Just Plain Ruff

study synopsis from 1987 - re: cost of gunshot wounds. I love the last sentence of the synopsis. http://www.corronline.com/pt/re/corr/abstr...9856145!8091!-1

I always admired Paul Pepe but he always reminded me of someone who had just come in from the jungle after a 3 year stint with the natives teaching them the finer points of doing a needle decompression in the deepest parts of South america. He seems like he'd be a great person to sit down with and shoot the sh*t with.

thanks

Imagine, running in front of a bunch of 1200 pound bulls, losing your footing and getting stomped. http://www.thekansascitychannel.com/news/9506099/detail.html

I Believe that this is a new study out there. Cited in numerous other articles. but not sure of the date. Enjoy http://content.onlinejacc.org/cgi/content/abstract/29/3/498

For instructors out there. Jems has released their Jeopardy game at their site. Here is the link. Have not tested nor reviewed but I have heard good things. http://www.jems.com/jemsjeopardy

I have an issue with the following statement that I read in the article in the original post!! Dallas is one of 10 North American cities chosen to participate in the largest-ever clinical trial of resuscitation methods, a designation local doctors and researchers say will make North Texas one of the "safest places in the country to have a heart attack or a car wreck." Being a cynic --- safest but I think that only applies to the people chosen to get the new treatment. If you don't get the new treatment then it's just like any other city don't you think The study is wonderful and in the end it will benefit all of us and I'm all for it. I just want to be the one who gets the test treatment and not the treatment that we would get anywhere.

Ncmedic, well your first post was both informative and insulting with the Grow up people comment. So be it that you are done with it. If it was any other service that had those pics taken we would have gone down the route of what's wrong with this picture also. Be if volunteer, paid, ems, non ems, police, security guards what not - when care is not rendered correctly then it becomes a prime example of starting a good teaching point. the lay public have no clue that the guy was not packaged correctly. All they see are the HEROES of the NYFD again in the news dragging that Nutbag out of the house. They see the helmets and coats and say, WOW those guys sure are brave. Didn't you have a part of your class for emt or medic that went over what should have been done and what was not done. Critiquing these pictures is no different than the M&M rounds that physicians go through on a weekly basis at every hospital in the United States. I bet that the supervisors of the NYFD/EMS who saw this picture were asking hard questions. Sure they had to get the guy out of the rubble and into a safe place but it appears that not everything that should have been done after the fact was. I never thought that this post was a anti firefighter post but it was a post about what was wrong in the picture and what needed to be changed. The actions we perform every day have real life consequences on patients. I don't know if you watch ER but remember the time when Pratt was tubing the guy with the really stiff neck- some sort of disorder he had that I think his vertebra were fused and he pulled too hard and paralyzed the patient. He thought he was doing the right thing, thought he could handle it and in the end the results of his actions paralyzed the boy from the neck down. He stepped up to the plate and admitted he did this and told the patient he was sorry. The question to be asked is not how you act when you are being watched yet how do you act when you know you aren't.

I know buddy, I just wanted to say I did learn some stuff from it.

I don't consider this a useless thread ACE my friend. I learned a lot yet I think some people only read the last page or what not and don't see the overall big picture. In no way am I saying that this happened here but I know sometimes I will read the last page if the posts have more than 5 pages or such.

Yet it isn't quite yet. Once the personal attacks begin they need to be locked.

Have we beaten this to death yet?

FIRE FIRE FIRE Away at ACE Boom boom flame flame Actually Ace, your posts are almost always spot on. I agree and have no flames to send.

I haven't thought of it that way Azcep. you make a really valid point. I too have been an instructor and let's take ACLS for example. The people I taught acls with would discuss the test before hand and go over each question and answer. I for one did not agree with this practice but it was directed down to the instructors thru the class coordinator. The participants would at times in certain classes be given the pre-test that was the exact same test as the actual exam. The class test was even open book. How do you learn material that you need to know when the test is open book open neighbor. This is a prime example of dumbing down the material. In my paramedic class, we were given the answers to the test only after every took the test. If someone failed a test no-one got the answers to the test until that person passed the test. Many times the test taker was given all the answers to the test between when they took the first test and failed and when they retested. There were no reserve tests that were available so the failing student was given the same test. One final item - before Missouri became a NREMT exam state there was a computer file floating around that had all the test questions and answers to the state exam. I will not admit that I had a copy, nope nope nope. But I do know that before each test many test takers got together and divided the questions up 5 questions per person, 1-5 to test taker 1, 6-10 to test taker 2 and so on. Their job was to somehow remember or surreptitiously write down somewhere the question and the 4 possible answers. The test bank of questions was quite complete. I had also heard that it was done the same way with the NREMT exams in Missouri. We are all responsible for our own education and if you are given the answers to the questions or given a hand holding to keep your certs up with education and such, then did you really learn anything?

So who chose the "NOT ME" Its everyone elses responsibility choice? Hopefully you were joking.

Those were hilarious. thanks

Ashman's Aberrancy UCLA School of Medicine, Department of Emergency Medicine, Torrance. The refractory period of the right bundle branch is increased when the R-R interval between the prior two conducted impulses is long. Thus, an impulse that arrives soon after the second of two impulses separated by a long R-R interval may be aberrantly conducted with a right bundle branch block morphology on electrocardiogram. This aberrant conduction is termed "Ashman's phenomenon" and is often responsible for isolated wide QRS complexes in the presence of underlying atrial fibrillation. This process may also produce runs of wide QRS complexes that must be distinguished from nonsustained ventricular tachycardia. A case of such multibeat Ashman's phenomena is presented, and the characteristics used to identify this phenomenon are discussed. A brief review of several recent studies on the differentiation of sustained ventricular tachycardia from supraventricular tachycardia with aberrancy in the setting of a regular underlying rhythm is given as well

Ace, if anyone chooses other than the first choice then SHAME ON THEM!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! ! You are responsible for the level of care and knowledge and no one else is responsible. WE have become a society of blame it on someone else and let us not take responsibility for our actions. Just look at the court dockets these days. WE have become a blame the victim society and I read a book called "Blaming the Victim" in a college sociology class and it was as true today as it was when it was written. If you are not able or willing to take responsibility for your actions, your level of care, your level of maturity, your level of education and the like then I DO NOT WANT YOU TAKING CARE OF ME!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! and don't even bother coming to my house to take care of me, I'd rather take a cab or walk. NUFF SAID.

settle down as for the patient in question- how the heck did they get that picture??? Where was the news camera - must have been in a helicopter or something. What is wrong with the picture is that there were a bunch of firefighters and a stupid dumb ass patient in a building that was on fire and such and this dumb ass made them go in to get him. I say if he wanted to kill himself a simple gun would have sufficed. I have no sympathy for this piece of trash. All the other statements about poor care apply here.

Rid your med director does sound visionary. I'd have been happy to work under him. I think that with enough training and the appropriate protocols that this would not be a big deal to admin even now. I'll have to read up on dilantin and such.

Rid, what are the pitfalls of administering dilantin or the other med you noted without having the actual level before giving it. More info please? I think it's a great idea but I know many many doctors who would stroke out if I gave dilantin to a patient without knowing the actual blood level first. Drawing the blood is a good first step but what considerations need to be taken. I've worked for a service that had every med in the book in the ambulance including enough insulin to start a drip. I'm just curious that's all. hint hint note to self ---- read up on drugs again.

i got called jeeves one time when I was an emt i've been called a driver, attendant, Hey You!!!!, Yo!!! Get over here. My favorite is and always will be Cabbie

That excuse may be good for horseshoes and hand grenades, but good god, holy crapola batman. That just tries to pawn off something terrible with a lame excuse. Training, training, training, Dust and Rid and Ace have pounded that to death here and this is a prime example of training. Goodness, no fuel in the hurst tool? cancelling the helicopter and then calling it back ambulance breaking down This is a shame. The litigants from our next case are entering the courtroom and Judge Wapner immediately says "Judgement for the plaintiff in the amount of 1.2 million dollars, renaming the town hall to the family name, and everyone involved gets 5 years of mandatory remedial training" If you'll see Rusty he's got some documents for you to sign. There is no substitute for appropriate training.

Moretzj wonderful to have you here. I think you will contribute greatly here. Follow your calling, I followed one of two callings - EMS and the one I did not was the ministry. I felt that I would better serve man by ems. I now serve in a different capacity - consulting ER's on their computer systems making ER's and hospitals safer. A different calling. I still have this intense desire to enter ministry but unfortunately it is right now out of my reach. If you decide to pursue EMS one thing you might want to consider is a EMS/Fire service Ministry. One thing to remember is not to proselytize to yoru patients unless they ask you or you get their permission first. I worked with someone who did this without permission and it was not a good thing. Many patients welcome someone to pray for them or pray with them and you will be in a wonderful position to help them both physically and spiritually. If you decide to enter into missionary work, then your emt or medic training will be so invaluable that you cannot believe how important it will be. Make sure to take along extra supplies though as the areas where missionaries go to most likely will not have places to get supplies from. I admire and honor your decision and if you ever need anything please do not hesitate to ask of me. I'd also like to hear about your experiences as a seminary student, what school you go to , costs and such. Please send me a pm and we can chat or email me at ruffems@gmail.com AGain, take care and be safe.

Thats a great poem but I have to ask one question. Do you send this poem to every person who has lost someone young or just selective few? I may be in a strange state of mind or have gotten up on the wrong side of the bed but sending poems like this to people you don't know strikes me as just a little bit creepy!!! I may be way off base but why are you looking at the obituaries and sending that poem to people? slam me guys if you think that I am wrong in what I wrote above but I am not sure how I'd react to getting a poem in the mail from someone I did not know. Windsong - You have have the good heart and outlook on things except for what I've said above.