Comments for Confessions Of An EMS Newbie Podcast

Comment on 74 The Final Final by For You EMS Newbies… | A Day In The Life Of An Ambulance Driver

For You EMS Newbies… | A Day In The Life Of An Ambulance Driver — Thu, 22 Dec 2011 20:22:03 +0000

[...] … Episode 74 is up on Confessions of an EMS Newbie. [...]

Comment on 74 The Final Final by Vince D

Vince D — Tue, 20 Dec 2011 09:42:00 +0000

Thanks for the response; it looks like regional variability strikes again! I kinda like your setup, but in my area there’s pretty much two arrival notifications we can use: emergent vs. non-emergent. It doesn’t allow much for shades of gray, but upon reflection I still think it’s a sound concept since so much of what we do is based on the doorway diagnosis of “sick vs. not-sick.”

Pertaining to Jamie’s question, I was rather shocked that Kelly hadn’t done a whole lecture entitled “The Lethal Triad” at some point, let alone had encountered the topic. I’m sure it’s something he’s taught but just never described as such. Speaking for our English colleague, I’ll note that in addition to listing the three factors Ron mentioned (hypothermia, hypovolemia, and coagulopathy), the concept of the lethal triad really focuses on how each piece affects the other two. Hypovolemia begets hypothermia and coagulopathy; hypothermia worsens coagulopathy and blood loss; coagulpathy leads to hemorrhage and more hypothermia. I, for one, really like how it emphasizes a multi-faceted approach to folks losing blood and the need to correct all three problems, not just the obvious loss of red cells into the street (or, as is usually the case at my community hospital, the toilet bowl). Enjoy your Christmases gentlemen.

Comment on SP 04 Bob Page by 74 The Final Final

74 The Final Final — Mon, 19 Dec 2011 07:01:34 +0000

[...] Bob Page on Stethoscopes [...]

Comment on 73 Environmental Emergencies by Acpfohl1

Acpfohl1 — Tue, 13 Dec 2011 08:28:00 +0000

I was listening to the podcast about cold. Being cold, wet and in the wind can be enough to chill someone too much. It happened to me after a fire in July the rehab sector set up a misting fan to cool the firefighters, I ended up being cooled to the point that I was shivering. The loan of a dry T-Shirt and a few minutes in the sun helped reverse the shivering. It was an interesting experience being so chilled on a 90 degree day that it resulted in shivering. I am used to being chilled in the winter not during the summer.

Comment on 72 Hematology and Burn Out by Wmoening

Wmoening — Fri, 09 Dec 2011 03:42:00 +0000

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

Comment on 72 Hematology and Burn Out by Michael Wilk

Michael Wilk — Wed, 07 Dec 2011 20:13:00 +0000

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.

Comment on 71 2011 Texas EMS Conference by Anonymous

Anonymous — Fri, 02 Dec 2011 20:11:00 +0000

great show guys. Question for you Kelly. Have you seen before any type of sticker for your car windshield that states the driver is diabetic & to call 911 if you suspect the driver is having a diabetic emergency?? I was walking into a local store and noticed a car parked in the handicapped spot having one of these stickers on the corner of the windshield on the drivers side.

Comment on 71 2011 Texas EMS Conference by Christine

Christine — Wed, 30 Nov 2011 00:28:00 +0000

Great seeing y’all at the conference! Thanks for the incredible classes, Kelly. Hope both your Thanksgivings were wonderful. (Too funny on the ending!)

Comment on 66 More Pediatrics by Christine

Christine — Tue, 29 Nov 2011 20:00:00 +0000

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?

Concerning Dextrose via IO, would it be better to just pop them with Glucagon IM? We do that with adult diabetics regularly if no IV access is possible. Would it work with pedis as well?

Could y’all talk about ALTE’s? It relates to the blue baby that resolves prior to EMS arrival. After having one of these, I did research on it and it apparently can be a precursor to SIDS. Our protocol mandates that we always, always, always transport these kids due to that risk. Is this related to the cardiac conditions Kelly discussed, or is it different?

Thanks y’all!

Oh, and yes… we learned about the neck bandaging technique in EMT-B. Believe it or not, I have a copy of the American Red Cross’ First Aid book from 1965 that contains instructions and detailed illustrations of that technique. They were VERY detailed about bandaging back then!

Comment on 65 Defenses and Pediatrics by Christine

Christine — Tue, 29 Nov 2011 19:41:00 +0000

Not sure why, but I seem to get a LOT of pedi calls. Way more than the average “10%”. I have found that for a lot of kids (especially reading age), cell phone games are a cool reward for being brave during procedures. They really seem to like the “Moron Test” app on my iPhone. You definitely have to place a time limit on it though or you will never get your phone back.

I had to laugh about the whole SANE nurse thing! Yes, they carry a HUGE kit. Experience has also taught me that you NEED to know where they are located. Calling facilities while on scene before transporting is a great idea. Some only have SANE coverage during certain hours of the day and if you transport a sexual assault to somewhere without a SANE nurse, they will need to be transported to another facility ASAP. ER’s are not very happy if you did not do your homework first. There is also a big difference between adult and pedi SANE capabilities and just because they can handle adults does not mean they do pedis. These are also typically horrible calls. Get your Kleenex box out, be prepared for an adult who is a basket-case, and don’t be afraid to ask for help for yourself after the call if you need it.