jmac

AK, sorry you disagree with me but i thought my post actuall said some of the same things your last one did. I am going on anthonys original post, I am not in any way shape or form ageinst teaching or showing what may or may not happen but if it leads to someone spending more time looking for things that they heard about or were informed about on a website in posts rather then dealing with the Pt in front of them "at their level" the teaching nad points of reference go out the window. A lot of the information being given here take a lot of learning time, a lot of people read this, i am just saying deal with the question, who is to say some person of a lower level then the poster decides to go with what he read here and not understand the processes and ignores the job he or she is supposed to be doing, its all well and good you or someone at your level understanding the posts, its when it is misinturpreted that is the problem, i thought teaching was for direction and these type of threads were to instill the urge to find more education...not to show what the end product of that education was or by how much some have learned. "a little bit of knowlege can be a bad thing"....in the wrong hands and no amount of posts on a website is going to fill in for education. thats my opinion, no insult intended just like to see things r3emain at the level they started off at.

pants : left cargo pocket gluecometer pack two 20cmX40cm dressings. right shears 20cm bandage, gloves two dated PCR's with crew PIN no's and penlight shirt : left pocket notebook, facility keycard, cash. right, various TACAIDS, MIMMS ect. have an onscene belt with minimag, pouch, radio that usually stays in the ambo unless its a big incident.

If i may say something here, Anthony asked when and why would he start PPV and if he made the right decision "at his level", well and good making all the points about DKA, and recognising ALL underlying problems but he was the man on the ground, it was not a fear of the man dieing that should have made him go code three it was the actual physical presentation. There is an old saying "a little bit of knowledge can be a bad thing", anthony did what he had to do, its all well and good thinking in a clinical enviornment, but on a supposedly stable transport you look at the Pt, the first thing you are supposed to learn at any level is that if anything goes tits up you go back to "A" airway, the physical presentation that anthony gave would make me treat the Pt the same as he did, it was the only intervention that he could do, why would he bother looking for any differential diagnosis that he did not have the tools to look for or the tools to treat. He treated what he had in front of him, if this is supposed to be a learning process why are we filling him up with all these interventions or overthinking what you may do in your level......in my opinion anthony did a good job and presented a somewhat more stable Pt to the ED , job done...well done...every Pt is different. I think the problem that anthony has is a worlwide problem, if we do something on the ground that reverses a problem and then bring the Pt into the ED it is hard for the nurses or staff to be in our position, thats the luck of the draw, its what we do, thats why i follow up where i can on my Pts and try to build a rapport with the staff in the ED so when they see me coming or i radio ahead they know i have a problem, though you are not right all the time with your diagnosis...you treat what you see, again well done anthony.

will it pick up drunks on a weekend ???????

OK, it looks to me that i am beat, thanks prpg for pointing that out to me, my arguments have no grounds, it is OK to ridicule other countries EMS or the fact that things are not done as well as all the things you can find on google. just some points 1. people say that the trendeluberg is redundant....then why is it still taught, no matter how many reports people put up here it is still part fo EMT training. 2. all the things that are quoted are the first ambulance on scene duty, if anyone here has been to an MCI they will tell you that nothing goes to plan, there are never enough resources. 3. in a terrorist event there are other circumstances to consider..is the event over...other agencies to ferry cas's from the area to keep resources flowing. 4. the pic itself....we do not know where this Pt came in the triage sort.. the Pt could have been through three or four stages of the sieve and could have been downgraded but still require transport in my opinion it is unprofessional to put up a pic and ask what is wrong with it, people do things that some may see are wrong in their eyes, it is very easy to pick out what you deem are mistakes when you are not involved or do not know the history..in my eyes it is also bad taste as for my spelling and grammer, i don't really care for your opinion, at the end of the day i do my job come here to chill and talk to friends, i do not have to try and prove myself to anyone here, if i learn something well and good but if i see something that i feel is wrong i will speak out...even if if it is misspelled, i have experience of terrorist events and of MCI's, i have seen things go belly up and you can only stick to your own personal standards..that does not say you do not make mistakes and i don't think there are many here who do not make mistakes...they just do not talk about them here.

OK, it looks to me that i am beat, thanks prpg for pointing that out to me, my arguments have no grounds, it is OK to ridicule other countries EMS or the fact that things are not done as well as all the things you can find on google. just some points 1. people say that the trendeluberg is redundant....then why is it still taught, no matter how many reports people put up here it is still part fo EMT training. 2. all the things that are quoted are the first ambulance on scene duty, if anyone here has been to an MCI they will tell you that nothing goes to plan, there are never enough resources. 3. in a terrorist event there are other circumstances to consider..is the event over...other agencies to ferry cas's from the area to keep resources flowing. 4. the pic itself....we do not know where this Pt came in the triage sort.. the Pt could have been through three or four stages of the sieve and could have been downgraded but still require transport in my opinion it is unprofessional to put up a pic and ask what is wrong with it, people do things that some may see are wrong in their eyes, it is very easy to pick out what you deem are mistakes when you are not involved or do not know the history..i my eyes it is also bad taste as for my spelling and gramme, i don't really care for your opinion, at the end of the day i do my job come here to chill and talk to friends, i do not have to try and prove myself to anyone here, if i learn something well and good but if i see something that i feel is wrong i will speak out...even if if it is misspelled, i have experience of terrorist events and of MCI's, i have seen things go belly up and you can only stick to your own personal standards..that does not say you do not make mistakes and i don't think there are many here who do not make mistakes...they just do not talk about them here.

jpinfv, i really do think that you should go away and get some experience, by your profile you state that you are a student, study up on MIMMS, if you had any experience of terrerist incidents you may not be so cocky. these incidents are an entirely different thing to an MCI, an MCI could be any incident with more then the number of Pts that the usual resources service, add to this unwarned use of explosives and its a nightmare for EMS, the usual scene safety goes out the window, other services come into play, EOD, specielist fire, hazchem the works are working around you......i say again working around you, its chaos and takes a while to organise but its still chaos. picture the first triage from the first Veh on scene or the second, bringing priority Pts away form the area, you seem to think its funny to have one pic to redicule, how do you know when where that pic was taken. unlike you i have had experience in this, and as a few ppl on this site have as well, i honestly dont think you can even see how silly your arguements and comments are, i did not want to say this as i thought you would have the maturity to leave this be, ppl read your signature and your profile and can see that you probably do not have the experience to actually comment on this, your just a bored student googling for pics...grow up this is not an arguement that i wish to have, even after i left the links you still come back like a petulent child.

http://www.itv.com/news/fa5ea160c743d51bb6...77d5d484f0.html http://www.rte.ie/news/2006/0828/turkey.html

what is wrong with you people, in 11 days most people on this site will be bowing their heads in remembrance of the most diabolical terrorist attack ever. this guy is evacuating a Pt from the area of terrorist bombings of his country and all you can do is take the piss and try to critique the way he is dressed and what way he has his PT. what you are posting is in bad bad taste,especially around this time, would the comments be so jovial if it was 9/11 pic under discussion, this bombing only happened last week in three separate areas, try google. i am very surprised at some and disappointed in others, is it a case that it is not terror unless it is in the US, and i would love to see some of the posters in the same situation with the same resources they had.

OK my reading of the pic, the Pt, this was a mass cas incident so there were med teams there so the lady could have been cleared C-spine and only has the coller on for comfort and transport...she is on a blanket` so not on the plastic for legs up for shock, is nobody thinking MIMMS here ? as for the pants, its easy to see that the guy is a firefighter and probably not all F/F's are trained up to EMT standard's so in poor visibility it makes sense that he is easy identified, also he could be a vol or part-time thus being supplied with all the Gucci gear. that's my take and i find it a bit strange to be posting pics from around the world and then dissecting them and criticizing them, especially when you are exporting programmes like 911 emergency and the like

I have to agree with cynic , race and medicdude, as an instructor with a lot of years experience i have found that the nice to knows and the need to knows are very easy to get across and putting the need to knows into practice where they will be used in real life or death situations is of the utmost importance. First aid is exactly that First aid and what i try to get across to a class is the need to actually do something so practical skills are pushed and the theory side of it is the "nice to know" things, we are not trying to make mini EMT's, sitting in a lecture listening listening to the components of a body system is not going to hold a class of lay rescuers for long but getting them to to actually feel the pulse of a pressure point themselves will, or changing positions constantly in two rescuer CPR with a vomiting Pt....practical scenarios, things they may come up against...no point in flogging a dead horse with lectures, get them working together. At the end of the day it is the instructor that has responsibility for his students and the examiner, if he is satisfied will card them, if the content of the course can be put across in less then recommended time, so be it, is it not better to have an interested first aider doing something when you arrive on scene because he did loads of practical exercises on his course and it held his concentration rather then some other one that is trying to remember part of some boring lecture, my two cents worth anyway.

i agree with what been said about hypoxic drive and O2 for COPD Pt's, but i think i am missing something here, the first post was about the medic asking why high rate O2 was being given, the way i would look at it is that the Pt was the first crews Pt and they treated as required. in my humble opinion the first crew on-scene initiates treatment, followed their protocols for the benefit of the Pt, stabilized the Pt so that the back-up ALS crew had a working body to deal with, whats the problem, if the BLS crew mess up (in my opinion they did not), that's why they called back-up for a potentially un-stable PT, i would go along with what has been said above, it was a medic problem....not a medical one.

I dunno but you can call me cynical but is this all leading up to having mechanical chest compressers on all ambulances, I sat through a lecture from all these reps trying to get the service to test them, they did not want to answer any frontline questions and kept reverting back to statistic from pig's ????????. maybe i am cynical :? .

to be honest mini it baffles me too, if it was me there you would get a thank you very much, but the medic may have had their reasons, i cant for the life of me see them but they may have, dont dwell on it too much...lifes too short :wink:

my two cents worth, i am enjoying this and its very good reading, just want to say that regardless of the monitor, 3 lead or 12, they can both misinform you at times, i had a case of psuedonormalisation a couple of weeks ago, this is where the t-wave after an old incident is inverted and with a new episode of chest-pain or possible MI the t-wave reverts to normal, i am told this is rare, this was my first case, so i treated the PT and not the monitor. Its little things like this that keep you on your toes, the EKG appeared normal in all leads and the PT had to be monitored for a period of hours before signs of damage showed, so it just goes to show sometimes we can become attached to our mechanical friends, but its better to take a look at the history and the PT, keep safe.

since the topic is broached, what is considered PPE on your health and safety statement's ??

sorry if this sounds like a stupid question....but do you guys have to buy your own PPE, is it not issued to you and if not why not, surely if the job wants to keep the lawyers out it should be issued ???????

for my two cents worth, it seems that a lot of people are going away from the basics of the job, in my opinion the more education you can get the better but there seems to be a leaning away from pre-hosp with page upon page of really nice to know info but really going away from the golden hour, treatment and movement of PT's. I for one do not really care what leval the person that i am talking to in chat or on the forums, discussion and debate are good, a good slagging is good as well, but to bring the topics down to the gutter, and this coming from self professed supermedics, it baffles me, i do not feel that the people on here , to quote terri "EMT's regardless of the following letter" come here to be beatten into submission, i thought this was a place to take away things from, and i dont mean resentment, but i would like to see the big "I AM's" tone down a little and maybe post a link to their info instead of posting reams of data. everyone has google now don't they, keep safe.

while i agree with all that has been said, it might be an idea to think that some are giving their opinion on a level that does not take into account that some people would initiate resus on an obviously deceased person, though this is an interesting discussion i myself understood it all wrong and and commented on things that i would take for granted, recognition of signs ect. i must apologise if i seemed arguementative, my fault entirely, i was looking at it as a level playing field and not from different skill or interpretive levels and my understanding of the money end of it is nil...so i will take a step back and i think i have learned something about the difference between countries, keep safe.

just on the strips, we do not have the litigation issues you have there, as i said this is done as hard copy for proof that we were there and the PT was declared by an MD or that there were signs incompatible or after ALS has failed...nothing strange...not that we do not know that the PT is deceased but as hard copy for data recovery to go with the arrest proforma and memory card, keep safe.

wow, really deep bandaid 8) 8)

I do not make policy, and as for a decomposing body, unless it is us that are the first response, no we do not run a strip, we do have some leaway, that is a police matter for investigation. but we do run a strip on all deceased for hard copy to go along with our report form and if it is the stupidest thing you have ever heard....there is a lot out there that would really amaze you, keep safe.

rid very interesting reading, and i mean that all jokes aside. just to clear up a few details, we take a two thirty sec strips for all pre-hosp deaths, thats just the way things are done here. i understand in theory what you are saying in and fully understand signs incompatible...if you are trying to inform impressionable minds on when to resus/not resus, out side of all the cost issues, what happens if one of these new EMT's fails to attempt and calls it prematurely, the waters are fairly murky here now. i am not new to EMS nor am i a young gun and have a fair amount of experience, my one fear is that because of the info put up here with no follow up in-house training, resus may not be started on one infant that could have benifited, to me that is one too many. i do realise the constrictions put on you by cost and time and that things are different here, but one is too many in my book, keep sagfe.

rid, this is an international site and if you do not want input from other countries or you are looking at this from an off the road approach you should have stated this. i explained my points of view a few times,we do not charge for emergency transport regardless of what the call is so cost issues are not my concern and believe me i do get real, that comment was uncalled for. you and ace put up a lot of litrature, i commend you for that but this is in EMS discussion, you put up a poll i voted and explained why i did, different countries...different viewpoints and clinical guidelines, you say you want students to think for themselves, but something outside your opinion is alien...why dont you get real. this is not a personnal attack on you, just answering some of your comments, i understand somethings are done differently from place to place, my original question was on signs of life and the use of the term in this thread, did not mean to escalate an arguement, just add to a discussion, keep safe.

i must say ruffems that is the best response post to this i have seen, as for the poll and some of the comments, this leads me to some questions of my own, is the poll there so that some people can just redicule others on why they would or would not resus, in my opinion the poll is flawed, it talks about dead infants...about SIDS, nothing about time factors, how long the infant is down. signs incompatible, if anyone who replied to theis topic does not recognise them and would attempt resus, they are in the wrong job, we are supposed to be professional here regardless of level, some infants have survived the symptems of SIDS and been resussed. the way i look at it is simple, i do not call an infant dead because they are not breathing and dont have a pulse or signs of life, signs incompatible well and good but if the signs are not there i resus, as for getting back on the road ASAP, thats a very callous and unprofessional attitude in my opinion, you can only do one call at a time so deal with the one you are on. if people come on scene and just look at the infant check pupils, listen with a stet and call it well and good, they do not start resus, thats their call, but if you want a poll and discussion about infant resus...have one but get the parameters set first, this is getting silly, keep safe.