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  1. #161
    Back In Black ChiefKN's Avatar
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    Quote Originally Posted by ffscm72 View Post
    does enough. you got to turn it for it to work chief...lol j/k
    Seriously... I've been there, done that.

    Had a trauma patient who desperately needed a tube.... there was even a doc on scene.

    Oral Airway aint the same thing.
    I am now a past chief and the views, opinions, and comments are mine and mine alone. I do not speak for any department or in any official capacity. Although, they would be smart to listen to me.

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  2. #162
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    Quote Originally Posted by BoxAlarm187 View Post
    Grab a King from the airway bag.
    Sure, if that's an option. In PA, there is currently NO options to secure the airway at the EMT level. Maybe DE has that as an option for the EMT? Given the subsequent reference to using oral & nasal airways, I'm leaning towards it not being one.

  3. #163
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    Quote Originally Posted by ffscm72 View Post
    You ignorance of the EMS system boggles my mind for someone w/ a paramedic level license.
    ROTFLMAO, if you think I'm ignorant of the EMS system, then by comparison, you must have been lobotomized somewhere along the way.

    Your cockiness doesn't surprise me. all i'm going to do now is sit back & watch you fall on you *****, when you finally come to terms that you as a medic are limited.
    I guess denial isn't just a river in Egypt.
    And your nonsense doesn't surprise me at all either. If you're going to do that, then I hope you have a comfortable chair because you're going to be waiting a long time to see me "fall on (my) *****" regarding this issue. By the way, I've already acknowledged that as a Paramedic, I am limited in what I can do. Others in this discussion have acknowledged the same, but for whatever reason, you don't seem to be able to comprehend that.

    BTW, this isn't "cockiness", the more correct term is "confidence". I am confident that I know exactly what my job (as a Paramedic) is. I am confident that what my job as a Paramedic is, IS NOT the same job as the EMTs I work with. I am confident that you truly know very little about what you've been trying to talk about. I am confident that you will continue to try and defend your indefensible positions and continue to fail at it. I am confident that I'm growing bored debating this matter with you. At this point, I almost feel bad for you...............almost!

  4. #164
    Let's talk fire trucks! BoxAlarm187's Avatar
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    Quote Originally Posted by FireMedic049 View Post
    Sure, if that's an option. In PA, there is currently NO options to secure the airway at the EMT level. Maybe DE has that as an option for the EMT? Given the subsequent reference to using oral & nasal airways, I'm leaning towards it not being one.
    Perhaps not, we're lucky that both agencies I work/volunteer for do allow this as a BLS skill.

    Part of my fuel was this...
    Quote Originally Posted by ffscm72
    I take it oropharyngeal airways are just beneath you all. To good to use a simple tool?
    ...and the implication that we're "too good" to use an OPA, even if there's a more viable option out there...which in my case, it is.
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  5. #165
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    Quote Originally Posted by ffscm72 View Post
    I take it oropharyngeal airways are just beneath you all. To good to use a simple tool?
    Well, in a sense, yes, they are beneath me. If the goal is to secure the airway, then why would I choose an oral airway when I have ETT & King-LT airways at my disposal? Options that would actually secure the patient's airway!


    P.S. The part in blue was a bit of cockiness, but only so I could have a little more fun mocking you.

  6. #166
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    Quote Originally Posted by ffscm72 View Post
    Quote Originally Posted by efd808 View Post
    I don't think anybody was making themselves out to be more than they are, we all have a job to do, and trust me I have been on the receiving end of some snot nose straight outta school medic try to berate my guys. Unfortunately for him he ended up looking like a fool in front of everyone, professional..no....fun...you bet. I have also had some basics that due to ignorant pride not call for help when the pt really needed ALS care. I think we all agree we are proud of what we do , and we use every tool we have to the best of our ability whether were on the fire ground or a medical call.
    That's all i was trying to say in a nut shell.
    If that's all you were trying to say, then you did a **** poor job of doing so.

  7. #167
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    Quote Originally Posted by BoxAlarm187 View Post
    Part of my fuel was this...

    ...and the implication that we're "too good" to use an OPA, even if there's a more viable option out there...which in my case, it is.
    Then hopefully post #165 brought a smile to your face.

  8. #168
    MembersZone Subscriber ffscm72's Avatar
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    I don't know what to tell you firemedic.As far as me sittin' for a while...I got time. I'm a patient man. I never said the OPA or NPA were great option, just option none the less.
    Maybe some day we can work together. Until then stay safe & save some lives with all them limited tools at your disposal. & I'll do the same with my even more limited tools...lol
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  9. #169
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    Quote Originally Posted by ffscm72 View Post
    I never said the OPA or NPA were great option, just option none the less.
    Once again you appear to be missing the point. The question was about how YOU would secure an airway at the BLS level. The issue wasn't about you saying or implying that the OPA and NPA were great options. The issue is that neither of them will actually secure the airway and you either overlooked that, didn't know that or intentionally ignored that.

  10. #170
    MembersZone Subscriber ffscm72's Avatar
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    Quote Originally Posted by FireMedic049 View Post
    Once again you appear to be missing the point. The question was about how YOU would secure an airway at the BLS level. The issue wasn't about you saying or implying that the OPA and NPA were great options. The issue is that neither of them will actually secure the airway and you either overlooked that, didn't know that or intentionally ignored that.
    It's a good thing you decided to be a medic & not a police officer. You are just missing the point entirely. Lord, never give you a gun...lol You'd shoot the public & not the person breaking the crime...lol

    No OPA or NPA would not be my first choice. It is my only choice as BLS. That's why I call you. But none the less a they are choices. not the best I agree.

    I'll take a quote from another thread that I had this discussion in:

    DrParasite: "BLS treats the signs and symtoms. ALS can do more to treat the signs and symptoms.MDs treat the causes of the signs and symptoms"

    You make yourself out more than you are because you have more tools. I get that but
    Last edited by ffscm72; 07-25-2011 at 11:05 AM.
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  11. #171
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    Quote Originally Posted by ffscm72 View Post
    It's a good thing you decided to be a medic & not a police officer. You are just missing the point entirely. Lord, never give you a gun...lol You'd shoot the public & not the person breaking the crime...lol
    You're only partially correct. I'd definitely be inclined to shoot the criminal. I'd probably be the Taser company's best customer.

    No OPA or NPA would not be my first choice. It is my only choice as BLS. That's why I call you. But none the less a they are choices. not the best I agree.
    I'm not missing the point at all. You stated the following:
    Originally Posted by ffscm72 View Post
    airway management- secure it...what else is there besides the tool you use? Medics have better tools to do that with...i get that...but we are still doing the same job....trying to secure an airway.
    In response, I asked how YOU would secure that airway as an EMT since we were "doing the same job....trying to secure an airway" and I am unfamiliar with what treatment options are available to the EMT in Delaware.

    As pointed out more than once, the OPA and NPA do not actually secure a patients airway.

    So, given the fact that the OPA and NPA are your only treatment choice at the BLS level, then the correct response to my question would have been "call for a paramedic".

    I'll take a quote from another thread that I had this discussion in:

    DrParasite: "BLS treats the signs and symtoms. ALS can do more to treat the signs and symptoms.MDs treat the causes of the signs and symptoms"

    You make yourself out more than you are because you have more tools. I get that but
    But what?

    I have more training, skills and tools to treat patients than the EMT, therefore my job is not the same as an EMT's. I know that I'm not a doctor, nor pretend to be one. How exactly am I making myself out to be more than I am (as a Paramedic)?

  12. #172
    Forum Member L-Webb's Avatar
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    OMG
    Does this guy........................... ........

    Beat the poor ol dead horse much?
    Bring enough hose.

  13. #173
    MembersZone Subscriber ffscm72's Avatar
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    Quote Originally Posted by FireMedic049 View Post
    You're only partially correct. I'd definitely be inclined to shoot the criminal. I'd probably be the Taser company's best customer.
    roflmao

    Quote Originally Posted by FireMedic049 View Post
    I'm not missing the point at all. You stated the following:
    In response, I asked how YOU would secure that airway as an EMT since we were "doing the same job....trying to secure an airway" and I am unfamiliar with what treatment options are available to the EMT in Delaware.
    As pointed out more than once, the OPA and NPA do not actually secure a patients airway.
    I ask you before i answer you, what are all the methods of securing an airway?

    So, given the fact that the OPA and NPA are your only treatment choice at the BLS level, then the correct response to my question would have been "call for a paramedic".
    Of course I would request for ALS. as it would be the best chance of survival for the patient. i don't deny this fact. But are still doing the same thing. Same job, different skill level & tools.

    I have more training, skills and tools to treat patients than the EMT, therefore my job is not the same as an EMT's. I know that I'm not a doctor, nor pretend to be one. How exactly am I making myself out to be more than I am (as a Paramedic)?
    I believe we are arguing same point but w/ different terminology in some cases.
    You care using the Acronym for EMT in the meaning the level of skill not Emergency Medical Technician?
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  14. #174
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    Quote Originally Posted by ffscm72 View Post
    I ask you before i answer you, what are all the methods of securing an airway?
    Not sure why that would be necessary, but........

    Endotracheal tube, King-LT, Combi-tube and a needle cricothyrotomy (or however that's spelled) are the options that I have/had at my disposal. I believe some places can do surgical cricothyrotomies. Beyond that, there's a tracheotostomy, but that's typically an in hospital procedure.



    Of course I would request for ALS. as it would be the best chance of survival for the patient. i don't deny this fact. But are still doing the same thing. Same job, different skill level & tools.
    Same job, but only in the overly simplistic fashion that you have acknowledged as being your meaning.


    I believe we are arguing same point but w/ different terminology in some cases.
    You care using the Acronym for EMT in the meaning the level of skill not Emergency Medical Technician?
    I am using "EMT" in reference to the BLS level since anywhere that I've been to, "EMT" refers to a BLS provider. Any reference to a provider with an ALS scope of practice is referred to with a different identifier, like EMT-I, CC, IV, AI, P or by paramedic or Health Professional (a RN authorized to do Paramedic skills).

  15. #175
    MembersZone Subscriber ffscm72's Avatar
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    Quote Originally Posted by FireMedic049 View Post
    Not sure why that would be necessary, but........

    Endotracheal tube, King-LT, Combi-tube and a needle cricothyrotomy (or however that's spelled) are the options that I have/had at my disposal. I believe some places can do surgical cricothyrotomies. Beyond that, there's a tracheotostomy, but that's typically an in hospital procedure.
    ur missing a couple.

    Same job, but only in the overly simplistic fashion that you have acknowledged as being your meaning.
    why make it deeper than it is? it just makes the job harder.

    I am using "EMT" in reference to the BLS level since anywhere that I've been to, "EMT" refers to a BLS provider. Any reference to a provider with an ALS scope of practice is referred to with a different identifier, like EMT-I, CC, IV, AI, P or by paramedic or Health Professional (a RN authorized to do Paramedic skills).
    I'm using the term EMT as the acronym. it precedes the level. I can see why we go back and forth on it...lol no biggy
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  16. #176
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    Quote Originally Posted by FireMedic049 View Post
    Not sure why that would be necessary, but........

    Endotracheal tube, King-LT, Combi-tube and a needle cricothyrotomy (or however that's spelled) are the options that I have/had at my disposal. I believe some places can do surgical cricothyrotomies. Beyond that, there's a tracheotostomy, but that's typically an in hospital procedure.

    To add to this, just because medics have the training and authority to use advanced airways doesn't mean they're going to automatically go to those. (Though, sadly, there are some that do I'm sure).

    Myself, I always consider basic measures first. Sometimes BLS stuff is all you need for a particular emergency, and as fun as intubating is when it's necessary, I'd much prefer to be able to just pop an OPA in a patient that only needs that much to keep their airway open., or an NPA is the situation fits. However, some patients require more than this, and that is one example where a medic does in fact make decisions as I have to decide with a particular patient whether an OPA or NPA is efficient enough or not. If in my opinion it is not, I choose to go with a more advanced airway. And in extreme cases where a patient is conscious enough not to tolerate an airway but they currently need or imminently will need advanced airway securing, I have to make the choice whether I chemically put them down to enable securing of said advanced airway. Just examples of decision making that goes on, all with the point that any smart medic will look at BLS first but have to make the decision as to whether that is enough or not. Has nothing to do with "being above" using BLS airways, it's whether or not that is enough for the patient or if we need to use more advanced airways we're trained and allowed to utilize.

    I'm all for being able to use an OPA or NPA and nothing else. Less stress and potential trauma to the patient, less stress on me, easier for everyone. But I won't skimp and cheat and just use that for the sake of making my job easier at the expense of my patient's well being just like I won't automatically jump to ALS care simply because I can and it's more "fun".

  17. #177
    Back In Black ChiefKN's Avatar
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    I suppose a Police Officer is also doing the same job when he starts CPR.

    Let's take the reasoning further. A boy scout is also doing "the same job" when he treats a bloody nose. Lifeguards, security guards... the list goes on and on.

    They all assess and treat... they don't transport, but neither do Paramedics in many parts of the country.
    Last edited by ChiefKN; 07-25-2011 at 06:46 PM.
    I am now a past chief and the views, opinions, and comments are mine and mine alone. I do not speak for any department or in any official capacity. Although, they would be smart to listen to me.

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  18. #178
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    Quote Originally Posted by ffscm72 View Post
    ur missing a couple.
    Then by all means, please share with the rest of us. It was not my intent to create an all inclusive list and apparently forgot to note that.

    why make it deeper than it is? it just makes the job harder.
    Why make it more shallow than it is?

    How does acknowledging that the actual job of a Paramedic is different than that of an EMT because it involves additional training, diagnostic equipment, treatment options and medications make the job "harder"?

    I'm using the term EMT as the acronym. it precedes the level. I can see why we go back and forth on it...lol no biggy
    Then you might be the only one doing so.

  19. #179
    MembersZone Subscriber ffscm72's Avatar
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    Quote Originally Posted by FireMedic049 View Post
    Then by all means, please share with the rest of us. It was not my intent to create an all inclusive list and apparently forgot to note that.
    doing something as simple as head tilt chin lift? basic as it is, & again OPA/NPA. They aren't the best of solutions but in a pinch and that's all you had. they work.


    Why make it more shallow than it is?

    How does acknowledging that the actual job of a Paramedic is different than that of an EMT because it involves additional training, diagnostic equipment, treatment options and medications make the job "harder"?
    As far as level of complexity...yes you're right, Medics have BLS beat by a LOOOONG shot. But the job itself is the same. Still limited to what you can & can't do. Be proud, but when someones pride becomes more than they can handle then they start making mistakes. sometimes life threatening. Daring to go beyond their scope of practice w/o the proper education or skills to do so.

    Then you might be the only one doing so.
    then I like being the only one doing it correctly
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  20. #180
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    Quote Originally Posted by ffscm72 View Post
    doing something as simple as head tilt chin lift? basic as it is, & again OPA/NPA. They aren't the best of solutions but in a pinch and that's all you had. they work.
    Sorry, but those don't count. What you seem to not be grasping is the importance of one key word in this part of the discussion. A word that I've highlighted and underlined multiple times - "secure".

    The head tilt, chin lift and OPA/NPA can certainly be used to open the airway, but they don't secure it and that's what you don't seem to be grasping.

    If the patient can aspirate his/her stomach contents, then the airway has not been secured.

    As far as level of complexity...yes you're right, Medics have BLS beat by a LOOOONG shot. But the job itself is the same. Still limited to what you can & can't do. Be proud, but when someones pride becomes more than they can handle then they start making mistakes. sometimes life threatening. Daring to go beyond their scope of practice w/o the proper education or skills to do so.
    I'm really not sure why you are having such a hard time accepting that EMT and Paramedic are not the same job. You seem to be able to grasp that there is a difference, but don't seem to be able to accept that this translates into them being different jobs. At this point, either you are extremely obtuse or you're a (insert your favorite derogatory term).

    This isn't about "pride". This isn't about going beyond the scope of practice. This isn't about any of the other BS you've spewed in this thread. This is simply black and white fact that they are different jobs. To view them in such overly broad simplistic terms (as a Fire/EMS provider), to be "the same job" is as disrespectful and ignorant as the public still referring to EMS providers as "ambulance drivers".



    then I like being the only one doing it correctly
    Well, I guess that's one way to look at it.

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