NYCEMS9115

You could have just spoken to your partner at the end of the call...

It's really up to you. What if the Hospital or Family calls to complain and no incident was reported? Management would think you like to hide stuff. Its better to hear from the crew than to hear it from someone else. But you'll be label as a rat by your co-workers.

Either way; you should speak up. Talk to your partner. You're only a driver but he can question your driving and he's the Tech. It goes both ways. You are providing some care (stretcher, chair, moving of the patient, etc.).

Good luck. All the best...

As you see; many of our peers are against collegiate education. Many rather want the 1 day - several months continuing education to add alphabets to their title but not realizing it; these alphabets must be re-certified in order to maintain the alphabet title. If you fail the exam; you no longer have the alphabet title. There have been many who've failed to maintain their alphabet title.

My AEMT-P every 3 years. My BCLS, ACLS, and PALS every 2 years. My CEVO/EVOC every 3 years. But my A.A.S. is forever. My A.S.N. which I will receive and the RN is forever. The B.S. which I will pursue and obtain will be forever.

It baffles me, why so many EMS/PHC Providers are against College. Why so many do not want to add hours, knowledge, and skills the curriculum.

I admire ones who continue in their education because at 40 years old; I do not want to do carry downs or ups.

It's tough in NYC for EMTs. Put your name on the FDNY EMS list. Keep applying to all the Privates. Try the Hospitals.

Go to Citiwide, Midwood, Coling, Hunter, Assist, and Lifeline. If you have a car; try Empress or Westchester EMS. Good luck.

Nudity isn't the issue. It's the 69, reverse cowgirl, doggy, carb/protein shake, creampie, eating out, ganging, DP, sucking, and slobbing in the nude; we're referring to. It's legal (it really isn't; NYC has it all wrong) to watch porn in the library but you can't be nude in the library. Either way, it shouldn't be allowed in the library.

But it's your right to feel otherwise.

http://www.foxnews.com/story/0,2933,90164,00.html

http://www.christiannewswire.com/news/6213216832.html

I can't argue with what's right. As it's legal to watch porn during a Children Reading Time at the Library. It's my legal right to disagree even though it's legal. I'm sorry if I'm placing a personal opinion. I haven't research why it's legal because I care not to know why the USSC ruled it legal. They are people with opinions; Pornography in the Library is protected under the 1st Amendment. They are people who feel that Porn in the Library it's protected under the U.S. Constitution. Yes, this is just my opinion. You can disagree. Not trying to change anyone's mind.

RMAs (Refusal of Medical Assistance) are among the most time-consuming, labor-intensive calls in EMS. It is tempting for caregivers in busy systems to take shortcuts when encountering patients who do not wish to be transported.

     Bad idea, unless you are intrigued by your state's legal system.

     The three most important steps in processing an RMA are document, document and document. Documentation is important in all areas of EMS, but never more so than when you are advocating a prehospital course of action that contradicts the patient's preference.

     Two RMA scenarios to be avoided are allowing a patient to refuse transport without assuring and documenting his awareness of risks and alternatives; and enforcing transport against the patient's will, in spite of his acknowledgment of risks and alternatives. The former can lead to charges of abandonment, while the latter could be construed as false imprisonment.4

     According to a 1998 study, it is wise to involve a physician in the RMA process, not only because of his/her superior assessment skills, but also because it is more likely that a doctor will succeed in convincing a patient to seek definitive care.7 Many EMS systems make RMAs cooperative ventures between field personnel and physicians. Prehospital providers contact medical control if they are unable to convince sick or injured patients to allow transport by ambulance.

     There are medical consequences of sloppy RMAs, too. A 2002 study revealed that 32% of patients age 65 and older who refused transport were subsequently admitted to a hospital for the same or a related complaint.8 It makes sense to consider high-risk factors, such as age and medical history, in addition to the patient's presentation when con-fronted with an RMA.

http://www.emsworld.com/print/EMS-World/What-NOT-To-Do-in-EMS/1$6381

Good afternoon,

Last night, President Obama announced that the United States has killed Osama bin Laden, leader of al Qaeda and a terrorist responsible for the murders of thousands of innocent people. He made clear that even though Osama bin Laden has been brought to justice, Americans should remember the spirit of unity in the days after 9/11 as we continue to secure our nation and work for a safe and prosperous future.

If you haven’t yet seen President Obama’s remarks, you can watch them here and read the full transcript below:

Full Transcript of the President’s Remarks on Osama bin Laden

Good evening. Tonight, I can report to the American people and to the world that the United States has conducted an operation that killed Osama bin Laden, the leader of al Qaeda, and a terrorist who’s responsible for the murder of thousands of innocent men, women, and children.

It was nearly 10 years ago that a bright September day was darkened by the worst attack on the American people in our history. The images of 9/11 are seared into our national memory -- hijacked planes cutting through a cloudless September sky; the Twin Towers collapsing to the ground; black smoke billowing up from the Pentagon; the wreckage of Flight 93 in Shanksville, Pennsylvania, where the actions of heroic citizens saved even more heartbreak and destruction.

And yet we know that the worst images are those that were unseen to the world.  The empty seat at the dinner table. Children who were forced to grow up without their mother or their father.  Parents who would never know the feeling of their child’s embrace.  Nearly 3,000 citizens taken from us, leaving a gaping hole in our hearts.

On September 11, 2001, in our time of grief, the American people came together. We offered our neighbors a hand, and we offered the wounded our blood. We reaffirmed our ties to each other, and our love of community and country. On that day, no matter where we came from, what God we prayed to, or what race or ethnicity we were, we were united as one American family.

We were also united in our resolve to protect our nation and to bring those who committed this vicious attack to justice. We quickly learned that the 9/11 attacks were carried out by al Qaeda -- an organization headed by Osama bin Laden, which had openly declared war on the United States and was committed to killing innocents in our country and around the globe.  And so we went to war against al Qaeda to protect our citizens, our friends, and our allies.

Over the last 10 years, thanks to the tireless and heroic work of our military and our counterterrorism professionals, we’ve made great strides in that effort. We’ve disrupted terrorist attacks and strengthened our homeland defense. In Afghanistan, we removed the Taliban government, which had given bin Laden and al Qaeda safe haven and support. And around the globe, we worked with our friends and allies to capture or kill scores of al Qaeda terrorists, including several who were a part of the 9/11 plot.

Yet Osama bin Laden avoided capture and escaped across the Afghan border into Pakistan.  Meanwhile, al Qaeda continued to operate from along that border and operate through its affiliates across the world.

And so shortly after taking office, I directed Leon Panetta, the director of the CIA, to make the killing or capture of bin Laden the top priority of our war against al Qaeda, even as we continued our broader efforts to disrupt, dismantle, and defeat his network.

Then, last August, after years of painstaking work by our intelligence community, I was briefed on a possible lead to bin Laden.  It was far from certain, and it took many months to run this thread to ground. I met repeatedly with my national security team as we developed more information about the possibility that we had located bin Laden hiding within a compound deep inside of Pakistan. And finally, last week, I determined that we had enough intelligence to take action, and authorized an operation to get Osama bin Laden and bring him to justice.

Today, at my direction, the United States launched a targeted operation against that compound in Abbottabad, Pakistan. A small team of Americans carried out the operation with extraordinary courage and capability. No Americans were harmed. They took care to avoid civilian casualties. After a firefight, they killed Osama bin Laden and took custody of his body.

For over two decades, bin Laden has been al Qaeda’s leader and symbol, and has continued to plot attacks against our country and our friends and allies. The death of bin Laden marks the most significant achievement to date in our nation’s effort to defeat al Qaeda.

Yet his death does not mark the end of our effort. There’s no doubt that al Qaeda will continue to pursue attacks against us.  We must –- and we will -- remain vigilant at home and abroad.

As we do, we must also reaffirm that the United States is not –- and never will be -– at war with Islam. I’ve made clear, just as President Bush did shortly after 9/11, that our war is not against Islam. Bin Laden was not a Muslim leader; he was a mass murderer of Muslims.  Indeed, al Qaeda has slaughtered scores of Muslims in many countries, including our own.  So his demise should be welcomed by all who believe in peace and human dignity.

Over the years, I’ve repeatedly made clear that we would take action within Pakistan if we knew where bin Laden was. That is what we’ve done. But it’s important to note that our counterterrorism cooperation with Pakistan helped lead us to bin Laden and the compound where he was hiding. Indeed, bin Laden had declared war against Pakistan as well, and ordered attacks against the Pakistani people.

Tonight, I called President Zardari, and my team has also spoken with their Pakistani counterparts. They agree that this is a good and historic day for both of our nations. And going forward, it is essential that Pakistan continue to join us in the fight against al Qaeda and its affiliates.

The American people did not choose this fight.  It came to our shores, and started with the senseless slaughter of our citizens. After nearly 10 years of service, struggle, and sacrifice, we know well the costs of war. These efforts weigh on me every time I, as Commander-in-Chief, have to sign a letter to a family that has lost a loved one, or look into the eyes of a service member who’s been gravely wounded.

So Americans understand the costs of war. Yet as a country, we will never tolerate our security being threatened, nor stand idly by when our people have been killed. We will be relentless in defense of our citizens and our friends and allies. We will be true to the values that make us who we are. And on nights like this one, we can say to those families who have lost loved ones to al Qaeda’s terror: Justice has been done.

Tonight, we give thanks to the countless intelligence and counterterrorism professionals who’ve worked tirelessly to achieve this outcome. The American people do not see their work, nor know their names. But tonight, they feel the satisfaction of their work and the result of their pursuit of justice.

We give thanks for the men who carried out this operation, for they exemplify the professionalism, patriotism, and unparalleled courage of those who serve our country. And they are part of a generation that has borne the heaviest share of the burden since that September day.

Finally, let me say to the families who lost loved ones on 9/11 that we have never

forgotten your loss, nor wavered in our commitment to see that we do whatever it takes to prevent another attack on our shores.

And tonight, let us think back to the sense of unity that prevailed on 9/11. I know that it has, at times, frayed. Yet today’s achievement is a testament to the greatness of our country and the determination of the American people.

The cause of securing our country is not complete. But tonight, we are once again reminded that America can do whatever we set our mind to. That is the story of our history, whether it’s the pursuit of prosperity for our people, or the struggle for equality for all our citizens; our commitment to stand up for our values abroad, and our sacrifices to make the world a safer place.

Let us remember that we can do these things not just because of wealth or power, but because of who we are: one nation, under God, indivisible, with liberty and justice for all.

Thank you. May God bless you. And may God bless the United States of America.

This one is for you: Marc Sullins, Keith Fairben, Mario Santoro, Yamel Merino, and all who lost their lives that day...

http://mobile.nytimes.com/article;jsessionid=5D7F95CAAD0FA2DEF5BF4EC696754939.w5?a=783466&f=19

There's a time and a place.

Just because the Courts views it as lawful or something just. As citizens we can not disagree? Quoting that the USSC Ruled it; is irrelevant to the Court of Public Opinion. We are members of this unsanctioned Court. All of us have that voice; that opinion; it maybe not be mainstream but it is still an opinion. Our opinions stem from our values, our core beliefs, & our experiences. Many of you agree with the USSC; that porn (happy; it's has been lower cased) is a right of an individual to view in the Public Library. Some do not. Just because it's lawful doesn't necessarily mean it's right.

So we're defending PORN in the Library as a 1st Amendment Right.

http://www.emsworld.com/article/article.jsp?id=16924&siteSection=1

Then what's the difference in this case?

Welcome to the City. There's a lot of knowledgeable people here. It's a good place to hear peer's opinions. There are differences in Practice. There's some controversy but it's a lot of fun...

I currently work in an ICU, but when I did work in the field we used Versed + Morphine + Sux + Vec. There have been studies done that suggest that pre-hospital intubation is causing harm, so it is likely that intubation will be removed from the scope of practice of ground based Paramedics in the future & be replaced with blind insertion devices unless we increase provider education, improve provider airway assessment & intubation skills..

I agree and I have made it known; I am for increase Education for the Basic & Advance Providers. Including, increasing didactic and practical hours. In addition, Degree only Paramedics. But many are against this.

Look as another Hospital pulls out of the Ambulance Business. With the cost of Healthcare rising; technology playing a big part in the increase in costs; people living longer; reimbursements at a low and not paying; people who depend on Entitlement Programs are increasing; unemployment; refusal of increase taxes; improper spending of tax dollars; among other things: has cause the demise in healthcare.

You can bill for X amount; doesn't mean you'll get that amount paid. The only "Business" where you get services rendered before payment. Where Emergency Services can not be withheld because of one's inability to pay. Going above and beyond is not cost effective. Service Awards, Merit Citations, Letters of Commendation, Celebratory Galas, and Salutations do not pay the bills. Anything multiplied by "0" equals ZERO.

We can grieve, gripe, and gather; it won't do anything. Healthcare Services will downsized and outsource; it has to or it will end up closing. A few dozen jobs lost is better than a few hundred. EMS for a Hospital is not money generating; its not necessary. Especially,if someone else can do it for less or free.

Ex. If an Ambulance transports a patient to the ER from home; the crew provided great care; they even traveled miles further than the closest ER because the family and patient insisted. Appropriate care was rendered; O2, V/S, ECG, IV, & Medications. The receiving ER were very please with the care the crew provided. The crew even assisted the ER Staff in the Triage Vitals, locating a stretcher; even cleaned and made the bed. The paperwork was completely and very thorough. The crew's Manager reviews the call and the paperwork; it was done properly. The Manager received a phone call from the family; praising the crew. The family had nothing but great things to say about the crew. The paperwork was forwarded to the Billing Department; the patient has NYS Medicaid: claims were submitted to Medicaid; no itemization, Medicaid won't pay for Pre-hosiptal Emergency or Non-Emergency Care; it pays for Transportation only; you can travel 0.1-100miles; one Flat Fee. A week later the family wrote a Letter of Commendation and had sent it to the President of the Hospital. A Special thank you from the President was given to the EMS Department. Weeks later, Medicaid Reimburses the Payment for the Transport. A BIG CHECK of $140.00. Would have received the same money; if the patient sat on the bench and was just taken to the ER.

That's why the Privates have survived and will continue to; if the State of Healthcare remains the same. Its all about Volume. We need to restructure Healthcare; meaning many people will not be happy who have Entitlement or HMO/PPO/CMO/EPO Insurance.; think that's majority of us.

http://www.emsworld.com/article/article.jsp?id=16916&siteSection=1

Good luck on the exam. There's still more to learn after school.....

Study, ask questions, listen, show respect, and be humble... Good luck...

2 1/2hrs.... I do it every year NYY at BAL....

No need to apologize for common sense and/or knowing the difference between right and/or wrong. You need to apologize for littering the thread with this whiney, self rightous bullshit.

If you have a point, make it. If you can't then save us all the "Oh my heart hurts that all can't be as divine as me...." shit.

So far the only difference between some jerkoff masturbating at the library and your posts in this thread is that your verbal cum ends up spraying us all...but still, is equally offensive.

Dwayne

Okay. Hey kettle. Your black. If that's the case; are you not doing the same? It's offensive? Profanity and insults are not offensive? Sorry no research for this reply; no quotes. Your statement you made; are you upset? This outlet is suppose to be good. We can let out our frustrations here but don't take this to heart.

Horrible act anywhere but there...

http://www.huffingtonpost.com/blackberry/p.html?id=855101

I meant to write, "Horrible act anywhere but there?"

Apologies...

I do not insult members on this site but many resort to insults rather than constructive debates.

What opinions? That America sucks, porn sucks, anyone that disagrees with you doesn't know the difference between right and wrong?

You shouldn't feel insulted by me but by your complete lack of any effort to produce something in this thread instead of simply strutting around like a self righteous child.

If you have at some point outlined and defended a point, please quote it here...there is nothing I would like more than to apologize for not noticing that you've not really embarrassed yourself and wasted everyone's time.

Dwayne

What do I have to outline? That I don't think PORN should be in the Library. Quote what? My opinion? That I think it's not a proper place for PORN. Because I used humor to give an example. I need to quote that? What research do I have to do? Plz educate me. Maybe I should throw in profanity to get my ideas across.

Thanks for throwing your $0.02 in; I would appreciate a $1 though... "All the best."

I disagree; I'm wrong. I agree; I'm wrong... Label me all you want. It is what it is. Because my opinions differ; I get insulted. Cool...

Is it just me or does it seem like maybe Crotchity and nycems9115 might be the same person?

No, it's just you. To compare me to someone who thinks his race is supreme is retarded. But your entitled to your opinion.

Sarcasm fail.

Are you aware of the overtly racist nature of spelling "english" the way you did? Just curious. It is your right to hold those beliefs. But I was really hoping to keep a certain forum member who likes to spew about how everybody is racist out of this discussion. It would spin irrevocably out of control at that point.

Racist? What the heck are you talking about?

No, sadly the majority no longer does rule, or we would never even be having this discussion.. Vocal minorities often get their way in today's society. He who has the most money and the backing of media to promote their message not only gets their message heard, but can actually get legislation passed in their favor. Often times the majority needs to simply shut up, accept something they disagree with so as to not offend a fringe group.

I also would not call the responses here indicative of a consensus of opinion. There are thousands of registered users of this site, maybe a hundred post with any regularity, and only a couple are actually involved with this discussion.

I know, I was just mocking the people who condone, or in this thread a Constitutional Right, people to watch Porn in the Library.

When you get caught up between the Porn and Public Library; I know its crazy but it's true!

Horrible act anywhere but there...

http://www.huffingtonpost.com/blackberry/p.html?id=855101

O-V-E-R-K-I-L-L!