Lone Star

Hmm, I'm almost morbidly curious about Taylor Ambulance. My EMS instructor worked from them (I believe in the early 80s) and he claims he got out "right about when things started getting bad". Some of the stories he tells are pretty shocking, regarding things that were done or said with patients present. He actually mentioned one of their trucks getting shot up so I wonder if that's the same incident.

I've read up about some stations and I guess it's just a matter of your level of paranoia, but I've discussed with my wife what I'd be doing if I was ever working in some of the shadier Detroit areas. I know you're supposed to retreat from unsafe scenes, but who's really to say if the scene STAYS safe, especially in some place like Brightmore or Cass Corridor.

As someone who spent years in the worst places in town(no, not Detroit) and running 25+ calls in 24 hours every day, I can attest to the potential danger. Had a few close calls, but generally we are NOT the targets. That said, we can get caught up in the middle of things that have nothing to do with us. It happens. That's when experience, common sense, and good peripheral vision are vital. In these areas, entire neighborhoods could be considered "unsafe", so the notion of an "unsafe scene" can be misleading. As long as you do not see an immediate threat to yourself or your patient, then there is no reason not to respond. We also developed good working relationships with the local cops. Because they worked in a high crime, violent area, they knew there was a better than average chance they may need our services so it was in their best interests to keep an eye on us. We did not cry wolf, so when we called them, we NEEDED them ASAP, and they knew it. Often times they would see us on a scene, pull over and stick around, just to make sure we were OK. I cannot tell you how much that helped our peace of mind.

My point is, in busy urban areas you will learn the job. You will see more in a week than many people get to experience in their entire careers. Is it for the faint of heart? Nope. You need self confidence, maybe a bit of bravado, and your patience will be tested on a regular basis. If you treat folks with respect, you generally will get that respect in return. If you work in an area on a regular basis, the neighborhood will get to know you, know what type of person you are, and know if you treat people right. That said, unfortunately you also cannot control what other crews do, or how they behave, so if you have a rouge crew who are acting like a'holes, you end up dealing with the fallout.

Here's a little tip that was shared with me years ago by a local gang banger- generally folks in the ghettos are HAPPY to see us and fire suppression. When we show up, we are trying to help someone. Unfortunately, law enforcement does not see that since more often than not, when the cops show up, someone is likely to lose their freedom, or the cops are looking to take away someone's source of "income". When we would arrive in the housing projects, the gang bangers who were lookouts for the buildings would actually announce our presence- meaning we were NOT the police, and to give us safe passage, hold the elevators, clear the hallways, etc. We would even occasionally have the thugs helping to carry equipment, or help restore calm in a chaotic situation. They knew we were there to do a job, not to mess with them or their "business".

Good luck- hope it helps.

You both have validated what I've been saying in your own ways....

CPhT by acknowledging how rough those areas are; Herbie by your advice.

The last tour of duty that my station (Station 16) was a 24-hour statation, we pulled a whopping 38 calls. Most were nothing more than IFT transports, but each time we were called, we had to deal with a PERSON. I get so peeved at people who run down the elderly, the homeless and those who are less fortunate.

Yes, I worked in less than 'ideal situations', and many 'unsavory areas' on a daily basis. I treated each patient with at least the respect due to any human being, and lo and behold, I rarely had any issues that involved law enforcement having to intervene.

Another factor in my favor is our uniforms didn't look anything like law enforcement; (different colors, no badges, etc).

Just because you're in a 'bad part of town' doesn't mean that your scene is guaranteed unsafe. Some of the nicest people have been in those areas of town.

With the time I've spent in EMS, I've seen too many providers dismiss people as inferior or insignificant, simply because the provider was in uniform or because the patient/family lived in 'that part of town'. It is this attitude that tends to make an already tense situation, (because of the fact that a family member is in need of EMS' services), much worse than it needs to be.

Another thing is to cultivate your relationship with law enforcement...don't bring them out for back-up simply based on your geographical location, or because of the chosen profession (or non-profession) of your patient.

As Herbie pointed out, even the 'gang-bangers' can provide more assistance than they're normally given credit for.

Maybe during my time in Metro Detroit, I was extremely lucky and didn't walk into 'bad scenes'; or maybe it was because of how I dealt with my patients/family, I can't say for sure. All I CAN say about it was the fact that a little respect goes a long way...

CPhT,

I'm sure your instructor could tell you tales that would keep you on the edge of your seat about his time in Detroit. I never worked for Taylor Ambulance. EMS is a major 'gossip mill', and according to 'Rumor Control', things for Taylor got REAL bad before and during the acquisition by Laidlaw. Ask your instructor about American Ambulance and their 'welded cots'....

Having been an EMT for 12 years before finally letting my license lapse because of CE issues (long story). I then had to start over, and got into a program at my local college which combined both EMT and EMT-I. From there I went directly into my Paramedic program.

With that being said, I can tell you from personal experience that the biggest issue with 'gaining experience/get your feet wet' concept is that it only makes it more difficult to break the bad habits that you're sure to develop.

Since you have expressed your intention of going for your degree in Paramedicine is a bonus. You'll find that in addition to the core classes, you should be required to take at least Anatomy & Physiology as a prerequisite or at least as a co-requisite.

The degree level A&P classes will help you understand how the body works, and how our interventions will affect the patients we treat.

Your algebra requirements aren't to find "X" (ever notice how many math instructors can't seem to keep track of things? They're always asking you to find "X", "Y" and all the other variables in those problems. If they'd just develop a better filing system, they would know where those things are!) they're designed to develop critical thinking skills, which will help you when you have to play 'detective' (especially in your medical patients). The English credits will help you with your narratives on your PCR and develop effective communication skills.

If you've passed all your tests (school and state), there is no reason to hold off going into paramedic class. If you're THAT concerned about 'getting your feet wet', pull some time in the truck while you're attending classes. Sure, things will be tough, but you'll be able to kill two birds with one stone this way....

The biggest 'differences' between your clinical rotations and 'real time' on the trucks is that in 'real time', you're going to be expected to know what you're doing, why you're doing it and then getting it done. During your clinical rotations, you had someone else that could step in if you were floundering.

Oh, the trash that gets posted when people realize that their already poor reputation can't go any lower......

*edited to remove multiple instances

Even when you don't hit the 'post' button only once, it happens to repeat the content severa times in one post.

As far as being 'retarded'....I MUSTbe...Who in their right mind wants to get back into a field with low pay, exorbitant levels of stress, irregular hours, coupled with having done time running into burning buildings.... Added together, it doesn't say much in support of 'mental stability' and 'normal psychological growth rates'.....ROFLMAO

B.F. Skinner would have taken many beatings for how he derrived his results. Not only were they turning the world of psychology on it's colective ear, but at that particular point in time, wasn't bound by all of the rules and laws we have now about ethics and such. In fact, other psychologists like Milgram, Watson, et al were responsible for the enacting of may of the ethical and moral limitations that the medical and psychology fields operate under.

I find it interesting what you say about caffeine. You react the opposite of what one would think, so is that because of ADD, or simply an addiction to the stimulant and you are essentially itching for your fix? Who knows? I "need" my coffee too, but I get the pounding headache, cranky, and I'm dragging my arse if I am subtherapeutic with my levels. LOL

Oh, I get the pounding headache and the 'grouchiness' as well, but my mind is just bouncing from one thing to the next with little getting done. I find on the days that I don't get my 'theraputic levels' of caffiene, I'm easily bored and on the prowl to find the next thing that catches my ......oh look! Shiny thing!

I worked EMS in the Detroit area in the mid 90's, and from what I saw about DEMS, their reputation is well deserved. They were continually being investigated for theft (material possessions, patient's meds etc). They also were in the news for not going into places like 'The Cass Corridor) unless they had PD back up. They were even investigated for poor patient care/negligence on more than one occasion.

Yes, Detroit has some 'unsavory areas, (like Ferndale, the 'Cass Corridor', Highland Park and Harper Woods), but a lot of the problems encountered by Detroit EMS and some of the other private services were 'self inflicted'. Take the incident involving Taylor Ambulance ... their crews thought it was great fun to pull up behind people in Highland Park and while going down Woodward Ave and hit the lights and siren just to watch the people in the cars 'freak out'. One day while they were posted at Detroit Osteopathic Hospital in Highland Park, someone pulled a 'drive by' and pumped 5 rounds from a shotgun through their truck. Funny thing is, that was my 'base station', and our truck was never touched (simply because that our crews treated people with the respect that they deserved).

We didn't pull the stunts that Taylor Ambulance pulled, we didn't harrass people on the PA system in the truck, we didn't drive down the streets like we were the only vehicle allowed to be on the road; you get the idea...

Detroit EMS had a habit of dismissing people who weren't in EMS as insignificant, and their paramedics wouldn't talk to anyone of lower license levels than them, unless they absolutely HAD to.

I've worked areas up and down Woodward Ave, Gratiot, Telegraph and all along the Lodge Freeway and never had an incident that even came close to what Detroit EMS, Taylor Ambulance (later Laidlaw) and others had. We were continually called to the 'Cass Corridor' (affectionately known locally as 'Blood Alley'), Harper Woods, Highland Park and Ferndale.

I was diagnosed as ADD/ADHD as a kid. I was put on meds (Ritalin). I don't know if the dosage was incorrect, or if I was being overdosed, but 30 years later, I met with my aunt who was amazed at how far I'd progressed with my 'problem'. When querried about what 'problem' she was referring to, I was informed that most of my extended family thought I was mentally retarded.

I know that drugs like Ritalin are actually psychostimulants; and in people who have ADD/ADHD, it actually has a sedative type effect....it slows these people down to help them concentrate.

In those who do not have ADD/ADHD, Ritalin is a big-time upper and will have them bouncing off walls in no time.

I don't remember a lot of my childhood (is it from the drugs or is it because it was a really bad time for me and I've blocked it out?), but I do remember being 'bored' in classes most days. I qualified for programs for 'gifted students' on several occasions, and remember failing in certain projects (like book reports) because I was a victim of trying to make things grander than necessary. I think to a degree that I still suffer from this, and tend to make things harder than they need to be, simply by rying to learn all I can about a subject.

I'm pretty much a 'coffeeholic' and find that on days where I don't get my usual 'dosage'....I feel like I'm running 800 miles per hour and getting nothing done. When I have access to all the caffiene I normally take in, I'm calmer and much more mellower (I usually have a cup of coffee in my hand all day long).

I think that ADD/ADHD is overdiagnosed, but I do not discount that it is a true disorder.

This scenario was one of two that I was recently handed in a homework worksheet. When I saw that there was a recent hip surgery, I was considering that it might be an embolus from possible clotting. I based this conclusion on the fact that it was hip surgery, and the fact that the patient discussed wouldn't be doing a lot of moving around due to the possibility of being in a lot of pain from the surgery.

That being said, I suggested placing the patient on oxygen, establishing an IV of NS (or even the insertion of a saline lock), application of at least a 5 lead monitor (simply beacause we haven't learned how to apply a 12 lead yet) and administration of 325mg ASA to help with anticoagulation.

I further questioned the usage of beta agonists, because of the vasodilation properties. If it was an embolus (either PE or coronary), wouldn't vasodilation allow the possible embolus to migrate to the cerebral vascular system and potentially cause a stroke?

I think dobutamine was also mentioned for its dromotropic properties.

Like I've said before, I can follow the cardiac conduction pathways, I can explain what should be occurring during each segment of the EKG. Part of the problem occurs when I've got to start interpreting the rhythms.....

Obviously, when the dysrythmia is atrial in nature, the P wave is either going to be absent, or look screwed up and the PR interval is gong to be either longer or shorter. If its ventricular in nature, then the QRS complex is what's going to be affected.

With that being said, one would think that when you throw a 6 second strip at me, I should be able to identify disrythmias pretty quick...right?

Well, to furhter complicate things, lets throw in 'flutter waves', 'fib waves' and the ever popular delta waves, j-points and ectopy.....AAARRRGGGGHHH!

Oh, lets not forget to stir up some 'regular'/'irregular'/'regularly irregular'/'irregularly irregular' rythms, and the ever popular "Just because it's below 60 beats per minute or greater than 100 beats per minute doesn't necessarilly mean that it's brady/tachy".....

This is all off a simple 3/5 lead strip. I looked at a 12 lead printout and thought that it looked all screwed up!

Just as I'm trying to wrap my pea-brain around statements like "When you see this:" (i.e. p waves preceeding every QRS complex implies a sinus rhythm)....someone throws in the qualifier "Except when you see this:" (i.e. PR intervals greater than 0.12 seconds), because that means ..........."

It seems that every time I think I see an approaching "AHA! moment", one of those qualifiers gets introduced, and that "AHA! moment" decieds to wave bye-bye......and that nagging vioce of doom/failure jumps on the loud speaker....

I've always been in awe of those who hold a license level above mine, based on what you most of you guys/gals can do, and how impressive it was that y'all could keep all this stuff straight in your heads. Now that I'm trying to step into your world, I'm feeling like the village idiot who is nothing more than a poser.

I understand that this is all new information, and I'm not expected to know this without the attached education; but at this point, I don't know if I'm just trying to 'overthink things' or if it's that I simply "just don't get it"........

I've suggested that we start forming 'study groups' so that we can help each other along, but so far it appears to be falling on deaf ears. I don't want to wash out of the program (y'all know that I had to drop out once because of that motorcycle wreck). This is why I'm reaching out to people here.

I know I've aggrivated alot of y'all with some of my viewpoints (from "I don't need a degree to be a great medic!", to some of my unpopular personal beliefs). I know there's really no one on this forum that WANTS to see me fail (ok, maybe there's one or two....), but the place I'm in now; I feel like I've bitten off more than I can chew this time....

And this is exactly why cardiology is going to be the reason I fail out of medic school! Its disheartening to think of all I've been through to get to this point, only to get washed out by a damn squiggly line....

I understand what each segment represents (which is definately a step up from where I used to be), I understand that changes in the 'averages' usually has significant implications. The problem appears to be when all the segments are put together repeatedly that it all falls apart.

I dont know if I've got enough fight left to try this 'one more time' if I fail............

This is a senario that was presented to me in my cardiology homework. I thought I'd throw it out here, just to see how others would handle it and see if they could explain WHY they chose the treatments that they did.

I was initially going to put this out as a running scenario, but decided to just post it in its entirety.

You and your partner are called to the scene of a rural residence where you find a 57 year old male who is complaining of chest pain. The patient reports a history of recent surgery which was performed to repair a fractured pelvis. Approximately 2 hours ago he began to experience “tightening of his chest,” chest discomfort and shortness of breath. He now reports that he feels nauseated.

1. What would be your primary assessment considerations with this patient?

Your partner records the patient’s vital signs as follows” BP, 180/120; heart rate, 140; and respirations, 32. When you connect the patient to the ECG, you see a wide complex tachycardia (uncertain type). When you contact the base hospital, your medical direction physician instructs you to follow the ACLS algorithm for wide-complex tachycardia and to keep him informed of the patient’s status.

2. Prior to initiating drug therapy, what questions would you ask the patient?

3. What is the most important step in the initial management of this patient?

4. Five minutes into your management of this patient, his BP drops to 130/74 and he exhibits a decreased level of consciousness. What would you do next?

He said 10 ft from shore in a POND, not raging river. Are you really gonna let the kid die, how is letting the kid die making things WORSE

Obviously, you've never seen how a drowning person will try to climb up their rescuer. I don't have statistics to prove my point, but what good is a drowned rescuer? People trained in water rescue are trained to deal with this sort of occurrance, I am not.

Just because they're ten feet from the shore, doesn't tell you how deep that pond is......for all you know, that 'pond' was part of an old rock quarry, and it just happens to be 60' deep.

*edited to add last paragraph.

Is this why mom always said "Don't run with scissors!"?

Kaisu,

There is nothing I can say that will help ease the pain of you and your family, and I am distressed by it.

My deepest condolences to you and your family in your time of sadness. know that we are here, if you need an ear, shoulder or sounding board. I wish ther was more that I, or we could do to help you and your family get through this.

The standard adult dosage of albuterol is 2.5mg in 2.5ml of NS. The standard pedatric dose is 0.15mg in 2.5-3.0 ml of NS. This is about 1/17^th of the adult dosage.

As far as the child in the pond in Crothity's senario, if the rescuer isn't trained or equipped for water rescue, they could end up making the situation worse. While it's noble to try to save the child, what good are you really doing if you end up drowning in the process of trying to save the child?

The same applies to the asthmatic in the original post. Howmany medics have we heard talking about cardiac drugs and make the statement "It was one of those 'A' drugs..."?

Was it Adenosine? Atropine? Amyl Nitrate? Amiodarone? Asa?

Part of the problem here is that the general public only knows what they see on television. They see cops solve major crimes in an hour and think that this is the way 'real life law enforcement' should operate. They see these action drama shows like "Trauma", "Third Watch" and "House" and think that we save every patient

Just be cause Mr. Smith has an albuterol MDI in his pocket, doesn't mean that little Jane Doe gets the same dosage. If an educated medic can confuse those 'A-drugs', how can we reasonably expect the general public to understand that just because the name sounds the same, it could turn out to be vastly different drugs and 'bad things happen despite good intentions'. Remeber, that the road to Hell is paved with good intentions, but it's still the road to Hell.....

Say you're a first aider and you're called for an asthma attack case. You give the girl oxygen for now. But you have no inhalers in your bag and the patient forgot hers, but you have people offering to give her theirs.

Would you give her somebody else's inhaler to use? Or would you just wait for improvement and if condition doesn't improve-- call an ambulance? Seems like the latter makes more sense, but I guess using somebody else's inhaler isn't so detrimental-- particularly if the patient recognizes her medications. Right?

WRONG!

First off, even as a multimedia first aider (like they teach in Boy/Girl Scouts; you should already KNOW when to activate the 9-1-1 system. Giving a patient someone else’s medication simply based on ‘she recognized the name of her medication’ is akin to prescribing medications without a license. In GA and MI, even EMT-I can’t just raid the drug box because the patient recognizes the name. We can ASSIST the patient taking their own medications.

Sorry Matthew remember your Rs

Right Name

Right Experation

Right Perscription

Right Dose

I would never give someone someone else's perscription. The only exception to that rule is Epi Pen, we carry our own in the lock box incase of anaphalaxsis.

Look at it this way, do you want to lose your liscense over a mistake that could have been prevented? Just because it is the same medication that the patient takes doesn't mean everything is the same. One thing you could do while waiting for the rig is add water to the O2. Sometimes moisting the O2 will realive some of the symptoms of the attack. Yes its not medication and no it won't completely fix the situation but it will buy you time and releave the patient discomfort to a degree.

Your best bet is to put a rush on the rig, have ALS respond as well, and keep an eye on your patient because an asthma attack could decompansate into respitory failure if it goes to long.

Actually Ug, there are more ‘rights’ (you only mentioned 4). They are:

Right patient: This holds true, especially when assisting the patient who is taking their own medications. This also precludes the good Samaritan from offering up their medications.

Right medication: The general public usually can’t tell you WHY they’re taking a medication (other than “the doctor gave it to me.”), why would you trust “that sounds right”?

Right time: This doesn’t mean that since the next dose is to be taken at 1800… that we make sure it happens. This includes right indications, no contraindications and the right conditions (i.e.: no nitro after taking Viagra within the last 72 hours.

Right date: Is the medication expired? Is fluid medications like epi clear?

Right dose: I think this one is self explanatory.

Right documentation: Document the administration of the medications, and all pertinent positives and negatives (responses to the medication for which it was administered. i.e.: If you give albuterol, did it relieve the symptoms?)

Sorry to hear about this Moby-lyzer!

Hopefully there's something that can be done to relieve your pain, and get you back on your feet again.

No need to apologize for trying to take care of yourself and the issues you face.

Good to see your face around the place, and I hope we see more of it!

LS

As far as the whole Waco incdent, the reports are clearly divided into two sides. The supporters of David Koresh and the Branch Davidians will say that the government used incendiary devices when they started launching tear gas grenades into the buildings of the compound.

There is evidence to prove that the fires that wiped the place out and killed so many were started in multiple locations in response to the tanks being used to breech the walls of the buildings.

Timothy McVeigh and Terry Nichols used both Waco and the stand off at Ruby Ridge, Idaho as 'justification' for bombing the Afred P. Murrah building in Oklahoma City.

As far as St. Nicholas goes, the Port Authority DID offer to move the church, and even offered more money to help with financing reinforced walls because it was being built over the screening area that led directly to the parking structures being built at Ground Zero.

What ISN'T being said is that St. Nicholas already had their own property and only wanted to rebuild on it, but was denied. Further, if the church HAD built on the proposed site offered by the Port Authority, the church was limited to size and height because of it's location to Ground Zero.

Unfortunately, none of these restrictions were made on the mosque/cultural center that has everybody up in arms.

No, the Port Authority didnt HAVE to offer the property to the church, but by the same token, the church DIDN'T HAVE to move, they already had their own property that they've owned for years.

Ultimately, the Port Authority backed out of the deal when the officials at St. Nicholas wanted to see the proposed plans for the screening area that was going to be directly under their church.

Additionally, the particular board that approved the plans for the mosque/cultural center has no authority in regards to churches and religious matters.

These points are mentioned around page17 and later in this thread.

http://www.usatoday....odox23_ST_N.htm

excellent excellent response sys, im really looking forward to reading more of your posts man, your gonna be an asset to these forums

I wholeheartedly concur with your findings on this subject, Bushy. I sat here reading Systemet's response while drinking my first cup of the day; and by the end of the post, I was crying 'uncle' (and I wasn't even the one to make an offending statement)!

:bonk:

I am but a poor medic student, please show mercy upon me due to my lack of complete education!

The television show "Emergency!" showed a couple episodes that almost seem inspired by this very thread. I ended up watching them because of this thread....what a vicious cycle!

http://www.hulu.com/watch/47100/emergency-trainee

http://www.hulu.com/watch/12088/emergency-problem

*Edited to add last statement and links to full episodes

I've always thought that after the initial and secondary patient assessment, we followed up with what's known as a 'continuing assessment' to provide the results of our treatments and to trend the patients condition. It is during these 'ongoing assessments' that the modality of our treatments may or may not change.

I haven't seen a posting to this thread that advocates the "Let's try this and see what happens!" mentality. The responses that disprove Crotchity's premise of "I know everything NOT in the book!" seem to be based on solid evidence, rather than conjecture.

Crotchity,

Since you know 'everything NOT in the book", why haven't you followed through with your responsibility to furthering the field of pre-hospital care, and begun to publish what the rest of us obvious idiots don't know?

While I've got some experience in a really major EMS system (I think metro Detroit qualifies as 'really major EMS system') I'm far from ever being confused with any MENSA members, (past or present); but I would be willing to follow the teachings/orders/directions/ advice of the respected physicians that are assoiciated with this forum (i.e.: Dr. Bledsoe, ERDoc, Doc 'Zilla, et al) and the guidance of the 'rock star members' that obviously know more than this mere 'medic student' will ever know.

Sure, equipment fails, it has its limitations, but given that we mere mortals do not have xray vision, clairvoyance and the God like power to heal by touch, I'm going to have to rely on those electronic devices to help guide me in the treatment of my patients. They are not the sole source I base my treatments on, (thats where education comes into play),but they ARE developed and used to help diagnose whats wrong with our patients.

One of the initial 'rubbing points' in that Port Authority deal was the fact that the Christian church was limited in the size and height that it could build to, while the cultural center was pretty well unrestricted. If I remember correctly, the church was told that it couldn't dwarf or obstruct the construction at ground zero, but the cultural center is allowed to overshadow it in height. I said it before and I'll say it again, if you're going to place restrictions on one, place them on all; and if you're going to allow one to have special priveliges, then you have to grant those same priveliges to all. You cannot grant special dispensations to one group while denying the same dispensations to another group so that you wont offend the first group. This is NOT how you promote healing, harmony and unity of the two diverse groups.

If you go back and read through the earlier posts, there should be links to this information as well (providing that the links are still active).

I can understand their reluctance to volunteer such information in front of a bunch of witnesses, but in this scenario, all involved appeared to be either healthcare providers or school administrators. Not the usual suspects that one would encounter in an identity theft incident.

Part of the reason we get the social security numbers in EMS is so that when it comes time to pay the bills, we know the 'right person' to bill for services rendered.

In the hospital, it's part of patient identification; this ensures that getting the right chart for the right face......

Its amazing how fast the reporter was to villify an entire profession, by insinuating that we're just predators looking to screw our helpless patients.....

The biggest problem that you'll find when you set a hard and fast inflexible rule to govern all situations along with penalties that are enforced for non-compliance, is that there are far too many situations where it cannot be applied to.

Michigan's biggest rule is that patients are transported to the closest appropriate facility. This simply means that if you have a cardiac patient, you're not going to transport them to the trauma unit (unless it's the same hospital that has the local cardiac unit).

It's amazing hat as we disprove the 'Golden Hour' and the 'Platinum 10' rules; someone like this does their best to keep things in the dark ages, despite evidence to the contrary!

I got into EMS simply because it was required for the fire department I applied to. In fact, it was the only thing holding me back in the selection process.

I went into my first class, and during the 'meet and greet phase', we had to identify ourselves and tell why we were interested in EMS. My response was "I'm only here because I HAVE to be!".

As time and the class progressed, I realized that not only did I 'have what it takes', but when my classmates were getting grossed out over pictures of trauma, I realized that there was more to it than I would pick up in that class.

I'm currently 46 years old, and working on my Associates degree in Paramedicine. I've been mistaken for faculty by students outside of my class. Don't let the "older than all of my classmates" thing get to you!

At the rate I'm going with all of the 'setbacks' I've faced, by the time I graduate, I'll be able to draw Social Security (if it still exists)!

I don't mean to nit-pick, but what exactly was meant by "off-duty"? It seems this question has been asked several times without any answer. Maybe if we know what it means it might help understand the situation a little better.

Presuming that 'off duty' means not in uniform, and not being compensated by their employer. This leads to the next question...if they were off duty, why were they hanging around the E/R, and why did they get involved in a situation that clearly violates HIPAA? Since he/she was not directly involved in patient care, or related to the patient...they had no business even setting foot in the treatment room with that patient.

Yeah, I'm going to take a different tack....an arrest in an ER, and you need more than two people for compression? And (what sounds like) a basic recruiting folks because he's unable to continue compression due to exhaustion? For a patient with an initial rhythm of asystole?

This entire code sounds like a cluster fuck. I'm thinking that if this was perhaps a competent medic that 'gloves' was maybe easier than saying..."I want no part of that mess...." But, then again, unless he's banging one of the nurses, or ill, I don't know what he was doing at the ER while off duty.

Just a thought...

Dwayne

I don't care if they were 'banging one of the nurses'...who hangs out in the local E/R on their days off? In my book, the excuse 'Just so I can be near you and spend time with you' isn't a satisfactory response.

The E/R isn't someplace you go to hang out and socialize. That is someone's place of employment and if you're not an employee of that establishment, you don't need to be under foot!

Even if said nurse is causing you to either 'pitch a tent', or gives you 'panty puddles', use the appropriate venue for socializing.

Aren't administration sets pretty much universal? Of course, this would exclude 'brand speciffic' for infusion pumps...