Ep 19 Thank God For Pigs

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!

Good luck! Should be a fun night!

Thank you, Greg!

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.