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Rats: just re read this, I do like the way you think.... but off topic a touch sorry, no tube hmmm and thats Murder not theft, gottcha. :twisted: cheers ps Its not the RNs that steal my Pens....its the DOCS! :shock:

Agreed +10

Oh yea an over night job, they put in a cam after but all they caught was an MD and an RN....er... being very "frendly" after hours, but that is another story...ever see the Sharon Stone thing in the parking lot with Micheal Douglas....opps outside voice again. cheers

Funny thing you ask! I leave the sheets at the hospital..... eeeewww! And if it ain't bolted to the ground and has a sticker on it is..... MINE! [align=center:1fce6c2060]"HONEST SQUINTS SLIGHTLY USED HOSPITAL EQUIPMENT" Looking for franchise distributers. Well I have to retire some day don't I?[/align:1fce6c2060] j/k Seriously in a past facility where I worked some one "and most likely an inside job" ripped off a complete Cardiac Cath Lab...including monitors, computers +++, If I would have caught them it would have been rounds of SUX for all ....and no ETT. I hate thieves, just imagine if your Mother had been waiting for 3 months to get her pipes checked? cheers I do have one scrub shirt... and it is older than most of the members on EMT city.

Absolutely + 5 for this comment. Simple Respect.....for your patients needs ..... whatever their beliefs not yours. Muslum, Buddist, Shinto, Judaism, United, Baptist, Petacostal,(sp), Catholic, Navaho or Cree. Riddle me this: What religion does not believe in a higher power? BUT Quoting Dust: You do not have to speak aloud to be heard.[/ cheers

Oh yea, pick Vent guy....3 minutes late and one time zone away plus my 'hunt and peck' tecknique. I don't a proposal to get run naked and drunk through the field of dreams...... foiled again! Its that Canadian thing isnt it...LOL... Ruffems. cheers

Well interesting comments by all, but I have a bit of a different perspective, can you call a save doing monkey skills as in CPR, shoot a tube, bang a line in, push a preloaded drug according to a cook book ? Can not any Paramedic can do these things what is it that makes a Save to me means much more, perhaps a bit harsher view than most on this board. So I submit this perspective for your review; Preemptive treatment with a patient that ultimately WILL arrest, Yes the that BiPap (asthmatic or COPDer) applied and coached cheating that tube and vent, the Lasix for that Pulmonary Oedema, that RSI in the 13 y/o head injured patient that siezes and posture's on take off (and discharged to go back and play hockey the next season) and on to all your specific calls not just the V-Fib patient or CPR on arrival. Vent Medic and I share a different point of view...yes the Vent farms, I bet my bottom dollar that because one single RT that decided that "This" one patient would NOT be allowed to give up and 5 months later decannulates that Trach...was it the Paramedic that saved that patient...maybe partly. We forget all of the others that make a huge difference to those potential patient's and their discharge to door, sometimes this proffession gets a very narrow view, we are just part of the team NOT the whole Team. These as are many other situations could be considered saves (if there really is such a thing in the first place) I am of the opinion that the choices that were made at that critical time because it was Me that made that choice, to run with it or stay and make that difference. Now, my experiance in the "early days" was single Paramedic, single Pilot and NOT short distances and even sometimes with 2 patients, one trying to deliver and one with a real funky rhythm, these were the times (with no other support) that I made a postive diffence to an outcome...or the proverbial save. After all there really is no hard and fast line in the sand.....really is there? cheers just my 2 cents CND.

Pro_EMT: I don't think your listening here, the advice your recieving is from true veterans, just try arguing a point of conjecture in an interview and learn a lesson plain and simple......hello! cheers and good luck......ever think of a rabbits foot keychain?

Was this :roll: Guest was formerly know as Turnip? :oops:

Well Well NPWIDMD? National Put Words in Dusts Mouth Day and I missed it.....Rats foiled again. :twisted: The 12 saves ?....well if you can't see the controversy in this thread ......... check out my signature. ak: Does the "village idiots helper line still work" at least I am employable..."helper" is the "KEY" word there! LOL. Seeing as the conversation has gone a little sideways here is my .02 cents CND: ok free. The myth of the 1 page C.V. is a 'old wives tale' unless your working for a puppy mill, if an employer doest want to take any more time than that to evaluate a future employee then so be it. It has been mentioned to myself during the interview process that (MY C.V. is 4 whole pages) long, the highlights of training are on the front page, that is a very good point, agreed. In your case Pro Emt and if your age really is 17, I would go with enthusiasn, willing to learn, excited about any educational opportunities route. Whatever you do don't pack details of job descriptions it just makes one look petty. Don't do ANY fabrication, this will sewer you even before your on the phone back list, the employers really look for this as an immediate file "G" ! If you get to the Interview process what can you do for your Employer, NOT what are the benefits and hourly rates of pay, that you can find out after. Good recommendations are a must, chose people that are concise on the phone, and make absolutely certain they are informed that a possible employer could be calling. The idea of "preening someone" "orienting them to a service" or in other words brainwash them into that particular organization I find quite distasteful, A GOOD employer is looking for someone with a good track record and 'educated' experience applied. Oh yes he may have to pay a little more, but a GOOD employer is doing a risk assessment as well woth it in the long run. cheers and good luck.

Some interesting points here....there is really no line to be drawn in the sand, Snow flight makes very good sence as in regards to RPP, we have dicussed the use of Inotropes ie Dopamine "Pumped Please" for cases of hypotension associated with pulmorary oedema and lots of links in the search engine. cheers

Ok stop the insanity, just quote the parts you are wishing to debate...I am getting dizzy! JPINFV So your point is what then? Solve the problem with a new improved homeboy/fire/government/driver? Please read Rids comments again, they do make good sence, your's are without any clearity unless your headed down the fire based service crap AGAIN. AnthonyM83: I don't fear good research I fear bad research, and penny pincing polititians that twist the values. The Opals Study I was responding too was due to AZCEP comment it was another "out of hospital arrest survival rates study" done in Ontario, it basically boils down to "in an arrest situation" the TIME to recieve ALS care is a determining factor, a system of Advanced Life Support System it should not be judged on this criteria alone, and I think very well stated by the author. cheers

Nice Ride =D>

We didn't go wrong at all! Scenario #3: *Headline News* Homeboy shot in a drug deal gone wrong is Rushed to Hospital by Homies. Kills an Entirely Family of 5, in Intersection Collision. Investgators file lawsuit for "stupidity" for publishers and researchers of a Study that "Driver" homeboy reads in magazine. Do you think that all studies are well researched....this study proves the point that some studies are simply a waste of breath.

As to why the OPALS study is flawed... author: a letter writing man. Although it claims to have been a before and after study that noted the changes in patient outcome with ALS, its before data is skewed as to its numbers. Were these same numbers gathered from the 17 OPALS communities before the ALS medics were trained and sent out to practice in the community? NO, the 17 base hospitals were not collecting such data before 1994. Lets compare apples to apples. What is the survival rate of cardiac arrests that enter the ER and take place in the ER in these same communities when the study question asks the benefit of ALS in the field? There was not a study in this area that gathers the ER data, thus would any improvement in the ALS save rate not be beneficial? No data that compares this. There was an improvement in save rate from 3.9% to 5.2% with in-the-field rapid defibrillation, but only an improvement of 5.0% to 5.1% with ALS treatment. Hmmm... compared to what? Give me relevant data to compare it with. And was there a bias in the researchers focus towards supporting CPR, rapid defibrillation, or relating such data to physicians in the ER (see note A below)? Objectively speaking, all data in trying to raise the dead is poor so why compare ALS medics to God when the stats are not available for the docs in the ER where the save rate would be questionably worse. All the reported OPALS data to date is geared to rate objective information. This is better than subjective study analysis in its validity, but is there a study that can rate how well a psychiatrist works with their patients? No, its all subjective unless one counts how many people out of the total actually commit suicide, bodily harm, or other crimes with the therapy of a psychiatrist verses without one. In response to note A - No improvement in the dead patients with ALS translates into what? And when compared to what? The investigator gives the notion to its readers in the conclusion that ALS bares no assistance in VSA patients so spend your tax dollars elsewhere. Hmmm... why didn't the investigator submit the results on chest pain, diabetic emergencies, or shortness of breath before the results that were obviously going to appear poor before the eyes of the public and its financial caretakers?Lastly, does the question of the study results translate into a taxpayer's bag for their buck in any way or fashion? A tax payer is always more worried about who is going to pick up their garbage on Tuesday morning verses the training of paramedics that pick them up, as nobody anticipates that need for an ambulance. But, ask those after the fact of receiving such care and the improvement that incurred during such care and they will be the ones to say more ALS medics. Note A - Conclusion statement of cardiac arrest study "There was no improvement in the rate of survival with the use of advanced life support in any subgroup. The addition of advanced-life-support interventions did not improve the rate of survival after out-of-hospital cardiac arrest in a previously optimized emergency-medical-services system of rapid defibrillation. In order to save lives, health care planners should make cardiopulmonary resuscitation by citizens and rapid-defibrillation responses a priority for the resources of emergency-medical-services systems."

Not me, but I know exactly why the combination confused you there bushy.....it was the glass of beer you were looking through! ......my bad? cheers

Well could anyone direct me to an on line translation guide? "caze ther aint no thang like a chiken wing" ? cheers

I was concieved in Churchill Manitoba, what else was there to do? AND Polar bears roam the streets at night. I think I remember the words somethin like "Oh Honey, there is a bear outside...oh look theres a bare inside" cheers

pinymayu Gee thanks uyamynip... I now give you permission to call me "turnip" LMAO a much more succinct description of my personality... again thanks to TERRI! The reason I have been called squint is that is the appearance I get when venturing into an area of controversy or conjecture need I say more, oh yea I can't play poker too, I lose every hand. I believe that the reason for some comments here in the "City" is that some forget that these discussions are "across borders" and sometime the "legalities in one area are very different than others" making blanket statements do tend to make one appear overly focused in one locale. For those that misunderstood this comment please reread it, in our hood a BLS x 2 EMTs and ALS 2 Paramedics in PAST were dispatched for a call on many occasions, we do not have the staff nor number of units to make this financial feasible, it is very different means of funding these EMS services north of the border, there is really no competition for calls as in the US (in some areas) or is that just a Kanukistanian misunderstanding based on Mother, Jugs, and Speed....a training prerequisite in Canada. As for believing that kev posted this view so how not true but: I do try to suck him into every discussion that I can....so Thanks.....again ROTFLMFAO! Kev Propofol: I have the "big guns" ie SUX in my kit, really I don't need it for most of the Tubes I have had in the past 2 years only needed Versed, and Fentanyl, but really nice to have SUX as the hammer if you need it! The whole idea of getting the tube on the first attempt is a "red herring" in my view, capturing the airway with proper ventilation and oxygenation are the Key factor (s).... not The Only Factor, these studies should include this and patient outcomes should are the KEY indicators, not the # of Attempts are we evaluating speed not skill once again? EDIT Headlines "THE MAN WAS RUSHED TO THE HOSPITAL" instead of "EVERY ATTEMPT ON SCENE WAS USED TO INCREASE HIS SURVIVAL" (something like that anyway, This mentality needs re: education of the public at large!) Ever hear in the news the patient was revived on scene? I have not, I digresss once again opps. I am working more actively with some of the ideas that we share ie your innovation thread, delivering improved "field care" in primary aspects, transporting every Tom dick and Harry to Hospital for care that can be appropriately delivered in the home and putting the Truck back in service without a 24 hour stay in ER for a simple Lac, or toothache is more my focus these days, If I can prove its worth in remote deployments for industry, with all their paranoia on legal ramifications, maybe it can filter down to rural the urban.....wish be luck or send me halodol for all these delusions......! In regards to CPR for the masses, should I mention in passing that this has been attempt in Edmonton, like over 20 years ago in a massive campaign to high school students over 10,000 trained in 2 days..... was based on the very old Seattle study, CPR was offered at every fire hall, a 4 hour deal and FREE! Firefighters in that Study in the US donated their time ...NOT EMS providers. Sometimes I wonder with the cost and time frame involved to obtain the "CPR TICKET" in that the American Heart Foundation and its Canadian puppets/counterparts in fact defeat their own goals, or just perhaps it is a financial ends to a means in? Cash for research? It sure costs me a lot every time standards are changed...YOU? cheers I dunno?

Hold urine horses there guys and gals! PEEP should be used with the same approach as a Drug, tube or no tube (non-intubated patient is very seriously dependant on the Practitioners abilities to deliver this without aggravating the situation, this can very difficult to accomplish in a moving truck) a patient fighting an attempt of manueal delivery of ventilatory support may just be the trigger to an arrest. Think of it as a manual BIPAP, and watch the duck valve very closely, it will assist in the timing of the breath. In fact Practice on each other this will give you a good appreciation of the timing required to be successful, it can be a very good tool in the arsenal of kit, in the educated hands. Positive Expiratory End Pressures can and do seriously affect B/P and very rapidly change the compliance curve, so drop your volumes and try to keep PIP Peak inspiratory pressures less than 40 cmH2O, (cheap gauges are available) or you will be dealing with esophageal opening pressures and the very serious consequences, remember do no harm. A protocol should be developed for the use of this "new to most providers" tool and don't ask me for one the background research just has to be learned on your own...no exceptions. ps the idea of "matching auto peep" is a hint, average measurement auto peep in COPDs in one study was + 14 cmH2O cheers That is a retrograde step, so those that need Lasix don't recieve it? Yea lets just intubate them put them on a vent instead that a way better method........NOT! and I want to read that study to be sure, in hospital or out? Is this a S.S. deal or what?

Dear Troll: Please deliver one gallon of Poly and does Pyxis have Ancef and Rocephin too? I won't tell anyone where I got it...really, really. There is beers and wings in it for you! chbare...... thanks for the link.

Hmmm, did I forget to mention a Grizzly Bear? there not true hibernaters..... and news to me. We are seeing more cougar attacks too as man infinges on the remote areas. Personally I look for the cougars in the bars...you know, the ones that have a cell phone number. te he.

I do appreciate the advice a diplomatic "Punting" out of the end zone is a the best idea so far, I don't want to reinvent the wheel or become a speed bump either. cheers

On the Money again and absolutely in agreement kev, the tiered response does not work to provide cost effective care, a BLS car and an ALS car on scene is twice the cost and the delay in providing ALS (when its required) is life threatening plain and simple in my view. Just my 2 cents but the definition of "tiered" should be redefined: One EMT and One Paramedic per car. Paramedic drives when no invasive therapy is needed and vice a versa. This fosters an excellent learning experience and motivation for the EMT to move up the ladder.