Ghettomedic351

Well I have personally worked with Maurice White and he is far from an aggressive individual. I think the fact that a person is given some authority,a badge and a gun does not make them right every time. If they were going to such an important call then why did the have time to stop and hash this out with the crew of this ambulance.The officers in question would have been better off calling a supervisor of the ambulance company and expressing their concern rather than a full blown confrontation.

I was not responding to your post. I was responding to another attack. I answered what was asked. Now if answering a question makes me the best Paramedic ever thanks. Guess what I'm not even a Paramedic yet. Wait till I get that to bestow the title. Have a great day and get your pantys out of the wad they're in before you post again.

I think if anyone is attacking it is you sir. As I recall you attacked saying that I work in a mother may I system.I agree this post has gotten way off base,I think one of the original sticking points was the "STOMP 2" pack that started this post and obviously our "Non paramedic" friend has gotten off on a tangent and I was lured in by his attitude. My apologies to all,I am finished.

Thats worse than cookbook medicine being in a mother may I system. Glad I am in neither. I have guidelines and can do what needs done.

Radios and cells don't work in the wild frontier where only real medical professionals can survive.

Well tell us slick......where is the "Wild Frontier" and a consult is not a mother may I system,it might actually save a "Wild Cowboy" on the "Wild frontier" like you from a date with a judge someday, I have experienced guys like you before. I am sure you have a S.T.O.M.P 2 in the back of your suburban with and old defibrillator you got from craigslist. Enlighten us and tell us your service name if you are not too afraid. or are there things a guy like you might have to hide in the "Wild frontier", I have no problems sharing my info.

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Ughh, where to start?

First off the amount of Morphine a pt can handle is based on a ton of factors. Are they chronically on MS? I once had a Chronic Pain pt on 400mg of MS a day. Do you really think 5mg is going to affect this pt in the least? Are they in a great amount of pain? Burn victims can require large doses of MS. To simply say that the dose should be 5-10 is wrong and feels an awful lot like cookbook Medicine.

Well Sir I beg to Differ on your "Cookbook Medicine" analogy. Cookbook medicine is where you simply do something because your "cookbook" says to do it that way. While people who do have chronic pain might require more than your stated 5mg, in the 21st century we have these really cool things call radio's which we can contact an actual physician and see if a higher dose would be prudent. As far as morphine and burn patients I think you should be careful to avoid the effect of the peripheral vasodilation which occurs,in that case a synthetic such as fentanyl might be more suitable or perhaps a little versed.

Should I change my avatar, ladies?

"Giggity Giggity Giggity"

Regardless, it appears his wife has a very nice Tan....did the kit come with a bronzing lotion for his lady to maintain that lovely tan while fleeing from disaster?

Is this lead II? If so there is evidence of an anterior hemiblock as well. The complex is down, lead III would be down as well, lending itself to a pathological left axis deviation which indicates an anterior hemiblock. As for the underlying rhythm... "it's lead II, so I have no clue." It'd be nice to call it a-fib, but without the benefit of a proper diagnostic ecg, it's tough to tell for sure. At first glance I actually thought I saw some p-waves, albeit inverted and differing in morphology. I initially thought it was a sinus rhythm with PAC's, and one (or two) really pissed off atrias. I realize this was a "teaching strip" but in the words of my very famous paramedic instructor... "What's wrong with the patient!"

Adenosine slows the conduction time through the AV node, and because it does this, it slows the ventricular conduction, which would be your QRS complex. Because it's slowing down that complex, it enables you to see what is going on in the atrias on the ECG. When the ventricles conduct the impulse, the QRS complex will over-ride and cover up what is going on in the atria thus making it impossible to determine the underlying rhythm. It's helpful to slow down the conduction to determine the underlying rhythm because it may alter your treatment, especially if you carry a decent cache of cardiac drugs (i.e., diltiazem, procainamide, amiodarone, etc.). Thus, the second bold part of your post: The investigation of supraventricular tachycardias. If it's PSVT the adenosine may terminate it, if it's a-fib with RVR you can slow the conduction enough to determine that is what the rhythm is, and treat according to patient presentation, with the correct medication.

I hope that was clearer than mud for you.

I just could not resist asking Lt. Robert Several question's,Just what makes it far,far better riding in a Memphis FD ambulance than any other ambulance in the world? Snappy uniforms,union benefits,really cool paint schemes on the ambo's? how much time have you spent on the ambulance in your career at Memphis?

St Louis FD EMS can Boast "65,000 calls for help +13 medic units,not one missed call, Justifiably proud" the Difference between St louis and Memphis is you don't have to be a Firefighter to be a paramedic. How many of your 130,000 calls for service belong to the Ambulance crews?

I have heard from several people who have went to Memphis for class ride alongs for Paramedic that EMS is viewed by fire as a "Sub Human Species",I understand that FDNY does the same with EMS being divided and Not Welcome in the firehouse hence having to sit on a street corner when not running calls. Another example of disaster striking with mergers of EMS and Fire is Louisville KY and Louisville Metro EMS,they are supposed to be all friendly and cozy in bed with all city services but I understand once again that EMS is shunned and left out in the cold to themselves.

Washington DC is another shining example of wanting FF/Paramedics,however the division still remains with the stigma associated with not being dedicated to "Firefighting". I get these examples first hand from people who were there and have seen it happen and experienced the frustration and lack of teamwork from the fire side. Hell I am a two hatter and have seen this myself.Is every engine/truck/rescue squad in the city of Memphis ALS equipped? Will the Battalion Chiefs also serve as EMS liaisons when a crew needs assistance? Are Battalion Chiefs required to Be Paramedics and will they first respond to provide care when an ALS engine/truck/Squad or ambulance is not available for service?

I had a co worker of mine make the comment once regarding fire based ems and "Good patient care", and I quote..."if it is not on fire they tend not to notice it" I have witnessed this for myself from both ends of the spectrum. I think one could site the great idea some people had years ago about a "Public safety" type department where police also doubled as firefighters and EMT's,just did not work out so well.Ponder that thought for a bit and get back to me.

Yes indeed an overreaction to something a child might not even pick up on if not for the astute powers of adult observation.This is not the first time this has happened nor will it be the last,Could be the next Salem witch trial in the making.

Since the typical dosage of dextrose is in GRAMS, not milligrams, are you sure about this?

I thought things like this only happened in the movies, (Mother Jugs and Speed) Alas we have a guy here that was still pulling crap similar to this just a few years ago. He especially liked to intimidate female crews,sad to say he still operates his own service. Acts such as these continue to happen and we wonder why people still call us Ambulance drivers.

What exactly does this have to do with the scenario presented?

Nowhere is this situation discussing a narrow-complex tachycardia.

Seven Drunken Nights - The Dubliners

What does the history of fibromyalgia have to do with whether or not pain management should be used on a person that has fallen and dislocated their shoulder? I understand that there are several people that don't believe fibromyalgia to be a real disease, however a dislocated shoulder is a real injury.

It's becoming increasingly unethical to withhold pain medication, especially when faced with an obviously painful injury or illness. That's how it should be. There is no reason any patient should have to suffer.

Perhaps you could clarify exactly what you're looking for in regards to your scenerio. Are you asking if someone with a shoulder injury should receive pain management, or are you asking if we believe her pain to be a figment of her imagination because she has a history of fibromyalgia? Not flaming you, I'm just trying to understand your thought process better.

I can see this being standard issue equipment along with a teardrop magnetic mount light.

Getting worse after.....

Looks as if my destiny is to be Satan also, at least I have a high job satisfaction rate......

The Really sad part is....someone is getting paid very well to sit around and think crap like that up for a sauce packet....meanwhile I am out slaving over a hot ambulance making peanuts for pay, perhaps a career change is in order.....Hmmmmm?

Cute....... :roll:

OK. I am the one that sent you the PM, largely because I believe if I have something really disagreeable to say to someone it should be done in private. Maybe your mommy and daddy didnt teach you that. If you would like to get insulting in public, I would be perfectly happy to accomodate you. The fact is that I started this thread with the hope of meaningful dialogue which it appears that you are incapable of. That seems to be impossible given the topic with which I started the thread since this is an argument as old as the hills. What should EMT/Medics teams do? How should they function together.Obviously you cannot provide an intelligent answer to this question. This thread has been hijacked so many times by people who didnt bother to read my original post, that I dont even know whats its about anymore. Many, including you, have just run off on tangents based on the previous post and not on the intention of the thread. I have do it too, to try to maintain dicussion. Maybe its time to lock 'er down. This is just getting ridiculous. Thet next time you say something noxious, ill-informed and stupid I will just blast you in the forum instead of PM. You are right. If I am going to insult you, I should most definately do it in public. Thats the least I can do for someone of you caliber.

Perhaps someone of your caliber should learn your role in EMS,I think many others have shared the opinion that her(EMS49393) posts were on topic. And as for yourself, when you get a little experience then you might be entitled to an opinion. In an ALS service the Paramedic is ULTIMATELY responsible for any actions that occur during the shift, therefore the Paramedic is in charge. I put my time in just like the rest cleaning up other peoples messes and playing the role of faithful sidekick. After all this was said and done I decided to become a Paramedic and move up the food chain, I would like to suggest that you do the same thing. Also you are the individual that appears noxious and ill informed and possibly stupid. I don't live far from your state of Illinois perhaps I should come "get to know you" as you suggested in earlier posts.

One last note before I close, respect must be earned and you have not gotten off on the right foot in that respect. You sir have a very large opinion of yourself and your knowledge for having been on this job for a year or less.

Well....Good Luck on finding an EMT-I class in Arkansas, the last I heard they were not going to test the I-99 and they are SLOWLY letting the old intermediates Die out, I have a Friend or two down at the State Division of EMS and I will try and confirm this for you, But I dont think you will have much luck in the land of opportunity.