Arizonaffcep

Which cat? There's usually tons... :wink:

From what I've heard about this gathering...this would rank among the the lowest places I'd like to get sick at... After all...I'd have an airway, 16 IV's and (potentially) no vitals!

According to the AHA, "These statements are fair generalizations: Early CPR and defibrillation (de-fib"rih-LA'shun) within the first 3–5 minutes after collapse, plus early advanced care can result in high (greater than 50 percent) long-term survival rates for witnessed ventricular fibrillation (ven-TRIK'u-ler fib"rih-LA'shun). The value of early CPR by bystanders is that it can "buy time" by maintaining some blood flow to the heart and brain during cardiac arrest. Early bystander CPR is less helpful if EMS personnel equipped with a defibrillator arrive later than 8–12 minutes after the collapse. Increased survival with CPR and AEDs Studies have repeatedly shown the importance of immediate bystander CPR plus defibrillation within 3–5 minutes of collapse to improve survival from sudden VF cardiac arrest. In cities such as Seattle, Washington, where CPR training is widespread and EMS response and time to defibrillation is short, the survival rate for witnessed VF cardiac arrest is about 30 percent. In cities such as New York City, where few victims receive bystander CPR and time to EMS response and defibrillation is longer, survival from sudden VF cardiac arrest averages 1–2 percent. Some recent studies have documented the positive effect of lay rescuer AED programs in the community. These programs all ensure adequate training, and a planned response to ensure early recognition of cardiac arrest and EMS call, immediate bystander CPR, early defibrillation and early advanced care. Lay rescuer AED programs consisting of police in Rochester, Minn., security guards in Chicago's O'Hare and Midway airports, and security guards in Las Vegas casinos have achieved 50–74 percent survival for adults with sudden, witnessed, VF cardiac arrest. These programs are thought to be successful because rescuers are trained to respond efficiently and all survivors receive immediate bystander CPR plus defibrillation within 3–5 minutes." This DOES NOT INCLUDE TRAUMATIC ARRESTS, which of course, have a much lower rate of "recovery." Here are some stats from Trauma.org in regards to ED Thoracostamys. "Mechanism of Injury For penetrating thoracic injury the survival rate is fairly uniform at 18-33%, with stab wounds having a far greater chance of survival than gunshot wounds. Isolated thoracic stab wounds causing cardiac tamponade probably have the highest survival rate, approaching 70%. In contrast, gunshot wounds injuring more than one cardiac chamber and causing exsanguination have a much higher mortality. Blunt trauma survival rates vary between 0 and 2.5% and some authorities suggest that thoracotomy for blunt trauma should be abandoned altogether. However, this is an oversimplification of the literature. There is a distinct survival rate for patients with isolated blunt thoracic trauma who undergo emergency thoracotomy. This is highest for patients who are severely hypotensive in the emergency room and are exsanguinating from a chest injury. Blunt thoracic trauma causing traumatic arrest in the emergency department should also undergo thoracotomy. Whether this should be extended to those patients arresting in the presence of prehospital emergency services is debatable."

My question for you Dust is: How do we do this? I'll use an example that I'm fairly familiar with (although I know you don't like it, but please hear me out). If you look at the amount of Firefighters across the U.S., MOST of them are vollies. By most, I mean most...last stat I heard was something along the lines of 2/3 to 3/4 were not career FF's. Yet they have a HUGE amount of political clout, and seem to have a system worked out, educationally, that works for both the career depts as well as vollies. In AZ, according to the state, you only need to be "trained" in FF tactics, skills, etc to be a FF. This works well for the vollie folks, but the career depts. have all the formalized training (so to speak), and are held to IFSTA, NFA, and other national standards. This system, even is such a backwards state as AZ has a tendency to be, has led to the rise of what most consider one of the top fire departments in the country...Phoenix Fire. Now...granted that has a lot to do with their previous leader, Alan Brunacini--truly a remarkable man. I use this example not to say we "need to integrate" or any other crap like that...just that clearly a system where there is a preponderance of vollies vs career folks can work, and does quite well. Should we be like that...no. But under CURRENT conditions, with a large number of vollies and the like, would it not be in our best interest to get a system up and running that would WORK to our advantage, and then change it as time goes on to be more "picture perfect?" Basically, compromise now to gain what we want in the long run. One reason I firmly belive that EMS is so fragmented is because, for some reason we, as opposed to PD and even FD seem to have a more "eat our own" mentality, where harmony and loyalty seem to have taken a back seat to discord and individualism. If we can get a "single" voice for our ideas, then I believe that we would be more successful in our endeavors.

The one thing that separates human kind from animals? Fear of vacuum cleaners! Honestly, a lot of what we do could be considered "monkey skills." IV, Intubation, 12 lead etc. The real ART of the profession lies in 1. assessment skill and the ability to translate what is seen/found to a plan of action, and 2. bedside manner, because, as the patient, typically I don't have enough knowledge to know if you (the practitioner) have "mad skills," but I can tell if you were rude/condescending or not. This is PRIMARILY where the patient's opinion of the practitioner/service/EMS in general will stem from.

What about the apparent move of the AHA to use video instruction with a LITTLE bit of instructor input to classes such as ACLS, PALS, and CPR? I know from my stand point, its more than a little annoying.

In spring semester, I did some research on Obama's health care plan...I can only assume similar TYPES of "plans" make up his campaign...which was a total sham. There is nothing of substance to his healthcare plan, NOR anything else I've seen from him. When you actually dig into his details and try to pin them down...there's nothing there. Everything is incomplete (that I've seen thus far). This is the reason I'm voting for McCain. That, and like it was pointed out earlier...Palin's hot!

Richard, is the MTA city or state run? If it's city...that's retarded. If it's state, then ok...kinda makes sense. Big trucks, especially ones that carry large cargo (water included) really can, over time dammage roads, and presumably bridges. When I was on the FD, our engines carried 1000gal of water (approx. 8000 lbs) just in water weight. Now, FDNY probably doesn't run with trucks with THAT much water (no need, we are rual desert district). But with water weight at about 8lbs/gal, just the water is heavy.

I have very mixed feelings on this issue...1, I can see why someone would want to commit suicide to some degree. In cases like being diagnosed with a terminal disease, etc. sure...go for it, just don't take out anyone else in the process. 2. While I have only practiced in the Southwest (so I can only speak from that experience) there seems to be a lot of people who just can't handle life-ie the (sorry if this is offensive, some of the EMS/Fire/PD slang here) MH (mexican histeria) or HP (hispanic panic) types (DOESN'T ONLY APPLY TO THOSE NAMED) who come in with a kid who just stubbed their toe, and they are crying and carrying on as if the world is about to end, all while rubbing their Rosary Beads. They seriously need to wash the sand from their crotches and put on their big boy/girl panties. If you got a desire to kill yourself, go for it, just don't be selfish enough to do it in front of your kids-or anyone else for that matter. No one cares! <<getting off my soap box>>. Sorry.

For those that like this kind of thing...zitlovers.com

And yet they still give us scalpels... :shock:

I hope you're not being sarcastic about the guys who paint the stripes being Picassos...if you are...you need to see them where I live!

I immagine that a more accurate saying would be "medics are the closest things to doctors/surgeons in the field."

Fine with me! It's all about me anyway...

While those are general pre req's for med school and what not, they are good classes for anyone in the medical field. After all, chemistry, for instance, is the basis for almost all other sciences and 2 semesters of it is kind of a drop in the bucket for learning a "base" science (no pun intended).

I agree, however the liability is the same IF they are the highest level o/s. If they aren't, they it's different. That's what I was getting at.

As far as I know, we still have them. They are NOT prevelant in central and southern AZ, but northern has quite a few. Don't know about western AZ.

I agree the "I" level is fairly useless. Don't know how it is elsewhere, but in AZ, they can do everything a medic can, except central lines. With a lot less schooling. How Cool!

Not really though...if the EMT-I is the highest provider o/s, then they have all the responsability as the highest level of care.

I was actually thinking it could be a BS degree, any higher and I think we would loose good people. But the format could be similar. One good incentive, as part of the curriculum, you could build in the pre-reqs for RN/PA/MD schools. I know for med school, MCATS require 2 semesters chemistry, 2 semesters biology, 2 semesters physics, and 2 semesters organic chemistry. Off hand, I would add at least 2 semesters of 200 level +A&P, some math, maybe up to college algebra or a little higher (I'm thinking trig is a little excessive). Another good addition would be an EMS specific leadership series, similar to the NFA's leadership 1, 2, 3 classes. Just thoughts. What do you guys think?

Reasons why my wife and I started an EMS education company!

So, there's this little boy and little girl, and the little girl asks the little boy, "What's a penis?" The little boy says, "I don't know, but my daddy will know. I'll ask him." So the little boy goes home and asks his dad "What is a penis?" His dad answers, "Well son, I'll show you"<<dad pulls pants down and shows him his penis>>"this son" pointing to it "is a penis. And for the record, this is a perfect penis." So, the next day the little boy goes to school and the little girl asks him, "so, did you find out what a penis is?" The boy says "yes, I'll show you"<<pulls his pants down>>"this is a penis, and if it this much"<<holds his fingers an inch apart>>"shorter, it'd be a perfect penis!"

Sorry to interrupt the "debate," however I am curious. I am not one for getting rid of the Basic cert, under CURRENT CONDITIONS. Why couldn't we take (I'm not just throwing this out, but seriously suggesting this) the whole Basic/Advanced/Paramedic thing, and make it a standard 4 year degree (could even equate this to "Med School"), where the first 2 years are nothing but classroom stuffs, and the last 2 class/clinical combo. Then...we could do away with the different levels, actually GAIN professionalism via education, and MAYBE, just maybe really expand our scope of practice. Seriously, why don't we try to do something like this?

So, just out of curiosity, before we got her onto a LSB, did we walk her spine? Any step off's/deformities/pain/discoloration?

Does anyone have or can send me a link to any interesting EKG strips/& or 12 leads you might have come across? Kinda looking for out of the ordinary. Basically, I'm trying to amass interesting strips for a medic class I will be teaching this fall.