Just Plain Ruff

but it's not my opinion that counts. It's the opinion of management of your current job that counts. If they say no tatts below the elbow so be it. If they say no body art of any kind and "We check" then no body art of any kind. I think the bottom line is this, take the most conservative service out there, I worked for them, they said no visible body art anywhere on the body. If it isn't covered up by a polo shirt and shorts then you cannot apply to work here. No piercings of any kind except ears of women. They were firm in their requirements and if you went out and got drunk one night and got a tattoo of you "Mama" on your arm and it wasn't covered by your short sleeve shirt then you were gone. Bye sayonara. They were extremely strict on this one policy. So I would advise this for all those who are looking to get a tattoo - if it isn't covered up by a polo shirt and shorts then think long and hard about getting one because there are going to be services that will not hire you or WILL fire you for tattoos. Better left unseen. Humorous story - I was on a plane and there was this little old lady sitting in the middle seat of a row of seats. I was right next to her. This guy came and took the window seat and he had KKK and skin heads tattooed all over his body. He had skull tatts on his bald head and also the words "Die" on one hand and "Jews" on the other hand. She asked him to move. He refused. She then rang her call attendant bell and asked the flight attendant to move him because his tattoos offended her. The flight attendant asked the guy to move and now he was just being an ass. The flight attendant asked the lady why she wanted him to move and she showed him her Concentration camp tattoo and the flight attendant said "I understand" the guy didn't move and became very angry and nasty. He was then removed from the flight by two Connecticut State troopers. The entire plane clapped as he was led off the plane. It was a good day. Some tattoos offend people and this was one of those tattooed people that offend people and this is why people have such a negative opinion of tatt's. The person may be the nicest person in the world but to have a tattoo gives them a negative connotation and impression that is very very hard to get past. So I've already said I have no problem with tatt's and I have no problem with those with tatts, but you need to be able to do your job and do it well and I expect nothing less from anyone else.

I second Asys's statement on the cardiac arrest and the no fly - Every helicopter service I've had a chance to use have never responded to a cardiac arrest. Now if it's a post code then yes they will come but not an active arrest. If the patient arrests in the helicopter then that's a different story.

See Richard, You really can't fix stupid.

yes yes yes yes yes CALL PD on this one. and there is no reason that a bail enforcement agent is going to get in my ambulance. PD is gonna be there. No matter how mad it makes Dog The Bounty Hunter.

wow what a corner this thread has taken. Good good discussion

Lady, this shows some guts to come back and reply after the beating that I hope you didn't misconstrue There are some really bad reasons for a ped to seize and even worse for that patient to go cyanotic. The first thing that I'd have looked at was how his head was positioned on the cot or for that matter in his moms' arms. Was he in his mom's arms or on the cot. When kids go cyanotic there is usually a reason and many times it's as simple as re-positioning the head and ensuring an open airway. I had a 5 year old one night sitting on a couch. he was nearly in an arrest state. His sat was 63%, his heart rate was 40 and he was grey in color. I was able to move him flat onto our cot, open his airway and give him some breaths via the BVM and wham bam, color improves, heart rate increased and LOC increases. Your original post sure did make it sound like you just thought of this as a basic level call and nothing more and I'm sorry we assumed that but that's what it sounded like. I as a basic would have never ever have gotten a cardiac tracing because that is beyond my scope and I can do nothing with it. It makes not an iota of difference in my care and could eventually have hurt you because the parents could have come back and said, "she put him on a monitor, why didn't she treat what she saw" I am also glad you clarified the no als available - that makes more sense. This is the call that many many many providers dread, having a critical child in your ambulance and having the parents along for the joyride. If this was me I would not have allowed them to accompany us but your decision is yours to make and you have to justify why you allowed them in. I can't criticise that. I hope that this kind of case makes you into a better provider because these experiences add to your knowledge base and I hope that this one call prods you to go to medic school as I think you are destined for better things than just being a basic. I am also offering condolences to you for your loss of your husband, never a good thing. I strongly urge you to hit medic school and get that licensure, think of all the good that you can do with a medic license. It would benefit you, your service and the patients you provide for. Keep up the good fight. **note, now sing the chorus to Kum-by-Yah!**

Great answer Dougd. those are all questions that should be answered before any of us go on to chastise or post negatively on this provider. I love pediatric patients but they still scare the crapola out of me especially the ones who are critical. I'm not sure what an EMT is doing going for a heart monitor other than it being an AED and then I'm suspect. As far as I'm concerned the primary cause of this patients frothing and cyanosis is respiratory and that needed to be corrected which it was by the BVM. (good call). I'm also curious as to how long this patient had been seizing? did the first responder notify you that he was actively seizing or was that activity from the call to your arrival?

Boe, I'm not sure what your issue is then? What real answers are you wanting? That its ok for you to have tatts? Or are you wanting answers to how to deal with patients who have issues with your tattoos?

Then I noticed my patient had become cyanotic, then I asked my partner for the pedi BVM and get him hooked up on the heart monitor. Heart monitor? are you a basic or a medic?

Yes unfortunately this call was fraught with issues and pitfalls and I don't want to jump all over the OP because if all she had available to her was a Basic level of provider then there is not much she could have done differently but.... I would bet that her pats on the back would not be so enthusiastic if they read what she wrote to us on her post. Lady, we'd like to hear more about this call.

honestly, boe, I could care less whether my partner has a tattoo or not. As long as they can take care of a patient and I trust them then more power to them. You have to consider how the patient's perceive them though, that's the reason for the rules against tattoos I think. But personally, I don't care if they have tatt's.

Great advice MedicCraig but unfortunately no matter how much you prepare and teach the drivers out there, the oddball driver like the elderly dead guy is gonna rear it's ugly head. I doubt that no matter how many lights and how loud the siren that there was no way that that accident was going to be prevented. Remember "you can't fix stupid"

I don't understand, do you have medic backup in your area? If you do why did you not request ALS intercept for this child that was obviously in real big trouble? A glasgow of three? I'm also concerned that you became very concerned at the point that he started to froth at the mouth, I think you should have been concerned much much sooner than you were. Any time a 3 year old is having a seizure is more than a basic call. There are some very very serious reasons a child would sieze and as a basic it's hard to keep an eye on the big picture. Not trying to beat you up on your "save" but I'd like some more info on why you thought that a seizure call for a 3 year old was "just a basic call" If you only have emt's available then yes it's just a "basic call" but if you have medics available for intercept then someone on this call dropped the ball. I'm glad the kiddo did ok. I think we are missing some important points?

Thanks for the reminder that we all are not perfect. If you go back and review 95% of my posts you will find that spelling and grammar are correct. You found one of the 5 percent. This person put's 3 posts together and there are more spelling and grammatical errors in 3 posts than in all of my recent posts put together. I do not call kettle's black. I wonder how long it took you to get your post completely grammatically correct so no-one can call you out. But I digress, you caught me, Bully on you!!!!!!!

was this letter written directly to the original poster or was it a copy from a friend of a friend of a friend?

yes, every park in Raymore MO (we have 5 parks) have this type of surface. I've been to all 5 of them and I have never had an issue with the temp of the matts.

nor would I put it past them.

The only thing I have found is that many of the courses (out 1800 or more to choose from) only have sparse contents and some not at all. I have spent countless hours looking at some of these courses and many are really good and have a lot of content but some do not. Take that for what it's worth. You may have to go through a couple of courses before you get a good one.

Maybe going to the top of this thread and clicking on the links might get you where you need to go??? just a thought.

Has anyone seen the video? Have you read the book. I have not done either but I have purchased the book but it's number 3 on my list to read. The Author Randy Pausch died last friday of the cancer that he talked about. I have begun to write my Last Lecture and I hope that you consider to do so also. I think it would be a great learning experience. To begin, just write what you think you would want to say if you had been told you had 3 months to live. What would you write about, what would you bring up? I am 3 pages into my last lecture and to say the least it has made me re-think almost everything and maybe do some things differently in the future. Who knows. I'll post it on my blog here when I'm done.

No Wendy, I didn't miss your post, I thought mine was more eloquent. I have had a crappy travel day, first my expenses were not put in the bank today due to an error on my companies part. Then some of my expenses came in from two weeks ago that were incorrect by the companies I dealt with and they overdrew my account, and now I have been without food and drink except for water since 8am today. My sugar is running a bit low, being a diabetic and all. So I'm crabby.

Wildfire, can I ask you a question, can you put together a sensible question. Each of the past 4 posts by you have been poorly thought out poorly worded questions frought with spelling and grammatical errors. Come on, you can do better than this stuff.

It is just those zero to hero medics that think they can triage at the level of the RN. It is just those zero to hero medics who think they can teach ACLS or Pals better than the RN's or even seasoned medics. But those zero to hero medics when put in a position that takes them OUT of the box are the ones who go screaming to their dispatch for a 2nd unit when they have two unstable patients that can go to the same trauma center. We've all seen em. We've all been green and brand new and unsure of our skills but it seems to be that more and more of the short course medics have a limited scope of their ability to function. I am not saying all the 6 month medics are less than stellar but we all know more than our fair share.

6 spelling and grammatical errors for 39 words. Proofread your posts please. Are you talking about police or fire departments? Or are we talking about the military.

Forgive me but letting an emt do triage is similar to letting a 5 year old change your Electric breaker box. Sorry if this offends the emt's out there but really, you think that you can triage someone with 110 hours of emt class. That is absurd. I am more comfortable letting a paramedic do triage(not because that was my favorite parts of the job at the ER I worked at and I did the triage) because at least in medic school you learn additional medical stuff (I know bad wording but the right words did not come to me during the typeing) An RN is the absolute logical choice but paramedics could do in a pinch but triage to me is not the same as triage in the EMS world. Triage in the EMS world is triaging more than one patient into priority to be treated and transported and how many units and helicopters you need. The minimum for triage in the ER should be a paramedic but ideally an RN is best. You also have to look at the hospital by-laws and see what exactly the EMT can do. Most hospitals that I know of and I've seen all the ER's in the KC area, most of all the ER's in the mid-missouri area and not one has EMT's as their triage nurses. I've worked with ER's to computerize them all over the country from Colorado (level 1 trauma center), New York City (level 1 trauma center), Detroit Michigan, Dubuque Iowa, Sioux city Iowa, Baltimore maryland(shock trauma and Mt. Sinai), Olathe kansas, Springfield Mass, Mayo Clinic In Jacksonville, St. Vincent's in jacksonville, St lukes in Jacksonville, St. Josephs, Patterson NJ, Jackson Health System, miami Florida, Butler MO, Nevada Mo and many others. All those listed do not have emt's at triage. Maybe EMT's at triage for vitals and the like but never doing the triaging. All these above hospitals cannot be wrong. Sorry, not