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About paramedicmike

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  • Occupation Pragmatist, Resident Cynic

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paramedicmike's Activity

  1. paramedicmike added a post in a topic Split Patient Care Forum?   

    Agree with the above.  I click the "New Content" button when coming in through the home page (how I access the site).
    I also think it's important to emphasize the idea that any care provided by any provider level be considered not from a BLS vs ALS point of view but more from an appropriate patient care point of view.  By keeping the Patient Care forum a general forum it also allows exposure to threads that people might otherwise ignore or miss because it's not in the forum for their provider level.
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  2. paramedicmike added a post in a topic Critical Care Paramedic yes or no?   

    This +1.
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  3. paramedicmike added a post in a topic Branching out   

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  4. paramedicmike added a post in a topic Modified valsavla in SVT   

    Ok.  I'll call myself out here.  Please excuse my embarrassment. 
    It's "Valsalva".  My apologies for the error.
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  5. paramedicmike added a topic in General EMS Discussion   

    Modified valsavla in SVT
    I heard about this recently on an emergency medicine podcast I listen to.  Thought it was interesting.  I'm not entirely sure how well it would work in a field setting given time and space limitations.  However, I found it interesting that there are, in fact, ways to make (or at least help make) valsavla maneuvers actually work. 
    Linky, link.
    Linkity link to Lancet abstract.
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  6. paramedicmike added a post in a topic EMT-B Pathos   

    How much room for textbooks worth of material do you have?  You are not going to be able to compile enough information in a notebook.
    It sounds, perhaps, like you're looking to make a list of differential diagnoses?  That is, a list of things that can be causing the chief complaint?  Take a look at your treatment protocols.  These will give you an idea of the most common presentations of complaints you will encounter as an EMT.  Take any given complaint, chest pain for example, and start reading about what can cause chest pain.  Create a list of differential diagnoses (chest pain, for example, can be caused by, among other things, angina, MI, AAA, PE, pericarditis, effusion, pneumothorax, trauma etc...).  This is all information you'll have to think of on the fly as you're dealing with a patient.  Chances are excellent you're not going to be able to pull out your notebook in the middle of a call especially if you have a really sick patient.
    Part of your responsibility as an EMT is to continue the learning process after you've completed your training program.  The best way to do this is simple.  Read.  Read a lot.  Then read some more.  Encounter something you've not seen before?  Read about it when the call is completed. 
    Then read some more.
    Or have I missed the mark with regards to your question?  If so, please refer back to my previous comment and be much more specific about what it is, exactly, you're attempting to do.
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  7. paramedicmike added a post in a topic EMT-B Pathos   

    Pathos (a quality that evokes pity)?  Pathologies?  Pathophysiology?  Please be much more specific with your query.
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  8. paramedicmike added a post in a topic My Pants Have No Pockets!   

    Guess I should've been more specific.  The longer you've been in the less you carry in your pockets.  The newer you are the more you carry in your pockets.  Or try to.
    And I'm pretty sure you knew what I meant as this is not a new discussion to these forums.
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  9. paramedicmike added a post in a topic My Pants Have No Pockets!   

    There is an inverse proportion as it relates to items carried by a provider and time spent in the industry.  The longer you're in the less you carry. 
    Aside from everyday items such as a wallet, keys and cash I never carried more than a stethoscope and trauma shears.  Even then there was a stethoscope and set of shears in the bag.
    I never carried Vicks, dog biscuits etc...
    You're new.  This is still all new and exciting and you want to be prepared.  However, you'll find that all those neat little tips your instructors talked about are either rarely used or just not necessary. 
    And welcome.  Congrats on completing basic school.  Don't let your education stop there.
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  10. paramedicmike added a post in a topic Physicians on ambulances? As a career?   

    I'm curious by what you mean when you refer to an EMS physician's limited scope of practice.  Care to expand? 
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  11. paramedicmike added a post in a topic Old folks Still here?   

    Speaking of Squint where is he?  Hope all is well with him.
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  12. paramedicmike added a post in a topic Pain with IO use   

    And what site would that be?  Care to explain what you mean by this?
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  13. paramedicmike added a post in a topic Site or Computer Troubles....Which one is it?   

    Clear your cache.  Close it out and try again.  What happens?
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  14. paramedicmike added a post in a topic Site or Computer Troubles....Which one is it?   

    Pages are loading for me when I click on the page number.
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  15. paramedicmike added a post in a topic When medicine just isn't enough   

    Sorry to hear it's been such a rough road recently.
    We see people all the time who choose to ignore or deny their health condition.  We see people all the time who refuse to take responsibility for themselves, their own health, their own well-being.  Many times they get to leave the ER only to come back again for yet another exacerbation.  The uncontrolled diabetics.  The COPD-ers with a pack of cigs hanging out of their pocket or purse.  The renal players who "missed" dialysis.  Again.  Hypertension players who don't take their meds.  It catches up to them eventually.
    You numb yourself to it because if you fought with all of those patients you'd go insane with trying to keep up on people who don't care enough to care for themselves.  We're all gonna die some day.  If sick patients choose to ignore or deny the means to delay their own death, or at least ensure some semblance of quality of life leading up to their death, that's on them.  I'll continue to act in good faith because that's the moral and ethical thing to do.  But I'll recognize that if they aren't willing to step up and do their part there's only so much I can do without their help.
    We all got into medicine, EMS, nursing or whatever because, on some level, we believe that life is worth fighting for.  We have a desire to improve the health status of those with whom we come into contact.  Pretty much all of us here will fight tooth and nail to save the life of someone who needs our help.  We will do so without prejudice, judgement or reservation.  At times, especially prehospitally, we'll find ourselves in dangerous situations (despite our best efforts) to do so.  However, there are limits as to what can be done.  I feel worse for those who've done nothing to deserve their situation.  Those folks will eat at me for days.  I'll do what I can to distract myself.  I'll run.  Read.  Blast music.  Run some more.  Distraction can help.  You just have to find what works for you.
    For the chronic players, though, those who've had multiple chances to turn themselves around, to do something to improve their own situation, I don't feel as bad.  I've learned to let it go. 
    If this is really eating at you perhaps some professional help with a therapist/counselor who specializes in dealing with heath care providers is in order.
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