38 Burns

(38:54) This week we talk about burns, intubation, vassopressors infiltrating from peripheral IVs and much more. Kelly is calling in live from the road returning from EMS Today, and Ron is in some of his hospital pajamas pre-clinical.

Remember all that discussion about what you should or would do if you were on scene for an emergency event, but not on duty? Well we get the answer today because Kelly and TOTWTYTR were at a diner when a women went into cardiac arrest. Find out what Kelly did by listening this week.

Listener Questions

I discovered your podcast last February and even though I’m not in EMS (I’m a nursing student) I’ve been fascinated with your podcast and have binged through the entire series during my workouts and trips on the train.

My question for you is if EMS ever has to do any type of genital exam, like in the case of vaginal bleeding? And what do you guys do to protect yourselves from patient allegations of misconduct?

I might be getting annoying with all the questions that I’m asking, but…..

If an NPA or an OPA is inserted into a patient, is a head tilt chin lift or a jaw thrust still neccessary? It’s one of those questions that has been nagging around in my head, and I’m curious about it.

As an EMS newbie myself (an EMT halfway through precepting) I’m having a hard time figuring out how to respond to the typical “new guy” crap. I seem to be held to a higher standard than the others, while at the same time being treated like I’m incompetent. I know it wouldn’t be wise to overreact and respond in a mean way… it would only vindicate those who are giving me a hard time. But I also don’t want to cave in and appear weak every time someone dishes it out at me. I want to earn the respect of those I work with, but I’m still trying to figure out exactly how that’s done in EMS. Any suggestions?


CPR for 90 min link
Hand washing. Talked about in basic episode.

Kelly’s excellently written account of his save is on his blog.

9 thoughts on “38 Burns”

  1. Ron where is the article man in rural MI having CPR for 90 min?? since I live in rural southern lower MI I would be really interested in reading about that.

  2. Ron, your pronunciation of many common medical words is so bad. I’m glad Kelly corrects you so you don’t sound ignorant in front of patients, but I have to say, I’m embarrassed for you.

  3. He’s a newbie, and you have to remember he’s seeing these words for the first time in class. They don’t teach medical terminology in EMT class any more, which makes grasping the terminology even more difficult when they bombard you with it in medic school.

    That’s what the podcast is about; me offering Ron the mentoring I’d give a newbie in the rig as he’s going through class. Ron makes that learning process public, so that our newbie listeners can learn from his mistakes. That’s not incompetence, it’s bravery.

    Besides,do you know how many 20 year medics I;ve seen who still mispronounce pharynx and larynx?

  4. To add to the answer to the question about genital exams (especially since I had the “pelvic/breast/rectal” right of passage today), there’s no real reason to do anything really past a look in a non-pregnant women with vaginal bleeding. Unless the bleeding is in the introitus (opening of the vagina) or vulva, chances are you aren’t going to see the source anything anyways. Unlike, for example, the trachea, there is nothing in the walls of the vagina giving it shape, so to see anything you need a tool to provide support and move the wall out of the way. Additionally, you need a light source. This is simply not an area to be blindly poking around with, especially without any sort of lubrication. Additionally, the fact that you can’t get a patient into a lithotomy position on a standard gurney would complicate the exam further.

    Also, to reiterate what was mentioned in the show, always have a chaperon, preferably one who is the same sex as the patient, when possible.

    Also, since the subject of ‘when to go hands on during delivery’ came up, how much training do paramedics generally get in shoulder dystocia maneuvers? Sure, most paramedics will never see one, but when it happens, the baby has to come out and there’s no reason why paramedics can’t do everything prior c-section. As the OB/Gyn running that session commented regarding the episodity, “We can repair it, just get the baby out.”

  5. Have to learn somehow, and the best way to do it is immersion. There’s a reason why medical students never have to take a medical terminology course because if the Latin names are used constantly (and as concepts are introduced), then using them becomes second nature.

    Since we’re on the topic of medical terminology, here’s the Dorsal Horn Concerto by the Amateur Transplants…

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