Scaramedic

Here you go BandAid Patrol. I believe these are the pictures you were trying to show. From.. http://michigan-ems.tripod.com/ Peace, Marty :joker:

How about a EMT-L, stands for EMT-Lawsuit waiting to happen! I did not know that systems are naming EMT levels for individuals. Interesting. :? Peace, Marty :thumbleft:

Here's the scenario for you. A 76 yo Female has pushed her LifeLine Personal Alert, LifeLine called her son who rushed to her house (she refused to have Lifeline call 911). He found her sitting on the toilet, complaining of shortness of breath. He calls 911 and you arrive on scene. You find her pale, diaphoretic, able to speak in full sentences but very weak. A&OX3, no LOC, no C/O CP, dyspnea has subsided. BP is 72/34, RR 24, HR 38, Sinus Brady without ectopy on the monitor, SaO2 98 on room air. LS Clr Bil, No neuro deficits. Finger stick Glucose was 133. Rest of assessment is unremarkable. Hx NIDDM, A-Fib, CLL, and HTN. Pt is on Glucophage, Coumadin, Atenolol and Lusinopril. NKDA. You start the usual IV 20g R AC NS TKO, O2 NC, Monitor. You do not do any further interventions. :shock: The question is this. Do you... A. Pick up all the trash you created and dispose of it in the unit. B. Pick up all the trash and throw in the patients garbage. C. Throw the garbage on the floor of the patients bathroom, kitchen and living room and leave it for the family to pick up later. Hah, you thought this was going to be a vagal thing didn't you? Well obviously it was, her Atenolol was causing too low of HR, and the BM caused a vagal response that dropped it even lower. The patient was my mom, I was the son who got called. She is fine and at home resting. They changed her Atenolol dose and D/C'd her after all the standard tests came back negative. The issue I have is that my family was irritated at the house being trashed, and they asked me if it is normal for an EMS crew to leave garbage everywhere. My answer was that I always tried to pick up trash that we created on scene. I understand maybe on a critical call leaving the occasional bit of garbage when treating the patient. This was not a critical call by far, I won't even start on the lack of treatment, that is another issue. My family does not know there were several things the crew could have done for my mom, they just know the crew trashed my mom's house. So the question is this; do you pick up after yourself when on scene? I am not talking an arrest or a load & go scenario, I'm talking your typical non-critical medical call. I would love to hear your opinions on this. Peace, Marty :thumbleft:

:shock: Uh-oh I feel another debate coming on!! Peace, Marty :thumbleft:

Oregon, another TV show filmed in Vancouver, BC that is supposed to an American city. :roll: 99.9% of the population won't know the difference anyway. I bet Multnomah County EMS and AMR are just thrilled about this new series. Peace, Marty :thumbleft:

Unless my memory is failing at greater rate than I suspected, 601 is Aaron. So just out of curiosity, if you don't mind, who are you? Peace, Marty :thumbleft:

EMSA West (Ok City) has a union EMSA East (Tulsa) does not. What is the average length of stay in any urban EMS system? When I recently visited after 5 years I found 1/3 of the Para's I worked with with are still there. Many of the Basics I worked with are now Para's. Several Medics who started after I did are now supervisor's, and several former supervisor's are now upper management. So is this out of line with national averages? I am asking because I really don't know. I see ads from a dozen companies around the nation on a regular basis, AMR (Insert any city they contract in here) and Acadian run ads all the time. Yes they are employed by Paramedics Plus and before that AMR and before that some company I can't remember the name of. So? Yes, the City has a majority of the problems. The response time and dispatch problems are in the City not in Tulsa. I have no idea either why the City seems to be such a problem. Maybe it's because Corporate is based out of Tulsa, so if Steve or Ann have an issue they can just walk across the hallway and chew ass on the Tulsa management personnel. I agree they have some good Medics, and that is constantly who I am defending. Like any system in the country they have good and bad Para's, I challenge you to find any system in the nation that has only perfect personnel. Which brings me to Dust... Please tell me you are not comparing all medics at EMSA to paint by numbers artists or McDonald's fry cooks? You know this from personnel experience or just what you have read on the internet? Maybe you worked with some dumb-ass who got fired or quit EMSA and worked with you somewhere, I am really curious to know your basis for these statements. As far as "High volume of non-emergency transfers," ummm no. The rule was no more than 1 non-emergent transfer per crew, and that was only if the system could handle it. Numerous times I have worked a whole set of shifts without ever doing a transfer. That was also before they re-instated the HPC unit, that does nothing but transfers. So I am not sure where that came from. Could be one of those Tulsa-vs-The City things again. EMSA was definitely not my first EMS job, but I liked the system and I loved the people I worked with as well as the people of Tulsa itself. Peace, Marty :thumbleft:

AZCEP is right, they have several types of EMS fanny packs, heres the link. http://www.statpacksstore.com/ Peace, Marty :thumbleft:

:shock: Wow Rid! I would have just said a change in BP and/or a dropped radial during inspiration, but damn! No provocation/palliation with that upper thoracic pain right? I always over think these scenario based things. :roll: OK so what do we do, well lets start with "we care" oxygen, 2L NC. IV, monitor/12 lead. Anything interesting on that 12 lead? Peace, Marty :thumbleft:

Abdomen, soft? Tender? Any masses? Lung sounds? Heart tones? Pulsus paradoxus? Peace, Marty :thumbleft:

Actually you wrote it in French Hammer, but admin translated it for you. Paix, Marty :thumbleft:

49. Does being that stupid cause you physical pain? Peace, Marty :thumbleft:

The monitor says it ok to bag the patient now...... Peace, Marty :thumbleft:

Was it a Nancy Caroline book Ruff? Peace, Marty :thumbleft:

Our bike team tried something like this because they couldn't carry a monitor, it was basically a little box with an LCD screen that showed the rhythm. To put it mildly it sucked, any movement on the patients part, you know like breathing showed massive artifact. Besides you should not need a monitor, or any other piece of machinery to tell you what your patient needs. Do not look at a monitor to see if your patient needs to be bagged, look at your patient. There is nothing you are going to see on that monitor that is going to change the treatment you can provide. A thorough assessment is the most valuable tool you have, do not waste your money on a useless gadget. If you want to spend money, buy a decent stethoscope and some tapes to learn lung and heart sounds. That will help your patients a lot more than a fancy EKG/Stethoscope thing. Peace, Marty :thumbleft:

I didn't mention the exercises because I wasn't sure the new editions kept that format. Hell they've dumbed down everything else so ya never know. I wonder if the new versions still have the photos of the 1960's Thunderbird to illustrate various views of the heart. :wink: Peace, Marty :thumbleft:

It's cool Bro, I didn't take it personally at all. If you want to see what happens if I take things personally look at the last thread "the-kid" made last nite, oh wait they deleted that thread. Peace, Marty :thumbleft:

Actually happened dude. What I didn't mention is that it was pure harassment on the part of PD. A Little history of Portland EMS. Portland (Multnomah County) used to have 3 ambulance services and the city was divided in roughly three zones, west, southeast and north/northeast. We had dropped of a pt at Providence Milwaukie and were "out of" our area. Some Portland Police Bureau officers were very protective of their districts and out of district ambulances were open game. So this Sgt. decided he found an excuse to pull us over, that's what made it really funny. He did not ask why we were out of district or anything he just left without harassing us. Peace, Marty :thumbleft:

I learned basic EKG interpretation from "Rapid Interpretation of EKG's" by Dale Dubin M.D. Here's a link to Amazon if your interested. I have the 4th edition, looks like their up to 6th edition now. :? http://www.amazon.com/gp/product/091291206...ce&n=283155 Peace, Marty :thumbleft:

Crazy Canadian Postcards. Peace, Marty :thumbleft:

Medicine is full of inconsistency when it comes to titles. Everyone from a CNA to an NP is called nurse. The public does not care that one person went to school for 8 weeks and one went to school for 8 years. An M.D. is called Doctor the same as someone who has a PhD in History. It's not just medicine that has this issue either. How many of us out there know the differences between all the disciplines in Computer Science? There is a difference between a system analyst and a data entry person, but most people just call them computer programmers. Titles are important within a discipline to differentiate who is who, but outside of that discipline worrying about titles is pure ego. This goes back to the "ambulance driver" issue, the public can call me what they want. I know my role and do not feel the need to educate the public on what I do. What would you want a PCP to call himself? A "primary"? Paramedic is in their title, if you have a problem with that talk to your lawmakers who changed the titles. Otherwise don't worry about it, the public sure doesn't. Peace, Marty :thumbleft:

Dust & Rid, sorry if that seemed a little harsh. I still have a lot of friends in Tulsa who work for EMSA, I guess I am a little protective of my homies. :? Rid, I started another paragraph last night that covered the fact that the protocols are way behind the times, but I almost fell asleep so I cut it short. That was why I mentioned Sacra was better than Mengis Khan (I can't remember how to spell his damn name, Meninges?). Anyway, that was one of the things I did not like at EMSA. It was quite a shock to go from Multnomah County EMS protocols to EMSA protocols. Sacra loosened them up a bit, now they are on standing protocol, no med control, but they are still limited in scope. The excuse I was always told was short transport time, so we did not need expanded scope/meds. So your right, no pumps, limited meds, no RSI, etc. Another thing I found interesting is how protective they are of their protocol books. I still have my Multnomah Co. EMS protocols and my Denver Metro protocols, but I had to turn in my EMSA protocol book to get my final paycheck. Weird. I have been critical of EMSA on these boards before, I am not a cheerleader for them. I just wanted the people who work or have worked there, to get credit for the high arrest save rate. I still agree the study is complete B.S. Peace, Marty :thumbleft:

OK, I understand what you want now. You do not want to work as an EMT, you just want the training so if you have an accident on the farm. That makes more sense. My opinion, do not worry about becoming an EMT unless you want to volunteer at your local VFD. An EMT-Basic cert has to be kept current, if your not with an agency that can be a problem. I suggest you take a first aid course at the Red Cross, you will learn basic first aid and it will save you a lot of money. Another option is the Farmmedic program, there are several in Iowa, here's a link, for real this time... http://www.marshfieldclinic.org/nfmc/pages...page=farmrescue Peace, Marty :thumbleft:

I agree with AK, Where's the camera, where's Allan Funt? Please tell me this a joke! :shock: Peace, Marty :thumbleft: