the doctors out, but i know something!

 Have you just started at a service that doesn't have cable? Did your service rip the carpet out from under the feet of  Abby and Gibbs ? Don't know where to go without DiNozzo? Is your service trying to shield you from the Illuminati grasp on cable media? Well here's some advise for you. Keep Calm and read FOAM.      But what is FOAM?  Well it's  Free Open Access Meducation  says the amazing folks over at  Life in the Fastlane . It's a fantastic tool to learn, teach, and grow as a person who providers medical care. It isn't just residents or doctors who use it. Nurses, respiratory therapist, medical assistants, paramedics, and ALL Allied health providers can benefit. FOAM has been facilitating collaboration across the world. In my little services we find it hard to talk to our neighbors, much less work with people in other countries. With social media connecting people on opposite sides of the world, it amazing to see d...

"Ooh, Ooh, Ooh, to touch a female vagina, gives Victor a hardon." Patrick J. Lynch, medical illustrator See, I said it. Vagina, hard on, and I'll just go ahead and add penis to this sentence. However, It worked for it's purpose. Remembering the 12 Cranial nerves. I – Olfactory II – Optic III – Oculomotor IV – Trochlear V (1,2,3) – Trigeminal VI – Abducens VII – Facial VIII – Vestibulocochlear IX – Glossopharyngeal X – Vagus XI – Accessory XII – Hypoglossal  - ( Via Wikipedia ) (Yes, I'm using Wikipedia as a source. No this isn't a scholarly or even very intelligent post, it's okay.) Sooo, I was suppose to memorize the 12 cranial nerves and their function (sensory, motor, or both) for a test this semester. I didn't, the test didn't go well. this is the point of test (or is how I use them at least). They are to show you what you need to learn! Within hours of that class ending, the tale of Victors sexual adv...

What type of organism is involved in spreading this pathogen (bacteria, virus, etc.)?  Identify the name of the organism (if any).  If you have been provided with an organism/pathogen what disease does it cause? Clostridium tetani spores Anaerobic gram-positive, spore-forming bacteria Spores found in soil, animal feces; may persist for months to years They can survive autoclaving at 249.8°F (121°C) for 10–15 minutes. The spores are also relatively resistant to phenol and other chemical agents. Tetanospasmin estimated human lethal dose = 2.5 ng/kg Causes Tetanus (Centers for Disease Control and Prevention, 2012, p. 291). What is the common route of infection (air, blood, etc.)?  Identify what would be the most likely way a paramedic would be exposed. Spores usually enters the body through a wound or breach in the skin. Toxins are produced and disseminated via bloodstream and lymphatic system (Centers for Disease Control and Prevent...

Into the Water — The Clinical Clerkships — NEJM Something that I have a hard time with and work equally hard at is understanding that I think, I make the world around me. I get so focused on trying to be "the best I can be" and all the silly ideas that come with that. I focus on the best I can be, which turns into just focusing on me, which turns into not thinking outside my own head. So it's good to hear I'm not alone in that thought. It's better to know that I can change it. I hope that as my education and understanding of the world around me gets better I'll remember to think more. Now I've been in EMS for 2 years, which is a small chunk of time in the scheme of things but I do understand how the clinical clerkship can affect providers. Tuesday night I had an elderly lady with chest pain. A man in his 50s who was having a STEMI.  98% occlusions of the circumflex was the cath lab report when we got back. A post arrest, vented Pt who was bucking the ...

Vark Learning tool Visual: 4 Aural: 12 Read/Write: 4 Kinesthetic: 14 The VARK very accurately describes my personal learning style. I have always learned best by doing. I have to actually manipulate and try things to do them to the best of my abilities. I also enjoy and do well with lecturing. I enjoy listening and talking to people. I am indifferent to visual aid and power points, I see them more as a reminder of what a good lecturer should be talking about. I also dislike just reading text. I understand it’s importance and do it willingly, but it’s a slow process for me and I often get distracted multiple times a page. With lecturing I am going to use my visual, aural, and more than likely reading/writing. Luckily my Aural skills are better and that makes me a good student for listening to lecture. Hands on learning happens to be my forte. I do very well working with people and practicing skills, I learn by doing very quickly and have a much higher retention ra...

"Shut up! you don't really work! you played borderlands for eight hours!" He spat.  I had complained I was never home.  I wanted him to get off his ass and stop playing games and help me clean up after I had worked 48 hours in three days. I had to bite my tongue.  He wouldn't get it.  He was right in a sense.  I had  spent a whole 8 hours playing borderlands.  Once.  The last 24 hours hadn't been like that.  Had not been like that at all.  The area I cover is fairly quiet most days, most days being a key component in that statement.  My favorite saying at work, to the point I would call it a mantra is "No rest for the wicked".  Assuming I'm a wicked person, it's about as true as they come. Like some dispatcher somewhere was watching me, as soon as I kicked my boots off the tones dropped for another call.  I was running on fumes by the time I got home. I wanted to tell him to go pound sand. I had  worked for the la...

Terrible things happen to good and/or undeserving people.  The drunk driver walks away from heaps of scrapped metal.  Parents do the exact opposite of take care of their children. One persons stupidity leads to another persons demise.  Sometimes people just die because of unintended side effects. I had the misfortune to help with one of these cases the other day.  A young female, no medical history.  Only medication was oral contraceptives (Now I'm hoping as I write this that it doesn't turn into the catholic churches next stand against contraceptives).  Started complaining of not feeling well a few days ago and had fainted earlier on the day I met her.  When I met her she was already intubated and waiting to go to a major hospitals.  She had coded a half dozen times already.  In EMS we have this silly notion of an "EMS code save" which means very little for people we treat.  It just means that we got them to the hospital with a...

The first thing I have to say about a Critical Incident Stress Debriefing(CISD) is that they are like civil fight clubs. They have a very sensitive, confidential nature about them, so like fight club it has 2 rules. You don't talk about the CISD.  You DO NOT talk about the CISD. Jk...

     You're called to residence for an unknown medical.  Short response time to scene.      Once you arrive you gain access by unlocked door and find patient slumped to the right in a kitchen chair and moaning "oh my head, it hurts" over and over.  Patient responds to speech by only continued moans.  Patients medications suggest significant cardiac history.  Patient rapidly moved to stair chair and moved to ambulance.  While moving patient from the house he stops moaning and is no longer responding to voice, only painful stimulus.

From the ME EMS Protocols : A. Preperation - Mix NOREPINephrine 8 mg in 250 ml NS.  B. Dosing - Starting Dose is NOREPINephrine 0.03    μg(mcg)/kg/min. Titrate by 0.03  μg(mcg)/kg/min every 3-5 minutes. Usual dose is 0.03-0.25  μg(mcg)/kg/min. Usual max dose is 0.6  μg(mcg)/kg/min. Absolute max dose is 3  μg(mcg)/kg/min C. Titrate to maintain SBP greater than 90 mm Hg. For 2013 the  Medical Direction and Practice Board decided to move away from Dopamine to  Norepinephrine. I am no doctor (yet) but I'm guessing it has to do with some of these studies  ( 2 , 3 ).   A subgroup analysis showed that dopamine, as compared with norepinephrine, was associated with an increased rate of death at 28 days among the 280 patients with cardiogenic shock but not among the 1044 patients with septic shock or the 263 with hypovolemic shock -   Daniel De Backer, M.D., Ph.D., Patrick Biston, M.D., Jacques Devriendt, M.D....  for...

     "It's simple really. You can't discuss politics like Syria in a university setting anymore; We have too many Middle Eastern students that think totally different from American students. We can't come to a clear, answer with all of these people thinking wrongly of us". - the genius state university students sitting at the next table.      I don't know what hurt worse, trying to keep with the crowd and eating my soup before it was cool, or the absolute atrocious logic from this "university student". As my tongue and ears burned from their respective assaults I watched as these two people talked of the great imperfections of the world. They were both going to be great scholars and thinkers and had to think of the global issues. I slowly chewed through my sandwich and slurped my soup as I listened, painfully, as they both debated the same small sliver of reality they lived in. I looked at them and couldn't help but be grateful of my "simp...

With the fall semester done and my program not actually starting until fall of 2014 I've hit an awkward place.  I don't know what to do with my time. I mean I still work 60+ hours a week, but I don't have brain burning work to fill every waking (and some sleeping) hour of my life! Like, I still have nightmares about just needing to find X! So I'm working on things to start doing to occupy my mind. Here's my list so far. This blog! I want to be move active writing in general. I have no idea where i want to go with this. I want it to be a conglomeration of what's going on. i might write about interesting calls I do. Things I'm learning/studying, recent musings, and other projects.  Returning to YouTube. I don't want to "vlog" or V-log as will start calling it thanks to Danisnotonfire . I enjoy acting, writing, and insanity... so V-logs and skits seem perfect for me... Magic the gathering! *sigh* This is slowly but surely becoming a new thin...