tag:blogger.com,1999:blog-24021163.post5833891036772730851..comments2024-02-18T01:56:38.508-06:00Comments on M.D.O.D.: Georgia O'Keefe911DOChttp://www.blogger.com/profile/06466669111561150174noreply@blogger.comBlogger39125tag:blogger.com,1999:blog-24021163.post-10789424336335669002008-06-03T12:58:00.000-05:002008-06-03T12:58:00.000-05:00I bow before igloodoc's great comment. I fart in t...I bow before igloodoc's great comment. I fart in the government's general direction.Lynn Pricehttps://www.blogger.com/profile/02958402288888144904noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-4669552750147448722008-06-02T18:35:00.000-05:002008-06-02T18:35:00.000-05:00With people these days, one never knows, so... I a...With people these days, one never knows, so... I am kidding, OK?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-61671803860998108882008-06-02T18:23:00.000-05:002008-06-02T18:23:00.000-05:00Dear Cletus Del Roy Spuckler,I don't think you wou...Dear Cletus Del Roy Spuckler,<BR/><BR/>I don't think you would have to worry about the fine examples of hickart on the side panels of your hickcar, since go-carts would roll right under your bumper and end up in front of you anyway.<BR/>As for the grille guards, they sell them at Bumpkin R'Us I am told.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-29474413561184630452008-06-01T23:45:00.000-05:002008-06-01T23:45:00.000-05:00We own a F-150 SuperCrew FX4 and a Prius. Figure t...We own a F-150 SuperCrew FX4 and a Prius. Figure that one out eh?Charleshttps://www.blogger.com/profile/04263878301793806625noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-14948731211806085102008-06-01T23:25:00.000-05:002008-06-01T23:25:00.000-05:00911, "...a 'smart' car passed me....i am very co...911, "...a 'smart' car passed me....i am very concerned. that thing is so small i think it could get under my bumper and dent my fender or scratch my paint."<BR/>Now that was funny!!<BR/><BR/>Old fart, I agree, I am NOT giving up my 3/4 ton.<BR/>Trauma rule #?? In a motor vehicle collision, injury risk of occupants is inversely related to the size and weight of the vehicle.make mine traumahttps://www.blogger.com/profile/18149160428613740527noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-60714583590749514272008-06-01T22:08:00.000-05:002008-06-01T22:08:00.000-05:00oldfart, was cruising down the avenue today in my ...oldfart, <BR/>was cruising down the avenue today in my F150supercrew 4x4 when a 'smart' car passed me going the other direction. i am very concerned. that thing is so small i think it could get under my bumper and dent my fender or scratch my paint. do you know of any add-on brush-guard device designed specifically to crush the smart cars and prius and other go-cart type vehicles? i spent a lot getting that sniper rifle and 50cal airbrushed onto the side panels and i do NOT want that artwork damaged.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-19728155116878773682008-06-01T22:01:00.000-05:002008-06-01T22:01:00.000-05:00dear ..., i would happily work for cash in a two r...dear ..., <BR/>i would happily work for cash in a two room clinic if i could be the boss of me and involve the patients in their decisions and their care, and not have to fill out anything other than a handwritten patient encounter form. i could do 80 percent of what i do here in ten minutes and for thousands less. hey, i sound like a commercial.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-84504241167359007402008-06-01T21:37:00.000-05:002008-06-01T21:37:00.000-05:00Top notch rant, 911. I dig it.Hey anon, want to kn...Top notch rant, 911. I dig it.<BR/><BR/>Hey anon, want to know why I drive a big truck? Back when I first started as an EMT we got called to a wreck. An illegal, who had no liscene and no job, who frequented the ER in the small town where I lived decided he would drive drunk in his small piece of shit pickup. He decided to cross the median on the interstate and run head on into a family in a very small car. It killed the dad (who was wearing a seatbelt) instantly. His wife, who was in her second trimester of pregnancy died. I could hear her gurgling, DROWNING, in her own blood as the FF's tried to cut her from the ball of metal that was once her car. There was a toddler in the back seat. We found him when we cut back the metal to get the mom out. He was completely unrecognizable. <BR/><BR/>Anonymous, I'm willing to pay for the saftey of driving a big truck. I'm confident that it will save me, my husband, and my unborn child if something happens.EEhttps://www.blogger.com/profile/13697074755915208566noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-5270907166522753152008-06-01T18:49:00.000-05:002008-06-01T18:49:00.000-05:00Hey Anon..I live in the the Great Republic of Texa...Hey Anon..I live in the the Great Republic of Texas and I have 6 trucks. All of my family drives one.Suck my Dick!! If I want to pay for the gas, then I'll pay for it! When it's too expensive, I won't..Who's gonna win when we collide?!My kids are safe in them and that's worth a lot against all the freakin' ILLEGAL ALIENS here. Younger son, 18, drives F-150 King Ranch. Recently, ILLEGAL MEXICAN tried to run across 3 lanes of traffic at 55 mph, my son hit her and her CAR was totalled. <BR/>Unless he pointed it out I wouldn't have known he was in a wreck.<BR/>I guess I just narrowed myself down to about 25 million humanoids..Oldfarthttps://www.blogger.com/profile/14333534023484494721noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-4707692905766461522008-05-31T16:22:00.000-05:002008-05-31T16:22:00.000-05:00"Frank Drackman said... 911, Tonight we render soa..."Frank Drackman said... <BR/>911, Tonight we render soap from fat."<BR/><BR/>Eeewwwww. Fight Club? Never seen it. Should I?Amelia Ameshttps://www.blogger.com/profile/17296224743117560163noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-11921901561209445562008-05-31T12:00:00.000-05:002008-05-31T12:00:00.000-05:00Nice one. Those of us living in our lovely sociali...Nice one. Those of us living in our lovely socialist paradises (joking, really joking) wonder how a country that produces such smart people can produce such dumb laws. Hmmm lets see yes all can have health care and we won't need anyone to pay for it. Makes the communist party seem smart ;-)Swedozhttps://www.blogger.com/profile/01731646301284972279noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-73929444096251558662008-05-31T11:57:00.000-05:002008-05-31T11:57:00.000-05:00Are other ER's (other than VA's, etc.) exempt from...Are other ER's (other than VA's, etc.) exempt from the EMTALA rules? Out in Middle-of-Nowhere-America we don't have an OB/BGYN within an 80 mile radius, so if a lady arrives at the ER in labor it's just an ambulance (or flight) to the nearest facility. Same with MRI's or casting broken bones, or anything involving a scalpel. <BR/><BR/>Actually, all we do here is pack 'em up and ship 'em out: 2 ER beds, and 8 hospital beds in the whole county. We're looking for staff if you're interested. <BR/><BR/>(how do I make a winking face on here?)...https://www.blogger.com/profile/05732267499361769403noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-31784740241981562532008-05-31T09:28:00.000-05:002008-05-31T09:28:00.000-05:00Uhhhh....anon 8:28, I think he was taking a well a...Uhhhh....anon 8:28, I think he was taking a well aimed, and well deserved jab at liberal beauracrats and their hyper- zealous fan club apopletically gyrating with their unrealistic idealism and social progressiveness that will shove our country into socialism and eventually communism faster than Michael Moore can cram a cheeseburger into his gaping maw if they are allowed to have their way with us.Amelia Ameshttps://www.blogger.com/profile/17296224743117560163noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-15309256025581205352008-05-31T08:28:00.000-05:002008-05-31T08:28:00.000-05:00I don't understand the rant about being a little t...I don't understand the rant about being a little thrifty. Why did the author consider eating healthy and not wasting a bunch of gas in a truck ("Have fun driving your Prius and drinking soy and wheat-grass shakes.") to be some how anti-American?<BR/><BR/>If anything, sending excessive money to nations that hate us in exhange for oil so you can drive a bigass truck around isn't manly or American. Its stupid.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-65640211860987278152008-05-31T07:45:00.000-05:002008-05-31T07:45:00.000-05:00911, Tonight we render soap from fat.911, Tonight we render soap from fat.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-76200445517087971752008-05-31T05:03:00.000-05:002008-05-31T05:03:00.000-05:00igloodoc, it just gets better and better doesn't i...igloodoc, <BR/>it just gets better and better doesn't it? well, i always wanted to play in the big game... shoot the game winning free throw... run for the winning touchdown... stand in the breach etc... so i've done my best to do just that for many years now and it's time for someone else to do it. thanks for your kind words. <BR/>cheers911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-5218789356360988842008-05-31T02:50:00.000-05:002008-05-31T02:50:00.000-05:00911Doc Tell them the really good parts of EMTALA....911Doc<BR/><BR/> Tell them the really good parts of EMTALA.<BR/><BR/>The 250 yard rule: This says that the Emergency Department extends 250 yards in every direction from the hospital property. Anyone who has an emergent condition and gets within 250 yards of the hospital property are to have the Emergency staff run out, with crash cart to tend to them. In our hospital, this means a freeway, 2 major intersections and half of a suspected meth house are part of the emergency department. Good news, if the patient keels over 251 yards away, we can call an ambulance.<BR/><BR/>The medical screen: Anyone who presents to the ER and asks for a medical screening exam gets one. EMTALA says you must do anything and everything to rule out an emergency. We are not allowed to ask any insurance or financial questions. So, if a patient comes in with an urgent condition, like a kidney stone, and asks if we take his insurance because he doesn't want a big bill, we cannot tell him. It is a violation of EMTALA. So he gets the CT of the abdomen because it could be an aneurysm, or bowel obstruction. And he gets a huge bill because we don't take his insurance. So the patient gets pissed at us.<BR/><BR/>And what do you do with the elderly parents who drive up and ask for a medical screen for the adult son that refuses the exam? EMTALA says the parents are allowed to ask for the screening exam and it must be done. But, we have to kidnap the patient out of the car to do it.<BR/><BR/>If we don't have the ability to treat a patient, EMTALA rules how to transfer the patient. If the patient has an intracranial hemorrhage, you need a place with a neurosurgeon. But, EMTALA accepts that if the receiving hospital has no available beds (in this case ICU beds), then the receiving hospital can decline the patient. So the patient, who might die without a neurosurgeon, sits in your ER while you go on to the next hospital, and the next, and the next. Then the next city, Then one of the four adjoining states. Hope the patient survives. <BR/><BR/>A study showed that EMTALA is slowing transfers by at least 1/2 hour. <BR/><BR/>And we are not even addressing the free care issue. Or the forcing the on call specialist to cancel his office full of paying customers to come to the hospital to care for one non-paying patient. Or the fact that the VA and military is exempt, so they can turn the ambulance away at the door.<BR/><BR/>Like I said before, an eagle of an idea sucked through the jet engine of government.<BR/><BR/><BR/>And, 911Doc, let me counsel you with the wise words of an old ER attending I once knew. He said that you may not get angry with the 1st patient, or 50th, or the 500th. But if you never get angry at a patient (or the system that enables him) and go off, you are not human. Take care, 911DocAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-5107392509140538942008-05-31T00:15:00.000-05:002008-05-31T00:15:00.000-05:00thanks mmt. one more thing janemariemd, federal fa...thanks mmt. <BR/><BR/>one more thing janemariemd, federal facilities, ie the VA and military hospitals, are specifically excepted from EMTALA. neat-o!911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-14980458760693397722008-05-30T23:54:00.000-05:002008-05-30T23:54:00.000-05:00911, It really hurts me to see you this way. Thank...911, It really hurts me to see you this way. Thank goodness you are getting out, for soon you will implode. Explode makes more sense but implosion is so much cooler.<BR/><BR/>And just what kind of flower has ole <BR/>Georgia O'Keefe been painting lately?<BR/>I didn't even know she was a lesbian.make mine traumahttps://www.blogger.com/profile/18149160428613740527noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-84400214175532800532008-05-30T23:25:00.000-05:002008-05-30T23:25:00.000-05:00dear janemariemd, good question. EMTALA was intend...dear janemariemd, <BR/><BR/>good question. EMTALA was intended to prevent patient dumping for the old wallet-biopsy. actually, it was written, originally, specifically to cover women in labor "emergency treatment and active labor act" or something like that. <BR/><BR/>two problems. they included the language "emergency condition" but did not define it. and two, didn't fund it. <BR/><BR/>so, with the fear of litigation being a real fear ERs have tried but failed to do good triage and send the 'non emergency' patients packing. this with heavy fines ready to be handed out for improper triaging, and, as you know, the hardest nursing job in the world is triage. <BR/><BR/>the fall back position has been to just see everybody. in our particular state, even when a patient is judged to be 'non-emergent' and told to get lost they can refuse to leave and pay exactly 0$ for their care IF they have medicare/medicaid or our state insurance. self pay? you pay a copay. insurance? you pay a copay. <BR/><BR/>this has become well known over time and folks not only use us routinely for stuff that their PCPs CAN and SHOULD do for them (and do better for them than i can) but many have also dropped their PCPs because they have to pay them. <BR/><BR/>so emtala, in practice, means we see and treat all comers for anything regardless of their ability to pay or whether they are truly sick. <BR/><BR/>cheers, <BR/>me911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-46326973763323650302008-05-30T22:57:00.000-05:002008-05-30T22:57:00.000-05:00yes, I thought the same as anonymous--wondered how...yes, I thought the same as anonymous--wondered how you really REALLY felt. But isn't the problem that most ERs don't have the guts to send out the non-emergent stuff? Isn't EMTALA only supposed to cover care for 'emergent' conditions?? Just wondering.janemariemdhttps://www.blogger.com/profile/04456131748909653894noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-15765240125454576142008-05-30T22:43:00.000-05:002008-05-30T22:43:00.000-05:00but how do you really feel?but how do you really feel?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-26764132623599321152008-05-30T22:32:00.000-05:002008-05-30T22:32:00.000-05:00amy, i don't know if i'll ever be full time ER aga...amy, <BR/>i don't know if i'll ever be full time ER again though i will continue to pull shifts as my skills, more than most (with the exception of surgeons) are perishable and if i get my head strait then i want to be able to come back.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-16461997756722885762008-05-30T21:42:00.000-05:002008-05-30T21:42:00.000-05:00"First, I didn't know vaginas were blue/green."Onl..."First, I didn't know vaginas were blue/green."<BR/><BR/>Only if you tatoo them or have a varicorse vein running through. In which case your nurse should not say "What on Gods Green earth is that?" It does not get rave reviews.pinkyhttps://www.blogger.com/profile/00198277802918823591noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-88568386837635230202008-05-30T21:35:00.000-05:002008-05-30T21:35:00.000-05:00Whatever language the "native" doctors speak sound...Whatever language the "native" doctors speak sounds foreign to me, so that really should not make much of a difference... ;-)Anonymousnoreply@blogger.com