Re: Fwd: Rapid Transport

[Guest guest]

As an ancient and decrepit dinosaur I have some comments to make regarding

this thread or skein of discussion. When some one asks me how long I have

been doing this and I answer around 30 years, they ooohhhh and aaahhhhh

about that. It’s funny that they assume that with experience comes untold

knowledge. Not one of these individuals has asked me how much education I

have had.

I have performed as a major trauma preceptor in a level 2 E.R. as an LVN,

and everyone has commented that I am qualified since I have been around

since Florence taught basic first aid. Again, no one asked me about

education. They assumed that as one gains experience; one gains knowledge.

No one asked about the 10,000-dollar medical text library that I invested

in; or the hours spent reading and researching questions for which I had no

answers.

Experience does not necessarily mean education. If you don’t LEARN from the

experiences, you are no better then the day you graduated from school, have

wasted numerous educational opportunities, and are quite possibly

endangering your patients health. Remember experience is based on the past,

in this fast paced career we have chosen, and with the rapidity of change in

the emergency care setting, living in the past can be detrimental to your

patients’ health.

For example,

When developing a preceptor program in one clinical setting; due to a

significant lack of ICU beds; we decided Swan-Ganz and cardiac output

monitoring was a required standard of care in our Emergency Department.

Something about having critically ill patients in the E.R. for 2-5 days made

it seem like an appropriate job skill. You should have heard the bitching

and howls from the nursing staff. We passed out the paperwork 3 months in

advance, came in on our off days (and nights) for study sessions and made

ourselves available to the nursing staff. No one availed themselves of

these learning opportunities.

The Day of Judgment came and we flunked the entire nursing staff. One

memorable statement was made by a new nurse who stated, “ This is not fair.

You expect us new grads and nurses to know as much as you nurses who have

years of experience. You need to have two standards for us, one for the new

nurses and one for the experienced nurses.” Sound familiar?

My response was this: “Tell you what. When we get a critically ill patient

who states-“Hey I want the uneducated nurse to take care of me”… we will set

two standards. Until then, I suggest you learn the material.” I believe I

used slightly different terminology regarding the “UNEDUCATED” portion of

the comment, but I have tried to clean up the language just a bit. Anyway,

the upshot of the story was the Head Nurse of the E.R., whom we flunked as

well, stood behind our standard of care. She issued a proclamation, which

stated, “People, I have begged the preceptors to give us another chance to

take the test. I suggest we study because if you don’t pass this time, I

will be more then happy to transfer you out of the department because you do

not meet the minimal standards for working in this department. That

includes me as well.” Believe it or not, everyone passed the next time, and

I can assure you we did not lower the bar, and the bar was set at 90% on the

written; and 100% on the practical.

Two things can be learned from this anecdote. 1. Our E.R. Head Nurse

defined leadership. 2. Expect the best and you will get it; eventually.

Education is the key to survival in any job setting. IBM requires a full

week of in-classroom education per year for every employee. When the

employee screws up in that setting; some money is lost. In our profession,

we bury our mistakes. How then, can we set our standards any lower then

what is demanded in other job markets?

Stay safe

Easley

Re: [texasems-L] Fwd: Rapid Transport

Andy:

I'm sorry, but you are dead wrong. Experience alone does not relieve

ignorance. A man can have been a paramedic for 15 years and can have grown

or progressed not at all in that time. For three of the individuals I

mentioned that is pretty much it. The only reason they are able to continue

as paramedics is the desperate needs of the volunteer services with which

they have been affiliated. I see no evidence that their time with a patch

has made them sharper or significantly more knowledgeable. I have seen some

evidence that this condition exists all over the state, although I fervently

hope this type of medic is an exception rather than a rule. Should those of

us who want our profession respected and elevated, and who have taken the

personal steps needed to achieve that, embrace these people who represent

everything negative nurses and many physicians attribute to all of us? No, I

say. They are holding us back. Sorry, but that's just the way it is. It we

smile indulgently and let 'em be, most of them will never change and will

never grow. They'll continue to give us a black eye for years.

The other thing you are dead wrong about is the thing about them being my

colleagues. Much as I'd prefer not to claim them, they wear the word

paramedic and the outline of Texas on their patch just as I do. They have

the same practicing parameters I do. Every action they take has the

potential to permanently affect my future and that of all the rest of us.

They are my colleagues. They are yours, They are Gene Gandy's. They are

colleagues of us all and what they don't know, haven't learned, and don't

think they need to learn or know can do all of us serious injury. I'd

advance that they already have. I daresay the (former) UTMB paramedics would

agree with me.

Wake up and realize its time for these people to grow, die, or get out of

the way. I for one am tired of all the sob stories and excuses these people

hand out for why they can't go out and get a decent education. For every one

of them that can hand out a Top Ten Reasons Why Not list, there is one or

more of us, including moi, who can match every one of their obstacles and

yet we managed to earn the sheep skin and we use what we learned to do a

better job. Little money, nearest college 75 miles away, 3 kids, whatever

the excuse, it comes down to one of two things. Either they don't have

enough faith in themselves to try, or they don't have enough guts and

initiative to buckle down and work hard.

I imagine I'll get nuked for saying the things I've said but the fact is

every time one of these characters puts another monkey wrench in the process

of elevating the minimum education standards for paramedics in Texas so they

can continue to play ny-an'-Roy a little longer it does harm to me, my

family, and all the other medics in this state who are trying to move us

into a better future. Don't expect tolerance or forbearance from me on this

issue. Its like what happened between the old, obsolete dinosaurs and the

more advanced, more savvy mammals. Guess who won.

Dave

Note: Shield up and at maximum. Flame away, you dinosaurs, while you can.

The asteroid is on the way.

Re: [texasems-L] Fwd: Rapid Transport

> In a message dated 10/12/2000 09:34:44 AM Central Daylight Time,

> d.jackson@... writes:

>

> << The sad thing is I know some Texas medics from

> which that post would have to be taken seriously. We do have some

colleagues

> who seem to revel in their lack of education and in their ignorance. >>

>

> You see, no one has yet to argue that education is the key, but we still

are

> downgrading our COLLEAGUES as reveling in their ignorance. I am just

saying

> that they are not ignorant nor or you their colleague if you refer to them

> this way. I only hope you understand what you are saying when you write

> these posts. We Love Education. OK but some do not have it and they are

> excellent 15 yr paramedics at a high level EMS system that do understand

more

> that you sound like you give them credit for. No wonder you cannot get

them

> to join you. Please read what you write and think of all of us as partners

in

> creating a better educated Paramedic. Thx for your consideration.

>

> Andy Foote

>

>

>

>

>

eGroups Sponsor

<http://click./1/9667/9/_/4981/_/971374234/>

<http://click./1/9667/9/_/4981/_/971374234/>

[Guest guest]

Hey, Dave, I'll loan you a pair of my flameproof undies. We all have

" colleagues " like you describe. Most physicians will, if you know them well

enough, tell you that they also have such " colleagues, " and I can't tell you

how many of my " colleagues in the practice of law " have been kicked out of

our profession for being criminals, drunks, incompetents, and so forth.

There will always be minimal performers, but the rest of us don't have to

accept them as having God given rights to screw up forever. Everybody will

screw up once in a while, but a true profession will demand that screwups

either " get it " or " get out. " When EMS becomes a Profession, we'll all have

at least the minimum educational requirements that cops and firefighters now

have.

Gene Gandy

[Guest guest]

In fact there WAS such a compromise agreed upon by the majority of stake

holders last year and it was mere hours away from being passed out of

committee when it suddenly fell apart. I was one of the people involved in

hammering out the agreement which took place over a few hours with multiple

conference calls, emails, and so forth. It was something I could have lived

with. I suspect I know who helped torpedo it and why but will not comment

on that here. I think it was a grand opportunity lost, but then was then and

now is now.

Gene Gandy

In a message dated 10/12/2000 14:30:37 Central Daylight Time,

d.jackson@... writes:

Barry:

That's pretty much what I'd like to see happen. We can't fairly raise the

standards retroactively for the folks already out there. That really would

cause chaos. But we could set up conditions to gradually phase out the older

standard as the old medics hang it up by making all new candidates meet new

academic and EMS curriculum minimums to earn initial certification.

Actually, the license has that stairstep escalation of minimal standards

already built into it, which arrangement is very similar to what I think

should happen EMS-wide.

Dave

-

> What would this learned group say to an implementation of higher

> standards to become a medic if it were phased in? Current medics

> would still be medics, but the new ones would be required to have

> higher academic standards to get into the game. This would accomplish

> both raising the bar for the profession and would still allow current

> practioners to still practice.

>

> If it did like nursing, then those with the more advanced skills

> would move up in the food chain and into new opportunities and those

> who wanted to move up could get with the new standards to open the

> same doors to them. Those who were comfortable at where they were

> could stay there and continue to be a great whatever they are doing

> the things they like doing.

>

>

>

>

>

>

[Guest guest]

It is more accepted for medical students to use the term " MS " followed by

the year of school they are presently in (i.e. " MS I, MS II, MS III, MS IV)

MD2B or DO2B (for politcal correctness) is not common nomenclature in

medicine. I would stick with the current system that shows what year of

training you are in.

Dr. Bledsoe

Pamela wrote:

> , I like that MD2B thingy behind your name.

>

> P. McClanahan, Paramedic Forever

>

[Guest guest]

The only question I have here....is there anybody on this list that has a

sense of humor???

Rhonda

[Guest guest]

Gene,

I am highly offended by your post. As a lawyer, I thought you would know

and follow the law. Everyone knows that the Preamble to the Constitution

of the State of Texas requires true Texans to chug Lone Star, not

Lite. Lite is only legal for consumption when received directly from

Detroit,in the same shipping crate as the new motor for a pick 'em up truck,

and only then if consumed by the driver of said pick 'em up while travelling

on a designated farm to market road.

Steve Pike

[texasems-L] Fwd: Rapid Transport

Good Lord, Man, you suggestin by yore post that Paramedics need to know

terms like " hemanopsia " and " ataxia? " You must be one of them " edjikated

fools " like some folks here in Texiz are awantin us to be. Us good ole boys

kin start a IV on a Snake-acrawlin-in-the-dark-on-a-muddy-road-an still chug

a -Lite. Don't unnerstan why we need no edjikation. By tha way,

y'all

do alligator rasslin in yore off times?

Gene Gandy, JD, LP, OTRC

(Official Texas Resident Cynic)

In a message dated 10/10/2000 21:45:39 Central Daylight Time,

SnakeJ19@... writes:

<< Subj: Re: Rapid Transport

Date: 10/10/2000 21:45:39 Central Daylight Time

From: SnakeJ19@...

Sender: trauma-list-admin@...

Reply-to: <A

HREF= " mailto:trauma-list@... " >trauma-list@...</A>

To: trauma-list@...

Mike,

Lets remember in my reply that I am a Paramedic in Florida... With that

being

said almost if not the entire state is covered completely with ALS first

response, which aleviates most of the problems that you run into.

With that being said. I read through most of the reply's you have been

getting regarding your decision to use lights and sirens and have found

no-one use the term " Stroke Alert " .

In my department every call that comes into 911 is answered by a ALS unit

responding to the call. Once on scene particuarly with a CVA patient you

would have to evaluate the patient and rule in or out " Stroke Alert "

criteria.

The INCLUSION criteria for STROKE ALERT is:

1.Patients must present to EMS within 6 hours of acute ischemic stroke

symptom onset.

2. The patient must exhibit any one or more of the following clinical

presentations:

A. Aphasia

B. Ataxia

C. Hemiparesis

D. Loss of sensation

E. Quadriparesis

F. Diplopia

G. Dysarthria

H. Hemanopsia

IF THE PATIENT PRESENTS WITH ANY ONE OF THE FOLLOWING EXCLUSION CRITERIA

THEY

ARE REJECTED OUT OF THE ALERT CRITERIA

1. Current use of oral coumadin

2. Use of heparin in the previous 48 hours.

3. Another stroke or head injury in past 3 months.

4. Major surgery in the preceding 14 days.

5. G.I. or Urinary bleeding withing the last 21 days.

6. Recent myocardial infarction. (3 months)

You should consider bringing up to your medical director something of this

sort of protocol that could lead down the path of figuring out what is a

" load and go " and was is not. Protocols simular to this would also

establish

BLS/ALS guidelines that could help you determine is this sort of call out

of

my scope, do I need ALS?

And just to throw in another twist I currently teach and instruct EVOC

certified through VFIS and consider guidelines such as these essential to

EMS

to assure proper use of lights and sirens.

Good Luck,

Tibbets EMT-P, B.S.

[Guest guest]

I'll keep that in mind when I get to medical school.

But for now I'm not real concerned with it. Thanks for

the advice though.

--- " Bledsoe, DO, EMT-P "

wrote:

> It is more accepted for medical students to use the

> term " MS " followed by

> the year of school they are presently in (i.e. " MS

> I, MS II, MS III, MS IV)

>

> MD2B or DO2B (for politcal correctness) is not

> common nomenclature in

> medicine. I would stick with the current system that

> shows what year of

> training you are in.

>

> Dr. Bledsoe

>

> Pamela wrote:

>

> > , I like that MD2B thingy behind your name.

> >

> > P. McClanahan, Paramedic Forever

> >

>

>

__________________________________________________

[Guest guest]

I've never heard (read?) Gene say anything derogatory about certified vs.

licensed medics. We all know that it's going to eventually go to licensed,

that's just fact. That's not because certified medics know any less are or

dumber or anything. Gene was trying to say that we all (from ECA to EMTP

whether licensed or certified) need to continue our education. Our class

curriculums are set forth to teach what we have to know, then we each need

to continue to study whatever we have available to add to that knowledge.

And, we each need to continue to study because of the numerous changes that

happen in the medical field every hour - well, at least every day. I think

Gene was just trying to say it in a funny way and most of us took his humor

to be just that, humor with a little message included. We all know that

Gene could do a lot of other jobs that would earn him bunches of bucks, but

he devotes his time to teaching our profession for much less pay. He also

spends a great deal of time teaching those of us who are on the list and, I

for one, really appreciate it. Thanks Gene for helping us and giving us a

real laugh!!!!

Take care, stay safe, and practice mercy, ya'll!!

Jana

FW,TX

Re: [texasems-L] Fwd: Rapid Transport

> That is how I took his post. Lord knows I've seen paramedics on both

sides

> of the fence. As for me I still read the text books and the professional

> journals...I hope I'm considered to be one of the 'edjikated fools'.

>

> Poe

>

> In a message dated 10/11/00 4:59:49 PM Central Daylight Time,

> LloydEMTI@... writes:

>

> << I for one do not think Gene was trying to be negative about anyone's

> understanding of words we were taught in class. I think he was trying to

be

> humorous and at the same time point out that some of us may have

forgotten

> them and that it shows more professionalism on a report if we use these

> words

> in place of the common everyday words. >>

>

>

> This book is dedicated to Jesus Christ and the principles that He taught.

Two

> thousands ago His parable of the Good Samaritan set the standards to which

we

> in EMS still strive to meet.

> Emory , MD, FACEP

> Basic Trauma Life Support, fourth edition.

>

>

>

>

>

__________________________________________________

[Guest guest]

My question is if I have a bachelors degree, does that automatically make me

licensed instead of certified regardless of what my degree is in?

[Guest guest]

Andy:

I'm also sorry, but it isn't a ME situation, its an US. Us being all of us

who have believed in EMS for many years, have gone out and gotten an

education which we could have used to make a better living elsewhere, and

have applied it to EMS instead. I can't argue with you about the last

sentence. If I had my way, we would have started with a requirement that the

degree be in EMS or at least Health Science-related. I'd still like to see

it changed so they don't accept just any old Bachelor's degree. I'm not

absolutely sure a Sociology degree would fall outside the range of

acceptability, though. You'd sure know that better than I would.

Dave

Re: [texasems-L] Fwd: Rapid Transport

> I'm sorry you feel that way. Yes and there are probably more like you

that

> have not understood a word I said. There are too many ME's in the way. I

> guess I am like the old sarge they tried to make an officer. I will never

> wear an LP, even with my degree, because of people like you. You must

admit,

> you will GIVE me one for $100 and my BS degree in Sociology.

>

> Andy

>

>

>

>

>

[Guest guest]

Gene:

Thanks, but I already ran out and got some of those new nomex BVDs. You're

right about " those " kinds of colleagues being a fixture in other medical

professions, too. The hospital for which my wife works as a nurse almost

ended up on the auction block a few years back because of an alcoholic

gas-passer whose colleague surgeons and anesthesiologists kept covering for

him. Finally, he managed to get into an operating room when his colleagues

had their attention elsewhere and proceded to anesthetize a patient into his

next life. Several docs either lost their practice or ended up bankrupt from

the legal actions, and we almost lost a hospital, too. They paid a major

price for tolerating colleagues they should have excised from their midst.

We shouldn't make the same mistake with the dunderheads in our own ranks. We

have, but certainly could do without our version of La Cosa Nostra (The Code

of Silence).

Only problem about these drawers... they sure are hot. Sorry, just wanted to

prove I do have a (small) sense of humor.

Dave

Re: [texasems-L] Fwd: Rapid Transport

> Hey, Dave, I'll loan you a pair of my flameproof undies. We all have

> " colleagues " like you describe. Most physicians will, if you know them

well

> enough, tell you that they also have such " colleagues, " and I can't tell

you

> how many of my " colleagues in the practice of law " have been kicked out of

> our profession for being criminals, drunks, incompetents, and so forth.

>

> There will always be minimal performers, but the rest of us don't have to

> accept them as having God given rights to screw up forever. Everybody

will

> screw up once in a while, but a true profession will demand that screwups

> either " get it " or " get out. " When EMS becomes a Profession, we'll all

have

> at least the minimum educational requirements that cops and firefighters

now

> have.

>

> Gene Gandy

>

>

>

>

>

[Guest guest]

There is nothing automatic about it. You have to send in an application,

attach a copy of your diploma or an official transcript, and cross TDH's

palm with $100 worth of silver (they accept gold and paper, too). However,

if you have a Bachelor's degree and are applying for licensure on that

basis, it doesn't matter what the degree is in. Above and beyond paramedic

training, it is the general education hours required for ALL Associate and

Bachelor degrees (English, history, math, etc.) that they are interested in

you having, not your specialty subjects (unless they happen to be EMS

related).

Dave

Re: [texasems-L] Fwd: Rapid Transport

> My question is if I have a bachelors degree, does that automatically make

me

> licensed instead of certified regardless of what my degree is in?

>

>

>

>

>

>

>

[Guest guest]

Been my experience that the only reason the Old Sarge din't

make a good officer is because he did not want to be an officer.

Darn! Back to that choice thing again.

Ernie

At 05:37 PM 10/12/00 -0400, you wrote:

>I'm sorry you feel that way. Yes and there are probably more like you that

>have not understood a word I said. There are too many ME's in the way. I

>guess I am like the old sarge they tried to make an officer. I will never

>wear an LP, even with my degree, because of people like you. You must admit,

>you will GIVE me one for $100 and my BS degree in Sociology.

>

>Andy

>

>

>

[Guest guest]

The lot of ya' rrrrrr wig ooutt.... go wit' Guinness Stout (if it naaaa Celtic,

it be crrrrrap)

Musick wrote:

> Shiner Bock??? You're killing me! Corona with a lime..mmmmmm. Although I

> just about have to save up to buy it!

> Ken

>

> [texasems-L] Fwd: Rapid Transport

> >

> >

> > Good Lord, Man, you suggestin by yore post that Paramedics need to know

> > terms like " hemanopsia " and " ataxia? " You must be one of them " edjikated

> > fools " like some folks here in Texiz are awantin us to be. Us good ole

> boys

> > kin start a IV on a Snake-acrawlin-in-the-dark-on-a-muddy-road-an still

> chug

> > a -Lite. Don't unnerstan why we need no edjikation. By tha way,

> > y'all

> > do alligator rasslin in yore off times?

> >

> > Gene Gandy, JD, LP, OTRC

> > (Official Texas Resident Cynic)

> >

> > In a message dated 10/10/2000 21:45:39 Central Daylight Time,

> > SnakeJ19@... writes:

> >

> > << Subj: Re: Rapid Transport

> > Date: 10/10/2000 21:45:39 Central Daylight Time

> > From: SnakeJ19@...

> > Sender: trauma-list-admin@...

> > Reply-to: <A

> HREF= " mailto:trauma-list@... " >trauma-list@...

> > </A>

> > To: trauma-list@...

> >

> > Mike,

> >

> > Lets remember in my reply that I am a Paramedic in Florida... With that

> > being

> > said almost if not the entire state is covered completely with ALS first

> > response, which aleviates most of the problems that you run into.

> >

> > With that being said. I read through most of the reply's you have been

> > getting regarding your decision to use lights and sirens and have found

> > no-one use the term " Stroke Alert " .

> >

> > In my department every call that comes into 911 is answered by a ALS

> unit

> > responding to the call. Once on scene particuarly with a CVA patient you

> > would have to evaluate the patient and rule in or out " Stroke Alert "

> > criteria.

> >

> > The INCLUSION criteria for STROKE ALERT is:

> >

> > 1.Patients must present to EMS within 6 hours of acute ischemic stroke

> > symptom onset.

> >

> > 2. The patient must exhibit any one or more of the following clinical

> > presentations:

> >

> > A. Aphasia

> >

> > B. Ataxia

> >

> > C. Hemiparesis

> >

> > D. Loss of sensation

> >

> > E. Quadriparesis

> >

> > F. Diplopia

> >

> > G. Dysarthria

> >

> > H. Hemanopsia

> >

> > IF THE PATIENT PRESENTS WITH ANY ONE OF THE FOLLOWING EXCLUSION CRITERIA

> > THEY

> > ARE REJECTED OUT OF THE ALERT CRITERIA

> >

> > 1. Current use of oral coumadin

> > 2. Use of heparin in the previous 48 hours.

> > 3. Another stroke or head injury in past 3 months.

> > 4. Major surgery in the preceding 14 days.

> > 5. G.I. or Urinary bleeding withing the last 21 days.

> > 6. Recent myocardial infarction. (3 months)

> >

> >

> > You should consider bringing up to your medical director something of

> this

> > sort of protocol that could lead down the path of figuring out what is a

> > " load and go " and was is not. Protocols simular to this would also

> > establish

> > BLS/ALS guidelines that could help you determine is this sort of call

> out

> > of

> > my scope, do I need ALS?

> >

> > And just to throw in another twist I currently teach and instruct EVOC

> > certified through VFIS and consider guidelines such as these essential

> to

> > EMS

> > to assure proper use of lights and sirens.

> >

> >

> > Good Luck,

> >

> > Tibbets EMT-P, B.S.

> >

> >

> >

> >

> >

> >

[Guest guest]

Yeah, verily, laddie!

Dave

[texasems-L] Fwd: Rapid Transport

> > >

> > >

> > > Good Lord, Man, you suggestin by yore post that Paramedics need to

know

> > > terms like " hemanopsia " and " ataxia? " You must be one of them

" edjikated

> > > fools " like some folks here in Texiz are awantin us to be. Us good

ole

> > boys

> > > kin start a IV on a Snake-acrawlin-in-the-dark-on-a-muddy-road-an

still

> > chug

> > > a -Lite. Don't unnerstan why we need no edjikation. By tha

way,

> > > y'all

> > > do alligator rasslin in yore off times?

> > >

> > > Gene Gandy, JD, LP, OTRC

> > > (Official Texas Resident Cynic)

> > >

> > > In a message dated 10/10/2000 21:45:39 Central Daylight Time,

> > > SnakeJ19@... writes:

> > >

> > > << Subj: Re: Rapid Transport

> > > Date: 10/10/2000 21:45:39 Central Daylight Time

> > > From: SnakeJ19@...

> > > Sender: trauma-list-admin@...

> > > Reply-to: <A

> > HREF= " mailto:trauma-list@... " >trauma-list@...

> > > </A>

> > > To: trauma-list@...

> > >

> > > Mike,

> > >

> > > Lets remember in my reply that I am a Paramedic in Florida... With

that

> > > being

> > > said almost if not the entire state is covered completely with ALS

first

> > > response, which aleviates most of the problems that you run into.

> > >

> > > With that being said. I read through most of the reply's you have

been

> > > getting regarding your decision to use lights and sirens and have

found

> > > no-one use the term " Stroke Alert " .

> > >

> > > In my department every call that comes into 911 is answered by a ALS

> > unit

> > > responding to the call. Once on scene particuarly with a CVA patient

you

> > > would have to evaluate the patient and rule in or out " Stroke Alert "

> > > criteria.

> > >

> > > The INCLUSION criteria for STROKE ALERT is:

> > >

> > > 1.Patients must present to EMS within 6 hours of acute ischemic

stroke

> > > symptom onset.

> > >

> > > 2. The patient must exhibit any one or more of the following

clinical

> > > presentations:

> > >

> > > A. Aphasia

> > >

> > > B. Ataxia

> > >

> > > C. Hemiparesis

> > >

> > > D. Loss of sensation

> > >

> > > E. Quadriparesis

> > >

> > > F. Diplopia

> > >

> > > G. Dysarthria

> > >

> > > H. Hemanopsia

> > >

> > > IF THE PATIENT PRESENTS WITH ANY ONE OF THE FOLLOWING EXCLUSION

CRITERIA

> > > THEY

> > > ARE REJECTED OUT OF THE ALERT CRITERIA

> > >

> > > 1. Current use of oral coumadin

> > > 2. Use of heparin in the previous 48 hours.

> > > 3. Another stroke or head injury in past 3 months.

> > > 4. Major surgery in the preceding 14 days.

> > > 5. G.I. or Urinary bleeding withing the last 21 days.

> > > 6. Recent myocardial infarction. (3 months)

> > >

> > >

> > > You should consider bringing up to your medical director something

of

> > this

> > > sort of protocol that could lead down the path of figuring out what

is a

> > > " load and go " and was is not. Protocols simular to this would also

> > > establish

> > > BLS/ALS guidelines that could help you determine is this sort of

call

> > out

> > > of

> > > my scope, do I need ALS?

> > >

> > > And just to throw in another twist I currently teach and instruct

EVOC

> > > certified through VFIS and consider guidelines such as these

essential

> > to

> > > EMS

> > > to assure proper use of lights and sirens.

> > >

> > >

> > > Good Luck,

> > >

> > > Tibbets EMT-P, B.S.

> > >

> > >

> > >

> > >

> > >

> > >