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captainstandup

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  1. While I do understand the OP's concern for their legal risk on both sides of this equation, I also would offer this opinion. Drug abusers', whether wearing an EMS, Police, Fire, RN, MD, uniform or filthy rags of a homeless person are at their very core drug abusers. No more, no less. Due to the "professional's" access to pain medicine, it makes for a very tempting environment to either steal or divert narcotics to themselves. News media of all forms are replete with seemingly countless examples of prescription med theft and instances of providers "diverting" or stealing narcotics through the practice of removing narcotic meds from vials and replacing it with 0.9% NaCL. In the example offered by the author, it is apparently uncontested that the student has a drug problem. From my perspective, the next time this person presents to class in an apparently intoxicated state, the instructor should contact security and have them removed from the class. Of course college policies must be adhered to implicitly. Once the student is removed from the classroom I would recommend insisting on a drug test to include hair analysis and a urine drug screen. Be very careful in allowing someone you believe intoxicated to drive. You could be exposing yourself to liability. If they insist on driving, call law enforcement. A policy containing the following would be helpful, along with requiring all students to sign a "Drug Free School" agreement. If the students tests positive, they would then be required to produce a prescription validating the reason the substance was in their system. Those without a valid reason for being intoxicated with the substance would be given one opportunity to "come clean" about their drug use / abuse. Dishonest individuals must be discharged from the course for violation of the drug free school policy. Honest students would be referred to the college version of he EAP for counseling and rehab services. Following completion of these services the student would be responsible for payment of periodic and unannounced drug screening to remain in the class. Any positive test would result in immediate dismissal from the program. Remember, regardless of who they are, drug abusers are not rational when needing access to the substance of their desire. Normally professional individuals have and will do virtually anything to satisfy their desire for the substance they are addicted to. This includes stealing meds from cancer patients, stealing meds from anyone they can, including patients they encounter in the clinical environment. It is your job and your responsibility to protect the patients from these individuals at all costs. Clinical Contracts / Agreements are precious to EMS Educators. If just one of your students is stupid enough or addicted enough to violate the trust afforded them by being allowed in this environment, it will be as if they opened Pandora's box. I promise you, if this happens, hell will pour out of it and your clinical agreements will vaporize overnight, and so will your career as an educator if you haven't shown "due diligence" in attempting to prevent the occurrence.
  2. If it was done in an adult cath lab, they had better da*$#d well been certified to perform pediatric heart caths and immediate access to a CV surgeon capable of emergency pediatric surgery. As you are aware, WPW is to say the least elusive and requires extensive mapping to locate the aberrent focus. I agree with one of the other posts on here that RF ablation is about 90% effective in resolving this. Since it seems to be recurring it makes me wonder if there were additional pathways that were missed. One question i have for you, is he on any anticoagulant medications? It seems prudent that he would need prophlactic meds to prevent the possibility of an episode creating an embolus. his of course carries its own set of challenges for a young person and especially an active young person but is manageable.
  3. Perhaps you would consider getting a few pairs of gloves and throw them in your "glovebox" I personally stopped at an MVA on I-40 one morning. A man driving a small pickup truck had been rear-ended at high speed and when I approached the vehicle he was unresponsive and gasping to breathe. All I had was a pair of gloves, but i was able to stabilize his c-spine and remove most of a McDonalds biscuit that had his airway occluded. He began to breathe easier, then normally and regained consciousness. This man did not have five minutes to wait for someone to clear his airway. With this said, if I would have had my kids with me I likely would not have stopped due to the douchebags on the roadways these days. I cannot put my family at risk to go to the aid of others. I have had two trooper friends killed on this section of the interstate and realize there is nothing in the universe more stupid than a motorist.
  4. Too much risk of cross contamination with an absolute host of "cooties" To mention a few, MRSA, CDIF, Flu, Hepatitis, HIV, Parasites such as Bed Bugs, Crabs, Scabies and who knows what else. If you are too lazy to sanitize the cot and change the sheets after each call, quit, find a new job. If by chance it were one of my family members and I caught them doing this, there would likely be an unpleasant parking lot discussion resulting in law enforcement response. Just do the right thing, treat everyone the way you hope to be treated when you need assistance.
  5. Its been a long time since I have posted to EMT City and must admit being provoked to once again join the action by Dr. Bledsoe's message announcing the passing of dustdevil. While I didn't know Rob personally, I did "meet" him through EMT City. Rob and I didn't necessarily see eye-to-eye at first, and continued to see things through our individual lenses. I did learn to respect and admire Rob. We had several spirited discussions within the forums and outside their confines. Rob wielded his intellect as if he were King Arthur wielding Excalibur! Those of us who found ourselves in the way of it's sharpest edge learned not to play with fire or insult Rob with pettiness, but to bring our A game to his arenas of discussion. I can tell you I am a better person for having met him through this utility and I am so very sad to learn of his suffering and his death. It is my most sincere prayer that he find peace, comfort and rest. I only wish I could have know him better and to have had the opportunity to learn more from him! RIP My Friend Randy Fugate, AKA Captainstandup
  6. Virtually any story that starts with an AHA moniker included is usually troubling at best. I'm sure dust has seen the same trend in dealing with the AHA over this many years, in that they are literally for sale to the highest bidder. One only has to look at the ridiculous science behind the AHA touting of vasopressin and amiodarone over the years to see this clearly! Then came the LMA and more suspect science but hey the equipment and medication manufacturers received a windfall every time AHA made big changes and ER's and EMS agencies ran out to purchase an entirely new bottle of snake oil. Little if any verifiable proof ever supported the use of vasopressin and amiodarone and although the LMA is reasonably effective in the OR it's efficacy in a moving vehicle or aircraft is, in my opinion, unacceptable. Students, especially those from a "patch factory" simply must be cautious in buying into any therapy being hailed as the newest and best thing since the discovery of fire. There is simply no way to effectively challenge the AHA given the fact it is an organization designed to aid doctors, doctors that prescribe medications to patients, medications from companies that are publicly traded and whose largest shareholders are, of course, doctors. Nice arrangement isn’t it? Educated providers, such as dust, supported by enlightened physicians make a great deal of difference every day in America and do the right thing for the right reason and based on solid science as opposed to greed or ignorance. Providers should admire and respect these folks and return to school to be worthy of joining their ranks, otherwise we are simply compressing syringes and pushing buttons because an "algorhythm or silly exam said we should"
  7. I believe a lot of times providers make a scene worse. Of course there are armed situations and domestics where we simply must leave or delay response, but I have seen many Paramedics make a situation much worse. Several years ago i was working with another medic, this guy was a real jerk, and was arrogant. He was unkind to his partners and certainly to the patients. We responded to a call for back pain at a local hotel. Upon arrival we find a construction worker who was VERY intoxicated. This fellow was jovial and wasn’t causing any trouble, but he kept trying to light a cigarette. I was trying to get him on the stretcher and he finally moved over to the cot. (The pain was non-traumatic) This fellow put another cigarette in his mouth and I told him we had to get him on to the hospital and that he couldn’t smoke at the time. The guy was arguing with me but in a comedic manner and he was harmless and just drunk but my partner, who was trying to become a cop at the time, was so mad that he finally began cursing and actually reached over and snatched the cigarette out of the patient’s mouth. In a split second the patient open handed slapped the crap out of my partner against the left side of his head. I was laughing so hard I couldn’t do anything to help! The paramedic was so mad he turned the stretcher over and pinned the guy to the floor. Law enforcement was called and felony assault charges filed against the patient. The sheriff’s deputy contacted me to testify and I refused. I told them to subpoena me, but reminded my idiot partner that if I came to court I was going to tell the truth. I never heard another word and the charges were eventually dropped. This is but one example of how arrogance and self importance combined with poor character worsened a situation. This is the same Paramedic that wouldn’t stage for law enforcement when instructed to do so. He was finally fired a year or so later.
  8. Drive only as fast as you are willing to crash! The public's "right" to safety trumps ALL patient situations! Not to mention the priceless value of emergency services staff!
  9. This is the reason I changed our probation period from 90 days to 1 year. Even an idiot can behave for the first 90 days, it's the other 275 days that usually reveal a new employee's character. Another advantage we had in NC was the fact that it's not a "right to work state" therefore provided the paper trail was created properly I could toss a ner do well employee regardless of tenure.
  10. A few years ago some medics ran into a great deal of trouble for starting IV's on each other during our state EMS convention. They got trashed the night before and really really sick and one of them had brought fluids in preparation for the festivities. Somehow an OEMS official learned of this and they were brought before the state EMS disciplinary committee for practicing medicine without a license. I don't know what the outcome was.
  11. Not really, I had simply decided to crawl into the gutter with Zippy for a bit. By the way dust, I already mentioned skilled nurses such as yourself in an earlier post. I have a very tame ego and am respectful of those deserving respect. An idiot with the misguided notion that a nursing license gives her/him superior clinical ability and especially outside the hospital is unworthy of my respect. Its highly unlikely that zippy has more education and experience than many lowly paramedics she/he seeks to degrade. I was merely trying to illustrate that not only do many paramedics have a great deal of education, but also are cross-trained in technical rescue, search and rescue, vehicle extrication, collapse rescue, trench rescue, hazmat EMS, high and low angle rescue, swiftwater rescue not to mention virtually all of the silly alphabet classes the nurses are certified in. You, of all people, know this better than most. I suppose the point is not only can we deliver excellent care but we can deliver that care under very adverse conditions. I am a bit suprised by the fact I was drawn into this silliness with someone who doesn't even live in the US, therefore her/his opinion and $4.99, (US) will get you the Big Mac Special at McDonalds.
  12. I could feel the Dolphin loyalty! I would likely have pulled for the "taliban" over the Patriots as only a true Dolphins fan would! By the way where is Bob Greise these days, God knows we need him and hey, he's only 63!
  13. No but these "tucks" had a really strange odor to them and for some reason my toothbrush was in a bottle of 151, oh and the Q-Tips are in a jar of homebrew and my bottle of afrin caught on fire. :twisted:
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