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Happy EMS Week

May 19, 2013 by tooldtowork Leave a Comment

Since nothing much has changed since last year, or the year before, or even the year before that, I’ll just do an encore presentation of my EMS Week post from last year. Since I’m not working n the field I don’t see the emails from my former employer telling us about all the wonderful stuff the hospitals will be doing for us. Except if you work on the night shift, all you get is the empty boxes the food for the other two shifts came in.

This is the easiest post of the year to write, sadly. Why is it so easy? Because EMS Week is predictably repetitive. A half hearted, half assed, attempt by management and that of various hospitals to show their “appreciation” for what the field staff does.

I’m going to re run, excuse me, give an encor performance of my 2009 post. I don’t have to change one word because it’s still the same old thing when it comes to EMS Week. It’s like “Groundhog Day”, only without Andie MacDowell. I wonder if it’s different in other systems?

As predictable as seasonal allergies, ants in the pantry, or pot holes in New England, once again EMS Week is here.

Our overseers partners at the American College of Emergency Physicians (ACEP) have a fun filled week of activities planned out for us. The ubiquitous and painful “blood pressure” clinics, demonstrations of equipment and what we do for the kiddies, and other activities for us to do on our “down time”. As opposed to relaxing on our down time, because we can’t have that.

Oh, and outreach to the elderly community, because none of them are familiar with EMS, right? Except that they are our best customers, and generally the most appreciative. Some of them know our jobs better than we do.

Here’s a radical idea. How about thanking the EMS crews for their hard work? Maybe take a week off from sending nag-a-grams about billing, documentation, response times, and all the other administrivia that consumes your brains.

Hospital Emergency Departments will join in the fun by offering food at, or more often just outside, the ambulance bay. Nothing says “we value you” more than stale bagels, donuts, and coffee on a cheap folding table. Unless it’s lunch time in which case it’s cold, greasy pizza on a cheap folding table. So much for heart healthy meals. Along with the cheesey gifts.

Of course since EMS is a Twenty-Four hour a day profession, these delightful morsels are only available for the day shift crews, with a little bit left over for the evening crews. If you happen to work the overnight shift, you don’t even exist, so forget it. Unless you consider cleaning up the wrappings and assorted trash left over from the day shift’s good times a celebration.

The folks over at the American Nurses Association are better at this, although there are no doubt nurses who feel differently. They minimize additional (non compensated) work for nurses and instead focus on celebrating nurses and nursing.

Just one more way in which the nursing profession outdoes the EMS trade in taking care of their interests.

EMS Week has as certain “Look at me, look at me, I’m important.” feel to it, an air of desperately seeking attention, if you will. The other 51 weeks of the year, we’re necessary, but not really important. Except of course to the small percentage of people who really do need an ambulance. Then, for a time, we’re the most important people in the world. Or at least in their world. They expect us to be there because that’s our job. I’m not sure that we should make a big deal about it, but it seems someone thinks we should.

EMS Week, meh. Give me Festivus any day.

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Filed Under: Uncategorized

It’s Not So Funny Now

May 15, 2013 by tooldtowork Leave a Comment

Back when the US Congress was debating the Affordable Care Act (aka Obamacare) a lot of us complained that it would mix the efficiency of FEMA with the compassion of the IRS.

That turns out to be not so funny now that the law has been passed and is starting to take effect. It turns out that the Internal Revenue Service will be the main enforcement and implementation agency for the act.

Which at the time I pointed out was not about health care or controlling costs, but was about control.

Byron York: IRS scandal raises fears about enforcing Obamacare

The IRS is critical to Obamacare. The structure created by the Affordable Care Act requires the government to know about both the health care coverage (or lack of it) and the financial resources of every American. The IRS, which already knows the latter, was the only agency with the reach to do the job.

 

A look at the text of the health care law reveals that much of it consists of amending the Internal Revenue Code to give the IRS more power. When Obamacare goes fully into effect in January, every American will have to prove to the IRS that he or she has “qualifying” health coverage, meaning coverage with a list of features approved by Health and Human Services Secretary Kathleen Sebelius. That will be done by submitting a document to the IRS, something like a W-2, to confirm coverage.

 

The IRS will also decide who is, and who is not, eligible for Obamacare’s subsidies. The law authorizes the IRS to share confidential taxpayer information with the Department of Health and Human Services for the purpose of determining those subsidies. And since subsidies don’t just apply to a relatively small number of the nation’s poorest citizens — under the law, they can go to a family of four with a household income of nearly $90,000 — they will affect a huge segment of the population.

So now, the federal government will be in your business, literally. The IRS will have a tremendous amount of control over our lives on a daily basis.

In addition, the IRS will keep track of even the smallest changes in Americans’ financial condition. Did you get a raise recently? You’ll need to notify the IRS; it might affect your subsidy status. Have your hours been reduced at work? Notify the IRS. Change jobs? Same.

All of this will be monitored and controlled by an agency that admitted on Friday that some of it’s employees probably violated federal law by selecting who to audit based on political affiliations and leanings. An amazing number of individuals and organizations that were critical of the current Administration and government operations were selected for audits or had their applications for designation as non profit organizations delayed while others were quickly approved. No one yet knows how far up into the Administration this scandal goes, but it clearly is much higher than a few low level employees at a local office in Ohio.

I don’t know about you, but I’m very nervous about how this supposed healthcare law is going to unfold. The opportunities for corruption and political abuse are far too great for any agency of the government to be entrusted with. This goes beyond the current Administration because once this President is gone, the law will still be there. I see this in the same light as I do the PATRIOT Act. Or the RICO statute. They are all broadly sweeping laws that give federal authorities a lot of power with little oversight. We’re seeing that now as both RICO and the PATRIOT Act are being used in ways that the people who wrote it, voted for, and signed it, never foresaw. Broad, sweeping laws designed to deal with a “crisis” stay on forever and are used in ways never intended when they were passed.

I see no reason to believe that the Affordable Care Act will be one bit different.

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Filed Under: Civil Rights, Politics, Politics of Medicine

Home Handy Man Project #1

May 13, 2013 by tooldtowork Leave a Comment

We’ve had a bathroom faucet that’s need replacing for a while now. Being semi retired I actually have the time to do projects like this, although generally I prefer to call my on retainer plumber. The last time he was over doing a fairly complex job for me I asked him about the bathroom faucet and he told me that it shouldn’t be too hard and that I could tackle it myself. OK, he knows what he’s doing and the truth is other than contorting myself into positions that I’d prefer not to, this job wasn’t exactly rocket surgery. I also had to take out the sink and re-caulk it since the old caulking had sort of crumbled.

While I was procrastinating, uh, contemplating the job I came across a new in box Delta bathroom faucet for very short money. I checked it out and it was still new in the box, with all the parts and instructions. I snapped it up and planned my project.

This morning I started on the project. My plan here was to make sure that I could get the water off, remove the feeds, removed the drain pipe, remove the old faucet itself, put in the new faucet and drain pipe, attach the new flex feeds, turn the water on, make sure that everything was tight, and then caulk the sink. If at any point I wasn’t able to disassemble something (generally the hardest part), I’d stop and call the plumber to come over and do the job when he could. This meant that I was going to temporarily loosen things and then tighten them until I was sure that all systems were go.

Pretty good plan, if I say so myself.

First the water had to be shut off. OK, that took a bit of twisting with a wrench as we have pretty hard water and plumbing tends to get a bit corroded.

I then loosened and then tightened the fittings on the water feeds. No problem. In fact much easier than I thought it would be.

Next, I loosened and then tightened the fittings on the drain pipe. That was really easy, I was still on a roll.

All that was left was to reach up and loosen the handy dandy nylon nuts that held the faucet in place. Which is where I should have stopped. These are supposed to be “finger tight”. That’s why the made them of nylon and not brass or something else. They even had little “wings” so that I could grab on and turn. Nice try, but those suckers were tighter than anything else in the project. I got my heat gun, not a torch, but one of those heat guns that looks like a hair drier but will set your head on fire if you use it for that. Slow, gentle heat for about five minutes fixed one of them, but the other one wouldn’t budge. I even tried about thirty seconds with the heat on high, but that didn’t help.

Which is when I should have quit, but didn’t. Instead inspiration hit me. Since I had to do the caulking anyway, why not just take the whole sink out, bring it down to my work bench, and take the faucet out there? This seemed like a good idea because I could take out the old faucet, scrape off the disgusting old caulking, replace the faucet and put the flexible feeds on. BRILLIANT!

That all actually went pretty well. I got the old faucet out, cleaned off the bottom where the caulk was going to go, put the new faucet in and attached the flexible feeds. Easy.

Back up to the bathroom where I placed the sink back into the vanity, attached the feeds to the valves, and then tackled the drain pipe. Which turned out to be a pain in the neck. Which it shouldn’t have been but decided to be. I put everything together, put the pop up for the drain in, turned on the water, and… the drain leaked like a sieve. Oh, would have helped to put the washer in, wouldn’t it? Duh. Took the drain apart, put the washer in, turned on the water and all was dry. Great. I was almost there.

I took the aerator out, which I should have done before the initial turn on, and let the water run. No problems with that either. I then did the caulking around the sink, a job that I hate. I’m just never really good with this, but I gave it a try. Nice job, if I say so myself.

One last leak check and I was done. I turned on the water, stuck my head in the vanity, turned on my flashlight, and was met with a waterfall. A small one, but a water fall, none the less. I checked all of the fittings and they were tight, the leak seemed to be coming from the faucet body itself.

WTF, over?

I called my plumber friend and left a message. He’s a good kid and more importantly, a very good plumber. Not only is he skilled in the way of pipes and drains and plumbing, but more importantly he calls back if he doesn’t answer the phone. I’ve known him since he was about ten and his father is one of my two closest friends. Maybe that’s why he calls me back, but everyone I have ever referred him to has raved about him. A reliable plumber is a thing of beauty.

He called me back and I described the problem. He opined that I had screwed up when tightening the fittings on the faucet end and since the copper isn’t really that robust I had probably cracked the pipe up where it ties into the mixing valve. Great. He suggested I buy another one and try again, being just a bit more gentle this time. Actually not a huge deal since I was only into the first one for a few dollars.

Off to the Despot I went and I found the newer iteration of the faucet. It wasn’t horrendously expensive, so I grabbed it and headed to the check out. Only one unplanned trip for parts is pretty good.

Back home, I took the “old” new faucet out, connected the feeds to the “new” new faucet, put everything back together, turned on the water feeds, crossed my fingers, and turned on the faucet.

Water came out of where it was supposed to and there was no waterfall under the vanity. Success!

I tidied up, put the aerator back in, and took one last look under the vanity.

Hmmm, the vanity wasn’t wet there before, even when the internal waterfall was at full throttle. Time to grab the flashlight and take a closer look.

Damn!

There were now two pinholes in the cold water feed. On the wrong side of the valve of course. The only way to stop this was to turn off the water for the whole house. Which I did.

I called my friendly plumber again, left a message, and 15 or so minutes later he called me back. I asked if he knew of a temporary fix until he could get over to the house. “No, and I can’t get there tomorrow.”

Double Damn!

“The only thing to do is for me to come over tonight. I’ll be there around 8:30 or 9:00.”

Which is where I sit as I type.

He’ll come over, he’ll fix this, he’ll charge me below market rates. I’d pay market rates without blinking, but that won’t be what he’ll charge.

I mentioned to him that I should have called him to do the job, but he said essentially that shit happens and not to worry about it.

Oh well, I’ll have a chance to redeem myself tomorrow or Wednesday. I have a front porch light fixture that needs to be replaced. The only problem is that I don’t know any electricians.

The way my luck is running maybe I should put the fire department on standby.

Just in case.

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Filed Under: Everything Else

I Didn’t Write This, But I Could Have

May 12, 2013 by tooldtowork 1 Comment

Only I wouldn’t be able to write it as well as did Jim Geraghty. Here is one quote, but you should really go over to The Optimistic Conservative and read the entire post.

Our political differences and culture wars are a big part of it. But I think it goes even further. How many times can a conservative encounter the low-information voters who don’t know who the vice president is, or watch the folks on the street get stumped by basic questions in Jay Leno’s “Jaywalking” segments, and not lose some faith in the American people as a whole?

For starters, I really have only the vaguest idea who Jodi Arias is. According to cable-news producers, this trial is a really, really, really big deal.

I remember reading the joke, “Far in the future, aliens will come and find the relics of our modern civilization and conclude that Kim Kardashian was our queen.” I really don’t understand why I’m supposed to care about this woman, and I don’t understand why it seems that I’m constantly being told things about her.

It’s why I sometimes think that I am out of step with the rest of the country. Or at least some of it. It’s why I’m sometime nostalgic for the good old days. Which is not to say that America was perfect in the days of my youth. It does say that the solutions both proposed and implemented to fix those problems not only didn’t fix them, they arguably made them worse. The solution to every problem is NOT to have the federal government institute a program and through millions or billions of dollars at it. I could list 100 programs that don’t work and yet tax payer dollars are thrown at them in ever increasing amounts.

Geraghty talks about losing faith in the American people, but I think the problem is with the American public education system and much of the American media. How many of your friends are talking about Benghazi, the immigration debate, the looming train wreck of Obamacare (Max Bauccus said this, not me), the increasing radicalization of the Middle East, or the financial collapse of half of Europe? No, it’s Kardashians, Arias, a mass kidnapping in Cleveland, and where and how a terrorist should be buried. Oh, we’re not supposed to call him a terrorist or even blame him for his actions, rather we should wonder what “we” did to make him become a radical.

There is too much reliance on government to solve problems that individuals can and should solve on their own or with the help of friends. The government generally doesn’t help, it just makes the problem more expensive to fix,


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Filed Under: Politics

From The Self Writing Joke Department

May 11, 2013 by tooldtowork 1 Comment

Smoke forces evacuation of White House press room

WASHINGTON –  Reporters and photographers were evacuated briefly from the West Wing of the White House early Saturday because of smoke from an overheated transformer in a mechanical room.

U.S. Secret Service spokesman Max Milien said that at about 7 a.m., smoke was seen coming from a mechanical room closet on the first floor.

And here I thought that Jay Carney’s pants had caught on fire.

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Filed Under: Politics

The Bloggers I Met At The NRA

May 10, 2013 by tooldtowork 2 Comments

First I’ll say that the National Rifle Association is very blogger friendly. Once we had our press credentials we were treated just like the “real” media. Full access to everything that they had, plus a bit more because we are gun owners as well as bloggers. Nothing big, just a little inside baseball information. The NRA is embracing alternative media wholeheartedly. At least it seemed that way. There was a press room with tables, chairs, electricity, and WiFi. Snacks and drinks too.

That gave us a convenient place to sit and also served as a meeting point where we could plan our day and coordinate our activities with the other bloggers. I think some of the “real” journalists were looking down on us, but none of the bloggers really seemed to care.

Anyway, on to the bloggers in no particular order.

“Awelowynt” of Snooze Button Ronin. He explains where he got the name “Awelowynt” and it’s not an acronym like “TOTWTYTOR”. I’m not a gamer, so I don’t quite get the reference, but no matter. He’s a gun blogger from Illinois, a not very gun friendly state.

Robert Morse of Slow Facts. Since he’s an engineer, his posts are well thought out as you’d expect. We had a nice conversation at one of the blogger dinners, I just forget specifically which one because we socialized quite a bit. Well worth reading.

Kathy Jackson of Cornered Cat. I’ve not been a regular reader because her site and blog are more geared to women shooters or would be shooters. She’s a charming lady and we had a long chat about… cats. Several of which she is owned by. She also gave me an autographed copy of her book which is going to my daughter in law as she starts her journey towards armed self protection. She’ll be able to protect herself, her children, and if need be, her husband. That’s a conscious decision and I expect that Kathy’s book will help her tremendously. Thanks Kathy.

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Filed Under: Blogs of Note, Uncategorized

A Better Solution

May 7, 2013 by tooldtowork 9 Comments

I was going to write a post about the new bloggers I met at the NRA Meetings. Those would be new to me bloggers who I am adding to the blog roll. Then I clicked on an email from EMS1.com which had the following story.

Shoals EMTs required to wear helmets

Which included this quote,

“The back of an ambulance is an unsafe place. We’re driving high rates of speed through red lights and stop signs,” said Gibson. “Hopefully they stop and they should, but things happen and sometimes people don’t see us and we get hit.”

Here’s a better solution Mr. Gibson. Have your crews stop driving at high rates of speed through red lights and stop signs. Have them come to a complete stop at red lights and stop signs and then proceed with caution when it is safe to do so. The few seconds that doing this will add to every response are are going to be more than offset by the increased safety not only to your crews, but to the public in general and your patients.

Are you going to require your patients to wear helmets when the are in the back of the ambulance?

That’s a rhetorical question, I know the answer.

I’m not against EMS systems issuing helmets to their employees, not at all. In fact, it’s long overdue. What’s not overdue are stupid one size fits none policies about wearing a helmet all the time while working.

“It’s a professionalism too. We feel more professional, nice uniform, nice helmets,” Hargett said. “We feel more comfortable, more involved, more professional – like the police or the fire department.”

Professionalism? I think that most patients are going to snicker at a paramedic coming into their house wearing a helmet, not consider them professionals. While fire fighters wear helmets when indicated, they don’t (at least in my area) wear them on routine medical calls. The police have helmets, but they too don’t wear them except when circumstances dictate.

Oh, if Gibson is concerned about the safety of his crews, maybe he could buy ambulances with some space in the patient module instead of cramped flower delivery trucks with stretchers.

Ambulance officials said the use of helmets is a growing trend across the country.

 

While this may be true, that doesn’t mean that EMTs and medics are increasingly wearing them all the time while working. It just means that finally ambulance services that aren’t affiliated with fire departments are providing helmets for use when needed, not wearing all the time. Maybe Gibson just wants to make sure he gets his money’s worth out of the purchase.

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Filed Under: Paramedicine/The Job

Home

May 6, 2013 by tooldtowork 1 Comment

A great trip. I met a lot of interesting people, including some bloggers that I hadn’t heard of before. I got to see some nice products, bought a few, and hopefully will get to review a couple more in the near future.
It’s going to take me a day or so to get caught up, but then look for some new posts. Maybe even one or two with EMS in them.

Oh, if you were watching any media conference of the NRA Annual Meetings and heard reference to more than six protestors, they were lies. Six was the maximum and that was on Friday. By Sunday it was down to four. One attractive young woman spinning a Hula Hoop around her hips and carrying a sign. Another was a guy dress like Cookie Monster. The other two were dressed normally, but held up the typical signs. There were more people watching them than there were protestors. There was even more media watching them than there were protestors.

No gave an official estimate of attendance, but I heard that over the three days that the exhibit hall was open about 80,000 people walked through. It sure seemed like it on Saturday as the hall was packed and it was a chore just to move from exhibit to exhibit.

More later, as I said.

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Filed Under: Civil Rights, Firearms

Addition To The Blog Roll

May 4, 2013 by tooldtowork 2 Comments

A Day In The Life Of A Talk Radio Blogger.

Apparently I’m a bit better known, or my blog is, than I think. Ambulance Driver introduced me to the proprietor of this blog who told me that he not only reads my blog, but has a link. Which is all I need to hear to link back and write a quick post about it.

This blogging thing is fun. Blogging from the press room at the NRA Meetings makes me feel like shouting “Stop the presses, get me rewrite” or something else from a 1940s newspaper movie.

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Filed Under: Blogs of Note

The Most Popular Rifle In America

May 4, 2013 by tooldtowork Leave a Comment

It might be the Ruger 10/22, but I don’t think so. After spending the better part of two days walking the exhibit hall floor here at the NRA Meetings and Exposition, I’m convinced that it’s the AR platform. The original was adopted by the US Army first adopted it in 1963. That’s right, 50 years ago. At first there were problems with the weapon, but they were resolved and after that the platform worked reliably. Since then other variations of the gun have been adopted, but the basic platform is still the same. There doesn’t appear to be a plan to replace it for most soldiers in the near future.

Among gun enthusiasts there are still highly esoteric debates about it’s effectiveness, reliability, cost, design, and everything else you can think of. None of which has stopped millions of gun owners from buying them. In fact I know people who have several different variations. They have target, hunting, self defense versions. Walking the exhibit hall floor I was just amazed by the number of companies offering AR platform rifles. That was only outnumbered by the number of companies offering sights, triggers, barrels, fore ends, magazines, bolt carrier groups, and every part you can think of.

Which brings me to the point of this post. The AR platform is a just that, a platform that owners can build into almost endless varieties of rifle. I’m going to hazard a guess that most are built to fire the 5.56 or 223 caliber round, they are also made in .308, 7.62×39, 6.8mm, and even a cross bow upper is available.

Which means that this platform is going to be around for a long time. It’s popular for target shooting, plinking, varmint hunting, deer hunting, hog hunting, and of course self defense. Id politicians do nothing more than rile up the base of AR platform owners, then any attempt to “ban” or regulate “assault weapons” is doomed to fail.

My daughter in law knows very little about firearms. She’s shot with me once and shot with my son a couple of times. She doesn’t think about guns that much, but she recently told my son she wants an AR around the house for protection. So do a number of her friends. They all understand that in the end, it’s up to each person to protect themselves and their families.

I think gun control is doomed.

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Filed Under: Civil Rights, Everything Else
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I'm a paramedic working in a largish city in the Northeast corner of the U.S. I've been in EMS all of my so called adult life. I'm more than just a little opinionated, but that comes with having been around the block more than once. Read More…

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