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Scientific Blogging

Turn The Page

Paramedics

I've long thought that Bob Seger's Turn The Page could easily be about EMS.  I'd like to use it for our annual company video sometime.  It describes the life of a rock singer, and I think there are some great parallels between how he describes his day and how we think about ours.  The song has a wickedly good sax solo & Segers tired, worn-out voice to add ambience.

Paramedic = Rock Star?

Paramedics

The other day I was chatting with my trainee, and she mentioned that her boyfriend plays in a rock band.  He had just called her and told her that he didn't get up until 2 that afternoon, because he had been playing music for most of the night.  That started a discussion about the similarities between Rock Stars & Paramedics.

 Activity

If EMS Had Our Own Fortune Cookies

Paramedics

EMS Fortune Cookie

 

This is what the fortune might look like.  Other fortunes:

You will lose important papers soon. 
(Don't let that DNR form out of your sight)

Dancing Around Privacy

Paramedics

I think that to some extent, all EMS blogs dance around the privacy issue.  Some bloggers go way out of their way to obfuscate the details of their professional life to maintain patient privacy, and some  don't.   Especially in a small town, trying to maintain some sort of storytelling while keeping a professional distance is extremely hard.  Now, not only can you not name the patient, you can't even provide enough details for anyone to pick out one patient from another.  I learned my lesson early in my blogging, and try hard to keep it ambiguous.

Polar Opposites

Paramedics

One thing I've noticed in this bidness is the glaring polarity of my patients.  Their reactions to circumstances can often be found at the very ends of the spectrum. 

For example:The middle-aged lady who was seated in her car at McDonalds, obtaining 'food' for her redneck family, when a drunk driver hit their car.  The damage was minimal.  The car was moved less than a foot.  About half an hour into the investigation, she developed “Allstateitis”, (the realization that she is a ‘victim’, which is followed closely by neck and/or back pain), and we entered the picture.After she was backboarded & brought to the hospital, she got the obligatory x-rays, which were surprisingly negative.  The cervical collar & backboard were removed, and she then proceeded to thrash about, whining and complaining.  When she got up to go to the restroom, she slowly & gingerly walked down the hallway, looking as if she were 130 years old.  Of course, she demanded and received strong pain relief.

Offensive Littering

Paramedics

We're on the South side of the bay, checking out some visiting Canadian warships, hoping to finagle a tour.  But, we get interrupted by the radio, dispatching us to an "assist the police" call on the other side of the harbor on one of the docks.

Dispatch tells us that if we need more info, we can call in.  So, I call up on my cell, and am told that the officers want us to identify some 'organs' to see if they are of human origin.  WTF?  I'm not a physician, pathologist or M.E., but what the hell - it sounds interesting.  What I'm thinking, actually, is that I'll tell the officer "Yup, that'd be a gallbladder from the Mexican Jumping Kangaroo, and I think it might have been diabetic."  That'll teach them to call us for help!

RT's Complaining about EMT's & Medics

Paramedics

"The notion of someone other than a respiratory therapist providing care to patients with breathing problems is preposterous."

This is one line out of a story about threats to Respiratory Therapists and their jobs.  The gist of the story is that while RT's have been worried about Nurses taking doing the RT function & taking away their jobs, it's actually the EMT that they need to be worried about.

2007 JEMS EMS Today Update

Paramedics

My conference started with a day-long Difficult Airway class, taught by members of the Maryland State Police Aviation Division, and by staff from the R. Adams Cowley Shock Trauma Center in Baltimore.

Some of the highlights:

  •      Hyperventilation can cause an increase in intrathoracic pressure, which can actually create a compartment syndrome in the chest, compressing the vena cava (and decreasing pre-load)
  •      An anesthesiologist said that using Vecuronium as a de-fasciculating dose does not affect the Potassium release from Succinylcholine (contrary to what I've been taught).  Will have to do some more research on that.
  •      Learned about the 4 D's and the 3-3-2 rule in assessing potentially difficult airways.
  •     The cadaver lab at shock trauma was very valuable.  We had 7 cadavers, and practiced different skills with different equipment.  We did intubations with multiple blades & techniques, chest decompressions, needle crics & tracheostomies.  We used Gum Elastic Bougies & the Glide Scope.  I was very impressed with the Glide Scope, but at $10,000 per unit, don't think we'll have it any time soon.  The Bougie appears to be a very inexpensive tool to assist in securing an airway, & I hope to arrange to have them in our units soon.

    The class was very well put together and had some impressive instructors.   Thanks to the Maryland State Police & Shock Trauma for some valuable education.

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