Just Plain Ruff

But couldn't the receiving doctor have asked us to add those additional items that would have helped the guy out. I'm not sure what those items were but they were the talk of the ER at that moment. Help me with the names of the additives that would have been beneficial to the patient because we were going from one ER to another and our pharmacy would have had those items at it's disposal to have us give to the patient wouldn't they have?

Missouri, if the chick is pregnant and under 18, then she's legally able to make her own decision which begs the question if she is under the age of consent, and she's under the age of adult hood and she got pregnant which is usually under the age of 18 a BAD DECISION why the HELL should she be able to make any other smart decisions when she's proven she cannot make one good decision? The above statement is not intended to be a blanket statement for all pregnancies, just the ones where the girl or boy didn't use protection or were just stupid.

Umm, How did you get those coordinates, you were not on the approved list, hence the no sleeved jacket.

This scenario sounds like this one Transfer by ground ambulance - birds can't fly in a blinding blizzard. Guy has a significant leaking AAA and he's going to die, it's just a matter of time. I'm the driver, I have three nurses in the back of the ambulance. They are given 9 units of blood to give to the guy during the transport. Were told if they can get all 9 units in so be it, but get as much in as you can. Takes us 2 hours to get to the big guys, about 20 minutes out of the big hospital the AAA pretty much ruptures and we end up doing cpr on him the rest of the way. On arrival they crack his chest and a shitload of blood goes everywhere, the proverbial bloodbath. All i hear from the ED Staff and the docs is "What the hell was that Ambulance crew thinking dumping all that fucking blood in him" and the nurses at least stood up to that criticism and said that our docs were told by your doc to put as much blood in him as possible to keep his pressure up. It shut them up. We dumped 7 units in the guy. The main criticism that was levelled after the fact because they did get him out of the ER alive was that his blood levels were so far out of whack because we didn't give any of the other fluids that were needed (I draw a blank as to what those were) in order to keep his electrolytes and fluid levels at a safe level. forgive me for not having those additives in my head right now. But the guy survived only to die two days later from DIC or some other nastiness.

Hint - Dudley Moore Starred in it and Russell Brand made a horrible remake of it in the past two years.

but you didn't answer the question posed.

If you knew terri like we knew terri, Oh oh I need a drink. What movie was that from? Substitute Susan for Terri and you will have the actual movie line.

http://www.foxnews.com/us/2013/03/05/spokesman-says-woman-who-refused-to-give-cpr-to-dying-87-year-old-wasnt-nurse/?test=latestnews Hating to say I was right, but the nurse or activities director, is on voluntary leave and she's soon to be out of a job. She's the sacrificial lamb. I'll bet the voluntary was only voluntary in name. She was probably given a choice that she couldn't refuse.

I'm going to my bunker, meet me there. All others who have been pre-determined as having access to the bunker please make your way to the coordinates in the incoming text message. I've got plenty of protection from the Obama/Holder Drones.

I think she might have been the woman who knew too much.

because you are deluzionalized from your life of being delusionalized.

No the sensation would be "time is brain" or whatever the current mantra is. Wait a second, Wasn't this a result of the Sequester cuts? OR was she a victim of the Obama Death Panels?

Triemal, I'm not saying the nurse was wrong, never said that, I just said it bothered me that she sounded so disconnected. Again, I've never faulted her for following policy, never once got on the band wagon to villify what she did was wrong because I don't think she was in the wrong in the least. I just was bothered by her flat affect. And I am totally seeing where you are coming from and I'm not arguing that your point is invalid either, we see things differently and that is what makes it nice to have a debate like this. If I were a manager would I want 100 more of her working for me dialing 911, I think I might because she was able to relay the particulars without being stressed. What I tried to say in my original post was that as a dispatcher in the past, I never heard ANY caller from a nursing home who sounded as calm, cool, detached and collected as she did. As a manager, that's the type of person you really want working for you to be able to give the info to the EMS staff or 911 dispatchers. Don't you wish all callers could give as good info as this lady did on the phone. Plus she really held her ground against a very persistent dispatcher. But she better polish her resume. She can now put in her highlights or bullet points "Overnight Media Sensation"

I'm as guilty of that as anyone here but once I realized that it was easier to not fight than to fight the person and often times in my few poke the bear get the bear furious episodes it resulted in a lot of paperwork, I found out that you really can do a lot more with honey than with the bear stick. Amazing how much just talking and finding common ground such as kids or hobbies or common interests can defuse a situation. But when it really comes down to if he's going to kill me or I'm going to kill him, He's going to lose every single time if I have anything to say for it.

Like I said in an earlier post, If the lawyers got ahold of the family I'll bet the family start to see dollar signs on the horizon. Here is what will play out. 1. The daughter will hire a lawyer 2. The daughter will sue 3. The facility will fire the director and the nurse who made the call 4. The facility will change it's policy to keep from having this happen again 5. The facility will settle out of court and we won't hear what the settlement terms were 6. The dispatcher will be hailed to be a hero for all elderly people in the world who might be forced to have CPR withheld from them by the MAN 7. EMS will be working a lot more codes 8. We will have a lot more loved one's who should have died but didn't and we get to visit them in full nursing centers because they were "SAVED!!!!!!!!!!!!!YAY YAY YAY" by the heroic efforts of the 911 system when they should have actually have signed a DNR or something to that effect. But the nurse is going to be fired and the policy of the facility will change within 3 months after a stringent review of what happened.

Yes Rural, I know exactly how you feel on trying to find clothes that don't show everything. Even stuff from Walmart or target which we usually get have gone down hill. We have found a wonderful little shop over in Shawnee KS that has some great outfits but they are a little pricey. If you get near that area and are interested in the shop let me know.

Welcome to the city.

Actually I don't think we are really very far off in what we are trying to say. I do agree with you that she might have done this thousands of times before thus making her an expert but honestly I don't agree. Here's where I think we disagree and let me see if I can get it right. You think that she might be a pro at calling these things in. I see that and can understand that but she has no emotion in her voice and that's what got me. I mean there is no emotion in her voice that leads me to think that she cares about this lady. It's like she's an automaton and that's what's got me. I'm sure that she's was just doing her job which required her to make the phone call and deal with a very persistent and irritating dispatcher. I am NOT faulting her for doing her job, sticking to her guns on the no cpr policy. I've just not heard anyone on the phone like that with that level of tone in a very long time. The last time was a psych patient. Again, I'm not faulting her, nor villifying her for doing her job, jsut the unemotional side of it. Does that make more sense?

What I was saying is that the caller didn't sound like any caller from a nursing home that I've ever taken a 911 call from. You do have a good point Triemal but she was just so detached, that's what I can't get past. But maybe she has made hundreds of these calls and she is an expert at it. But I do have to disagree that an 87 dying is a routine event, sure it's a routine event all over the world but at that facility if it was a routine event to the point where this person was able to talk about it so calmly and detached, then they must have a lot of 87 year olds dying and a lot of vacancies opening up. But I digress, her demeanor is what pissed me off, I'm not upset whatsoever that she didn't do CPR, nope not a dang bit upset. As for MikeEmt, I've been saying all along that there is more to this story and that the media SUCKS big donkey balls and they report whatever the hell they want to report and don't really care who they hurt. The media has blown this way out of proportion and I'm actually sickened at the amount of coverage it has gotten when there are hundreds if not thousands of facilities with the same policy all over the country. I would bet if you called the nursing facilities in your catchment area you would get across the board differences in how they treat and respond to patients in cardiac arrest, I'll bet you that for every 10 facilities you call you will get 10 different answers. I agree Mike and I've said it throughout, we do not have all the information and crucifying the nurse isn't productive in this.

My first day at the University of Maryland Medical System is April 8th. We move there the week previous or somewhere around that time. I finally after 15 years of doing the hospital computer system work have a management level job. Nervous about this HELL yeah but it's a new fun time in my and my families life. Michael

Ok, this story has made headlines in my city, KC MO area. The local news went to the local nursing homes and retirement communities owned by the one in story and maybe this will put some light on this whole thing. The policy of the locally owned facilities is that they are to call 911 and then it is up to the facility and it's staff members to do what they feel comfortable doing. So my suspicion is that if that is the policy of the local facilities then that is the policy of the national headquarters. I bet that what will come out is that this particular nursing home's policy is that they do not want their staff doing CPR but as a overall policy for the company it's left to the local facility to make their own policy on just this scenario. But as a side note, I'm really pissed at this nurse. She sounds so disconnected to the whole situation. She sounds like she just doesn't give a shit and she couldn't care less about the resident. She doesn't sound stressed, doesn't sound like any nursing home/retirement center's nurse that I've taken 911 calls from because she doesn't sound freaked out enough. I'm not pissed at her actions of not doing CPR but I'm pissed because she just sounds like she doesn't give a shit. The actions of the dispatcher although in the arena of trying to save this ladies life were rude, condescending and you can't say she didn't try everything in her bag of tricks to get this nurse to do something. But the dispatcher releasing the tape or the 911 center releasing the tape when the family members had not a single issue with the care their family member received is terrible and bad bad form. If I was the overseer of this 911 call center I'd be cracking heads.

Holy hothouse hell batman, am I reading right that in some places you have to have insurance yourself to cover damage to the ambulance you are driving while working? Say it isn't so. If that's the case, very very slippery slope indeed. I would avoid working in that agency or jurisdiction like men avoid marrying Liz Taylor.

Ok, I was able to get a reviewers copy from a friend in PDF format. Justin's review was spot on but I have more to say on the matter. Here is my review to Amazon.com I too obtained this book and am at a loss for words. The brevity or let's say lack of brevity of content that you provide for the money is lacking and I'm very worried that someone will take this book and use it when they need professional training the most. A course on Behavioral first aid should not be 20 pages long and be able to be read in less than 20 minutes. It should also not be filled with spelling and grammatical errors. The tips that you give are laughable at best and dangerous at worst. You came on the EMTCity.com website and broke the terms of conduct rules regarding advertising as well. For those in the EMS profession that are looking for a book on behavioral emergencies and how to deal with them should stay Far and away clear of this book. A better book would be one that I have in my library called "When Violence Erupts - A survival guide for First Responders" which you can purchase right here on Amazon from this link http://www.amazon.com/When-Violence-Erupts-Responders-Continuing/dp/0763720704 This book cost 33 dollars which is more than Stevies book but you will be Well served by going with any book other than the one being reviewed. The life you save by not reading Mr. Stevensons book might just be your own or your partners. Mr. Stevenson,if you are to read this review, I strongly urge you to take your book off the Amazon market, the Barnes and Noble Market and the Lulu.com market. You are truly doing more harm than good.

I'm not going to finish the scenario because this is meant to be a discussion of what you have in your arsenal of tricks on how to possibly get out of this situation or shit hole you got yourself into by not waiting for the police. (this only qualifies as a shit hole if you have a policy of psych patients having police respond as well) But what have you learned in your schooling, your field experience or just what has worked when you have been faced with a pissed off patient or a psychiatric crisis patient. (I wonder where our resident pamphlet author is on this one). But What has worked in the past for you to talk someone down? What has not worked and what has caused an otherwise normal patient to go apeshit on you? Sort of a what NOT To do type of thing.

So Scenario Called to the scene of a man who says he's depressed and just wants transport to the ED For evaluation of depression. On arrival you beat the Police and being the Stud that you and your partner are, you enter the house with simply the med bag and nothing else. You call out and a voice beckons you back to the back bedroom. You walk back to the bedroom and find it empty. You turn around and find a middle aged man, wide eyed and deranged look with what appears to be a .357 magnum handgun in his left hand. He says "Aint none of us getting out of here today" You(studly medic) and your partner(super studly medic) look at each other. You are able to slowly reach down and press your radio's emergency alert button before the guy realizes what you did and makes you take everything off except for your fabric uinform. Everything but your shirt, pants, and shoes. He proceeds to throw out the front door everything you brought in with you which of course lands in the front yard as the first responding police units arrive. He proceeds to yell "Don't you fucking cops come in here or the ambulance drivers are dead, you hear me?" What do you do now? What are some of the steps that you think you could use to defuse this situation before this house of cards falls down around you. Apart from the "Should have waited for PD" thoughts running through your head, what can you do in the immediate time period before the hostage negotiators get there to get yourself out alive? Have at it guys. (and please, don't use the book that was advertised on this site a few days ago).