To Medic's

[Eric]

I want to start a medic class in the next year or so.

And would like your help in haveing a head start on school.

What kind of books / training guide / or online help.

So i will have a better understanding of some of what i well need to pass the NR and become a better care giver

[Kiwiology]

Advanced life support requires performing increasingly omplex assessment and treatment (often on persons with many co-morbidities such as [N]IDDM, asthma, COPD, cardiac problems, obesity etc etc) where there is exponentially increased potential for catastrophic and fatal harm to be caused through substandard practice.

Example: PubMed lists two cases where adenosine was given by paramedics for symptomatic AF, the patient went into asystole and died. Now, does that not strike you as odd? Hmm, diagnosing AF vs. SVT .... see what I mean?

Practice must therefore be linked back to a wide knowledgbase of anatomy, physiology, pathophysiology/etiolgy, cardiology and pharmacology with the ability to reflect, critique and improve upon practice through self-directed quality improvement and research based upon evidence based medicine.

Now to put that into terms we can relate to the real world (blasted real world, why must you constantly remind me that I live here? ) is that you need a good education. I am surely no expert on the DOT Paramedic curricula or how it is taught but I've seen some fairly shady classes out there on the net. At one point I thought I was pretty hot shit because I could recite protocols off the top of my head and knew how to perform them, now, I quickly got bought down to earth when I took up some college science classes because I realised I knew sweet F/A and just how important getting as much knowledge as you can is!

My suggestions are as follows:

Do: Take college level A&P (with lab), pharmacology, pathophysiology, English and math.

Do it because: You will learn far more than is probably required by the DOT curricula and this will lay the foundation for practice and quality improvement. I'm talking proper, nursing level (if avaliable) A&P, patho and pharm not those "fundamental" classes taught for Paramedics over two weekends. The DOT states the biggest problem for Paramedic level students is lack of grasp on english and mathematics and I'd believe it!

Do: Get the list of A&P objectives out the Appendix of the NHTSA/DOT 1998 Paramedic curricula and answer them

Do it because: It'll reinforce all important knowledge! (It's a fairly big list, I was quite impressed)

Do: Take a college level research methods paper

Do it because: You will be running into journal articles and research and "evidence based medicine" in your medical audits and QI stuff as EMS begins to focus on it more and more. Knowing how to pick apart a research article or journal paper is important because often a lot of shady and misleading numbers can be slapped together and make something we do look bad (look at the skermish about intubation a couple topics over)

Do: Look around eMedicine, PubMed, ScienceDirect etc for articles and journal papers on things you want to know more about

Do it because: You will gain a better understanding and wider perspective on what is practiced and why it is done

Do: Learn 12 lead ECGs to begin with

Do it because: You will also learn how to interpret a 3, 4 or 5 lead ECG as well so in the event your service doesn't have 12 leads yoiu won't be at any disadvantage; and if you get 12 leads it won't be an extra learning curve

Do: Stay the hell away from cookbook, accelerated or unaccredited programs

Do it because: You are doing yourself a disservice by getting "minimum" education!

Now, as for textbooks I have used the following and found them to be excellent!

- Marieb & Hoehn: Human anatomy & physiology (7th Edition)

- Lippincott's nursing series 12 lead ECGs (little brown book)

- Walraven: Basic arrythmias

- Lehne: Pharmacology for nursing care

- Springhouse: Pathophysiology made incredibly easy

- Bledsoe, Porter & Cherry: Essentials of paramedic care (note you have to supplument this with the other books as it's often superficial)

Hope this helps!

[Dustdevil]

Quality post, Ben.

The key is not to try and pre-learn the things you are taught in medic school. It is to learn the things that they do NOT teach you in medic school, in order to establish a foundation for understanding what they do teach you. So purchasing textbooks, study manuals, practice tests, and the like are a complete waste of time. You're going to need to take some prerequisite courses if you want to actually get a leg up. The only books I recommend, if you're don't care enough to take prerequisite courses, are these:

1. A programmed medical terminology self-study text.

2. An anatomy & physiology colouring book.

3. Rapid Interpretation of EKGs, by Dale Dubin. And you shouldn't even crack that open until just before you start the cardiology portion of medic school.

Anything else is just going to cause more questions than answers.

Edited August 5, 2009 by Dustdevil

[fireflymedic]

Are you looking at going through Know How Inc's program? If so, I believe they are either through or currently going through the accredidation process right now with KBEMS. Check with them to be sure though because if they don't pass or don't plan to you are wasting your time (that is for any program mind you with the new rules in process). If so, you'll get a SOLID Anatomy Physiology prep by them, so short of the lab (they kind of do a mini lab deal) it's almost as good as a college class as they use people that have a biology degree to teach it so they know well what they are talking about. From what I've heard they have a pretty solid program, but then again so does anchorage and a few others in the area. I"m not sure where you are looking at, but with the new accrediting process and join up with KCTCS for pushing for it to become a degree program I think we'll see some positive changes. Also - you'll do your morgue time in the A and P section rather than later and what you get in the book will just be a review. Just find out what book they are using. I think most around this area are fond of Brady, but there are a couple programs using Mosby and a small handful with Nancy Caroline (which is worthless). Best of luck to you.

[EMS49393]

I disagree that any A&P class is good unless it has a lab attached to it. You need that lab time to bring together all the concepts you're learning in the book. I initially took a great A&P course that used the Martini book, but only had a day long cadaver lab attached to it. I later went through college level A&P and was amazed at how the weekly lab, lab assignments, and experiments actually helped me better understand what was presented in the text.

I wouldn't recommend anyone take the easy way out with an A&P class that isn't offered by a college and requires a weekly lab.

Edited August 6, 2009 by EMS49393

[fiznat]

Hmm, diagnosing AF vs. SVT .... see what I mean?

Not really. Rapid a-fib is frequently misdiagnosed as SVT or vice versa, which is why even the AHA recommends the use of Adenosine as a "trial maneuver" in such cases.

Practice must therefore be linked back to a wide knowledgbase of anatomy, physiology, pathophysiology/etiolgy, cardiology and pharmacology with the ability to reflect, critique and improve upon practice through self-directed quality improvement and research based upon evidence based medicine.

Agree I guess, but this is really a kindof masturbatory way of summing things up. I don't believe that our knowledge is really all that exhaustive. We get a cursory training that covers a very small slice of medicine, and I think it is much more important to recognize our limitations than it is to trump up this quasi doctor vision of paramedicine. Work hard, yes, but also know where your understanding falls off (a lot earlier than you think).

To the OP, my answer would be to brush up on your A+P, and otherwise simply prepare yourself to pay attention in class. That's all.

[Kiwiology]

Agree I guess, but this is really a kindof masturbatory way of summing things up. I don't believe that our knowledge is really all that exhaustive. We get a cursory training that covers a very small slice of medicine, and I think it is much more important to recognize our limitations than it is to trump up this quasi doctor vision of paramedicine. Work hard, yes, but also know where your understanding falls off (a lot earlier than you think).

Somewhat, yes. It seems we are taught a little about a lot. I would argue that no, we are not doctors or nurses, depending on where you go EMS has a larger scope of practice and less education than an ED RN (which strikes me as rather odd) but that to restrict onself to the required knowledge of the DOT curricula is (personally I think) rather narrow minded.

Now, some widsom I was imparted: It's great to have all that knowledge about A&P and patho and pharm and whatnot but remember, it changes very little about what you auctually do for the patient; keep it simple and be quietly confident that you know the what and why but don't forget the how and when or you will get yourself into trouble out there.

[Eric]

thank you all lfor your post to the person in ky you in the ville?

[fireflymedic]

thank you all lfor your post to the person in ky you in the ville?

Just study hard - and no I'm not in the "ville". I avoid that plague unless I'm sent on an IFT to U of L and yeah, I prefer to avoid the three ring circus there just to get a "parking space" lol. Hope you haven't floated away with all that flooding. We had a similar amount but not as bad as it could have been. We're still waiting on some areas to dry out. Best of luck to you in class. I'm a certed instructor/evaluator and know the majority of the programs in the area. If you have questions about one specifically, feel free to ask. Stay safe and be smart.

[Eric]

thanks you and be glade you never worked for yellow well never go back to that place