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Jaymazing last won the day on December 27 2012

Jaymazing had the most liked content!

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  1. Brand New EMT Student

    First off, don't worry about being older than your classmates. Life experience is vastly important in this industry, and you'll find that age will offer it's own particular benefits when it comes to communicating with your patients in the future. Secondly, keep on 'nerding it up'! Enthusiasm is a trait that some of the more bitter, jaded folks in this industry might scoff at, but truth be told, this profession needs more people who are passionate about healthcare. Never lose that spark, and remember; find a job you love, and you'll never work a day in your life. Welcome to the city, and welcome to our community.
  2. Gender Uncertainty & Good Manners

    I don't know where to start with this...
  3. Gender Uncertainty & Good Manners

    Thanks everyone for your comments! Except for you, Mikeymedic. I don't know why you chose to comment at all, since dismissing the question and discarding other peoples responses is neither productive nor helpful to me. You clearly operate under a completely different set of personal guidelines than I, and while I'm sure you're MUCH smarter than me (you've clearly demonstrated that), I can in fact think of situations where this is pertinent information to have, and thus am admittedly still trying to improve upon my patient interview skills when it comes to broaching the more tender topics. Maybe where you work is different than where I work, but I can easily say that at least 80% of my calls aren't really "emergency settings" by most standards. And perhaps my tendencies to address my elders as "Sir" or "Ma'am" are outdated where you are. But I'm supposing we live in very different worlds. On a brighter note, I really like the bra-strap-auscultation idea, MariB, and I'm going to store that one in my toolbox for next time I need it!
  4. A humbling call

    Welcome to the city. I'm going to take a stab at deciphering this. I think he was trying to be friendly, not condescending, but maybe I'm just reading it with a different shade of sunglasses (the writing is indeed poor). I think what he meant was first, "congratulations on the good call, and performing good patient care", then second, "We are all human. I've had 12 *years* of continuous patient care (at various levels) and never had that happen, which makes that even more impressive". And then I think he was asking for a history, because he thought this was a scenario....but I'm being hopeful. Obviously a complete Hx gets put on the backburner when you haven't passed the 'C' of the ABC's. I'm not ashamed to admit, I've struggled to find carotid pulses on people who I knew were alive. And I wouldn't be ashamed if I couldn't find one on someone who I thought was dead, either. I hope that nobody thinks that makes me a poorer practitioner, but if so I'd remind them that it's only when we acknowledge our shortcomings that we can truly improve upon them. This sounds like a fun call, did you get to bust out Mobey's Magills?
  5. So, I'm sure we've all been in this situation to some extent at some point in our careers, and I'm curious to find out the best way to go about handling it. Those patients who you just can't tell if they're a male or a female. How do you go about asking? Is there a polite way to do it? Maybe a subtle trick you use; perhaps in how you phrase questions? Or is it all about being blunt? For the sake of eliminating a few of the obvious answers, lets say the patient is in their early twenties, average weight, doesn't have a wallet (and therefore no identification or paperwork), has a unisex name, is wearing bulky winter clothing, and has a voice that keeps you guessing. The balls in your court. And yes, that was a pun, and no, I have no shame.
  6. Dizziness/nausea post being backboarded

    On slow days when we have EMT students, I like to get them to experience being strapped down on a spine board in a moving ambulance. It's a weird feeling, even for a healthy person, especially when the vehicle turns a corner. It certainly makes me feel dizzy, too. Sometimes tilting the board for a while helps alleviate the dizziness, and as a plus you'll also be ready if the dizziness turns to nausea. You can also try dimming the lights, that's worked for my patients in the past, but of course this is only really useful when you don't need the lights on.
  7. Cloudy urine in trauma

    I'll take a stab at this! I'm just bouncing idea's around, so let me know if I'm out to lunch here. Phosphaturia! And if I had to guess some mechanisms, maybe an increase in serum calcium 2ndary to the trauma and #'s, leading to increased excretion of phosphate, leading to milky urine output. Or maybe the patient just drank a lot of milk or milk-based alcoholic beverages before their high-speed-collision. But that doesn't sound as cool as phosphaturia. Bailey's anyone? As a side note, if you market "Mobey's Hybrid Selective Comfort Spinal Motion Restriction", I'd like to create a jingle for advertising. M-H-S-C-SMR rolls so nicely off the tongue...
  8. That's okay. Won't hold it against ya, bud.
  9. That's how I feel about it, too. And I don't advocate going against your medical control or protocols, by any stretch of the imagination. If you want to go against your medical director, become a doctor hahah I'm also a big fan of BLS before ALS when considering Tx for tachydysrhythmia's
  10. I couldn't agree more; SVT is a catchall phrase. In many respects, I believe the phrase is used more as a safety blanket than it is a confident diagnosis. I've gone on a few tangents about this topic in this past, myself. I'll spare you my typical SVT lecture (also known as my NCT lecture), as I get the impression we'd agree on most of the key points. This basically is repeating my statement made previous, in which I made mention of likelihoods, not certainties. Speaking strictly statistically, most accessory pathway abnormalities are found early in life (what with advancements in education, understanding of electrophysiology, and newly available telehealth consultation technologies) following previous events. While not being impossible, it's getting more and more rare to both see these phenomenon, but also be the first to discover someone with this phenomenon. However, I digress, because statistics can only take you so far, and I'm pretty sure I'm preaching to the choir here anyways. Plus it's hard to dissuade from the allure of anecdotal evidence, even among the most knowledgeable practitioners. I'm a little jealous of anybody who's caught it in person
  11. Nobody can be 100% certain of a rhythm Dx at that rate in a prehospital setting. End of story. So I guess you're never giving Adenosine. Which is a shame, because it's a good drug for most tachyrhythmias. If you're going off the rate that the monitor gives, bare in mind that the depicted rate will vary occasionally based on irrelevant artifact (such as patient/vehicle movement), and determination of rate should more likely be based on hands on palpation and R-to-R measurements (use the small box method if it's that fast). It seems to me that your medical director is opposed to the use of adenosine...Sucks for you, man. The only time I can think of A-FIB being a contraindication for Adeno is if it's in the presence of WPW or LGL syndrome, which are both incredibly rare, and it's likely that if they have either of those conditions that they'll be able to tell you. Remember though; consider your causes, and is your patient stable....
  12. I think this topic is spinning into the ditch. The Lewis lead is a hand tool, if used correctly and in the right circumstances, to acquire an extra piece to the puzzle when met with an interesting case. What I think people are trying to suggest here isn't that it's pointless to broaden your knowledge of ECG's, cardiology, or patient care, but are instead suggesting that there is in fact a delicate balance that must be maintained when applying these non-standard practices to standard-care. What Kiwi and Craig are saying is a valid and reasonable response to the concept of modifying chest leads in the prehospital setting, and I do not believe that their remarks were meant to shut you down. While no, you did not suggest the act using this configuration on unstable patients, we should remember that many tachycardic rhythm's in which atrial activity cannot be accurately defined are statistically unstable by their very nature, and current studies suggest that recognizing distinguishable, organized atrial complexes is an act that often times delay's treatment (even if it wouldn't delay your treatment). I have't had any clinical use for the Lewis lead in my career, but I look forward to the day it helps me diagnose a tricky rhythm so that I can show off to my partner. I fear I've yet to impress her...
  13. Well hello there

    Hello! I'm Jay, I'm an EMT-A/Primary Care Paramedic in western Canada, and have been for a little over 2 years now. I just stumbled upon this website, and really enjoyed the scenario forum, and thought it seemed like something I'd enjoy partaking in! I am passionate about everything EMS related, but I have a particular love for cardiology and ECG's, and I'll probably be submitting a few ECG's from my collection once I'm familiar with how things work in this forum. I'm excited to get involved in the discussions, and to hopefully learn a thing or two to make me a better practitioner.