Kaisu

The law sir... is an ass. It used to be legal to do many things that today are considered horrendous.. and illegal to do things that today are considered acceptable. The fact is that the law trails behind justice... and it is people working outside the legal that force the changes.. I see the disney prostitots engage in dress and behavior on television that your children watch that would have you running for the torches and pitchforks if you see it on the gay pride parade. This double standard exists because the sexual preferences of those in power are understandable and ok, while those "not like us" are deemed perverted and obscene

Jealous? Just a partial list of what the straight community acts like in relationships: Simple Assault Dispute/Disturbance with Physical Abuse Aggravated Assault Threats Harassing or Obscene Telephone Calls Malicious Destruction of Property Larceny Rape Theft Kidnapping Robbery Stalking Annoying & Accosting Arson Disorderly Conduct Extortion/Blackmail Indecent Assault Trespassing Peeping & Spying And I don't mean to imply that gay people don't do this too.. far as I can see, we all pretty much act the same.

Let's remove the homosexual element from this for a minute, and talk about another group of people who's sexual expression is not maintstream; BDSM. These are individuals and groups who's sexual expression and gratification is derived and explored with activities outside of mainstream, socially accepted norms. (remember that as little as 50 years ago, in North America, the only socially accepted norm was a man and a woman, married, in a bedroom in the "missionary" style) Many BDSM events are held in semi-public places; hotels, convention centers, etc. Participants are always advised to "not frighten the horses" in other words, to keep extreme dress and displays to socially acceptable levels in the halls and corridors, and to engage in their more creative efforts in the private spaces. And why is this? Because if other guests are offended, they will complain. And if they complain, there will be repercussions. People maintain their anonymity in this lifestyle because it costs them a lot to be "outed" - Jobs, family, custody of children, etc. etc. etc. Many in BDSM claim a sensitivity to the sensibilities of others, buts the bottom line is... people will suffer a lot of grief because they have sexual practices that are not approved by society as a whole. Due to tremendous effort and sacrifice on the part of a lot of people, it is now ILLEGAL to fire people for their sexual orientation. Gay people still face a lot of discrimination in many areas. Gay Pride day is one day to take these activities and make them public.. to be open and proud of the things that fulfill and exhilarate you. It can be a giddy feeling, and yes.. even reckless. There are those that purposefully "scare the horses". That can be an act of aggression and anger. It's throwing all those labels into the face of society and saying YEAH - I AM A SICK AND DISGUSTING PERVERT - what are you gonna do about it? Certain displays offend you? Why? Primal disgust at men sucking each others dicks? Why? Pissing on each other? Why? I am not asking these questions to try and imply that these activities should not be confined to more private arenas (altho if you take your kids anywhere near the vicinity of a gay pride parade and get upset at what they see then you are an idiot. It's not like these things are sprung on people by surprise) but to encourage you to question your judgements about what is and what isn't acceptable in the sexual arena and why? So much of what we hold as "correct" in sexuality in this country is repressed puritanism. Question it. Believe me, your mind (and your sex life) will soar. ... and this offends you Mobey? Why? because he's got an ass crack and a big belly? He doesn't look like a model? Cause he's a guy? Guess what? Most of you macho male EMS types look a lot more like this guy than like the media paragon of human beauty that we wouldn't mind seeing naked. Heaven forbid that we should accept this and like it... It might mitigate the body hatred and self loathing that leads to so much self destructive behavior.

We still use the jelcos.. and have the been shaped plastic basins too.... *** sigh ***

I missed you flaming...

Welcome to the site.. watch out for those canucks tho.. they lull you into a false sense of security with their civility.. they really are batshit crazy.. forewarned...

Just a cursory glance at the literature demonstrates to me that intra-arterial administration of drugs is NOT a good idea. Some of the studies I looked at: Intraarterial Injection of Anesthetic Drugs Bernard G. Fikkers, MD, PhD, Eveline W. Wuis, PharmD, PhD, Marc H. Wijnen, MD, PhD and Gert Jan Scheffer, MD, PhD States in part “Inadvertent intraarterial injection of drugs may be accompanied by serious complications. Management strategies were discussed in a recent review (6) and also in this Journal (7). Several anesthetic drugs have been injected intraarterially by accident (Table 1). Thiopental was one of the first drugs in which this complication was described, being able to cause extensive edema, gangrene, limb loss, and even death (8).” and further “In general, intraarterial injection should be discouraged. However, when IV cannulation is impossible and intraosseous access is deemed too invasive, intraarterial cannulation may be an option. Isotonic fluid administration is safe and drug administration should be limited as much as possible. Among the anesthetic drugs that have been injected intraarterially without adverse effects are fentanyl, midazolam, succinylcholine, pancuronium, and atropine (Table 1). Intraarterial injection of drugs not dissolved in water (such as diazepam, propofol, and etomidate) or with an alkaline pH (like thiopental, phenytoin) should be avoided at all cost.” Extravasation injuries and accidental intra-arterial injection Caroline Lake, FANZCA FRCA B Pharm Christina L Beecroft, FRCA FDS RCS “Inadvertent IA cannulation and injection may be hard to detect as the classic signs of cannula misplacement may not be apparent and the drug may inject easily with few local signs. Warning signs include: The cannula ‘flashback’ appears pulsatile. The flashback blood appears redder than expected. It is possible to palpate a pulse proximal to the cannula. There are distal signs of ischaemia. Inserting the cannula was more painful than expected. If there is doubt as to the accurate placement of a cannula, it could be transduced for an arterial waveform or blood sampled for blood gas analysis. However, by far the safest approach is to remove the cannula if there is any doubt that it is placed in an artery. In the case of arterial lines, a protocol should exist for the management of arterial cannulae which aims to minimize the likelihood of accidental drug administration.6 Complications After Unintentional Intra-arterial Injection of Drugs: Risks, Outcomes, and Management Strategies Surjya Sen, MD, Eduardo Nunes Chini, MD, PhD and Michael J. Brown, MD Abstract Unintentional intra-arterial injection of medication, either iatrogenic or self-administered, is a source of considerable morbidity. Normal vascular anatomical proximity, aberrant vasculature, procedurally difficult situations, and medical personnel error all contribute to unintentional cannulation of arteries in an attempt to achieve intravenous access. Delivery of certain medications via arterial access has led to clinically important sequelae, including paresthesias, severe pain, motor dysfunction, compartment syndrome, gangrene, and limb loss. We comprehensively review the current literature, highlighting available information on risk factors, symptoms, pathogenesis, sequelae, and management strategies for unintentional intra-arterial injection. We believe that all physicians and ancillary personnel who administer intravenous therapies should be aware of this serious problem. Even these few examples make clear that administration of medications intra-arterially is fraught with risk, even in a controlled environment. Some of the pictures I found were pretty graphic. Do not want to do that to a patient.

I saw this story on the Phoenix news tonight. According to the news, the trailer did not qualify for insurance and did not qualify for the 75$ annual subscription. The owners would have gladly paid it, they didn't have the option. Interview with the owners revealed unsophisticated people who stated they were grateful the FD was there because if anything had happened to their neighbors it would have been "awful"

Thank you thank you thank you. You folks never let me down. Of course the victim in this was Vin. He is a friend of Cookie's and she does things for all the people she cares about. It's an obligation to pay forward for all the people that did things for her when she was powerless. Cookie Monster will get over it. Thank you again for the honesty of the replies.

I thought everyday was heterosexual pride day...

That is very expensive. We have a fee schedule here. BLS transports and ALS transports are the same price. There is no additional charge for procedures or supplies. It is a flat rate. The only variable is mileage. The rate is 1300$ and we are in the top 20% for AZ.

10K for an ambulance ride? Holy cow... maybe I need to start a service in you neighborhood

It is not validation that sticks in CM's craw... It's the injustice. She realizes that there are battles you can win, and battles you cannot. If no one calls it what it is and fights it, never change. Is there a fight here? and if so, how to fight it? AK - do you really believe that its one of those little things? Taken in the context of the injustice and unfairness CM (and most women in the field) deal with every freaking day on the job?

Take this as a hypothetical situation. Bear with me as I describe this scenario. I am looking for your comments, as well as advise as to what, if anything, the hypothetical characters described should do about it. Cast of characters Cookie Monster, hereafter referred to as CM CM is an outsider in an insular situation, intelligent in some ways, incredibly naive in others committed to her profession and working hard to get a handle on this whole EMS thing Jake Mains, hereafter referred to as Jake Jake is a firefighter EMT-P. Jake once worked for the same private as CM, then did a circuitous route through various Fire Departments, finally landing in Green Acres Fire Department Jake has been referred to by some as “God's Gift to Para-medicine”. As many young, intelligent and ambitious FF/EMT-Ps, he has made enemies along the way, however with the requisite demographic (young, male and macho) most of this has been forgiven. Jake certainly has more leeway in his interpersonal style than someone like CM, a female and an outsider. Jake and CM had a rocky start (Jake going so far as to tell CM's supervisor at the start of her career that she did not belong on a 911 ambulance). Over the years, CM was under the impression that they had resolved their differences, and while never being close, CM had a degree of trust in Jake, and perhaps naively, felt there was some mutual respect. Radman Anders, hereafter referred to as Rad While Jake can be accused of some arrogance, Rad takes it to the nth degree. Rad has done private ambo, fire and flight. If Jake is God's Gift to Para-medicine, Rad is God. He has quit/been fired from many jobs, mainly because his superior skills, knowledge and general all around awesomeness have not only not been acknowledged, but even misunderstood. Some have gone as far as misconstrue street smart expediency for lack of ethics. Rad has certainly rubbed CM the wrong way, as CM has a very low irritation threshold when it comes to posturing, grandstanding and pseudo knowledge (read catch phrases and shallow thinking). CM is careful to not offend, however: certain interpersonal attitudes cannot be disguised. Rad has never had the cojones to confront CM, rightly fearing that in this battle of wits he comes unarmed. Rad, having the requisite demographic (young, male and macho) certainly has more leeway in his career than CM, although does not enjoy quite the reputation that Jake does. (seems just given the level playing field the boys enjoy). Rad hates CM. And to complete the list of characters, we have Vince Lennon, hereafter referred to as Vin Vin is a middle aged EMT-B with a checkered past. His early life experiences include watching his alcoholic father bleed out on a toilet. Vin is not academically the sharpest pencil in the box, but has character and grit. Vin is in EMS for the right reasons. He is fire certified and has worked for small town FDs. Vin was CM's EMT partner on CCT ground for almost a year. Relevant background Jake and Rad both work for the GAFD. Jake has been quite active as an instructor for refreshers, CEUs etc. and is a good teacher. Rad knows his cookbook. He has perfected his skills and is never troubled with conflicting treatment choices on scenes. Rad rarely gets into trouble for his methods of practice and loves to regale others with stories of his brilliance on scene. He has the terminology down pat and comes up with simple, succinct reasons for everything that happens. He is considered a great field instructor for the newbies coming on line and molds them in his own image. Jake decides that GAFD needs to start a medic school. He sets this up. It is Jake's baby and Rad is his right hand man. Their first year of operation enjoys success. Of the 20 or so students that started the program, 14 graduate and 14 pass the NREMTP. CM has the same criticisms of this program as she does of the rest of them in this area – heavy on techniques, learning the recipes, passing the test and light on pathophysiology, anatomy and understanding. Vin applies for the program, along with 20 or so others in the second year of its operation. CM is at one of the bi-annual regurgitations of old power points required to maintain NR certifications where Jake is teaching some of the sections. They talk. CM tells Jake about her partner Vin and reiterates that she thinks he will make a great medic, given he can pass the didactic. Jake re-emphasizes his personal policy that if the student is willing to make the effort, Jake will make sure they work with him/her and get them through. Knowing that Vin never gives up and works very hard, she then asks Jake if a letter of recommendation from her would help Vin get in. Jake states that it will. CM provides a letter and Vin gets into the class. There are issues from the beginning. Vin, as expected, is struggling. He expresses his doubts to CM many times. Vin feels the program is badly structured and taught. He has problems with differences in teaching between Rad and Jake. Vin questions the quality of guest instructors and has a hard time making the grades. He wants to quit before the cut- off date to get his money back. CM discourages him from quitting and talks him out of it many times. This program has the “get less than 80% on a test and you are out”. Vin gets a 79% on a test. Jake takes him into a back room and tells him to go over the test and find something he can make a valid argument about for the extra point. Jake tells him if he can justify an answer Jake will give it to him. A few minutes later, Rad walks into the room and makes a heated case that what Jake is doing for Vin in unfair to the other students, unethical and wrong. Vin is out of the class 1 week after the deadline to get any of his $3,500 back. Vin doesn't give up. The following spring, he enrolls in a community college paramedic program. ( to get in, he has to pass a pre-Algebra Math competency test. Vin doesn't even know how to do fractions. CM tutors Vin in Math for 4 weeks. Vin works his ass off, learns it and passes the test.) Vin is passing this course. 3 months in and he is maintaining an 82-83%. The class is assigned a presentation with a large amount of points on the line. Vin is computer illiterate. He gets together with CM, who helps him put together a power point presentation. Vin and CM are in the backyard taking a cigarette break. CM says “I've been thinking.. I wonder if I helped you or hurt you with that recommendation to GAFD last year. Just wondering based on how things came down for you”. Vin hung his head and was silent for a minute. He said “The day they called me and told me I was in they also said it was conditional.” “They said you are in as long as you never let CM precept you”. Vin said “I didn't tell you because I didn't want to hurt your feelings”. CM wants to know who made the call – Jake or Rad. Rad had made the call. Vin was provided with no reason for the condition. CM is angry. She tells Vin “ I thought Rad was a cowardly piece of shit. It appears I have overestimated him. I didn't think he would stoop so low as to get to me through you.” CM and Vin go back to work. (Vin aces the presentation) The class that Vin was cut from was the last class GAFD held. Not surprisingly, the program had serious problems and was eliminated. Jake had lit out for one of the remote gigs in the foreign sandboxes. CM is not sure where Rad is at these days... CM found Jake on one of the social media sites and set him a message. He immediately responded. She then asked him about the condition on Vin's acceptance to GAFD Medic School. Jake has not responded. I always rely on you folks for good solid advice, and for a shoulder to cry on too. What would you tell our friend Cookie Monster about this hypothetical situation?

LOL,, well I was rude... and the guy took me to task for it... so I wanted to explain why.. Now stop irritating me you two...

oooo.. I think I like the new ruffles

Sounds interesting. Do you have the study? Can you link to it? thanks

Not necessarily physical survival, but survival of the ego state... scratch hate - find fear loathing and despair.. usually of oneself....

As you have already figured out.. the cat is not "playing". The cat will not get close enough for the prey to harm it until the prey is good and dead. Those bats are designed to elicit defensive behavior from the pray, causing it to expend energy and weaken. When its no longer "fun" - the prey is good and dead.. it is safe for the cat to eat. However, how "intentional" is cruelty in humans? We only call it cruelty because we believe that as sentient human beings, the cruel "should" be thinking about what they are doing and recognize it as "cruel" based on our and our society's general acceptance of what is cruel is. I have yet to meet a criminal (except for the psychotic) that didn't think that they were a good person. What is one man's cruel is another man's survival strategy.

I swear those pictures were photoshopped....

headslap.. yeah.. old shit dies hard... and even harder in some parts of the country than others. So much depends on the involvement/interest of your medical director. If you have a doc that really cares about EMS and his patients and has the time to devote to staying on top of the evidence it is reflected in ongoing education and progressive protocols. This is by no means a one way street. If medics are interested in ongoing education and learning, they can bring things to the attention of a medical director that is open to it. This site is a wonderful resource for that. How often do we learn about something really great in another part of the country (or the world) and then shake our heads at how woeful our area is? How many of us actually muster up the evidence and take it to our medical director? How many of us have a medical director we are comfortable doing that with? If we don't do it, why not? If we are not comfortable doing it, why not? I think these are two ways in which we can make a lasting and positive contribution. So why don't we?

Help me out here.. what is LSB?

You know Ruff.. you are really very sweet.

only illegal if they are same sex yaks

I think it's some Mongolian sport involving yaks and grease....