72 Hematology and Burn Out

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(33:54) Blooooodddd, maybe this should have been the halloween episode. Ron learns about blood diseases. Its also scary how burned out everyone in class is getting at this point. Only 3 weeks to go.

Ron gets his textbook changed. He also gets an EMS job, find out what’s scary about that on this week’s episode.

What I Did This Week

Got something added to the new addition of Paramedic Care, Testicular Torsion

Had a Job interview – I got the job

Medical Emergencies

Another test. Are they trying to trick us?

Special Populations

Skills lab – Which do you think is the most challenging skill when testing?

Airway lab

Clinicals

Giving Glucagon IM when you can’t get a vein for Dextrose

Christine asked about it. Someone on FB asked about it.

I had an interesting situation with Oral glucose when we could’t get a vein.

Listener Questions

Please help settle a debate that has torn my partner and I apart. We’ve argued in many different hospitals, stations, and nursing homes about pushing D50 through an IO. It’s not actually a situation we run into often; I think we just like to argue.

One of us argues that pushing D50 via IO is practically a guarantee that the patient will lose a limb. The other thinks we would have heard about all these limbs going necrotic by now, and that it would be discussed in EMS more or perhaps popping up in a new protocol.

Thanks in advance,
James

Hi Ron and Kelly. I have an answer, a question and a comment for you all.
The answer to the question Kelly was asking on episode 66 is the McMartin Preschool trial, which took place in California.

The question is I am an EMT student and our program has just released us to do ambulance ride alongs. What are the best things I can do to have an effective ride along experience and help, rather than hinder my preceptors?

Finally the comment- I’ve been listening to your podcast since episode one and it, along with your can do approach is a significant reason why this 40 something guy believed that it would be possible to become an EMT.

Thanks and keep up the good work!

-Marc

  • Kelly, Are you one hundred percent positive that 250 mLs of D5W has the same of amount of dextrose and D50. My math shows that 250 mLs of D5W would have 12.5 g of dextrose (glucose). Just curious.

  • Wmoening

    James, yes Dextrose in any available consintration may be administered through a patent IO without fear of necrosis or osteomylitis. The blood vessels within the ostium absorb the medication very quickly due to the drastic increase of pressure within the bone. However, this only applies to a patent IO if it is improperly placed or if there if a fracture to the bone in question then yes the solution can infiltrate the surrounding tissue and cause necrosis.

    W. Moening, CCEMT-P