armymedic571

Awesome.

It is nice to see so many actually giving a crap about their bodies.....

As someone said, 75-80% of this is diet......You have a diet, you don't go on a diet. Working a truck and shift work do not lend to a healthly life style. But here are a few rules that I use...

1. Brown bag. By doing this, it saves a boat load of cash.

2. Go clean....Simply, try to take as much processed crap out of your diet as possible. Processed Gluten is responsible for inflammation to the intestines which has been linked as a precurser to cancer, heart disease, diabetes, and the list goes on and on. Read for yourself.... http://robbwolf.com/

3. Work out. It really doesn't matter what you do, as long as you like what your doing. Many people rant and rave about the next best thing......Billy Blanks, Zumba, P 90-X, Insanity, the list goes on and on. I personnally Crossfit, but the important thing is to like what you do, and have a measureable and achievable goals......

I think taking control of your body is important in our field and our "Profession". Before returning to the Army full time, I was part of a group that got our Department Director to talk the hospital into paying for gym memberships.

Our hospital loves to save money, and Pre-hospital services has the worst payout in workmans comp...... But with a little research and some searching, we were able to find enough studies that proved that a little investment in fitness and diet counceling would save the hospital thousands, if not tens of thousands....

Cheers

We should add one:

Your tube, your chart.......

but that might be me being selfish......

Wendy I agree with you whole heartedly, and I must agree that in many systems orientation consists of "theres your truck, and you have a call holding". I am speaking specifically to new medics with little experience. You have to walk before you crawl, but rookies tend to lean on the machines too much. I agree, as you progress and fine tune your assessment skills, you may jump to the fancy machines quicker, or as a first tool. I imagine when you learned to drive your parents started you off in a parking lot, or a road that had little traffic, they did not dump you out on an interstate at rush-hour on day 1. And yes, there are too many oldfarts in this industry who are incompetent and lazy.

To add to Croaker, doing CPR in the back of a moving ambulance is DANGEROUS. This is FACT and I will not site the studies. Do your own research......

These studies have been out for years. It is sad that we are still debating the outcomes of them. Or the fact that people do not know about them, or refuse to learn from their findings.

The same reason ER doctors order a CT on every patient with a bump to the head, the LAWYERS. The public has been educated by TV and Movies that every patient magically is saved in the ER. Medics have been sued for failure to transport because the family believed they took away their only chance of survival.

Is it right ? No

And then occasionally you read that story where medics declare someone dead, and then have to go back and work the patient when the coroner or funeral home found a pulse or saw the patient breath.

Not that your assessment is not incorrect, but why whould the mainstream Pre-hosptial provider have to lower themselves to a few lazy bums that passed their exam?

Because we have too, not much else there

Unfortunatley we transport most dead people because OLMC are unwilling to call a patient over the phone. OLMC doesnt trust their medics

You live in a sad system. But you are part of the problem. You have paradigmitis. Give up, its the way its always been.......

Dude, don't give in to the dark side......

This and this, sort of.

I think there is a misunderstanding in the public that there is more that can be done at a hospital then in the field, and services think that transporting the dead decreases the possibility of a suit because "EMS didn't help my dad/mom/sister/dog, the let him die"

Or for concerns of provider safety...I've had more then a few codes where the living get physical with EMS because they think we are giving up

Also, I'm in NJ, ain't to much progressive EMS 'round these parts, squads still backboard off MOI. one service requires c-spine in all GSW

Another excuse. Isn't part of your job as a provider to EDUCATE the public. Also, find the research and present it to your peers, and Medical Director. Maybe they are lazy and just don't want to do the research?

Two reasons.......

1. Medical Directors still make providers bring dead people in, so that they can determine that they are.......dead.

2. Uneducated/Under-educated or unsure providers are too wrapped up in "what if's" than science and safety.......

But that's justmy anecdotal self speaking.........

Since you bring up EBM, here is an article on EBM from the British Medical Journal that I found interesting.

http://www.bmj.com/c...9/1459.abstract

ERDoc....I think I pee'd in my uniform.....hilarious......

Crap Dwayne.....this means I have to do something today........Blah..........lol

Does anyone find this ironic that in a day and age where EVERYTHING we say and do revolves around evidence based medicine, and it seems ERDoc has found one last Anecdote to debate.....I was slightly astounded, but not surprised that I could not find two pieces of evidence that confirmed each other. Not that I searched very hard mind you. But something that is used often by many fields, I would think would be easier to find.

Cheers.

I would have to say that a 20 point increase in systolic and a 10 point drop in diastolic would sufice as a baseline for Blood pressure.

I have always used a 20 point increase in pulse rate, but can't seem to verify that with a legitimate reference.

The same goes for time......it seems that different references have different criteria, and that some some even use heart or pulse rate as an indicator....

Very interesting indeed......ERDoc, it seems I picked a good evening to log in after a long hiatus from this site.......

Not to Monday Morning Quarterback......but someitmes the most expirienced crews get caught by complacency.

I would chalk this up to a learning experience. Seems your gut instinct was headed in the right direction.

Cheers.

K

MP-EMT22, I'm pretty much in the same boat with you in terms of your experiences. My last enlistment (2005) I wanted to reclass as a 68W and was denied because of my MOS (88M) was a "critical" MOS and I would not be able to get out of it, ok whatever took my 15k bonus and suffered thru my horrible unit till now. I'm 9 months short now, not enlisting but taking a break to prep and attend Medic school and get my family life squared away.

I have 14 years in with 2 tours, I want to retire with more then 20 yrs so I'm halfway there. While I love being an 88M when I'm actually doing my job, all the TC units I've been with and around are ate up beyond belief. I want to become a 68W and finish my career doing what I love to do, I know military EMS and civilian EMS are worlds apart and don't recognize each other when it comes to qualifications and certs, but I'd love to have the experience of being on both sides of the fence.

Armymedic, you're up at FIG? I live down in Lancaster, used to drill in Lancaster until I got pawned off to our sister co. at Dix. We're up at FIG often and I remember mooching some equipment off of a training unit up there for our FTX. Don't know if it was your unit or not but they were awesome in allowing us to use their equipment.

Do you guys teach CLS by any chance?

Sean

CLS.....sure do....check your ATTRS link on AKO for dates......

You OBVIOUSLY are not in the military. There are numerous militaries around the world that are fully co-ed and I wouldn't be surprised if the showers are also. If you are sooo worried about one of your troops checking you out in the shower then maybe it is YOU with the mental illness. I would be more concerned about you in the heat of a firefight because your mind is on the gay guys trying to check you out, you would be a danger to me, my soldiers, and the mission. I speak from experience here, when I had the opportunity to take a shower, the absolute last thing in my mind was who was looking at my junk. My concerns were if I was going to take a shower again or if I'd see my family again or if one of my guys OR girls were going to fall the next mission, NOT who was gay and looking at me.

It's funny you seem to think that Homosexualism is a mental illness. If so the HATE is a mental illness. Hate for people who are not bothering you in any way shape or form but yet you still hate them. WELL DUH I guess that makes you as mentally ill as gays!

Well we banged out women and gays, what's next ambulances for whites only and coloreds only????????

Sean

Haha....right on

Support and stand behind your troops, asshole ... or feel free to enlist and stand in front of them.

You're obviously of no decent character, so in no position to be judging others as you just have.

FUNNY.....but I believe it is "if you don't stand behind our troops, please feel free to stand in front of them!"

I see that there are many different opinions. Most everybody here, except for the guy who thinks gays are mentally ill.....sorry lets get back on track.....

Most people agree that there shouldn't be an issue. Besides Lonestar, CHBare, and a few other, how many of you have served???????

How many have deployed to the far reaches of the earth where people really want to kill you?????

I just wonder........not that I disagree with the majority, I just want to know the base of your opinions?

But, to get to the point here is the...I mean MY bottom line.

IT DOES NOT MATTER.

Some of the best, most rugged, and most effective soldiers I know and have fought with are gay. It does not matter.

I think it boils down to this, either your professional....or your not.

Anywho, just my 2 cents.......peace .

First off, I, and others both on this site, and not on this site, thank you for your military services.

Second, when reclassifying from one primary mission in the military to another, doesn't the military require some time in the new or reclassified primary mission, to "get their money's worth" from the personnel with the new line of training?

In the Pre-FDNY EMS in NYC, such time commitment was required from anyone who upgraded from EMT to Paramedic, at least 2 years (I think), or pay back a cash penalty to the service. Doesn't the military do something similar, as I already asked in this posting?

Richard, this is correct. The point is depending on the time requirement, and how much time is left on the soldiers contract, it may not be an issue.

Hey, if this guy is a certified medic, treat him/her as such. Value their opinion and discuss issues. By allowing them to talk through the calls, and not interjecting your opinion or ego, will let them know that you are there for them.....

Cheers

If the man was in hospital for 2 days before dying, whatever ailed him at the time of the car accident may not have been evident enough for either EMTs or Paramedics to diagnose. The ER staff, or the people on floors might have caught on after you turned care over to them, so it might not even be something covered within our scope of practice.

Did the hospital advise you of what happened after transfer of care to them? It might have been something not told you in the patient's history that suddenly went acute.

Also, do not jump to conclusions, and tell your classmates that, too. There's the old story of a man went home, early, from a dinner party because he didn't feel well. With the party still in progress, the hostess got a phone call that he died. She rushed everyone, all the remaining 15 guests, to the hospital, where they all had their stomaches "pumped", fearing it was her cooking. Then, they all found out he died, because he got hit by a truck while crossing against the traffic light!

Richard,

I need to apologize. I went to give you a plus one and hit the negative 1.

I am very sorry, because I like your post, and as usual, it is well versed in experience.

Please do not take offense to my amateur mistake.

Jeff

Sorry for the late post folks. Been out of town......

To the OP. You do not know me, so let me put this into perspective for you. I have 14 yrs in service with 10 year on active duty. 4 tours, with 3 of them to Iraq. The four years I was part time guard, I worked as a civilian paramedic, and was an instructor/preceptor. I went back to active duty, and now teach 68W reclass at Ft Indaintown Gap, PA.

The bottom line here is being a proficent 68W CAN make you a proficent paramedic. BUT, they are two seperate jobs, with different scopes.

I would not use 68W as a means to the ends of being a Civilian Paramedic. I would recommend the reclass if you want to become an Army flight medic, or are going to re-enlist beyond your initial contract. But, by the sounds of it, I dont think that is going to happen.

What ever pro's you are looking at to go 68W are over shadowed by the fact that those same traits are ones you most likely have as a soldier.

Feel free to PM me if you need.

To 21to68...The answers to both your questions are YES.....but why would you want to? If you have no intention on re-enlisting beyond your current contract why go through the hassel of a reclass? If your intent is to go civilian EMS, please reread the above comments......

......CH knows what he talking about.

Cheers everyone.

Army,

IMHO, we need to beat the crap out of medics who like to think they are more than medics. Minimisation of on scene time does not put a time frame on it. If you have a patient who is out of the vehicle, & can be stretchered, treated for spinal precautions (not all spinal patients need a LBB, but I have posted about this elsewhere), why not scoop & run, a line can be inserted en route, fluids can be set up, again en route. pain managment can be done, en route. Stop me if I am wrong, but lets complete a primary survey, detailed secondary survey, get them into the ambulance, then lets do another survey, once we have the other shit done.

Too many times we hear that all this should be done prior to departure. WHY? WHY? WHY?

Our patients, & one has to assume because this is a discussion on the Golden Hour that it is about trauma, need the difinitive care of an ER under the care of a Trauma Team. Not a bacteria infested back of an ambulance with a medic. Lets get rid of the attitudes that we are the greatest, yes we save lives, we save lives by delivering them to hospital in a stable condition. Nothing more (with the exception of a tension pneumothorax).

We do a lot of nivce to stuff, but at the end of the day, if we do nothing more than maintain an airway, ensure breating & monitor circulation, deliver the patient to hospital, where have we failed?

Phil.....cannot say I disagree with you SURVEY of the situation. I need to apolgize as the first time I read this, I thought you where attacking me. Obviously not the case, but I find it funny now........I must need another cup of coffee..........

I would further what you said by saying that transport to definitive care is the key not just in trauma, but in medical patients as well.

I agree with Phil here; we are now teaching the Load And Treat Enroute (LATER) concept.

That however does not mean we have to race everybody into hospital on red lights at breakneck speeds just to deliver them to the trauma team nor that everybody should just be thrown on a scoop and extricated from the scene in the least time possible.

We need to focus on which patients are time critical and which we can spend a little more time on.

Should we have just ripped that old lady off the floor, thrown her on the scoop and driven to the hospital or was it appropriat fror us to spend an hour at the job ensuring adequate pain relief and minimally agressive extrication? ... as an example.

Kiwi.....is the LATER copyrighted (haha) or can I use that. Not only do I agree and practice that concept, it should be the standard of care regardless of type of model you work in.

Gents, enjoy your day.....

What do you know. I am in PA as well. Welcome to the City......

Fear Mongering to promote an Agenda???? What?? Would never happen...not in politics, not in religion, not ever!

Funny because it's true. Down with the politicians:thumbsdown: .

However, it is truely sad that some people are that dispicable!!!!

the biggest 'problem' with the concept of the '|Golden Hour' is when it moves from a concept aimed at reducing 'second peak' deaths and becomes a target or even a performance metric, It's another scenario where education vs training comes into play.

another factor to consider is how many of the 'prevented' second peak deaths become third peak deaths?

One could ague that the "Trimodal" trauma system plays right into the "Golden hour" as the first peak is time of injury to 1 hour. It has been argued that the trimodal system may not be valid, and can vary from system to system. There are also issues with types of trauma as the different types produce different results using the same parameters (Blunt vs. penetrating) http://www.journalacs.org/article/S1072-7515(05)00537-5/abstract.

I however agree with your second point, as to how many deaths are prevented as in they did not die of wounds received, but later die from infection, organ failure, etc......

IMHO, these two concepts need to be tossed, and we need to start re-evaluating our needs.

I am not saying this is the case. BUT, most people that I know who fail the NR the first time, do so because they overthink and/or over analyze the questions. Remember, keep it simple....A, B, C's. Don't worry. Many people have failed the test and have gone on to be great providers.

The question is, do you have the stones to pick your self up and give it another go?

Edit- because my spelling is horrible.

Very Pausible. However, from what I recall most people like this come to the US illegilly have their children and raise them here as homegrown terrorists. The issue is that most of the kids don't want to finish what their parents started.

As far as the politicians are concerned.......typical. I do know that sometimes, some members of congress cannot site their sources, because they sit on different panels which received classified briefings

BUT, based off of what Ruff explained (as I did not go to the link) it sounds more like verbal diarrhea, and playing on public fear to me.

Good topic Ruff.

Our protocols now reflect this as part of our practice. No longer do we simply pump fluids into trauma patients, but manage the patient to a palpable radial pulse through small bolus of fluids to maintain said pulse.

Lets maintain the clots that are there rather than blow them through over exuberence with fluids.

A lot of this argument also stems back to what i said earlier about Trimodal death patterns. We are not God(s) (although some like to think otherwise). If a person is going to exanuate, then chances are they have injuries to their Spleen, Liver, pancreas, probably pulmonary contusions, some renal issues as well. At some point we need to accept, as harsh as it sounds, that some patients will die. Regardless of our actions. Blood products have a short shelf life, so it is not practical to be carrying them, just in case, as we do with saline or ringers.

Phil, I agree with your statement. I would just add radial pulses, and proper mentation ensuring the brain is getting enough. Not always possible I know, but good markers to go off of.

Plus 1 for humility.

Good luck, and keep asking questions!