crotchitymedic1986

A couple of thoughts that I havent seen yet ? You are looking at the clearly black and white, but are not considering the gray? 1. The hospital can not forcibly admit the patient (unless for psychological reasons). People have the right to go home and wollow in cat poop if they wish. When you do find patients in this condition, it usually takes a Judge's order to get them removed from their hobble. 2. Who says the patient did not have family or a friend who could come sit with them, or an alternative residence they could have went to for that night. His legs were contused, not broken. There are lots of people who live a sedentary life, with a port-a-pottie and a remote control for the TV nearby. I would have gladly deposited him on his sofa or bed, and put the phone next to him so he could call 911 if there were any problems. 3. There is nothing wrong with asking questions or taking a moral position, but you have to ask what will I win by doing so. In your plan, you pissed off your partner, and could have possibly lost your job, but you would have been morally right in your mind. There would have been nothing wrong with raising your concerns, but again, what did you want the hospital to do, once you raised those concerns ? Send a live-in nurse to his house free of charge, admit him to the hospital for a bruise ? Send him to the Ritz Carlton for the night ?

This is not necessarily what I want, but it is what is needed to ensure the survival of our industry: 1. Medical Directors should be held liable for the mistakes of the company's employees. Once they have that fear in place, real training will occur. 2. We need to go to a mandatory tiered system. The current economy will not support double medic trucks, it is a tremendous waste of resources. There is no reason to have EMT-B's, they should be banned from ambulances. 3. I see no reason to mandate college degrees, it just makes more money for the colleges. To those who think it brings respect, would you respect a plumber with an associates degree more than you would one that has no degree but has 10 more years experience ? Our job is a blue collar job, park your ego, and deal with what we are. Be a good EMT/Pmdc skill-wise. An AKC registered dog's shit smells the same as a mutt from the pound. Paperwork does not make you better. 4. All ambulance models should be crash-tested and brought up to car standards, airbags in the box, better restraints, more crash worthy in a rollover. 5. Any shift longer than 12 hours should be banned. If a longer shift is still permitted, you should not be allowed to work the shift immediately following, at any provider. 6. No one under the age of 21 should be allowed to work in our industry. I am sorry, but if you have 1-2 years experience driving a car, are you really competent to drive an emergency vehicle ? Wonder why you dont see any 16 year old 18-wheeler drivers ? 7. You should have to pass a real "skills test" atleast once per year, where failure means you come off the truck until you prove your competency (every drug, every skill). 8. You should have to dress like a professional (no tshirts, no polos). 9. Each department should reflect it's community in minority make-up in employees and financial budget. We have been too "white-male" for too long, where the money goes to supplement the pensions of old white guys who make decisions that help the future old white guys. If your population is 70% hispanic, your workforce should be 70% hispanic, which means you have less white chiefs, and use that money to produce scholarships to medic school. 10. Your system should be profitable, or atleast break-even financially. The tax payors should not have to waste money on your chief's EMS Kingdom, full of too many non-productive work hours (hours not running calls), expensive trucks, too many personnel for call volume, not enough cheaper BLS trucks to handle the majority non-ALS calls. To do this, private interfacility transport services should be banned, all ambulance transport that occurs in a companie's "borders" should be handled by the licensed 911 provider. If you are not good enough to be a 911 provider, you should be in the wheelchair van business. Thats my short list, I am sure I will add more. Good TOPIC !

You are making a big mistake if you base your job search on hourly pay: 1. The places with the highest pay rate will also be the states with the highest cost of living. I am sure New York and California will rate high in pay, but a one bedroom home will cost you three times what it costs in other states. 2. There is probably a catch. If a system is paying far above the norm, it is probably because they HAVE TOO, to attract you. This means you will probably run twice the normal call volume, or work in an area that is similar to a combat zone. 3. The pay rate may be higher because of the hours worked. If you are paid $10.00/hour on a 24/48, you will earn 28,600 per year. If that same system has traditional 40 hour week positions and pay the same yearly salary, the reported hourly rate for that job would be $14.01/hour, but it is still just $28k. Rather than chase $$$$, find the area you want to live in, the company you believe in that also matches your values and desires, and learn to live within the income that system produces. There is nothing worse than being trapped in a city or pay rate that you can not afford to quit.

As 2010 draws to a close, I thought it might be interesting to read what your service improved this year. I am guessing that most of you had some kind of CQI or QA/QI project that you worked on. So what was the outcomes, maybe another service can learn from your success or failure. Your ideas may spark someone on here to start a project for 2011 at their service.

I think polos are fine, if you work at McDonalds or Wendys

Is it just me, or is anyone else tired of seeing people in our professions wearing nothing but a t-shirt on calls ? I think it is ridiculous that we allow such an unprofessional image in our industry. I am not saying everyone should wear a tie, but can we please put on a uniform shirt ? What say you, are polos and T-s the way to go ? Is dressing like a landscaper professional ? And can we have some fashion police for the 300lb medics ? You do not look good in that t-shirt, with your belly hanging out of the bottom !

The troll would answer that all laws are based in a "moral code", which is usually based on the predominant religion of the land (for better or worse). For instance, note how Saudi Arabia deals with crime versus the United States; they have a different set of laws and punishments that have roots in their religous principles. The troll would also argue that all males who are pedophiles who seek out young boys, are homosexual. Who are gays hurting ? A religous person may claim "society". If you remember, Rome was a great society until it gave into it's sinful wishes, and ultimately collapsed. I imagine many religous people would look at the plight of America today and would blame it on our sinful nature. You should also remember that most people believe that AIDS was brought to us by the homosexual community (I believe it was the government who brought it to us, but we can argue that in another forum). I would decline to call homosexuality a mental disease, but who is to say that it is not a product of environment ? A woman with low self-esteem will always be attracted to abusive men, subconsciously, even though she knows that it is a bad relationship. Maybe homosexuals are attracted to the same sex due to some similar issue ? Now as far as the military goes, I think they should have some say in the matter. Imagine if some government body decided tomorrow that all ambulance crews must be made up of one male, one female, and that one of those two had to be a racial minority as well (to ensure diversity and fairness) without any regard for how that would work in your company (maybe you live in North Dakota and couldnt find a minority EMT anywhere, so you would have to import them). Why would it be wrong for the military to say we will use gays, but not in combat/field operations, instead they will serve in a support role. Why is that wrong ?

Sevral million Christians would argue that it should. I think they would also point out that we humans find a way to justify our sins, so that we do not have to do the right thing. I am surprised that none of those who are religous have not spoken up on this one, where are you guys ?

There is something to be said about common sense and leadership in this moment though. I do not think there is anyone who did not know that the air was unhealthy, especially in the first 48 hours after the towers fell. In hindsight though, someone should have stepped up much earlier and declared this a "recovery mission" instead of a rescue mission. This would have allowed for proper rest while waiting for needed supplies to come in. With that being said, I would have taken the same risk if it were my coworkers in the rubble.

Its all a joke, the only thing that saves cardiac arrest patients is immediate CPR and defibrillation. Until we start doing our jobs and educating the community to CPR and have the vehicles to deliver a defibrillator in 4 minutes or less, we are wasting our time. Pour the whole drug box in them everytime, you still will have less than 10% that walk out of the hospital.

I agree with whoever said we are all prostitutes, we all sell a piece of ourselves and our time to get the things we want in life. If you are a teenage or college age girl who gives it up on the first date because the guy bought dinner and a movie, how are you any different than a professional ? And all you guys know you said and did whatever to get those girls naked in your backseat, and that you have used women for sex many times. I think she is brilliant, and the ultimate capitalist, if she can just earn $100,000 for giving it up, that is far better than most women who give it up for a few $100 dates. My question would be why would you pay so much to get a virgin ? She has no skills, you know she sucks in bed, give me the professional for $1000.00 who will take me around the world, and rock that world.

Remember that i have already come out in favor of this in this forum and in previous forums, but being the troll that I am, I have to ask: Why are you a homophobe if you just disagree with the lifestyle ? Like it or not, the Bible is very harsh on homosexuality, from the standpoint of the "behavior exhibited" by homosexuals. If I have a problem with this behavior, and choose not to associate with them, that does not make me scared of them. I do not condone child molestation, rape, or beastiality; so if I choose not to associate with people who commit these acts, it is because I do not condone the behavior, its not because I am a pediphilephobe, a rapistphobe, or a beastialityphobe.

I would say it is totally in your hands, you could be promoted in a year, could take 10 years, but you can control your destiny. First concentrate on being a great field medic. Then meet with the decision makers and ask them, what do I need to do to be the next one promoted. In between, take some management classes, be the guy/girl they can always rely on, do not be the problem child. Be the solution to all their problems, work on committees, take on challenges. Whenever there is a problem, you want management to say lets bring in emtbasic13 on this one. *** If you are in a big city department, this is even more important, as promotions are harder to earn, come around less often, and often result in lawsuits. Still, most medics do not start behaving right and doing extra until a promotional exam is announced, so it should be easy for you to run laps around them, if you start now.

10 cardiologists would come up with 10 diagnosis', but I would call it third degree with conduction delay, regardless of what you call it, it is too slow and needs to be corrected immediately, so argueing over what it is really moot. What was the patients b/p supine and sitting ?

Now why did you have to go an call me out. I have been one of the few people who have highlighted how gays are the only group left that you people can legally discriminate against. I definitely do not want to be associated with emtpociets, but since I too have been labeled a troll, I have to wonder how homo-friendly some of you really are. Answer these questions truthfully: 1. If you are straight and contend you are not a homophobe ("hell, my best friend is queer"), how many gay bars have you been to in the past 12 months ? Surely you did decide to hang out with some of your gay partners when you were off-duty, didnt you ? 2. If you are a straight man with a male child, would you allow your child to stay in a daycare where the staff was all male homosexuals (not just once, but on a daily basis). I am all for the repeal of DADT as the same arguments were made against us negroes when whitey was forced to let us in the military.

I do not believe Albuterol is contraindicated, but Atrovent is.

You do not have the experience to present some of the ideas suggested. Why not make it simple, and write about what you know; ie..... what if you wrote about your clinical experiences from the student's perspective: 1. How could those third-rides have been a more educational experience ? 2. Were you treated like one of the family, or like a burden ? 3. Is there some equipment/procedures you could have trained on in the classroom prior to your third ride that would have made it better ? 4. Were there identified objectives for your clinicals, were those objectives met ? 5. Should your clinical time have been longer or shorter ?

Who said it? I Family sitcoms: "Dy-no-mite!" Jimmie Walker, Good Times "Aaay" Fonzie, Happy Days "Stifle!" Archie Bunker- All in the Family "Oh, my nose!" ? [bMarsha or Bewtiched] II Other sitcoms: "Baby, you're the greatest!" Ralph Cramden, Honeymooners "I know nothing!" Sgt Schultz, Hogans Heroes "How YOU doin'?" Friends "No soup for you!" Seinfeld III News catchphrases: "And that's the way it is." Cronkite? "Good night, and good luck."? Edwin R Murrow "One small step for man ... " Neil Armstrong- first man on the moon IV Cop show catchphrases: "Book 'em, Danno." Hawaii 5-0 "Just one more thing ..." Columbo "Let's be careful out there." Hill Street Blues "Who loves you, baby?" Kojak V Sci-fi catchphrases: "Resistance is futile." STNG "The Truth is out there." ?xfiles "Beam me up, Scotty." Star Trek "You've just crossed over into the Twilight Zone." Rod Serling, Twilight Zone VI Catchphrases from cartoons: "D'oh!" Simpsons "Heh-heh." Beavis and Butthead "Don't make me angry ..." ? bill bixby aka incredible hulk VII Game show catchphrases: "Is that your final answer?" Millionaire "Come on down!" Price is Right "Once you buy a prize, it's yours to keep." Let's Make a Deal? VIII Sports catchphrases: "Do you believe in miracles?" Al Michaels? "Let's get ready to rumble!" Actually Michael Buffer, Boxing/wrestling "Know your role, and shut your mouth!" ? The Rock, Wrestling IX Comedy catchphrases: "What you see is what you get!" ? "Mom always liked you best!" Smothers Brothers "Sock it to me!" Laugh In "We are two wild and crazy guys!" SNL(when it was funny) X Variety show catchphrases: "Here it is, your moment of Zen." ? The Daily Show "Now cut that out!" Jack Benny "We've got a really big show!" Ed Sullivan XI Ad catchphrases: "It takes a licking ..." Timex "I can't believe I ate the whole thing!" Alka Seltzer "I'm not a doctor, but I play one on TV." ? commercial XII Reality show catchphrases: "The tribe has spoken."Survivor "You're fired!" Apprentice "Smile, you're on 'Candid Camera'!" Candid Camera XIII Political catchphrases: "Oh, the vision thing." ?george bush SR "They misunderestimated me." Bush? "I didn't inhale …" Bubba Clinton "I took the initiative in creating the Internet." Al Gore XIV More political catchphrases: "Senator, you're no Jack Kennedy." Lloyd Bensen? "I'm not a crook." Nixon "There you go again." Reagan "Ask not what your country can do for you ..." JFK

Hate to tell you, but you will most likely have a difficult time. The one thing that is missing is your age, which is important. If you are under 23 and have major offenses and/or suspensions you can not be hired. Then again, its not much better if you are older as insurance companies view a 32 year old with DUI worse than a 18-21 year old. You should talk to some of the local employers and ask them, but it is difficult to put anyone on that has had a recent DUI. But you can go from EMT school to Paramedic school without getting employed, and by the time you finish all of that, you will be hireable.

I saw some agency did something like what you are talking about. They put an ambulance in a parking lot at night with lights flashing. They put 6 people in uniform at various places around the ambulance, and then pulled a vehicle in front of the scene with headlights on "bright" aimed at the general scene. They took a picture of the scene from the other vehicle, and asked you to count the EMTs you saw in the pic. Then they had everyone put on a safety vest, standing in the same position. It was amazing how big a difference it made. Don't forget to push safe driving practices, as your employees are far more likely to get killed or injured in a vehicle accident, than all other possibilities combined.

Ok, let me ask the obvious question. What would you do if you found FHTs to be too low or too high ? Emergency C-section ? Drive at 72mph instead of 70 ?

Good question, but I think everyone is looking at this the wrong way. Dwayne positioned the question with "morality". As far as I know, Islam is the only religion that allows for murder. I think all other religions do not condone murder for any reason. We as humans like to interpret religous rules to meet our desires. If you ask "what would Jesus, Buddha, Ghandi, Mother Theresa, or Billy Graham do ?" The answer is that they would not murder someone for any reason. So if you consider yourself religous/moral, you can not be for capital punishment, abortion, murder, or war.

Wow, you have to love a good Holy War. Would just like to point out a few facts that have been overlooked: Most of the eroding of religious RIGHTS/TRADITIONS, have been done by two groups: Atheist Groups and Corporate America, not minority religions. Atheist groups accomplished this through lawsuits against governments who promoted christianity (ie.... the nativity scene at the County Court House). Note that the govermnents lost these suits based on American Law, which dates back to the Constitution. Corporate America then sold you out because they feared they would lose money by backing one religion (christianity). It is these two forces that have done the most to kill your Norman Rockwell vision of what America should be. With all of that being said, this is very similar to the "Prayer in School Argument", in that those who are offended have no rationale basis for their argument. Any student who wishes to pray in school, can do so at any moment, as often as they like, as long as they do it silently and do not demand that others join them. The law does not stop you from praying, it just prevents the "school" or any person to force "the group" to pray to their GOD. No one has stopped you from saying Merry Christmas, you can say it all day long, as often as you wish, on any day of the year. At the end of the day, "Merry Christmas" is a salutation, and America has a long history of changing salutations. We now change our salutations for the year based on the most recent Super Bowl Commercials (Remember WAZZZZZZ-UP) If you know that I am a practicing christian, then it is entirely appropriate to say Merry Christmas to me, but if you do not know, you should use a more generic salutation. As far as protesting, it is a First Amendment Right, if you disagree with it, you should get the law changed. There is a group from the Westboro Baptist Church who travel the country to protest at the funerals of service people from our current two wars. I do not like it, but that is what makes America great. Do you really want to adopt the policies of Iran that would prevent such speech/protests ? http://wjz.com/topstories/Corporal.Matthew.Snyder.2.421120.html

Well obviously this is a racist issue as well, since sickle cell patients rarely get pain relief versus the rich white woman with the supposed migraine. JUST KIDDING, COULDN"T HELP BUT TAKE THE CHANCE TO MESS WITH ALL OF YOU ! There is a double-edged sword to not "spotting drug seekers". If you continue to treat the fakers, they will call you more often, as they will get better meds from you than they will from the ER. I can envision some of my old frequent callers, calling several times per day instead of several times per week, if they knew I would give them the good stuff. Once the got to triage, they could walk-out, catch the bus, head home with a good buzz, call again when it wears off. You also have the issue that if you treat fakers with the same zeal that you treat real patients, it will probably not be very long before the ER Docs start screaming to change your protocols and reign you in. I agree, that if there is any doubt, we should treat, but what about this scenario: 30 year old male with chronic back pain calls you on Saturday night for back pain that is a 10 out of 10. He is resting comfortably on his couch, B/P 110/80, Pulse 70, RR 16, warm and dry. He is allergic to Tylenol, Motrin, Toradol, and Codeine. He states his pain can only be relieved with Dilaudid or Morphine. So how do you treat this patient, what is your medicine of choice to relieve his "pain" ?

You guys miss the point entirely. The reason that you are charged the $4200 for lab tests that costs 100s to perform, or $1200 for the scan/xray that really costs 100, is that medical providers (including ambulance services) write off the first 55% of every dollar billed. Therefore, they have learned to bill at 2-4 times the rate of the actual cost of the procedure, so that after write-off, they will have a profit. The problem is that if you charge anyone less than what you have charged Medicare, it is fraud. Therefore, they can not charge an individual the "cost" price, they have to charge you the same they charge Medicare (they can provide a discount for cash payment, but it is usually less than 20% of the total). Like it or not, if you have insurance, you are paying for those who do not have insurance through higher premiums per paycheck, and actual outofpocket costs when the bills come due. Remember in the US, hospitals can not refuse to treat you because of lack of insurance. We can argue about whether or not Obamacare is the answer, but it would make sense that if everyone were insured (however that happens), your cost would go down.