Ep 40 – HazMat

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(38:41) This week we talk about the time Kelly stripped down in class. Ron’s trauma test and scenario. Learn how chest decompression really works. Handling belligerent bystanders, and HazMat. After the Harris County HazMat team talked to Ron’s class, he learned how a thumb has been replaced with a pinkie. Kelly informs us of the rule of donut.

Listener Questions

BG from NY –

Great show guys. Been an EMT -B for 5 years in NYS and worked for several volunteer squads and just signed on for a squad in NJ now. I was wondering if you have watched the show Trauma on NBC and in the last episode one of the paramedics who is trained as an MD did a few procedures in the field and saved the pts lives but in one instance gets caught and the pt although alive ends up being paralyzed from the neck down. Long story short, she gets her license suspended and possibly faces jail time. Although an unlikely scenario I wanted your thoughts in today world with malpractice rampant etc as a paramedic would you do procedures not allowed for example in your county but perhaps allowed in another state in order to save a patients live but lose your license. When you always taught that pt comes first, at what point do you put yourself and your interest ahead of them. If you did happen to save their life but left a debilitating disease or injury worthy of a lawsuit is it worth it. Rather than following the rules and if the patient doesn’t make it that’s just the nature of the job and situation. Reason I ask this is I had a recent call with a4th year medical student who refused to use his skills to because he was only a certified EMT-B but was ACLS certified but due to not being a paramedic or an EMT -I could not use any of his skills which related in the pt from an MVA ending up braindead. Let me know your thoughts guys. Great show again, even thought I am only an EMT-B i learn a LOT from the podcast and enjoy hearing about your journey through paramedic school. Keep up the GOOD WORK

Hey Ron,

I am an EMT-B and paramedic student in San Antonio. I had a patient a few days ago with contractures to all four extremities secondary to a stroke he had several years ago. The call was for HTN, so getting a blood pressure was a priority, but when I tried to put the cuff on the patient’s arm I found it to be nearly impossible. Even if I had been able to get it around the arm there would have been no way to listen to the artery due to the arm’s bent position. I was wondering are there any other places to listen to blood pressures of patients like this or with other similar difficulties? I ended up palpating the BP with the pediatric cuff around the patients forearm but I was not sure how accurate that method was.

Thanks!
Seth Bruton

Mentions:

Ep 20 – Maintaining Control Kelly’s hazmat exposure.

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  • Great show guys!! I had tears in my eyes from laughing so hard. Last semester, I got to play the deranged victim in one of our scenarios, had a ball with it completely freaked out the gal being leader. Although, I didn’t have to go as far as Kelly did, but I shook them up but good. FYI I am taking my national registry written on Monday 4/4 wish me luck.

  • My favorite mis-use of medical terminology. Other medic says to me, “You can’t check her blood pressure on that side?”

    “Why not?” I asked.

    “Because she has had a vasectomy on that side,” he replied.

    Patient, after snorting, “I assure you both that I do not have a vas deferens.”

    Me, smiling broadly.

    Other medic, also very young, looked very confused.

    Vasectomy vs. Mastectomy. Important to know the difference.

  • For the first listener question, there are much harder decisions to make than the one in Trauma in real life. For example, there was a case in California a few years ago during our wild fire season where a paramedic assisted with an RSI outside of her scope of practice. She was trained in South Dakota and had worked previously and still had an active card in Washington State, which are both places that allow RSI. She ended up working a MVA with a mutual aid paramedic engine company from her old community in Washington who was back filling the area, and the patient was an acquaintance of her’s from Washington. She ended up being suspended with the state going after her license, and apparently it took a year before it ended up in front of an admin. law judge. I wish I could find a better source than her lawyer’s blog, but my Google-Fu is currently failing me.

    http://thelegalguardian.blogspot.com/2010/06/paramedic-nailed-for-saving-life.html