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Let’s talk about TXA and brain injuries. Maybe we can put to rest the suspicion that TXA creates further injury in patient’s with a TBI. TXA is an amazing tool to use for our trauma patients. There has been so much success TXA that there are trials to see how effective it is for GI bleeds.
As with most medications new to a service (mine has had standing orders on TXA for about a year), there are always questions and concerns. One that continually comes forward is, “does TXA create further harm in a patient with a brain injury?”
Curious and in an effort to self educate, I searched and found an article on my favorite blog, EMcrit.
The CRASH studies were used to see the effectiveness of TXA and the trauma patient. The CRASH 3 study was specifically a sub study for the TBI patient. It was ran as a pragmatic study. Meaning, it was a non-controlled atmosphere and based in a real life setting with unpredictable variables. Much like a bad trauma patient.
“CRASH-3 was designed to further investigate using tranexamic acid for patients with traumatic brain injury. This study utilized the following inclusion criteria:
Enrollment within hours of injury
Either Glasgow Coma Scale <13 or intracranial hemorrhage on CT scan
No major extracranial bleeding
This was a massive, pragmatic, double-blind RCT involving 175 hospitals in 29 countries, with a target enrollment of 10,000 patients. Patients were randomized to receive either saline or tranexamic acid (1 gram loading dose over 10 minutes followed by a second gram infused over the following 8 hours; this is the same regimen used in CRASH-2). The primary endpoint was head injury-related death in the hospital within 28 days of injury.”
The utilized saline as the placebo versus TXA. The results showed a reduced mortality rate in patient’s with non-severe TBIs. With an emergency room study such as this, the results were “not statistically significant.” The criteria for a TBI patient is vast. There are too many complications. What proceeded forward was the need to take out the obviously brain dead patients (GCS>9 and fixed pupils). The severe TBI patients would not benefit from TXA just due to the impact of their injury. More severe, the less of a chance of effectiveness.
Now, the mildly injured patient’s proved effective. There was a significant increase in the decrease of mortality with in 28 days of the patients who received TXA while suffering from a brain injury. To receive the proper and fair outcome, it was just a matter realizing that some patients were too sick to save.
“ Subgroup analysis shows benefit from tranexamic acid among patients with a greater hope of recovery. Specifically, tranexamic acid reduced head injury-related death in the subgroup of patients with GCS>8 and also the subgroup of patients with reactive pupils.”
What were the take away and conclusions of the study?
“The conclusion of this article sums things up nicely: “tranexamic acid is safe in patients with TBI and treatment within 3 hours of injury reduces head injury-related death. Patients should be treated as soon as possible after injury.”
The greatest strength of this study might be an extremely thorough evaluation for possible adverse events among 12,639 patients. Tranexamic acid was found to be safe, without increased rates of any adverse events (including thrombosis, seizure, and stroke).
The primary endpoint of this study was technically negative (p-value slightly above 0.05). This likely reflects the inclusion of moribund patients, who diluted out the signal of benefit from tranexamic acid. Numerous subgroup analyses indicate that among patients with a greater hope of recovery, tranexamic acid is beneficial (figure below). As a statistical rebel, I would consider this trial to be positive, despite having a technically negative primary endpoint.”
Check out the article at; https://emcrit.org/pulmcrit/crash3/
By: Maria Shila Clarion Caraan-Medic/456
It is those kinds of days when the world is normally quiet and people are outside their homes and in the busy streets celebrating happy moments with families or simply just wandering around when some unforeseen events may occur exploiting the people’s expectations about life and the enjoyment of it. The EMS personnel whom dedicated to serve have their own purpose. For us, every life matters. Every second is precious. Coping with stress witnessing the death and dying, even the smallest nerves on our system, quivered. No matter how strong we are trying to portray ourselves on extremely stretched situation, no matter how calm, we acted though overwhelmed by the event, it is our heart that fears of losing the battle. The battle which is not intended for us personally as far as professional versus personal connection is concerned. We cannot just cease all hopes and say to ourselves; “This is God’s plan”. After all, we have been trained to help save lives.
It is a common notion that people in the EMS are working in a job with good pay and less workload. But behind the bright smile of men and women in the EMS; bleeding hearts and distorted minds are far beyond comprehension. We carry the burden on our shoulders. Seeing the sick and injured every day makes us weak inside and out. We are vulnerable human beings too. Because of the need of us being out there, we change the value of holidays to work days. So when the entire world asleep, we are outside in the streets saving lives. Some may question why we choose to be here? The answer is just simple: If not us, then who will? The world may forget us because we didn’t go to war to defend our country. Our memories may be of less of importance from the views of our arch-critics whom we dedicated to serve, even to our people. We won’t have a medal of valor and a flag on our coffins on our death, but the lives that have been saved in “God’s Will” through us will always bring a smile in everybody’s lips and a joy in their love one’s hearts. It will surely change their lives. Perhaps, we have played a very good role in the lives of our arch-critics, but it is at the expense of our own family’s enjoying our time together, which is seldom and very rare. There is so much sympathetic pity for the misfortune of others in the medic’s heart that flows like a stream in which ordinary minds fails to fathom. In saving lives; it is the passion with compassion.
Poetry for unsung heroes: By Maria Shila Clarion Caraan – Medic/456
In the deep of the night
when entire world retired
the sounds of sirens
broken the silence.
A dancing headlight
of red and blue
giving you a clue
someone’s on the limbo.
We gather our strength
when you call for help
we extend our hearts
not just our hands.
There’s that emotion
we can never hide
for every sweat our shield
it is our greatest pride.
We equip ourselves
knowledge and wisdom
so when there’s a call of duty
we won’t walk there, empty.
Our only shield is the blend
of the trust being gained
and the faith that flaunt
our victory staunched.
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DO NO HARM
Do No Harm is one of the rules we live by in public safety / Ems. There are many forms of harm that can be done, by doing nothing in a situation in fact can be causing harm. Doing something is better than doing nothing, As long as your not causing harm. Sometimes thou you will find yourself in the situation to not fix what is not broken that is still doing the right thing.
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So I started a medic program this last August, and well things have been going great, I understand pharm, although memorizing doses is kind of a bear, but I will get it. Cardiology is pretty smooth for me, I picked up on it faster then most of my fellow classmates. So here is the problem, our main group of students is split into two lab groups, and the group I am in, we are ahead of the other group, so we started working on ACLS algo's and I can pretty much recite them, but when we ran our first mega code I froze up completely... So here is were you guys come in, any suggestions as to how to not freeze up? That would be great!
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Today was a strange day. First, I came to our station and was greeted from my collages with roars of laughter. Then I went to our disposition to receive the keys and the folder of our ambulance, and got the replacement vehicle allocated because of the Reason that our ambulances was in the auto repair shop. After a short check of our replacement ambulance we got then our first run, which was canceled 20 minutes after departure from our disposition so that we got as second run a Infection run for a Patient with Pseudomonas aeruginosa from a Rehab to a University Hospital. But on our way to the reab our run was been canceled again by our disposition, and we got another infection run on the other site of our city for a Patient with methicillin resistant germs. After that run we got another infection run for a Patient similar germs. So our morning consisted mostly of permant disinfecting and talking to ur disposition becouse of our runsand desinfection times. I can't say how much I hate that special runs with Infection Protection clothes and Desinfection in the morning. But somehow the beginning of the day drew like a red thread through the day. Our last run was an acute abdomen at a nursing home which looked really badly. After that when we reached the Hospital my Partner said to me that she feels really sick with nausea, because a coffee with milk which she got at midday in a nursing home. And now I am at home and I feel tired and badly.
But I know the show must go on tomorrow....
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Tonight my son graduated from the vocational school. He got a certificate from carpentry. He made it all the way up to two week before graduation and he failed out of the nursing program. This was hard on him and myself all these years I have told both my boys you can do anything you want in life if you fail you fail as long as you do your best that is all anyone can ask. I am so proud of him he has come into his own in many many ways.
But he is like his mom he isnt going to let a set back stop him from his dream we go to the college on wednesday to enroll him in their nursing program so pray all goes well for him. His choice not mine.
I have learned a lesson from him over the last two weeks, one is he is more of a man than i could have imagined, the high school he attends couldnt change anything on his schedule since he only has two weeks of school he had no morning class anymore i told him he could stay home and then check in. He did not do this he went every day to the LPN class as though he was still in class. He opted to keep going so he could finish out the those two weeks. I am so very proud of him. Me i wouldnt have went back but he is no quitter.
Tomorrow night is his final graduation from high school my baby will be ready to go into this big cruel world and spread his wings. This is bitter sweet I would love to keep him with me forever but I know its time for him to come into his own. I do worry did I do good enough job raising him did I make the right choices while i was raising him alone? Did I teach him the things he will need out in this world? Did I forget to teach him something.
Tonight as i watched him go across that stage I could never describe the feeling of how proud I was of him. Yes he failed LPN but he didnt let that destroy his dream. Maybe I need to take a lesson from my son.
Well this semester is officially over! I believe it was the hardest one yet! I took environmental biology, drama, and statistics. There were times I considered dropping, but I am so glad I pushed through! I got my grades today, and while they could have been much better, I passed! I am done with the local community college and moving on...
I was accepted into University of Texas at San Antonio into the Emergency Health Science program. It starts in July and I can't wait to take classes that I am interested in! The people that I have talked to at the University are all so friendly and helpful, such a stark contrast to my community college!
In other news, I am having a "mass" removed from my ankle next week. After all the problems I had last year, nobody knows exactly what it is. I am unsure how the surgery will be, or what will happen afterwards, so my excitement for school comes at a great time! It is definitely something to look forward to!
Have a great day everyone!!!
Drako is a big scary dog. He is a pit bull / rottweiler mix and he is big and strong and scary looking. He came into my life about 7 or 8 years ago when he was rescued, with another smaller pit, from an abusive situation. He was going to live with my daughter and her family. I happened to be in town when he arrived. I spent a few hours with the dog in my daughter's house and put my foot down. I explained that he was going to hurt someone in that family. Her chaotic, dynamic family was not the right place for Drakeo.
We immediately thought of my brother. He lived alone in an A frame that he had built with a chainsaw and timber he had hewn from his own land. He lived in the country, very isolated in a remote part of Northern Ontario and had just lost his guard dog.
I called him about Drako, and my brother came to see him. I didn't know it then, but it was the last time I would see my brother alive. I live in Arizona and our contact was sporadic.
Long story short, my brother took Drako home with him and over the next 3 years, turned him into an excellent, loving dog. With a combination of discipline and dogmanship, my brother rehabilitated Drako.
Drako was there when my brother shot himself. Drako almost got himself shot by the police. He was so protective of my brother's body. Eventually, a friend was able to persuade Drako to leave his best friend.
Another long story short, Drako arrived here in Wisconsin to live with me a week and a half ago. I had spent time with him during my sojourns into Canada, when he was living with my daughter, where he had gone immediately after my brother's death. We are old friends.
The most striking feature of my brother's face were his huge, expressive brown eyes. I see them in my mind's eye, looking at the world when he was a little boy, and when he was a broken man. Drako has the same eyes. It breaks my heart.
So here I sit spinning around in my own little world, waiting for some cheese and bread for my wine. No my whine. It will be my last post because obviously there is nothing in the last 3 that has made anyone offer any words. No slap upside the head, no you deserve what you've been dealt, etc etc. I posted in hopes of finding out if anyone could put their virtual arm around me and tell me it would be ok, that it would get better. Study more, try harder, give it up. Your employer sounds like a moron would have been awesome. I did some research and I found evidence that other EMS agencies use systems to manage their employees, track problems, provide solutions to head off problems, remediate and retain as needed. So I'm encouraged that another place may hold out some hope.
I do leave you all with this, and I know at least 300 people have read the blog: We're charged with taking care of people on what is often their worst day ever. I know there's plenty of abuse, plenty of free loaders, plently of people with no coping skills. I never minded that so much which is why I thought I had something to offer to the field. No matter how dumb assed, how stupid or how abusive, I gave every patient compassion and kindness, even when they didn't deserve it. I treated them to the best of my ability without abuse, which is more than the ER I had to take most of my patients to ever did. No matter what dumb mistake a co worker ever offered up and I've seen some doozies, I treated them with kindness and respect and tried to be helpful about offering alternatives that might have been more appropriate without trashing them either to their face or behind their backs, which almost seems to be a sport in EMS anymore. See how hard you can go at someone until they break and then celebrate it?
In a field where we take care of people, we suck at taking care of each other.
I have to wonder what is wrong with someone to go into an elementary school and just start shooting. Innocent babies dead because someone decided it would be a good idea. The shooters mother dead because she was a teacher in that school. Can someone explain it? anyone? cuz I sure can't.
This world has gone absolutely insane. It seems that this kind of thing is getting more and more frequent. We all think of Columbine and the shooting at the Amish school in PA and I'm sure that there are others but they slip my mind just now. What in your life can be so bad that your only alternative is to kill your mother and 20 innocent children in kindergarten and first grade? along with 6 other adults? Did nobody see this coming? Did nobody see that there was something wrong with this person? Have we, as a country, become so used to this kind of gun violence that what happened today is just commonplace?
Don't get me wrong, I advocate the fact that people have the right to keep and bear arms. I grew up around guns...my father taught me how to shoot when I was old enough to hold them without shooting myself in the foot. NY has some pretty stringent gun laws. I cant shoot my husbands pistol because I dont have a pistol permit but I can shoot the shotgun and rifle. I can protect myself and my son should the occassion arise....and God willing it never will arise.
I just don't understand this kind of thing..,I don't...and I am saddened that the world that my son has to grow up in, is so violent. That, for some people, the only answer to thier problems, is to pick up a gun or 2, go to the local elementary school and kill 26 people.
I wish that I could turn back the clock 30 yrs. A time when you could leave your house doors and windows open and unlocked and nobody would even think to walk in if your car wasnt there. When you could leave your keys in the car at night, without worrying that it would be gone in the morning,.....when your kids could go to school and not be afraid that someone is going to come in with a gun, and kill you and your friends and your teacher and anyone else they happen to come across. I wish......
My thoughts and prayers go to the families that lost thier sweet babies today and the families of the adults that were killed. And to my EMS brothers and sisters in CT....I am so sorry that this kind of thikng has happened in your town and state. I am thinking of you all and pray that you find the strength to go on.
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Today is a day off. Currently I am reclined in a chair and catching up on Hawaii Five 0. There is nothing like a little McGarrett and Dano to clear my mind.
Yesterday was the extra day I worked. I came to realize of how hard I am on myself, but also realizing that due to this anxiety come into play. Now many of my fellow colleagues would advise me to get out of the field if this is the case. Yet, this time in my life, I am determined not to give up.
I can only hope that my experience through my career will help those, who may be experiencing the same issues or help those coming into the field some ways to avoid the situations.
In April of 2013, I will be in my 19th year of EMS. It took me 7 years to feel comfortable to move onto pursuing my paramedic. When I reached going to paramedic school, I wanted to do very well. I passed, what do we say what do you call a person who passed their paramedic test "Paramedic". I feel that's as far as I have become. I left one job because I felt unappreciated due to attempt to advance, moved on to another service where I was removed after 2 years.
It was almost 2 years before I came back full time. Worked jobs non related to EMS feeling as if I was lowering my standards. It wasn't until I was about to lose my license and certification, that I made the decision to return. I was working as an LNA in a hospital. I was losing my mind seeing how much I really knew.
After returning full time this June, it was as if history was repeating. Before I returned I told my superior that as I began as a paramedic, I joined this particular organization, to learn and become and exemplary employee. I ended up with a wheelchair driver who recently received his intermediate with no experience on an ambulance. After that it was two partners who I believe were trying to believe undermining to my leadership and care. As I iterated before, I came back as if history was repeating myself. Partners who my superiors knew were substandard in their performance. Not following my orders, not relaying pertinent information, and one having poor assessment skills.
My company has the contracts for working 911 in the two cities of my previous company. One city where I worked for 6 years and have lived for over 30 years. I was advised by one superior that due my past performance I would not be recommended to work in that location. Last week, I was reprimanded with a suspension for a policy that does not pertain to patient care, and was written up for a mistake that still has nothing to do with patient care and it was the first offense.
I know for many of my colleagues. I will have their opinions of I am whining. The point of all of this is. Yesterday, I ended up working with my first partner. I found out a few years ago he received an accommodation from the city for his work. I was floored. Yet, I took being able to work with him as a blessing. Wondering what am I doing wrong.
Well, what I learned is I have a difficult time working as a team, and I just focus on how to make myself look good. By doing this my anxiety goes to a level where I end up sabotaging my reputation. My first call I ended up making a mistake. I felt like the smallest person in the world, wondering why this still happens.
This is when I was coming to the realization, but also feeling as if there was no hope. I was hoping for redemption. A few hours later the craziest thought came through my mind, the saying "God won't give me what I can't handle." My last call was a true inferior MI. It actually went quite well. I did everything in my power to change my approach. It seemed to have worked.
After all I have been through, I am trying to change. I believe change needs to come from me. I want to be positive and become the person I've always wanted to be. Maybe this starting over is bringing awareness and improvement. Wish me luck, if there is hope for me at this mid portion of my life. Maybe others who have gone through similar situations or have the same questions I have had can be helped or we can support each other through this grueling and difficult profession.
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As some of you know, it has been a long time since I have really been here in the city... and to be honest, I have been avoiding it, mostly in shame.
In 2009, I started paramedic classes... I loved it, even though juggling a not-so-stable home life, running my own business, and being guardian and sometimes caregiver for my mom was sometimes a challenge. I did well in my classes, and was looking forward to my practicums.
In 2010, two tours into my practicum, my mom became acutely ill, and within 3 days, I had to make the decision to remove her from life support and explain it to the rest of my family.
As I was not allowed to take time off from my practicum, I withdrew for a year, as was required by the college. I went back in 2011, and struggled through my first practicum. I felt my preceptors weren't being the mentors I wanted. When I asked for clarification, they said "look it up." When I asked for them to quiz me on medications, they said "later." Although they signed off on all my skills and competencies, at the end of my practicum, they informed me that they were not going to pass me to go on to my next practicum because "you are not sociable enough." Not with patients, but with other staff... they said I studied too hard and didn't spend enough time having coffee with staff (WTF???). They also refused to complete the final evaluation, so I was in limbo..
I contacted the college numerous times to see what my options were, without getting a response. Finally I appealed to the Dean and President of the college. Instead of accepting my completed competencies, I was required to re-do that practicum AGAIN.
I did not perform well. I was frustrated, and I struggled. I lost focus, I was making dumb mistakes. One of the staff where I was doing my practicum told me that my preceptor had been told by the college to make my practicum as difficult as possible, so I would leave, because I had embarassed them by appealing my previous practicum.
I couldn't do it... I gave up and withdrew... I failed in my attempt to be a medic, something I always wanted... and in the year since then, every day I wake up and hate the fact that I didn't make it. I hate that medics I work with tell me that I should be a medic, that I am better than half the medics out there, and yet I couldn't do it. I hate that I wasted all that time and money, and have nothing to show for it. I hate that there are people who I thought were really good friends, who haven't spoken to me since I left school. I should have fought harder. I should have done better. I should have been successful...
I stalk this site, and read the posts.... and think "I have nothing to add... " so I don't..
I am not posting this for sympathy... I don't want sympathy... I am posting so those that asked, know why I am not here anymore. I don't think I have anything to contribute... and until I figure out how to regain that confidence, I won't. I won't go back to school - I can't afford it, and on the positive side, my business has really expanded in the last year, and I still work casual on an ambulance, so that helps keep me busy.
Be safe all...
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Hello EMS friends!
I am the medic that invented the Turley Backboard Pad. I am now trying to get a grant to develope other complimentary products. I need 160 more votes in 12 days.
Just go to www.missionsmallbusiness.com Hit Login & Support, then enter Turley Backboard Pad Co, state of WA, city of University Place, Search, then hit Vote.
Thank you so much to all my peers that want to help me make a realy improvement in patient care.
Hello everyone, I've been a member of emtcity for quite sometime, although I don't come around here too often. I just would like to fire a shot in the dark and see what I hit. I am currently serving as a FMF corpsman in the US Navy. I have 1 combat deployment under my belt as a corpsman with a Marine unit in Helmand, AFG, I was an instructor for Marines in combat life saving and Im currently working in the ER at a Marine base in California. I had my paramedic cert prior to joining, I had been working about 3 years of 911 prior to enlisting, including time in post Katrina New Orleans area. Im in the process of getting my EMT-P back with NREMT and the state of CA. As of now, I have a year and a half left but im trying to find a contract somewhere out there that is about 3-6 months. My goal is basically to make enough to survive 3 months of the fire academy out here financially. The GI bill is good but is a bit low for where I live. Any information, ideas, or contacts dealing with overseas paramedic contracts would be greatly appreciated. I don't care if it's Afghan, been there done that, my mom might be a little upset but thats okay. Thank you again to anyone who can help.
Welcome back dear Readers!
I know it's been far too long since we've spent any quality time together, so I'm going to try to rectify that now...
For those that don't know, I was in the hospital for about a month with diverticulitis/diverticulosis. I presented to the local E/D unable to walk into the triage area because of severe abdominal pain. I thought that I had suffered a abdominal herniation due to having to help move a rather 'portly woman' who was brought into the same E/D in cardiac arrest. While in the hospital, I was taken off solid foods, and when the clear liquid diet didn't produce the desired results, I was taken off all foods by mouth and recieved nutrition from a PICC line in the right upper arm......
Well, because of the month long stay at Hotel Hospital, I ended up falling too far behind in class, and was forced to withdraw from the paramedicine program once again; this time in my last semester.......(nsert heavy, sad sigh here).
Well, after all that, one would think that I'd earned a break through all this and MAYBE something would go my way for a little while.......wrong!
As it turns out, I'm back in the hospital for apparently the same thing. Looks like a relapse or maybe just a 'flare up' of the original condition that never really went away. Either way, docs are tossing around terms like 'surgery', 'ostomy' and 'resection' far more than I feel comfortable with....considering it IS MY colon they're talking about hacking into.......!!!
I'm at my wits end, and have actually thought about giving up on ever getting my Paramedic license. Ive worked my ass off TWICE now, only to have it snatched out of my hands (first the motorcycle wreck, now this).....
l honestly don't know if I've got what it takes to go back 'one more time'.....after all, I'm closing in on 50 years old far too fast for my liking, and would REALLY hate to finally accomplish the degree in Paramedicine, only to find out that I can't use it .......
Right now, I'm searching for a reason to 'hang in there' on getting my degree; but I'm coming up empty.......
I just saved hundreds of dollars on car insurance, simply by selling that POS car!
A stroke occurs when the blood supply to the brain is cut off by an artery in the brain that either ruptures or is blocked, cutting off critical oxygen supply to neurons. Approximately 80 percent of neurons die within three hours of the time that oxygen is cut off; therefore, rapid action is critical to prevent irreversible brain damage. Healthcare professionals working with adult patients have developed a catchphrase—“Time is brain”—recognizing that acute stroke recognition and treatment is of premier importance to preserve brain tissue, limit the amount of disability patients suffer in the long-term, and increase the stroke survival rate.
In order to save time—and potentially brain function—in patients that have suffered a stroke, the American Heart Association and the American Stroke Association have developed a community-oriented “Stroke Chain of Survival” that links specific actions to be taken by patients and family members with recommended actions by stroke prehospital care providers, emergency department (ED) personnel and in-hospital specialty services.
The “Stroke Chain of Survival” is characterized by four sequential stages, including
- Rapid recognition and reaction to acute stroke warning signs;
- Rapid emergency medical services (EMS) dispatch;
- Rapid EMS system transport and prearrival notification to the receiving hospital; and
- Rapid diagnosis and treatment in the hospital.
These four stages within the “Stroke Chain of Survival” include the execution of seven distinct steps in acute stroke diagnosis and treatment, also known as the Seven D’s. The seven steps also highlight the key points at which delays can occur, necessitating organized and efficient care at each step to avoid needless delays. The Seven D’s of stroke care, as well as the major actions to be performed in each step, are:
- Detection of the onset of signs and symptoms of acute stroke. Early recognition of hallmark signs and symptoms of acute stroke is critical to improved patient outcomes.
- Dispatch of EMS by telephoning 911 or another emergency response number. This communication activates EMS systems and ensures prompt EMS response.
- Delivery of patient to a medical facility. Patients should be transported to a stroke hospital or other facility capable of providing acute stroke care, and advanced prehospital notification should be given to the selected medical facility.
- Door of the emergency department (ED). Immediately upon arrival, the patient should undergo general and neurologic assessment in the ED.
- Data collection, including computer tomography (CT) scan and serial neurologic exams, along with reviews of patient file for potential fibrinolytics (tPA) exclusions.
- Decision regarding stroke treatment. If the patient remains a candidate for tPA therapy, review risks and benefits with patient and family and obtain informed consent for tPA therapy.
- Drug administration as appropriate, and post-administration monitoring.
The window for administering treatment after a stroke is very limited. From the onset of stroke to the administration of treatment at a hospital or other medical facility, the Institute of Neurological Disorders and Stroke (NINDS), a branch of the National Institutes of Health (NIH), recommends that no more than three hours elapse to ensure improved patient outcomes and maximize the chance of stroke survival.
"Time is brain" is more than a catchphrase—it is a call to arms in acute stroke care. Healthcare providers, hospitals and communities must rally to develop streamlined response systems to execute the Seven D’s of stroke survival and give stroke victims the best care possible, the best chance of survival and the best chance for resuming a normal life.
Health Education Solutions additionally offers ACLS, PALS and BLS certification courses, as well as CPR and AED certification.
The information included in this article is based on the 2005 guidelines for CPR, first aid and advanced cardiovascular care.
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- Rapid recognition and reaction to acute stroke warning signs;
Could it be? The day is near where I finally test for my emt-paramedic. Nervous? Yes. Excited? Yes. Blogger? No. I have no idea why I am writing this, and no idea who will ever read it. But whatever, why not. It's past midnight, I am losing my mind, and instead of studying I am reading EMS forums and looking up videos on rebuilding transmissions. Priorities may be more mixed up than salt in saline.... I guess I am all studied out. I have asked everyone I know who has passed the NREMT-P what to expect, and I get differant answers from everybody.
"It's so easy bro..."
"It's so hard man..."
Study this, study that...
Study more cardiology than peds...
Study more peds than cardiology......
Study more pediatric cardiology than respiratory.....
Enough to make your head spin. I guess I just have to take this test and see firsthand. The scariest part though? It's not this test. It's not any test. It's actually finally becoming a paramedic. No longer the student, but a full on, patched, med pushin', scene controllin' paramedic. I think I am ready. Not yet comfortable, but definatly ready. I was comfortable as a waiter... but then again I did that for almost a decade. My EMS career is in it's infancy.
This should be pretty awesome.
If you just read this, YOUR pretty awesome too. I guess I am a blogger now too. emt-b. emt-blogger.
So I sure have had a lot of learning experiences so far as a Medic. I had a status epilepticus that had been seizing for 40 minutes, STEMI, MVCs, and the most memorable so far, running my first code as a medic. We were called actually for an intercept for report of a "person down". We make intercept and the EMTs are just hysterical. We literally have to make them stop yelling and shouting at the patient as they are doing CPR. Come to find out it was a fellow EMT. I actually did well at focusing on the task at hand, running the code. After butting heads with the other medic (He wanted to use new ACLS standards and I have not been taught them so I wanted to run the old ones), we made it to the hospital. We ran the code for a little bit longer before calling the time of death. That was when I got a really good look at the patient. It suddenly hit me that the patient was a co-worker. I am trying to be the one that maintains my composure at this point because the EMTs were really upset and the family was just devastated. So I get everything cleaned up and ready to go for the next call. Well once things calmed down I went and apologized to the EMTs for yelling at them (but they needed to calm down) and it kind of hit me that I worked with this person. They were healthy and no medical history. SO long story short I have been working my way through all that. I am not letting it bring me down though. We had the debriefing and I know that I did all that I could do. Still was a tough call to deal with.
Other than that things are going well. I have officially been named "shit magnet". My co-workers just make me laugh. They enjoy picking on me and torturing me with this creepy plastic hand. Thats just part of working in this job though. You are going to get picked on....a lot!!!
Well I suppose I better get some work done. I just wanted to let you all know that I am still alive and kicking. Things are going great and I am learning a lot!! I am starting to get more comfortable in my skills slowly. :
Until next blog,
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ok, so my son is in cubscouts. He wants the scholarship but the only way to meet his goal which the scholarship is 2500.00 in popcorn sales, is to hit up everyone of our friends, neighbors, relatives and whoever else he want's to sell to.
I find that a pain in the butt because people seem to feel like they can't say no. I've said no enough but only because money is so tight.
I put this here because I'm offereing online popcorn ordering but only if you agree to have an email sent to you with the popcorn sale link.
If you want a popcorn item or want to purchase popcorn to support my son and his cub scout pack, please email me at email@example.com
I will send you a link to my son's popcorn ordering page and you can order online and have it shipped directly to you.
No pressure. Just voluntary if you want to get some pretty dang good popcorn if I do say so myself.
if you would consider purchasing popcorn to send to the troops overseas, you can choose the two Military popcorn options, 50.00 and 35.00 Both of these items gets popcorn in that amount sent to the military serving overseas as well as domestically.
Thanks for listening and reading.
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