WANTYNU

COOL I LOVE Maple syrup! W-

Ours too, (btw the ear wax thing was ENTIRELY “TMI” :puke: ), but every time I forget mine and use the one in the bag (which is bad enough because it su*ks and I’m old and deaf), I seem to get an ear infection which su*ks even more… Be Safe, WANTYNU

I'd send you a carabineer… but wouldn't want to be acused of buying your opinion. I would like to avoid both those options, after all I started making this thing for myself, it just happened other folks seemed to want them as well. But there are times I wonder if it’s worth all the hassle, at this point for the money it’s cost me, I could’ve bought a nice car! Best. Be Safe, WANTYNU

Boy, Dust, I was thinking the same thing… glad to hear it was hypoglycemia and not ureic acid poisoning…. :roll: W- btw I'm still waiting to hear back on the underling PHYSIOLOGICAL reason behind not using ice. (I KNOW ICE BAD...) :roll:

Folks, Thanks for the outstanding and thoughtful posts, At this point I think it’s fair to give some background to this poll, I recently received an email from a vendor that has convinced me the folks who carry and choose our equipment don’t give a damn about us, just our money. He was bragging that they get knockoff stethoscopes for less than $5 that look just like Littman’s that he sells for $40 + each, (an 800% markup) and other common equipment that doesn’t come to mind at the moment. To them we are a captive audience with limited choices. I wish I could say more about my relationship with this vendor, but I’m pretty sure it’s against forum rules, so I’ll just quote the rep for the vendor. [/font:fc4401ec63] I know I have other hurdles, such as mine for the most part is an “issued” item versus something you buy yourself, the quality vs price debate is answered not by the end user, but by an administrator concerned by budget. I’m not sure you know you can buy a bag of 100 plastic wrenches for $59 dollars (this place sells them for $4.95 each). The point is, for us in the field who depend on our equipment, quality is clearly priority one, but the reality in the market place, believe it or not, we aren’t give the choice. Personally I think this is BS and we deserve better. I guess another question I should ask is: Do you ever go out to buy an item you are issued for free? Thanks again for the thought everyone has put into their posts. Best Be Safe, WANTYNU

So are you and spenac saying beyond quality (which in my experience is next to impossible to tell without using a product), when buying indirectly, the next on the list that would influence you to take a chance is a company backing guarantee? Does that mean failure guarantee (if it breaks it is fixed or replaced) only or must it also include a satisfaction guarantee (money back for any reason) as well? I’ve been told a money back guarantee makes the produce look cheaper. Be Safe, WANTYNU

Also a sound theory, the only wrench I’ll l throw in these money works is: Isn’t it already a physiological response to surface cooling to shunt the blood flow away from the outer skin to preserve core temperature, that being so, if it’s a natural response, wouldn’t the body have a defense mechanism in place to prevent damage to outer layers? As well to the antidotal evidence we see in the field every day with geriatrics using ice & ice packs for therapeutic needs. W-

Awhhhh Dust your making me work... again. (I agree with Spenac, I don't want to work today, you picking on the new guy again?) :roll: But hook firmly placed, I take the bait... After all I come from NYC, I gotta put up to a challenge! It was late, I did make a mistake, but I still say the answer is simple. As for the rest, I did read every post, and I made my statement based on what I read. The reason, stated here for not using ICE, (tissue damage) is incorrect, and I stick by that answer, otherwise, why is ice still prescribed and used effectively for a sprain and other skeletal / muscle injury . When tissue damage from cold for snake bite treatment is discussed, reference is to CRYOTHERAPY, Ice therapy is different from Cryotherapy (which is aggressive wound cooling via carbon dioxide gas, dry ice or other intensive skin cooling). Many answers to this statement. If you reread the literature it’s all about slowing (not stopping the venom flow). Good information, but I didn’t see it as germane to the discussion about topical ice application (not deep cooling). Getting back to point, the question was: “Why don’t you put Ice on a snake bite”. The JEMS article you referenced (which I read when it came out) involves a series of other treatments (mostly ALS, and Definitive), I interpreted the question as BLS (since ICE is a BLS option and we all say BLS before ALS). And I stick to what I said the answer to the question “Why don’t you put Ice on a snake bite”. Ice promotes skin surface vasoconstriction; pushing blood and venom into the body, causing faster absorption than if left alone. Remember the name of the game for emergent (not definitive) treatment modalities is to slow the process down. So I’m disagreeing with Spenac on this one (rare I know), but hey he’s one of the one’s who “toughened” me up (refer to earlier thread on tx of noob’s) so I do believe he can take it. I have no answer for this other then everything we are permitted to do is under physician directed control, If an emergency medical provider does as you describe, he / she is clearly operating outside the standard of care they were taught, and that my friend is horse of different color (horses – Texas, like the reference… ;-) ). But our scope of practice is not based on what it is possible for us to do wrong, if that were the case, I don’t think we’d be allowed within ten feet of a patient. Never implied it, I know at the heart of this we are on the same page and you take this as serious as I do. Well OK then. There is the JEMS article you quoted. Wilderness Medical Associates: Field guide author Jim Morrissey, EMT-P WEMT NOLS Wilderness First Aid isbn 0-8117-3084-0 Paramedic Care: Bledsoe, Porter, Cherry FDA Snakebite Treatment Page (PS forget the SAS survival book, it’s completely wrong…) All of the above state no ice, but make no reference as to why (I’m working on that) I remember reading the explanation I gave above, but currently can’t find the source, but shouldn’t it go to reason, if ice is not harmful to the skin for sprains the same would go for bites? Following that reasoning there has to be a different reason for the contraindication of using ice on a snakebite. I have emailed a physician I know at Jacobi Hospital NYC one of the top Snakebite centers in the country. I will find the answer, and will post it. Be safe, WANTYNU

OK, I’m going to date myself here, but back in 1975 (When I first took Wilderness First Aid) it was use the kit, now it’s not, the caveat is unless prolonged transport time is anticipated, and antidote is unavailable, as in your deep in the back woods and it’s a few days from getting definitive care. I’ve read every post here, but as far as I can see nobody’s given a direct answer to the question, It’s pretty straight forward. The REASON you don’t Ice a snake bite, is because unlike a bug sting, snakebites are envenomated PUNCTURE wounds, that typically pass below the epidermis in the fat and mussel layer (IM), by cooling the skin you do two things, you constrict surface peripheral blood vessels and dilate deeper vessels forcing the venom deeper into the mussel and circulatory system causing the body to circulate it faster. Sorry for not quoting you, but someone here said keep the patient calm, limit movement, and keep the affected limb below heart level all also part of the treatment plan. But the bottom line is: no ice is correct, but the answer is not intuitive. As Always, Be Safe, WANTYNU

A little research question. When choosing emergency equipment what is most important to you. If more than one answer applies just post the order. Thanks, Be Safe, WANTYNU

btw, did you notice how her eyes were all a blaze while she told her little tail... I blame the last line on peer pressure!

Fireman, ya that’s funny, They reserve that for the NYC stories, About 4 years ago we had two trains “bump” underground Pen station, a true MCI with 300 + Patients, thankfully all green tag, the media played it up (of course), but Fire was on top, so much so, they’re PR folks ran the job, we (All EMS) were staged 2 blocks away, the pumpers and ladders were of course in front of the cameras… But you are right, calling her a talking head may be befitting, but doesn’t make it right. Good point. Only I do reserve the name of journalist for the folks who have the guts to go where you are and actually report what is going on (as much as is allowed), so we mushrooms back home have a fleeting (as in tiny) idea of what you are facing. A friend of mine is a medic, and just got redeployed (for the THIRD TIME) after 6 months home with his new kid, going back in March. Even with the stories and pic’s I can’t begin to even imagine how much that sucks. Be Safe (and keep your powder dry) ;-) WANTYNU PS, I can’t help it, did you see the clip? She’s still a talking head…. (sorry)

Thank you, if you haven’t tried it, try the 6 second ECG (under ALS recourses), it’s fun, (how sad is that, thinking reading ECG’s is fun…). Anyway, I now have a rant, its 2007 (8 soon), And my question is: HOW STUPID DO YOU HAVE TO BE TO BE A NEWSCASTER? a) Rock Stump c) Big steaming pile of Sh*t d) All of the above plus some. You may inquire why as an otherwise composed and civil NYC Paramedic would go off on a rant, and I will be happy to share with you the catalyst to this current irritation: (Long Island - WABC, November 29, 2007) - Police on Long Island are on the hunt for someone who threw a piece of wood at an ambulance, which injured the driver. The reporter (wait that implies she can read and write), which is done for her. I Meant to say: so the talking head reads a report, about an idiot who thinks it’s a good idea to throw a LOG through the window at a unit responding to a call, She of course referred to the victim by full name, then states he is: “THE DRIVER”, as well as the "THE AMBULANCE DRIVER", actually at one point she at least calls him an “Emergency Medical Technician”, and after that calls him the “AMT” four times. Maybe instead of the politicians we should start on educating the NEWS REPORTERS!!!! Check out the link: http://abclocal.go.com/wabc/story?section=...&id=5792458 End of rant, thank you for time, you may now go back to your regularly scheduled random thought thread… As Always IMHO, Be Safe, WANTYNU

Wow, Thanks for clearing that up, my bad, for a minute here I was actually thinking this had a point.... Be Safe, WANTYNU

WTF?!?!? I’m not even sure where to begin or for that matter why? We’ve gone from picking on new folks, to education, tough love, to etiquette, spelling, grammar, making apologies, elections, and youth corps, California types, peace, love, surfing, and (yuck) tofu, Hot DA's, Hot chicks vs. whining men (HUH? not even women like whining men), and the Big Apple compared to La La Land, (both filled to capacity with superficial self-involved rich people, who couldn’t care less about us, one will be blown up by people who hate us, and the other will burn up and fall into the ocean from a earthquake, in my book a tie) am I missing something? Well at least everyone’s talking; let’s see if we can try to refocus this. I understand Asysin2leads point on volunteers; it’s a big issue, especially with medics, and this is a questions as old as EMS, where do you start, I started as a jolly volley, and after a year went into the paid sector, so I think I’m qualified to state there is a big difference. Honestly, would you want someone (no matter how pretty) giving a family member potentially harmful drugs, who has maybe done three similar calls in as many months, or a full timer (i.e. Paid) who does ten times as many calls on a minimum? Practice makes perfect, or at least usually pretty good. But that is not this thread, I’m sure you can find a thread comparing paid and non paid, and get lots of opinions, and I’m not poo pooing the subject, I think communities need to pony up and pay for their EMS services, the why buy the cow when you get the milk for free attitude, when applied to EMS is both dangerous and wrong. Were not drivers anymore, we do complex emergency medicine, mirroring Hospital ERs, and in some cases surpassing them, we are not a substitute for definitive care, but for the acute, need treatment now cases, there just is no substitute for on the scene care we provide. To deliver that care, we need ongoing practice, training, updates, review, and more training. This all takes money, from a community leaderships POV why put money towards something they get for free when the park needs cleaning, AND THAT COSTS MONEY… I stray again, (hey maybe it’s this thread, it causes ADD?). A lot of good points have been stated here, but what happened to how we treat people new to this board? Or is bashing just another form of prison initiation? Be Safe, WANTYNU

OK, this is a sign, it’s time to be afraid, be very afraid… Dust has gone soft! He actually said something nice about a dyed in the wool Noo Yawker… I think I see a stocking stuffer TACTICAL O2 wrench in his future…. ;-) I feel so warm and fuzzy, or is that the hypothermia setting in? OK back to the point at hand, I’m not so sure about the “Tough love” preached here, but being able to stand up for one’s self has a valid point. We work in a field wrought with High Risk, Low Frequency events, sometimes with no time to make a decision (Thank you Dr. Gordon Graham). Under those circumstances there is no room for indecisive fear, it’s on you, just do it (Just make sure your documentation reflects your reasoning…) but that’s the real world. This is not, it’s simply a forum for sharing ideas and open discussions, temperance on the part of the forum “elders“encourages participation, and after all isn’t that the goal? Personally I don’t want to hear how well you can write a put down, ESPECIALLY for something trivial, in my book that’s just mean spirited. What I want to hear is how smart you are though genuine discourse (so I can learn), and when I’m wrong, I don’t mind it being pointed out with a salient argument and supporting evidence. Honestly, this is a time when it’s more important than ever that we stick together as a group, let’s scare a few politicians instead of folks new to this environment (there’s plenty time for that on the bus…). As always IMHO. Be Safe, WANTYNU PS. To the paramedic students out there, on my website under EMS resources I have most of my internet downloads and some notes as well as Links I used when I went to medic school, including the stuff I used in my refreshers (including the National), all of it is still great reference and practice material (Drug Calc reference, reading EKG, 12 leads etc). I post it with no strings attached because I strongly believe the better you look as a clinician, the better we all look. Good Luck on your Medic course!

Well put, with that said everyone is human and have lives outside of this message board, so it is up to us to help our moderators and point out issues and to an extent police ourselves (but try not to take the law into your own hands…). A couple of things to keep in mind, there is a fine line between a club and click. You don’t invite a new person into your house, ask for their opinion and then start insulting them. If you do, you’ll find they might not come back, and we are all less for their absence. EMS (big and small) is in crisis, we are under recognized, underfunded (not talking fire here), and have ongoing functional identity issues. Ask most Fire / EMS who they are and most (if they are speaking truthfully) will tell you firemen /women (to be PC). Yet fire is on the decrease, and the recognition that prehospital care does work is on the increase, but the public (and most doctors and nurses) WE ALL HAVE SEEN THE JOHNSON AND JOHNSON Ads, have no idea who we are. Hell, we can’t decide: EMT, EMT-B, EMT-D, EMT-I, EMT-CC, EMT-P, Medic, Paramedic, Paramedic-CC have all been called at one time or another AMBULANCE DRIVERS, our early past sticks to us like beach tar. Yet, we still argue over who’s better, more important, fighting among ourselves, wasting breath and time. Yet still we have no NATIONALLY ACCEPTED STANDARDS for training, practice, population funding (pay), or license. See articles in JEMS this month by Bledsoe, or EMS magazine last month by Scott Phelps two very smart people. (Go to www.ems-safety.com to listen to interview with Bledsoe). If you really want change (and maybe better pay) get political, call your local, state, national representative, and let them know you’ve had enough, let them know you want an identity. There is power in numbers, and we do have the numbers. As always be safe. WANTYNU

I find so much bitching, but not doing. We all know it’s easier to complain, but call your local representative that takes work... But like JFK said, (Well paraphrased anyway) We do the hard things not because it’s easy, but because it right… Here are a few others who lead by example… “Great works are performed not by strength but by perseverance.” Samuel Johnson “Through perseverance many people win success out of what seemed destined to be certain failure.” Benjamin Disraeli “The only thing we have to fear is fear itself.” Franklin D. Roosevelt “Never, never, never give up.” Sir Winston Churchill We will make changes to the system when we want to… Lead, Follow, or Get out of the way!

Great reason for turret mounted 50 caliber machine guns and push bars.... GRRRRRRRRRRRRRRRRRR :cussing:

Ambulette Driver

W A N T Y N U !!!! (OK shameless plug....) :wink:

makes horse poop...

Dinosaurs

DustDevil, Once again you prod me to elicit a kneejerk response, I started this post with something referring to our standards being some of best and the highest in the country (PS we are moving to, as you have always stated we all should {nationwide} a paramedic degree program} and the number of jobs we do etc. Yet another pissing contest, Then I stopped and realized this is the problem not the solution. Every time one of us states “I’m better then you” it puts us all down. Yesterday I was making a purchase, and the store clerk noticed my shield in my wallet, and asked which am I? One of the “Boldest”?, “Finest”? and I said “no”, the she added “Bravest”? Strongest”? After awhile of guessing I finally said “None of the above, I’m a Paramedic” to which she said, after looking slightly confused, “Oh, well bless you anyway”. MY point is in the public eye we don’t exist, and never will until we stop pissing on each other… Nice to “see you” again DD. Best to all WANTYNU PS: now how about some BUSINESS STORIES?

So a couple of folks who visited this forum stated they were thinking of starting a business. What in? Services or production? Let’s hear some stories! Best to All WANTYNU