DwayneEMTP

lol im with you there is this like EMO revolution going on at my school...i just dont see how all those guys wear pants that are so tight, I would die.

So what is 'EMO'? Elmo...now I'm with you there...but what's EMO?

Wait! Emotionaly Maimed Offspring? Hmmmm.....maybe not....

Dwayne

AnthonyM83,

Sorry I can't help on the call...it sounds like you're in an impossible situation in your job.

But I did want to say this may be the best post I have ever seen!

Even those that don't share your question can learn much about posting, linear logic and self examination....Outstanding.

Good luck in your new job!

Dwayne

This is like a psychology/patho(?)physiology lesson all wrapped up in one!!

Though how do I bleach those images of becksdad out of my brain?

Dwayne

"A Second Officer brings c-spine into neutral in-line position (unless contra-indicated)"

I saw this quote on Timmy's vacuum mattress website and it got me to thinking.

In the basic academy we were told to return c-spine to neutral in-line position regardless of how it was found unless patient is screaming in pain (" and if it's really deformed they will be screaming!") or extreme resistance is encountered.

I also saw somewhere (maybe here, I'm not sure) someone talking of splinting the neck in the position found when it's extremely deformed, and getting reamed at the ER.

I believe the story went something like "positive PMS in all extremities, but neck deformed with head 90 degrees to shoulders". It's just hard to imagine forcing this injury back to it's inline position when this situation exists....(though I have a hard time imagining this situation existing)

What would happen in real life? Any stories, pro or con along these lines?

Thanks all...Have a great day!

Dwayne

At this point, becksdad sneaks off to the bedroom while his partner does the work. He is later found by PD snooping through her lingerie collection :shock:

Wow...maybe I won't be an accountant after all....

Dwayne

Aside from the beating you're going to take for grammar and spelling, please tell me you are not asking which to put on your private vehicle...?

I hope you have a thick skin...you are likely to need it in this thread...(search would have been your friend here)

Dwayne

Amazing huh?

When we lived in CA that was the rule...I was floored..I thought they were kidding! Most autistic kids will only play chase games with other kids (the reason is unclear). Having an autistic son, one of my main goals in life is to teach him to enjoy the company of other people (not like Dust, and asys...I mean normal people)...and they took that option away. I finaly had to go through the school board and offer to build a small fenced area for the special needs kids to play, before they gave in. (They ultimately set aside a small grassy area for this purpose.)

If I remeber correctly, no chasing (running by yourself, off the concrete was ok), no balls on the concrete (where the basketball hoops were) it seems like there was something about the swings....but I can't remember now....Pretty crazy!

Thank Goodness I'm in CO now....Though they think those rules were pretty funny...the liberal crap that starts in CA has a way of finding it's way everywhere....(I'm not anti-CA, It showed me a good living for several years...not a big liberal fan though)

Bottom line...when they start to take the "adventure" from your kids childhood, they will finish if you don't knock some pee pees in the dirt!

Dwayne

Wait just a dang second....

So:

I can't drive fast...

I'm supposed to study..every day!...

Have to tuck in my shirt...

No lights on my car...

And now no tattoos?

That's it! I'm becoming an accountant! Anyone know where they get their badges?

I'm going on Ebay right now to see if I can find an H&R Block window punch....

Dwayne

Hey Tracyd1

I also didn't get from your posts that you're a medic.

I know sometimes, like now, it can feel like pulling teeth trying to get the info you asked for...but if not here, where?

Hang in there...But I think what most are saying is that if you're an intermediate where you live....it's time to start turning lemons into lemonade...

Have a great day!

Dwayne

On shore, an emt octopus was performing CPR on a crustacean patient. A bystander called out, "Hey, you should do something about that man lying on the sand, gasping for breath!" The rescuer replied gruffly, "Can't you see I'm too octipied right now?"

I'm not sure CPR is withing his scope of practice....He should have waited for a sturgeon.

Dwayne

There are some truly great quotes coming out of this unlikely topic!

=D>

That is pretty dang funny...asys..you make a pretty funny gangster yourself!

Seeing you and Dust talking like that...made my whole night!

Dwayne

OK....I'll read it all this weekend...jeez...

Ruff....that's funny!

Dwayne

Ask more, learn more, do more. Then share it.

I think this is the quote of the day!!

Dwayne

Hey all,

I know I've seen something like this posted before, but can't find it.

It seems like I'm seeing more and more of these articles...Is anyone hearing of people calling EMS for pets yet?

Isn't it the next natural abuse of the system given all the publicity? Seems crazy to me....See below.

"They're man's best friend, but when a dog or any other animal is injure, it's hard to tell just how they'll react.

"If an animal is hurt, they're going to go into a self defense mechanism and they're going to protect themselves, so even though you're coming to help them, they don't know that," said Bob Struck, Executive Director of the Upper Peninsula EMS.

Assessing an animal's wounds is much like assessing a human's; the communication isn't there, so those responding may need to take extra precautions. Applying a muzzle is one step they may need to use. Today's medical professionals practiced this technique on stuffed animals and then worked with real dogs.

"It would be the same as a human being: check the airway, the breathing, make sure the heart is working, take care of immediate breathing," said medical professional Dan Breggs of Rapid River.

They're using the knowledge and training they already have and expanding it, so they're ready for any situation, even if it's rare.

"Anytime you can take the training that you already have and broaden out to help more, in this case animals, it is a very worthwhile thing to take in to. This is more background for EMS, so if they find themselves in a situation involving pets, they will be able to deal with it," said Dr. Larry King, a Hermansville veterinarian and EMT.

Officials say you should first call a veterinarian in an animal emergency." (bold by me)

First? Doesn't this seem to suggest EMS should be second?

I don't know....I'm curious to hear what you think....

Dwayne

http://www.pantagraph.com/articles/2006/10...ters/119833.txt

State EMT test best approach for most

"I am both a physician and still certified paramedic. I spent the larger part of my EMS life in Illinois. I found the editorial sent to me, ``Addressing EMT certification deserves priority'' very interesting (OurViews, Oct. 2).

I just returned from speaking at an international EMS conference where this very same concern arose. The ``national certifying'' process is actually the ``average'' and is best used when any EMT may venture out of state.

I totally agree with the comments/concerns of the Illinois Fire Chiefs Association. There are questions that, if missed, would count against you (On my test all the questions worked that way.)and if you are practicing in Florida, they are helpful. But in rural Illinois, I had never encountered a coral snake.

I am more favorable to a state test. But if a person may leave Illinois, as I did, then the national test offers a ``basis.''

I keep my certification because I teach EMTs and paramedics, and in order to talk the talk, you still have to walk the walk. But I am careful for the jellyfish and the coral snakes.

Dr. Craig Jacobus

Schuyler, Neb. "

How can they possibly not see that this is not about coral snakes!! It is about their inability or unwillingness to learn 2-3 (guessing) more pages of text in a 9lbs book!

I had to learn about Flow-Restricted, Oxygen-Powered Ventilation Devices even though we were told we would probably never see one. It certainly took more time to learn than all we were taught about spiders and snakes. But it was part of the required curriculum, we didn't cry, we just added it to our brains.

It amazes me that not being able to pass is the only excuse they could come up with...I would have shot myself before admitting that.

I am sorry that the sharp IL folks we have on here have to be lumped in with the fire boneheads (publicly, not by us I hope).

Pretty amazing all in all...

Dwayne

You crack me up...

Dwayne

I can't take the time to read it all...but what I did read is pretty thought provoking!

Pretty fun....Thanks

Dwayne

Kyle, you're going to come to understand (hopefully) someday that people that have an intelligent critique of you and your opinions are your best friends. (If you don't think his opinions are intelligent then knock his weewee in the dirt next time he's wrong. I'll bet he'll thank you for it.)

The fact that he enjoys it just makes it fun...and funny.

Run away from people that tell you you're doing everything right...they are helping you fail.

I want to be better tomorrow than I am today...I can't be my best by myself, unless being by myself is my goal.

Dust may get under your skin, but I guarantee you that you are smarter today because of him...And the others like him.

Keep your chin up, the fact that you keep coming back speaks volumes about you....

Dwayne

EDIT: for spelling...sheesh.

Hypotonic - this solution has less solute than the comparitive solution (see 2nd sentence....these terms are relative); a hypotonic solution will receive solution across the gradient from a hypertonic solution.

Hypertonic - this solution has more solute than the comparitive solution; a hypertonic solution will give solution across the gradient to a hypotonic solution.

Unless I'm having brain fade (which is common) I think you got it turned around in the second half of these two sentences.

(Then what JPINFV said)

Dwayne

Yikes...thanks! I probably should have been able to riddle that out...

I've googled it each time I see it and get a gazillion results from soccer team names to types of irish poetry...but no medicine that I can find.

I assume it has something to do with the heart and little to do with poetry...but that's as far as I've gotten...

Thanks for the help!

Dwayne

(No link as it's from another site, credit to ncmedic309)

What do you all think? Do you see problems with the treatment or implementation pre-hospital?

Wake County NC paramedics use new 'cool aid' method

by

Starting today, cardiac arrest patients in Wake County will have an edge that improves their chances of leaving the hospital walking and talking.

Paramedics with Wake County Emergency Medical Services and the county's two 24-hour cardiac care hospitals, Rex Hospital and WakeMed, will begin using a novel therapy that protects patients' brains from damage by quickly dropping their body temperature.

Cooling the patient reduces the brain's need for oxygen, helping to minimize the damage that typically occurs after the heart stops and blood flow to the brain is interrupted.

Studies of the treatment, called therapeutic hypothermia, suggest it prevents brain death in one out of every six patients. That means a patient who would have been in a persistent vegetative state, and possibly removed from life support, instead might survive intact.

"We hope to see more people surviving in a meaningful way," said Dr. Brent Myers, a Raleigh emergency physician and medical director of Wake County EMS.

EMS responds to a cardiac arrest in Wake County roughly every 18 hours -- more than 600 last year alone, Myers said.

But the number of people who receive the cooling therapy will be relatively small. Some patients are beyond reviving when paramedics arrive. Others regain consciousness after a quick shock with a defibrillator and don't need the treatment.

Instead, the treatment is aimed at patients whose heartbeats are restored but remain unconscious. Myers estimates that EMS will use it on 80 to 100 people in the next year, based on the number of cardiac patients who would have met eligibility criteria for the therapy last year.

Paramedics will start cooling down the patients in the field with ice packs and infusions of ice cold saline solution, then transport them to Rex or WakeMed. Hospital staff will continue the cooling by hooking up patients to devices that gradually drop the patient's body temperature as low as 89 degrees Fahrenheit.

For optimal results, patients must be kept cool for between 12 and 24 hours, then gradually warmed up again, according to published research.

If Wake County's results are at least as good as those published in American and Australian studies, therapeutic hypothermia may result in an additional five to 15 patients a year making a successful recovery, Myers said. Success is defined as patients being sent home able to care for themselves and able to hold at least a part-time job.

Potential is great

That might not sound like much, but it would be a significant increase in the number of patients who make a good neurological recovery. Last year, Myers said, just 23 cardiac arrest patients who would have been candidates for the therapy went home with good brain function.

"Usually these patients don't survive," said Dr. Bob Denton, an emergency physician at Rex Hospital. "The benefit is potentially overwhelming."

Wake County is one of the first communities nationally to begin offering therapeutic hypothermia after cardiac arrest. Myers, the EMS medical director, said he is aware of only two other communities -- Seattle, Wash., and Pittsburgh, Pa. -- that offer the treatment or plan to begin it shortly.

Myers said that Wake EMS started looking into doing therapeutic hypothermia for cardiac arrest last year as a way to give patients every chance of surviving with a good quality of life. Patients in Wake County are successfully resuscitated -- that is, their hearts are restarted -- about 30 percent of the time, according to data kept by EMS.

But despite those results, which far exceed the national average of 5 percent to 7 percent, most patients were still suffering brain death, Myers said.

Dr. Paul Hinchey, a Raleigh emergency physician who was completing a fellowship with EMS at the time, suggested trying therapeutic hypothermia. When EMS asked the county's hospitals to discuss collaborating on the project, it took off. Rex, it turned out, was already considering starting the therapy for cardiac arrest patients transported to its emergency room. And after reviewing published studies, WakeMed was game to try it.

"It didn't make sense for EMS to start this if hospitals weren't going to continue it," Myers said.

Dwayne

The day that people choose EMS as a profession because they truly seek the intellectual challenge of diagnosing disease and alleviating suffering is the day that our profession will grow ten-fold. But as long as the majority of the people are attracted simply by the thrill of the siren, the mystique of the blood and guts, and the ability to have it all in two weeks of 8th grade level training, EMS will continue to be $hit.

I am disgusted. :roll:

You know, the farther I get into this it seems that EMS instructors may be as big a part of the problem as the people coming into it...(maybe this has been obvious before, but I'm just now getting it)

I sit next to a kid in A&P lab that is an EMT-I. He just got his cert and is taking A&P (anatomy mostly, in the first semester) because it's required before he gets his Paramedic cert at a local hospital. He's getting it there instead of the college because he doesn't need A&P II there.

He's a nice kid, seems smart, non-wankerish but they convinced him in his Intermediate class that A&P isn't really necessary it's just "the state helping the college make money." He shares my disdain for the people just trying to get through class to get a fire job. (on our last practicum I got 110/116-class ave. 71-our two firemen got 18 & 27/116)

I'm trying to convince him otherwise, but then who am I? Certainly not a paramedic, just some old guy trying to get a degree. I believe if they had instilled in him the need for education he would have stepped up to the plate...he seems to want to be first rate, and is getting a first rate education based on the standards he's been given.

In my Basic class there wasn't really any indication that I didn't know all I needed to know to be a basic...in fact it was often stated that our "academy" taught much more than was expected. I believe that may be true, but all would have been served had the point been made that this was the beginning of an education, not the complete education.

I'm a freak for my education, but mostly because you all have convinced me that if I want to be taken seriously by the people I respect that that is what's needed...but how do the people that don't have you all get that info? Are they running into people elsewhere that make it clear to them that they need to be smart to do this job? That they need to go beyond the educational scope of the people they work with that are already doing this job? And how do we convince them, when they run into people all the time, doing this job, that don't bother to do so?

Out of my class or 22 or so, you can see most only want to get through with a grade high enough to maintain their student money. But there are 6-8 that you can see that really want to be the best at the career they have chosen. But what happens when they find out that the people defining "best" for them have terribly low standards?

It just got me to thinking. Most of the new folks are kids, I think many would do better if they knew better....

Dwayne

You find the dangdest stuff Michael...pretty funny!

Though you have to wonder if it had anything to do with hiccups.

Dwayne