FAK question

Discussions of the best (or worst) equipment to have on hand for use in the event of an injury during an emergency.

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Rds4969
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FAK question

Post by Rds4969 » Thu Jun 11, 2015 6:15 pm

I've been watching this and several other forums and I've noticed a common issue with the FAK's some people are making. They are loaded with military style gear to the point of being extreme. example. 4 tourniquets, 10 chest seals, 4 decompression needles 20 kerlex. These are all fine items for a combat medic in a combat zone, however are certainly not needed in the area most of these kits are going to be working. Some logic on this. These skills are above what anyone can use out in the civilian world during normal times. If the situation is a PAW or WROL, even if these are used the post definitive care to take care of these people doesn't exist. So why that hang up with carrying all this advanced gear.

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Re: FAK question

Post by Halfapint » Thu Jun 11, 2015 6:54 pm

Rds4969 wrote:I've been watching this and several other forums and I've noticed a common issue with the FAK's some people are making. They are loaded with military style gear to the point of being extreme. example. 4 tourniquets, 10 chest seals, 4 decompression needles 20 kerlex. These are all fine items for a combat medic in a combat zone, however are certainly not needed in the area most of these kits are going to be working. Some logic on this. These skills are above what anyone can use out in the civilian world during normal times. If the situation is a PAW or WROL, even if these are used the post definitive care to take care of these people doesn't exist. So why that hang up with carrying all this advanced gear.
I don't think you've read what people on here carry, other forums perhaps. Personally in my EDC first aide kid I carry a single tourniquet and an izzy. I carry about 200 band-aides though. You might be mixing up peoples home firstaid kit. I know a few people who have what you say in a car kit or a home kit.
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Re: FAK question

Post by CrossCut » Fri Jun 12, 2015 7:29 am

Halfapint wrote:You might be mixing up peoples home firstaid kit. I know a few people who have what you say in a car kit or a home kit.
Or mixing up medical supplies that are stored outside of kits. Need to have the means to restock the kits as items get used too.

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Re: FAK question

Post by Rds4969 » Fri Jun 12, 2015 4:40 pm

Seen lots of kits on several boards with multiple different tourniquets and chest seals. Pick one kind and learn how to use that one with your eyes closed. Also to the ones with experience, you know that if a person needs a chest seal and/or a needle decompression their chances of survival in a wrol or paw is about 1%.

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Re: FAK question

Post by zXzGrifterzXz » Fri Jun 12, 2015 5:52 pm

Rds4969 wrote:Seen lots of kits on several boards with multiple different tourniquets and chest seals. Pick one kind and learn how to use that one with your eyes closed.
Yes, though I can't remember seeing many kits on here with multiple different tourniquets. Maybe multiples of the same one, we see that often. Honestly, one MCI like a multiple car motor vehicle crash could easily involve 4+ people. That is 16+ potential limbs with traumatic bleeding.

Chest seals maybe people on here have multiple kinds/makes but sometimes you acquire things and truth be told there isn't much to the average chest seal, if you are worried that you won't be able to figure it out or aren't able to understand that the sticky side goes on the patient over the hole in their chest than maybe you aren't the best provider for the job at hand.
Rds4969 wrote:Also to the ones with experience, you know that if a person needs a chest seal and/or a needle decompression their chances of survival in a wrol or paw is about 1%.
Yes, that is very true but I wouldn't be in EMS if I didn't try to save lives. What if I rolled up on scene of your grandparent's cardiac arrest event and told you I wasn't going to work their code because they were older and out of shape and the chances of survival was slim? I bet you would want me to do anything I could to save them, correct? Why would that be any different than trying to save a family member, loved one, or comrade in a PAW?? Some people try to talk tough about saving supplies but honestly whats the good of having a stock of medical equipment if you never want to use it because you "might need it later."

Also, keep in mind that some people on here have small first aid kits but many of us who posts pics and "show off"(for lack of a better term) our large kits have medical provider level certifications.
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Re: FAK question

Post by Rds4969 » Fri Jun 12, 2015 8:21 pm

You talk about 16 potential limbs in a mult-person car accident. But the truth is this. Tourniquets, chest seals and needles are rarely used. I just think most people don't understand where these items fit in. If someone rolled up on an accident and has a bag full of tourniquets and chest seals who is going to apply them. In a paw or wrol the problem isn't using the items. It's the post care. No hospitals.......at some point you have to sort out the ones you can save and ones you can't. On another forum one guy had a full compliment of cardiac meds. In the best of scenarios cardiac arrest survival rates are extremely low.. Even if you get a pulse there is no continuation of care. That person will die....period.

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Re: FAK question

Post by Rds4969 » Fri Jun 12, 2015 8:30 pm

Don't get me wrong. If you are trained to use these items, by all means carry them. If you are trained then you also know when and where to use them. But...on all the forums I've looked at. There is a group that thinks it's tactiCOOL to carry military grade equipment in bulk but have no clue as to when and where they are appropriate. These are probably the same people that think you need 20 different weapons and 10,000 rounds of ammo. PAW or WROL won't be massive running gun battles. Most people will be just trying to survive. I'm going to hide as much as possible

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Re: FAK question

Post by Murph » Fri Jun 12, 2015 8:39 pm

I don't get it, why are you miffed about people who are trying to be prepared for worse case scenarios?
Does your BOB at least have: water, basic tools, fire, food, first-aid kit, and shelter?
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Re: FAK question

Post by Rds4969 » Fri Jun 12, 2015 10:29 pm

Never said I was miffed. Just making an observation that on several forums there is a lot of time and money put into advanced practice items that can not be used, or in a paw won't have the system in place to continue care after their use. Just an my opinion

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Re: FAK question

Post by KGBrick » Fri Jun 12, 2015 11:05 pm

Okay, so you needed a rant - I get that. Now you've got that out of the way it is probably time to look around a bit and learn about this place. We're mostly not preparing for The End of the World As We Know It - they're preparing for life. Floods, earthquakes, hurricanes, tornados, working as an EMT, shooting on two-way ranges, living in the middle of nowhere, and so on. Being reasonably prepared for TEOTWAWKI comes along free with some of that.



P.S. Didn't we have a guy who ended up using his own tourniquet to save his own life after a ND at a shooting range a few years ago? Or am I thinking of somewhere else?

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Re: FAK question

Post by Rds4969 » Fri Jun 12, 2015 11:18 pm

And that is part of my point. Being prepared for everyday situations why would you need chest seals and needle decompression needles. I have no problem with trained people carrying one or two for total disaster, I'm just saying. Realize it is most likely a futile effort. Without continued care that person will die....period and I think some people have the misconception that once the procedure is done everything will be good. I posted this mostly as an educational posting. In normal times there is no need to carry them. In WROL or PAW. I'm glad that people are willing to give it the effort. Just expect the worse outcome.

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Re: FAK question

Post by zXzGrifterzXz » Sat Jun 13, 2015 9:05 am

Rds4969 wrote:You talk about 16 potential limbs in a mult-person car accident. But the truth is this. Tourniquets, chest seals and needles are rarely used. I just think most people don't understand where these items fit in.
Ok man, I was trying not to be that guy but who says they are rarely used? And is this statement based on your personal experience in the field/on scene? Cause both in Phoenix and in the Philadelphia metro area, stabbing and GSW rates are very high, which means chest seals are used often. And TQs are very commonly used for traumatic bleeds/amputations.
Rds4969 wrote:If someone rolled up on an accident and has a bag full of tourniquets and chest seals who is going to apply them.
I don't think a single person here is saying you should EVER carry an item to which you are not familiar with its use. Seriously read our mission statement, its pretty much the first rule of "Zombie Fight Club." And furthermore, I could teach my grandmom and my 6 year old cousin to use a CAT TQ in under a minute. "Put high on traumatically bleeding limb, twist until tight, note time of application, move on to next life threat."
Rds4969 wrote:In a paw or wrol the problem isn't using the items. It's the post care. No hospitals.......at some point you have to sort out the ones you can save and ones you can't.

In the best of scenarios cardiac arrest survival rates are extremely low.. Even if you get a pulse there is no continuation of care. That person will die....period.
Fair enough tough guy, but you say this like you read it out of a book or on a forum. You want to hand out DNRs?? You look that poor bleeding fuck in the eye, you see his fear and hold his hand while bubbles are coming out of his chest, while he struggles to breathe against the air/blood filling his plural space, and you tell him you don't think he has a chance so you aren't going to help him. Cause I've been there and I am not about to ever give up on a patient till I have no other choice. I don't care if I have to personally kick the grim reaper square in the balls, this patient is mine and I will work him till the gods say otherwise.
Rds4969 wrote:On another forum one guy had a full compliment of cardiac meds.
I don't think I have ever seen anyone on here carry meds they weren't familiar with or prescribed. I've seen a shitload of post about people asking if they should carry Rx meds but 99% of the time the response from the providers here is "Don't carry it if you aren't prescribed it or able to prescribe it to others."
Rds4969 wrote:And that is part of my point. Being prepared for everyday situations why would you need chest seals and needle decompression needles. I have no problem with trained people carrying one or two for total disaster, I'm just saying. Realize it is most likely a futile effort. Without continued care that person will die....period and I think some people have the misconception that once the procedure is done everything will be good............... In normal times there is no need to carry them. In WROL or PAW. I'm glad that people are willing to give it the effort. Just expect the worse outcome.
LMAO... WHAT? In "everyday situations" when EMS and definitive hospital care is a cell phone call and a short ambulance ride away, THAT IS THE BEST TIME TO BE ABLE TO APPLY LIFE SAVING FIELD/SCENE TREATMENTS. For those of us who are trained and able, we should always strive to find a way to carry a kit with us. I have a jump kit in each one of my vehicles. As providers we should always be prepared to help those around us to the best of our ability, otherwise what the hell are we doing in this field to begin with? Cause it sure isn't for the pay. :lol:

And yes, patients may die, we get that, it sucks, but none of us will ever like it, and we will always try to prevent it.
Rds4969 wrote:I posted this mostly as an educational posting.
To educate whom? Those of us on here carrying these items are trained, experienced, and literally medically certified to use them. I feel like you have good intentions with your posts but I believe your target audience isn't us. I really invite you to spend some more time looking around ZS and familiarizing yourself with our community, I think you will find we aren't like most prepared communities, most of us have "been there, done that, and have the tshirt."



P.S. - I had a lot of pre-workout this morning.

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Re: FAK question

Post by Rds4969 » Sat Jun 13, 2015 9:33 am

Maybe I came accross wrong. What I'm seeing in general is people putting items high on a lost that get a low frequency of use. Then when are used have to potential for being used by the wrong person or being used without post care facilities being available. I'll give you two scenarios, I'd like to see your answer.

1). Non PAW. 2 car accident you come accross at 3 am. Patient one is the driver of the first vehicle driving 50 mph t bones another. Patient has an open femur fracture with significant bleeding. Patient 2 is the driver of vehicle 2. Only complaint is short of breath and chest pain. You may ask more questions and I will answer.

2. This one is in a WROL. 2 patients, both with gun shot wounds. Patient one has a gsw to right lower lung. Blood coming from hole. He is complaining of being short of breath. Patient 2 has a gsw to upper left of center, almost midline with his nipple. He is also co sob. You have your aid bad you normally carry

What would you do and why

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Re: FAK question

Post by taipan821 » Sat Jun 13, 2015 7:02 pm

Rds4969 wrote:You talk about 16 potential limbs in a mult-person car accident. But the truth is this. Tourniquets, chest seals and needles are rarely used. I just think most people don't understand where these items fit in. If someone rolled up on an accident and has a bag full of tourniquets and chest seals who is going to apply them. In a paw or wrol the problem isn't using the items. It's the post care. No hospitals.......at some point you have to sort out the ones you can save and ones you can't. On another forum one guy had a full compliment of cardiac meds. In the best of scenarios cardiac arrest survival rates are extremely low.. Even if you get a pulse there is no continuation of care. That person will die....period.
I'll add my two (AUD) cents:
1. you are right about tourniquets, chest seals and decompression needles being rarely used. most times you'll need dressings and pads to manage small wounds as those trauma supplies need training, but, when the traumatic injury occurs (and it will) the specialised trauma supplies will make your life easier (have you tried making a flapper valve on a casualty using plastic and duct tape?)

2. the guy on another forum had a full complement of cardiac meds...so what? does that person have a pre-existing condition, or does cardiac issues run in the family. I carry aspirin and GTN for cardiac emergencies because of family and friends. I also have the equipment and training to administer said medications

3. as other forum members have mentioned, we aren't preparing for PAW, that just comes with whatever disaster we are prepping for. what disaster are you prepping for? with cyclones I might come across car crashes, collapsed buildings, live wires, the list goes on, so my first aid and trauma kits reflect that. tourniquets and chest seals my the dozen might be a mass shooting aid bag, we just don't know.

4. "the problem is post care" you are right there, in a PAW definite care will not exist unless you know a medical professional. let's look at that. When TC Yasi was threatening QLD, any hospital in the danger zone was evacuated and shut down. during Yasi a call came in to the ambulance operation centre, person was having a medical emergency, the ambulance did not go due to the weather, yet they survived until the hospital was reopened and the ambulance was dispatched because a doctor troubleshooted over the phone and, using medications the person had, managed the condition until the winds died down.

In a nutshell, use other kits as an example, but work out what you need in your kit to counter whatever medical issues your disaster will throw up. If your disaster involves loss of medical services, then focus on that, if your disaster will produce casualties, focus on that.
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Re: FAK question

Post by zXzGrifterzXz » Sat Jun 13, 2015 8:46 pm

Rds4969 wrote:Maybe I came accross wrong. What I'm seeing in general is people putting items high on a lost that get a low frequency of use.
Honestly, you wont see that around here much, though it is quite common on many other forums. but as I said before, ZS is very different than the average prepared forum.
Rds4969 wrote:Then when are used have to potential for being used by the wrong person or being used without post care facilities being available. I'll give you two scenarios, I'd like to see your answer.

1). Non PAW. 2 car accident you come accross at 3 am. Patient one is the driver of the first vehicle driving 50 mph t bones another. Patient has an open femur fracture with significant bleeding. Patient 2 is the driver of vehicle 2. Only complaint is short of breath and chest pain. You may ask more questions and I will answer.

I assume I am driving alone? Immediately pull over my vehicle and dial "911", Report 2 vehicle collision with significant mechanism of injury, unknown number of patients at the moment and relay number of patients when able. Retrieve my jump bag and mechanics-wear gloves from the rear of my vehicle, stuff the mechanics gloves in my back pocket just incase I need them. Pull out and put on a pair of nitrile gloves from my bag while cautiously approaching the closest vehicle giving a wide birth to the front and rear bumpers and noting any visual significant findings(deployed airbags, leaking fluids, etc...) to the 911 operator. For this scenario lets assume the closest vehicle contains the driver suffering from shortness of breath and chest pain. Approaching the vehicle I will call out to the patient telling him my first name and that I have called 911 but am an EMT and able to help him. Assuming he provides consent, I will perform a rapid trauma assessment given the severity of the mechanism of injury while asking the patient if he has a known heart condition. Unless I find any other life threats in my assessment I will ask the patient if he has an allergy to aspirin. If not, depending on my findings, I could suspect a cardiac event and if so I will provide him 4x81mg chewable aspirin PO to chew up and swallow. All of this will be reported to the 911 operator while I am performing it. Then instruct him to stay put but that I will be right back after I assess the patient in the second vehicle.

I will approach the second vehicle in the same manor as the first, also identifying myself while speaking to the patient(assuming they are conscious). Perform a rapid trauma assessment, upon discovering the life threat of the open femur fracture I will deploy a tourniquet high and tight on the affected leg. Noting the time to the 911 operator. I will deal with any other life threats found and then place a large bulky dressing on the open femur fracture.

By this point I would assume EMS would be on scene, I would turn over both patients to the EMS crews giving a verbal report and offer to help with anything they need.
Rds4969 wrote:2. This one is in a WROL. 2 patients, both with gun shot wounds. Patient one has a gsw to right lower lung. Blood coming from hole. He is complaining of being short of breath. Patient 2 has a gsw to upper left of center, almost midline with his nipple. He is also co sob. You have your aid bad you normally carry

What would you do and why
Glove up, Rapid trauma assessment of patient one, paying special attention to looking for exit wound. Seal all holes with occlusive dressings and deal with all life threats. Place in position of comfort.

Patient two gets similar treatment, keeping in mind also possible cardiac tamponade.

Pull vitals on both patients and reassess ever 5 minutes or as needed whichever comes first, Transport both as quickly as humanly possible to highest level definitive care available. Pray.
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Re: FAK question

Post by Rds4969 » Sat Jun 13, 2015 10:14 pm

zXzGrifterzXz,

I hate to tell you but even in the busiest EMS systems chest seals, needle decompression and tourniquets just aren't used that often. Even with most gsw there is little need for them as most bleeding can be controlled by conventional means and fewer more produce tension pneumos. (The term sucking chest wound is no longer used btw). And since you have been the most vocal on here just what is your level of training. I see it says EMT. I'm pretty sure you can not administer meds off duty. And when you said you would give the first patient aspirin. Why would you assume a trauma patient is having an mi. This first thing that should come to mind is trauma related not medical and you just have him an anti-clotting drug. Something you would most likely lose your cert for. Just because you have the training for a certain item doesn't mean you should use it.

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Re: FAK question

Post by zXzGrifterzXz » Sat Jun 13, 2015 10:36 pm

Rds4969 wrote:zXzGrifterzXz,

I hate to tell you but even in the busiest EMS systems chest seals, needle decompression and tourniquets just aren't used that often. Even with most gsw there is little need for them as most bleeding can be controlled by conventional means and fewer more produce tension pneumos. (The term sucking chest wound is no longer used btw). And since you have been the most vocal on here just what is your level of training. I see it says EMT. I'm pretty sure you can not administer meds off duty. And when you said you would give the first patient aspirin. Why would you assume a trauma patient is having an mi. This first thing that should come to mind is trauma related not medical and you just have him an anti-clotting drug. Something you would most likely lose your cert for. Just because you have the training for a certain item doesn't mean you should use it.
Do you know chickens can't swim?

I know I haven't sited any information to validate this or stated my level of knowledge/experience on the matter but as a random person asserting my opinions on the internet I am to be believed without question.

I'm done feeding the troll. Time for bed.
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Re: FAK question

Post by Rds4969 » Sat Jun 13, 2015 11:01 pm

I wouldn't call it feeding a troll. I would call it being accountable for the things you say. You have misstated facts and given false information to people on the board. Making several thousand posts does not make you an expert. Your level of training according to your signature is EMT which is the lowest level of the nationally recognized certs yet you represent yourself as an expert. You even gave a patient in the scenario I gave a potentially life threatening treatment. And when asked to cite your expertise you took your toys and went home. You should probably humble yourself and check your attitude.

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Re: FAK question

Post by weatherdude » Sat Jun 13, 2015 11:58 pm

Rds4969 wrote:I wouldn't call it feeding a troll. I would call it being accountable for the things you say. You have misstated facts and given false information to people on the board. Making several thousand posts does not make you an expert. Your level of training according to your signature is EMT which is the lowest level of the nationally recognized certs yet you represent yourself as an expert. You even gave a patient in the scenario I gave a potentially life threatening treatment. And when asked to cite your expertise you took your toys and went home. You should probably humble yourself and check your attitude.
I think it's time you leave. You came here and your first post was asshole like, and you just keep getting worse.
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Re: FAK question

Post by JohnE » Sun Jun 14, 2015 6:06 pm

The entire thread should leave...
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Re: FAK question

Post by JohnE » Sun Jun 14, 2015 8:33 pm

I can't help but laugh a bit at the clown who tries to insult another person by claiming they should "check themselves..."

Does the expression about the pot calling the kettle black mean anything to you?

One of the people in this disaster lists his credentials in every post, one of the others is a troll.

Guess which one is which?
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Re: FAK question

Post by airballrad » Mon Jun 15, 2015 10:07 am

Hello Rds4969, and welcome to ZS.

Cool gear taking priority over proper training is a common theme on "prepper" forums, no doubt, but ZS is usually a bit different. At very least, someone showing up with bags full of gear and no clue how to use it will be strongly advised to get some reasonable training, whether in First Aid, Firearms, or any other part of the forum.

I think your original question "So why that hang up with carrying all this advanced gear." has been answered, although perhaps the answers did not satisfy you. I would contest your contention that "These skills are above what anyone can use out in the civilian world during normal times.", as I have very basic first aid training administered by the FD where I work and they still covered application of a CAT (granted, these FFs are working for the Army).

You have had several responses in the thread imploring you to read more before you condemn this group (lumped in with the other forums you've browsed) to being obsessed with tacticool gear over education, and I would repeat that suggestion. I do think your concerns will be addressed if you take the time to do so. A new poster with an adversarial style is generally a good conversation starter, but seldom results in good conversations.

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Re: FAK question

Post by Stercutus » Mon Jun 15, 2015 1:28 pm

I carry a bunch of crap in my IFAK because I am just a dumb cop. If God forbid I have to respond to yet another mass shooting incident then it would be really nice to have some extra medical supplies. At the last mass shooting I responded to both a tourniquet and decompression needle were used to save a man's life. So yeah, I pack heavy cuz you never know. I don't have any heartbreak with anyone else who wants to pack heavy too because that is just less shit I have to carry if it turns out to be needed.

I also don't pick fights with people for having too many golf clubs or pairs of shoes in the trunk of their car. If they want to tote that stuff around then more power to them.

I am curious RDS4969 what your level of training and certifications are? If you are going to go around browbeating people you should at least do it from a position of authority.
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Re: FAK question

Post by Rds4969 » Mon Jun 15, 2015 10:03 pm

For the last 2 responses thank you for your posts. Since you say you are a police officer I actually encourage you to carry those items. Not only in a bag but in a patrol officer kit on your person. Most of the responses (except for one person) have been fairly legit. I probably should not have listed the tourniquet since it so common now. But yes. On several prepper type forums I have seen bags with multiple decompression needles and chest seals and wondered why? Since you asked about my qualifications to make my statements I'll throw them out there.
18 years as a firefighter/paramedic in one of the busiest Ems systems in the country (I have run over 20,000. 911 calls in my career so far)
Previous flight medic
Previous wild land firefighter on a helitak crew
Previous law enforcement ( yes post certified)
Military with one tour in Iraq
Current paramedic instructor at the local college
Bachelors in fire service administration
Associates in paramedicine
National registry exam proctor
I will say that it is not impressive with the one member I mentioned saying "I have been there, done that and have the t-shirt". Or "I'll kick the grim reaper in the balls". If you really want to continue in the fire or Ems service I would change the attitude. You have only had your EMT (basic) for a year and are trying to be a fire fighter. So you have not been there and done that. Come down off your high horse. The rest that posted actual responses..thank you

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