Dustdevil

Well then, it's certainly a good thing you didn't try it. You might have killed him!

A fluid challenge is indicated in PEA. I didn't see that mentioned in your report.

All patients are cooperative... right up to the point where they become suddenly and violently uncooperative without warning. Sorry, doughnut boy. If you are "uncomfortable," I am ten-times that. If it ain't safe for you, then it damn sure ain't safe for me. Your purpose is not to catch the guy after he kills me. Your purpose is to protect me from him in the first place. Either you ride, or you transport in your caged car. NOTE: "Doughnut boy" and "you" are used in referring to the cop in the scenario. They are not a reference to you personally.

Yep, and shouldn't all patients be completely exposed anyhow? That's what the DO's say!

Again, consent is not even an issue here. If the patient says no, I don't know any medics who are going to engage in a wrestling match with the patient in order to achieve the search. After all, avoiding physical confrontation is the whole purpose of the search in the first place. So what we are left with is exactly what you suggest. Either the patient says "okay" and gets searched, or they refuse -- in which case I am fully justified in disengaging -- and they get to go with the police. No assault. No battery. No illegal search. I don't know what all these psycho instructors are teaching out on the left coast, but here they still teach safety first.

According to whom? Your no-name basic EMT instructor in California? Next class, I hope you intend to ask him for a reference to the specific federal statute that backs up his claim so you can see the "deer in the headlights" look on his face when you both realize he's talking out of his ass.

Who said anything about no consent? They either consent or they wait for police to transport them. Given that choice, I have never had one refuse. And you broken records who keep pretending to know of a specific law prohibiting us from searching patients need to either produce the law, verbatim, along with a verifiable link to it, or step off. And this needs to be a federal law, since you continue to claim that this applies to all of us.

ALL transports. ALL the time. NO exceptions.

Can you give us a link to the applicable federal statute, please? And please do not post again in this tread until you find it. Can you please post contact information for at least two of those three agencies. They are obviously so progressive that the rest of us could learn valuable lessons from them.

Just curious, how many EMS agencies have you worked for that you are so sure "most" of them have written policies addressing this?

I thought it was common knowledge that Zoll sucks.

Damn! I thought I was the only one who did that! I was the only one I knew doing it in the early 80's. It works too! Them Holsteins will jump up out of a dead sleep for the electronic air horn and start mooing like a coyote howling at the moon!

I've thrown up a couple of times while after the victim vomiting in my mouth during mouth-to-mouth. That's all I can remember.

At the very least, they should be taken off the ambulance for the shift! :wink:

Except that half they time, they are unable to fly due to weather. So now I am stuck with a minimum one hour long drive to the nearest trauma center. If I can spend that hour doing something more productive than praying, then I will. And mobile radiology might offer that option.

I use Netscape exclusively for everything except this website. Since the chatroom won't work with Netscape, I reluctantly fire up IE for this website only.

Absolutely. But that is not what is happening here. We're talking about adding those costs and then telling people that is part of your car payment. It is not. It is an intentionally deceptive statement. It is a lie. When you intentionally pad your numbers by making an apples to oranges comparison, your entire argument is invalidated.

I know. And that was my point. You are adding unassociated costs into the punishment equation. All those extra costs you throw in there to tip your scales have nothing to do with punishment, and are therefore irrelevant to the cost analysis of life vs. death. The only people who would utilize those figures are those with a dishonest agenda to sway opinion in a predetermined direction. That may not apply to you, but it certainly applies to those who fed you your figures. It's simple. In order to debate the costs of punishment, you have to maintain an apples-to-apples comparison. Figuring in unrelated factors invalidates the comparison. That would be like figuring in the cost of gas, speeding tickets and the resulting high insurance rates when telling people the cost of your car payment. Arguing the costs of the judicial system, while a valid topic for discussion, is a wholly different topic from the costs of punishment. And if you presume to debate the cost effectiveness of the prosecution of capital crimes, then the math is always going to say it's cheaper to let criminals go than to prosecute them, no matter what their ultimate sentence is. Duh!

I think anybody who falls for that old "it costs more to execute them than to give them life in prison" line is incredibly naive. First of all, the appeals don't figure into imprisonment costs. That's like figuring prosecution costs into convictions and saying it's cheaper to just let people go rather than prosecute them in the first place. It's idiocy. And second, it assumes that those who are sentenced to life in prison are not also filing appeal after appeal for the next twenty years, which you KNOW they are, at pretty much the same cost. So yeah, they did fail math. But unfortunately, they learned just enough statistics to spin them. :roll:

Ah, okay. That is a plus for you, because it is a lot easier to get funding for a potentially profitable business venture than it is for a money losing, subsidized public service with a low reimbursement rate. Back in the early 80's I was familiar with the SBA process, having had friends who went through it, including some minorities. But it has changed significantly since then. The best I can suggest is to simply call the SBA and get an appointment to speak with a counselor there to get some info and an overview. I would also get with your local minority business council, Chamber Of Commerce for advice. In addition to information on hand, they can put you in touch with others who they know who have very recently gone through the SBA and can give you up to date info. It doesn't have to be an ambulance company owner. To the SBA, a business is a business, and they are pretty well judged by the same criteria when assessing eligibility. Good luck!

As noted in the last statement of my post, the value of any and all of these will be dependent upon the sophistication of the EMS system and the remoteness of the incident. Since most of the United States -- indeed most of the world -- is not in immediate proximity to a trauma center like you are, then at least the distance caveat applies to most systems. And although probably a great minority of them are clinically sophisticated to be doing thoracostomies in the field, they should be. And I would expect it to become more common in the future. Of course, field radiology would create a confidence necessary for many systems to consider thoracostomies.

Professionally and economically it does, that's for sure. But I don't put a 2-year degree RN any higher up on the professional scrotum pole than I do a 2-year degree Paramedic. An EMT on the other hand is nada. Just a couple months of part-time night school. Probably not even equal to your first responder there. Certainly not a professional.

Acknowledging all of the afformentioned problems related to this concept, I do have to admit that I see some potential benefits to this. While I suppose it is natural to think "ortho" when talking x-rays, we have to remember that there are many, many other diagnostic values to radiology. Here are some examples of a few non-orthopedic conditions a field x-ray could tell me of that my patient would benefit from me knowing: * Endotracheal tube placement * Hemothorax * Pneumothorax * Pleural Effusion * Pulmonary Edema * Pericardial effusion * Foreign body location (bullets) Of course, as originally mentioned, the value of any radiology in the field is going to be dependent upon the proximity of the patient from the hospital. Therefore, Dallas, Texas has no use for any of this, but the next county south might greatly benefit from it since their nearest trauma center is an hour away in Dallas.

How do you think I feel? I'm a degreed RN and I still get called an EMT!