smle
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Posts posted by smle
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I was just wondering if anyone else here played in the Society for Creative Anachronism (SCA) and if you use your EMS skills as a member of the Chirurgeonate?
For those folks who have no idea what I'm talking about here are a few links to help you out.
www.sca.org
www.chirurgeon.org
http://www.chirurgeon.wastekeep.org/whatis.php
For those who do know what I'm talking about, I am the Deputy Baronial Chirurgeon of the Barony of al-Barran in the Kingdom of the Outlands.
www.outlands.org
www.al-barran.org
Have you ever had to use your mundane training at an event? IE: done more than the Good Sam FA? Some of the bigger events can really generate some "NSTIW" stories.
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When I originally posted that thread, I really only intended to provide an example of how things are done here where I am. I realize now that I should have explained that better in my original post. I actually agree that just because you are allowed to use certain skills and/or meds solely because of the letters on your license, doesn't necessarily mean you have a real clue about those skills or meds. I'm sure that everyone here has seen a few MDs who were little more than over educated fools who shouldn't have been allowed to practice on cadavers let alone real patients. At the same time, we've all known some savvy, streetwise basics whose true level of knowledge and medical wisdom was far above their license level. FWIW, I'm always trying to learn more about my job every shift I work. I look at each day as a learning opportunity and believe that is up to me to turn that opportunity into something profitable for myself and my patients.
As for the "stuffed shirts". There ARE a few hypocrites out there who subject those of lower licensure level with scorn but who would pop a blood vessel is they were subject to the same treatment from someone further up to food chain than them.
I meant to do one thing, wound up doing another I did not intend. So to anyone I offended or pissed off, I sincerely apologize. :oops:
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smle, what do you want to know about the program?
If you could post a link or 2, that would be great.
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In the old "Emergency" TV show, they used radio telemetry to send the ECG to the hospital, this was in the 1970's. Is this still used anywhere in the US? It seems like we have even better communication technology now. Would this still be a good idea? Or was it just a matter of keeping EMS providers under tighter medical control in the early days of field ACLS care?
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This is a really great thread, I really enjoyed reading the posts about how it used to be in EMS. I would also like more information about the Explorer program. Someone mentioned the 65 pound monitors, we have Zolls now that weight about 10 pounds and include O2 sat, BP, and ETCO2 and will work as AEDs or manual defibrillators all in one unit.
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:twisted: I'm just amused by the sputtering indignation of certain "stuffed shirts" who seem to think that nobody without a "P" on their license should be allowed to adminsiter this or that drug. I reminds me of a certain set of other stuffed shirts who think nobody who doesn't have "MD" after their name should be allowed to "play doctor". :roll:
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Just to toss some gasoline on the flames: Here in New Mexico, EMT-Basics are allowed to give Narcan AND use it *diagnostically*. In cases of unconscious/unresponsive patients with no known cause, Basics may administer 0.4mg Narcan IM/SQ on standing orders up to 2mg. Basics may also administer Narcan intra-nasally.
NALOXONE (NARCAN®)
CLASS OF DRUG
Narcotic antagonist
INDICATIONS
1. Reversal of narcotic effects, particularly respiratory depression, due to narcotic drugs, whether
ingested, injected, or administered in the course of treatment. Narcotic drugs include agents
such as morphine, Demerol®, heroin, Dilaudid®, Percodan®, codeine, Lomotil®, propoxyphene
(Darvon®), pentazocine (Talwin®).
2. For unconsciousness of unknown etiology to rule out (or reverse) narcotic depression of CNS.
CONTRAINDICATIONS
1. Hypersensitivity
2. Absences of indication
DRUG INTERACTION
1. May induce narcotic withdrawal
ADMINISTRATION
Adult: [0.4 mg – 2.0 mg] IVP (2.0 mg total dose) - [0.4 – 2.0 mg] if IM, SQ, ET
Titrate to respiratory effort/rate. May be repeated at 2 - 3 minutes, if needed.
[2mg (1mg per naris)] IN
Pediatric: [0.1 mg/kg]< 5 yrs or 20 kg, [2 mg] 5 yr or > 20kg IV, ET, IM, SQ, IO,
May be repeated at 0.1 mg/kg if no response.
Neonate: [0.1 mg/kg] slow IVP, ET, IM, SQ, IO; repeat in 2-3 minutes, if needed
(mix 1 ml of naloxone, 0.4 mg in 9 ml of D5W, which gives 0.04 mg/ml)
Note: Much higher doses should be given to patients with suspected propoxyphene
(Darvon®), pentazocine (Talwin®), and fentanyl overdoses.
SPECIAL NOTES
1. The patient may quickly become conscious and combative.
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Our "uniform" is just black EMT trousers and a dark blue polo shirt with the company logo on the left chest. We don't wear patches now anyway. I get my satisfaction from patient care, not dressing up.
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Well I worked a marathon shift over the past weekend. Went in at 07:00 Friday and left at 23:00 Sunday! I put 2 kids on the helicopter in 2 days. One was a 3 YOM who got mauled by a big German Shepherd cross dog. MAJOR damage to the head. Then a 12 YOM who rode his motorcycle into the side of a car. Broke his left leg in the mid-shaft femur and the-fib. What made this weekend really satisfying is that I was running my own truck as an EMT-I. I had some good calls and good outcomes and actually helped a few people. Making the step up from EMT-B has made a great difference in my satisfaction level in EMS. Does anybody else feel that moving up in level has made the job better for YOU?
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Is it worth it? Can anyone recommend a good source?
Thanks in advance!
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I picked that option because that's what I'm doing.
I want to eventuallygo to Paramedic school, but I want to get some experience as an EMT-I first. For me, working as a Basic has helped me learning to be an Intermediate. Some people might want to work for a while as a Basic before even trying to go to Intermediate, just to see if they can deal with the job.
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Where I work, LMAs are Paramedic only according to protocol, even though in NM Basics and Intermediates are trained in their use. I started my own poll about who can use LMAs here: http://www.emtcity.com/phpBB2/viewtopic.ph...&highlight=
The big issue seems to be the security of the airway. My Intermediate instructor is a Medic and RN and works on the local Life Guard chopper. He told us in class that Monday(6/6/05) that he dropped an LMA for the first time in his medical career on a Pt. who coded in the chopper. He said it worked very well and was very easy to put in.
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If you can't ventilate through either tube, you must have it in the wrong end of the patient! :shock:As for the LMA being dummy proof.. LOL... So are CT's. If ya can't ventilate thru either #1 or #2 tube :? -
When I was in EMT-B school last fall, they trained us in the use of Laryngeal Mask Airways, or, LMAs. Now that I'm working for an ambulance service, I see in our protocols that the LMA is a Paramedic only device.
In your Country/State/Service, who, if anyone, can use LMAs?
I know that this device was originally for operating room use and was adopted by EMS. It certainly doesn't secure an airway as well as a Combi-Tube or ET tube.
Any Chirurgeons here?
in General EMS Discussion
Posted
What I'm asking is are there any folks here who are members of the SCA, are Chirurgeons within the SCA and if any of those folks have had to go above and beyond the BFA level at an event.
You could say the SCA is "similar" to the Ren-Faire groups. There are common interests and some cross over membership. The big difference is that the Ren Faires are done for profit and the SCA is a non-profit educational organization.
The group you are referring to may be SCA, we use rattan weapons, not wood. The beating the heck out of each other sounds like SCA though. If you like the middle ages stuff, you should check out the SCA. There is more to it than the fighting. Let me know where you are and I can point you to a local group. Or just follow the SCA link in my original post. PM me if you like, and we can discuss all things medieval without wasting forum bandwidth.