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mikeymedic1984

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Everything posted by mikeymedic1984

  1. You can forget the "release form", it is worthless, if you crash, everyone will sue you regardless of how many forms you have. It is best to have family ride up front in the cab, with a real seatbelt (and usually airbag). In any significant crash, everyone in the box will be injured if not killed (google ambulance crash videos).
  2. No service will hire anyone at this age, so if he/she completes school, they will be unhirable until at least age 18, maybe 21, assuming a clean driving record. Go all the way to Paramedic school (Insurance companies will not cover a driver under age 18, most will not cover under age 21.
  3. The day that disturbing calls do not bother you is the day you should get out of EMS; but with that being said, please keep this in mind: 1. We do not cause the pain or ailment, we respond and do our best for each patient, and often, that will not be enough. It's not fair, it's not right, but it is reality. We see, smell, and remember things that no one should, but who would do it if we didn't. You will never find me running into a burning building for any reason, but I am grateful that there are people who do. You have to do what works for you in these situations, whether that be CISD, talking to whomever, but at the end of the day, we do need you back in the saddle. There are a finite number of people who can do this job, and even a much smaller number that can do it well. Should you choose to leave and take on a job that is less stessfull, who will fill that vaccuum? Yes there are plenty of rookies in the pipeline, but which of them could jump on the truck tomorrow and be as good as you are after 8 years? 2. For every one of these "bad" calls, remember the many good calls where "you" touched a life, even if you did not save it. I imagine there are several folks walking this earth today solely because you were there in their moment of need. 3. The following is probably the dumbest/corniest advice you will ever recieve, but it is applicable in many ways: http://www.naute.com/stories/worrytree.phtml
  4. Regardless of who the manufacturer is, you should be able to find some service nearby that has purchased that product; solicit them for real feedback, not just anecdotal hearsay. Also do your due dilingence and compare "warranties" from several manufacturers, and realize that at the time of bid, you may be able to push a manufacturer to give you a better warranty than their standard (I got one to give me lifetime electrical without any hassle). More importantly, do your homework on which chassis is best (Ford, GM, Dodge, Mercedes). Your bosses are asking you to trim cost, which is not surprising in this economy; see if there is a way to keep using your current provider by cutting back on some of the "options" you usually order (can you use a smaller version, are there bells and whistles that you see as usual that others may see as frivolous). The base cost of the purchase is just one factor to consider in the overall value; it is your job to prove what is the best "value" overall, regardless of price. Cheapest is usually not the best, but then again, the most expensive does not necessarily equal a superior product either. I would love a cadillac, but if my budget does not allow for it, then an upper-end Kia/Hyundai with a 10year/100k warranty may be a better value. Everyone is having to cut their budgets, and budgets will be cut, so at the end of the day would you rather have a cheaper vehicle or less pay or people on the payroll ?
  5. I am sorry, and I do mean this in the most sympathetic way, but if you need medications to just deal with normal day-to-day life, then EMS is not for you, unless you stay on the non-emergency transport side of the business. I know lots of folks who are on these types of meds and work in EMS, and I would say generally that they are not the medics I want to see when I look up from the ditch. I am sure there are some that do it well, but I have not met them. This is also not a good career for people who have to function in "black and white" structure, where everything fits a schematic (engineers). EMS is very gray a good bit of the time. Consider other medical careers where you are the follower and not the decider.
  6. Really ????? You don't work dead bodies ?? How many dead infants have you left at home ?
  7. You answered your own question. "Sir/Madam, we can transport your weapon, but it is not allowed in the hospital, and will be taken from you by security upon your arrival. Since you may not have access to it at the hospital, I think it is best to : ____________________________________" . These people are not problematic for EMS, its the other 90% that have a weapon in thier pocket you do not know about.
  8. It's not afib -- consider typical SVT or junctional tach. The rhythm is not irregularly irregular.
  9. 1. ACLS is the cookbook, always follow the recipe.
  10. Am I the only one shocked that he did not at least get manslaughter. He is not a cop, he gets out of his car with a gun and stalks the kid to a dark area. Then gets in a fight, and kills the kid, after the police tell him not to chase the perp. Isn't that like climbing an electrical tower that has signs and a fence that says no trespassing, and then suing the electric company when you get shocked ?????
  11. Checking my racist handbook (we in the south are all give one at birth). First rhetorical comment to any comment that suggests you might be racist (thumbing to page 5); state you have "2" black friends, or you have a black in your neighborhood (but never say you have dated one, that is a bridge too far). Why are blacks so intolerant of the cold in the North ? As I understand it, blacks are thriving in Europe and Canada, I guess they are special blacks. We whites can argue this all day and night, you would need to really ask blacks why they choose to live in area that is so inhospitable to them if that is what you think the south is, and also ask them how they survive economically in an area that only lets them pick cotton. "Blacks choose to live in the south solely because of the climate" (not a quote, but consences of comments); Really, Really, Really ??????? -- and my comments were considered the dumbest ???? P.S. : Island EMT, you meant watermelon and chicken.
  12. Wow, amazing how all of you with 3 black people in your state assume that we in the south are still wearing our klan outfits and burning crosses. Have you ever pondered why black people CHOOSE to live in the south (Atlanta, New Orleans, Memphis, Tupelo) versus moving to the racist North. If you have only a handful of blacks in your area, you might want to ask WHY ? Is it because there are no jobs for blacks, is it because your cities are "cold" (emotionally not temperature) to blacks. Why is it that tons of white people live near you, but no blacks ? I can assure you that the race issue is far more of an issue in Chicago than it is in Tampa (skinheads). This case has nothing to do with race, this is about a holster-sniffer who could not be a cop who wanted to be a hero. It did not matter that the kid was black, white, or purple, Zimmerman saw a chance to be a hero, and took it; but it went wrong. Racist in glass states should not throw burning crosses. P.S. I am a black family who fears death from racist, but we all choose to live in the SOUTH, instead of the Midwest or Northwest. Yes, that makes sense. But myself as a white person, chooses to live in the suburbs instead of downtown for my family's safety. Yes, that makes sense.
  13. I would suggest taking it to a professional installer. Vehicles today are very complicated, and it is not as easy to wire-up anything like you could when I was I kid without causing a shortage or a "draw" on your electical system. No matter where you live, I am sure there is a shop that does this service for local public safety agencies. And again, I call SHAME on the EMTCITY NATION for being so judgemental. There is no reason to denegrate another poster because you THINK you are superior to them. If you have nothing nice to say, then go to another post. In your eyes he/she may be a "siren queer", but if he/she is the closest responder to your grandma's house when she is in trouble, then they could be every bit of a hero as you think you are. In the future, when you have the choice between being "right or superior" with your comments, or being "nice", choose to be nice first.
  14. Dwayne is spot-on. I have been married for 26 years now, and I believe the worst thing you can do is choose a mate based on anything besides true love (looks, age, career, money or lack-there-of, etc). It is easier to find someone at work since you spend half your life there, but that is not necessarily the hunting ground I would choose, since one or both of you may have chosen an EMS career in your younger years, but may choose the opposite later in life. Which isn't to say that two EMS'ers can't make it work, but that would never be my sole criteria, regardless of the career you are in (women with no self esteem who chase cops or military guys to replace the daddy who did not beat them enough or beat them too often). Get out from behind your computer and go live life with real people, doing the things you enjoy. If you are doing that, chances are the people around you have similar interests and hobbies as you, which gives you a conversation starter and a mutual interest to start things off with. We all get ugly and wrinkled as we age, so choose someone that is absolutely gorgeous on the inside, that you can communicate with easily, and whose company you enjoy no matter what you are doing. Side note: If you are young, don't worry so much about finding the "one", until you have dated "many". What you thought was love at 14 was different at age 18, 20, 25, and will be different at age 30, 40, 50. So don't base a lifetime decision on thoughts you have at age 18.
  15. My vote is wait until you are atleast 50 years old, that way if you die or become a vegetable you can argue that you lived your life for a long time. I can't find the stat now, but you are almost guaranteed to be in an accident within your first 5k miles of driving it (could be a minor accident, but an accident nonetheless). There are just too many stupid people driving cars out there, not to mention things in the roadway (debris/trash) that can cause an accident when you are doing everything perfectly right.
  16. Just to play devil's advocate, how far do you take your "no treatment" stance because you have ingested alcohol ? No finger sweeps of airway, no heimlich, no CPR ? And what do you tell all of your friends at the party, as the only trained medical professional in the room chooses not to use their training and wait on 911 ? Doing nothing may be worse than doing too much (not advocating a trach with a kitchen knife, just saying you can't stand there and watch them die).
  17. I am with Dwayne, the view must be exquisite from all of you'alls moral HIGH HORSE. Let's swap questions, but give the same attitude" "In VFIB, do you prefer Lidocaine or Amiodarone ?" Answer from high horse crowd: "What did you do to put the patient in VFIB ? Did you overdose them, do you usually try to kill all of your patients Pmdc Dexter ?, Are you trying to save money by using Lidocaine ? , Why do you want your patient to die ?"
  18. Unfortunately, YOU GET WHAT YOU PAY FOR. Until the citizenry is upset and willing to pay for quality, you will be stuck where you are. I would caution you about airing to much of your dirty laundry publicly though, as you may wake-up in an AMR or RM uniform one morning (which may be better than what you have, but I doubt it is what you are seeking). The bad news is that sooner or later, your system will kill a kid or someone important, and if it is a slow newsday you will be provided a forum to discuss the needed changes.
  19. You forgot to mention a critical piece to the puzzle, "is the patient stable or not" ? Although your EKG class taught you the basic rhythms, if you ever work in an ICU or for a company that interprets holter monitor reports you will find that there are all kinds of "inbetween" rhythms that 10 cardiologists would interpret differently. Sometimes, the smart thing is to just start an IV and monitor the patient, especially if you have an ETA to the ER of less than 20-30, when you encounter a weird rhythm. The "irregularly irregular" definition of Afib still guides my choice.
  20. I know this will ultimately get shut down, but thought I would give it a try. We all know that most marriages end in divorce because of finances or sexual incompatablilities, so I ask, DO YOU have any tips about either ? Or do you have any questions ? We are all adults, so we should be able to discuss the sex topic just as we would any other, the money aspect is probably more important. The rules are that you must keep the language clean, dont' be too graphic, and be serious. I will offer a money tip: There are two months in the year where you get three paychecks instead of two. I knew someone who was able to put both of those "extra" checks in savings, and it paid for his Disney trip every year. If you can't save it all, try to save 50% of both checks.
  21. Thats not a vision, you are basing your plans on what EMS has been since the 60s. You want vision ??????: 1. Use a first response vehicle staffed with a PA or NP, who can write a prescription and leave them at home, and only call for transport when needed. 2. I-Stat Lab machines to do labwork in the home and a portable x-ray machine; again, dont clog the ER, diagnose at home. 3. EMT-Bs on a car that pick up prescriptions written by the PA/NP and deliver to the patient. 4. If you are remote EMS, use your station as a walk-in clinic, let them drive to you versus you go to them. 5. Find a drug, system, or technology that saves more than 50% of cardiac arrest victims. We still suck at that (as a whole).
  22. I seriously doubt that deafness was the culprit as much as being postictal. Had he been able to hear you, I doubt the situation would have changed. In the future, get enough resources on scene so that you can PROPERLY restrain the patient. Sitting on the patient does work, but it puts you at serious risk for injury from the patient or a vehicle accident. You can not do proper patient care if you sit on the patient for the ride. Even in the most rural areas, law enforcement is usually available to assist.
  23. I would have a conversation with your boss first. Rookie Paramedic and Rookie EMTB ????? That is not only stupid, it is dangerous.
  24. You would be surprised how much linen service costs hospitals. Call your local linen provider and see how much it would cost you to set up linen service for your EMS agency. Then of course, hospitals then have to pay for what we in EMS steal or borrow that may never come back to that hospital. Most of our hospitals have gotten smart and orderd white linens for their patients and "orange" linens for the ER and EMS. This limits the loss of the good stuff, and all of the local hospitals in my immediate area use the same system. Miles away, in the big city, the hospitals order linen with their name printed on it, any linen that shows up that does not have their name is sent to the ambulance bay for our use. To answer your question, crews will loose your blankets, it will become a nightmare to keep them clean, so the best bet is to continue to use hospital linen if you can.
  25. Your problem is not the wheelchair, but to answer your question, most fold-ups will fit in the side box door-well or at the end or side of stretcher, as others have mentioned you can use seat belts from the squad bench to secure. Ask your Director, Medical Director, and one of the local ER Doctors who has treated him to contact this patient's personal doctor (not a HIPPA problem, it is about his care and how his drug seeking behavior is hurting him). They can have him committed to a program, or at least make a plan to cut him off from getting drugs at any local ER (I imagine his personal physician has him on pain meds, and is unaware of his ER visits). He is probably not "using" the prescriptions for pain, but instead "selling" the drugs he gets from the pharmacy. In my state, the Medical Director of an EMS agency has very broad powers. When we encountered this situation, he wrote a protocol that stated we could only transport these patients to the local ER (in county) and would only transport them once in a 24-hour period for issues related to "pain". Before everyone freaks out, we had 2 patients that would literally go to the ERs (shopping different ones) 3-4 times per week (every week), and would somehow find a way to get home (no public transportation in my area) and then call 911 again within a couple of hours of the first ER trip if they did not get the drugs they wanted. They had no issue requesting us to bypass several hospitals to go to ones that did not know them that were over 60 miles away. It was an issue of not tying up "911 resources for foolishness". It worked.
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