Wackerdan

CHAPEL HILL -- The paramedic who treated Atlas Fraley on the day he died resigned 15 days later. When paramedic James Griffin couldn't reach Fraley's parents at work, he had the 17-year-old sign his own discharge statement, according to a patient care report released Friday by Donald Strickland, the Fraley family's attorney. Griffin had worked for Orange County for nine years. He responded to Fraley's home about 1:50 p.m. Aug. 12 after the Chapel Hill High School football player called 911 complaining of full-body cramps Fraley "specifically asked for an 'IV' to make the cramps stop," Griffin wrote in the patient care report. "[The patient] was continuously walking around the house and wouldn't stand still for more than a few seconds. [He] wouldn't sit down at all. ... [He] kept asking how long before the cramps would subside." Fraley stood while Griffin took his blood pressure. Griffin reported that he found Fraley's pulse to be strong and his breathing normal. He noticed several empty bottles of water on the kitchen counter, advised Fraley about dehydration and told him "to continue what he was already doing when I arrived. [He] had plenty of water and Gatorade in the house." Griffin did not give Fraley intravenous fluids, and he did not conduct an echocardiogram -- an ultrasonic heart examination -- "due to the [patient] not standing or sitting in one place for any length of time." County protocol requires an ECG if the patient has suffered heart trouble, fainting, an antidepressant overdose, difficulty breathing or electrical shock. None were among Fraley's complaints to a 911 dispatcher or appeared in the paramedic's report. "After being unable to reach either of the [patient's] parents I decided to let the [patient] sign the declination form with instructions to continue drinking water and Gatorade and continue to work out his cramps," Griffin wrote. The county's 165-page EMS protocol guide does not address how old a patient has to be to make his own decision on whether to decline hospital transport or under what circumstances a paramedic should administer IV treatment. An autopsy report released earlier this week suggested Fraley's dehydration and cramping may have led to a fatal heart attack, though the autopsy could provide no definite explanation for Fraley's death. Orange County officials have not said whether Griffin followed county protocol when responding to Fraley's call. A statement this week cites personnel and medical privacy laws in declining to comment on whether EMS personnel handled the case appropriately. "Those types of questions are either falling under ... medical or personnel privacy," said county spokesman David Hunt. In their statement, county officials said their investigation included a review of the paramedic's actions by a peer committee and by the county medical director. They are also reviewing their procedures to determine whether any changes in protocol need to be made. Jim Jones, a spokesman for the state EMS office, said Orange County EMS officials will present their findings to the N.C. EMS Disciplinary Committee as early as April 2, part of due process for potential employee discipline. Jones said counties, not the state, determined whether paramedics could discharge minors without their parents' permission. Fraley had collapsed from dehydration a year earlier. After that, at the advice of a paramedic, he started drinking a few bottles of water or Gatorade before football practices and games to avoid another incident. But a morning scrimmage on Aug. 12 didn't leave as much time for this hydration routine, his father, David Fraley, has said. State medical examiner Dr. John Butts reported that multiple causes might have included dehydration or a genetic disorder that caused a breakdown in Fraley's muscles. Such a disorder would have released toxins into his vital organs, according to UNC-Chapel Hill sports-medicine expert Dr. Mario Ciocca. http://www.newsobserver.com/news/story/1452060.html -What is your take on this. I know what I would have done even though I am an EMT, but what is your protocal and how would you have handles this?? I would like to know...Thanks.

The below email was sent to me from my mom, i watched it and thought some of you might enjoy it. This is SO SO Good!! Make sure you have the sound on.. THIS WAS WELL DONE! Well ... here's another good one! No ... here's one that beat's them all! An excellent song and video. One of the best I have seen in a long time! I had to watch it three times to just begin to see what it took to put it together. A masterpiece! It's a song written by Keith Carradine and performed by artists from all over the country. It will be performed Sunday night at a Gala at Washington 's Renaissance Hotel. It has a powerful message, just listen to (and read) the words. I hope you enjoy it as much as I have. www.bornagainamerican.org Kiss.bmp

An old lady dies and goes to heaven. She's chatting it up with St. Peter at the Pearly Gates When all of a sudden she hears the most awful, blood curdling screams. 'Don't worry about that,' says St. Peter, 'It's only someone having the holes put into her shoulder blades for the wings.' The old lady looks a little uncomfortable but carries on with the conversation. Ten minutes later, there are more blood curdling screams. 'Oh my God,' says the old lady, 'now what is happening?' 'Not to worry,' says St. Peter, 'She's just having her head drilled to fit the halo.' 'I can't do this,' says the old lady, 'I'm going to hell.' 'You can't go there,' says St. Peter. 'You'll be raped and taken advantage of.' 'Maybe so,' says the old lady, 'but I've already got the holes for that..'

Giving Up Wine I was walking down the street when I was accosted by a particularly dirty and shabby-looking homeless woman who asked me for a couple of dollars for dinner. I took out my wallet, got out ten dollars and asked, 'If I give you this money, will you buy wine with it instead of dinner?' 'No, I had to stop drinking years ago', the homeless woman told me. 'Will you use it to go shopping instead of buying food?' I asked. 'No, I don't waste time shopping,' the homeless woman said. 'I need to spend all my time trying to stay alive.' 'Will you spend this on a beauty salon instead of food?' I asked. 'Are you NUTS!' replied the homeless woman. I haven't had my hair done in 20 years!' 'Well, I said, 'I'm not going to give you the money. Instead, I'm going to take you out for dinner with my husband and me tonight.' The homeless Woman was shocked. 'Won't your husband be furious with you for doing that? I know I'm dirty, and I probably smell pretty disgusting.' I said, 'That's okay. It's important for him to see what a woman looks like after she has given up shopping, hair appointments, and wine.' I just know you're laughing!

New Heart Alert for Some ADHD Drugs Strongest Warning Focuses on Amphetamine-Based Drugs By Miranda Hitti WebMD Medical NewsReviewed by Michael W. Smith, MDAug. 22, 2006 -- Amphetamine-based drugs for ADHD, such as Adderall and Dexedrine, now come with a new, expanded 'black box' warning for an increased risk of sudden death in patients with heart problems. A black box warning is the most serious warning added to a drug's label information. Earlier this year, two FDA advisory panels recommended new warnings and information for all stimulant drugs used to treat attention deficit hyperactivity disorder (ADHD). But the panels didn't quite agree on the warnings. In February, one panel recommended a black box warning. But, in March, a separate panel stopped short of recommending the black box warnings. Since Adderall and Dexedrine are amphetamines, they already had a black box warning about amphetamine abuse. That black box warning for the two drugs now includes the following sentence: "Misuse of amphetamines may cause sudden death and serious cardiovascular events." Notice of the warning for Dexedrine appeared on the FDA's site yesterday. Ritalin and Concerta, two other drugs used to treat ADHD, aren't amphetamines. So they don't bear the black box warning about amphetamine use. However, they are stimulants and do carry warnings about the risk of sudden death in people with heart problems. The FDA has not decided these drugs need to carry a black box warning. Ritalin is made by Novartis. Concerta is made by McNeil Pediatrics. Adderall is made by Shire. Dexedrine is made by GlaxoSmithKline. All are WebMD sponsors. ADHD Drug Warnings Warning information for all stimulant ADHD drugs includes the following: Sudden death has been associated with stimulants at usual doses in children and teens with structural heart abnormalities or other serious heart problems. Children, teens, or adults who are being considered for treatment with stimulant medicines should have a careful checkup (including family history and a physical exam) to check for heart disease. Patients who develop symptoms such as chest pain during exertion, unexplained fainting, or other possible heart symptoms should promptly get a heart evaluation. Sudden death, stroke, and heart attack have been reported in adults taking stimulant drugs at usual doses for ADHD. Adults are more likely than kids to have serious structural heart abnormalities, cardiomyopathy(a disease of the heart muscle), serious heart rhythm abnormalities, coronary artery disease, or other serious heart problems. Adults with such heart abnormalities should also generally not be treated with stimulant drugs. GlaxoSmithKline, maker of Dexedrine, said in a letter posted on the FDA web site that it added the warning based on recommendations from the FDA advisory committees. WebMD contacted the makers of Ritalin, Concerta, and Adderall for their comments. In a statement emailed to WebMD, McNeil Pediatrics spokeswoman Julie Keenan confirmed that McNeil Pediatrics has worked with the FDA to update the warnings section of the prescribing information for Concerta extended-release tablets. The update was "based on recommendations regarding use of stimulant medications to treat ADHD from two FDA advisory committee meetings," Keenan says. "We encourage parents whose children use Concerta to contact their physician if they have any questions," she adds. The makers of Ritalin and Adderall didn't respond before deadline. The ADHD drug Strattera isn't a stimulant, so it doesn't carry the same warnings. Strattera is made by Eli Lilly and Company, also a WebMD sponsor. View Article Sources SOURCES: News release, FDA. GlaxoSmithKline: "Important Prescribing Information," Letter to Doctors, Aug. 4, 2006. Novartis: "Prescribing Information for Ritalin." McNeil Pediatrics: "Prescribing Information for Concerta." Shire: "Prescribing Information for Adderall." WebMD Medical Reference from Healthwise: "Pediatric Cardiomyopathy." WebMD Medical News: "Experts Urge Stern ADHD Drug Warnings." WebMD Medical News: "New Warnings Urged for ADHD Drugs." Julie Keenan, spokeswoman, McNeil Pediatrics.

Heart exam, EKG recommended before children get ADHD drugs By STEPHANIE NANO – 16 hours ago NEW YORK (AP) — Children should be screened for heart problems with an electrocardiogram before getting drugs like Ritalin to treat hyperactivity and attention-deficit disorder, the American Heart Association recommended Monday. Stimulant drugs can increase blood pressure and heart rate. For most children, that isn't a problem. But in those with heart conditions, it could make them more vulnerable to sudden cardiac arrest — an erratic heartbeat that causes the heart to stop pumping blood through the body — and other heart problems. About 2.5 million American children and 1.5 million adults take medication for attention-deficit hyperactivity disorder, or ADHD, according to government estimates. Stimulant drugs, like Ritalin, Adderall and Concerta, help children with ADHD stay focused and control their behavior. The medications already carry warnings of possible heart risks in those with heart defects or other heart problems, which some critics said were driven more by concerns of overuse of the drugs than their safety. The heart group is now recommending a thorough exam, including a family history and an EKG, before children are put on the drugs to make sure that they don't have any undiagnosed heart issues. "We don't want to keep children who have this from being treated. We want to do it as safely as possible," said Dr. Victoria Vetter, a pediatric cardiologist at the University of Pennsylvania School of Medicine and head of the committee making the recommendation. The label warnings were added after a review by the Food and Drug Administration of its databases found reports of 19 sudden deaths in children treated with ADHD drugs and 26 reports of other problems including strokes and fast heart rates between 1999 and 2003. There were also reports of heart problems in adults; the committee didn't look at adults. An EKG can detect abnormal heart rhythms that can lead to sudden cardiac arrest. Children who are already on ADHD drugs should also be tested, Vetter said. If problems are found, the child should be sent to a pediatric cardiologist. With careful monitoring, Vetter said, children with heart problems can take the medicines if needed. The cost of an EKG varies depending on who does it and the location. For example, the amount that Aetna Inc. pays for an EKG in a doctor's office ranges from $24 to $50; Medicare's payment rate is about $23. Vetter said Children's Hospital of Philadelphia, where she works, has been doing EKG screening for three years and it has been covered by insurance. She said a screening of about 1,100 healthy children found that about 2 percent of them had some kind of heart problem. "We thought it was reasonable to include the electrocardiogram as a tool for the pediatrician, the psychiatrist so that this would help identify additional children who have heart disease," Vetter said. But Dr. Steven Pliszka, a child psychiatrist at the University of Texas in San Antonio, said he was baffled by the EKG recommendation. He said there's no evidence that sudden death is a bigger problem for children taking stimulants than for children who aren't taking the drugs. Pliszka said an EKG might deter people from seeking treatment because it's an added expense and hassle. Psychiatrists aren't likely to have an EKG machine, and pediatricians might not either, making patients go elsewhere to get the test, he said. The American Academy of Child and Adolescent Psychiatry recently updated its treatment guidelines for ADHD, and did not recommend routine EKGs, said Pliszka, who was the lead author. He has received research support or served as a consultant for makers of ADHD drugs. "We definitely did not feel we needed to screen everyone," Pliszka said. He noted that the heart association doesn't recommended EKG screening for young athletes to prevent sudden death. The group has said it wasn't feasible or cost-effective to screen all student athletes. Representatives for Shire PLC, which makes Adderall and two other ADHD treatments, and Norvartis Pharmaceuticals Corp., which makes Ritalin, said the labeling already suggests patients be evaluated for heart problems and an EKG done if needed. "There's no new information here. And frankly, we're a little perplexed as to the purpose of the American Heart Assocation coming out with this statement at this time," said Shire spokesman Matt Cabrey. An ADHD advocacy group called CHADD said parents should monitor their child's reaction to all medications. EKG screening "will bring an even further measure of safety to what is already a safe clinical treatment approach," the group said. On the Net: ADHD drugs: http://www.parentsmedguide.org/ American Heart Association: http://www.heart.org National Resource Center on ADHD: http://www.help4adhd.org

I would like to take a pole. First a disclaimer. This pole can not go against the final decision of Admin or the "Board of Directors" of EMT City. My reasons are only so we can clean it up a bit and have a better experience without the rif-raf.

[quote="WANTYNU Personally I think we should all drop this bickering and call ourselves Medics, educate the public that we are HEALTH CARE PROFESSIONALS and the rest will fall in line. As Always IMHO Be Safe, WANTYNU

Lone Thank You! This, in my 15 years of EMS experience, has got to be one of the best thing I have ever heard from any EMS provider!! I :salute: :salute: :salute: You! !!!

Author Message johntiger10 Posted: 1 Post subject: -------------------------------------------------------------------------------- I work in a plasma donation center, I don't have to give any meds, start iv's. All I do I physicals, I have a Title of Phys. Substitute, The only thing I have to give is a few tetanus and hep b shots. I don't think it to bad. What company do you work for? ----------------------------------------------------------------------------------------------------------- I also work in a Plasma donation center, only recently, and if they forced you into signing something that you were not certified to do then I agree. But I am certified within the company to give shots(Hep B & Tetanus). I cant give I.V.'s but we also have a nurse there that can. (BioMAT)

Wal-Mart announced that, sometime in 2008, it will begin offering customers a new discount item ---- Wal-Mart's own brand of wine. The world's largest retail chain is teaming up with Ernest & Julio Gallo Winery of Modesto California to produce the spirits at an affordable price, in the $2 - $5 range. Wine connoisseurs may not be inclined to put a bottle of Wal-Mart bran into their shopping carts, but "there is a market for inexpensive wine," said Kathy Micken, professor of marketing at University of Arkansas , Bentonville. "But the right name is important." Customer surveys were conducted to determine the most attractive name for the Wal-Mart wine brand. The top surveyed names in order of popularity were: 10. Chateau Traileur Parc 9. White Trashfindel 8. Big Red Gulp 7. World Championship Riesling 6. NASCARbernet 5. Chef Boyardeaux 4. Peanut Noir 3. I Can't Believe it's not Vinegar 2. Grape Expectations 1. Nasti Spumante The beauty of Wal-Mart wine is that it can be served with either White meat (Possum) or red meat (Squirrel). P.S. Don't bother writing back that this is a hoax. I know possum is not a white meat.

I just retook the test YOU ARE 66% WHACKER!!! YOU HAVE A WHACKER PROBLEM BUT CAN STILL BE A GOOD EMS PROVIDER. LEAVE THE BAT BELT AND FANCY TOYS AT HOME IF YOU WORK AT IT YOU CAN BEAT THE HABIT.

YOU ARE 48% WHACKER!!! YOU ARE ENTHUSIASTIC, BUT NOT A WHACKER. YOU ENJOY YOUR JOB. YOU CAN BE CONSIDERED BODERLINE WHACKER BUT THIS DOES NOT BOTHER YOU Gee...maybe i should change my name (lol)

Brentoli wrote: I nominate this thread for best of 2008! I'm buying the popcorn! EMT Paramedic Fleshlight pr0n Can I get some of that popcorn and I agree...2nd nonination. Ride safe

First let me say that i have enjoyed all of your replys, thank you. But please correct me if I am wrong or if your State protocols don't let you do this, but let me play out a small scenario....You get called to a, ok frequent flyer, and when you arrive and do your proper assessment skills that we all went to school so long for, can you not call your medical command or regional hospital where you can talk to your medical director or however it works in you state or country for that matter and get released. I like the words of, and I'm sorry to use these guys as examples, Johnny and Roy, he explained in one episode that a paramedic is the eyes and hands of the doctor they report to. So if your doc that you report to does indeed trust you, why not try to get released and go to the next serious call. Here is where you need to make a very serious judgement call. Don't just try to get released because someone is being a pain in the back side, but if indeed it is a stubbed toe on a normal adult, or or something truly minor enough that the person could go by bus or other means of public transportation, why not try to call your medical command and get released. Just a thought and I would like to hear your replies.. thanks and safe riding.