emtannie

We have a specific protocol for firefigthter assessment at scenes. I have tried to attach the protocol as a gif file, but if you can't open it, let me know, and I can email it to you.

The biggest problems I have had with this protocol aren't with the protocol itself, but with the firefighters.... it is hard to get them to hold still and allow themselves to be assessed, and harder to convince them to take a break when their HR or BP is too high.

I agree with other posters that you need to talk to your medical director. And good for you for doing the legwork first! Your MD will be a lot more cooperative when you go to them and say "this is what I want to do, and here is what I think the protocol should look like, and this is why I think it should be like this."

Good luck!

We don't have it in the rigs, but it is used a lot in our hospital, to work with specialists at other hospitals when it isn't efficient or in the patient's best interest to be transported 3 hours (one way) for a consult or followup.

I am curious - how do the Baton Rouge medics like it? Do they use it often? I would like to hear some success stories about it.

There have been some great posts from others on this thread… good to see the positive contributions!

Just a couple days before this thread appeared, one of the medics I work the same rotation with regularly referred to his partner as “my work wife.” We all laughed about it, but then discussed it in more detail. Working 12 hour shifts on a 4 on, 4 off rotation, especially if your spouse works a regular 8 – 5 job, means that you spend more time with your work partner than you do with your spouse/girlfriend/boyfriend. This can cause stress at home, especially if your work partner and you get along very well.

I’m not talking you and your partner getting along well in that you have an intimate relationship, but you know how there are some people you work with where it just clicks – they know what you need, and what the patient needs, and you just seem to work calls smoothly, and get along in between calls too. Do you come home to your significant other and spend time telling them about your day, and every sentence starts with “my partner….” Even if unintentional, this can make your significant other feel like someone else is taking their place.

Like many other jobs, EMS takes a lot of effort, and even during time away from work, many spend that time reading the latest journals, keeping up on their CEU’s, and heading to the gym. Is time with your fiancé coming in second to these other things?

Others have said – make sure that you schedule specific times where you spend time with her. When you are off the clock, your home life should come first. For those that are passionate about EMS, this can be difficult, as loving the work you do can be so consuming. Remember…. You don’t live to work, you work to live…. Appreciate the time that you have away from work, and appreciate the time you have with her. …. In the long run, that is the important part of life – the time you spend with those you love.

I am glad to see that you have gone to counselling – keep it up! Having an outside person who can look at both of your opinions and concerns objectively is a huge help, and the fact that you are willing to take that step is a good sign that you want your relationship to work.

All the best to you!

Not to get into the age old intubation debate, but don't most systems say ETI first and THEN blind airway? Personally, in my system, those are strictly backup airways; first line is ETI.

Unfortunately, in my region, we have different protocols depending on the area you are in in the region. This is due to a couple of cowboy medics completely f***ing up some attempted intubations, so medics have to call OLMC for the ok to tube. In those areas, until we can recover from the stupidity of a couple people and renew the medical director's faith in the medics, the blind insertion airway is first choice.

Dang - I didn't get into this discussion quick enough to offer initial interventions, but I agree with those above -

Is OPA and bagging maintaining the airway? If not, do we carry LMA, King LT, or Combitube? If those airways aren't available, and OPA isn't enough, intubation to maintain airway is indicated.

Were we able to get a large bore line in and bolus fluids to try to bring BP up?

Once glucagon and Atropine are administered, do we see any improvement?

I want a second crew to respond, as my partner is busy bagging this patient, and I won't be lifting him by myself.

I am curious - the call to the wife was 4 hours ago.... so she waited 4 hours before calling EMS? Was she hoping he would be successful? And, she doesn't feel this is important enough to leave work to come home? I can see if she works far enough away that she can't, but she could offer more information on history if she is still available to be contacted.

As some of you are aware, I am just starting my first practicum of the paramedic program I am in. The purpose of this practicum is to start thinking like a medic, not an EMT, and become proficient in assessment, history-taking, and differential diagnosis, learning to integrate paramedic skills and scope of practice.

I had a call the other night, and I would like some opinions on it. I hope I can explain it well enough.

We were called to an 85yo male, complaining of abdominal pain causing shortness of breath.

We arrive on scene, and he is in his recliner, alert and oriented, no obvious distress, good skin color. Note he has a urinaery catheter bag at his feet, and tube coming from under his bathrobe. (also note a good collection of Playboy and Penthouse magazines under the end table next to him - good on ya, old guy!).

Guy is deaf as a stone, so I have to yell (even though both his hearing aids are in) to get any information.

He is complaining of abdoninal pain he describes as pressure, like gas "if I could just fart, I would feel better" kind of discomfort. He says that it feels like it is pushing upwards, and that makes him short of breath, especially when he lays down.

He says this started 2 days ago, and was bad the night before, and he considered calling 911, but hoped it would just go away.

On assessment:

HEENT: skin pink, warm, dry, pupils ERL, patient does not appear dehydrated

Neck: no JVD noted

Chest: note bruising common to elderly, especially those on warfarin, no sternal scar, no medication patches. Denies chest pain or discomfort. Lung sounds have fine crackles in all lobes, and patient says he had pneumonia 2 months earlier, and still gets a bit of a cough

Abdomen: distended, quite rigid, no bowel sounds noted (am thinking possible bowel obstruction at this point). Patient says discomfort is across entire abdomen, but at one point, when asked to point to the pain, he points to just above umbilicus. No pulsating masses..

Pelvis: urinary catheter, urine in collection bag is dark, like tea, about 200mL. Patient stated he had had a BM earlier in the day, but smaller than usual, no diarrhea or pain during BM.

Legs: significant pedal edema, pitting, bruises, difficult to find pedal pulses, good motor function and sensation

Arms: strong radial pulses, movement, and sensation, same type of bruises as on legs and chest

Back: unremarkable

Initial Vitals:

HR 60, strong, irregular (patient states irregular HR is normal for him)

BP 170/100

resps 22

SpO2 95% on room air

Temp: 36.5C

BGL: 5.8mmol

Hx:

No known allergies

Meds: metoprolol, nitro patch (only wears for 8 hrs/day), lasix, flomax, diazepam, warfarin, prednisone

MI 3 years ago, had 3 stents put in

prostate cancer - hence the urinary cath

denies CVA, diabetes, HTN, any other medical issues

eating normally, no decreased level of consciousness, can recall all events

Because of the SOB, and at one point when I was trying to get information, he pointed above his umbilicus, I ran a 3 lead.... Rate was irregular, between 60 - 130, with several PVC`s (4 -5 per minute). I did a 12 lead, which showed elevation in V2, V3, V4 and depression in V5 and V6.

So, I showed it to my preceptor, and say my gut tells me this is an old cardiac issue, not acute, and that we are still dealing with a GI issue, not a cardiac issue, but I want her opinion on it. She looks at it, shows it to the other medic, and we discuss back and forth for a minute.... my argument is that he is pink, warm, dry, good SpO2, no cardiac complaints except the SOB, and is it possible that the 12 lead could be showing prior injury, not acute onset? But, I question my preceptor - should we be treating the cardiac findings as well, with ASA and nitro? I don't want to treat based on monitor findings only, when his symptoms appear non-cardiac....

They agree, and we transmit the 12 lead to the hospital (gotta love bluetooth technology) and call the ER doc. He says give ASA and nitro, and treat as cardiac until we get to hospital.

So, we draw blood tubes, give the ASA and nitro, continue O2 via nasal cannula, continue monitor, and transport....

There was no change in patient condition, so I still think it was GI, but we never got back to the hospital so I could follow up....

It was good to see that my preceptors were as stumped as I was..... I was completely convinced it was a total GI issue, until I got the 12 lead.... but then when I saw the ST elevation, then I thought "Whoa, do we have more going on here?" And yet the only cardiac symptoms were the shortness of breath, and irregular heartbeat, neither of which were acute onset.

The one ER nurse said she remembered him from a prior visit, where he had the same symptoms, and he was admitted, given doses of Lasix, and returned home within a couple days.

So….. my questions are:

- is it possible for a 12 lead to have ST elevation or depression that is from prior damage, not acute onset?

- Would you have treated as a cardiac patient, or a GI patient, and why?

I am hoping to be able to follow up on this guy my next tour – the ER docs where I work are pretty good about discussing cases so you can learn from them.

Did your paramedic program require you to take A&P as a prerequisite for paramedic school? If not, it's going to be all new material for you and shame on them for not requiring that at the very least.

I am in the same program, just a year ahead of Neesie.

Many programs do require A&P as a prerequisite. This program does not, but it is also a longer term program to allow for that. The program offered by this college is one of the toughest in this province, mostly because the didactic portion is done on line and distance learning, and you spend several weeks on campus every few months to do labs and skills work. There is a great deal of self-notivation required. Before anyone hacks this program to bits, part of the reason I chose it was because it fit into my schedule, and partly because it has an incredibly good pass rate with the provincial registry exam, which a number of the other colleges do not.

Now, that being said, I can relate to Neesie on this one... A&P is difficult, and it is the foundation that a number of other courses depends on. Knowing how cells work, and then being able to explain how a drug enters or affects a cell is hugely important. If only I haad known how important acid-base balance was when I took university chem a hundred years ago, I would have paid more attention!

Neesie, some things I did to assist me through the course were:

- I bought the Anatomy and Physiology coloring book, and worked on the pages of areas that I was struggling with

- I also subscribed to a site called audible.com, and downloaded the audio version of the A&P text. The downloaded version is like a Coles notes (or Cliffs notes, for those of you in the US), where each chapter is summarized into a short version, and then there are review questions.... I downloaded it to my iPod and every time I was in my car, I listened to it. That was a huge help to me, as wading through hundreds of pages in the text overwhelmed me sometimes.

- there is a website called www.purposegames.com. If you go to that site, and search "anatomy" a number of simple quizzes come up... from "name the skeletal bones" to "name the bones of the skull" to "name the parts of the brain" to "put together the parts of the kidney".... it seems mindless, but it is a nice change from just reading, and is just a different way of testing your knowledge.

You can do it!

Annie

Finish your degree!

You may feel now like it is 2 years that won't do you much good towards your career choice, but that just isn't true. Having your degree will open more doors, both in EMS, and elsewhere.

Having a degree means you have more education, and are more marketable, when compared to the person who has their EMS education only.

Having a degree is a prerequisite for a number of management positions, so years from now, when you decide your back has had enough of lifting patients, you will already have the degree, while others that you are working with are trying to get a degree while working so they can get into a management position.

Having a degree makes you more appealing to colleges as an EMS instructor, or to instruct entry level science courses. Some colleges require a minimum of a Masters, but a number still are happy with a Bachelors for teaching entry level stuff.

Keep your options open - and having a degree means more options!

Wish you all the best!

Well, not being a US citizen, I read this with some interest.

I agree with thrutheashes, who said that the general nature of politicians is similar everywhere, and it is not just US politicians who line their own pockets first and spend without making a difference to their citrizens.

I think what NYCEMS9115 was trying to say is that everyone is responsible for their own success, and we can’t blame everything on the government.

I think government corruption is alive and well in most countries. How many times do we hear that there is no funding for something that would benefit a large group of people, and yet there always seems to be funding for travel expenses, meetings in exotic places, extensive benefits, and retirement and severance packages for politicians?

I am amazed and appalled at crotchity’s comments (why do I continue to be surprised at the dreck this person spews?) Thank God for the current government for saving the US from a depression? Really? US unemployment rates in 2009 and 2010 are higher than they have been since 1983 (US Department of Labor www.dol.gov) The only reasons the current economic situation in the US is not called a “Depression” is because that word brings back reminders of the 1930’s and people would prefer to think that things are not that bad. Although the financial situation is not as dire as the 1930’s, the US, and world economy is indeed in a depression, where there has been a longterm downturn of economic activity. Many economists consider the last 4 years to be the worst economic crisis since the 1930’s. This "recession" is a culmination of decades of poor management and policy-making by government, big business, and financial institutions. The current state of affairs did not come about because of the last 4 or 8 years of US goverment - this has been building for a long time.

One of the largest failures of our time, is that we have not held current generations accountable for their actions. The mentality of “the government will provide” is so alive and well, and that is part of the drain of funds. Whether it is the stereotypical white trash or black ghetto neighborhoods, there are so many people that expect the government to care for their basic needs, rather than getting off their collective a**es and putting in an honest day’s work to earn their keep.

At the same time, education levels are falling, the quality of education is falling, and as individuals, many are depending on the schools to provide what in previous generations was provided at home. Today’s schools are not just a place of learning. They are daycare centres, social services centres, food banks, and safe havens for those with no other place to go, providing the day to day needs that should be provided for at home. Add to that the decreased level of education and training that a teacher in the US needs today compared to some other countries (I will use Canada as my comparison) and no wonder education if failing. In Canada, to be a teacher in a secondary school (kindergarten to Grade 12) you are required to have a minimum of a 4 year Bachelor’s Degree in Education, which includes several practicum components. In the US, having a college diploma in any field is acceptable in many areas.

Watering down the educational programs deteriorates an economy as a whole. We all know that in general, more education means higher incomes. Higher incomes means more disposeable spending. More disposeable spending means more demand for products which generates production, which further stimulates the economy.

But I digress….. is all this the government’s fault? Mostly, yes. The government has told the average citizen that they will be well cared for in the “best country in the world.” It has become too easy to fall into that lazy “the government will provide” mentality and not take responsibility for one’s own actions. At the same time, the government, being government, has its corrupt decisions, and self-serving policies, which protect those in government, rather than those that they are to serve. The remaining fault lies with those who are too willing to blame everyone else for their problems “I’m not educated, so I can’t get a good job (but I dropped out of school),” “I am discriminated against (since I refuse to see that it is my actions that are preventing me from achieving my goals).” “My business is failing and the government needs to bail me out (even though I was a poor manager and refused to see that my spending was exceeding my income).”

Back to Dwayne’s video – yes, funny, but sad too – it summarizes in a nutshell that the government does as much harm as good, and many citizens are doing little to take responsibility for themselves. Sadly, those that are working hard to ensure a good life for themselves are working for more than their own families – they are working to put dollars into a politician’s pocket, and a social assistance abuser’s pocket. That cycle cannot last without complete collapse eventually.

Dangit, I forgot to add - if anyone gets video of AK dancing to this, can you please post it here? I would love to see that....

Cougar, I feel your pain.

I was lucky to have the opportunity to get into EMS via the volunteer route, and realize that this is where I want to be, but in my many years since then, I have found the same thing that you are. Many volunteers feel that because they are volunteer, they shouldn’t be held to the same standard that paid services are held to.

I agree with others, that a training session needs to be completed. You don’t have to beat them over the head to cover the issues you are seeing. Put together some examples of what you have seen without naming providers or patients, and then ask your crew “how would you handle this if it went to court? Could you explain what happened and justify your assessment and treatments?”

Remind your members that this is in THEIR best interest, and it covers their a**es if something should ever happen that they end up in court.

I work for a paid service in an urban centre, and continue to volunteer when I have time in the rural community where I live. More and more I find it difficult to support the volunteer crew, when I continue to see the mentality of “we don’t get paid, so we don’t have to meet the same standard.” I always come back with “the patient expects a competent provider; they expect someone who can provide the best care possible, not just a ride to the hospital.” I also reinforce that in rural and remote communities, we don’t just have to meet a minimum standard, we have to exceed it, because we have that patient for 30 minutes, 60 minutes, or sometimes more, before we can get that patient to advanced care, where in the city, there is almost always a crew to back you up, and the hospital isn’t that far away.

Yes, they are providing a service to their community, but they need to be reminded that they have to provide competent service to their community, which includes good report writing.

I think if you can show them that making these positive changes is not just something that is an administrative pain, but is something that will work to their advantage, and to their patient’s, they will be more willing to make the effort.

I agree with Dwayne – you may lose the wankers, but really, that isn’t a loss. Those that are committed to quality will step up and improve.

Good luck!

OMG mobey - that is incredibly sad, yet funny... I think you could make a Lego youtube video about that.

Your sis should talk to her family doc about the treatment she received, and show her doc that pic. That is pathetic.

But Lone......

Firefighters spend their day playing with their own hose.... and cowboys think 8 seconds is a good ride....

I will take a shot at this…

Symptomatic tachycardia at rate >250, lethargic, hypotensive….. definite candidate for cardioversion.

As only medical hx is the SSRI prescription which matches the anxiety attacks, overdose is a possibility, but we can’t really solve that right now, unless she admits to it, we know time of ingestion, and we have charcoal and gastric lavage in our protocols (and I don’t want to do that in my ambulance – I don’t want to clean that up!).

Going with Dwayne’s tx, so far, IV is in, monitor is on, O2 is being administered, we have hx andf vitals, she is still conscious, and I am assuming vagal maneuvers didn’t work…. I would explain to her and her family that I need to shock her heart to attempt to reset it to a normal rate, and I will give her an analgesic (fentanyl) and sedative (Versed) prior to welding her.

Given the distance we have to travel, and I agree with others that getting the chopper is not something we want to stay on scene and wait for right now, I wouldn’t stay and play too long, but I would try to cardiovert on scene.

Once I have attempted cardioversion, I want to move into differential diagnosis, but I have the feeling Ruff doesn’t want me to do that yet…..

I would not recommend spending too much money on any of the current guideline study guides. There are new ACLS protocols out and they will start teaching them next year with some major changes. If you can wait for a new protocols class that would be ideal but if not, don't waste money on the current study guides that are available. They are already outdated and you will have wasted your money.

Here is a quick summary of the changes coming:

CHANGE

* Trained rescuers should change BLS sequence from A-B-C to C-A-B

* Chest compression rate should be GREATER than 100 beats per minute

* Chest compression depth should be GREATER than 2 in./5cm.

* Untrained rescuers should perform Hands-Only CPR

DELETE

* "Look, listen, and feel" for breathing is no longer recommended

* Atropine is not routinely recommended for all PEA or Asystole cases

ADD

* If available, continuous quantitative capnography is recommended throughout the peri-arrest period

to assess physiologic change

* Adenosine is recommended for stable, regular, monomorphic wide complex tachycardia

* Post-cardiac arrest care including PCI and Therapeutic Hypothermia when indicated

I think it may be slightly confusing to expend a lot of energy learning something and then very soon have to unlearn it or change your mindset on certain things.

I can see your point on this.... however, to defend my previous post, the book I recommended has a significant portion on cardiac anatomy, review of rhythms, and patient assessment, to ensure the reader has the background knowledge before getting into the algorithms. I too have seen the changes to the new guidelines, and if someone has the basic knowledge, I don't think it will be too confusing to transfer to the new guidelines. We had to make changes 5 years ago (especially instructors) and we will do it again. Most of the new guidelines have been in discussion forums on this site and elsewhere for some time, so none of the changes should be coming as a complete surprise.

When I originally took ACLS, my biggest problem with the algorithms was that I was weak in rhythm analysis. Once I was more confident in my analysis, the algorithms were easier.

Ugly, I can see your dilemma. And, as much as I like to see everyone achieve the highest education they can, I can see why you aren't going for your medic. I like that you are still willing to learn more, so you can do more for your patients. And, although a la carte isn't a perfect situation, it is better than nothing.

I teach EMR (which is our equivalent to your EMT- and one of the biggest frustrations I have is exactly what you have already stated.... students don't learn WHY we do the interventions we do. Your example of giving a patient oxygen is a perfect example.

I think taking a Human Anatomy course is a very good start. If you do end up taking A&P, you may also want to consider purchasing the Anatomy coloring book. Sounds silly, I know, but it is a good learning tool.

I don't know what meds your units carry, if any, but you may also want to consider a basic pharmacology class. If you can't access a class, a textbook that is very useful is Dr. Jeffrey Guy's "Pharmacology for the Pre-Hospital Professional." He also has podcasts on iTunes (they are free!) related to the book, but the podcasts make sense even if you don't have the text, so you may want to just listen to a few of those and see what you think before buying the book.

Do you do 12 leads on your patients? Maybe consider more education in cardiac dysrhythmias - you may not be able to treat en route, but you may be able to give a clearer picture to the ER staff. There are a lot of good references on line for this.

Just a few thoughts....

One book that was a big help to me was:

ACLS Study Guide

Author: Barbara Aehlert, RN, BSPA

Third Edition

ISBN 0-323-04695-9

I think it costs about $35 - you might want to check Amazon. It was worth it to me!

Thanks for sharing that video, croaker.

What an excellent reminder of who the true heros are, and how much we can learn from the courage of those kids. That is a powerful video.

Thanks again..

Annie

A young engineer who graduated with distinction, was leaving the office at 3.45 p.m. when he found the Acting CEO standing in front of a shredder with a piece of paper in his hand.

"Listen," said the Acting CEO, "this is a very sensitive and important document, and my secretary is not here. Can you make this thing work?"

"Certainly," said the young engineer. He turned the machine on, inserted the paper, and pressed the start button. "Excellent, excellent!" said the Acting CEO as his paper disappeared inside the machine, "I just need one copy."

Lesson: Never, ever assume that your boss knows what he's doing.

I was sent this link from someone more nerdy than I, and thought it was pretty cool.

The Merging World – a 4 minute presentation on life expectancy and wealth of 200 countries in 200 years…. Statistics for the inner geek in some of us…

http://www.flixxy.com/200-countries-200-years-4-minutes.htm

It is kinda neat to see it in animation, showing the changes in life expectancy and incomes. What is just as amazing, and scary and sad, is how some countries have hardly moved on that grid in those 200 years.

I’m a geek, so I wanted to share this….

Hate to burst your bubble annie, but there are absolutely no provisions in federal law to protect queers from discrimination. And for good reason I might add, they deserve no protection.

First, thank you Wendy, for reporting this post.... I would have done so if I had seen it before you.

I would like to direct a few comments to emtpociets... You have been on this site for a very few days, and have shown yourself to be completely narrow-minded and uneducable. You have posted here and in other threads, based on opinion only, with no evidence to support your claims. As most here, I don't have a problem being involved in a heated discussion or debate, but your posts do nothing to encourage intelligent debate. Rather, they just show that you have no interest in expanding your knowledge or education, nor researching your current opinions to see if they are valid. As a medical "professional," as your profils says you are an EMT, you should be ashamed of yourself, as you appear to have absolutely no interest in expanding your views or improving your education.

In the grand scheme of things, does it really matter if this video is a real or staged event?

The OP never said it was a real event, and it is on youtube, the video equivalent to wiki...

However, it has generated 5 pages of discussion in this thread, and many who have watched it here have posted it to their FB pages and/or emailed it to others with a reminder to stay safe out there. It has made those who have watched it evaluate their own responses to mvc scenes, and review their own skills and knowledge. So, IMHO, regardless of whether this video was a real event or a staged one, it has done its job, and it has been successful in reminding us all to be more aware of the situations we walk into and the potential dangers surrounding us.

Sorry, Doc, but on my list of priorities for this country right now, the issue of gays in the military comes in at around 250 out of 250. I also would NOT consider this a basic human right, as defined by the UN.

I heard a number that said since DADT was initiated, 14,000 soldiers have been discharged because of sexual orientation. Me being the cynic that I am- I wonder how many of those folks who were "outed" were actually gay, and how many were looking for a way out of their service. Whatever. So, let's add up what percentage of the total fighting force this actually comprises? I'd guess it's probably statistically insignificant.

I am not a soldier, so my opinion of this is completely irrelevant. I've seen polls of soldiers giving completely opposite opinions on this issue- depending on who is doing the asking. Whether it's good, bad, or indifferent to the military, is NOW- while we are still actively fighting in Iraq and Afghanistan- really the best time to repeal this? Is even the potential for such a distraction to our soldiers a good idea?

I'm still stumped on the whole distraction thing. I am easily distracted by shiny objects. I am also easily distracted by a man with no shirt who has a great set of washboard abs.... does that mean that I am a menace to society? (I refuse to comment on the troll emtpociet's posts - it would be a waste of my time to expend energy on the garbage that person posts). I am easily distracted by a completely rebuilt 1972 Chev truck, especially if it is red. What is this "distraction" that people are talking about when they talk about gays in the military? Gays are there to do a job, just like straight people. There is no more distraction than having a male soldier check out a female soldier, or vice versa. Soldiers are supposed to be adults and act like adults. This distraction excuse is just that - an excuse.

I'm also stumped by the DADT being a complete discrimination issue, and people thinking that is ok to leave it in place, with no evidence to support it. In the workplace, I can't hire or fire someone based on their sexual orientation. If their actions are contrary to the job that the hold, and puts the project or someone's life or limb in jeopardy, that is a completely different thing. Their ACTIONS made the difference, not their orientation.

Yes Herbie, there are a lot of things in the US that should be on the top 250 list... the economy, employment figures, the US trade deficit, the instability of the US dollar, education, health care..... the list can go on and on. That being said, those people that the citizens of the US voted into power decided that this was something they wanted to work on. You don't agree, voice your opinion to your elected officials, and use your vote to express your displeasure.

In reality we can all be accused of prostitution, we sell ourselves everyday we go to work. But, i was refering to not all women, just those who manipulate to get what they want through sex. You tell me, & be honest Annie, only if you want to, have you ever used your sexuality to manipulate a situation? Isnt that the same thing?

LOL - we are sidetracking this thread, but here goes....

Phil, in reply to your question of have I used my sexuality to manipulate a situation? I am sure I have, eve3n though I can't think of an exact example at the moment.... just as you have probably done so as well. Have you dressed a certain way, or when meeting with a woman, acted a certain way, knowing that those actions were a means to an end? Probably. I am well aware that I am not centerfold material, so I don't tend to think of using sexuality as a means of obtaining what I want. And, having worked in a male-dominated field for many years (being the only female commercial bank manager for many years in my region) I spent more than enough time just fighting for equality in pay for equal responsibilities. I didn't want anyone ever accusing me of getting where I was through sexual means.

I think it is unfair of accusing just women of being manipulative and using sex as a means to an end. I do see mobey's point though, of women tending to withhold sex as punishment - I can agree with that, that some women definitely do that. However, I do think that men also use it as a weapon, in other ways, and I am not talking violence against women. We can look at the "I won't give you a promotion unless you give me a blow job," situations, the "I want sex.... oh I'm done but you're not and I don't care" roll over and snore situations, and the boys in the bar betting on which one will get lucky first that night.

It is interesting how perception of sexuality differs between men and women. If a woman sleeps with a lot of guys, she is a slut, and that is considered damaging to her reputation... if a guy sleeps with a lot of women, those notches in his headboard are trophies that he and his friends can cheer about, and his reputation doesn't get damaged like hers does.

So, if we go back to the original video.... if it was a 21 year old guy who was going to sell his virginity, would we feel differently about it? Would that be ok?

Wendy, I agree wholeheartedly – I don’t care who you are interested in, I care that you can perform the duties required in service to your country.

There were some very interesting quotes and statements in the article…

Obama said…. "It is time to recognize that sacrifice, valor and integrity are no more defined by sexual orientation than they are by race or gender, religion or creed."

"As Barry Goldwater said, 'You don't have to be straight to shoot straight,"' said Senate Majority Leader Harry Reid, D-Nev., referring to the late GOP senator from Arizona.

“The Pentagon study found that two-thirds of service members didn't think changing the law would have much of an effect. But of those who did predict negative consequences, a majority were assigned to combat arms units. Nearly 60 percent of the Marine Corps and Army combat units, such as infantry and special operations, said in the survey they thought repealing the law would hurt their units' ability to fight. “

With regard to the last paragraph quoted, I know we have a number of members on this site who serve in Marine and Army combat units. I would like to hear their opinions on this. Why and how would having a gay person in the unit hurt the unit’s ability to fight?

Herbie,

marriage is prostitution as well. Women know if they want something, they just have to give it up & they got it.

Interesting thought process there.... are you implying that all women are whores, and all men are just guided by their penises? I'm not saying that is wrong, or a bad thing.... just wondering if we can dissect all man/woman interactions down to that basic a level.

Maybe that is what makes virginity such a commodity- the basic competitiveness of men - the "I got there first" mentality. Just a thought....