pyroknight

As a matter of fact, I AM! She entered the military straight out of high school; served honorably in the USAF for seven years; was an extremely talented and well-respected 911 dispatcher in two large urban areas, was a single mom when I met her, has supported me through two fire academies, EMT training, paramedic training, nursing school, and graduate school; and she still has the sex drive of a teenager. What's not to be proud of? To bring this discussion back around, I think that a very vocal minority of homosexuals have the same mindset as VS - they like controversy and they relish seeing the reaction they get from people who have knee-jerk reactions. Both sides of this debate should take a chill and live and let live. There is nothing in the bible (or any other divine text that I am aware of) that requires followers to make public displays of their intolerance for others lifestyles. Christianity, I believe, goes so far as to extol "judge not, lest ye be judged." I know the Muslim doctrine is a smidge more aggressive in it's condemnation of homosexuality (note the sarcasm, people), but I hardly think Allah intended for anyone to OBSESS over the issue. Unless someone is putting their hand on part of your anatomy or insinuating that they would LIKE to, how is anyone else's lifestyle affecting you? If a homosexual boy scout leader is teaching my son how good it feels to have his penis held, we have a BIG problem. If he's teaching him how to knit a scarf to keep his neck warm, am I supposed to be up in arms? The latest pedophile I saw on TV was some 400 lb. grandfatherly type with no previous record. He was "babysitting" little girls. THAT is a problem. We have SO MANY other pressing issues in this country - nursing shortage, federal spending out of control, gang violence, a lack of affordable housing (to name a scant few) - do we REALLY need to be using our collective energy to debate the social palatability of two people of the same sex having a relationship? Since carbon dioxide has now been deemed a controlled pollutant, I propose that we tax people who spew excessive amounts of CO2 rich hot air into the atmosphere shooting off their big mouths attached to their miniature brains about topics that have no relevant impact on their lives! MY problem is with dim-witted individuals making arguments they can't support (often which are unsupportable period) about issues that either cannot be solved or do not NEED to be solved, NOT with homosexuals (or metrosexuals, or transexuals, or any other -sexuals). Whew! That was longer than I intended. I blame post-exercise hypoxia. That's my story and I'm sticking to it.

I have to agree with the idiocy of the current US military policy. My wife was in the Air Force and has told plenty of stories of sexual exploits that she either participated in or knew of while she was serving. I have other veteran friends who have related similar stories. If you are not going to require everyone to be celibate, then what difference should their sexual orientation make? If you have individuals who commit sexual discrimination, sexual harassment, or some other infraction, that is what courts martial are for. Prosecute the offenders and let those who confine their sexual exploits to a private setting do as they wish. Merely mentioning a sexual preference is ridiculous grounds for discharging someone from the military.

I think the biggest "problem" that people have with homosexuality in the US is the current push to have same-sex unions recognized as being equal in status to a traditional marriage. Many of those who vehemently oppose "gay marriage" do so because of their belief in the family unit. If you want to discuss statistics, look at the statistics on children who come from broken homes. Their is no debate that children raised in a loving, two-parent family fare better than those raised in single-parent homes. Everyone knows someone who was raised in a single-parent home who turned out great or someone from a two-parent family who is messed up, but when you look at the averages, two parents are best. Two homosexual parents would likely be just as positive (I have never heard of a study, so I am guessing), but homosexual parents cannot make a decision to HAVE children, they must rely on someone approving them to adopt. US society has typically placed a certain value on families. If you look at many of the social problems in our country today, most of them can be traced directly or indirectly to the undermining of families. Benefits to spouses were originally designed so that wives could stay home and raise the children. (More studies for you. Consider how much better children who stay home with mom fare than those shuttled off to day care when they are a month old) Maybe spouse/partner benefits should be modified for married couples, too. Perhaps health care benefits should be changed to be more like a welfare benefit that you have to qualify for. One partner (of any gender) would be eligible to be covered under the other partners health insurance when pregnant and for a set period (one year or until school age?) after birth or adoption. This would allow one member of ANY "family" to stay home with each new family member. After the kids start school, it's time for "mom" to go back to work and earn her own health insurance. I should run for office. No. Wait. I don't want the press digging around in my closet. 8)

Isn't it counter-intuitive to state that homosexuality is genetic? I mean, if it were, wouldn't they "breed" themselves out of existence? I hope they do find the "gene" that creates homosexuals. Instead of "curing" homosexuals, I think we should innoculate the idiots. If we could determine IQ early enough, we could "make" them homosexual and eliminate those genes from the gene pool! Unfortunately, one side effect of this course of action would be a reduction in the number of EMS responses. The idiots DO provide job security for EMS. What a conundrum!

If you do not need the IV access, most of the drugs we carry can also be administered IM. I can hit a muscle a lot easier than a vein! 8)

Ambulance on way to accident get hits by moose SUTTON, Alaska (AP) - Alaska State Troopers say a moose near Sutton had no respect yesterday (Thursday) for emergency lights and a siren. An Matanuska-Susitna Borough ambulance responding to a traffic accident at Mile 70 Glenn Highway was struck by the moose at Mile 84. Clint Vardeman is deputy emergency services director for the borough. He says the ambulance came around a corner and the moose was on an elevated piece of ground next to the highway. The moose jumped into the ambulance's passenger-side door, taking off a mirror, smashing the window and putting a small dent in the box of the ambulance. Neither an ambulance passenger or driver Brian James Anderson were injured. The 53-year-old driver was wearing a seat belt. --- Vardeman says they were able to open the passenger door but not close it. The moose was injured and killed by troopers. Damage to the 19-92 ambulance is estimated at four-thousand dollars. Juneau Daily News online

Well, we office weinies have to squeeze our surfing in whenever we can, LOL! I have been travelling the state spreading cheer and good will in the name of EMS. "I am from the government and I am here to help." Rural/Metro seems to be falling on some hard times out in AZ. Their home turf no longer has R/M fire OR R/M EMS. They should never have gone to bed with little Bobby Ramsey. He waited out his "do not compete" clause then bought another ambulance company and drove it right up their &$$! Oh, and EMS is STILL not definitive care 8)

Don't get me wrong, I'm all for more education. I went on to get my RN after my paramedic and I have a masters in another field. I have no desire to rack up the debt required to go to med school and EMS people are WAY more fun to hang out with than a bunch of physicians! (If they weren't, why would we have a couple of ED docs hanging out in here instead of in some stuffy MD forum? HMMMMMM?) My medical career has reached its apex, I shall go no further. I accept this fact, follow my protocols, and provide rapid transport with competent care. If a PHYSICIAN were in an ambulance it STILL wouldn't be definitive care. Leave your tent at home - triage, treat, and transport.

Like nearly ANY statement, there are exceptions. In the case of "EMS is not definitive care" the exceptions are few and far between (and have been listed previously). Transfer to definitive care is not transfer to the ER, but transfer to the hospital facility which includes the ER, the OR, the ICU, and all the other acronyms. EMS at its best rapidly stabilizes patients and safely delivers them to an APPROPRIATE facility. If you take a severe trauma patient to a psych hospital or tiny community hospital, you have failed in your EMS responsibilities. If you take a cardiac patient to a facility that does not have a cath lab when there is a cath lab equipped facility in town, you have failed in your EMS responsibilities (unless, of course, they've already coded - before you go there). If you are worth your salt, you should be able to do nearly anything en-route that you can do on scene. As has been previously mentioned, EMS units are more limited than ER beds in many areas, why tie one up if you do not have to? If what you are doing on scene will improve the patient's condition, take the time. If not, pack your mess up and get on the road. If you want to have more authority over patient care, go to med school. Too many wanna-be-docs who get in a huff when you call them "wanna-be-docs" set up their little ALS camps on a scene and FAIL to do what EMS is supposed to do - stabilize the patient and quickly and safely transport the patient to definitive care (which, if you haven't been paying attention, AIN'T US). Just my 0.02.

Other than being tachycardic and tachypneic, this patient appears stable. Depending on the information given to dispatch, they may not be at fault here either. I would be interested in knowing what was actually WRONG with this patient.

Even as an ALS provider, I am not sure I would go code 3 with this patient. She's 33, I have no reason to believe that she's exsanquinating, she's received pain medications - so I'm not OVERLY concerned. I can see where a BLS provider might be a little nervous, so I would certainly not FAULT you for going code 3 (I just happen to believe that it often puts everyone at greater risk with little reduction in transport time). Any supervisor worth their salt should have your back as well. Second-guessing providers when you weren't on a call should be avoided unless glaring errors are committed (which, in this case, was obviously NOT the case).

I agree there are still things that can be done to increase the safety of the rigs themselves (increased use of rounded/padded edges, crash-worthy mounting brackets for equipment that cannot be housed in cabinets, passenger restraints that minimize interference with patient care, etc.), BUT ambulances are dramatically different from passenger vehicles and there will be times when the caregiver simply must remove his or her restraint device while the vehicle is in motion. If anything, I think helmets make MORE sense (safety-wise) in ground units than in air units. I would think that survivability is lower in air ambulance crashes, therefore reducing head injuries could be accomplished more easily in ground units.

The overarching problem here is one that has been previously mentioned: too many people (many health care providers among them) have NO IDEA what our scope of practice / skills are. EMS has done an exceedingly poor job of educating our fellow health care workers (let alone John Q. Public) about what we actually DO. That being said, it never hurts to be as cordial as possible. My recommendation would be a statement like "I appreciate your willingness to help, but my crew and I have the equipment and skill to assist this patient if you will kindly step aside and let us care for her. I would be happy to discuss our patient care with you later when not in the middle of an emergency situation, but right now I need to take care of this patient."

Merginet - Safety Advocate Suggests Helmets for EMS Workers The article above suggests that in addition to wearing seat belts in the back of a moving ambulance, EMS caregivers should consider wearing helmets to protect their brain housing units. I have always liked headset communications between the back of the unit and the front and think this would be a great way to integrate communications and protection. What do the great EMS masses think?

Well, as my sister, the veterinarian, always says: "Real doctors treat more than one species!" Love you sis!

I guess it's a good thing so many of us in here aren't "average EMT"s, eh Dust?

The best "uniform" I've ever observed was when I was on a private ALS 911 ambulance in Arizona. We responded to an area West of Tucson and one of the female volunteers showed up wearing a "51% sweetheart, 49% bitch, don't push your luck" T-shirt. She interacted well with the family and I took her report like I would any other member of the patient care team, but my partner and I did have a laugh about her wardrobe selection after the call!

It sounds like you are trying to say that your NY EMT expired, but you have been certified somewhere else. If THAT is the case, you need to check into reciprocity. Many states will allow certified parties from other states to apply for certification in their state. Some require some type of test, others do not. Contact the NY EMS office directly with your questions. There should be someone in the state office willing to help you. If you can find an email address on their website, it may be easier to get a response that way than to attempt to contact them by phone.

Has anyone else's agency had a Zoll that would not defib? My last agency had a unit give an error message instead of electrical therapy in a code situation. As you can imagine, it was not pretty. Having to rendezvous with another unit to get a functioning defibrillator is a BAD thing, lol.

Unless and until they change the laws to allow US to refuse care to the patients, EMS will continue, now and forever, to be a LOSER financially. You can bill until you run out of paper, toner, and skin on the pads of your fingers, but if your patients are unwilling or unable to pay, you will not receive compensation. You are right in that government subsidies will not solve the problem. I am not at all sure that allowing us to refuse certain patients would be a bad idea. Certainly having alternate transport destinations besides the overcrowded emergency room would be a good idea. Our health care system is in a state that is damn near crisis. Someone is going to have to come up with some creative alternatives before the patients who really need our care start dying because of the cracks in the system.

I think you're making my point for me Brian. Paramedics are starting to earn decent money because you can't get a paramedic license in six months anymore. Nearly every paramedic program in the country is now a two-year, associates degree program. If EMT-Bs had to have an associates degree, the entry level pay for EMT-Bs would have to bump up accordingly. If paramedics moved to a four-year degree, they would also see a corresponding increase in their wages. If physical therapists can do it, EMS can too. It is going to require a decision on the part of the industry as a whole that we are willing to make the sacrifices and worthy of the pay.

BrianG - as a well-trained auto mechanic, you make more than an EMT. Why do you think that is? If ASCE (I hope I got the acronym right) certification were not the gold standard in auto repair and if it did not take so much time to achieve, we would have 17 year-olds under the hoods of cars in every auto dealer in the country. Even the AUTO REPAIR business requires more education than EMS!!! You can practically sign up for one of Sally Fields study-at-home programs and get an EMS credential. What is that worth? Until the profession requires an investment, we will continue to be treated as unskilled labor. The fire service in many parts of the country is suffering from the same challenge. Firefighters now respond to EMS calls, perform extrication, mitigate hazardous materials incidents, and generally deal with any emergency that arises. The community thinks all the fire service does is nap and occasionally put out a fire or two. If you compiled firefighter I/II, EMT, technical rescue, vehicle extrication, and hazardous materials into one training program, threw in an english, a math, a physical science or two, a psychology, and a sociology, I almost GUARANTEE you would have enough course work for a bachelors. It's way more than enough for an associates degree. If the fire service ever figures out just how much they are getting the shaft, look out! Because firefighters accumulate all their education in two to four hour blocks, very few realize just how educated they are. If firefighters actually compiled all that training into a degree program and demanded to be paid for being SKILLED workers, the entry level salaries for firefighters would double.

Have you been to the ER lately and been told "You need an x-ray, but, unfortunately, we don't have a radiology technician available right now."? Have you noticed a shortage of laboratory technicians? How about physical therapists? Seen any pharmacies closed because they couldn't get any technicians to fill prescriptions? All of these professions set high standards years ago that kept any dick or jane from walking off the street and three months later being a "pseudo-professional." If we REALLY want to change how our profession is viewed by those outside our profession, we are going to HAVE to change the educational requirements. There will be a need for an entry level for as long as our citizens refuse to pony up the funds for full-time paid EMS. As long as there are volunteers, there will be an absolute need for a level of care that is attainable by people who cannot quit their jobs to go to school. In my mind, this would be a first responder certification that approaches what our current EMT level is today. These people would be trained volunteers, but would not truly be part of the profession of EMS. If you want to volunteer in a hospital, they don't make you a doctor. EMTs should have at least a two-year degree and paramedics should have a bachelors. If the entrance requirements go up, the compensation will go up. When the compensation goes up, people will seek entry into the field. How many diploma nurses do you know? Associates degrees have become the minimum in nursing with most employers preferring BSN. As a nurse, I can tell you first hand that nurses are no better than paramedics. The job a paramedic does is tougher. Why do we not get paid for what we do? Because even we don't take ourselves seriously enough to require a reasonable entry level education.