Question on traction spints

[firefighter523]

Ya know who you remind me of, yes you guessed it, John Kerry! Your little college education was probably given to you by your parents, and you probably still don't respect them for it. You come into this line of work, thinking you know just so much, when all you have done in life is read a couple of books. I don't care about you, your college schedule, or what comes out of your little brain to be placed on your next text. It is cry-babies like yourself who make this job SUCK, and that is the ONLY reason this job SUCKS.

Now let me tell you a little bit about me. I am a former US Marine, Crash Crewman who has served all over the world, including Japan and Australia. I have been in the Fire/EMS service for 12 wonderful years (dealing with know-it-alls) like yourself. Don't know what you want to do in your medical career, but whatever it is, STAY IN THE HOSPITAL, under a controlled environment!! That would be the best place for you! Leave the rest up to the PARAMEDICS who make life and death decisions on their own, in a split second. I don't think you could handle such a great responsibility!! You need to grow up, get the silver spoon out of your mouth, and live life son!! You don't know what it is like out in the real world yet, because you are still young and stupid. Anyone can read a book!! You want to impress me, put your little biology book down, and pick up an M-16 and hit the sand!!!

For the rest of you, sorry I digressed a little, but people like this (above) make me SICK!!

[JPINFV]

Ya know who you remind me of, yes you guessed it, John Kerry!

Your little college education was probably given to you by your parents, and you probably still don't respect them for it. You come into this line of work, thinking you know just so much, when all you have done in life is read a couple of books. I don't care about you, your college schedule, or what comes out of your little brain to be placed on your next text. It is cry-babies like yourself who make this job SUCK, and that is the ONLY reason this job SUCKS.

Now let me tell you a little bit about me. I am a former US Marine, Crash Crewman who has served all over the world, including Japan and Australia. I have been in the Fire/EMS service for 12 wonderful years (dealing with know-it-alls) like yourself. Don't know what you want to do in your medical career, but whatever it is, STAY IN THE HOSPITAL, under a controlled environment!! That would be the best place for you! Leave the rest up to the PARAMEDICS who make life and death decisions on their own, in a split second. I don't think you could handle such a great responsibility!! You need to grow up, get the silver spoon out of your mouth, and live life son!! You don't know what it is like out in the real world yet, because you are still young and stupid. Anyone can read a book!! You want to impress me, put your little biology book down, and pick up an M-16 and hit the sand!!!

For the rest of you, sorry I digressed a little, but people like this (above) make me SICK!!

lol.

wHo needz all that edumacation ne wayz?

[paramedicmike]

disregard

[Asysin2leads]

Firefighter: One word: Decaf. Relax, calm down, take a deep breath, just because someone went to college doesn't mean they're better than you, you don't have to fly into a rage. Its ok. We're all friends. You have what is known as an inferiority complex, but with a little therapy, and perhaps some medication, you'll be able to move on.

While I was in the hospital cafeteria the other day, two orthopaedic surgeons were in line so I used the opportunity to ask them their opinion on reducing an open fracture in the field, given the risk of infection. They're consensus was far from surprising. Basically, they felt that if the person is maintaing perfusion to the distal extremities, and you have a relatively short transport time to the hospital, then the protrusions should be covered in sterile dressings moistened with normal saline and the limp splinted in the position found. However, if there is significant compromise of blood flow to the extremity and/or you are in an area where transport time will be prolonged, reduction should be attempted after grossly decontaminating the protuding bone with a normal saline rinse.

Given that these two were surgeons at the specialty trauma center, I'm going to take their word on the subject.

[weasel 108]

Ya know who you remind me of, yes you guessed it, John Kerry! Your little college education was probably given to you by your parents, and you probably still don't respect them for it. You come into this line of work, thinking you know just so much, when all you have done in life is read a couple of books. I don't care about you, your college schedule, or what comes out of your little brain to be placed on your next text. It is cry-babies like yourself who make this job SUCK, and that is the ONLY reason this job SUCKS.

Now let me tell you a little bit about me. I am a former US Marine, Crash Crewman who has served all over the world, including Japan and Australia. I have been in the Fire/EMS service for 12 wonderful years (dealing with know-it-alls) like yourself. Don't know what you want to do in your medical career, but whatever it is, STAY IN THE HOSPITAL, under a controlled environment!! That would be the best place for you! Leave the rest up to the PARAMEDICS who make life and death decisions on their own, in a split second. I don't think you could handle such a great responsibility!! You need to grow up, get the silver spoon out of your mouth, and live life son!! You don't know what it is like out in the real world yet, because you are still young and stupid. Anyone can read a book!! You want to impress me, put your little biology book down, and pick up an M-16 and hit the sand!!!

For the rest of you, sorry I digressed a little, but people like this (above) make me SICK!!

holy crap :shock:

like Asysin said,relax.,drink decaf. Sounds like you need a hug.

[AnthonyM83]

JPINFV, Quick note: Rarely use your educational accomplishments to back up your argument. There will always be someone better...every now and then it'll be the person you're arguing with.

Certifications and experience is one thing...but talking about the classes you're taking is lame. (Especially when not that impressive) It's experience and application of knowledge and EMS common sense that matters more in this field. Education experience does not equal field experience. I've only met one person with a better academic background than me at work (my FTO who is leaving for med school), but most any of the others could school me anyday because I'm new to the FIELDWORK.

And Firefighter, I think his original post debating infection with you was just that. No punches thrown yet...I think that's fine and it's an opportunity for everyone to bring their views to the table. As you can see, it wasn't only the newbie who had concerns with infection. Regardless of who is "right" it was a valid concern to keep pushing.

That's all from me.

(edited for grammar)

[ERDoc]

Between rounds I did a literature search on Pubmed. There is relativley literature to support the use or non-use (is that a word?) of traction splints. Here is what I have found so far:

http://www.ncbi.nlm.nih.gov/entrez/query.f...l=pubmed_docsum

As you can see it is not much. There really is no good evidence to support or not support the use of traction. I like the thinking of the orthopods that Asys talked to. Any open fx is going to end up in the OR for washout and repair anyway, reguardless of what you do in the field.

[JPINFV]

JPINFV, Quick note: Rarely use your educational accomplishments to back up your argument. There will always be someone better...every now and then it'll be the person you're arguing with.

Certifications and experience is one thing...but talking about the classes you're taking is lame. (Especially when not that impressive) It's experience and application of knowledge and EMS common sense that matters more in this field. Education experience does not equal field experience. I've only met one person with a better academic background than me at work (my FTO who is leaving for med school), but most any of the others could school anyway me because I'm new.

And Firefighter, I think his original post debating infection with you was just that. No punches thrown yet...I think that's fine and it's an opportunity for everyone to bring their views to the table. As you can see, it wasn't only the newbie who had concerns with infection. Regardless of who is "right" it was a valid concern to keep pushing.

That's all from me.

You can't apply what you don't know. The only reason why I even brought in my educaitonal backgroud was because firefighter wanted to throw pot-shots at me instead of discussing the issue at hand.

Unfortunately, EMS common sense is rarely common and sometimes hurtfull. I've had an FTO tell me not to hook up a patient to a hospitals tele-box following a CCT because I might "hurt the patient" (9 volt battery worth of shocking goodness maybe?). Look at all of the "common sense" treaments thrown out over the years. MAST pants, trendelenburg, narcan titrated to LOC instead of respiratory status, fluid resusctation of trauma patients, etc. Field experience is nice, but we'd all be more effective if we understand what we're doing then if we just follow cookbook protocols. Unfortunately it is so easy to loose sight of the long term effects of our actions when we only see the patinet for 15 minutes. Experience won't clue you in until it's too late for your patient.

[AnthonyM83]

Those things aren't "EMS common sense" (rather theory stuff thrown out) ...I see it as in-the-moment decision making, knowing when to apply the knowledge you have and when to look at the bigger picture and realize what's needed at the moment for the situation. I never said theory is not needed (re-read)...I was making a point that you shouldn't try to qualify yourself with it too often (especially in field public safety).

-Example me not using EMS common sense: (During training I was prompted to get BP as soon as we got inside the rig. Finally thought to do it on my own without prompt, but failed to realize medic was getting IV ready, which I should have been prepping instead)

-Example of it: (RR decreasing on pt, so getting BVM out at my side).

Even if you're being bullied, it's in poor taste and adds to the stereotype to some people that those with degrees are know-it-alls...and part of the reason why I avoid mention of my academic background at work.

PS I think your debate with Firefighter was fine...but don't assume he doesn't know about infections. Classroom theory isn't the issue in question...it's applying it situation and figuring out which is a bigger risk (laceration/infection).

I'm just a new (in EMS that is), so take it for what it's worth.

[firefighter523]

College boy, and everyone else. For the record, don't worry, I don't think you are better then me, or anyone else because of college. I think it is great that you are going to college and furthering you edu. I am doing the same thing myself. Your mouth, or in this instance, your fingers come off to people that you have it all figured out. I know that infection is possible, especially in the immunocompromised. I also would not mess with a stable limb if I didn't have to. However if you think that I am going to let a pt suffer great pain (NOT STABLE) from a broken femur because I am worried about the latter effects of infection you are mad!! Have you ever taken care of a pt with a broken femur, obviously NOT! It is the most horrifying death scream, that you will ever hear in the back of a bus. I am sorry, but your comments piss me off, at that point, who cares about his infection!!!!

I don't care if it is open, or closed, if there are no contra-inds, I WILL hold traction, because it WILL in most cases relieve there pain somewhat. It does help with internal third space tamponade, and also keeps the muscle from further spasms. Then you may proceed with the MS, or whatever you use. You and I both have alot to learn, in fact, the moment you think you are above learning more, you are dangerous! Like someone said before, who the heck cares what classes you are taking, I could give a rats @%* about whats involved in diagnosing mental problems. That is NO emergency to me, but to each his own, right!!

Good luck in future endeavors!! Remember my friend, we are all human, and nobody is perfect!! We need to learn from each other, leave your attitude back in the rear with the gear micro-boy!!