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Posts posted by P_Instructor
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I am in the process of developing curriculum for our regional Community Paramedicine program, and I am desperately seeking any imput on potential reference materials that would be of great assistance in my endeavor. Please respond via personal message, or contribute on the thread. Any imput again would be greatly appreciated.
P_Instructor
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You are correct Bare! I attended one of the scenario workshops in Chicago, and the event was absolutely enlightening! Any instructor that does not go through the workshop and understand the portfolio concept will be giving their students a dis-service. These new students will be picking my butt up one day soon, so they better be ready.
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My bones are creaking......must be I am old.....still on occasionally.
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Two days Saturday and Sunday cleaning the garage setting up for rummage, then a glorious 24 hour Labor Day shift. Ahhhhh, it's great to work part time.....
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type 2 trigeminal neuralgia?
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Think outside the box. I have had 2 cases like this. Work him up to rule out AMI with 12 Lead. My cases were both atypical presenting heart attacks.
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Which book are you looking for? Any specific publisher?
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From another old fart that started back in '77, welcome.
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Heck, diggin around in the attic and found some old glass syringes and the real steel needles.
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Emergency Crews Attempt To Rescue Olympic Figure Skater Who Fell Through Ice Sports News in Brief Sports olympics ISSUE 5007 Feb 19, 2014 0 0 0 SOCHI, RUSSIAIn a race against time, local emergency crews reportedly rushed to rescue Italian figure skater Carolina Kostner Tuesday after the Olympian plunged through a hazardous thin patch of ice during her short program at the Iceberg Skating Palace. Unfortunately she skated way out into the middle of the rink where the ice was weak and it collapsed instantly when she landed her triple axel, said rescue worker Ignativ Barkov, adding that Kostner ignored the sounds of cracking ice while performing an otherwise flawless step sequence and combination spin. We have to act fast or shell succumb to hypothermia. Granted, a world-class athlete like Kostner can withstand the initial shock for a few minutes, but her thin, sparkly leotard will do little to protect her from the deep and frigid water below the ice. At press time, crews were attempting another dive after initial efforts had only managed to recover a sequined headband and several loose rhinestones
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Paramedics to be trained to harvest donated organs on scene
Posted by: RJ Beam in EMS News 21 hours ago 0
Provisions in Obamacare will make getting approved for an organ transplant much easier. Unfortunately the supply of organs is still very low, meaning the chances of getting a transplant are still unlikely. Much the difficulty in obtaining organs comes from a delay in the ability to harvest. So in an effort to get more organs harvested, Paramedics will be trained to accomplish the task, on scene.
<img src="http://cdn.1starriving.com/wp-content/uploads/sites/7/2014/01/organ_trasplant-300x180.jpg" alt="organ transplant" width="300" height="180" class="size-medium wp-image-2640" />Doctor Wellington Yueh a former paramedic turned heart surgeon is spearheading this program. NREMT has already pledged their support. The AMA is reviewing the idea and seems likely to approve because the organ donors are dead.Soon Paramedics will be helping harvest organs for transplant.
Dr. Yueh had this to say about the new initiative.
“We see many instances of Paramedics being on scene where a person is obviously deceased. But because police and the coroner have reams of paperwork to complete the body sits in the scene for hours. By that time none of the organs are viable for harvest anymore. This new protocol will get transplant surgeons the needed organs, yet still keep the bodies on scene for the cops.”
In addition to special training, paramedics will also need some new equipment for organ harvesting. An extremely sterile kit will be added to ambulances staffed by organ harvesters. The kit will include a number of surgical scalpels, saws, bone cutters and clamps. In addition the ambulances will be outfitted with a chilled storage box.
Professor Paul Atreides Criminal Justice department chair at the University of Duncan, Idaho is apposed to this idea.
“There is no way we can let these ambulance drivers cut open people at a scene like that. Anytime someone dies outside of a hospital setting the police need to do a complete investigation. I realize the idea here is to save lives. But the cost is too high. How many criminals will get away with murder because some medic screws up a crime scene doing surgery on a dead guy?”
Margot Fenring the Dean of EMS at the Ben Gesserit College sees this as a great opportunity.
“We have some very well trained paramedics that can do many of the life saving skills any ER doctor can. Keep in mind our paramedics do medical procedures in a space 1/8 the size of an ER that is traveling at 50MPH. With that level of skill they can easily recover human organs from the dead. Obviously I do have some bias as my staff is currently developing classes to teach these skills. But the key point is that this will save lives. Viable organs were going without harvesting due to bureaucratic red tape. Now those organs will be collected and transplanted into people who will get to live.”
No word on when the program will be implemented. Rumor has it that limited markets will be tested during 2014. If results are positive by early 2015 paramedics should be in the organ harvesting business.
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Watching a new medic worry more about the stupidvisor calling them on their cell phone when he knows the crew is on a stemi call, and not paying attention to the patient.
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If you are on duty, being paid for your services, and come upon an MVC that you could possibly utilize your training, you should have a duty to act. I am not sure what you mean by jurisdiction. Is it the same city? same county? same state?, or different state?
The big thing is that you are driving the biggest, most advanced and star of life emblazed mobile billboard that you can think of. You don't stop, and there may be more problems down the road.
Ahh, rules and standards, morals and ethics.....love it.
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IV's rule the roost here.
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I look at it as the prep time for IV versus IO is about the same. Looking at the initiation of the puncture, IO faster. Secondary fluid or med administration seems better with the successful IV. IO's have the need for pressure infusors that take a little time, etc.
My feeling is alternative fad that is useful in particular patient populations where IV access may be delayed or impossible. If so, go IO. Routine IO because someone is lazy and hazy to gain access via IV should be looked at closely.
Everyone has valid responses, etc., but being opinionated, you should be able to get the IV. If not, the skills seem to be lacking.
Overall, my first impression is that the 75% is greatly inflated, however, one must look at the evidence closely, The question is as addressed, why all of a sudden the great influx of IO's?
Around here, rare IO's unless no IV can be started. EJ's usually prior to IO.
Waiting for the true numbers.
Great question/post!!
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Question to the Instructors in the forum. 12 Leads are now being incorporated into the static psychomotor exams for the NREMT. How many current institutions are utilizing 12's in static station practices? Just wondering.
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As many of you are aware of, or are being told now, Mike Smith, Paramedic and national lecturer and instructor from Tacoma, Washington has passed away. Many EMS providers have listened to his lectures at numerous conferences throughout the US.
I as others did get to know Mike personnally, had a few brewski's with him, and gained insight to his vast knowledge in the EMS corridor.
If you had the opportunity to visit with Mike, please remember all the good things he brought to the table.
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miscusi has really laid it out for you. Call your state agency in regards if you are eligible or even capable of obtaining certification/licensure.
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Per california law this type of facility was under no obligation to provide any level of medical care if I heard the story right. They dont even have to help you take an aspirin. This facility is an assisted living facility which helps with activities of daily living and emergency care is not in the purveyance of their care regimen.
And pinstructor if your family member acknowledged that no cpr would be given when you became a resident then NO you would not own the franchise.
And let us not lose sight of the fact that the family does not seem to have an issue with this...........yet. Since the mrdia got a hold of this story there might be dollar signs popping up on the horizon.
I quess I still haven't seen the fact that a document was signed for no CPR. Many are assuming. If so called document was signed, and P&P's were followed, so be it. I am not in tune with Cali-law, so probably am way off base here. Agree again that there is way to much info that needs to be brought out here.
Secondary thought.....if there were 'no code' documents, what did the paramedic crews do with the patient? We know they transported to the hospital. What were their protocol concerning this? Did they ALS or BLS the patient? Just wondering to get better insight.
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Constipated as I am, I do want to say I agree with both of you that there is much more information that needs to be discovered here. I do not disagree with the 'sensationalism' of the media as you portray.
The only aspect I am trying to bring out is that as medical professionals, we are to be the patient advocate. I do not disagee with what you both are stating, and would like to know more information. Either I stay constipated or have a glorious bout of diarreha.
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The ICN Code
- According to the ICN, a nurse’s
primary responsibility is to patients, and she should treat them with
respect for their rights, values, customs and beliefs. Personal
information she learns about them should remain confidential. In addition,
she should continue her learning because she is personally responsible and
accountable for good nursing practice and she should take care of her own health so it doesn’t interfere with
her ability to care for others. She should co-operate with her co-workers
but, if a patient’s health or safety is threatened by others, she must
take action to protect them.
The ANA Code
- Like the ICN, the American
Nurses Association believes that a nurse’s first commitment is to her
patient, and she should have compassion and respect for every individual
no matter who they are, what kind of health problems they have, or what
social and economic background they come from. A nurse also has a duty to
establish, maintain, and improve health care environments and conditions of employment so that high quality
health care can be provided. She should work to improve health
care locally, nationally, and internationally, and she should also work
through her professional associations to influence social policy
concerning health care. Finally, she has a duty to maintain her own
competence and to grow personally and professionally.
Types of Ethical Issues
- Registered nurses responding to
a 2006 survey reported 21 different ethical issues they faced while caring
for their patients. These issues included the use of restraints, pain
management, determining best interest of the patient, organ
donation, life-sustaining treatment and end of life care, reporting
errors, dealing with impaired nurses, conflicts of interest, justice for
people with disabilities, the ethics of research and the use of
information technology and confidentiality.
Nurse Dissatisfaction
- In a study investigating the
relationship between ethics and the intent of nurses and social workers to
leave their profession, researcher Connie Ulrich, Ph.D., RN discovered
that 25 percent of practicing nurses and social workers wanted to leave
the field. More than 52 percent of those who responded said they were
frustrated with the ethical issues they faced. Hospital workers reported
more ethical stress than caregivers
who worked in other settings. Nearly 40 percent of hospital workers
reported they had no organizational resources to help them with their
ethical concerns, while another 25 percent said they had never received
any ethical training.
- According to the ICN, a nurse’s
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No morals, no ethics. Societal changes that is sending this country downhill. I would own that whole franchise of nursing homes if it was my family member.
Triemal04......what do you mean 'POS dispatcher' should be fired? They were trying to do the best they could trying to get assistance to the patient. The only morons in this case were the facility employees that can't/won't do the right thing.
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Tough situation....one that you hope is rarely seen. However, can be very taxing when confronted with this type of scenario. One cannot routinely be prepared for this type of call unless working in that area/environment all the time. I would think out of the box and use common sense. On scene, utlilize shifts on the extrication if possible. One idea would be to get the biggest, heftiest tarp available and cover the car/patient to keep the wind off. That would be the biggest problem ... the wind chill (patient and providers).
What was the outcome?
Smartest thing youve ever seen a patient/family member do
in Patient Care
Posted
Called for elderly female with chest discomfort. Patient was non english speaking grandmother where 8 year old grandson on scene and initiated 911. This little fellow was the best interpreter I have ever had, even against the paid individuals utilized at the hospitals we serve. I had the little guy ride along and he immediately and understandably interpreted and relayed every piece of vital information need to assist his grandmother.....and I am talking medical related terminology. When arrived at cardiac center, the staff was wondering where my interpreter was. I just pointed at the little guy and said 'use him'. They were not impressed and started to go into panic mode to call someone to interpret. I immediately confronted them and stated that this little fellow was the best interpreter I have ever encountered and probably would be the best they would ever encounter. Skepticism was rampant, but after I coaxed further information and questioning where his abilities were shown, the staff shut there traps and were in awe.
I lost track of what happened, but I am sure that he is providing real good care to someone now......