The State Of Public Education

Mrs. TOTWTYTR came home from school today and told me that one of the other teachers had been called to an "emergency" meeting with one of the administrators. Seems the other teacher had chastised one of her students for talking like a "dirty pig". Which meant that he was swearing in class, although I don't know if said swears were directed at the teacher or just general conversation.

The teacher brought a union representative with her, just in case. Which turned out to be a good thing. Seems the student had complained to his mother who called the school and complained that his feelings were hurt and his self esteem harmed.

The union representative advised the teacher that the best course of action was an apology. From the teacher to the student, not the other way around. Seems that the "proper" way for the teacher to handle this was to send a note to the school office and request that one of the assistant principals come down to the room to speak with the student. If that didn't work, the student could be given a detention.

Oh, the student is classified as "special needs" for behavioral problems and so is a protected class of person.

Ambulance Driver has named this particular type of disorder "Chronic Hickory Deficiency". Unfortunately the lad's Mom didn't apply the treatment when he was younger and the teachers can't do it now. So, he'll just turn into one of society's problem children. No discipline in school or at home now, he'll probably end up making license plates for the state before too long.

Doomed. We're doomed I tell you.

Random Thoughts

Or what passes for thoughts.

There are no bad submarine movies. I don't know if there even any mediocre ones.

Tiger Woods is in the rough right now. I don't think he has a club that will help him out.

Doing Cocaine to cure "the worst headache of your life", might cure it, but not in the way you figured.

Calling Obama inept is an insult to inept people. Speaking of which, what happened to all the "love" we were supposed to get from other countries because he was elected? I'm not feeling it.

I'm really starting to dislike Comcast. I pay a lot for Internet and email, and yet when I use their not so great webmail client, I get bombarded with ads for all sorts of crap that I don't want or need. I sent them an message on their "Tell Us What You Think" page, but of course they didn't respond.

The hardest thing in the word to do is throw out trash barrels. The trash guys won't take them unless you're standing their to tell them to. Their story (which I can believe) is that every time they take them, the home owner calls town hall and complains that they took their trash barrels.

75% of people are full of bull shit 90% of the time. They'll promise to do something, but won't follow through. I guess the adage should be "If you want something done at all, do it yourself."  Maybe I'm just old fashioned, but when I tell someone I'm going to do something for them I do it or I have a damned good reason why I couldn't.

The Soviets Russians are now chiming in on "Climategate". Seems they think that the United Kingdom climate research scientists were fudging data too. One has to wonder if  the Soviets Russians know more about how the "stolen" data was obtained and released than they are admitting. As police detectives say, "Follow the money." My guess is that the Soviets Russians don't think much of the whole Carbon Footprint thing and want to drive a stake in it's heart. Or that it will hurt their economy more than the United State's.

It's surprising how small an opening it takes to cause a big draft and make a room cold. And how easy it is to fix.

Makes My Head Hurt

If you're one of my readers that doesn't visit my friend JayG at his blog MArooned, please hop over and take a look at one of his posts from today.

First Amendment? What First Amendment?

This is Olympic Class Stupidity. No, it's Stupidity Hall of Fame, Lifetime Achievement Award stupidity. In fact, it's so stupid I'm adding a Sumdoap Chronicles tag to this post.

Go read and comment.

Arrrrrghhhhh!

OH, Look At The Grouse!

Our tax dollars at work!

Video: Wild Grouses Enticed into Mating With Sexy Fembot

Part of the reason the fembot is so successful is that male sage grouses are particularly randy, hoping to mate with as many females as they can, as often as possible. The female grouses are the picky ones, blowing off most suitors. Researchers estimate only about one in 10 male sage grouse mate in a given season. The ones who do mate are veritable prairie players -- Patricelli told Science Nation that the top male in her study mated 47 times in one season.

[Insert random Tiger Wood's joke here]

So, what do we learn from this? Male grouses like to have sex with female grouses. Presumably attractive female grouses. Then again, only they know what an attractive female grouse it. Female grouses are picky because they can be. This is not unlike humans, I think.

More importantly, we learn that I'll use any excuse to insert a Three Stooges reference into a post.

Things Can Change

Part of a comment by Brendan to my post That Didn't Take Long reminded me that Louisville, KY had embarked on an ambitious plan to merge the city and county into one "metro" city/county government structure. Part of that plan was to take EMS out of the City of Louisville FD where it had been placed several years before and merge it with Jefferson County EMS.

I remember reading about that back in early 2004, but hadn't really thought of it in a long time. Through the miracle of Dogpile I found a link to the Metro Louisville EMS web site. Looking around I found this story from JEMS in 2006,
"Louisville Slugger, One City's Miraculous EMS Transformation"
Since I don't subscribe to JEMS I've never seen this article before.
Early on this caught my attention,

As a first step, Abramson—who had engineered the merger of EMS into the fire department in 1995—announced in January 2004 that he was taking EMS out of LFD and merging it with JCEMS to create a new entity: Louisville Metro EMS (LMEMS).

It's seems like, at least to me, that Mayor Abramson did some re-evaluation and determined that he made a mistake in 1995. That's pretty unpolitician like, but I like it.

In late 2004, Metro Louisville hired Neal Richmond, MD, a deputy New York City EMS medical director, as the first chief executive officer of LMEMS, which was officially established on Feb. 14, 2005. Then things really started moving.

A doctor from New York to run an EMS system. Sounds like a recipe for disaster since doctors are notoriously bad managers and people from New York are even worse. Combine the two and you run the risk of a disaster. However, this seems to work pretty well.
From reading the JEMS article, it seems that just about everything had to change during the transition.

Here is a recent article that provides some updates. First, the 10 hour schedule referred to in the article has been scrapped. Second, it seems like there is still a shortage of paramedics and EMTs. Hiring can be difficult for agencies that require more than a certification card and a warm body. Which doesn't seem to negate the pluses of the restructuring, it just reflects reality. It also seems that someone at WLKY has "a thing" about the amount of overtime LMEMS employees work as there are other articles that seem to hint that overtime is a bad thing. Or something.

Nonetheless, this answers the commenter's original question. Yes, mergers can be undone, it just takes the realization that it didn't work and the will to make a difficult change. Which requires a courage that is rare among politicians and managers these days.

Read both articles, because although some thing didn't work, a lot did. Conversion to a tiered system, with paramedic "fly cars", and other things that Dr. Richmond have instituted seem to have improved the system quite a bit. Not that Jefferson County had a bad system before hand.

It will be interesting to see how this model of delivery works compared to the old one over a longer period of time.

New Acquisition

I picked this up recently from another gun owner who was thinning his collection out. It's an almost new Smith and Wesson Military and Police (M&P) 9 Compact. It's very handy self defense weapon. Note that compact does not mean light weight. Although the frame is made of polymer, the slide is Stainless Steel and rather heavy for it's size. It's also had professional gunsmithing to lighten the trigger pull from the Massachusetts required for sale ten pounds to an easier to fire accurately, but still quite safe six and a half pounds. Other than that, nothing will be done to it. Well, other than the curved magazine floor plates that S&W will be sending me at no cost. One magazine has one already and it's much easier to grip properly with a curved floor plate.

Once those are installed an extended range session is in order. Because no one should carry a firearm for self defense until they are completely familiar and comfortable with it.

Besides, it's fun.

That Didn't Take Long

Actually, it took longer than I expected.

DC’s medical director announces his departure. Dr. James Augustine cites health reasons for his resignation.

Dr. James Augustine has announced his resignation as medical director for the DC Fire & EMS Department after 17-months working for the department. Dr. Augustine is citing health and wellness reasons for his departure. Sources tell STATter911.com the climate in the DC area is not beneficial to a medical condition afflicting Dr. Augustine.

Does "I'm sick and tired of this shit!" qualify as a medical condition? OK, that's inappropriate snark, I apologize. Still, DC FD/EMS seems to have a revolving door in the medical director's office. As one wag commented, only half jokingly, "They usually measure the DC EMS medical director's tenure with a stop watch, not a calendar."

I wonder if this, District sued over man's death had anything to do with it?

The family of a Northeast Washington man who died of a heart attack hours after being told by a D.C. paramedic that he suffered from acid reflux filed a wrongful-death lawsuit against the District on Tuesday.

What was that you said about paramedics being able to tell when someone needed to go to the hospital?

Augustine replaced Dr. Michael Williams in 2008.
DC's medical director has resigned

STATter 911 has learned Dr. Michael Williams, the medical director for the DC Fire & EMS Department, submitted his resignation this afternoon.

What was that quip about a stopwatch?

Seriously, and sadly, this won't help in efforts to improve the EMS system in the nation's capitol. Which is to bad because it should be a model of how to provide EMS, not in how not to provide EMS. The residents of that city deserve better care and the EMTs and paramedics certainly deserve a better agency to work for.

What was that radical idea some EMS Chief from Boston had about separating the two services? Maybe it doesn't seem so radical now. Maybe a separate EMS agency with a focus on medicine can work where an "all hazards" one hasn't. Whatever they are doing now certainly doesn't seem to be improving things much.

Stuff You Can't Make Up

New England Patriots Mascot Arrested in Sex Sting

PROVIDENCE, R.I. — A man who acts as a mascot for the New England Patriots is among 14 people who have been arrested for prostitution-related crimes in Rhode Island since a new law went into effect that banned indoor prostitution.

This one goes right into the Sumdoap Chronicles.

I hope he wasn't wearing his costume, that would be just so creepy.

Bill Belichick was reportedly not amused in the least.

Ooops.

I haven't written about the TSA for a while, but this is too good to pass up.

Gov't Posts Airport Screening Guide on Internet in Error

WASHINGTON - The Transportation Security Administration is investigating after they say an outdated version of their standard operating procedures manual was posted on the Internet. Who gets more scrutiny in line? What countries' passports are singled out? Who's exempt from screening? The answers to those questions and more were posted online for everybody to see.

I'd expect the Congressional hearings on this to be fun. I might even have to turn on C-SPAN for them. On the other hand, outdated or not, this sort of information out in the public domain can't be a good thing.

The posting was improper because sensitive information was not properly protected, TSA spokeswoman Kristin Lee said.

Brilliant insight, that.

As a result, some Web sites, using widely available software, were able to uncover the original text of sections that had been blacked out for security reasons. On Sunday, the Wandering Aramean blog pointed out the document in a posting titled "The TSA makes another stupid move.

This just makes me feel sooooo much safer when flying.

From an anonymous reader in the comments,

One of them gave me the evil eye as I showed my badge to him to get through (with screening). He said "why do YOU have a badge". I said. "I have one so people know the degree to which I have earned the public trust in matters of national security. You have one so people don't mistake you for someone employed in the food court."

He wasn't happy. I didn't care

The Golden Hour

If it's not bad enough that I admitted that I watch Emergency on Retro TV, here's another admission. I watch Dragnet too. I've seen most of them several times, but as I get older, I see different things each time I watch. Besides that, all Jack Webb shows were technically very accurate, so they provide some insight into how things worked in society and the department or agency being depicted back when they were filmed.

The episode called Personal - The Shooting, which involved two officers who were shot during a robbery. Aside from the plot, there is a quite a bit of interchange with the doctor at the hospital and an explanation of what was going on in treating the officers. If you'll stipulate that it was a pretty accurate description of contemporary treatment, then you'll see that treatment was pretty primitive compared to what we are used to today. No trauma centers, no paramedics, very little treatment in the field. You can see the episode at Hulu.com by clicking on the link.

As the saying goes, I told you that so I could tell you this.

Before there was EMS, or Emergency Medicine for that matter, there was, well not much. There were emergency departments, which were often little more than receiving stations for the "real" hospital. There were ambulances, but they did little more than provide for transport.

All of that started to change in the mid 1960s with the publication of "The White Paper: Accidental Death and Disability, The Neglected Disease of Modern Society" in 1966 lead to what is known today as EMS. As part of this process, hospitals in some parts of the country started to develop ways to get trauma patients into definitive care more quickly. That generally meant surgery since that's mostly what fixes trauma induced injury.

One of the places where this was going on was Baltimore Maryland, at what is now known as the University of Maryland Medical Center Shock - Trauma Center. R. Adams Cowley MD was the founder of Shock Trauma and is widely considered the father of advanced trauma care in this country. One of the problems that he encountered, and it's depicted pretty well in the Dragnet episode, is that too much time elapsed between the event causing the trauma and the beginning of treatment (surgery) in the hospital. Dr. Adams wanted to change the mindset of both pre hospital and in hospital personnel so that more patients would survive. Thus, was born the conceptual tool, a teaching tool really, known as "The Golden Hour". It was and is a good concept, but not a perfect one.

I've been told by a close friend who was there that one hour was picked more or less arbitrary. Mainly because "The Golden 53 Minutes and 27 Seconds" doesn't exactly roll off the tongue. Like many ideas, both good and bad, the concept was born over some beers and drawn out on a cocktail napkin. My friend is a bit of a pack rat and might even have the napkin, but I've never asked.

Remember, "The Golden Hour" as conceptual teaching tool. The point, which seems to be lost, is that the sooner the definitive treatment, the better. If you can get your patient to the operating room in five minutes, that's good. Forty Five is OK, but not as good as five. The idea is to discourage people in the field and in the ED from performing unnecessary procedures or tests.

Sadly, that seems to be lost on a lot of people. There have been a lot of blog posts, or maybe it just seems that way, lately excoriating "The Golden Hour" as a useless concept. I think that's wrong because the concept is useful as a reminder that time is not on the side of seriously injured patients. I think it's also a good tool because it's resulted in more patients being brought directly to designated trauma centers instead of less capable hospitals from which they will have to be transferred. That process adds hours to the time line and often trauma patients don't have hours.

There certainly is a downside to this concept. It has lead to the over use of medical helicopters for patients that don't need definitive care immediately. Ironically, Maryland seems to have a large part in that trend, but it's not alone.

Bryan Bledsoe, DO has written and spoke extensively and more eloquently than I ever could on the to topic. You can find his thoughts on Trauma Care, Helicopters, and a lot of other things at his web site. Which coincidentally is Bryan E. Bledsoe DO.

And so the debate rages over "The Golden Hour" with too many people losing sight of the basis for it's development.

Which is, that for trauma patients often what is required is what Ambulance Driver refers to as "A Large Diesel Bolus". Don't take short cuts in performing life saving procedures, but be sure that you are doing them because the patient needs them, not because you can do them. Keep in mind that paramedics or EMTs are NOT going to save a trauma patient. What they should be doing is keeping the patient alive, and preferably in no worse condition, until they can get to definitive care. Which, as I stated at the beginning of this post, is surgery. Think about what's necessary to keep the patient alive. Airway? Check. Breathing or ventilation? Check. Control of life threatening hemorrhage? Check. EKG? Not so much. IV? Depends. Keep the patient warm? Check.

All of which all too many paramedics seem to forget all too often. Which once again, is why R. Adams Cowley et al., came up with the concept of "The Golden Hour". If it helps you feel better, think of it as "The Golden Indeterminate Time Period, But The Sooner The Better". Won't fit on a cocktail napkin, but it still gets the idea across.

Must Be A Coincidence

Kin: Slain prof was Mass. native, Sox fan

The anthropology professor who was stabbed to death in his upstate New York office was a Shrewsbury native and avid Red Sox [team stats] fan who had traveled the world trying to promote understanding between religions, his family said.

So, who would want to kill a professor that worked to promote understanding between different religions?

Police have charged graduate student Abdulsalam S. al-Zahrani, 46, a Saudi national, with second-degree murder in the death of Professor Richard T. Antoun, 77, who was killed in his Binghamton University office Thursday. No motive has been released.

Obviously a dispute over whether Bay or Holliday should be signed to play left field. /Sarcasm.

Antoun apparently had a meeting with al-Zahrani in his office when he was stabbed four times with a kitchen knife, the New York Daily News reported.

Unless al-Zahrani is a culinary arts student, carrying a kitchen knife to a meeting would seem to my non lawyer mind to be evidence of premeditation.

Of course it would be racist of me to think that religion played a big any part in this murder. Oh, sorry, alleged murder.

Is this an act of terrorism? Probably not by definition, but it might well have been done to send a message.

I'll stop now, before I say something I'll regret.

Because We Forget Too Soon

Inside the Arizona Memorial. Those who speak, do so in whispers.









The control Tower at NAS Ford Island. The Red and White Tower was added in 1942 to train Navy divers. Most of the buildings that were in use before the attack are still standing, but not open to the public. Some of them still show the damage from the attack.

Terrorism or Stupidity?

At least 101 dead, 140 injured in nightclub blast, Russian authorities say

My inclination is to be suspicious when I read a story like that. Russia certainly has it's share of terrorism, especially from the Chechen separatists, and bombing a nightclub would fit the MO, as the police say.

Explosives experts of the Federal Security Service examined the club building, the ministry said. The preliminary theory behind the blast in the city of Perm, 900 miles east of Moscow, was "unsanctioned use of pyrotechnical devices," the ministry said.

This makes is sound more like stupidity than an act of terrorism, but then again, it's not like the Russian government wouldn't lie to cover up an ugly incident.

If it is in fact an accident, it's eerily reminiscent of this tragic fire from 2003.

If He Were A Republican

He'd be forced to resign and it would be solid 24 hour a day coverage in the Lame Stream Media.

Senator Max Baucus (D) Montana.

Baucus Nominated Girlfriend for U.S. Attorney

We'll see what happens, but I'll be nothing. Interesting that the story was released on a Friday. Which is an old politician's trick with bad news because a lot of people don't follow the news on weekends and a bad news story has a good chance of dying by Monday.

CNN apparently hasn't got the memo yet, but even the New York Times in running a story in it's Saturday edition.

Wonder if people will still be talking about this on Monday?

Oh, That

Someone who wanted to email me told me (when we finally connected) that my email address isn't on the blog. Which was a surprise since I remember putting it in my profile. I went to look and sure enough it was there. Only, for some reason that no doubt makes sense to the people who run Blogger, there is a box on another page that has to be checked for that to appear on the profile page. Duh. In any case, that's corrected now, so if you feel an urgent need to contact me directly, and not via comments, it's there for you to see.

I'll try to reply to emails promptly, but with all the Viagra, Penis Enlargement, and get rich quick emails I get, it might take some time.

Oh, and putting Penis Enlargement in this post is probably going to increase my site visit count.