DwayneEMTP

I didn't say it was the same percentage for everyone .

Anyway,

Cowards die many times before their deaths;

The valiant never taste of death but once.

~ Shakespeare, Julius Caesar

becksdad, haven't you learned the divident payed by trying to outfox Michael most often isn't worth the investment?

You guys crack me up...

Dwayne

Seems like we've all had our say...Good questions from becksdad I think...I don't know what the hell he's talking about.

I'm counting at least 3 replies from somedic that seem to show that a points been made....

Perhaps we can quite quite slamming him simply because his past behavior made it easy, and judge him on his last several posts....

I'm not defending him...he's full grown...Just thinking if everyone's had their say we can get back to learning now....

Dwayne

Admin...Thanks for letting this post continue...We've learned much about each other, if not medicine, and I think we'll all be better for it. And perhaps not have to do this again anytime soon...

Dewayne: Good response. I dont run from any one on this forum. If AK really wanted a question answered he would get that. Im not a bully as you suggest. I do point out things other people may think but never say. Proclaimed prowess? What the hell are you talking about...keep reading or reread...Im not into bragging. Dont mistake a mindset different than for "self proclaimed prowess"

If you read my posts correctly you would have got an insight into what Im really like.

Im glad to see you respond back to me..it shows you are not a push over.

I see no reason to keep this dispute ongoing. My points are valid whether you think my attitude is justified or not.

Fair enough...

Dewayne EMTB: To begin with If you are not a 17 year nationally registered paramedic in an aggressive EMS system and if you have never been deployed with several military units to several countries and practiced in austere enviroments..You are outside of your capability radius...to put it another way...you are out of your league in any dealings with me on this forum. Dont test my resolve.

Or you will what....hold your breath until I give in? Beat me up via email? Quite that kind of talk...it's silly.

Besides, we've had that same pedigree read to us by people that have never seen the inside of an ambulance. If you're for real, God bless you, but I've seen no sign of it so far.

For the rest of you: If you go review my posts, I've indicated that there are certain times an EMS physician that knows the system well and can function without egomania would be an asset in some incidents but in a well established system this would be a rare occurrence.

I did look through some of your posts and didn't see it. (well, one post that I'll bet even you won't hold up as evidence of this point) And what additional requirements would you like Death Doctor to have before you consider her worthy? I'm sure she's tapping her foot, waiting on your approval.

There are those of you that would be inclined to say that I'm the one with Egomania/Para God syndrome, but you would be wrong. I knew at an early age that I wanted to be a Paramedic. I believe in all EMS systems reaching their full operating potential.

Then how do you explain your "Doctor Death medicine woman" comment? It seems she is working to help her system progress. Once again, you on the other hand chose to blow off AK's questions...leading me, and many others I'm sure to wonder why you run when asked simple things. I can't think of another paramedic on the board that would have backed down from that with silly insults instead of valid information.

AK didn't so much come to my defence use us as an example to show that you're being an ass. If you have the experience you claim, then when can we hope to benefit from it in a medical way? As I review your posts there is example after example of you attempting to be a bully (long uphill climb on the internet) but I didn't find a single example of your proclaimed prowess in regards to medicine. Dust, Asys, Rid, and many others may sometimes choose to knock our wee wees in the dirt but NEVER without backing it up morally, professionally, medically and/or ethically. You choose to just say "your icky 'cause I say so"...That just doesn't wash.

I'm a student...I've never claimed to be anything else...I use my real name instead of hiding behind a username, and as far as not belonging on the forums with you...? When you start to talk medicine I'll give you the respect you may decide to deserve, until then, I'm going to do what I can to keep my mouth shut and let the people that are here to teach and share, instead of strut and blow, get back to what they do best.

Sorry to everyone for being a dick and not letting this die..I promise to try and do better now...

Have a great day all!

Dwayne

One thing is for sure here: You dingo people stick together on something. It's common knowlege that Paramedics and EMS (modern version) were created in America.It seems to me that you aussies are lacking in the same thing that make American paramedics the best:..TESTICULAR FORTITUDE...Its what made us the greatest nation on earth and we started just like you in Dingoland

Back on point...Im fully capable of managing bad scenes as a Paramedic in my system and will never need some "Dr Death medicine woman" getting in the way and spreading drama. One day you aussies can look forward to making it up to our level of professionalism and self reliance.

Cheers, Beers and Kangaroos!

SOMEDIC

To make becksdad's point...

Is it so-medic or some-dic? I'm know I've made up my mind....If you gave the previous response to what Doctor Death posted above then you need to read it again....At least she had a point, which included some information. You should take notes...

Of course I could be mistaken...perhaps if you explained the last time you did surgery in the field I could see where all of your contempt was coming from..

And if it's the grasshopper thing that's got you all bent out of shape....well...yikes.

Have a good day all!

Dwayne

Another one of my favorites...

"I tell you Sid, that one of these days we'll look in to our microscope and find ourselves staring right into God's eyes,

and the first one who blinks is going to lose his testicles. "

Harry Wolper (Peter O'Toole)

Creator

Dwayne, you're right, for a trauma and an MI (unless we can treat it with streptokinase in the field), scene time is a crucial factor. However, most calls are not major traumas or MI's. Most calls are runny noses, broken ankles, and panic attacks. If a doctor spends more time in the field on one of those calls, the patient is still being treated. Besides, give the docs a little more credit, I know I'm going to open the door for "stupid wet behind the ears doctors who are all edumacated and citified" anecdotes, but the truth of the matter is a doctor will probably know better than anybody that getting someone to the OR quickly is crucial on a trauma.

Asys, two things....

One, anytime you reply to one of my posts, and it involves the phrase "your right", it makes my whole week!

Second, I'm glad you made the point about giving the docs credit. I've read about a million "And I told the doc to get the hell out of the way or be prepared to do everything him/herself!" or "And then he/she screamed 'I'm a nurse, what the hells going on here'"' posts, and I find when I saw the heading for this thread I immediately thought "Obvious...long scene times, Obvious...God complex with no cooperation, Obvious...no understanding of prehospital care". I had no idea I even had an opinion on the matter until this thread came along.

Thanks for reminding me to think before having an opinion. And thanks for helping me be less of a dope tomorrow than I was today!

Dwayne

Okay, everyone repeat after me...

The reason scene time is increased is because the doctor is treating the patient. The goal of EMS is getting treatment to the patient, not getting the patient to the hospital as quickly as possible. Scene time is a measure of the delay to the hospital, and to definative treatment. If the doctor is doing definative treatment in the field, then scene time isn't a factor. Man I feel like I'm beating my head against a wall!

Man...you're probably going to kick my ass...but doesn't this fly in the face of "paramedics don't save traumas (lives), surgeons save traumas (lives)"?

I didn't invent the above saying...I'm not in love with it! It just seems to be something often quoted by medics (or people claiming to be medics)

I ASSumed the people beefing about scene time are talking trauma and MI mostly...so...It seems long scene time with the addition of a doc isn't really an advantage, right?

Most things about EMS I don't know...I was just wondering about this...

Dwayne

When I did my time in the ER for basic, we had a 12-14 yo boy with a 3 1/2 inch lac on the back of his hand through all tissue layers. Bleeding was stopped when his parents brought him in, but when the nurse pulled the rag off of his hand to examine it for triage it started to bleed badly and they couldn't get it to stop again with pressure and elevation...I'm not sure what the issue was....

I was a little surprised that the doctor was unable to stop the bleeding to suture it (thought they surely had some magic bullet) until finally, on the advice of the medic working in the ER (not sure of his job description) they used a bp cuff as a tourniquet (placed on the brachial artery as if taking a blood pressure). They both claimed it was the first time they had used one, but explained, that if the need arose that the cuff was pretty much ideal.

I'm not sure if that helps as I'm unsure of their skill levels or options at their disposal that might have been used instead...but there you have it!

One a side note, I haven't heard of uncontrolled bleeding that didn't involve blood thinners (cardiac meds, alcohol, etc.). Any idea why this would happen in a young boy? (I wasn't there for phx, but when asked, the nurse said it was unrelated to the issue)

Have a great day all!

Dwayne

That's crazy funny! Thanks Michael!

Dwayne

Dr Novak called. He said that your proposed address to the Medical Congress on "The Profit Incentive in Misdiagnosis" is really not very funny at all.

Harry Wolper (Peter O'Toole)

Creator

Michael, you need constant adult supervision...Unfortunately that can't be found here...

Dwayne

I found this on another site and finally know what Dust means when he says "I think my head is going to explode!"

The remainder of the article talks about some people that want to fix this problem...My issue, other than the obvious, is a posters reply below the article.

Shortage of Emergency Personnel Leads to Innovative Training

By JENNIFER COMPSTON-STROUGH Assistant City Editor

The National Fire Protection Association sets codes and standards for fire departments across the country. In a 2002 needs assessment completed in conjunction with the Federal Emergency Management Agency, the NFPA found that more than a quarter of volunteer fire department personnel who deliver EMS services lack formal training in those duties. ( Me: Formal training, meaning ANY training or certification?)

The majority of those EMS personnel were not certified to the level of Basic Life Support — the ability to provide patient assessment, basic airway management, oxygen therapy, stabilization of spinal, soft tissue and shock injuries, stabilization of bleeding, sudden illness, poisoning and childbirth and to provide cardio-pulmonary resuscitation and automatic external defibrillator capability.

Almost no departments had all their EMS personnel certified to the level of Advanced Life Support, according to the NFPA. This means most EMS personnel lack the ability to provide advanced airway management and intubation, manual defibrillation, intravenous access and drug therapy.

But Clevenger and other local educators are working to change all that in the Upper Ohio Valley. (bold added by me)

And one reply to this article:

"My whole dept has just gone through the first responder course and cpr recert so everyone that is active and responds too all calls is qualified to handle just about everything (within MO law) but we do have several others that higher Qual levels so here we dont have a problem with untrained personnel fortunatley." (emphasis added by me)

Sometimes it seems talking about education in EMS is like chopping wood with a marble.....

I guess I don't have a point that hasn't been made before. I'm just venting....

Dwayne

I have been reading posts here for about two months and have never seen the need to register an account. I have never had the urge to post. I normally just read and agree, disagree, or laugh at the posts. I thought I might find it enlightening to read other peoples point of views in our career path. Here is what I have gotten from the posts on the site,(and this thread is very similar to all others ). Im starting to notice quite a trend......

I am so glad that this site has people like Dustdevil, NSMedic, and RidRyder! If it werent for these people your site that you all like to post on would be full of threads that would contain the following....

1. Subject, 2. Statement or question by poster, 3. Replies to post by other fellow site dwellers that may be enlightening or may not,but since we you all have the aforementioned posters on the site we can all rest assured that they will clog threads with with no offering of feedback to the original poster( which is who the thread was created by obviously), but are chock full of reasons why everyone else is a bonehead, and they are ofcourse right, again

I'm sorry you are so far unable to see passed that point of view. If you had visited many other sites you would see many/most threads are filled with the following (exagerated, but not by much):

Medic: "Man, had to pick up a gomer at the NH that fell out of bed...ER doc went ballistic because he didn't have oxygen or spinal precautions!! As$hole!"

Poster 1: "Yeah man, I fel yur pane! They shuld ride in the bus onse or twise and they wuld see what we half to put up with!"

Medic: "And the dum nurses wouldt even back me up!"

Poster 1: "Hel..They half a lttle colleg and think thy now everything!"

Followed by post after post of people "feeling his pain". When the most benificial thing, thus kindest thing, someone could say to them is "Stop what you're doing, right now, and choose to discontinue being ignorant!"

Thanks to Dust and others, it is a little scary here to post here foolishly (and I don't feel posters in this thread were foolish). And I like that. It's unfortunate that you make a point of saying that you benefit from this site without contributing....and yet your one contribution (should it be called that?) is to take a shot at the very people that help keep this site worth visiting. (I'm assuming you agree it's worth visiting as you've been coming for a couple of months).

It is uncommon to find a question posted here with replys that don't force you to think, or take a pretty hard look at your educational background. The feeling seems to be that most issues became issues because the necessary knowledge was not in place to resolve them. Pointing this out is not self centered, it is a realistic step in helping the posters further their patient care, job satisfaction, and career.

I hope you stick around....It would be great to learn what you have to teach. Though, as you've pointed out, if your unsure of your education or professionalism or are unwilling to trade a little critisizm for a little knowledge, perhaps it's best if you just continue to watch.

Have a great day!

Dwayne

Edited to add to part of a quote for context. Sheesh, and spelling.

Could be a lesson to be learned from my perspective, every pt is a scenario that deserves this much thought and care.

Good point!

Dwayne

we just learned more about u then anyone will ever want to know, with the exception of dustdevil

Kyle, you know, you tend to grow on a person....

Dwayne

Thanks all!

Your answers are what logic was telling me was right,(except for scoliosis or kyphosis from osteoporosis) yet it seems the more I learn the less common logic seems to apply.

The more I learn, it feels like the less I know...if I learn much more I won't know anything!

I had to ask though as I've heard some pretty amazing stories....which I think I'll move into the B.S. column until further notice...

Thanks again....Have a great day!

Dwayne

I would attempt to do inline stabilization. If you can't put the patient in an inline position, just immobilize them the best you can and document the situation.

But what would define "can't"? I'm thinking live deformations just don't happen that often?

Dwayne

Yikes....days and no response...

Should I take the hint that this is really a dumb question?

Dwayne

Wow...is this business as usual?

Dwayne

I'm confused about the issues involved.

From the outside looking in it seem pretty clear.

I don't report it, and when it is discovered some day I am guilty of, at least, not being thorough in my job (Am I responsible for the contents of my ambulance? I'm not sure) Or I become one of a list of suspicious employees that might have put it there. Negative outcome all around.

I report it, and an attempt is made to resolve the issue by finding the breakdown in the procedures that allowed this to happen, possibly leading to hard times for the guilty party(s), if any should happen to exist, which is a positive outcome it seems. Of course management then showers me with praise and a huge raise...another positive outcome.

So turning it in seems to be a no-brainer.

The only thing more obvious than the above is that people I respect are saying it's not that obvious, so I don't know what the hell I'm talking about.

So what are the politics/issues involved?

Dwayne

I'm sure I'm going to look like a complete bonehead...

But relief upon rising. Perhaps being vertical is what brings relief, might that point to a heart issue?

Dwayne

Hey now. Maybe he looks good.

He might...you know becksdad, you could answer this question with one quick snapshot!

You know, I'd throw in a few bucks to see that happen! (Damn the consequences, I'll get therapy later)

Dwayne

Actually, I'm not sure why I posted this, since I really don't know (bored?).

Oh Lord....that was funny....

Dwayne

It's a homeopathic approach to eliminating a sufferer's pain by intensifying it within a severely restricted network of predictable dissonant experiences. Comfort is offered through solidarity within large, commercially organized groups. It's supposed to make you feel better, but doesn't, yet once you've been assimilated, you find it very hard to extract yourself.

Oh, wait, that's HMO.

So it's a bunch of whiny people that get together for the purpose of promoting and supporting unhappiness? (I always think I know what you said, but am rarely sure I know what you said)

I don't get it...unless there's sex involved. Otherwise they should just get married...

Dwayne