Ep 19 Thank God For Pigs

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[audio:19_Pigs.mp3] (43:24) This week we talk about giving narcan, should you give nitro before or after getting an IV. Can an IV of Lactate’s Ringer cure a hangover?

What the inside of a heart looks like

We talk about doing patient assessment the same way every time and and getting your reports done quickly. Can an experienced paramedic get a pulse without a watch? Well you newbies can’t, so wear your watch. Looking for patients on scene and finding ones that weren’t there before.

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Aimee Binning from NAEMT talks about the TACOS acronym

TOTWTYTR

Naloxone: The Most Abused Drug in EMS

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  • Christine Springfield

    As a former miitary medic, I can indeed confirm the LR IV for hangovers… it worked even better with high-flow O2. Oh, and if YOU were the medic, you got to start it on yourself. It takes a special sort of desperation to start one backwards, upside down and on yourself. Avoiding that particular experience is highly advisable!

    On the jackets, a good source of inexpensive and field-tested jackets is the local military surplus store. Most military jackets come with liners, come in black or blue and have been extensively tested in various conditions, then you can add reflective tape pretty inexpensively if you want it. Galls.com is also a pretty good source if you want specific EMS jackets. Spending the funds on one with a layering system is worth the money because it can be adapted to various temps throughout the winter, and even your shift, if necessary. Of course, your best bet, since you are heading to the TX EMS Conference, is to inspect the offerings there and wait until the last day to buy… they are usually heavily discounted because no one wants to pack them up and carry them home. Happy shopping!

    Ron, did you have any especially memorable experiences during your clinicals that you have not mentioned? Mine have been really, really interesting… brain surgery, funky cardiacs, CPR with lesions to the chest from the compression device, scoping/ulcer cauterization and removal of gastric ulcers, etc. Still got a few more clinicals to go, so I’m sure I will be adding to that list. Never a dull moment!

  • Christine, I am the biggest white cloud in the universe. I had nothing happen during any of my clinicals. I’m trying to get the cloud to go away. I’m doing an ambulance shift Halloween night in the rough area of Houston. It is my white cloud vs the hood on the devil’s day.

  • Christine Springfield

    Good luck! Should be a fun night!

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  • TACOS

    Tobacco

    Alcohol

    Caffeine

    Over-the-Counter

    Sexual Enhancement Drugs

  • Anonymous

    Thank you, Greg!

  • A.

    S = Sexual/Street Drugs

    🙂 Thang Greg for Getting the word out there!
    Aimee

  • JPINFV

    Well, I’m going through the archive catching up, however backwards.

    You were talking about airway anatomy at the pig lab. One excellent source actually is Youtube. For example, here’s a video of a physician performing an awake needle cric (with assistance) followed by intubating himself with a fiberoptic scope. http://www.youtube.com/watch?v=bDRTzmuwMnQ&feature=player_embedded Similarly, one thing you might want to try is emailing any local medical schools (I don’t know where you’re at) and try to get permission to visit their anatomy lab.

    For medications and TACOS acronym, that really covers two different parts of the assessment. Medications, which includes prescribed, OTC, and supplements, and then social history, which includes tobacco, alcohol, and recreational drugs, as well as other elements that have varying amounts of importance, such as job and sexual history. Of course this also really depends on how you structure your exam and your specific way of writing your PCR. If you follow a traditional SOAP format for PCRs, social history is recorded separate from medications.

    A special note about sexual history, I highly suggest taking a sexual history of every patient until you get comfortable with it. It’s very… awkward… the first couple times you go down the route of, “Ok, I need to ask a few personal questions to get a better evaluation of your health. (I personally put my disclaimer before the alcohol/tobacco/recreational drugs part) Are you sexually active? Men, women, or both? One partner or many? Do you use protection? …and so on. Does every patient need it? Not really, but every GU, GI, or abdominal pain (especially in females) should get those questions asked and you need to be completely comfortable asking it before broaching the topic.

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