akroeze

I don't think they are trying to recognize the providers as a medical specialty. I think they are trying to recognize the EMS Physicians who oversee them as a medical specialty.

Happy π day everyone!

Ah hah! I KNEW the Lifepak 10 could do a 12 lead, and people said I was crazy!

The situation of you being right about the LP10 does not in any way exclude the possibility of you being crazy...

When China stops building a coal-fired, non-EPA regulated power plant every week, I'll start worrying about the environmental impact of my one ambulance. :rolleyes:

So because someone else does something you consider worse it makes what you do ok?

I think it's called the critical hour. It was done both in Toronto and in Baltimore at shock trauma.

Interesting, that is a different show then. I'd be interested to see it. I'll have to hunt around my cable box's channel guide and see if it plays here.

DocH, I think what they are trying to say is that you should treat every call like the person is acutely ill (speed wise) even if they aren't that way when the time comes that you have a serious patient there is no problem in acting quickly since it is what you are used to.

I know it's irrelevant, but I was watching a show on Discovery Health Called "Critical Hour" when I read over this post, and they were showing that same trauma room.

creepy....

Did you mean to say Situation Critical? That is a show that is along the lines of Trauma: Life in the ER but shot at Sunnybrook and at St. Michael's. Those are Toronto's two trauma centres.

Okay I'll be more specific:

1. Do you routinely determine the mean QRS Axis and can you apply that information practically? No, something I have been meaning to learn but have a hard time grasping unfortunately

2. Are you aware of the Sgarbossa Criteria and have you used it before? Sounds very vaguely familiar, something I'm going to have to google

3. Do you routinely check for Cor (or P) Pulmonale?Yes

4. Do you look for LVH, BER, and BBB on every STEMI?Yes

5. Do you systematically interpret every 12 lead you read in the same order every time?I try to as much as possible but get distracted very... oh look a kitty!

6. How familiar are you with syndromes like Brugada, Pericarditis, Wellen's, WPW, hyper/hypo K, and long QT?Familiar enough with all those except Wellen's.... never heard of it, another thing to google

Others....?

My answers in red above.

Would you actually nebulise the salbutamol? I would probably be more inclined to just squirt it down the tube. After all, we're not trying to get it to all the alveoli like in bronchoconstriction, we're trying to get rapid distribution into the blood stream.

Unfortunately for me the only two options I have are bicarb (we only carry one amp) and salbutamol.

I have personally been involved in giving Solu Medrol for suspected spinal cord injury. I was called for a diving accident where the party was still in the pool and completely flacid. Pt. was removed from the pool and flew him to regional trauma center. When we made contact with the Trauma center, we were given orders to administer 2 grams of Solu Medrol. We only had access to 750mg to administer but flight crew administered what they had and the patient got the balance at the trauma center. Turns out patient had C3 and C4 fracture with pressure on spinal cord. 2 days later patient was walking and today has made a complete recovery.

Our service now carries 2+ grams of Solu Medrol on all trucks. This incident made a firm believer out of me for use on spinal injuries in the field.

One time I punched my patient in the face and they didn't end up dieing from their asthma attack. Obviously all asthma patients should be punched in the face for their own good!

Unfortunately the only anti-emetic I have experience with is Gravol (Dimenhydrinate.... you 'mericans call it Dramamine) IV/IM. Is there an "official" statement out there as to the strengths and weaknesses of each? Sorta like you can find for narcs.

*confuzzled*

My first instinct even in the absence of a DNR would be to contact medical control. More than likely my medical director would not "make us" work this poor woman. Given her past history, what quality of life would she have even if by some act of divine intervention a pulse was restored. Putting her body through the trauma of CPR, is not worth it. I know what I say probably sounds bad, but I have been doing this long enough to know that the chances of getting a pulse restored from asystole is less than 20%.

I guess you're right in that under 1% is also less than 20%

We'll see what happens. Haven't gotten any response yet from the ~15 councilors but it is a holiday.

So for better or for worse I decided to submit my letter to council anyway. I just sent the file linked below to every councilor's e-mail address plus the mayor. I will let you folks know if I get any response.

http://home.cogeco.ca/~rkroeze/ACP.pdf

Who's going to go to school for to years and work for $12.00 an hour?

With increased education comes increased wages.

You have to have the increased education FIRST before the wages go up.

Okay, I give up. My mistake because Education is horrible for EMS. Education is horrible for EMS. Education is horrible for EMS. Repeat.

Is there truly something wrong with informing people that there are might more ways to approach something if they come across the same situation? Obiviously there is and education is horrible for EMS. There are more people reading these posts than the one EMT involved here. Some might actually see some value from a different approach that they hadn't thought of regardless of some of the closed minds here who know all there is with their EMT certification. Patients and situations will be different and there will be times so just the way this one scenario was handled does not mean it should be applied to all patients who present similarly.

But for the sake of peace: Education is horrible and no one in EMS should be made to learn more.

:roll:

Point out to me where I said anything about education being horrible for EMS? If you look at my history here I'm a HUGE advocate for furthering education. I have 2 years of BLS education and another year of ALS education and I feel it should be a degree at the BLS level (if we are going to continue to separate the levels at all).

I am simply trying to illustrate why CB is frustrated. He is saying that he did his best to inform the patients of the risks of refusing transport and you are jumping down his throat insulting him. Insulting people is not a good way to sway someone to your side just FYI.

Sorry.... what does any of this have to do with the topic? I notice lately people have been bringing their own agendas and pushing them into threads.

Soapbox? Why is it that everytime the word "education" is brought up it is a "soapbox".

This can be an example of where the patient probably has more medical knowledge than the EMT and knows it. What is so wrong with suggesting that one educates themselves about medicine a little better than the general public they serve?

The education of an EMT is less than 200 hours and they can be easily manipulated by patients that know a little bit of pharmacology or buzz words they've picked up from the neighbors.

Okay soapbox: education, education, education. Some U.S. EMS providers need to get over their fear and insecurities of education and the people who have made an effort to become educated.

I was more trying to comment on the fact that the following was happening:

Person #1: Apples are red.

Person #2: Apples are horrible because I choked on one once.

Person #1: That doesn't change the fact that apples are red does it?

Person #2: Aren't you listening? Apples are HORRIBLE.

Repeat

Some are just missing the point...about education.

If you only have a minimal knowledge about disease processes, the patient can state they have whatever to get anything out of your bag of medicine without you being the wiser. Patients can find out more about different diseases from the internet or from their neighbors than what you will find in many EMT or even Paramedic classes. If you can show the patient you might actually know a little about some things, they might listen. If you listen to some patients' statements "everyone has asthma" because their neighbors made the diagnosis based on some dearly departed aunt that had the wheezes. And the EMT has just confirmed this "diagnosis" without having proof of a history.

"The nice EMTs have been treating me for Asthma and didn't tell me I had anything wrong with my heart or had cancer". "I trusted their diagnosis."

Why are some so against exploring the bigger picture in the world of medicine than what is taught in an EMT book and a 110 hour EMT class?

Ok, I apologize. I had you misread on this issue. You aren't suggesting that this patient should have been kidnapped, for some reason you chose this thread as a spot to get on a soapbox about education standards. You'll have to forgive us for getting confused as this really isn't where you normally expect that kind of preaching.

Because King Obama will take care of it. King Obama will rid you of all of your troubles.

It must be difficult walking around with that huge chip on your shoulder :shock:

I'm agreeing with you here CB....

Vent, you seem to be completely missing what he is saying. He TRIED to get the patient to go but they refused to comply. Are you suggesting that he should have kidnapped the patient?

ASA is the only medication given by any level of EMS proven to increase morbidity and mortality in acute MI.

Typos are fun

Sun Parlour used to provide for Leamington, Kingsville, Woodslee, Essex and Tecumseh

I don't understand how advocating for a higher level of paramedic care in your home community would leave you with a black mark. Regardless of whether or not people agree with you it's difficult to fault someone for trying to make improvements to a service. Perhaps there are more politics at play than I am aware of?

The powers that be that run the local company are so anti-ALS it isn't funny. They practically froth at the mouth when spewing out anti-ALS comments.