BEorP

My question wasn't really about whether or not seeing elevation in two contiguous leads is enough to have a high suspicion of MI since that is what we have been taught. My question was, assuming you can have a high suspicion of MI from elevation in leads II and III when seen on a 12 lead, could you have the same suspicion based on leads II and III from just a 3 lead. I don't mean to say that ST elevation in two leads can definitively diagnose MI though because obviously there are other things that can produce ST elevation. It seems like AZCEP answered my question by basically saying that it depends on the monitor that you are using since some might actually have a lover quality when only doing a 3 lead... hopefully I've understood this correctly.

Thanks for all the replies.

Hopefully I can make my question make sense... We've recently started learning about 12 leads and were taught that they have "diagnostic quality" if we find ST elevation in two contiguous leads to suspect an MI. What I am wondering is if with just a 3 lead you could conclude that someone is having (at least) an inferior wall infarct if there is elevation in leads II and III? (I'm not saying that this would rule out any other areas of infarct or be a reason not to do a 12 lead if you had the capabilities though.) I was told by an instructor that you cannot because a 3 lead does not have the "diagnostic quality" of a 12 lead monitor, but that didn't seem to make much sense to me... are leads II and III shown differently (or more clearly) on a 12 lead? If we could say a pt is having an inferior wall infarct from elevation in leads II and III in a 12 lead, why could you not do this with just a 3 lead? Thanks

Are you saying that EMT-Bs in Australia are trained in intubation or know what it is?

Advanced airway management and IV therapy?

I wouldn't argue with that :wink:

I'm not putting you down because you lack the training of Paramedics... I'm not trying to put anyone down, I don't mean to make it personal... but this is just going back to the much discussed lack of education in some EMS systems. I don't think EMT-Ps have enough education either if that makes it any better. I wouldn't disagree with BLS before ALS as long as it is educated BLS before ALS.

There's a difference between paramedicine and the first aid or standby medical coverage that you provide, but paramedicine is medicine. I don't mean to be disrespectful to you, but as Dust pointed out, you're not in EMS. Being a first responder or whatever you want to call yourself is not medicine... it's giving out band aids and giving oxygen to the people who are actually sick. I don't mean to bash your organization but I know that being a volunteer "medic" it can be easy to come under the false impression that you have seen and know a lot more than you actually have. For example, it seems that you are big on trauma with your motocross stuff... are you aware that most EMS calls are medical? What would be the purpose in having a doctor on an ambulance? They are highly skilled and educated but they also know a lot more than they need to (e.g. there is not need to interpret an x-ray in the field right now). There's also EMT-Bs in the US who I would consider no more than ambulance drivers and maybe sometimes give them the credit of being medical technicians. So where do we draw the line? It's hard to say for sure but obviously somewhere in the middle. I think a good start is a four year degree with a large focus on patho to ever be able to call yourself a Paramedic and respond to my family's call for help.

We also use ECGs Made Easy and I've found it to be very helpful... the CD that is included is also great.

Under 18 can't be trackside at motor sports even but you can run onto the track to save the day? http://www.emtcity.com/phpBB2/viewtopic.php?t=5974

It just doesn't bring them back, they were already dead

We should worry about education, not training. Look at a PCP program in Ontario and then tell me again that EMTs are sufficiently educated.

...like Saved?

Sorry I didn't pay enough attention when reading your post but NR or state the advise is still the same for practical stuff. I don't know what your NR or state or any exams are like, but what I find helps me on EMS tests is to just think of the questions as if it is a scenario you're about to do and decide what your priorities would be before even looking at the options. (Obviously this advise is for questions about a call rather than just "what is the size of a D tank" or stuff like that.) It may seem like an obvious thing to do, but I think it really helps and can increase your confidence when what you thought of is one of the options below and the other three or four are obviously wrong.

I don't know if it is just the written that is causing you problems or the practical too. If it's the practical part then my advise would be to practise a lot (and I mean a lot lot lot). Although ride alongs are good to see how what you're learning will actually be applied, you'll see how things are done in the field rather than how they probably need to be done for testing. If you do enough practice scenarios or skill stations or whatever you will be tested on then you will be able to do it without even thinking and hopefully the nerves won't be much of an issue. (It's like the whole social facilitation thing... you'll be so good at the practical part that it will become an easy task for you so under the stressful condition of testing you will do as good or better than always... hopefully.) If the practical part was not causing you problems hopefully that might help someone else who finds this thread in the future. I don't have any advise for the NR since I'm not from the US. Good luck.

Give him a break... he wanted to give it every possible chance to live. Threads were made to be posted in and now he can leave it up to a mod to lock and and say it's done

Sorry I wasn't able to help...

Zee Medical Products out of Irvine, CA is what Google tells me

I am just one bad apple... along with many other "one bad apples" on this site who will agree with me. It may worry you that I am in the EMS profession, but at least I am in it as a profession. Thank you for recommending I see someone about my childhood issues, I will get right on that.

EMS is a profession, not a hobby. Medical standby at the advanced FA (EMT- level I have no problem with, but there is no reason for you to need a Sager especially since I am guessing you have very little experience responding to true emergencies.

Is there a reason that whoever you work for does not provide you with this equipment?

Goes well with your stars of life...

I know that the points I am about to make have already been pretty much covered, but I am really disappointed to see someone who has their occupation as "Educator" who either doesn't teach CPR classes well (if you are an instructor) or has never seen a good CPR class taught in your time as an EMT-P. My "we" below refers to where I recently completed my FA/CPR instructor course... We tell them <5% survive. We tell them that CPR only buys time until the pt can be defibed. We tell them that the person will not sit up and thank you and go on with their day even if you do everything right. We tell them that you can expect to break bones and when you do, just be sure that you are still compressing in the centre of the chest (rather than too much to one side so you are compressing the ribs) and then continue on. This is probably the part that concerns me most. How can you teach a CPR course without students leaving with a firm understanding that CPR is done on dead people? I know you did not say that they were never taught it, but rather that they forgot what they were taught. Dead people getting CPR is such a key point in teaching CPR that if they forget that within a year then they probably did not have a good instructor or maybe they did but that instructor should not have certified them. Just as Dust said, any instructor who doesn't cover these points adequately sucks and should not be teaching CPR. And if the instructor is covering these points and students leave the class and have forgotten them all by the time they get out of their chairs then they should never receive a certification. On a side note, any CPR instructor who hasn't failed someone probably sucks too. But back to the topic... I haven't read enough about CISD to know about how good or bad it is, but I think that if lay rescuers understand that the casualty is dead, the casualty can't get deader, CPR alone will not save the casualty's life, and if everything goes perfectly the casualty will still probably not come back to life then I do not see a need for it.

Could it be that part of the blame on the accident could be for the person driving their personal vehicle in an unsafe manner since they had lights? (rather than blaming the "bubble" light for not attracting enough attention)