THE_DITCH_DOCTOR

Dispatch

EMS-1 respond to 412 N. Ridenour St. for a female unconscious but breathing! The way it comes across to all of scannerland is that the pt. is unconscious buttbreathing. I ask you, WHAT IS BUTT BREATHING? :?:

In Fountain County, Indiana, you never know. (greetings from someone who grew up in Parke County) :wink:

Like was said before, it all depends on the circumstances. We've transported people in the cab of then engine at my former VFD because there was no ambulance available. So if push comes to shove, do what you need to do.

We all know your affiliation with a Canadian paramedic union or some such group, and that you're simply toeing the party line in regards to this issue, but I don't see it as a terribly big problem. Personally I'd have more problem if the firefighters were sitting around with their thumbs up various orifices waiting for an ambulance rather than getting resourceful.

Of course the issue that firefighters in Canada aren't EMS trained (at least from what I was told (correct me if I am wrong)), adds another side to the story, but remember that there are several police departments in the US that will throw shooting victims into radio cars and haul butt for the nearest ER (not so surprisingly with equal or sometimes better survival rates than for those patients transported by ambulance).

"In hindsight, giving humans free will: HUGE MISTAKE"

I looked at the map in Time magazine, and surprise, surprise, its the states in the bible belt of the south that are pushing this "intelligent design back-door to lovin' jaysus" stuff. I say, let them. New England, the Mid-Atlantic states, much of the Midwest, the West Coast, we all say "SAY WHAT?" when someone says "let's make up some wacky theories to why we are the way we are rather than the scientifically validated ones".

If the south wants to remain steeped in the Middle Ages, they can knock themselves out. Their children will be less prepared for the reality of a science and technology driven world, leaving more jobs and opportunity for those of us who paid attention in biology class. Like Darwin said, its survival of the fittest.

Eeeeeexxxxcellent Smithers, excellent.

Now too bad we can't make them into their own country. Hard to believe we fought a war and lost several hundred thousand good men in order to keep the ancestors of these idiots in our country

Want my honest opinion? If that fault produces an earthquake of the magnitude of the 1811 and 1812 quakes, pretty much everything in a 50-100 radius of the fault break is going to be screwed up. Local response is not even probably going to amount to much and they will have to rely heavily upon outside help (DMAT and DMORT teams, Red Cross, etc).

true Steve, but if the community has the same feelings for the instructor as the two students have chances are this was an excellent opportunity to have him trip over himself and laugh him right out of the community. Im sure these arent the only two that have had a complaint. Id check with anyone else who had gone through the class previously and see if they had similiar treatment.

I would also talk with other instructors in your area and see what their opinion is. If he's not well liked by other area instructors chances are that he's not well liked by the local EMS community either.

But Id also keep my head down and my mouth shut until the investigation was finished. If the state finds nothing wrong, Id just say screw it and go through someone else to do it and explain the situation to them, they might offer a lower tuition to re-take the class for their trouble with a previous instructior/instituition since it is the same board and DOH that certifies them, or allow them to sit in on a test/examination.

Once again, my two cents for what its worth.

-Alco

Don't mean to be blunt Dix, but you're not exactly one who should be giving out advice on how to cause trouble for EMS authority figures since you've painted yourself into a corner in regards to impressions you've made in your area.

I don't think we are prepared but we can be entertained. A couple of years ago I read the book The New Madrid Run. The Earth's Magnetic Field shifts setting off quakes and a few survivors have to trek to safety. Check it out at- http://www.amazon.com/exec/obidos/tg/detai...710209?v=glance .

:roll:

Man I love making arrogant condescending jerks look foolish.

Me too. Nice work.

Sounds like a well constructed study.... :? I'd like to see a full protocol for that.

The use of sodium bicarbonate should be restricted to cases where an arterial blood gas has revealed significant metabolic acidosis, or in cases of TCA, aspirin or diphenhydramine overdose

Best way to solve this problem for future students,

spread the word around to parents and students of the school that carries this course that the instructor is malicious and will not allow a student to register for state examination based on one incorrect answer. Also send a letter to EMS Instructor Certifying board and complain, if this gets around enough students looking into EMS as a possible career will know NOT to take this elective as it is a running scam. Eventually less and less students will enroll in this elective course and will take the EMTB training from another school/instructor, and this instructor will be out of a job......

Just my two cents.......

-Alco

No offense, Dixie, but this is an excellent way to wind up blacklisted. Yeah, the guy's a dickhead, but chances are he's far better connected than these two students in the local EMS community and will do everything within his power to make sure they do not ever get a job.

Just food for thought......

Epi-shock, bicarb-shock? Uh........

No, not the same medical director....at least not for most of my career. The one I spent the most time working under actually treated most of us (read as those who could back up our reasoning and have an intelligent conversation) with a great deal of respect and he would have the ass of anyone who didn't respect "HIS" medics (and he called ALL of us that- from FR's up to EMT-P's). He was not a man you wanted to cross, but he got more pissed if you didn't stand up for yourself during audit and review than if you fought tooth and nail about something you felt was right. That's where I learned the debate technique I utilize on here.

And another thing, protocols aren't always correct- hence adaptation. If you do something outside of your protocols, you should do well as long as you meet the standard of care, you use your head, critical thinking and common sense and you have supporting arguments and a train of thought for why you did what you did. (It's called thinking outside of the box.)

That's assuming a couple of things:

1. You can defend your argument in some semblance of an organized, logical and educated manner. Many can't.

2. Your medical director is not an egomaniacal prick who thinks you have an ego problem, compounded by a serious lack of education because you are (in his mind) one step above a guy who asks "Would you like fries with that?". Many are.

3. Your patient has a good outcome because of, in spite of, or irregardless of the care you provided. Many don't.

I pick fights on internet forums. I'm kidding.

No, seriously, I do research and go to school full-time in addition to working (which really isn't that stressful anymore since I now work at a radio station), so I spend my off hours sleeping. That's my way of relaxing.

Ah, nice to see that some people in EMS still check common sense at the door in their balls out rush for the most "advanced" treatment possible.

You didn't piss me off. I just stated my opinions and gave my response to what you said. There would have been a funny picture if you had pissed me off.

i never said anything about lowering there standards. And I say again for the 3rd time that if they are good medics and know there stuff and are qualified there shouldn't be a degree requirement. I think a lot of you are not really understanding what i am trying to say.

Education is a good thing. But for the money medics are making now. Saying they don't get a pay raise for there education requirements it would be pointless to have a 2yr degree or more. (related to the EMS field)

Rid I think that you are right on the ball with your comments.

I do encourage raising the bar.

I'm sorry if i am sending the wrong message just my OPINIONS

It's like saying that, well the ship is leaking, but lets keep on sailing because most of the compartments don't have water in them. If you want to retain more of the "good" medics you need to make this a profitable career which means advancing things educationally and legislatively.

I find it rather contradictory that you are all for advancing the field but you have a problem with the way of doing that. As I've pointed out before, in various debates, you don't make rules for the best and brightest- the good medics- you make them for the dumbest and most immoral EMS provider- the one you wouldn't let treat your dog. You increase the educational requirements from what they are now in order to weed out the less desirables and grossly unqualified, at the same time making the "good" medics you speak of, even better.

I believe Lee Iacoca said it best in those old Chrysler commercials: "Lead, follow, or get out of the way."

The problem is that there are a lot of very ignorant people who can pass the test (which is not nearly hard enough at any level). Just knowing what to do and when is not enough. You need to understand a tremendous amount more if you want to be able to help this become more than just a job. This is a career field and it needs to be treated as such. The only way to do that is to impose more staunch educational requirements upon those entering the field, irregardless of a shortage. I don't see nursing lowering their standards and they are far more shorthanded than EMS is currently.

BUMP*

And to think if they had just shot him in the head the British wouldn't have to pay for a trial and imprisonment.

I can beat that for worst attempt:

One of my friends from the military has the video of me doing the worst attempt ever at beer bonging Yuengling.

Ewwww.....funny, but exceedingly gross.....

By the way, speaking as the staff RT here, , a CPAP unit is not a ventilator. Yes, CPAP is a mode of ventilation but it technically does not ventilate the patient. A BiPAP unit is akin to a pressure ventilator because you can set an inspiratory time and pressure, over the EPAP setting. If push comes to shove (you have NO other choice) you can actually ventilate an apneic patient using some BiPAP machines (either non-invasively (by mask) or after the patient is intubated; but the machine MUST have a time setting in order to set the RR), you can not ventilate an apneic patient with CPAP.

For the benefit of those who don't work with ventilators or CPAP and BiPAP on a regular basis, CPAP has one pressure setting- measured in cmH20. BiPAP (bilevel positive airway pressure) has two settings- for instance 12/5, also measured in cmH20. The first number is the inspiratory positive airway pressure (the maximum pressure being delivered (akin to the systolic pressure in BP readings) and the second number is the EPAP- expiratory positive airway pressure) is the same thing physiologically as CPAP. It is the lowest pressure that occurs during the cycle with a level of 0 indicating ambient (atmospheric pressure).

EPAP or CPAP is also the same thing as positive end expiratory pressure (PEEP) which is a term used in other modes of mechanical ventilation).

Also Pigginsick, have you read any of the studies stating that atrial fib is a relative contraindication to the use of CPAP, as the increase in intrathoracic pressure that accompanies CPAP usage can impair venous return and can drop cardiac output, thereby decreasing BP. It's not a reason to withhold needed care, just a very good reason to be cautious and not overly aggressive.