DwayneEMTP

1. Trendelenburg is not a myth and is a moderately effective method for managing shock.

2. The point is to shunt blood to the core.

3. Leave it to Rid to bash techniques which have been used forever, and with good reason, often just to hear himself talk

4. Trendelenburg is sort of negated by having the head raised as well.

Rid, perhaps you could stop bashing emts. Remember, a Paramedic is also an EMT. I know thats hard for you to accept but its true.

Yikes...what is going on here??

Basic...do a search on this subject and you will see that your statements are far from true.

(1) Trendelenburg is far from proven as an effective method of handling shock. (Did you look at the info from the previous posts?)

(2) Very few people support new people here and Basics in general like Rid does. (If you can't separate educational critique of the position from critique of the people that do the job then you're missing the point. Unfortunately for you, your stand on Trendelenburg makes this point for him.)

Is everyone just ticked off about something today? (I guess me too since they seem to be pushing my buttons )

Have a good day all...

Dwayne

what is wrong with you people, in 11 days most people on this site will be bowing their heads in remembrance of the most diabolical terrorist attack ever.

this guy is evacuating a Pt from the area of terrorist bombings of his country and all you can do is take the piss and try to critique the way he is dressed and what way he has his PT.

what you are posting is in bad bad taste,especially around this time, would the comments be so jovial if it was 9/11 pic under discussion, this bombing only happened last week in three separate areas, try google.

i am very surprised at some and disappointed in others, is it a case that it is not terror unless it is in the US, and i would love to see some of the posters in the same situation with the same resources they had.

Wow jmac...having a bad day? Other than not taking the question very serious I don't think there is anything wrong with us.

I did a search on the pic before I posted...no mention of terrorism and I'm not sure it would change my thinking if there was.

If you had been part of previous discussions of this type you would have see disclaimers such as "you weren't there, you don't know all the facts" ad nausium. Here we don't know ANY facts, therefore this is not judgment, it is simply a mental exercise.

'Not terror unless it's the U.S.'? Perhaps review some world history and you will see what an idiotic statement this is....

I will certainly bow my head again on 9/11. I also will never use a tragedy such as that to grandstand and attempt to prove my political correctness.

Sorry you got shaken up...

Dwayne

Hmmm...I might be able to hit the easy stuff...

C-collar without necessary stabilization (blocks, board) Also back is bent. Not sure why the head and feet are both elevated unless that is a position of comfort, though it would be contraindicated for spinal stabilization (unless there are ways I don't know of...like most things).

No obvious injuries noticeable from the pic...but...guessing again...secondary to a blast injury, would IVs (possible internal bleeding?) and oxygen be indicated? Perhaps she should be stripped to check for shrapnel injuries as well?

Not sure...but those are my thoughts.....

Dwayne

Kansas Stan, Dominion300,

I think you both misunderstand the reason many of the rest of us DO come to this board.

And that IS to be judged.

I took several beating when I first came here. Because people took the time to show me that I was presenting myself as ignorant, uneducated and naive. Many boards are willing to be my personal "cheerleaders", and tell me how awesome I am for "trying". It is not my goal to try...it is my goal to succeed.

If you can't read between the lines and see that Dustdevil and others took the time to tell you the truth then I'd be willing to bet you spend way to much time on "rah rah" sites....not much "rah rah" here.

I will take one "Good question" from one of the experienced guys or gals here over all the "You might not spell good but we love you anyway's" (incorrect punctuation intended) in the world. One helps me grow...the other encourages me to fail.

I'm sorry you all got your feelings hurt....but why would you want to hang out with people that don't demand anything from you?

The previous posts were not unkind at all. They explained why the question, as asked, will not be well received by most professionals. They also explained that the goal as it was expressed would be bad for the poster and the industry. I think they were pretty clear and the poster is encouraged to succeed if they are taken at face value.

Hang in there...Re-read the posts with a little thicker skin...Be glad that people with decades of combined experience were willing to explain to you how to be taken seriously in EMS.

Good luck in whatever you choose!

Dwayne

A friend sent me this article...not sure if it's posted before but maybe can't hurt to post again..

http://www.jems.com/educationandtraining/articles/13369/

Checklist for Success in EMT/Paramedic School

David S. Becker

The EMS Manager

For those students just starting out in EMT education or students who have passed their EMT training and are now advancing to the paramedic level, I thought I would give you some suggestions on how to be successful (or more successful) in school. Regardless of your background—if you’ve just graduated from high school or college, or if you’ve been out of school for a number of years—you owe it to yourself to get the most out of your time commitment to becoming a member of the EMS workforce. These suggestions can enhance your learning experience and help you get the most benefit from your efforts to become an EMS professional.

Embrace the change. From the first to the last day of class, every day will be about change. Every time you learn something new, you will change. Students who embrace the changes will find themselves seeking more opportunities to educate themselves and ways to challenge their learning abilities. They will have started on the path of lifelong learning. They realize that they know more today than they did yesterday, but less than they will tomorrow.

Follow the rules. School can be good preparation for working in EMS. When starting a new EMS job, you’ll be expected to follow the rules; the same applies to attending school. Don’t think you can set your own rules or that academic guidelines don’t apply to you. Within the training program, someone will be watching you, seeing if you fit in and are able to be a part of the class—and the same will happen within an EMS agency.

Be on time. One of the rules is to show up on time for class. Punctuality says a lot about your commitment to the program and your respect for the instructors. On occasion, you may get stuck in traffic or have an emergency that prevents you from arriving on time. But such delays should be rare; don’t make a habit of arriving five minutes late for class. Set your schedule to give yourself plenty of time to make it school early and be ready at the start of class.

Dress professionally. And when you show up on time, leave your baseball cap in the car. Casual attire may have been OK in high school or maybe in your current job, but T-shirts with logos or blue jeans with holes should be reserved for your personal time. In class, dress a step up from casual. You don’t need to wear your best jacket and slacks, but your clothes should demonstrate that you care about being seen as a professional.

Make time to study. Students who expect to show up at class and be passively taught everything are missing the point of being a student. Class is where an instructor shares with you the highlights of the material you are studying. No instructor can teach you all the knowledge you need to function as an EMT or a paramedic. As the student, you must spend as much time as possible reading and studying the course material. Learning means being involved in your own education and not just listening to an instructor talk. Learning means you’re able to talk about the new knowledge and share your experiences. It allows you to also take information from other students and apply it to your own development.

Study with someone. Find a study buddy or form a study group, and spend time outside of class learning with them. The more time you spend reading and discussing the course material, the more you’ll develop your approach to patient care and your understanding of prehospital emergency medicine. EMS is a team sport, and you are only as strong as your team members. Working and studying with them makes everyone better.

Practice, practice, practice. In the case of EMS skills, practice and a great deal more practice does make you better. The technical skills an individual needs as an EMT and as a paramedic are crucial in helping sick and injured patients. You perfect those skills only by practicing them over and over, until you can do them without really thinking of all the steps. You don’t proficiently learn how to take a blood pressure or other vital sign by performing it only once; you must practice it again and again.

Improve your writing skills. While in school, work on your writing skills. A great deal of your life as an EMS professional will involve complete and accurate documentation of your patient care and treatment. It does you little good if you can perform all the technical skills but cannot provide a clear, concise written patient care report.

Improve your speaking skills. Along with improving your writing skills, you must be able to communicate clearly. Especially important is your ability to speak with your patients and other medical professionals, such as physicians and nurses. Take every opportunity during your class presentations to enhance your speaking skills and to get feedback on ways to improve.

Don’t be afraid to make mistakes. Making a mistake means you learned one way not to do something or, in some cases, 10 ways notto do something. But mistakes really mean that you’re making an effort, and so many times it’s the people who never make an effort who don’t succeed.

The final two tips will make a major impact on your studies and ultimately your success:

Have a good attitude. Hopefully, you’re getting into EMS for the right reasons. If your instructor asked you to write a paper on why you want to be an EMT or paramedic, what would you write? A number of students list their reason to become a paramedic as the only way to get hired at a fire department. Is your commitment to EMS as strong as your commitment to becoming a firefighter? Do you come to class every day looking forward to learning something new and to putting another piece of the EMS puzzle together? Or are you counting the days until you’re finished and believe you won’t ever need to study again? Even when you’re having a bad day at school, how you handle negativity and challenges demonstrates your ability to make a difference as an EMS worker.

Remember the little things. As in most things in life, it’s the little things that matter. If you can’t get the little things correct, how can your instructors and eventually your supervisors expect you to do the big things right? For example, perhaps you don’t really feel the need to check your monitor at the start of your shift. It’s always worked and the crew before you reported they didn’t have any calls. One morning, you get a call for the cardiac arrest of a 25-year-old female. When you arrive on scene and begin to hook up your monitor, it beeps once and goes dead. Switching batteries doesn’t help, and nothing you do can get it to work. That little thing you thought was too little to bother with came back in a big way. So it’s important to pay attention to your learning and know that skipping over a small detail can have a big effect later. The same principle applies to your learning. Skipping a small step in your learning could have a big impact on your knowledge and skills later in your career.

Learning is work, and it takes effort. Becoming trained as an EMT or paramedic is difficult. As the saying goes, if it were easy, everyone would do. The amount of time, energy and effort you take in your education and learning is directly related to your success in becoming a successful EMS professional.

David S. Becker, MA, EMT-P, has been a paramedic for 28 years, holds a master's degree in Health Service Management and is a graduate of the National Fire Academy Executive Fire Officer Program. He is the EMS program director at Sanford-Brown College in St. Louis, Mo. Contact him via e-mail at dsbeckermo@msn.com

Hey, Toy, I'm new to this site, but for what its worth it is a good thing that you have seen a negative aspect of people and attitudes within EMS. There are basically 2 ways to learn this stuff - 1)-what to do; and 2)what NOT to do. Yes, there are folks who are burnt out, who have bad habits, who treat patients poorly. And we all have days that we b*tch and moan about. But now that you've seen this, seek out EMT's and Medics who are really good at what they do. There are many excellent people doing this who will guide you along. Find medics who provide superior patient care, take pride in their work, their truck, their partners and themselves. Make your own commitment to be the best provider you can be, and hang around with like minded people. Learn about more than required to function as a Basic. If you can support/assist a Paramedic partner as he/she provides ALS care they will LOVE having you as a partner, and you will find in a short time you have many valuable mentors. If this field is for you, and you surround yourself with as many positive and skilled people as possible....well, its the best damn job in the world. Good luck to you!!!

P.S.- Just remember we're all a little whacked in the head...look past our individual insanities OK?

This should appear in every self-help guide to life book published.

Work hard, learn your craft, avoid whiners, make your team better.

Great post!!

Dwayne

I worked as a hotshot in my earlier days besides the "con crews" from the prisons. Hard working guys....treated very bad by the guards.

I had a lot of respect for those crews...but would not let them in my house, alone, with my family.

I have been in trouble...been in jail...but when you screw up enough to go to PRISON (a distinction some seem to have trouble making) you certainly relinquish your rights to have access to people who are unable to care for themselves, their possessions and their medications.

This has nothing to do with my feeling superior or perfect. It seems like pure logic to me. Are there many ex-cons that would be a credit to this profession? You bet....Are you going to test drive them on my friends and family until you know the difference? Not gonna happen.

The prison system is certainly not about rehabilitation...I wish it worked the way it could...Showing our concern for a convicts future by putting them in EMS just doesn't seem to be the answer.

And the argument that they have paid their debt to society....What is the rate of recidivism? Huge...haven't each of them (felons) been deemed safe to return to society?

Giving a felon access to vulnerable people is kind of like having Dustdevil teach your 20 yo daughter about chastity....Your intentions may be good...

Dwayne

boneknuckleskin,

Perhaps you are all of those things. If so why are you having such a hard time seeing that people are not going to give your opinions any weight when you don't seem to be able to give your own interpretation of the strip.

It will not longer be necessary to keep telling everyone what idiots they are once you explain the strip and show them why they are wrong.

Other than being an ass simply for the sake of making a scene, it does seem you have something to offer.

Shut em up by proving your point.

Dwayne

I really like these threads. They tend to bring out the best and worst in people...

nbsp, I don't really see why your post sure stir up any shit...I think it was pretty well stated and I can see your point.

As a Christian (though today that term is not as specific as it used to be) I am often amazed by the arguments that are expected to sway non-believers to religion.

I tend to start from the point of view that my faith is not based in provable fact (my feeling...others feel differently) and expect that anyone that is curious about my faith

will expect me to have FACTS when I talk about it. I don't really have any....I have stories...that when put together...convinced me that there is more to life than what I can touch and feel.

Someone else's stories would not have had the same effect. I don't believe mine will have that effect on others. We find our way or don't...I don't know what decides how it works.

I also don't believe that faith makes you a good person. I know many atheists...without exception they are fine people...good friends...great parts of the community. (No...I'm not claiming to know all atheists, I'm sure plenty are assholes...just not the ones I know) Though I know many self professed Christians that I wouldn't allow around my family.

What I wish for these discussions its that we could see that vs-eh? and nbsp make valid, logical points. By retorting with "I'll pray for you" (which obviously is not only a weak response but lost on someone that doesn't believe) or "Well I guess you're going to hell" we just degrade any opportunities for dialog...not such a good thing I think.

These arguments are interesting to me because Christians seem to believe that speaking of God gives them credibility without the need to be validated.

And atheists seem to have the need to disprove or at least disagree with anything and everything faith based. Gotta knock those bible thumpers off their thrones.

Makes for some pretty fun discussions!!

Have a great day all!!

Dwayne

Man...yeah...laugh is probably best....but something about that does make you want to slap him till he wakes up..

That's one of those things that if you tried to describe it I'd say "shut up....now you're just making stuff up."

Unbelievable

Dwayne

I think most basic classes run from around 120-150 hours or so.

Mine was 150 hours plus 40 hours of voluntary labs (which 4 or 5 of us out of 32 used) in two months.

People smarter than me will need to weigh in on a one month class. I would have found it difficult to find enough study time in one month I think.

Good luck!

Dwayne

I was just reading this to my wife and said...."This seems like a good idea"

And she said "But then you have all those people on a list the bad guys can use"

I really don't want to think that my wife and Dust have ANYTHING in common....sheesh

We can pretty much end this discussion here....my wife is always right...

Dwayne

Guys....no offense...but after you've been here a while you'll understand not to snipe at Rid until you know what he's talking about.

You'll notice that no one with over 20 posts have taken offense to what he said...Read a few more threads and you'll see what he means..

He's not slamming Medics....it's just "I'm a medic, why can't I do a nurse's job?" Is a pretty common thread...often asked and answered.

Have a great day all!

Dwayne

Dust...looking at the pic of your cubicle...Are those Little Mermaid sheets I see?

I'm not saying that's a bad thing.....

Dwayne

Pretty cool pics Dust....Thanks for keeping us up to date!

I think this has gone on long enough....you should all come home now....spread the word...everyone should grab the first thing flying and come home...

If Bush asks tell him I said it was OK....that should smooth things over. (nope...not a Bush hater...trying to be funny)

Stay safe...send more pics...come home when you can...

Dwayne

Welcome Kevo! As a new student I can promise you will learn more here in a month....if you pay attention....then you will learn in your Basic class!

Work through the old scenario threads....ask smart questions.....and you will be miles ahead of your classmates.

The things I've learned here have completely changed the course of my personal education!

Good luck!

Dwayne

When carbon dioxide diffuses into the blood plasma and then into the red blood cells (erythrocytes) in the presence of the catalyst carbonic anhydrase most CO2 reacts with water in the erythrocytes and the following dynamic equilibrium is established

H2O + CO2 <-> H2CO3

Carbonic acid, H2CO3, dissociates to form hydrogen ions and hydrogencarbonate ions. This is also a reversible reaction and undissociated carbonic acid, hydrogen ions and hydrogencarbonate ions exist in dynamic equilibrium with one another

H2CO3 <-> H+ + HCO3-

Inside the erythrocytes negatively charged HCO3- ions diffuse from the cytoplasm to the plasma. This is balanced by diffusion of chloride ions, Cl-, in the opposite direction, maintaining the balance of negative and positive ions either side. This is called the 'chloride shift'.

The dissociation of carbonic acid increases the acidity of the blood (decreases its pH). Hydrogen ions, H+, then react with oxyhaemoglobin to release bound oxygen and reduce the acidity of the blood. This buffering action allows large quantities of carbonic acid to be carried in the blood without major changes in blood pH.

Hb.4O2 + H+ <-> HHb+ + 4O2

(Hb.4O2 is sometimes written HbO8.)

It is this reversible reaction that accounts for the Bohr effect. Carbon dioxide is a waste product of respiration and its concentration is high in the respiring cell and so it is here that haemoglobin releases oxygen.

Now the haemoglobin is strongly attracted to carbon dioxide molecules. Carbon dioxide is removed to reduce its concentration in the cell and is transported to the lungs were its concentration is lower. This process is continuous since the oxygen concentration is always higher than the carbon dioxide concentration in the lungs. The opposite is true in respiring cells.

Pretty cool thread chbare! Is it ok to cut and paste or do you want summaries?

(man I hate bio-chem)

"The Krebs Cycle"

Dwayne

Hell...20

The advantage of being older than I think? The perks behind knowing why drive-ins were so important!

Dwayne

I've read the posts about lights and sirens on POVs not helping you get where you're going...but saw it yesterday...

I was the third or fourth car back at an intersection that has two lanes going each direction, just as the lights are about to change.

Suddenly there is an ambulance right on top of me! Siren blaring! So I'm trying to find it, so I can get out of the way....but it's not in any of my mirrors....but..he's somewhere!

The traffic that was turning in the intersection mostly comes to a stop, some people facing the red light attempt to go through to try and clear the road. Of course this puts them in the way of the people going through the green light trying to clear the road....

I'm still sitting still like an idiot...because I still can't find the ambulance! Finally the intersection is a mess (It's still amazing to me that no one was hurt)....People are backing up, going forward, sitting still....just trying to figure out who needs to do what to clear the road...

Then I notice a little brown, muddy Toyota pickup with a camper shell threading it's way through the traffic...one little flashing light just visible through the tinting on his camper shell window.....That Little Prick!!! He goes on his way while the rest of us continue to try and get untangled....

He was only one or two cars back at the light that was going to turn green....He easily caused himself 2 minutes delay by turning on the siren....Pretty crazy...

druidman227, When others here tell you you don't want to be this guy....It's not because they have nothing better to do than beat up on people....They've been there...done that....This is the first time I've seen it firsthand (though I didn't doubt those that have posted in the past) and I'll have a hard time not beating up "what kind of lights do you use" posters in the future....(Ok...well that's not my way...but I may be thinking it)

You're 17....try not to be offended, but instead by grateful you were given opinions by a caliber of people you are not likely to be fortunate enough to meet by chance elsewhere....

Good luck to you....don't get mad and go away....We're happy to have you here!!!

Dwayne

I don't claim to be the brightest bulb in the box...perhaps I did miss the joke...but I don't see any humor in that post...

I don't know what you mean by the rest of your post...

Dwayne

Windsong, I can almost never tell what the hell you're talking about....

You go on about stupid Americans, prayer in school, flag burning! (two issues near and dear to many American hearts)

But wasn't it an American that posted these trivia points? I didn't notice him asking about wood huts or igloos..???

What in the hell is the matter with you? If you have a beef...come out with it....

If you don't know that/why flag burning and prayer in schools are vital issues for defining what it means to be American then you shouldn't talk about anyone being ignorant of Canada.

I've spent quite a bit of time in Canada...love it...I'm glad you are not a good representation of it's people....

Sorry for the rant all...I usually don't respond to these type of statements...but this one got under my skin....I must be burnt out.

Dwayne

One thing that always strikes me when vs-eh? posts on the topic of God is that he is always careful to capitalize God and He when appropriate.

He may not have respect for my God, but by doing this he seems to show respect for my opinions. When did we decide that disagreement equaled disrespect?

I have faith in a higher power, that has no basis in logic, that I can't represent to him with even the shakiest scientific evidence....

I have evolved to the point of having faith. If he didn't follow a similar evolution then his believing in my God is certainly equivalent to my worshiping his car keys.

(I might be able to fake faith in his car keys because everyone else seemed to have it...but would also refuse to do so)

I believe you learn faith, you don't choose faith. I appreciate his opinions and his logic, though I wish spirituality for him...it just doesn't compute for everyone....

(sorry vs-eh?, I was going to capitalize "car keys" to make the point but couldn't bring myself to do it)

Dwayne

Dwayne

But on the other hand...if God loves me why do I only have 1.5 reputation points?

(Sorry...that thought just cracked my up)

I only answer because I respect your opinions mostly vs-eh?, and think maybe you're going somewhere with this....Plus I love to watch these arguments unfold...

I believe in a higher being.

I don't believe my definition of a higher being fits everyone or even anyone else.

And nope, I'm not here to sell this to you.

This works for me, I hope your way works for you.....

Dwayne