MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'emt'. Sat, 03 Sep 2011 02:11:53 +0100 http://www.medworm.com/index.php?rid=4742427&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2011%2F04%2F21%2Fthing-to-know-before-your-next-obstetrical-call%2F There’s something about the patient in labor that makes my palms sweat. I’m not alone. Most of us EMS folks get a little anxious at the idea of delivering a baby. Obstetrical calls can go very right and they can go very wrong. The stakes are high. Here are a few things to consider before you run your next obstetrical call. 1) At full term, pregnant females have a heart rate 10-15 beats per minute faster than when they were prepartum. (Psst…Before they were pregnant.) They also have 25%-30% higher stroke volume and 30%-50% higher cardiac output. 2) Pregnant females will tolerate significant blood loss before they become symptomatic. Once they are symptomatic, they will decompensate rapidly. 3) The official obstetrical term for the mother’s water breaking is “r... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=4742427 Thu, 21 Apr 2011 19:06:19 +0100 4742427 http://www.medworm.com/index.php?rid=4424237&cid=t_151895_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffire-department-app-theres-a-hero-in-all-of-us%2F2011.02.01 Just admit it: Deep in your heart you’ve always wanted to be an emergency medical technician, if at least for a few moments. If you’re located in San Ramon Valley, California, you can now live that dream: The local fire department has released an iPhone app that will alert you of any emergency activity in the area. The well thought-out application will send out a push notification to users who have indicated that they are proficient in CPR whenever there is a cardiac emergency nearby. In addition, the closest public-access automated external defibrillator (AED) is located by the app. Current response status of dispatched units are shown and incident locations are pinpointed on an interactive map. There’s even a log of recent incidents including a photo gallery. For the ol... Better Health blogs http://www.medworm.com/rss/comments.php?id=4424237 Tue, 01 Feb 2011 14:00:12 +0100 4424237 http://www.medworm.com/index.php?rid=4355744&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2011%2F01%2F16%2Fyou-bet-your-life%2F What would you bet your life on? In 1996 I took a job about 40 minutes south of San Jose, California with a small mom-and-pop ambulance company. The service was named after the owner and had been serving a mostly rural area of northern California for a couple of decades before I arrived in town. They were, without a doubt, the worst ambulance company I ever served under. The owner ran the place like a dictator. I started work the day after my interview on a dirty ambulance wearing an old uniform that was two sizes too large. My partner was the grumpy silent type. The station conditions were deplorable and the policies and procedures were down-right unethical. (As an example, the owner would frequently order crews to respond to scenes, after they had been canceled enroute, so that they coul... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=4355744 Sun, 16 Jan 2011 18:05:51 +0100 4355744 http://www.medworm.com/index.php?rid=4151824&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F11%2F09%2Fready-for-duty%2F Conclusion I give the Magnum Elite Force 8.0 an enthusiastic recommendation. I think you’ll be really happy with this boot. With a retail price of $160.00, Magnum’s Elite force line comes in at the upper mid-range of the market and I believe that they are a value for what they offer. Most folks who’ve worked in EMS for a few years will tell you that it isn’t worth it to skimp on boots. With this boot, you’re going to like what you get. I know I’ll keep wearing mine for years to come. Now it’s your turn: Do you wear Magnum boots? What do you think? What makes a great EMS boot? Read More Stuff: Are All Aspirin Created Equal? Glucometer Errors Just Call 911 – A Novel Idea Chest Pain: Is EMS Really Best? Understanding OPQRST (Source: The EMT Spot) The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=4151824 Tue, 09 Nov 2010 20:49:11 +0100 4151824 http://www.medworm.com/index.php?rid=4077283&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F10%2F17%2Fthe-protocol-skill-breakthrough%2F Once you understand the protocol / skill connection you might come to see a host of problems with the way we develop, use and teach our protocols. I’d like to tell you about two biggies. As we explained in the protocol / skill connection, we are dependent on our protocols to different degrees at different levels of skill development. This is defined by the Dreyfus model of skill acquisition. Misunderstanding this concept leads to some predictable problems. The problem with our protocols is that they were written with the expectation that everyone would use them the same way. The problem with our field education is that proficient and expert field providers teach novice and advanced beginner students. These two groups think differently about their protocols. Let’s look at both o... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=4077283 Sun, 17 Oct 2010 19:35:00 +0100 4077283 http://www.medworm.com/index.php?rid=4077284&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F10%2F15%2Fskill-acquisition-and-protocols%2F Part one of a two part series. (Part two is here.) If you’ve ever grown plants in pots you know that selecting the right size pot for the plant is essential. Put a plant in a pot that’s too large for it and the new life will struggle to find water and nutrients. Place the same plant in a pot that’s too small and it will struggle to find space to grow. Such is the nature of growing things. It works the same way with you and your skills and your protocols. Your relationship with your protocols is going to change as your knowledge and skill grow. It’s going to happen. This isn’t my opinion. It’s called the Dreyfus model of skill acquisition. And when you understand how it relates to you and your medical skills, you’re bound to have one of those ah-... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=4077284 Fri, 15 Oct 2010 17:18:05 +0100 4077284 http://www.medworm.com/index.php?rid=4074108&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F10%2F15%2Fskill-acquisition-and-protocols%2F If you’ve ever grown plants in pots you know that selecting the right size pot for the plant is essential. Put a plant in a pot that’s too large for it and the new life will struggle to find water and nutrients. Place the same plant in a pot that’s too small and it will struggle to find space to grow. Such is the nature of growing things. It works the same way with you and your skills and your protocols. Your relationship with your protocols is going to change as your knowledge and skill grow. It’s going to happen. This isn’t my opinion. It’s called the Dreyfus model of skill acquisition. And when you understand how it relates to you and your medical skills, you’re bound to have one of those ah-ha moments. Here’s how it works. Stuart and ... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=4074108 Fri, 15 Oct 2010 17:18:05 +0100 4074108 http://www.medworm.com/index.php?rid=3972928&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F09%2F15%2Fcoping-with-victims-emotions%2F Today we have a guest post from Sally Davison. Sally is one of the masterminds behind the website FireScienceDegree.com. If you’re looking for a degree in fire science, Sally’s site offers what just may be the most comprehensive, no nonsense resources on the inter-web. Sally also knows her way around the EMT field and has some advice for new EMT’s preparing themselves for the prehospital environment. She welcomes your comments at sally.davison091@gmail.com  Please give her a warm welcome. There’s much more to being an EMT than just providing emergency medical care alone; in most situations, you are much more important than doctors and specialists because your timely response and actions help: Save lives Save limbs and prevent lifelong and debilitating disabilities Pre... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3972928 Wed, 15 Sep 2010 12:00:29 +0100 3972928 http://www.medworm.com/index.php?rid=3902920&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F08%2F25%2Ftoo-much-information%2F It’s the week before the final exam and my EMT class is feeling the pressure. The two-hundred question final looms large on the horizon and, in less than a week, the students will need to perform five randomly selected skills stations perfectly. This is the task that has most of the students really feeling the heat. So we do what we do every class. We practice and practice and practice. So there we were, gathered around in groups, practicing our National Registry skills sheets. That’s when Joey asked me the question that absolutely floored me. It floored me and annoyed me, but really didn’t surprise me. I’ve heard the question asked before in many different ways. Joey finished up his medical scenario and I was giving him some feedback on his performance. He looked d... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3902920 Wed, 25 Aug 2010 16:09:17 +0100 3902920 http://www.medworm.com/index.php?rid=3868760&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F08%2F15%2Fpatients-define-their-emergencies-part-2%2F True Story… The dispatch information was updated before we had even rolled our rig out onto the pad. Eye injury, no serious symptoms. Jodie shut down the lights and I informed dispatch that we’d be responding non-emergent. Up stairs and inside the small two bedroom apartment, Samantha, our patient, was waiting on the couch, holding a hot compress to her swollen right eyelid. Mom worked calmly in the kitchen finishing diner for her other two children. Alan, Samantha’s father sat on the edge of his seat next to his daughter in a state of barely containable anxiety. He had recently arrived home from work and his wife had informed him of the apparent infection in Samantha’s right eye. One look and he was on the phone to us. Now he breathed rapidly as he fumbled throug... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3868760 Sun, 15 Aug 2010 22:10:06 +0100 3868760 http://www.medworm.com/index.php?rid=3868738&cid=t_151895_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fan-emergency-medicine-myth%2F2010.08.15 I’ve internalized all the dogma of medicine, for good and bad. When I was an EMT, green as a twig in an ER, I learned the basics: For any wound with hair employ the razor, and get the hair away from the laceration so the doc could do a good closure. So, employment week #3: Eyebrow laceration? Shaved that sucker clean off. ER doc freaked out, and I learned some medical dogma: Don’t shave eyebrows, they don’t grow back. Heard it later, too — all the way through training, in fact. (more…) *This blog post was originally published at GruntDoc* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3868738 Sun, 15 Aug 2010 12:00:29 +0100 3868738 http://www.medworm.com/index.php?rid=3802415&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F07%2F29%2Ffire-based-ems-vs-private-ems%2F “In Germany they first came for the communists, and I didn’t speak up because I wasn’t a communist. Then they came for the Jews, and I didn’t speak up because I wasn’t a Jew. Then they came for the trade unionists, and I didn’t speak up because I wasn’t a trade unionist. Then they came for the Catholics, and I didn’t speak up because I was a Protestant. Then they came for me – and by that time no one was left to speak up.” - Rev. Martin Niemoller Yesterday an Action Care ambulance covered my station while I was at a training. Action Care is the local private ambulance service. I know, the name always seemed a little silly to me. If a super hero ever created an ambulance service, he would most certainly call it Action Care. I jo... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3802415 Thu, 29 Jul 2010 13:40:17 +0100 3802415 http://www.medworm.com/index.php?rid=3790728&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F07%2F26%2Fbehind-every-great-emt%2F Call it a curiosity. I wanted to know how the EMT Spot readers would finish the sentence, “Behind every great EMT…” So I asked. I asked on twitter. I asked on Facebook. I even asked right here at the blog. And the answers poured in. Your responses represented the full spectrum of personalities that inhabit our workplace. Their were poignant responses, cynical responses and a bunch of funny ones. The responses made me smile and frown and think. Within this list of answers you’ll find feedback from 30+ year EMS veterans and newbies just getting their EMS feet wet. Everyone is represented. And the responses are telling. I’m rather proud of how this little experiment turned out. I hope you find these responses as enjoyable and thought provoking as I did. Thanks fo... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3790728 Mon, 26 Jul 2010 19:35:38 +0100 3790728 http://www.medworm.com/index.php?rid=3743537&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F07%2F11%2F8-tragic-ems-behavior-flaws-to-avoid%2F In Greek tragedies, the hero typically displays some form of hamarita, also known as a “tragic flaw.” Hamlet was brooding, Othello was jealous, Macbeth was ambitious. For the most part, it is their tragic flaw that is usually the key to their undoing. When the hero ultimately falls, they tend to sow the seeds of their own demise with their respective tragic flaws. People often use the word hero when they refer to EMS caregivers. EMT’s, paramedics, firefighters, we all get the hero moniker pinned on us from time to time. I cringe at the term. Most of us are uncomfortable with it to different degrees. And, if there is any truth to our hero title, it is certainly closer to the heroes of Greek tragedy that the comic book heroes we grew up with. In other words, we all have our... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3743537 Sun, 11 Jul 2010 14:39:22 +0100 3743537 http://www.medworm.com/index.php?rid=3671734&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F06%2F17%2Fmidnight%2F Our department recently offered an early retirement buy-out option.  I understand a half-dozen or so people took it. So next month, 6 or so of my colleagues will run their last call and close the door on their career. Six people will write the final chapter and be done. It makes me wonder. I wonder what that’s like, to hear the tones go off and say, “Yup, this is probably it, the last call of my career.” What will people say about your EMS career when you’re all done? For many of the readers here at the spot, retirement is a long way away. It’s hard to imagine what is will one day be like to not be in EMS anymore. Yet, it’s worth considering, because you never really know when your last call will be. Consider Elizabeth Ann Mitchell. Elizabeth was 24 ye... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3671734 Thu, 17 Jun 2010 14:24:15 +0100 3671734 http://www.medworm.com/index.php?rid=3658956&cid=t_151895_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmourning-the-death-of-strangers%2F2010.06.13 I was about to leave work a few nights ago when EMS was dispatched to a 10-50, which is a motor vehicle accident. Enough years in emergency care and that tone makes your radar, but doesn’t create much of a blip. Many of those crashes have EMS arrive, only to discover no injuries. Some have patients transported, with minor problems that lead to their speedy evaluation and discharge from our ER. A few have serious, life-threatening injuries. They take all our speed, skill and attention to save life and limb. And often, require transfer to other facilities. But this last call was none of those. Around 1AM the radio traffic crackled back to dispatch (which we could hear in the emergency department): “Probable Signal Nine.” Signal Nine means the victim is dead at the sc... Better Health blogs http://www.medworm.com/rss/comments.php?id=3658956 Sun, 13 Jun 2010 16:00:16 +0100 3658956 http://www.medworm.com/index.php?rid=3655614&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F06%2F11%2Fwhere-do-you-put-the-fear%2F I once thought that part of the goal of being a competent paramedic was getting to the point where I no longer felt any fear or anxiety about running calls. After all, most of the folks I worked with appeared to be absolutely fearless. At least the competent ones did. They never go flustered or rushed. They smiled. They remained calm in the face of very real emergencies. I needed to be like that. Eventually I figured out how to act like they acted, but I never really mastered the whole not-feeling-any-fear thing. It nagged at me for a long time. It took me almost a decade to figure out the secret. Everyone feels the fear. Yes, everyone. Everyone carries around their own special brand of fear. Fear of failure, fear of being in the spotlight, fear of public embarrassment, fear of not having... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3655614 Fri, 11 Jun 2010 16:10:51 +0100 3655614 http://www.medworm.com/index.php?rid=3610295&cid=t_151895_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F05%2Femts-faked-training%2F Authorities in Massachusetts and New Hampshire are investigating up to 200 emergency medical technicians who faked training certificates that allowed them to practice. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=3610295 Sat, 29 May 2010 07:27:15 +0100 3610295 http://www.medworm.com/index.php?rid=3595612&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F05%2F25%2Fthe-ultimate-emt-guide-to-vital-signs-2%2F Part 2: The Blood Pressure I love teaching each new EMT class cycle how to take a blood pressure. It’s fairly simple and strait-forward, but there’s also a real art to it. Folks who are good at it wield their blood pressure cuff like a teppanyaki chef wields his knife. You can tell they’re good by watching the confidence in their movements, the order that they perform the steps, and the attention they give to the details. There’s a big difference between the guy who chops vegetables down at the local Denny’s and the chef at the Benihana. Same tools, different level of skill. You see what I mean right? If your blood pressure skills are still somewhere in between the short order cook and the teppanyaki chef, here are some tips to getting better. 1) The blood p... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3595612 Tue, 25 May 2010 14:01:10 +0100 3595612 http://www.medworm.com/index.php?rid=3556121&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F05%2F11%2Fhow-being-burnt-out-can-ignite-a-rebirth%2F A Guest Post By Jim Hoffman “The EMS Professional,” “The Paramedic Mentor,” Today’s guest author, Jim Hoffman has more nicknames than a retiring prizefighter and he’s earned every one of them. From the streets of The Big Apple to New Jersey and now the secluded mountains of upstate New York, Jim has been a paramedic for the better part of two decades. In his down time, Jim runs EMS-Safety.com, a one stop shop for low cost EMS training resources. He’s also part of the team behind The EMS Boot Camp series. After a little cajoling I talked Jim into letting me post his Handover contribution as a guest post. So this is me, stealing all of Jim’s literary  goodness for you. (Thank me later.) And now Jim: As an EMT in a large EMS system I found myse... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3556121 Tue, 11 May 2010 12:00:47 +0100 3556121 http://www.medworm.com/index.php?rid=3552272&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F05%2F11%2Fhow-being-burnt-out-can-ignite-a-rebirth%2F A Guest Post By Jim Hoffman “The EMS Professional,” “The Paramedic Mentor,” Today’s guest author, Jim Hoffman has more nicknames than a retiring prizefighter and he’s earned every one of them. From the streets of The Big Apple to New Jersey and now the secluded mountains of upstate New York, Jim has been a paramedic for the better part of two decades. In his down time, Jim runs EMS-Safety.com, a one stop shop for low cost EMS training resources. He’s also part of the team behind The EMS Boot Camp series. After a little cajoling I talked Jim into letting me post his Handover contribution as a guest post. So this is me, stealing all of Jim’s literary  goodness for you. (Thank me later.) And now Jim: As an EMT in a large EMS system I found myse... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3552272 Tue, 11 May 2010 12:00:47 +0100 3552272 http://www.medworm.com/index.php?rid=3471808&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F04%2F14%2Fthe-emt-liability-pop-quiz%2F There really is a dizzying array of stuff we can do to get ourselves in legal hot water in EMS. I was considering a few this afternoon and I got this idea. Let’s play a game. I’ll give you a whole list of scenarios and you match the legal transgression to the act. OK, that was a really boring and overly technical way to describe my game. I’ll say what they did; you tell me what they did wrong. Sound like fun? I agree. Let’s begin. Here are all the possible answers: Sounds OK to me Negligence Battery Abandonment Assault Jot your answers down on a scrap of paper. I’ll be back on Thursday with my answers and the rationale behind them. 1 ) An ambulance crew arrives on scene of a heart attack patient and discovers that their oxygen tank is empty. The patient end... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3471808 Thu, 15 Apr 2010 04:46:14 +0100 3471808 http://www.medworm.com/index.php?rid=3435058&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F04%2F03%2Fthe-c-spine-helmet-issue%2F The good news in the world of head trauma and brain injury is that we’re seeing a lot more folks putting on helmets before they go out and do potentially dangerous, head crushing stuff. The good/bad news is that we’re encountering more patients who are wearing helmets and need to be placed in full spinal immobilization. This brings up a controversial decision. Should we remove the helmet or leave it in place? The leave it or remove it controversy has been around for as long as I’ve been in EMS and, like most controversies that remain unresolved for years, there are merits to both options. In these instances, it’s easy to create blanket rules and then follow them mindlessly. “Always leave the helmet in place, unless it obstructs the airway.” “Alway... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3435058 Sat, 03 Apr 2010 12:00:23 +0100 3435058 http://www.medworm.com/index.php?rid=3420504&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F03%2F30%2Fits-not-my-emergency%2F Part one of a two part series on scene presence. A regular reader of The EMT Spot asked a great question recently. (Thanks Timothy.) “How do I keep my cool and not loose my head in stressful situations?” I want to give you a tip that has worked well for me in the past. It’s a phrase I learned as an EMT and it’s helped me on countless occasions. “It’s not my emergency.” I know. I know what you’re thinking. On the surface, “It’s not my emergency.” sounds like a very callous and uncaring thing to say. But give me a chance to explain. I was taught the phrase, “It’s not my emergency.” by a talented young paramedic who was a mentor in my early years in EMS. Since I first learned it, I’ve heard it used in a ... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3420504 Tue, 30 Mar 2010 12:00:29 +0100 3420504 http://www.medworm.com/index.php?rid=3311701&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F02%2F25%2Fresponding-to-hypothermia%2F Part 2 of a 2 part series. (Part one is here.) In our last post we looked at some of the causes of hypothermia, both typical and atypical. Then we talked a bit about the recognition of the hypothermia progression and what patients might look, feel and act like as they progress through their hypothermic condition. Now let’s look at some of the guidelines for treating our hypothermia victims. On the surface, treating hypothermia might seem deceptively simple. The treatment of mild hypothermia often is simple. Bring them in, stop the cooling and rewarm them. But as we progress into moderate and severe hypothermia, things get more complicated. Here are 12 guidelines to consider when the patient is more than just a little chilled. Stay warm. As much as it pains me to make a statement t... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3311701 Thu, 25 Feb 2010 19:53:46 +0100 3311701 http://www.medworm.com/index.php?rid=3254470&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F02%2F08%2Fmastering-the-head-to-toe-assessment%2F You probably practiced your head-to-toe assessment a bunch in your EMT class. Maybe more than any other skill in the EMT curriculum. If your class was or is anything like mine (as a student or a teacher) you performed the head-to-toe assessment again and again. As much as we practice this skill in EMT class, I often wonder why so many EMT’s have such bad head-to-toe skills out on the street. It seems that, once we get out on the street, the systematic, thorough head-to-toe assessment falls out of favor and quickly gets replaced with the faster, more direct focused assessment. That works just fine most of the time. If it didn’t, I figure it probably wouldn’t be such a universal phenomenon. (For the record, have you ever worked somewhere where this wasn’t the case? ... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3254470 Mon, 08 Feb 2010 21:46:07 +0100 3254470 http://www.medworm.com/index.php?rid=3216608&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F01%2F28%2Fmedicine-between-the-frames%2F One of my favorite bloggers, Seth Godin, recently introduced me to the work of Scott McCloud, an author who’s written several classic books on understanding comic books. Scott dissects the comic medium and explains the ongoing allure of the comic book to the uninitiated. One of Scott’s observations is that comic books require imagination on the part of the reader because, in all great comic books, the action occurs between the frames. The artist only shows you snapshots of action and dialogue. Most of the story takes place in our heads. The real story is the stuff that we invent that happened in-between the frames. Medicine works in much the same way. We assess, we ask our questions, we do our head-to-toe and we make a guess (educated) about what’s going on. Then we ... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3216608 Thu, 28 Jan 2010 12:00:35 +0100 3216608 http://www.medworm.com/index.php?rid=3171922&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F01%2F14%2Fthe-e-book-is-coming%2F OK, I can’t keep this to myself any longer. It’s time for the big announcement. With the final draft still in the mail from my editorial team and the final design still lacking a few details, it would probably be best to just keep this under wraps for a few more weeks, but I can’t wait. My first E-book is scheduled for release on January 21st, one week from today. The e-book will be free and it will be available right here at The Spot. The Book is called The Non-Conformists Guide to EMS Success. This book is the culmination of two decades of EMS experiences, mistakes, failures, trials, and errors that lead to my ultimate success. My goal was to write something that would be useful to EMTs at any stage in their career. And I didn’t hold anything back. This is my r... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3171922 Thu, 14 Jan 2010 12:00:39 +0100 3171922 http://www.medworm.com/index.php?rid=3163803&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F01%2F12%2Fcpr-right-now%2F I helped teach CPR to our latest EMT class this past week. This class is always a good reminder of how fast emergency medicine changes. Here in their first week, the new students are beginning to hear our warnings. “You are going to hear about many different ways to perform this skill. Some are older methods than the ones we are teaching you today. Some are newer. Some things you are learning will quickly go away. New methods, new machines and new research are all in progress. That doesn’t mean what you are learning right now is wrong. It is an imperfect method. Prepare for change.” Some students get stressed over the idea that CPR isn’t a gold standard technique handed down unchanged for decades. I worry for their future. Like the banner says, “Medicine mov... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3163803 Tue, 12 Jan 2010 16:32:22 +0100 3163803 http://www.medworm.com/index.php?rid=3163802&cid=t_151895_101_f&fid=38966&url=http%3A%2F%2Fdtsemt.wordpress.com%2F2010%2F01%2F11%2Fcall-statistics-for-2009%2F So, here we are – call volume for 2009 (DTs and his merry crew only, not corporate- or station-wide.)  Note that we work about 2 days a week – 104 days a year.  817 calls therefore represents an average call volume of 7.85 calls/shift. The actual distribution is as follows: Call Volume Distribution Calls per Day Occurrences 1 24 2 42 3 21 4 12 5 18 6 23 7 16 8 12 9 11 10 4 11 1 12 1 Call Volume Total times toned out 817 ALS 432 BLS 341 CCT 9 NICU 23 PICU 12 Placed In Service 65 Lights and Sirens per MD 29 The demographics also includes information for patients who refused transport, or for patients where the information is known but we were placed in service. Demographics Male 390 Female 425 Average Age 53.29 yea... DTsEMT blogs http://www.medworm.com/rss/comments.php?id=3163802 Mon, 11 Jan 2010 19:35:42 +0100 3163802 http://www.medworm.com/index.php?rid=3126633&cid=t_151895_105_f&fid=36987&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FIvorKovicMd%2F%7E3%2FMcez8peU6jI%2F I discovered Informed Pocket Guides almost two years ago and have been a huge fan ever since. The first product I got was the Emergency & Critical Care Pocket Guide. I believe the fact that I take extra care this little/big guide is always in my bag when I go to work, says it all. It is small, light and compact, yet it has all the necessary reference information you might need in medical emergencies. It is especially useful if you work in the field. Emergency & Critical Care Pocket Guide has almost 200 pages and covers the following topics: Current ACLS Algorithms, Lab Values, Metrics, Notes Emergency, ACLS Drugs & Top Prescription Drugs IV Drips, Drug Infusions, Dosages Poisons & Overdose / ‘Rave’ Drug 12-Lead ECG Section & Acute MI Medical Emergenci... Ivor Kovic, M.D. blogs http://www.medworm.com/rss/comments.php?id=3126633 Tue, 29 Dec 2009 02:01:37 +0100 3126633 http://www.medworm.com/index.php?rid=3120438&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F12%2F22%2Fhard-questions-about-emt-life%2F                             …. Answered I asked for the questions and I got them, in spades. I put the challenge out there; What’s the hardest question you’re willing to ask about the life and job of an EMT? As usual, I started out with high expectations and then was blown away by the awesome response. In fact I got so many great questions I needed to divide this post into two parts. So here are my answers to some tough reader questions about the life and work of an EMT. Thanks for asking them. I’ll post the second installment next time. 1. How do you deal with smells, blood, guts, disfigurement and dead bodies?@BrownCoatEMT via Twitter I’ve never been real great with smells. I’ve come close to puking but never full-on hurle... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3120438 Tue, 22 Dec 2009 12:00:05 +0100 3120438 http://www.medworm.com/index.php?rid=3105039&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F12%2F19%2Fthe-art-of-the-pulse-check%2F    Fast or Slow, Strong or Weak, Regular or Irregular I’d like to teach you how to take a pulse in three seconds or less. Yes it’s possible. I am, quite possibly, about to contradict everything you learned about taking a patients pulse in your EMT class. Hear me out on this one. In general, I think we overemphasize the importance of coming up with a set of numbers that represent the patients vital signs and we underemphasized the importance of placing the patients vitals in context for their condition. The pulse is a prime example of this dynamic at work. The patients pulse holds a wealth of clinically significant information. The exact heart rate isn’t one of them. Sometimes, we get this misconception lodged in our brain that the purpose of feeling the patients pul... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3105039 Sat, 19 Dec 2009 12:00:55 +0100 3105039 http://www.medworm.com/index.php?rid=3096878&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F12%2F17%2Fregarding-the-duty-to-act%2F A while back, when I wrote about the duty to act, I emphasized the idea that the duty to act only extends to “on-duty” medical personnel. In fact, my exact words were, “If you are a trained medical professional and you are acting with an expectation of compensation you have a duty to act appropriately and within the scope of your training when called to assist with an emergency situation.” I figured I should emphasize the idea that trained EMTs don’t have a duty to act when they aren’t being compensated for their services. This seemed to be the point of greatest confusion. I never thought much about making it clear that while you are on duty, working as an EMT, you are required to act. I know … it seems painfully obvious. I thought so too. But over... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3096878 Thu, 17 Dec 2009 12:00:17 +0100 3096878 http://www.medworm.com/index.php?rid=3089309&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F12%2F15%2Freasons-why-you-should-be-a-better-emt%2F Sure, this site isall about being a better EMT, but perhaps you’ve asked yourself, “Why?” OK, granted, it was probably one of your more cynical moments. Perhaps you had a bad day, a couple of frusrating calls or a less than optimal interaction with a patient, your partner, another agency, your boss … or perhaps all of the above. Then you went out and threw down your stethoscope. Or maybe you didn’t throw it down because you remembered it was a Litman and a gift from your aunt, but you raised it over your head and thought about it. And while that stethoscope dangled over your head in your clenched fist you thought, “Why? Why do I work so hard to try to be better at a job that pays so little and offers so little in return?” “Why?” We&#821... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3089309 Tue, 15 Dec 2009 13:02:52 +0100 3089309 http://www.medworm.com/index.php?rid=3084800&cid=t_151895_101_f&fid=38966&url=http%3A%2F%2Fdtsemt.wordpress.com%2F2009%2F12%2F13%2Fpoint-and-cluck%2F The pager buzzed, and we were off to pick up a pre-adolescent “vomiting blood”. As usual, DTs and his rising-medic preceptee were bouncing ideas back and forth. “Okay, gimme some reasons why a kid would be vomiting blood.” “Ingestion of something?” “Yep – could be. In which case we have to definitively ID the substance and contact poison control, right? What else?” “Maybe the blood’s from someplace else?” “Very possible – say from a posterior nosebleed, gets swallowed, irritates the stomach and gets chucked back up. History of nosebleeds, maybe something got jammed up in there depending on the kid’s age, or perhaps chemically irritated. Next?” “Maybe the kid’s just been vomiting for ... DTsEMT blogs http://www.medworm.com/rss/comments.php?id=3084800 Sun, 13 Dec 2009 17:04:20 +0100 3084800 http://www.medworm.com/index.php?rid=3071183&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F12%2F08%2Fthe-art-of-the-nasopharyngeal-airway%2F I would surely rank the nasopharyngeal airway (NPA) as one of the most under-rated / under-utilized pieces of equipment in the EMT bag of tricks. They’re useful, simple and versatile. As a group, we tend to do a pretty good job oxygenating our patients, but I think we drop the ball on BLS airway adjuncts. Most of our unresponsive or semi-responsive patients should be arriving at the ER with an NPA in place. If you’re bagging a patient they should have one … maybe two NPAs in place. They’re fast, they’re friendly, they work much better on the semi-conscious and they don’t stimulate the gag reflex quite like their cousin the oropharyngeal airway. They also stay in place better, leaving the mouth open for examination and advanced airway techniques. I... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3071183 Tue, 08 Dec 2009 16:44:57 +0100 3071183 http://www.medworm.com/index.php?rid=3044768&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F12%2F01%2Fwhat-is-ketosis-anyway%2F The carb craze may be responsible for thrusting the term ketosis into the mainstream vernacular. Before that, it was a word you rarely heard outside of medicine. Before Dr. Atikins and the low carb evangelists came along, you could relegate ketosis to a power point slide in an occasional diabetes lecture and be done with it. Now it seems like ketosis is the in-word with soccer moms and zone dieters alike. And, while its conceptual popularity has grown, there’s still a lot of misunderstanding floating around about what ketosis is and what it means for your body. Much like belly button lint and the popularity of boy-bands, the ketosis phenomenon is well known yet somewhat mysterious and difficult to explain. So let’s review. If you don’t have time for the long answer... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3044768 Tue, 01 Dec 2009 17:46:36 +0100 3044768 http://www.medworm.com/index.php?rid=2999547&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F11%2F17%2Ftest-for-unconsciousness-the-sternal-rub%2F Ahhh the embattled sternal rub. Revered, reviled … the sternal rub is the Ann Coulter of medical interventions. Abrasive, annoying, loved by many, hated by many more. The subject of the usefulness of the sternal rub is bound to cause controversy in any EMS forum. In other words … it’s a great subject for The Spot. Like many controversial assessments and treatments, the sternal rub (sometimes referred to as the sternum rub) got its bad-boy reputation more from its misuse than from its own shortcomings. Never-the-less, the technique does have its shortcomings. Like so many other tools, it has its place when used appropriately and it has its potential for misuse. So let’s make sure you understand its uses and limitations. If you’ve never encountered this techni... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2999547 Tue, 17 Nov 2009 12:00:53 +0100 2999547 http://www.medworm.com/index.php?rid=2967302&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F11%2F05%2Ften-things-you-cant-learn-about-ems%2F                                         From Your Computer        As you might imagine, I’m a big fan of E-learning. I also have a soft spot for the social media craze. But there are still a few things that you just can’t learn staring at a computer screen. OK, there are a LOT of things you can’t learn staring at a computer screen. Here are ten:         1.) You can’t learn pattern recognition. If you’ve ever wondered about how experienced EMTs and medics can figure out exactly what’s wrong with the patient two steps inside the front door, it’s not magic. It’s pattern recognition. When you’ve seen what CHF looks like a hundred times, you can pick out the pattern almost instantaneous... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2967302 Fri, 06 Nov 2009 02:16:58 +0100 2967302 http://www.medworm.com/index.php?rid=2930999&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F10%2F27%2Fare-all-aspirin-created-equal%2F “I took an Aspirin when I started feeling the pain.” Close to a decade after the Aspirin for chest pain idea hit the main-stream, more and more folks are medicated themselves at the onset of chest pain. But are all Aspirin created equal? Does chewing make any difference in the rate of absorption? No … and yes. A recent study out of the University of California, San Diego took 14 healthy volunteers and feed them a moderate dose of Aspirin on three separate occasions. First they were asked to swallow adult size tablets, then they were asked to chew adult sized tablets and last they were asked to chew children’s chewable Aspirin tablets. After each administration the volunteers had blood drawn at set intervals. The results were predictable, but telling. After swa... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2930999 Tue, 27 Oct 2009 12:00:44 +0100 2930999 http://www.medworm.com/index.php?rid=2916134&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F10%2F22%2Fatypical-cardiac-chest-pain%2F We taught you what cardiac chest pain looked like, right? You remember. We painted the perfect picture for you in your cardiac emergencies lecture in your EMT class. The pain felt like a pressure. It was brought on by exertion. It radiated to the left arm and through to the back. Sometimes, in your EMT skills stations, we would get fancy and have it begin at rest and radiate to the jaw. Just trying to keep you on your toes after all. All this stuff is good to know. But we may have done you a disservice. You may be walking around with the idea that you can do a quick OPQRST and a SAMPLE and walk away with a fairly good feel for whether or not your patient is having a heart attack. You may be dead wrong. What we may not have told you was that a large percentage of your patients sufferin... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2916134 Thu, 22 Oct 2009 12:00:26 +0100 2916134 http://www.medworm.com/index.php?rid=2886448&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F10%2F13%2Fwhat-makes-a-good-emt-part-2%2F Still struggling with the good EMT thing. I’m glad to be at your service. Grab a pen and answer these questions for yourself. What’s your internal bias toward dealing with patients and their challenges?  When patients have needs that don’t meet with your expectations how do you tend to react? Could you do that better? How? What’s it like to be your partner? How do people feel about you after they’ve run calls with you? Is that by your design? How do you handle it when you fail? When you have a bad call or things don’t go right? Are you willing to be fallible before your peers and own your mistakes? If you really felt that you were good at what you do, what would be the ideal way to address these inevitable errors? What is your tolerance for learning. A... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2886448 Tue, 13 Oct 2009 12:00:09 +0100 2886448 http://www.medworm.com/index.php?rid=2886452&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F10%2F12%2Foh-crap%2F Sitting in the car on standby, it’s nearly the end of a long and busy shift. The siren tone on the computer screen alerts me to the likelihood of another late job……Champion! I look down at the screen: “34 yr old female, Pregnant, wanting to push” Oh well, might as well finish the shift on a high! I head off at speed, half excited and half nervous (you can see why in my post ’scary babies’). Ive only travelled a few hundred yards when the radio is activated: ” Medic999, just to let you know this is coming through as a ‘Cat A’, due to the fact that she is only 21 weeks pregnant” “Yeah, thats received!” ” Unfortunately we dont have anyone to back you up at the moment but we will get a crew on the way as soo... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2886452 Mon, 12 Oct 2009 21:12:53 +0100 2886452 http://www.medworm.com/index.php?rid=2881182&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F10%2F10%2Fwhat-makes-a-good-emt%2F I get a bunch of E-mails from people just starting their EMT education who want advice on how to excel in their programs. “How should I prepare? What books do you recommend?” The questions vary but their is always the familiar flavor of enthusiasm and the same basic question, “How do I do this well?” Success in this field is fairly predictable. Use the right recipe and you’ll get there. I think the hierarchy of EMS success looks like this:            1.) Attitude 2.) Motivation 3.) Tolerance for repetition 4.) Goal orientation 5.) Strategy and tactics 6.) Performance              Attitude is at the top of the list for a reason. You need to start with an outward focused desire to serve others or you’ll always be fighting against... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2881182 Sun, 11 Oct 2009 02:29:33 +0100 2881182 http://www.medworm.com/index.php?rid=2879415&cid=t_151895_101_f&fid=38972&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FLifeUnderTheLights%2F%7E3%2F6ULgrGljbho%2Fsoapy-demons-ckemtp-is-geek.html (Source: Life Under the lights) Life Under the lights blogs http://www.medworm.com/rss/comments.php?id=2879415 Sat, 10 Oct 2009 15:13:00 +0100 2879415 http://www.medworm.com/index.php?rid=2879419&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F10%2F10%2Fsimple-actions-can-save-lives%2F As any paramedic or EMT will tell you, the opportunities to really make a difference dont come around very often. The times when you can say that you actually did save a life. There are many times that we can say that we relieve or ease  someones suffering, or help them get to the place they need to be, to continue their care. Even just reassure them and let them know that everything is going to be alright. These are the reasons why we come to work day after day and night after night. Some would argue that it is self indulgent, but the feeling of actually helping someone or even sometimes saving their life is a wonderful one, not generally experienced by the vast majority of the population on a daily basis! This was one such time….. Working with my crew mate Tim, we were dispatched ... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2879419 Sat, 10 Oct 2009 08:09:01 +0100 2879419 http://www.medworm.com/index.php?rid=2865686&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F10%2F06%2Fthe-soap-reporting-break-through%2F The objective portion of the report is the time when you state your case and tell everyone the stuff you found during your assessment. It’s time to become the CSI investigator and talk about your investigation and you findings. This will tend to be almost entirely objective information, however, don’t be scared to throw in the occasional subjective tidbit if it helps to paint your picture. “She thinks this bruise may be old.” or “His ankles are always a bit swollen but not this much.” If a subjective addition adds to the picture, include it. When telling my objective story I tend to start with the level of consciousness and skin signs then move strait into a head to toe report of pertinent findings. Remember that pertinent information can be positive fi... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2865686 Tue, 06 Oct 2009 13:43:13 +0100 2865686 http://www.medworm.com/index.php?rid=2858642&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F10%2F03%2Fthe-normalization-of-deviance%2F In the span of a generation, NASA has lost two spacecraft and 14 pilots in the collective disasters of the space shuttles Challenger and Columbia. Can you tell me why? Trust me, it’s worth exploring. The space buffs in the crowed might recall that faulty O-rings in the Challenger’s solid rocket boosters failed and allowed supper heated gasses to escape. The result was a catastrophic explosion and a sullen announcement from my school principal in the middle of sophomore science class. In his quiet monotone, we learned that the mighty Challenger, moments before, had been destroyed and the crew was lost. Our teacher didn’t know quite what to say, and in the silence that followed, my sixteen year old world got a little smaller. More of you might recall that Challenger&#82... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2858642 Sun, 04 Oct 2009 04:01:50 +0100 2858642 http://www.medworm.com/index.php?rid=2855602&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F10%2F01%2Fthe-september-ems-roundup%2F “And the days dwindle down to precious few, September, November - and these few precious days I’d spend with you. These golden days I’d spend with you.                         Maxwell Anderson, American Playwright 1888-1959         With the golden days of September behind us and October upon us lets put down the rakes for a moment and take a look at all that happened in the world of EMS.  Here at the spot, we started of the month with a hugely successful readers survey, Talked a bit about trust and paid homage to Jim Page and the victims of the 9/11 attacks. We debated what to do when common sense and written protocols collide and we looked at the success of the muscular dystrophy drive with a closer examination of the MD dieses process. I t... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2855602 Fri, 02 Oct 2009 05:24:20 +0100 2855602 http://www.medworm.com/index.php?rid=2851795&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F10%2F01%2Fwhat-happened-to-jack-ecg-geek-6-conclusion%2F For part one of this post, please click here. Right where were we? Oh yes….That ECG! Click to open in new window (See Mart, I said I would figure out how to make them bigger!) Now then, here is my interpretation of this ECG, which many of you got spot on. I can see no discernable p waves and the rhythm is irregularly irregular, therefore it has to be Atrial Fibriliation. It appears to show a grossly normal cardiac axis, and normal R wave progression with an appropriate transition in V3. There is approximately 2mm of ST segment elevation in I and aVL, with reciprocal changes seen in III and aVF. Lead I and aVL correspond to the lateral edge of the heart and therefore I see a Lateral STEMI, with inferior reciprocal changes. Which I really didnt expect, and it had me a bit stump... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2851795 Thu, 01 Oct 2009 16:21:01 +0100 2851795 http://www.medworm.com/index.php?rid=2846387&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F09%2F29%2Fthe-frequent-customer%2F Before I start, I havent forgotten about Jack and ECG Geek 6, thats coming tomorrow. It would have been tonight but I have been asked by Happy Medic to pitch in on a post discussion that he and CK from Life under the lights are currently having. To understand what is going on, click here to read CK`s post that started it off, then click here for The Happy Medics follow up. Once you have finished with them, Ill give my two penneth. The topic of discussion is the ‘frequent flier’, or our ‘regulars’ as we like to call them. I know for a fact that every ambulance service in every country has these people. The ones that you come to know very well. Sometimes you may actually grow to be fond of them, but mostly then can become a source of frustration when you realise that ... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2846387 Tue, 29 Sep 2009 21:48:41 +0100 2846387 http://www.medworm.com/index.php?rid=2842548&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F09%2F29%2Ftulsa-ems-in-the-classrooms%2F Most of us have been there before. A puking, nearly unconscious teenager on our pram. All the predictable problems; airway issues, responsiveness issues, behavioral issues. When kids learn the hard lessons about alcohol and drugs we’re often the ones who get called in to clean up the mess. And, as tiring as the routine gets, we do what we can. We protect the airway, administer our oxygen, start the IV, monitor the capnography, pay attention to the heart rhythms, the whole kit-n-kaboodle. (You may use another term … that’s just me.) The subtleties of treatment change with level of certification and protocols, but the call runs remarkably the same. Some medics is Tulsa, OK decided that we run this call far to often and they got the bright idea to see if they could chang... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2842548 Tue, 29 Sep 2009 12:00:33 +0100 2842548 http://www.medworm.com/index.php?rid=2836188&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F09%2F26%2Fshould-all-patients-have-a-12-lead-ecg-ecg-geek-6%2F Im starting to come to the conclusion that virtually all of my patients are going to get a 12 lead ECG unless there complaint is so minor that its just plain ridiculous! I have had so many cases now where the patient has presented with a complaint which makes me think that maybe I should do an ECG, sometimes without any real reasoning behind it other than ‘I just had a feeling’, only to find a significant cardiac abnormality or evidence of an acute coronary syndrome. A job I had last week was another that confirmed my new assessment rule. Called to a 92 year old very fit and healthy man, Jack. Jack lives on his own in an upper floor flat. He has no carers and is not on any medication. He has no significant medical history and enjoys a daily walk to the shops around the corner ... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2836188 Sat, 26 Sep 2009 19:28:33 +0100 2836188 http://www.medworm.com/index.php?rid=2834276&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F09%2F25%2Fthe-final-part-of-the-jewish-ems-tale%2F To bring this short series of posts to an end regarding my experiences with the Gateshead Hatzola, I thought I would share an email that I received from Jacob, a registered Paramedic in the States somewhere. He gave me permission to reproduce his email here, but asked that I not divulge his exact whereabouts, which I will of course honour. Jacob is also an orthodox Jew but rather that being part of a voluntary emergency services group such as a Hatzola, he decided to go the whole journey and become a paramedic. He still has to conform with certain aspects of his religious beliefs whilst at work, and he gives us all a fascinating insight into his working and religious life: So can it be done? Can you be an Orthodox Jew and a Paramedic? Sure, it’s easy to do in Israel, where you are ... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2834276 Fri, 25 Sep 2009 20:10:19 +0100 2834276 http://www.medworm.com/index.php?rid=2832171&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F09%2F24%2Fthings-my-kids-taught-me-about-ems%2F I’m blessed with two kids. They are amazing. Kids change your whole perspective on the world. They re-frame your purpose. It’s wonderful, the way a few minutes with your kids can put an entire bad day in perspective. They also force you to evaluate some of your own behaviors. (If your lucky.) Here are a few of the more valuable lessons I’ve learned from my kids.           1.) Test Your Limits. Kids know this instinctively. The moment you create a boundary they begin testing it. There is no running in this area. How fast is running? Can we just walk really fast? What about jogging?  It’s like they just instinctively know that life is more fun when you’re testing the limits. Sure there are boundaries that we all have to live within but when was the l... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2832171 Fri, 25 Sep 2009 04:38:34 +0100 2832171 http://www.medworm.com/index.php?rid=2814442&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F09%2F20%2Fworking-with-my-community%2F Part of the response area that I work in is a very large Jewish community, complete with some internationally recognized Jewish schools which draw students from all over the world. Yet, it’s not very common at all to look after patients from this community. The main reason for that is the presence of a dedicated group of Jewish volunteers who form the Gateshead Hatzola. This is a service provided to the Jewsih community of Gateshead, by Jewish first responders who obviously have an good  knowledge of both the medical and religious requirements for caring for this special part of or population. Now, before I even begin getting into this, I’m going to apologize to my new friends for not knowing nearly as much as I should about their service and the difficulties that come with t... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2814442 Sun, 20 Sep 2009 18:23:42 +0100 2814442 http://www.medworm.com/index.php?rid=2812396&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F09%2F20%2Fdriving-through-the-streets%2F My mind wanders as we weave our way through the streets of Gateshead on the way back to station. Its 02:30, and its been a busy night so far, but its been a good night. Nothing major, no big traumas, or ‘big jobs’, just the usual run of the mill emergencies on a Saturday night. Even the two very drunk children were actually quite pleasant and we managed to have a bit of a giggle with the parents on the way to hospital. Im working with a good partner, someone who I can have a laugh with and someone who is wanting to progress in this career called paramedicine. More importantly, he is someone who likes to learn and doesnt find it uncomfortable to be questioned and have ‘learning points’ discussed. That just makes all of the difference!! Im starting to feel a little b... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2812396 Sun, 20 Sep 2009 03:02:51 +0100 2812396 http://www.medworm.com/index.php?rid=2807614&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F09%2F17%2Fwhat-is-muscular-dystrophy-anyway%2F Since we’ve been talking about the fill the boot campaign the annual MDA telethon, why not use our “what is” series to take a closer look at the group of diseases we commonly refer to as muscular dystrophy. While most EMS caregivers have a general idea of what to expect in a muscular dystrophy presentation, few of us are as knowledgeable as we should be about what muscular dystrophy is and what it does to the body. Let’s take a closer look. While we tead to refer to muscular dystrophy as a single defined disease process, it is actually a group of disease that share some common characteristics. Add to that the fact that all of these diseases are degenerative in nature and you can imagine how remarkably different these patients can be. The nine primary diseases in... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2807614 Fri, 18 Sep 2009 01:17:02 +0100 2807614 http://www.medworm.com/index.php?rid=2790282&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F09%2F13%2Fwant-to-learn-ecg-interpretation%2F As you will have already realised, I love looking at ECGs. I used to think I was quite a clever clogs on them. My work colleagues certainly seem to think so. To be honest, and without being big-headed, I think I do know a little more than the average street wise paramedic. Some may say I know things that arent necessary for a paramedic to know about, but that is a whole different discussion. My point in this post however, is that I have realised that I still have sooooo much more to learn. I have started reading some of the blogs out there that are dedicated to ECG interpretation, and these guys REALLY know their stuff! So if you want to really learn how to comprehensively interpret 12 lead ECGs you really need to bookmark these blogs. Prehospital 12 Lead ECG Toms blog is as comprehensive ... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2790282 Sun, 13 Sep 2009 17:11:40 +0100 2790282 http://www.medworm.com/index.php?rid=2790283&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F09%2F13%2Fecg-geek-5-is-this-too-easy%2F Ive been looking through my rather extensive collection of ECG traces that I have collected over the last couple of years (some may find that a bit sad but hey, what can I say)and I am picking some out to share with you over the coming months. However, I am trying to find the right difficulty to work on. I know that we are all at different levels of knowledge on interpretation but I want to post ones which most of you will find interesting rather than just think, ‘well thats obvious, its…….’ So here is a quick one for you. Have a go at the interpretation and let me have your thoughts, but more importantly, if you find it easy please tell me in the comments. The history for this one is a 47 year old man who is short of breath on exertion. No previous cardiac problems... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2790283 Sun, 13 Sep 2009 16:43:51 +0100 2790283 http://www.medworm.com/index.php?rid=2788643&cid=t_151895_101_f&fid=38966&url=http%3A%2F%2Fdtsemt.wordpress.com%2F2009%2F09%2F10%2Fyet-a-few-more-strips%2F Just a note:  The absolutely mundane strips (SR without ectopy or dysrhythmia, etc) don’t usually get saved and scanned, so there’s almost always a glitch or blip of some slight interest in these.  Sometimes, though, the interesting phenom is obscure… (Source: DTsEMT) DTsEMT blogs http://www.medworm.com/rss/comments.php?id=2788643 Fri, 11 Sep 2009 02:55:17 +0100 2788643 http://www.medworm.com/index.php?rid=2788706&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F09%2F08%2Fseven-flawless-physical-restraint-tips%2F Physical restraint techniques and procedures are a subject of debate and controversy in EMS. Few agencies have taken the time and energy to research and develop a comprehensive restraint guideline for field providers to follow. When violent or aggressive patients show up (and they always do) EMT’s are left to fend for themselves. In these situations we take on a great deal of risk, both personal and legal, to bring the patient safely to the hospital. I’ve had my share of both good and bad take-downs. When things go well the call transitions smoothly from the street to the hospital. The patient stays protected, the prehospital personnel stay safe and everyone goes back in service happy. When things go badly people get hurt, patient care gets compromised and everyone ends up wri... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2788706 Tue, 08 Sep 2009 16:32:01 +0100 2788706 http://www.medworm.com/index.php?rid=2788771&cid=t_151895_101_f&fid=38972&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FLifeUnderTheLights%2F%7E3%2FJz0v1eKZkBE%2Fwhy-i-love-this-job.html (Source: Life Under the lights) Life Under the lights blogs http://www.medworm.com/rss/comments.php?id=2788771 Mon, 07 Sep 2009 16:35:00 +0100 2788771 http://www.medworm.com/index.php?rid=2788845&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F09%2F05%2Fholy-street-fight-batman%2F I have been trying to search my memories for my ‘funniest job ever’ for CKs edition of ‘The Handover’ at the end of the month. I’m having some real trouble trying to think of a job that fits the bill (isn’t it strange how yo can always remember the bad, horrible ones, but not the ones that make you laugh) I was working with one of my station colleagues the other day, when I asked him what was one of the funniest jobs he had been to. He replied with the following story, and its just too good not to share (with his permission) Steve was working on the ambulance one night shift when he was sent to a ‘brawl in the street – 40 men. One unconscious”. Steve looked at Mike, his partner and straight away got back onto the radio to ask for a RVP ... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2788845 Sat, 05 Sep 2009 20:10:11 +0100 2788845 http://www.medworm.com/index.php?rid=2788707&cid=t_151895_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F09%2F05%2Fwritten-protocol-vs-common-sense%2F Steve Valdez only wanted to cash a check. In retrospect it seems so simple. The check was written to him from his wife’s account at Bank of America. He had two forms of ID, both with photos. The address on the drivers license was the same as the ID on the check (printed by Bank of America.) Bank of America thought differently. Here’s the rub. B of A has a written policy that states if you don’t have an account at their bank you need to leave a thumbprint. You’ve probably seen those by now. Either you dab your thumb in an ink blotter or you use the fancy thumb scanner. But Steve Valdez doesn’t have any arms. And based on his inability to make a mark with his non-existent thumb, B of A refused to cash the check. Clearly the bank representative thought that follo... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2788707 Sat, 05 Sep 2009 12:00:27 +0100 2788707 http://www.medworm.com/index.php?rid=2788846&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F09%2F04%2Fno-i-insist-after-you%2F “Hello, is there anybody there?” No answer…… I look to my partner and ask him to contact control to request an ETA for the police. We had been dispatched to an address for a ‘concern for occupent’ , which in about 80% of cases ends up with the police forcing entry and us finding a deceased person in the house who had passed away sometime in the last 12-36 hours. This job had all the makings of the same. I was only new in my career, maybe six months, and was a trainee advanced technician at the time. It was 20:35 on a winters night, dark and freezing cold. The neighbours had called 999 as they had noticed that ‘Jims’ curtains had been closed all day and they hadn’t seen him go out to the club for his usual 2 pints that afternoon. We arri... Medic999 blogs http://www.medworm.com/rss/comments.php?id=2788846 Fri, 04 Sep 2009 20:29:41 +0100 2788846 http://www.medworm.com/index.php?rid=2788775&cid=t_151895_101_f&fid=38972&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FLifeUnderTheLights%2F%7E3%2FP19-lrhuhyM%2Fems-trendsetters-conference-2009.html (Source: Life Under the lights) Life Under the lights blogs http://www.medworm.com/rss/comments.php?id=2788775 Thu, 03 Sep 2009 18:26:00 +0100 2788775 http://www.medworm.com/index.php?rid=2788644&cid=t_151895_101_f&fid=38966&url=http%3A%2F%2Fdtsemt.wordpress.com%2F2009%2F09%2F01%2Fthe-greeks-had-a-word-for-it%2F In Isaac Asimov’s essay, The Rigid Vacuum, he describes Aristotle’s coining of the word ether to describe what must lie beyond Earth’s atmosphere. “It was impossible to reach the heavens and study this mysterious substance, but it could at least be given a name.  (The Greeks were good at making up names, whence the phrase, “The Greeks had a word for it.”) And so they probably did, a word for most everything, but what that word is is sometimes elusive. Our patient was quite out of it, eyes open but rolled back in the head, mid- and lower-airway at that borderline point where one more ounce of fluid will completely remove lung sounds, but right now sounding like Aqualung: “And you snatch your rattling last breaths with deep sea diver sounds”.�... DTsEMT blogs http://www.medworm.com/rss/comments.php?id=2788644 Wed, 02 Sep 2009 01:38:27 +0100 2788644 http://www.medworm.com/index.php?rid=2788782&cid=t_151895_101_f&fid=38972&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FLifeUnderTheLights%2F%7E3%2F2o1BFSxmy5A%2Fhandover-is-coming-handover-is-coming.html (Source: Life Under the lights) Life Under the lights blogs http://www.medworm.com/rss/comments.php?id=2788782 Thu, 27 Aug 2009 19:40:00 +0100 2788782 http://www.medworm.com/index.php?rid=2699616&cid=t_151895_105_f&fid=36987&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FIvorKovicMd%2F%7E3%2FN03vYQ9-JnY%2F I want to tell you a story about a father and his son. George senior and junior, obviously not Bush because this is a happy story :), but Ure. My friend George Ure jr. lives in Seattle and works as an emergency medical technician. His father on the other hand lives in Palestine, Texas. Not long ago a resident of this small town died after an accidental electrocution. Unfortunately, first responders who rushed to help were not equipped with a defibrillator, which in this case might have saved a life. George senior decided to do something about it, so he raised money and bought two automated external defibrillators (AED) for the local Fire Department. George junior then flew from Washington to teach fireman how to use these devices and hopefully save some lives in the future. Way to go fath... Ivor Kovic, M.D. blogs http://www.medworm.com/rss/comments.php?id=2699616 Thu, 13 Aug 2009 18:25:29 +0100 2699616 http://www.medworm.com/index.php?rid=2458118&cid=t_151895_105_f&fid=36987&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FIvorKovicMd%2F%7E3%2FKTzrvjm0xNg%2F By-line: DENA WHITE is a freelance writer and covers topics such as nurse assistant and medical careers, health care topics, and more. Just a quick search on the Internet and you can see some great screenshots from the video game Zero Hour. Zero Hour is a fantastic video game that has you playing as an EMT who must respond to catastrophes such as a biological weapons attack in a major US city. You have to treat and diagnose panic-stricken patients as well as manage supplies, which are disorganized and unpredictable. The United States Department of Homeland Security created this game in some measure as a way of training responders for emergencies in real life situations. This is the perfect example of interactive virtual reality modernizing the way professionals are taught and trained. The... Ivor Kovic, M.D. blogs http://www.medworm.com/rss/comments.php?id=2458118 Sat, 06 Jun 2009 12:27:33 +0100 2458118 http://www.medworm.com/index.php?rid=2390220&cid=t_151895_134_f&fid=35187&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDiabetesDaily%2F%7E3%2FJ0sJS8sFlUs%2F5-diabetes-rules-health-workers-should-memorize.php "In nursing school, they just taught us that when people under 18 show up with high blood sugars, they are type 1 diabetics. If they're over 18, they have type 2. It's pretty straightforward" - My cousin on her misguided curriculum, January 2009When Elizabeth went to the hospital with blood sugars over 400, they diagnosed her with type 2 diabetes and sent her home with a prescription for Metformin. In... (Source: Diabetes Daily) Diabetes Daily blogs http://www.medworm.com/rss/comments.php?id=2390220 Tue, 05 May 2009 16:00:00 +0100 2390220 http://www.medworm.com/index.php?rid=4517186&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F04%2F12%2Fpatient-collapsed-first-aider-on-scene%2F “Pt Collapse – First aider on scene” When that comes up on the terrafix system in the cab, it always seems to bring some remark from the staff on the ambulance, and not always a positive one. This isn’t through any inherent dislike or disregard for the abilities of first aiders, or the crucial assistance they can give both before we arrive and once we are there. It is through direct experience of dealing with many, many first aiders either in the work place on in large public shopping centres, just like the one directly opposite my station, less than a mile away. Over the last 9 years I have seen both very good and very bad first aiders. I have seen a patient conscious on the floor trying to pull off defib pads whilst a automatic defib is announcing loudly “Pl... Medic999 blogs http://www.medworm.com/rss/comments.php?id=4517186 Sun, 12 Apr 2009 07:31:11 +0100 4517186 http://www.medworm.com/index.php?rid=4517187&cid=t_151895_101_f&fid=38975&url=http%3A%2F%2Fmedicblog999.wordpress.com%2F2009%2F04%2F10%2Fits-no-different-being-a-paramedic%2F Kim over at Emergiblog has been talking about progression in the Nursing profession and Happy Medichas been writing about the loss of the “traditional” fire fighter in his station and area. Two completely separate topics which seem to come together in my post today. I was working with a relatively new paramedic (lets call him Steve) the other week who used to be an advanced ambulance technician (possible like and EMT-I?). During our day I asked the question that I always do when working with someone relatively new to the ranks of a paramedic “So, how are you finding being a paramedic?” The usual responses I get are: “Its a bit daunting, all the responsibility” “Brilliant, I love being able to do more for my patients” “Its really good, ... Medic999 blogs http://www.medworm.com/rss/comments.php?id=4517187 Fri, 10 Apr 2009 15:13:29 +0100 4517187 http://www.medworm.com/index.php?rid=1908801&cid=t_151895_113_f&fid=34933&url=http%3A%2F%2Fpalmdoc.net%2F%3Fp%3D1987 EMT personnel might be interested in this freebie : Ambulance Timer AmbulanceTimer is intended to help ambulance drivers fill out their log books. The program keeps track of the important events in an emergency call so that time figures can be included in the written log or report that is often required. The driver simply taps the button for the activity to be recorded, and the current time is saved. Times area saved until the reset button is pressed, even if other programs are run in between. It was recently listed in Freewarepalm as updated: Update Description: v1.1: - By popular request, added user-editable button text, up to four screens of buttons. The product homepage also lists a “Pro” version with more features like GPS support, unlimited groups, and ability to generat... The Palmdoc Chronicles blogs http://www.medworm.com/rss/comments.php?id=1908801 Sat, 25 Oct 2008 04:00:00 +0100 1908801 http://www.medworm.com/index.php?rid=1073337&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F12%2Fmy-er.html well not mine exactly, but you know what I mean. Pretty cool, no? (Source: Backboards and Bandaids, Papers and Projects...) Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=1073337 Thu, 06 Dec 2007 05:15:00 +0100 1073337 http://www.medworm.com/index.php?rid=1058541&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F11%2Fgunshots.html There's been a lot of gang fighting lately. A lot of gunshots in general. I guess the citizens are finally sick of each other. Tonight I found myself walking into a hazy house that smells like gun powder. It is obvious there has been quite a bit of gun fire due to the many shell casings lying all over the floor. Then I find the first victim, lying on his side. I roll him over and find no pulse. I yell into the room asking if there’s anyone else hurt, and some dude sitting in a chair hollers “yea me” but it was only a graze to his calf. He can wait. As I’m cutting off the first victim’s shirt I find the bullet hole that spans all the way through to his heart. There’s a chick standing over my shoulder, she’s totally sedate. She asks me, “is he dead?” My partner, who is bagg... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=1058541 Thu, 29 Nov 2007 07:41:00 +0100 1058541 http://www.medworm.com/index.php?rid=1057601&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F11%2Fquote-of-night.html Me: Sir, what did you call 911 for?Dude: I've been having this pain in my toe since 1983.The weird thing is, he had insurance. Spooky.I have a test tonight. I HAVE to make an 85 or above on this test to do well in chemistry....eek. I'm going to go study some more now. (Source: Backboards and Bandaids, Papers and Projects...) Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=1057601 Wed, 28 Nov 2007 18:11:00 +0100 1057601 http://www.medworm.com/index.php?rid=1049993&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F11%2Fhow-and-why-i-got-into-ems.html I got into EMS for several reasons:A) EMT’s make more money than fast-food workers. I needed a good paying job. I don’t have the attention span to flip burgers anyway…which leads us to my second reason, B) I have a short attention span. Well, not really, if I need to I can focus on something for a very long time, but I don’t want to. I wanted a fast paced job, where things were constantly changing, because I loveC) Adrenaline rushes. I love adrenaline rushes. A lot of things give me that rush, rollercoasters, sports, and MVCs.How I got into EMS: I took an ECA course fall of 2006 (graduated first in that class, thank you…I also only missed 2 on the National Registry test, thank you very much…hey leave me alone, I don’t brag often). Spring of 2007 I took an EMT-B course (gradua... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=1049993 Mon, 26 Nov 2007 07:14:00 +0100 1049993 http://www.medworm.com/index.php?rid=1048761&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F11%2Fi-bled-it-out.html GREAT SHIFT! I LOVED IT!Dude falls down and cuts his head open. Lady bandages it up and they get in a car and meet us halfway. Dude: Yea, I cut my head.Lady: I bled it out real good before I put the bandage on.Me: Bled it out…wtf?Ah, that explains the fair amount of blood ALL OVER him. Geez!I’d write more but I’ve ran calls for 23.25 hours straight now…and I’m tired. Did I mention that I have had a BLAST today? As soon as it ices over we’ll get busy all over again. Good night guys. (Source: Backboards and Bandaids, Papers and Projects...) Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=1048761 Sun, 25 Nov 2007 05:02:00 +0100 1048761 http://www.medworm.com/index.php?rid=1028382&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F11%2Fmusings-on-life-and-time.html Me: i cant believe its already thanksgiving, this semesters going by fast. Boy: yeah too fastMe: shyeah Boy: it doesn’t slow down either Me: im not sure if that’s a good thing or a bad thingBoy: I don’t know eitherThat’s part of the conversation I had with my guy friend last night on AIM…this semester has gone by so fast. As I look back though, I realize that I wouldn’t change a thing about it (well, except for the dying parts)…In August I moved into the dorms that will be my home for 8 months. I met my roommate. I met my best friend’s roommate who would become my second best friend. I met a lot of new people. I experienced my first college lectures. I introduced a girl to a guy, they became a couple. I welcomed home a friend who had served in Iraq. I played racquetball for... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=1028382 Thu, 15 Nov 2007 03:59:00 +0100 1028382 http://www.medworm.com/index.php?rid=1018010&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F11%2Fand-thunder-rolls.html I'm working...on a Friday night. Lame. I'm in college, I shouldn't have to work on a Friday night, I should be out drinking and partying in preparation for the UT verses Texas Tech game...but I'm not, oh did I mention this is my fifth night in a row to work? It's ok though, I'm saving lives, making a difference, right?Wrong. I'm playing Medicaid taxi. I've had a N/V/D for 4 days patient, who didn't look that sick. He decided to call right at dinner time. I had an ear ache patient. 2 minor MVC's who were screaming about their necks. I had a pregnant lady who was feeling nauseous...and the list goes on.With every lame call another piece of my soul dies. I'm going to go study now, because I'm cool like that. (Source: Backboards and Bandaids, Papers and Projects...) Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=1018010 Sat, 10 Nov 2007 01:31:00 +0100 1018010 http://www.medworm.com/index.php?rid=1012612&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F11%2Fand-award-goes-to.html The award for lamest call goes to…stay at home dad with more than 5 kids, all under the age of 8, his complaint, “I can’t sleep.”The award for most awkward call goes to…more than 300 pound lady complaining of “my piercing got ripped out while my boyfriend was coming down on me.” Reason number 394840302 why you shouldn’t get your labia pierced, it might get ripped out…and yes, it does bleed A LOT.” The award for scariest call goes to compliant (yes, compliant, weird) diabetic lady. “I can’t wake mommy up.” I HATE that. The worst calls I’ve been on involve kids finding their parents dead. Thankfully, this wasn’t one of those calls. Thank goodness the kid found her, and was smart enough to call 911, I doubt she would have survived the night with a sugar level tha... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=1012612 Wed, 07 Nov 2007 20:31:00 +0100 1012612 http://www.medworm.com/index.php?rid=968486&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F10%2Fsad-sad-sad.html Note: This is not the wreck I described the other day on my blog. It is similar. It’s what reminded me of the wreck. I do not work in Ozona. I have no affiliations with Ozona. A fellow EMSer informed me of this wreck. (He also told me that the little boy died, I don’t know this for a fact, but apparently he passed away Monday evening.) If you’re the praying type please shoot a quick one up for this family. PLEASE buckle up your kids. PLEASE wear your seatbelt. My heart goes out to the parents.Two children die in accidentBy MELISSA PERNEREditor and Publisher A one-vehicle accident killed two children, injured one child and his mother Saturday on Interstate-10. Five-year-old Ashley Johnson and two-year-old Logan Johnson were both pronounced dead at the scene by Justice of the P... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=968486 Mon, 22 Oct 2007 05:25:00 +0100 968486 http://www.medworm.com/index.php?rid=965430&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F10%2Fquestion.html Work has been rather slow, I'm working at my old station, the not so busy one that's forever away from where I live, the commutes loooong, but they pay for travel, so whateva. We’ve run 2 calls in the five hours that I’ve been on. Naturally, they both occurred right after I feel asleep. It’s all good though, we have a student on with us (freaking a’ there’s always some sort of student or rider or whatever working here, it’s ridiculous!) if he (it seems like it’s always a he too) doesn’t get at least 5 runs before 6 am he has to work the next 12 hour shift as well. He’s rather obnoxious and a know-it-all. I really hope we get 3 more calls.Anyway...On a different note, I have a question for you married/engaged folk.How long after you met your man or woman was it before yall... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=965430 Sat, 20 Oct 2007 05:17:00 +0100 965430 http://www.medworm.com/index.php?rid=959109&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F10%2Fslinger-part-3.html I’ve been putting off this last post. I shouldn’t have started writing about it in the first place. They say talking about things makes you feel better…so whatever. Sorry this isn’t as detailed as the other 2 posts, but I really don’t want to talk about it. I just don’t like to leave cliff hangers. We ended up flying out the mother. She died on the operating table. The bystanders realized that their rescue attempt was failed. They finally let the little boy go.The little girl went asystole at the scene.The baby was finally cut from the car. She had a few cuts and lots of bruises, but otherwise was fine. It was a miracle she survived. That car was torn up. She was literally in the middle of a ball of metal. I don’t know how she didn’t get killed. They say there are calls tha... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=959109 Wed, 17 Oct 2007 19:55:00 +0100 959109 http://www.medworm.com/index.php?rid=952545&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F10%2Fslinger-part-2.html “We saw the wreck happen. We saw him get thrown out. Early CPR. You can’t stop CPR once it’s been started.” I tell them that it’s been to long. His injuries are fatal. He’s gone. They refuse to stop. My partner yells for me, so I go over to the wrecked vehicle. “Emily” he whispers to me, “the guy’s dead, decapitated. The woman’s pinned from the waist down, strong radial pulse, good BP, complaining her belly hurts. She’s very repetitive, possible head injury.” I ask over my radio, “Rescue, how far out are you?” “ETA, 2 minutes.” “Waaaaaaaaaaaaah” I look at my partner, “that sounded like a baby.” My partner asks the lady, “Ma’am, how many kids do you have, “4, my kids, are they ok, my babies…” There’s a baby trapped in this vehicle. The b... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=952545 Mon, 15 Oct 2007 21:16:00 +0100 952545 http://www.medworm.com/index.php?rid=948942&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F10%2Fmost-nonemergent-case-ever.html The tones go off. Dispatcher: Rural EMS 1 respond to ________ for male with foreign body impalement. No other information at this time. We get there and this middle aged dude has the cotton part of the q-tip stuck in his ear. Apparently while he was cleaning out the wax the cotton slipped off the end of the stick and became lodged in his ear. Granted, he needed to have it removed, but did this require an ambulance ride to the hospital? No.It was an interesting weekend to say the least. (Source: Backboards and Bandaids, Papers and Projects...) Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=948942 Tue, 09 Oct 2007 01:45:00 +0100 948942 http://www.medworm.com/index.php?rid=948947&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F10%2Fdrunken-emt-rants-on-radio.html I found this on a myspace forum:Drunk EMT Rants on Radio, Calls 911JOHN ANNESEStaten Island Advance (New York) Drunken dialing's always a bad idea, especially when the number you're dialing is 911.An off-duty FDNY emergency medical technician learned that lesson firsthand yesterday morning, after she supposedly made several fake emergency calls a few hours after police wouldn't arrest a bartender she thought had wronged her.Pamela Falco, 48, was "out cocktailing in the Bay Street area" Wednesday night, according to a police source. Around last call, a bartender took her car keys, afraid she might get behind the wheel drunk, the source said.Ms. Falco called the police at about 5 a.m. yesterday, telling them the bartender had assaulted her, according to court papers. But the officers who res... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=948947 Tue, 02 Oct 2007 13:32:00 +0100 948947 http://www.medworm.com/index.php?rid=948953&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F09%2Fways-to-suck-life-out-of-your-emt.html Ways to suck the life out of an EMT…If you’re a patient…1) Call the ambulance. Meet us at the curb. Ask to ride in the front seat. 2) Forget your medications and history, until the nurse at the er asks you.3) Have a spiral staircase in your home.4) Have an uncovered pool without a fence around it. Then don’t supervise your kids. 5) Have a trampoline. 6) Let your kids ride 4 wheelers without a helmet on.7) Have luggage to take with you to the hospital.8) Ask if your girlfriend and her 6 kids can ride with us. Then get angry when I say no…A) there aren’t enough seatbelts B) you called me for a cut toe.9) Spit at me.10) Live in an apartment building with no elevator.11) Tell me how to do my job.12) Throw a bag of weed under my stretcher when the cops walks in…yea, real smooth, y... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=948953 Wed, 26 Sep 2007 18:13:00 +0100 948953 http://www.medworm.com/index.php?rid=948955&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F09%2Fglass-thermometer.html One of my RN friends invited me to join him to a family BBQ. He’s a flight nurse, works in the ER from time to time and is an overall hilarious and really nice guy. We went, ate some BBQ, and were having a good time. Then his sister came up to us…said her son was sick and asked if we could check him out, because, in my nurse friends words, “when you work in the medical field, people think you can heal by laying hands on them.” We go into the house and find her 5 year old son lying in bed; he’s warm and dry to the touch, slightly lethargic. He threw up a few times, but is able to keep down some fluids. He went pee a few minutes ago, it’s still in the toilet, and it’s not all that dark…so we’re not really too worried about him being dehydrated. “My ear hurts real bad will... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=948955 Mon, 24 Sep 2007 23:00:00 +0100 948955 http://www.medworm.com/index.php?rid=948957&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F09%2Ffor-record.html I've set 2 personal records tonight. I'm at work. I've been at work since 1800...I'll get off work at 0600 Monday morning...I have no life. Haha. We have a student on with us tonight. He's about 20 years old, and WAY to eager about everything, even the "pelvic pain" chick who just wanted a ride to the hospital for a pregnancy test. He was shaking with adrenaline...it was quite comical. Anyway, record number 1: We have been toned out 31 calls, we've only made it to the scene of 19 of them, and the rest got cancelled enroute...yea crazy. Personal record number 1 is 12 calls cancelled in one shift...that number will increase as my shift goes on. Record number 2: 5 crack overdoses in one shift. Wow.I'm gonna crash before we get toned out again. More on these topics later. (Source: Backboards a... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=948957 Sun, 23 Sep 2007 08:18:00 +0100 948957 http://www.medworm.com/index.php?rid=948958&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F09%2Fwelp-i-worked-this-weekend.html Welp, I worked this weekend. Left my college town at 0130, got “home” at 0530, started work at 0600. That was Saturday morning. Monday morning at 0600 I left work, got back to campus just in time for my 1000 Art Appreciation class…well not just in time, due to the traffic I was 30 minutes late, but it’s alright because our professor didn’t notice and probably doesn’t care. My job’s amazing, they pay me for travel expenses. They pay me while I’m driving, it’s amazing! I made nearly 100 dollars just driving! I’m really lucky to have such a great job.I was the shift leader. We’re rural, you have to take what you get. I’m a basic, my partner was a basic as well, but he only has 3 months experience under his belt…still wet behind his ears. We also had a student on with... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=948958 Tue, 18 Sep 2007 00:47:00 +0100 948958 http://www.medworm.com/index.php?rid=948962&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F08%2Ficu-woes.html Whatever happened to people that called the ambulance when they weren’t actually sick or hurt. I know I used to piss and moan when we got calls like this, but now I realize that these things were a nice break in the chaos of things.Lately the majority of our calls have been people that actually needed my help.We had an older gentleman the other day that wrecked his car. I found out that he died 2 days later in ICU, a prime example that drunk driving kills. A young family that I know had a wreck awhile back. Only 2 of them were injured; a toddler and the mother. The mother had open fractures all up and down her arm. She’s still recovering from that, but has regained most of the use of the arm. The toddler on the other hand isn’t so lucky. She had (among many other injuries) an open sk... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=948962 Tue, 14 Aug 2007 02:15:00 +0100 948962 http://www.medworm.com/index.php?rid=948963&cid=t_151895_101_f&fid=36535&url=http%3A%2F%2Femergencyemilly.blogspot.com%2F2007%2F08%2Fthings-i-learned-today.html I'm working the 6pm-6am shift today. That'll be followed by a 12 hour break and then a 72 hour shift. It won’t be too bad since it is midweek. I should get a decent amount of sleep. Hopefully everyone keeps their cars on the roads and out of the bar ditches or at least wears their seatbelts. Anyway enough of the boring…Here's a list of the things I learned since I last posted a blog:1) The cribriform plate of the ethmoid bone (horizontal lamina) is received into the ethmoidal notch of the frontal bone and roofs in the nasal cavities.2) If you’re going to climb a fence that has barbed wire on the top, don’t do it in a mini-skirt, especially if you’re not wearing underwear, you might get cut in awkward places. (If this ever happens to you, please don’t show the EMT your cut unles... Backboards and Bandaids, Papers and Projects... blogs http://www.medworm.com/rss/comments.php?id=948963 Mon, 13 Aug 2007 03:42:00 +0100 948963