age for insurance (unless self insured) .. I have seen many of requiring up to the age of 23. Again, this is a profession. What are the challenges of studying to be an EMT that I should be aware of? It is nothing like you see on television. Usually, there are several hours of boredom with few minutes of terror! Studying basic EMT is simple, it is set at at a 10-12'th grade reading level. Repetitive practice will allow you to master the basic skills. Again, as you master other academic courses such as anatomy, chemistry, English, Psychology, EMT course will be a breeze. If you're concerned about the emotional and mental strain of the job, but know it is a challenge you want to try and overcome, should you think twice? There is an emotional factor that we are now seeing more than ever. Not everyone is emotionally stable enough to handle the hum-drum of EMS and the abuse calls. If your looking for a high adrenaline job, chances are EMS is not what your looking for. I used to say age is not a factor, but I regret saying that. I believe the nature of our business is being able to understand the whole business of EMS. That we are there for patients (not vice/versa) and the 3' o-clock for grandma being lonely is just as important as that truama call... grieving parents or the new widow of the spouse of 65 years.... and yes, it's also a business. To provide care but also make money.... It's not that younger members can't but research has proven that many do not mature until early twentys. I ask you... What's the hurry? Really.... EMS will be there for you, if you do make a rational and educated answer. It's much better than entering only to never really enter it or leave it in 3-4 years, before one has obtained true experience Good luck, R/r 911
  13. 4 points
    I just finished my EMT course after graduating HS. As far as learning the information, the tests were a piece of cake( at least the ones my teacher gave us) but I still studied my butt off because I knew that all the information will count at some point. I don't know how long your course will be but they cram in a lot if info in a short amount of time and most of the people there would just study what they needed to pass the test, we didn't even go through the whole book. I made sure that I read the whole book and researched EVERY thing that was discussed in class. I was one of the youngest in the class but by the end of the semester people were asking me to run their scenarios and quiz them (teaching someone else something is the best way to learn and remember it!) I still have to take the written exam but I have a good bit experience on an ambulance and I don't find that my age hinders me much. As long as you are willing to learn and ask question no one really cares how old you are. If you decide to go for it, make some connections with the older more experienced people in the class. Demonstrate to your instructors that you really want to learn and always volunteer to do things and they will see that and help you more than the kids playing on their phone in the corner. I was lucky enough to know someone that has been in EMS for a while so I keep in touch with him discuss everything I am confused with. Hope that helps
  14. 4 points
    Welcome. Direct questions are some of the best questions to ask. Why beat around the bush? I don't know. Should you? What do you think? Are you up for it? Do you want it? As Clutzy said the only person who can answer this is you. How old are you? The challenges are different for everybody. They largely depend on you, who you are, your background and your motivations. Do you second guess other decisions in your life based on similar concerns? EMT class and being an EMT or paramedic isn't the only challenge people face that brings with it emotional or mental strain. How do you face these other challenges? Your answer to how you face those challenges will help you decide if you're up to this challenge. You're welcome.
  15. 4 points
    A few years ago I was playing basketball and the ball jammed my pinky. I looked down and it was dislocated. Before the pain hit I pulled it back into place. When my daughter was 2 she pinched her finger at a museum and split the nail horizontally. If you opened it you could see down to the bone. I did what any responsible parent would do. I wrote her a script for antibiotics and put triple antibiotic ointment on it, with a bandaid change twice a day. I woke up in the middle of the night with the worst headache of my life (if you are not sure why this is a bad thing, google subarachnoid hemorrhage). I started puking and was terrified I had a SAH. My wife called out from the bedroom asking me if I was okay. I told her I was fine and she should go back to sleep. Once the vomiting stopped, I did what any responsible ER doctor would do, I took 800mg Motrin (if I had a head bleed I was going to make sure that my chances of survival were 0) and went back to bed, terrified that my wife wouldn't be able to wake me up in the morning.
  16. 4 points
    I'm reaching out because a friend of mine needs some help !!!! His wife told him to go out and get some of those pills that would help him get an erection. When he came back, he tossed her some diet pills. Anyway, he's looking for a place to live. Can you help him ????
  17. 4 points
    I'm well aware of the levels in NYC and have worked with many EMTs and Medics on LI who also worked in NYC. Again, you failed to answer the question. Do you work for FDNY, a hospital based service or one of the privates? You know exactly what I mean when I say cowboy. Should I use the term buff? I know you understand that. I also know full well that EMTs and medics are not doctors. I did EMS in NY, not NYC, for 10 years and know the systems from Staten Island to Montauk pretty well. When we say scared, you know we do not mean it literally. However, the fact that you cannot do anything more and cannot properly provide the care the pt needs because of the standards in NYS and the fact that you are an EMT should literally scare you. People are dying because of the dismal state of EMS in NY but that is for another thread. So what are you going to do when this guy goes unconscious because his SBP is 70 and you can't bag him and your ALS backup is tied up on another call and you have to take care of the pt. You are right, there is nothing you can do but watch him die. The fact that that doesn't bother you makes you a piss poor provider in any system.
  18. 4 points
    Sorry to go off topic since medicgirl is looking for help, but I'm sensing a troll. Check out these girls:
  19. 4 points
    I apologize for replying to this forum because I know it is for EMTs only. I feel I must comment on this since I do have experience with Peds and work for a large Children's hospital. You do not always have the tell tale wheezing with asthma. Also, not all that wheezes is asthma. Children can even be in CHF from a cardiac condition. There are also numerous other disease presentations which can wheeze. Children with asthma may also have intrinsic "peep" from the air trapping initially which gives the impression the patient has great SpO2. If the SpO2 is declining then the downside is coming. In this situation, the oxygen mask was appropriate. Blow by anything is not good except as a very last resort. Blow by nebulizers are a waste but it makes the provider feel like they have done something. Kids deteriorate fast. Don't split hairs or waste time on a pulse ox reading initially on a child with signs of distress which is hard as hell to get on most children. If the child is still enough to get an accurate reading, that child is probably in serious trouble. Good by other clinical signs and get to an ER preferably at a children's hospital. Unless you can provide definitive treatment for this child and have the appropriate oxygen device to meet his needs including ventilator demand, go with what works now to give him some relief. Even a nonrebreather mask is no match for high flow devices which can meet the demands with a fairly consistent FiO2. You might think a nonrebreather mask is giving 100% but for a patient with a high demand from distress that is not true.
  20. 4 points
    In court... "Mr Jones, you state you didn't claim injuries to the Sheriff's Deputy at the time of the accident, yet now, 3 months later, you're claiming a broken leg and other minor injuries from that same accident. Please tell the court why you delayed making the claims?" "Your Honor, it's simple, actually. When I swerved to avoid that deer in the road, my car and horse trailer went off the road, and both overturned. My horse, Jupiter, was hurt bad, as I could hear him screaming in pain. Deputy Simpson must have seen the accident, as she arrived only seconds later. She went to the trailer first, saw Jupiter and his injuries, pulled her sidearm and put my horse out of his misery. Then she over to me, with the gun still in her hand, and asked if I had any injuries. How do you think I was going to answer?"
  21. 4 points
    Hi all, I wrote the below post in my blog and was curious about your thoughts. The idea from it actually came from a discussion of FB. Some saying that compassion, and/or "hand holding" is part of EMS, like me, and others saying that it can be, but that it's not necessary to do good medicine. Anyway, the below isn't directly regarding that, but it's what got the ball rolling in my head.. From, www.chasing-my-life.com Let’s talk about the spirit of EMS for a minute… June 4, 2013by Dwayne Let’s talk about wankers first. (wackers, wannabes, Ricky Rescues, whatever). I’ll start. They hurt my heart. Truly. And they also, without knowing it, hurt their own hearts as well. And probably worse, they hurt the spirit of EMS very much. I believe that there is an amazing spirit that lives at the very heart of EMS. If we listen to it, it can make EMS the most amazingly rewarding career that I can imagine. If we don’t, then we can sometimes end up being just another wanker that’s been given a truck with lights and a siren. And I’m not a big fan of the wankers. They just don’t ‘get it.’ We’ve worked hard for the privilege of being “the” person that people call when they are terrified. The person called when they, or someone that they love, are hurt, or ill, or sometimes just mentally or emotionally lost. Yet somehow there seems to be a huge segment of the EMS population that has decided to whine about that. To complain about the fact that they’ve been asked to actually perform in the role that they’ve worked towards and applied for. They’ve decided that to be cool you have to show how detached you are from compassion and simple human decency. Fortunately, I believe that most of us don’t fit into that category. And most that do don’t want to, they are just not strong enough yet to go against their buddies that choose to act cool instead of being competent. Let me lay out a few guidelines regarding our EMS spirit, yours and mine. If you’ve transported an old person and later referred to them as a ‘lizard’ or ‘gomer’, you’re a wanker. If you’ve bragged about how much you love the sound of breaking ribs during CPR, you’re a wanker. If you’ve ever explained to someone how you’d love to give your most recent suicide attempt (real or pretended) better instructions so that they can be successful in the future, you’re a wanker. If you’ve ever chosen to leave a patient’s spirit in worse shape than when you found it, in any way, you’re a wanker. Those gomers and lizards have lived a long time, and have accomplished things that you can’t possibly imagine. They’ve lived through a world war, some of them more than one, and multiple depressions, including the Great One. They’ve watched their friends, brothers, sisters, and too often, their children die. They’ve been humiliated as their driver’s licenses have been taken from them, again as their bladders and bowels began to betray them, and in many, many cases they were forcefully removed from their homes and placed in terrible institutions against their will, by the children that they raised. They now live in a world that many of them don’t understand, are afraid, feel unwell, and are powerless. They deserve, and have unquestionably earned more than our county gives them, but at the very least they deserve our respect and very best care. Those breaking ribs belong to a human being that is almost certainly in the last seconds of their life. Trillions and trillions of memories, loves, tears, laughter, all ending at that moment. The cracking sound that you’re so proud of will be heard, very often, by their families and loved ones. It’s that sound that they will involuntarily associate with the last memory of their mom, dad, or child, for the rest of their lives. Sometimes these worn, tired, amazing people need help. They need a hero. So they call for an ambulance. If you’re a wanker, unfortunately they sometimes get you instead. You laugh about the smell of their rooms, make jokes about their diapers, the way they talk, the way they chew, draw pictures of their sagging breasts. You drop them off at the hospital and then go to the bar later, strutting, wearing your EMS or firefighter t-shirt, accepting accolades for all of the amazingly heroic things that you did with your day, though no heroic things were done. Accept free drinks for being willing to put your life on the line during every shift!! Wanker bullshit at it’s finest. If you’re a wanker, you have the opportunity on these calls to be a hero. But as there were no burning buildings, or bullets to dodge, no cameras around to put your face in the paper, you couldn’t be bothered. You had the ability to ‘see’ this tired old person. To get them to tell you their stories, and truly listen to them. To get them an extra blanket even if they didn’t need one, simply to show them that they were still important. More important, you had the opportunity to stand up for them after the call. To choose to promote their dignity instead of joining your buddies in crowing about their uselessness. During each call we have a chance to make a difference in someone’s spirit, and therefore their life. After each call we have a chance to make a difference in EMS. And please, if you’re a wanker, spare me the argument of, “I may say those things after a call, but that doesn’t effect my patient care!” Bullshit again. In fact, if I even have to explain this to you then you’ve likely deluded yourself so completely that I’m not sure that you’re reachable at this point. Do our attempts to make a difference always work? No, almost never. Do they sometimes create drastic change? Yes. Do they ALWAYS make some positive difference in our patient, and just as important, in us? Yes, they do. Every, single, time. Is there ever a good reason NOT to try? One. If you’ve got a dozen plates spinning, trying to save a life, then perhaps you don’t have time for this type of compassion. But as soon as one of those plates is taken down? You’re out of excuses again. Besides, despite what you allow your family and girlfriend/boyfriend to believe, those are what? 1/10 of 1% of your calls? Maybe your attempt at some positive thing does something, or maybe it doesn’t, or maybe it does but you won’t be there to see it at some later date. Any way you slice it, succeed or fail, making the attempt is just simply good medicine. Language is powerful. Each time we use, or hear such terms as those above it should make us feel a bit ill. You know that feeling. When you’ve discovered that you pushed the wrong drug, or the wrong dose? Or delivered a medication before finding that you forgot to consider interactions with the other drugs they’re already taking? That ill feeling that you get when you know that you’ve done bad. That you were called to help, but hurt instead. Wanker or not, I’m confident that you know what I mean. I certainly know that feeling well. I know that you went into this wanting to be a champion for those that can’t champion for themselves. I know, I truly believe, that you went into this to make a difference. I know that at the end of the day that you want to lay your head down knowing that someone’s life is better because you were a part of it when they were in trouble. Please. Listen to your EMS spirit. Take a minute on every call and actually see your patients beyond their pathologies. Treat their bodies, but heal their minds and spirits. If you’re not doing so then you’re missing a vital part of the medical arts. It costs nothing but an additional bit of your focus. It takes no additional time. But the rewards are monumental. Leave the wankers to do what wankers will do. But today, choose not to participate. Will the world change because you’ve made a different decision? Yes, for this one person, their families, and friends, the world will be different. It should feel like a privilege to hold such power as to be able to be part of a stranger's memories for the rest of their lives. Those memories will be good or bad, either way those that carry them will be changed. To the professionals in EMS that get the reason, and the need for such posts…I salute you. Thank you for watching out for my family and myself. For bringing the best of EMS to every home, and to every patient. I promise to continue to do, every day, the best I can to be considered your peer and to live up to your example. To those of you that think that this is just a bunch of feel good rah, rah, bullshit. I thank you to, for the work that you do, though I’ll likely never consider you a professional. My wish for you is that you to take a minute to think, and go back to the days when you could be proud of the job that you do every day. When you do? Man, nothing would make me happier than to welcome you to the ranks of the brotherhood of professional EMS providers and scratch another name off of the wanker list. To those of you that really don’t know what the hell this is all about? That’s ok… You will. And as you move forward maybe this will give you a bit of a compass to help guide your way. I hope so. I’ll keep an eye out for you down the road… Have a great day all…
  22. 4 points
    Hey guys! Thanks for the warm welcome! I'm a EMT from North Eastern, PA. I've been an EMT for about a year now, Paid city ALS units primarily. Anyways, I'm going through the process to begin Medic school in the fall, and I have allot of questions! Not only do I have questions, but I'd love to share my experience's with anyone who is thinking about the path I have chosen. Paid EMT- Volunteer Fireman on primarily a Truck company. and I Volunteer EMS in a more country area nearby. I've been a fireman for 6 years now. I plan on making a career out of emergency services in some way shape or form! Again, thank's to all those who welcome me, I've been impressed with the content I've found here and I wouldn't want to be anywhere else! -Picc
  23. 4 points
    Just to recap the information provided: From the door Patient mentation: Altered/Unresponsive. Cyanotic around lips/peripherals Eyes open. RR - Shallow, labored, 35/min Pulse - Fast, weak. Obese Hx COPD/CHF "Okay" yesterday (HAHA, what does that even mean? Talking, conversing, aware? Or in the same exact unresponsive state sans SOB - I'm going to assume the former) Diagnostics EKG: Narrow Complex Tachycardia - 210 BPM; No P-Waves BP: 84/58 SPO2: 85% LS: Rales in all fields I think that's it? I'm coming late to the party but from what I've gathered, we're on the brink of cardioversion. And chbare brings up an excellent point. You don't have a lot of time. Interventions (~2-4 min with 2 ALS crew members?) O2 via NRB -> BVM IV - with blood glucose from the stylet; NS flowing @ < WO. Monitor - 4 Lead Cardioversion Prep Physical Assessment: Eyes PEARL? Smell of urine/feces? Sores on her body? Edema? Abdomen palpation - soft/hard? Assessment Questions (during interventions) What is she in rehab for? What is this patient's baseline mentation? Why is she not on oxygen? What has this patient's trends been in rehab? Improvement or deterioration? Increasing complaints of SOB during her stay or sudden onset in the last 6 hours? Any other complaints? Bed-ridden or active? Paperwork history: Recent infection, surgery? Pertinent meds - Antibiotics, Anti-Coagulants, Antiarrhythmics? Ddx Infection (sepsis), Stroke, Hypoglycemia, Hypovolemia (internal bleeding), Overdose, PE, CHF/COPD. While it's easy for me to say I'm shying away from immediate cardioversion, I'm sitting at my kitchen table nursing a caffeine headache in shorts and a t-shirt. On-scene would probably be a different story. I feel like an immediate cardioversion may convert her rhythm to NSR only to revert back to its narrow complex tachycardia (which I'm going to assume is SVT). So with my assessment questions in hand, I can cross off quite a bit of my differentials as I package. Assuming none of these questions are answered: TX Cardiovert; -> No response, package. (If there is a response, stop here). I feel like cardioversion is an appropriate, valid response. But I don't believe it will solve the problem (with the information available). Grab a nurse or a third responding crew member En route: BVM (followed by RSI), 12-LEAD. On-scene time: 10-15 minutes; Transport time: 10 minutes; Total elapsed time: 20-25 minutes. I'm a new, green medic. If this is inappropriate or VERY inappropriate, please tell me. I'm still in the midst of being trained. I'm working on my prioritizing my assessments so any feedback would be appreciated. And whoever thought of the auto-saving feature on this forum, you're awesome.
  24. 4 points
    I can hear just as well in the back of the truck wit a $30 sprague as with my wife's master cardio II Littman. It's an acquired skill thats takes time to learn. When you start releasing the air from the cuff, palpate at the wrist and listen at the same time. It may be a right brain skill that only lefties can do though:::
  25. 4 points
    Triemal04's points have been validated in the past, so while I'm not going to allow the Kiwi 'calling out' to continue, I'm also not going to allow any Triemal bashing to begin. He had reasons to be pissed, and to be pissed still, but there is no benefit to the board in rehashing it. Those that have been here a few days know how terribly ugly that got. Triemal, enough said Brother. Kiwi, we have no need or desire to hear your medication and psychological history attached to nearly every post. Many here love and respect you, but I will from now on, when I have access at least, delete any post, and any associated posts, that make the tiniest hint at suicide. I see no benefit to you from the never ending pity party you've come to love so much. Many of us have burdons in our lives that we consider 'heavy.' Take those conversations to private if there are those that want to hear about it, or keep them in threads focused on such issues. Everyone else....Please, please, please, let's try not to get follow others down these unproductive paths. There's just no benefit that I can see to all of that negative energy. Dwayne
  26. 3 points
    It has been a long time since the glory days of "City" with Dust, Rid, Mike, AK, and a host of others I would list if there was room. I would love to hear from as many of you from the 10 years ago era who are still around, as well as meet the new crew. I do recognize some names, and will check in as much as I can.
  27. 3 points
    Clubs, OOOOOOOOOOOOOHHHHHHHHHHHH so you mean like the Calvin and Hobbes club GROSS (Get Rid of Slimy girlS) club??? Can I be the first to make one? Please please please.
  28. 3 points
    Welcome. Stick around. Ask questions. Learn lots.
  29. 3 points
    You're missing the point Mikey, it's not the number of suicides, it's the number per 100,000. In Canada the national average in 2009 was 11.8 per 100,000 people. The suicide rate for first responders is more than double the national average. Why is there such a discrepancy? The only real difference from the national average is the carreer. 34 people might have died in bicycle accidents, but how many million rode a bike there are far more bicycle riders out there than there are first responders? In that case, the numbers just aren't as significant and you're comparing apples to oranges.
  30. 3 points
    I'd be cautious about treating someone's blood pressure before a definitive diagnosis of a hypertensive urgency/emergency, and ruling out alternatives like a hemorrhagic or ischemic stroke. Even then, you are aiming for a 10-20% max reduction in the MAP over the first hour which might be difficult to do outside of an ICU or stepdown environment. I agree with treating the nausea and pain first and then reassessing blood pressure afterwards.
  31. 3 points
    I have been doing this a long time, and I have yet to need a gun (and yes I have worked urban 911 in the hood). Guns do not always save police officers, and many times when those officers (who train with guns all of the time) are in a shoot-out, they miss their target (even when standing less than 10 foot from the perp). How would you feel if in a moment of fear you unloaded 15 bullets in the generic area of the bad guy, and hit innocent people in the neighboring apartment / street / scene ? I am sure there are some dead medics out there somewhere that could have used a gun, but you have a much greater chance of dying in an ambulance crash than you do from being assaulted.
  32. 3 points
    Should I become an EMS student and eventually an EMT? This is totally up to you. I took my EMT-Basic class when I was a senior in High School (not part of school but rather a class through the fire department). It was tough. I started the class at 17 and graduated at 18. Was it tough for a 17 year old kid? Yes. I enjoyed the class but you better make sure that EMS is what you want to do. I knew I wanted to eventually be a medic. It took me 12 years to eventually hit that goal. Was it worth it? Yes. I was grateful that I had the experience I did when I was in medic school. I think it helped me alot. I suggest taking a basic class and then getting your feet wet. This way you can decide if EMS is truly what you want to do. I have seen students come and go and I have seen many of them brand new EMTs with no experience that quit because they realized it isn't all daiseys and roses. Just being honest. Also, will my age hinder me greatly? It can. I was 18, but as stated before, more and more services are requiring you to be 21 because of insurance purposes. You should look into your area. What are the challenges of studying to be an EMT that I should be aware of? You learn really fast that this is real life. What you see in the Hollywood is not what EMS is. Many times you run a code, the person dies. I have had one save in my career. The rest have died. Thats how life is. Diseases are VERY real. HIV, Hep-c, Hep-B, all of that.....yes it is real and yes you could be exposed. Get an accidental needle poke and you suddenly realize how scary it can be waiting test results. Class is serious. Yes, we all goof and have fun but you are learning how to save someone or help them when they are in need. If you use improper skills you that can be the difference between life or death. Don't think you can just breeze through it. You need to study and you need to know your stuff. Do NOT get cocky!!! You may think you know it all but there is a difference between book smarts and street smarts. It is my personal pet peeve to have students come in that think they know it all. You are there to LEARN, not to prove how much you know. Sorry if it sounds harsh but I don't sugar coat it. EMS is not a sugar coated profession. If you're concerned about the emotional and mental strain of the job, but know it is a challenge you want to try and overcome, should you think twice? If you question your personal abilities you need to really put thought into this profession. Yes, there have been calls that have gotten to me. It happens. As I said above it is not all roses and daiseys. But also know that there are services that are available to help you deal with some of the stress. I have found that talking with the person on the call with me helps me if I doubt something I did. If I am with a basic, we discuss the call or even go talk to the doctor to get some input. You need to be able to have positive coping skills. Going to the bar and getting drunk it not healthy. Make sure to have a hobby that you enjoy. I found that my photography is a great way of coping with the stress of work at times. If you find that you can't handle the consistant stress then you should get out. I am not trying to be mean so don't take what is above personally. I had someone tell me pretty much what I told you when I was wondering about getting into EMS. I am glad she did. I walked into this profession knowing that it was going to be tough. I love what I do and I am very happy in EMS. There are some lessons that you have to learn the hard way but they can make you a good EMT or medic if you learn from your mistakes. Ash
  33. 3 points
    Thank you all for responding! To answer your questions, I'm turning 18 next month, and graduating high school this June. I really appreciate all the advice! Thank you by the way, Clutzy, for mentioning the human aspect. It's reassuring to hear that what makes the most difference to the patients is being able to connect with them Few more questions if you all could answer them, What's the Brady Book? What can I get a head start on that will help me through tough classes like A&P? Thanks again everyone!!
  34. 3 points
    holycrapdwaynesbackfromthebush
  35. 3 points
    Listen to lung sounds and hope to feel a bra strap
  36. 3 points
    You won't find any female bias from us here. The females we have here have already beat it out of us and put us in our place.
  37. 3 points
    It's not a dragster, it's an ambulance. Fast acceleration is not a priority, smooth acceleration is. Your partner and your patient will appreciate it far more.
  38. 3 points
    For the record, and maybe I'm showing my age, but my biggest issue was with the attitude of, "Could you please help me, but while doing so, don't waste my time with any of your happy horseshit...I've never done what you do, nor know anything about it, but I know enough to know that other than, within this tiny window, you have nothing of importance to offer me because I've already Googled EMS and know all about it..." It's just such a common, and poisonous attitude in EMS...
  39. 3 points
    Hypothermia is indeed a major concern in the trauma patient. Significant hypothermia (somewhere less than 35 C) in a trauma patient can be disastrous. Proteins in the body like many of our enzymes have a special shape known as conformation. This shape is in part responsible for how a protein works or performs it's specific job. Hypothermia may induce conformational changes resulting in a bleeding dysfunction broadly called a coagulopathy. This results in impaired ability to clot. This appears particularly pronounced in acidotic patients (not uncommon in hypovolemic shock). This creates somewhat of a dichotomy. Controlled hypothermia can decrease post arrest morbidity and mortality but can increase trauma morbidity and mortality. Therefore, it is important to be sure what kind of patient you are dealing with. Trauma versus post medical arrest. Also, hypothermia can be devastating in children but may also be helpful in paediatric patients who are post medical arrest. I'm not sure there is significant data at this point however. Hope that helps. (Bonus points for figuring out how many times I said "this.")
  40. 3 points
    My first day at the University of Maryland Medical System is April 8th. We move there the week previous or somewhere around that time. I finally after 15 years of doing the hospital computer system work have a management level job. Nervous about this HELL yeah but it's a new fun time in my and my families life. Michael
  41. 3 points
    So have we developed a new obesity scale here? Obesity=lose a twinkie, moderately obese=lose the remote, morbidly obese=lose the chiuhuaua.
  42. 3 points
    How about we move beyond n=1 anecdote? What does the evidence suggest? http://www.ncbi.nlm.nih.gov/pubmed/19586701
  43. 3 points
    This thread....officially derailed.
  44. 3 points
    The Troll calling them Ogres? Pot calling the kettle black...no? In what manner? But you fail to mention why they would do such an unprofessional thing. And what did he do about it? On every call or just ones to your house? No Comment, there are enough about NJ EMS here already. Find out what the source is. It may not appear so, but I sympathize with your plight. Unfortunately you haven't really done anything to provide us with information regarding your situation, all you've done is call them names and point fingers at them. Why did they yell at you for 15 minutes? Maybe they had what they thought was a good reason. For all I know you took offense to how they were treating your mother and you threatened them without realising that they were actually helping her. Maybe the police come on calls with them because they have felt threatened by you in the past. How do they mistreat your mother? Do they yell at her? Demean her? Or are they providing a necessary medical treatment to her that you don't understand and when you try to interfere they are forced to restrain you? It just strikes me a bit odd that someone would come here to complain and seek direction from us when he could pursue this along proper channels just by looking in a phone book for the number, filing a complaint with the police, talking to the staff at the hospital....
  45. 3 points
    A word of warning about the EMTB Registry testing. It's really, really important that you believe me when I say that everything on your test is going to go back to the A, B, Cs and scene safety/BSI. The questions are worded in a way that makes it really easy to try and create a complicated question where there isn't one. On every question ask, "is the scene safe? Are they breathing? Is their heart beating? Do I need to do anything about any of those situations? Am I wearing gloves?" I promise you that you will rarely, and likely never, get past asking/answering those questions before your computer based testing is completed. I choose to recert each time by retaking the NR test and each time I've come away (except for the first time) angry at the childish simplicity of the questions. It is almost unbearably attractive to try and make them into questions that would really separate those that have worked hard to become part of EMS from those that haven't, but that just simply isn't the case. Read every single question as being as simple and straight forward as you can. Assume that every question is meant to test students that are, say, two weeks into class, and you will do fine....Trust me on this.
  46. 3 points
    Band Aid, it's known as progress. If you want to be considered more than an ambulance driver you have to do more than drive an ambulance. The push is on for the concept of EMS to go the way of the dodo. Nowdays, many ambulance services across the world have adopted a Mobile Health Services model. EMS is only one component of this service. If any of my medics were to tell me "I went to school to do emergency calls, not to provide post surgical wound care/wellness checks/diabetes education/vital signs checks/medication compliance checks...."well, you get it. My response would be, there's the door, the choice is yours to use it.
  47. 3 points
    First of all welcome to your own thread! Good on you for stepping out and asking a very good question! I am only an EMT so I hope some of the medics will chime in. I am interested in their opinion as well. I have found that many patients with dyspnea that are alert are not receptive to rescue breathing. I find that pulse oximetry is a useful tool in determining how well a patient is perfusing and shape my interventions accordingly. If they need oxygen, that is a good place to start. I try to keep the pulse oximetry around 94%. Discovering the underlying condition that is the causal factor for the difficult breathing will ultimately be the key to improving their ventilation through interventions. The patient might benefit from nebulization or a dose from their measured dose inhaler. The patient might be having an allergic reaction, or have a host of pulmonary and cardiac pathologies or diseases that could be causing their increased work of breathing. If we can identify and rectify the cause we will do the most good in reducing their respiratory distress. I always ventilate adults at the same rate for rescue breathing although there are cases when we would want to ventilate slower of faster such as head trauma or preparing for an advanced airway intervention. In pediatrics I only ventilate if the patient will accept the ventilation. A child that will let us breath for them is an indication that they need the help. If the baby is well enough to fight off the mask he most likely is ventilating well on their own with the exception of an occluded airway which would require other interventions. Good on you for starting an airway thread!
  48. 3 points
    pericardit......awww screw it.
  49. 3 points
    Foreplay. You have something against classic freestyle?
  50. 3 points
    I can guarantee you this had nothing to do with him being a patient advocate as it does with him showing who has a bigger penis.
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