pinymayu

"tskstorm, " Content Removed - Admin Out Here, pinymayu

Content Removed - Admin

Floppy, I'll again caution you to heed my previous advice..

Ok, "flopey," you went there, I didn't Remember that. Read on, you've pegged my meter: Please point out where I said anything of the sort and reference-post the exact quote where I said those words... I said nothing of the sort. THANK YOU FOR PLAYING PLEASE DON'T TRY AGAIN :roll: Yes there are nursing staff who are as foolheady and stupid as the next EMS provider and apparently as he posts here as "tskstorm" is. I have no issue with a lighthearted discussion. Yet, I find it interesting you seem to take no issue with gross negligence as previously posted. I'll be awaiting your 'facts' and quote as well, your position is indefensible as it stands above. I warned you not to go here, but you chose this road, so BRING IT.. pinymayu

Lets also not forget those patients who turn out to be extremely sensitive to NTG and become extremely and refractarily hypotensive from NTG as well, usually without warning. ALso I echo "Rids, Medic001918, AZCEP, Ozmedic's, Chbare's, and many others" comments above as well Food for thought, pinymayu

and yet strangley you have grown wiser and see that he is right..... :shock: who knew..who could it be? Are you objecting to the substance or are you making an observation?

I like to ensure that my patients recieve the BEST and most appropriate care. Apparently you seem to agree with the individual above and may not. If you accept subpar care as OK and or appropriate then perhaps you need to re-evaluate your position on stayiong in EMS as well. I'll warn you don't come to an intellectual arguement with less than the needed amount of ATP. Y ou will lose, and look like a fool in the process. You wouldn't pull this crap with Dustdevil or asys, or many others of fame here. Don't be fooled by the low number behind my post count and think I'm an easy newbie mark. I'm not; so before you even attempt to make a personal or professional attack against me, consider what you say wisely and for along time.... pinymayu

I saw it just fine thank you, and it clarified nothing..If anything it begot more questions than it answered. Thanks for the unhelpful insight, and non-productive comment. pinymayu.

Your duty bound to treat the emergent presenting condition which you find and be sure that the patient recieves adequate care and get acess to continuing advanced care. PERIOD refusing to transport and leaving..that abandonment pure and simple as once you assume care you can't just say no way and walk away unless there are safety issues. Irregadless of company policies. FURTHERMORE, thoise same policies will not protect you from failure to follow the standard of care. They will just gain the plaintiff more money and make the Co, a co-defendent. Next you give no context as to what 'high' is and whether you truely have the intelligence, capability or clinical knowledge to determine whether thatn is a 'critical' or 'concerning' value for that patient. Especially when your first post put your competence in question. You have no choice, also, you must provide appropriate care as well as transport...PERIOD.. Why are you asking a question you should be answering? More than likely the Dr's and nurse take cover and run and the patients fend for themselves. This statement shows you are ignorant to the realities of ER care and policies... ALOT of CCT transfers go via the ER and are done only after an ER doc has been consulted with and agrees. Your staement is thusly false and misleading. It's good to know you don't refuse to do everything you should. Kindly clarify this statement..Also explain what being a marine has to do with refusing to do psych calls? Unless of course your a marine psych pt? No it begs mnore questions than it answers. These two astuite and highly capable and experienced individuals were just being nice and trying to politely tell you that you're wrong. They believe in being PC, I am not going to coddle you like they do on Parris island with stress cards and counseling and such. I'm kinda like the clue bat that you so obviously need to get educated about EMS care. In closing I will refer you to this graphic. Out Here, Pinymayu

Double Post..DELETED

You should not have an EMT ticket. Your so WRONG and negligent in the instances you mentioned above I don't even know wheren to begin. Do your patients a favor amd apply as a janitor to work at McDonadls where you will hurt none except yourself. pinymyachia?

The search key would have yielded you a lot of reading on this had you utilized it... :roll: Seems someone performed thread ccccccccccccpr

Hello Everyone, Great points, and I agree with many of the ones raised above. It seems though, that we are only addressing pieces of the issues. Here are some of the things that need to happen in a loosely assembled but yet not iron clad order of importance. 1.) Unification of purpose. We need to cast off the sense of professionalapathy that many EMS clinicians have built into their personalities as away to protect themselves and work in an austere environment. We all need to recognize, accept, and stand up to make the hard choice which are mandatory to effect the desired changes. 2.) Funding. Everyone is worried about the allmighty dollar, euro, ruble, etc.. Where does it come from? Why should we pay more taxes, more for courses and certs, etc... Fact of the matter is the majority of funding is in placealready. It is just holding up the weak foundations of an ineffective, failing bureaucracy. If we elimeminate this and creat a national level EMS (only) agency which will also oversee and have the 'teeth' to mandate change and education on a national level. The creation of the federal administration was a crucial step to bringing governmental attention to a long overlooked part of the public safety triad. This ideal of educating providers, both individuals and agencies, to the highest possible levels. The creation and enforcement of this ideal requires the support of a federal agency (cabinet level?) dedicated to similar principles. By bringing this organization's support for the federal administration, we will in effect, help to facilitate the transition of the current system to a new ideal. 3.) Education. Discussed adnauseaum and there is alot of 'golden' suggestions in the archives of this forum and in recent threads. This entails that a new group of practicing EMS clinicians should be brought to fruition. The means to do so will be via a shift from the current system to one, which would provide nationwide equality in our profession. This metamorphosis will occur in concert with a progressive, innovative consortium of EMS and non-traditional EMS educators, and related medical professionals. After implementing the new national 'gold' standard education these EMS providers, will become licensed professional EMS clinicians. By establishing a national 'gold' standard EMS licensing board we intend to eliminate the current difficulties of unequal provider education, clinical competency, and hurdles to geographic provider movement and practice. This licensing body would provide a standard time frame for licensing duration, minimum education, and clinical competency standards, on going evaluation of the educational EMS process standards; and still allow for local modifications in the scope of practice for that particular systems needs. These modifications are not to exceed the new National Standards, but set the new minimum levels of continuing education, re-licensure requirements as well as professional development for each level of licensure. It should be noted though that this new body of more effective EMS clinicians will function in environments and roles as yet to be determined. These clinicians will perform functions, roles and procedures beyond the scope of the National standard as it is currently conceived after meeting appropriate training, competency requirements, and oversight in accordance to the new standard. This benchmarks a fundamental shift from all states meeting the minimum education, and training requirements to all providers nationally being trained to the same ideals of practice and allow for professional development and advancement through out the EMS and medical community. This shift would streamline all education, allow for lateral recognition of licensure between all states and territories, thus elevate the quality of available patient care possible by all EMS clinicians across the EMS horizon. Additionally, as an added measure the national EMS regulatory body recognizes that this shift would also allow for all regions to pick and choose what skills are best suited to each practice environment. This also conversely allows regions to remove those which are not applicable to that practice environment and or system needs. By removing the uneven EMS provider education currently in place this plan allows for greater flexibility in each EMS system to provide maximum efficacy, efficiency and access to rapid, timely well trained capable EMS care for the entire populace. This standard will be subject to continual review, evaluation, upgrade and progressive change. 4.) Legislation With the above unity, a clear funding and educational plan standing on the foundation of a small, efficent, autonomous national level organisation at the cabinet level. Legislation should be enacted to allow for continued funding, and the ability to make states fall into line and accept the afore mentioned. These are just a few of the steps to be taken. There are more. Pinymayu

"Spock," Thanks for taking the time to re-iterate and share you expertise on this. You have yet again made clear the all to important difference between sedation-anxiolysis-amnestics, and analgesic medications usage yet again.. The only two points of "Rids," statement I disagreed with were the aforementioned and who said what. Your both great resources here. Thanks, pinymayu

"Rid," As your my respected, learned, colleague from OK, as well I know you've agreed with the preceding statement in the past. If not tacitly, then ceratinly passively many times here in the past. Please read on and understand this is no personal attack. This statement (above) is one which you ( I believe mistakenly, I've made this mistake myself in the past) misquote (pinymayu) in the regard that it was they who stated it as opposed to the cleverly if potentially dyslexiclly (?, nuttin but love for the grizzled and distinguished kodiak of the north :wink: ) albeit certainly facetiously applied screen name "tniuqs"(aka:"squint" and is certainly one of my fav canuks :shock: 8) ).That being said it appears that the terms sedation and analgesia are being mistakenly used and or potentially mixed up. There was a thread here sometime ago started by FL_Medic (If I recall correctly) which covered this. Additionally "Spock" also clarified on the subject in that thread as well. I'll try to dig the link up and dust it off from the database for you. My point was essntially thus. If your going to do the procedure, and administer the sequence, do all of it, completely and correctly (Unless contraindications or circumstances which warrant a change exist). Here is the link with the appropriate resources, info and citations, etc.., to back up my statements. If your asking yourself is it worth it to read the 6 pages the answer is yes, but the debate really begins on page 3-4 and moves on. http://www.emtcity.com/phpBB2/viewtopic.php?t=687 Hope this helps, pinymayu