crotchitymedic1986

Well it is obvious that I will never change your mind, so all I can do is pray that your glucometer is 100% accurate, 100% of the time, otherwise there will be a very bad outcome. We have beaten this horse to death, thank you for the debate.

And to be Repedantic, ASA could improve if it is a musculoskeletal issue. And Aspirin reduces blood clotting, which can help blood flow through a narrowed artery that's caused a heart attack, which is probably what is causing the cardiac type chest pain -- but thanks for trying, and no, there is no doubt that I am right on this one.

tnuigs if you cant tell the difference between hypoglycemia and CVA, that is a whole other issue. For the record I was asking for the "veterans" (meaning like more than 10 years experience in a busy 911 environment) to voice their opinion.

AMAZING !!!!!!!!!!!!!!!! I know all you old-timers hate my guts, but for the love of God, please jump in and help with these rookies.

Good one ruff, you almost got me lol.  But I would say the difference in the two is that no one is being discriminated against in ACLS, everyone has the opportunity to study for ACLS - using the same book, and the same ACLS curriculum is used nationwide.  So if I am taking ACLS in Indiana or Hawaii, and I have studied the material, I have an equal chance in both places (unless the instructors are racist and give me harder scenarios at the mega code to fail me intentionally -which i am not saying that happens).  And if ACLS fails me due to that, or has a faulty test, there is a way to appeal.  When applying for the job, I have no idea what the winning candidates scored or why they were chosen above me, and there is no way to appeal a bad decision (other than sueing)

When applying for a job it is different in every single city, county, state.  I have no idea what they will ask me or what is on the test, so I cannot "study" for it.  In big cities, the testing may have been created by a testing company or university, but in most towns and counties it was written by Joe Bob who works for the department.  So if you would create a national employment test that would be used by every single department (similar to the National Registry Test for certification or ACLS), then I would have no pity or arguement for the people who fail, regardless of race.

You guys keep wanting to ignore the fact that the court ruled that there was discrimination here. I did not make it up like a scenario.  The facts are the facts.

I would do the same, because I treat the patient, not the monitor or the glucometer

WOW I AM AMAZED ! Thank you for making my point, the younger generation is apparently all about the equipment. A half amp of D50 is hardly similar to pushing cardiac drugs. So then let me see if you are willing to kill any other patients besides diabetics ? You have a 40 year old male with crushing chest pain, SOB, pain radiating down left arm, but your 12Lead says NSR (no infarct). Are you going to withhold ASA and NTG (NTG is far more dangerous than 1/2 amp of D50)? He could be having an embolus, a AAA, it could just be gas, or pneumonia/pleurisy. Or do you give the ASA and NTG and see if it improves the patient ? Now explain to me how the diabetic scenario is different.

I hear crickets ! Did it click yet ? Treat the patient, not the equipment.

Yes you should. The difference between bad medics and super medics is "Critical Thinking Skills". The crazy scenarios that will probably never happen exercises your brain so that you can treat patients properly.

While I agree with you that the "boot camp" method might not be the best teaching method, I would also point out that the "let everyone pass" method is not education at all. For the last 3 ACLS classes I took, I never bought or opened the ACLS book, which is sad. All of the written question answers were provided verbally before the test, and the megacode was a joke. Imagine if the recert for airline pilots was as easy as ACLS, would you get on a plane ?

sorry, I thought you meant the call happened to you as a medic, I would never have implied those diagnosis if I knew you were the patient. I apologize.

I am not ensenuating that anyone in this room is racist, I simply reported that the courts found that the Chicago FD had a racist test, and made them hire people they excluded. If you have a problem with that, take it up with the courts.

AND TO HELP ALL OF YOU UNDERSTAND THAT RACISM DOES EXIST IN MOST WHITE PEOPLE, CHRIS ROCK SAID IT BEST, I WILL PARAPHRASE

THERE IS NOT ONE WHITE PERSON IN THE U.S. THAT WOULD TRADE THEIR SKIN AND BECOME BLACK. YOU COULD BE THE POOREST WHITE TRASH, LIVING IN A BOX, EATING DOG FOOD, AND YOU WOULD NOT TRADE YOUR PLACE IN SOCIETY TO BECOME BLACK, NOT EVEN A RICH BLACK PERSON.

If you speak honestly, you will agree, and that is where the hidden or institutional racism comes from. Think about it for awhile, then ask, if I would never accept being black, date a black, or kiss a black, how do i keep that subconscious bias from leaking into other areas ?

Chances are if you detest obese people, you will not hire them (ever see a 300lb receptionist in an office building). Same is true of black folks. And if you remember I posed the question once before, out of everyone in this room, how many of you have a black supervisor at work ? I think 2 said they did (maybe 3, but it was single digits).

Thank you ruff for helping me make my point:

1. If most of the firefighters that are employed there can not pass the physical agility test, then why is it a requirement. That would be like making all EMT-Bs take an ACLS test to be hired as an EMT-B. The test is only there to weed people out, and they do it both ways: The either make the test so easy that everyone technically passes, so then they can choose who they want (young heterosexual white guys). Or they make it so hard that only the fittest of the fit triatheletes can pass (discriminating against most men and women over age 35).

2. No I have no documentation of test questions, but if a court ruled it was discriminatory I have to agree that it was unless you can show that the court was biased in some way. The evidence must have proved that it was. If they had slam-dunk proof that it wasn't racist, and had the experts to testify that it wasn't, they would not have lost the case.

3. Depends on which 5th grade you are at. If you are at the Obama's children's school, or most predominately white schools then yes. If you are at inner-city public school in Detroit or Compton, I say no.

4. Yes, it is well documented that minorities score far worse on tests than whites. But as suggested before, when you do not allow a whole race of people any opportunity for education for over 200 years, then put them in bad schools for 40 years, you can not expect a Harvard candidate to come out of that situation often. I will admit that over 50% of that is our race's fault for our rate of drug use and single moms, if you will agree that your race's educational genocide of our race led to where we are today.

http://www.alternet.org/story/13826/

http://www.collegebo...wsat/index.html

If the test wasn't racist, why did they change it ?  Note taking out analogies in both articles.  The problem with all standardized test is that it is much like the "Physical Agility Test" at any Fire Department.  The test is created by old fat men who can not pass the test, to keep women and minorities out.  In any Fire or EMS Department you have a wide variety of backgrounds, income levels, educational levels, and developmental issues that are unique to each individual.  If I grewup in NYC my whole life, I probably will not be able to answer questions about a farmlife (words like tractor, plow, and gizzards are probably not in my vocabulary). Conversely if I am the farm kid, words like Stoop, Living in a Flat, taxi cab, cannoli, or lox is probably pretty foreign to me.  

I offer the same solution as offered before, make the whole department take the test every year, then average the score and make that the passing bar.

Since you seem to imply this was not a usual case, I guess three possible scenarios without knowing any details other than what was presented.

1. I had a rather healthy TV executive who just flew back in from Jamaica, had similar presentation with a B/P of 40 palp, and this guy was like 6'2" 250lbs. He had mixed some drugs and a ton of alcohol on his trip (per his friend, but he would not divulge the drugs for fear of losing his job). Or

2. I say the prostitute slipped a little something in his drink to knock him out. Or

3. He is having a reaction to the cleaning chemicals used by the hotel staff.

This took about 5 minutes, I am sure if I spent the night googling I would find more

ACLS:

http://en.wikipedia....ac_life_support shows the major changes 1980, 86,92, 2000, 2005, 2010.

http://circ.ahajourn...ppl_1/I-86.full discusses 2000

http://circ.ahajourn...12/24_suppl.toc 2007

http://media.america...r-updates.shtml 2010

BLS:

http://www.amazon.co...13960767&sr=1-1 iscusses 2000 and 2005 changes

http://www.msnbc.msn...-new-cpr-rules/ 2008

http://www.heart.org.../ucm_317350.pdf 2010

I disagree dwayne, respectfully. I did not get a degree, and I have found it has shut me out of some management positions where an Associates or Bachelors was a minimum requirement. The poster may not be interested in management now, but 10 years from now, things may be different.

Also I forecast that AMR and Rural Metro will gobble up a significant amount of private and municipal providers as they did in the 90s, as the economy worsens (it is about to get a lot worse in my opinion thanks to the lack of leadership in DC -- both parties). I agree with Dwayne that in most municipal departments a degree is useless, but in the corporate world it will make a difference.

I would suggest a Bachelor's in Health Care/Management/Sciences (whatever they call it in your area), which opens door to other medical industries outside of EMS (Hospital managers change jobs about every 2-4 years). Good luck!

It really does not matter, every 2-4 years AHA changes the algorythm to sell more books and keep themselves relative, but the truth is despite all those changes, out of hospital survivability has not significantly improved. So go through the motions to put on a good show for the family, then transport the body to the ER to be pronounced.

In other words, "Thanks crotchity you were right, I was tunnelvisioned by my glucometer and searched for every other disease process including malaria, instead of what is the most likely cause, statistically speaking, while my patient's blood sugar continued to drop. I would have started an IV, O2, maybe backboarded them . I would have then transported to the nearest emergency room, emergency, because they continued to deteriorate as my malaria treatment did not correct their condition, and they arrested 15 minutes into my care plan. After reading what I wrote, I realized that I should consider D50 in my treatment plan much earlier than I originally planned, but I could never admit you were right, so I will say that I will now consider it."

You're welcome, and ten years from now when this scenario really happens, I want you to come back and teach the new rookies in the room how to handle this patient. I am not claiming to be smarter than you, I have just seen a lot more patients and situations than you have. You know everything that is in the textbook, I know everything that is NOT in the textbook.

http://www.infoplease.com/ipa/A0001454.html

My list shows it's been pretty much a Muslim thing, I can only hope that our wonderful military is killing ten times as many of them as they have to us, but we never know since those numbers are no longer released.

You know, I've done a lot of thinking and I've come to this conclusion

We should all be pissed off when a more qualified applicant regardless of their race is passed over because a minority person who did not score as well gets the job.

I do take issue with the department not taking into account the other couple of tests which the black applicants did very well on apparantly.

So why didn't they do that? My conspiracy theory brain is befuddled but my suspicion is that this whole thing was racist, the only score used was the written test. The whites probably did very very well on that test while they did very very poorly or didn't do as well as the blacks.

They threw out the lower scores of the physical tests and only used the written.

Hey at least they hired on a curve.

Would you be as outraged if the tables were turned and it was a bunch of white guys who didn't get hired because they threw out the written tests and just used the physical agility/ability scores which apparantly the black applicants did better on than their white counterparts?

If the playing field were completely level, I would be against discrimination against anyone for any reason, but discrimination against whites happens so rarely, I would not shed many tears if it happened. As far as asking about how tests can be discriminatory, we argued that to death in previous posts.

But I have a solution, but I doubt white folks would be brave enough to make it the rule:

1. Interviews for hiring and promotion are done by the neighboring jurisdictions personnel, no one from that department can be in the process, except maybe one member from the HR Department (this gets rid of the buddy-buddy system, or bribes or brown-nosing the chiefs (decision makers).

2. All interviews are blinded, the applicant sits in another room and can not be seen, and uses one of those voice changing devices that changes their spoken word into the same monotone computer voice (cant tell male/female, ethnicity or nationality). The applicants are then given a "score" for interviewing.

3. The applicants are given one written test, written by a test-writing company or university, and are scored with no curves or weird formulas. Again, the test is taken in private, applicants are not seen.

4. Once the applicants have both scores, background check, drugscreen, and physical done, the outside interviewers hold a one day skills observation test (or physical agility test) where the applicants are viewed for the first time by the outside panel, and they score using the same score sheet for all. If it is a physical agility test then everyone is graded by the amount of time it took to complete the test. To establish a minimum cut off that is fair, I would mandate that everyone that is a current employee from chief on down to rookie has to take that same physical agility (or skills / if skills it has to be national registry format) test annually; they would then average everyone's time/grade to create a "department average". Applicants must surpass the department average to be considered for the position. It is not fair to disqualify a female for not being able to pass the test, when half of your department is so overweight that they can not pass the same test;

Skills Score should be weighted to = 50% of your total score

Interview and Written are weighted to = 25% each of the total score for a total of 50%

Tell me why that isn't fair ?

And if you site extra costs, there shouldn't be any. When it is the other department's turn to do the same procedure, you will do it for them to pay them back (no extra payroll). To protect employers I would be fine with a 90 day orientation period where the applicant is only awarded temporary employment and can be terminated if the candidate is somehow unacceptable, but the employer will have to show clear proof of why the applicant is unacceptable and document the steps they took to try to bring the applicant up to standard.

wow, very mature. Since I frequently get admonished by admin, can I ask for a little two-way street here. Posters should not be allowed to curse or call people names like this when unprovoked.

You are right, the court found that there was discrimination here, but you only seem to get upset when white people dont get hired. Go figure ?

No when a freak occurrence occurs 3 times in 30 years, it is still a freak occurrence, even if all 3 occur in the same year. Actually we may even be able to go back over 40 years, I do not remember what the first outdoor concert was, but Woodstock comes to mind as one of the biggest in my era.

Nevermind, I just found the answer : http://en.wikipedia.org/wiki/Monterey_Pop_Festival

so we have had 44 years of outdoor concerts and a handful of stage collapses.

You are welcome again Doc.

Well lets let the members decide. How would the rest of the room treat this patient ?