Scaramedic

GO UNIONS!!

My RNs friends and I are enjoying a 10 day paid vacation in SF during the CNA (nurse) strike. My RN friends are making almost $90/hr with 1.5x after 8 hours and 2x after 12 hours. We are in a beautiful hotel in downtown near the bay. Our flight and meals are paid for.

Do I have a problem being a "scab" by some union standards? NO! This strike is the 3rd for these nurses in less than a year and they are going to have another in 3 months. The strike is not about wages or benefits. They can not even say it is about working conditions since their nurse to patient ratio is protected in California statutes. It is about the hospital corp building a larger neuro/CVA center for acute intervention and rehab in a non union hospital. It is being built there because that is one of the few facilities that is retrofitted for earthquakes. It is not just to piss the union off. Luckily 50% of the RN didn't see this as a valid reason to walk out. The other 50% were led like sheep. Bless them because I needed a vacation in another state for awhile to appreciate Florida even more.

MMMMM. fresh sourdough bread, See's and Ghirardelli chocolate!! My cholesterol would be 900mg/dl if I was there.

To be honest I never encountered this Basic vs Medic crap until I started posting on these boards. I think a lot of the problem here is that some Basics and Medics use the anonymity of the web to say things they wouldn't say in the real world. :wink:

Welcome to the city.

I would suggest you practice on family members. Become so comfortable with your assessment skills that when you lock up on scene you will revert to your training.

i am truly tired of being put down because im am an emt-b.just because i am not authorized to run a line doesnt mean that i am not a good ems provider,there are more bls than als so of course they are going to send the ones they can spare the most first and then IF we need the back up then we call for it

Well there goes the whole 'nice ALS' debate, once again shot to hell by a noob with a tude.

so far i have read several of your replies and you seem nothing more than a cocky medic who thinks their god.get off your high horse and remember your basics and stop thinking you are the best because you can push a couple of drugs.i bet if you had a real trauma job you would wet yourself and calling for bls because you forgot how to put on a band aid

Umm Dust just got back from Iraq scooter. Have you been to Iraq. I seriously doubt you've stepped outside Mooseknuckle County.

a minute in the street

I'm sure that's not the only that takes you a minute!

and then you continue your assesment en route.if the pt is critical enough then you get the hell off the scene and call the hsp ahead of time with what you got so this way they can prepare better to treat the pt. ALS=always losing seconds BLS= best life savers

I'm sure they are in Mooseknuckle County, especially when Cooter is not working on the Duke boys car and can respond to calls.

thats why you have to be a emt BEFORE you become a paramedic

No you don't.

and even then you guys are useless until we get someone who is in arrest.any good trained emt can handle anything and get their pt to the hsp WITHOUT the need of ALS every time.

No you can't.

maybe you guys should be better trained out there like we are where i am

Hell maybe we should. I mean I've never ran a patient hot for an hour on a squirrel bite, minute man. :wink:

Amiodarone 150mg over 10 min., repeat x1.

If no change,

Versed

Cardiovert

This is my favorite EMS cartoon.

Oh man I have had so many scenes like that. Especially the naked guy reaching to the sky and the naked cherub carrying a putter.

That's Big Daddy Mars from the movie Ghost's of Mars. I highly suggest it, a great movie from John Carpenter.

I was going to post your pic Tniuqs but I didn't want to scare the kiddies.

Alas now I must go down and entertain. The annual family get together for Easter. About 100 people will be here soon for food and an egg hunt. I am getting too old for this crap. Takes two weeks to set up for. :evil:

Yes Dust, I agree but this is the first topic in a long while that has given ALS providers something to debate. I love it.

Duckman!

I agree with some of what you say, too many people (whatever thier mode of transport) do not understand the readings, there are many variables in fact, as I have mentioned prior, hypoperfusion states, (number one on the hit parade) dyes, a few meds, motion and sunlight contamination. But anecdotal notations are just a very poor point in during an intelegent rational debate, and in passing the evidence based medical findings and the value of pulse oximetry "in the early days" this study was done in the US, therefore not my Fly Boys,(& Girls too!) oh btw they are your Brothers and Sisters, generally speaking they have more education, training, but then again I may be more influenced by that silly literature I read from the National Flight Paramedics Association Magazine, ie the N.F.P.A. and in by in large this group has been involved with more evidence based research than ground.

Actually you can go to PubMed and find dozens of studies both ways. From field to OR to ICU. It has been covered pro and con many times. I tend to read EMS magazine and RN magazine since we have subscriptions to both. Oh and just for the record most of the experienced medics working flight in Oregon are not degreed like those newbies coming out of the schools now.

One can breath around an ETT when its in the cats **** hole, unless you are using sux

The cat comment goes over my head. But yes we are using sux for initial intubation and Vec for long term paralysis. Our Doc is also very aggressive when it comes to airway and gives us a lot of latitude for RSI.

NO SIR you have drawn that conclusion on your own, the personell here in Kanukistan work there way up the ladder, and the vast majority are proven Paras with at least 3 years on the street minumum, (not that much fling wing here, mostlt stiff wing and this long distance thang is not a quick hop in most cases) That said many land loving Paramedics are most excellent practioners, without any doubt, but many of that group either suffer from motion sickness or are too physically um "PORTLY " PC term ? to be wt./ flight effective, many fling wing craft are challenged with excessive payload and fuel. ie BK 105/ long jetbox.

cheers

Or some of us just hate to fly. Not to mention in little planes or egg beaters with no wings. If we could get Mag Lev trains I would never set foot on a plane again. :wink:

It's not different here you have to work your way up. But some people really don't like it when they get there. Personally I'll be happy to finish my BSN and sit in a nice quiet and grounded ICU somewhere.

Basically every line from Full Metal jacket, well beginning part of it in boot camp

Oh come on you gotta love...

Private Joker: I wanted to see exotic Vietnam... the crown jewel of Southeast Asia. I wanted to meet interesting and stimulating people of an ancient culture... and kill them. I wanted to be the first kid on my block to get a confirmed kill!

Or...

Door Gunner: Git some! Git some! Git some, yeah, yeah, yeah! Anyone that runs, is a VC. Anyone that stands still, is a well-disciplined VC! You guys oughta do a story about me sometime!

Private Joker: Why should we do a story about you?

Door Gunner: 'Cuz I'm so f*ckin' good! I done got me 157 dead gooks killed. Plus 50 water buffalo too! Them's all confirmed!

Private Joker: Any women or children?

Door Gunner: Sometimes!

Private Joker: How can you shoot women or children?

Door Gunner: Easy! Ya just don't lead 'em so much! Ain't war hell?

even...

Private Joker: Ya know, half of these gook whores are serving officers in the Viet Cong; the other half have got T.B. Be sure you only f*ck the ones that cough.

and finally.

Crazy Earl: These are great days we're living, bros. We are jolly green giants, walking the Earth with guns. These people we wasted here today are the finest human beings we will ever know. After we rotate back to the world, we're gonna miss not having anyone around that's worth shooting.

Awesome movie.

You don't have to move out of California to still be a "traveler" or contract employee. It no longer matters where you live anymore as it had in the past. One just has to hook up with an agency and negotiate a contract. A few health care professionals have eliminated the agency and negotiated they own contract after forming their own agency.

You could pretty much have your pick of agencies now. What is there now about 6 million Travel Nursing companies. RN mag for example, damn near every other page is a travel agency.

Nothing annoys me more then working with morons who can't be fired because they are in the union.

Then you would hate teaching. Now there is a racket that the unions have set up. Tenured and your untouchable. In Oregon they just found out that pedophile teachers are being shuffled around to different districts because the NEA protected their jobs. Sound familiar, yet the story is not receiving as much attention as the Catholic Church situation in Portland. Alas, media bias is alive and well in Oregon. :roll:

Positively and Absolutely I whole Heartedly DISAGREE !

Pulse oximetry is a Vital Sign..... everywhere ! If one looks to the studies it is abundantly clear (ps these studies were done in the US btw!) and by experianced flight Medics and RNS, yes clinical judgement is clearly a guideline when Dyspnea or SOB c/o but when the flyboys/girls and can't identify Cyanosis until those that are truely hypoxic and cyanosed until they are a life threatning < 77%. Its a proven fact JACK, the reliability factor is wholy based on perfusion and the complete understanding of the device, its only as good and reliable as the practitioner that is using it ! say JUST like the 12 lead EKG .....

But this TOO is a side bar and excuse me for getting off track, the topic is 12 leads ! sheesh.

I disagree with you.

I have only had a handful of patients that were less than 80%. Most dyspnea patients fall in the low 90' to upper to mid 80's and I can identify them when I walk into the room. If your Fly boys can't detect them until their into the 70's I would be concerned. Also I didn't say NOT to use it. I said that you shouldn't use it as to rule out using an NRB. I only use NRB's on patients in obvious distress. Yes I consult my SPO2, but I do not rely on it. There are too many variables that can affect the readings. Unlike, say a BP, if you get a funky reading you take it on the other arm. Too many people including Flight Medics and Flight Nurses tend to take the reading they get as gold and treat that reading. Hell, a partner of mine got a piece of paper to read 87% on a pulse ox. Yeah we were really bored that day.

Also like Rid pointed out my system is also is all about the ETCO[sup:0ca48bb131]2[/sup:0ca48bb131] waveform. Our Doc considers a waveform as the only true way to assess a patients respiratory and circulatory status. Even our tubes are not considered verified until we get a waveform. He does not accept auscultation anymore. No waveform and your ass is grass. I'm not a big fan of that idea either. I like listening for my tubes not trusting a damn machine. Maybe I've just seen too many Terminator movies.

Also I like your attitude that Flight Medics are better Medics than ground Medics. Please. I've known several mediocre Medics than are Flight Medics. I have also known several excellent Paramedics that went flight and then they came back because once the thrill of flying got old they found the job boring. Let's get on scene pick up a patient who is already packaged and fly him 8 minutes. How exciting. OK now let me work in the ED for two hours and then pick up a NICU. No thanks.

I got to meet Randolph Mantooth. I had my pic taken with him and had him sign a picture and a Washington State Paramedic Patch. He was a really nice guy, he was touring with their rescue on the way to the Smithsonian. They stopped by EMSA in Tulsa, it was really cool. It was neat to see what people brought to have him sign, Station 51 toy helmets and trucks, patches, fire jackets, you name it.

OK, boys and girls everyone play nice because I can see this thread is going to shit real quick.

1. VS. Yes, we all know your superior to us in every way. Sadly no one cares.

2. a. Black Crow welcome to the city. Love the avatar, I am a true Brown coat.

b. Long before Pulse Oximetry we didn't need machines to tell how much O2 to apply. We didn't need them because we could look at our patient and gauge their oxygenation status by such things as skin color/pallor, respiratory rate, general appearance and LOC. Please do not rely to highly on the machines they can be wrong. Go with your training and gut instinct. ALL patients do no require a NRB, in my opinion most do not. In fact, a majority of your patients don't even need oxygen. Watch your patient not the snazzy numbers on the box.

3. Dwayne. VS thrives off stirring up shit. Ignore him and he goes away.

Now everyone back to their corners and get back on topic.

Considering the cuts in Medicare I think we should become self supporting. I propose we go with a NASCAR type model.

It never ceases to amaze me how these uniform threads always turn into a debate about badges.

can wear t-shirts from between May 2-4 and Labour Day..

Why just May 2-4? Canadian Summer?

i think all firefighters and emt's should be dressed accordingly to proform the job weather it be a duty shirt or tee shirt

Welcome to the chat room.

Anybody who has ever played a Super Mario Bros game or any video game will totally relate to this guy. Funny as hell!

Warning: Very Explicit Language

Super Mario Frustration

Hyperkalemia pops into my head first. What was her EKG? Did she have weakness, numbness in her extremities?

Did she actually get the Dialysis or did they decide to hold off that day for whatever reason? Sometimes for various reasons they do not always get their dialysis. She might have been hyperkalemic because her shunt was bad and they hadn't ran her that day. Though dyspnea is not a common Hyper K presentation it can happen.

Look for QRS widening, increased P-R interval, Peaked T's and arrhythmias in a R/O Hyper K, supposed post dialysis patient. Remember just because she went doesn't mean she got it that day.

Maybe because we roll 8 people deep on every call (2 squad Medic/FF's, 4 engine FFs, and 2 ambulance EMTs), I might be too used to situations that would be considered inappropriate elsewhere.

Not slamming you Anthony but, that's just plain stupid. Especially coming from LA-LA land where their telling us we should all be walking everywhere and cooking over dried turds like they did in the middle ages. Talk about a carbon footprint. Does L.A. county buy carbon credits and plant some trees to make up for this idiocy?

It's sad to see L.A. county hasn't changed the system Johnny and Roy worked in. WTF do you need FF's for, is the patient on fire? Bad system. I don't know how you can stand it.