paramedicmike

Whatever you do, don't click here. -be safe

So, then you're involved with the activities that lead to the FBI raiding your offices back in May? How's that working out for you?

For something even remotely legally defensible, you may wish to discuss this with a lawyer familiar with EMS laws/regulations for your state. I know *I* don't want to be responsible for you having to go to court over a refusal. -be safe

Yep. I can and have questioned. Sometimes things have even been changed based on my speaking up. -be safe

I agree with chbare. If you want to be a doctor then don't bother with paramedic OR nursing school. Get yourself into college on a full time basis majoring in pre-med or a similar science heavy major (bio, chem, bio-chem). Paramedic and/or nursing school will only delay you. If being a doctor is really what you want to do then don't waste time with them. Focus on an educational program that will get you where you want to be in as direct a route as possible. Good luck. -be safe

To which you reply, "I do. But don't expect them back. I'm keeping them for my collection." -be safe

Perhaps leave a copy of your protocols for him and let him know you're available to answer any questions he might have? And then ask for a question and answer session so you're both more in tune with what's expected on both ends. -be safe

I've used the Cook Melker. It did have a lot of pieces but I didn't find that any of them got in the way even though it was a high stress situation. Placing it went quickly and smoothly. I haven't used the others so I can't offer anything by way of comparison. But I didn't have any problem with the Melker. Hope this helps. -be safe

Is gun violence limited only to urban areas? Not last I checked. -be safe

Pessimism aside, while some of what UM is saying is true, it's not the final word by any means. Will a BS help you in this industry today? Probably not in the way you want it to (salary et cetera). Will it help you in the long run? Probably. We don't know for sure the direction this industry is headed. There's a lot of different things going on. The educational background received from a formal educational program, as opposed to a tech school preparation that doesn't offer the additional education you've received, will serve you better in the long run. No matter what objections the naysayers will raise, a degree carries weight with those with whom we interact. You may not see a financial kickback from it today. But don't think about today. Think five, ten years from now after you've been doing this for a while. That educational base, combined with continued formal education that you should be doing as well, and you'll be set for where ever this industry is headed. Besides, you need your time in the trenches to start. That'll occupy your time for a few years after graduation. Where can you go? From my understanding, any place outside of western PA. If you head east, closer to Philly (but avoid Philly itself) the wages get better...in some places you can make fair money. I'd avoid the northeast otherwise...especially NJ. Before you make the big jump to go anywhere, do your research of the local market and cost of living. Ask here. There are people all over the world who frequent here. But whatever you do, don't drop school once you get that big envelope in the mail. You'd be shooting yourself in the foot. -be safe

Uh...CH...something you want to share? Not working out as you thought it might? Hope everything is alright. I fly, too...well...I fly when we get flights. We're in our slow season. It's alright, though. I tend to be a bit of a $hit magnet. When I fly people tend to be pretty seriously hurt. Or it's an incident earning the attention of the national news. That's *really* annoying. -be safe

You think it's laziness that keeps people in the station? Really?! What are the vast majority of fire calls? Alarms. Do we really need to head out for every alarm? Isn't that what the FD is for? And if the FFs on scene of an alarm get hurt just what were they doing? Further, if you feel that no matter what people can get hurt, then why not have a personal ambulance assigned to everyone out there? After all, I might fall down the stairs...or get in an accident...or trip over my dog and smack my head on the coffee table. It could happen at any time according to your logic. So why not? It's silly to send an ambulance for every fire call. They won't do anything but sit in the ambulance and wait for all the FFs to get tired and go home which will still elicit the same lazy comments as posted above. So it seems pretty smart to sit in the station and wait until they're needed (and remain available for the public at large) instead of wasting time by committing themselves to an incident where they're not needed. -be safe

It could. It depends on how picky the employer is about such things. I've known people to be passed over in a hiring situation due to color blindness who had no problem getting hired at a competing service. Persistence will be your friend. -be safe

Dilaudid is another name for Hydromorphone. It is a morphine derivative. Quite potent as you found out. Hope this helps. -be safe

It took a second...and I had to say it out loud...but I got it. Nice. -be safe

Softball's for wusses. Are you saying you're a wuss? Stop your whining. She's your senator. You had your chance to do something about her. In fact, the rest of the country was *counting* on you to do something about her. And what did you do? Put her back in the Senate. Gee. Thanks for that. :roll: -be safe

There's a difference between practical jokes and full out hazing. Hazing is increasingly illegal. A practical joke can, if given the right environment and people, be a good laugh for all involved. Until you know how the newbies will react, it might be best to hold off until you get to know him/her a little better. The last thing you want is to be named in a hostile work environment complaint. You'll lose your job and FAST! Even if it was all "harmless and in good fun". I'm going to have to agree with Jake on this one. If you want to be treated as a professional then it's best to act like one. If you want to stand out from the rest of the whackers out there then this is just one of the many things you can do to clearly identify yourself as a professional. It's a far cry from joking and playing pranks with your partner after you've been working with him/her every day for months, if not years, on end to "initiating" a new hire. If you feel you absolutely, positively *must* stoop to such first grade levels, then perhaps get everyone else involved and just make the rookie *think* something's coming when, in fact, there's nothing coming. Suspense can be the worst prank of them all. Until then... -be safe.

As to the original post, it's all been said. As to the pain question, the goal is to achieve "zero" pain. Not a little pain...but no pain. Zero pain can't be quantified as "one" as that indicates there the patient is not feeling no pain (or zero pain). Zero is devoid of any value. You wouldn't say you ran one call when you really ran zero calls, would you? So why would one suggest that they have a pain level of "one" when they really have no pain at all? It's not just semantics. -be safe

Too many variables. Am I proud of my employer? No. Actually, they astound me, and dare I say my coworkers, with their continued feats of stupidity. Am I proud of the actual physical location where I go to work? Eh...it's alright I guess. Could be better. Could be worse. Am I proud of my coworkers? Every damn day I go into work. Am I proud of the job I do? I just go in and try to do my best. Pride is such a wide ranging and dangerous feeling. It's tough to break it down that easily. -be safe

Go back to how the heart actually sits in the body. It rests on the right ventricle. The right ventricle is what we see as the inferior wall when we do a standard 12 lead. If there is any right sided involvement you'll see it in the inferior leads on a standard 12 lead. I suppose then, if you were motivated, you could try the right sided image. But it would simply be for the sake of knowledge at that point (not entirely a bad thing, though). But then that takes us back to the response you got from the ER doc. There was no right sided (i.e. inferior wall) involvement noted on the normal 12 lead so the right sided image probably wasn't indicated. Was it wrong to do? Eh...probably not. But it probably wasn't indicated either. As for your technical question, to the best of my knowledge you had it right. Just move V3-V6 to their corresponding points on the left side of the chest and take your tracing from there. Keep in mind, I'm not saying you're wrong. So long as completing the right side didn't detract from treating your patient then why not, right? -be safe

I had a discussion with a couple of ER docs recently regarding right sided 12 leads and suspicion of right ventricular involvement. Basically, what I got from the discussion is that right sided imaging like this is purely academic. A normal 12 lead should give you enough of an image to tell you if there is right sided involvement. Because when you look at a normal 12 lead, those inferior leads are really the right side of the heart. Extra imaging isn't usually going to give you that different a picture than what you already have. The inverted T waves could be something left over from a previous cardiac event or something else entirely. It's tough to say without having another recent EKG from the patient for comparison...or even without more information on the history provided to you (and then to us). With all that said, I don't think you were wrong to do what you did. But don't take it personally that the doc dismissed you as readily as you described. It could've been just a bad day for the doc (even docs have a bad day occasionally). You did what you thought needed to be done based on how the patient presented to you. You were thinking which is always a good thing. In the future maybe press the doc for a little more info? Tough to do at times given the situation in the ER and what else may be going on. But it never hurts to ask for clarification. Hope this helps. -be safe

Kids come with. We have a built in child seat in the captain's chair. We also usually carry an extra child seat as a back up. Took a mom in one night in a scenario not that dissimilar to the originally presented situation. She had five kids. Husband was out of town on business. New to the area. No family. Didn't know anyone. So mom and five kids got a ride to the ER. Another time the local volly fire chief offered to stay with the kids. Dad was on his way home but would be a while. Mom agreed. Mom was a little odd. -be safe

For some reason I can't post an active link. I think it has to do with the spacing used in the URL. Copy and paste the whole thing to get to the .pdf. If you click on what's highlighted you won't get there. Gotta copy/paste the entire line of the link. Here's an interesting position paper from the NAEMSP. It might prove to be an interesting read for some. http://www.naemsp.org/pdf/Drug Assisted Intubation New.pdf Happy reading. -be safe

Couldn't the same argument be made about paramedics intubating? We have even less controlled environments than ERs (nevermind the ORs) yet have the same expectations that we manage the airways effectively. I don't know that this necessarily addresses some of the studies that negatively reflect on paramedic intubations. But it might have something to do with it. (I think the crappy educational programs for paramedics has something to do with it, too. As does the type of person EMS tends to attract.) Just playing devil's advocate. No need for anyone to get bent all out of shape. That's funny! -be safe

No. I've seen too many people out there who shouldn't have drivers licenses operating as medics. I don't trust them to drive much less with the ability to paralyze someone. Hell, I don't think some of my coworkers should have access to it and we're actually allowed to do it. -be safe