WAS967

To be more accurate you see Tommy rushing to stop his uncle. Unlce pulls gun. Someone you assume is a cop in plain clothes makes an "oh s***" face. You hear a shot. Blood splatter hits tommy in the face. Cops tackle uncle with gun still drawn. Grandpa just stands there. Tommy wipes face and just walks away. Writers are sneaky. You don't see who is shot, who did the shooting, etc. For all we know it could have been someone else who shot him first and the uncle gets busted with a weapon's charge. Who the heck knows. Guess only time will tell. We'll see in 2006. If you really want to watch the last two minutes, let me know. I can probably crop the video and send it to you. (Whoever missed it)

Ouch. Thanks for the info.

Being the non-firematic type I was curious as to why this is. TIA.

Yup. And it drives me nuts. Why should we be less able or looked down upon simply because we are certified and not licensed? Does this mean we can tell all the nursing homes to stop calling us and to take the patient to the hospital themselves?

Not according to NYS unless something was announced last night. When HVHC gets it's designation it will be announced. As of now, diversion to HVHC with a stroke as opposed to Nyack or WPHC would be inconsistent with protocol.

Actually it would be tombstone T-Waves. They are visible most commonly in the first 30 minutes of MI and then progress into the ST segment elevation you mention. ST segment elevation is also common in electrolyte abnormalities, especially in Hyperkalemia. I have a cool 12 lead of an acute hyperkalemic patient (kidney failure). The advanced stages take on the appearance of a sine wave. Very ominous sign. A single lead isn't very diagnostic either. I've seen many a bad ECG mimicked by poor positioning of leads. A medical group had a few leads switched on a 12 lead that mimicked an MI. The cardiologist got a good laugh from that one. I understand the single lead raises suspicision in your mind of an MI, but I still don't see how it affected patient care. Did the Paramedics or the ER jump right on top of the MI protocol based on your single lead ECG? I sincerely hope not. I would rather hope that is was a well executed physical exam that found the patient diaphoretic and pale (and perhaps other S&S) that peaked thier interest more. I wish more EMTs had your rhythm recognition skills. But unfortunatly most do not. Rhythm recognition isn't even part of the BLS skill set anymore. Far gone are the days of the EMT-D who would sit in a one day class, learn some quick rhythms (NSR, Asystole, V-Fib (Fine and Coarse), V-Tach) and come out thinking they could save the world. Like I said before, I'm not 100% against the addition of glucometers to the BLS skill set. But I'm not 100% for it either. Call me on the line. But I still fear the day someone shows up at an unresponsive, whips out the glucometer before the oxygen, gets a reading of "Lo" and then proceeds to dump a tube of oral glucose down the patients throat. I've seen more negative outcome from the addition of now "toys" then positive.

Sometimes. When used properly and well integrated into an effective treatment modality yes. When they become blinders to the basics they can be detrimental. Which do you think occurs more frequently? Sounds like the outcome was good. But I fail to see how the mentioned "toy" affected outcome. You (properly) dispatched ALS based on a good patient assessment that picked up signs and (possibly) symptoms of a greater problem. How did the AED impact your care of this patient?

YES! Dinosaur BBQ is excellent. They started out in Syracuse then open up a place in Rochester. The seem to like establishing near a major university. They're all of a few blocks from Columbia.

I remember that as well. Big guy in big Ram Charger/Tahoe/whatever, pulls up right behind the reported and jumps out just as the video cuts to the studio.

I don't know how I can explain it any better. Perhaps someone else can?

I'm all for any healthcare provider expanding thier scope of knowledge. What I have a problem with is people (not specifiying level of cert either) getting blinded by having "toys" and forgetting the basics. [Medics can be just as prone to this as anyone else - don't even talk to me about RSI] War Story (sorry if this has been heard before but it's just glaring) - I get called to a house for a person with chest pains. PD meets me at my truck to tell me they have the monitor on the patient, that patient is in "V-Fib" but they are "awake and talking". I respond - "No they're not". They guy gets all defensive and I state: "People in V-Fib don't usually talk". I get inside and find the patient in agonizing pain on the stairs of his house, AED (with crappy screen) on the patient BACKWARDS. What's the first treatment for a patient in chest pain? OXYGEN. Was it provided? NO. KNOWING HOW to use a glucometer is just one part of the equation. Knowing how to integrate a glucometer into patient care is another.

I was living at my friend's house and he knocked on the door and said turn on your TV. I was just getting up anyway because I was set to do a 10-6 shift at work (I think back then we had two ALS busses on and the second was 10-6, i forget exactly). As I turned on the TV I recalled the story of the army plane hittign the Empire State Building way back when (1950s?) and thought it wasn't a big deal. Then I saw the second plane hit. My first thought was "My god". I really expected something worse. I half expected to see the flash of a nuke. I knew right away it was terrorism. I'm glad there was no flash. I made my way to work and just as I arrived we got word that the first tower had fallen. Slowly over the course of the day a few of our ambulances and flycars headed down to NYC with a caravan of volunteer units from surrounding VACs. The sight of the smoke rising from downtown was surreal. The images of all the roads being closed. The HUNDREDS of ambulances lined up at Shea stadium. People flocking out of manhattan over the 49th street bridge on foot all taking pictures as we drove by like a parade. The shin deep ash all over the place. The lobby of the financial building looking like it was hit by a bomb. It will always remind me of what I'd imagine the apocolypse to be like. Seeing a whole city block on fire. Trucks piled full of body bags. The pile of rubble and torn steel. The remainder of the frame of the WTC (exoskeleton). Seeing fire trucks and ambulances and police cars destroyed. Burnt out cars. The huge line of construction vehicles that passed us at Chelsea Piers heading to ground zero. Huge triage stations setup for patients, yet not many to be found. It still effects me and everyone else to this day. Never Forget. How can I?

What is the difference between certified and licensed? In CT, it means you pay, what? $70/year for your card? In NY, we pay nothing. What other difference is there? I don't see how a change in a word is going to stabilize pay and open up other opportunities for medics. I'm all for further education. I always try to take classes to expand my knowledge base and would love to get my Bachelors Degree. Too bad I have to work 80 hours a week to support my family. Part of the 2 year program idea is this: Like the nursing profession, medics are in short supply. And the problem is getting worse. If they make Paramedic a mandatory 2 year degree then it will further limit the pool of people coming into the profession. EMS isn't seen by most as a career. Many use it as a stepping stone to other things. Be it nursing, law enforcement, fire services, etc. Why would anyone want to go to school for 2 years to make $43,000/year when they can do any number of other things and make much more. The problem is paramount and I won't pretend to have answers to any of it. It's easy to say, "well, we should get paid more". With medicare cutting rates, insurance rates tripled after 9/11, gas prices at an all time high and growing at the worst rates ever (yes, adjusted for inflation), the cost of running an EMS agency is through the roof. It's easy to say, "just make EMS a part of the fire service. it works for California!". Well thats great. But good luck getting it past the taxpayers. Just mention a tax increase and people start to riot. You know what kills me? Last I checked municipalities are required to provide certain services to thier citizens. Law Enforcement and Fire Protection I believe are two of them? Is Emergency Medical Service? Uhm, no? Does anyone see a problem in this?

It's not Nuclear, but there is a sizable Chemical Plant (name slips my mind, DuPont perhaps?) in Rockland (Nanuet I believe) that has it's own on site HazMat team and fire brigade. They are available for mutual aid to other agencies in the county. We used them a while back (like 10 years ago) after a fire at RPC that got to some backup batteries in the basement of one of the buildings and released some toxic fumes. Assessing a dozen or so nut jobs was an experience.

I noticed that for classes you have to submit a Training Authorization letter. This appears to be only for firefighters. Is training at Camp Smith (and other OFPC sites) open to non-fire (read: EMS/Police/etc) personel?

Dang. Count me out. CLI class is that weekend.

I went there last year for my dad's birthday. Awesome place. You actually walk past the giant brew kettles to get to the bar and your tables. They had (and hopefully still do have) a Summer Ale/Lager with Blueberries in it. At first I was skeptical, but it was excellent. They sell "growlers" of beer for about $10. I forget how much it had ounce wise, but basically it was about 2.5 "pint" glasses.

Yup. I was going to post that link the other day but must have gotten side tracked. Foamy rules.

If you lived in SoCal you'd realize how much good stuff we have here too....

Fine with me....who's leading the group? IF you have a good number of people and you call ahead, you might be able to get your own field.

Wouldn't it just be cheaper to buy a new/used pager?

WhiteCloud: When you follow those direction you gave, is there any prompts given on a screen by the pump or is just a series of beeps or something to let you know you're doing the right thing? Worst case scenario, if you can't get the pump to shut down, clamp the hose with some forceps. DO NOT CUT THE LINE.

According to the info I found on a quick google search you need to have a DirectX 9.0c compliant video card. They mention requiring NVIDIA® GeForce™ 3/4/FX/6 series (GeForce 4 MX not supported) ATI® RADEON® 8500/9000/X series cards. Your Intel onboard might not work. First see if you have DirectX 9.0c installed, and if not, install it. If it still does not run, you might need to upgrade the video card. Is this a laptop or desktop?

You are joking right? Everyone that doesn't buy gas one day will just buy it the next. Trying ditching your fuel guzzling SUVs and buying hybrids or electric vehicles.

Okay. I just had Quiznos for the first time Sunday in Yonkers. Talk about awesome. I forget the name of the sandwich, but it was On Parmesean bread with chicken, mozarella, spinach, pesto and tomatos. The toasting definatly makes a difference. Very tasty.