All posts by marcm

74 The Final Final

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(21:58) Ron goes through his final final and some skills testing. No more lectures, no more teacher’s dirty looks.

What I Did This Week

Clinicals

Paper work. What a pain.

Mentions:

Bob Page on Stethoscopes

Listener Questions

I had originally planned to contact Kelly directly, but then realized his answer would probably be useful for EMS Newbie fans as well.

Hey Kelly, I know that you’ve blogged on this topic many times and I’ve got a quick question for you. Since you’re apt to transport some rather sick (yet not entirely time sensitive) patients without lights, sirens, and guns a blazin’, do you sometimes still describe your transport as “emergent” when giving radio report to ensure the receiving staff understands that the patient is sick? It would sure be nice to trust that painting a clinical picture would be enough to alert the nurses that they should plan on placing the patient a corner or hallway, but having spent a lot of time working in the department, I fear the staff would sometimes be too busy and distracted to pick up on less overt signals. Even with a fairly obvious description, our nurses are often multi-tasking while taking radio report, and it would be very easy to assume: “The patient can’t be that sick, I didn’t hear any sirens and they’re non-emergent.” As always, thanks for the podcast,
– Vince

Hi Ron, hope you are well. I was just wondering if either you or kelly had heard of the ‘lethal triad’ with regards to trauma and whether this was something that you guys were being taught about on your course or whether you thought it should be?

Warm regards from a cold england
Jamie

On the GI symptoms relating to anaphalaxis, I had heard that people with a new food allergy will often go through a progression of allergy symptoms to a certain stimulus before reaching full-blown anaphalaxis, often starting with GI symptoms. My understanding was that they would consume the food and have nausea, vomiting and/or diarrhea but not necessarily an airway issue, so it might be written off as “bad food” or stomach bug or something similar. Next time they ate that food, maybe they had worse GI symptoms but still did not connect the issue. Eventually it progresses up to true anaphalaxis with airway issues. Have y’all heard anything similar?
Andaew – Hey, In regards to stethoscope is there really a difference from a low end stethoscope and a high end stethoscope? If there is a difference how much of a difference is it and would it be worthwhile purchasing a higher quality stethoscope?

71 2011 Texas EMS Conference

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(27:30) This week Ron and Kelly podcast live from the 2011 Texas EMS Conference. They discuss the different lectures and sessions they attended, which were good, which were packed so full of information it was tough to keep up and which left the brain as soon as the feet left the room.

There’s talk of C-PAPP, the number one reason of geriatric altered mental status, another episode of “This week in firearms”, retrograde intubation, and the new myths of EMS by Dr. Brian Bledsoe.

SP 07 Wilderness EMS

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(29:02) In Special Episode 7, Ron interviews Jeff Isaac from Wilderness Medical Associates.

Ron and Jeff discuss how wilderness doesn’t necessarily mean deep in the back country or in a cave, how the definition has changed over the years, and why WEMT is useful for all EMT and Paramedic practitioners.

Jeff is a physician assistant with a particular interest in backcountry and marine medicine. His 30 years of professional experience includes service as an ambulance and fire/rescue crewman, professional ski patroller, and medical staff in hospital emergency departments and ski area trauma clinics. He has also been a senior instructor and course director with the Hurricane Outward Bound School and has worked as mate and licensed captain aboard sail training vessels from New England to Trinidad.

Listener Questions

Bruce asks…
Most EMS personell say that WEMT is a waste…have you found that to be the attitude?
Andy W asks…
Does the Wilderness EMT program cover special considerations to take during cave rescues?
Caitlyn
When would wilderness protocols take effect?