the doctors out, but i know something!

This statement, in general, is ridiculous. No one needs to teach you to wear pants in college or the workplace. You and I learned how to put on pants as kids. Our guardians taught us cultural norms about the expectations of wearing pants... So why are we having trouble with it now? Let's preface this with humans are naturally lazy energy-conscious; we know and accept that. Unfortunately, humans have done more “work” than any known species, we also have to continue doing work to keep our value. Work meaning “ exertion or effort directed to produce or accomplish something; labor; toil ” From a scientific standpoint work is only produced IF result are produced. I can lean against the empire state building for days and have done zero work. I feel like I’ve looked at algebra problems for days… and done zero work. As an EMT I am expected to show up to work a certain way: A half hour before my shift starts. Wearing a clean appropriate uniform Having good personal hygiene ...

While perusing the the twitter sphere I found this tweet... Ultrasound in every service.My #ECCU2015 pick with Drew Harrell MD @tingles005 @paramedic_al https://t.co/CUAHCNagaI pic.twitter.com/mQs1Tj6eZc — Word on the Street (@wotsukrobl) December 11, 2015 It really caught my eye thanks to the paper I just wrote and shared  here . Point of Care Ultrasound (POCUS) has great utility in acute care and it will probably be the only imaging modality that could reasonably  be put in an ambulance. Sonosite and Philips  just released pocket/tablet form US devices that could easily be kept next to a cardiac monitor. If Philips is listening they will realize they make EMS cardiac monitors and US probes that could be added together... just an idea.

Please feel free to comment, on the topic or my grammar! This paper has already been graded. ;-) Prehospital Ultrasound in Undifferentiated shock, Cardiac Arrest, and the End of Resuscitation. Nicholas Jackson Southern Maine Community College For years ultrasound was an imaging modality for sonography technicians who acquired them and the radiologist who reviewed them. With the rapid rate technology has evolved and developed we now have point of care ultrasound. Point of care ultrasound allows physicians in the emergency department and office setting to acquire diagnostic quality imaging at the bedside. While physicians have a vast array of transducers, protocols, and views The question remains, Can paramedics perform the same feats to help our patients? In this paper we will review the “Focused echocardiographic evaluation in life support (FEEL)” protocol, the “Prehospital Evaluation of Effusion, Pneumothorax, and Standstill (PEEPS)” protocol, and assessment of non shockab...

#AAEM15 Winters: 18% Inc in mortality per 5 seconds of pause during CPR. http://t.co/QpVVdvYx7F — San Antonio EM (@SanAntonioEM) March 2, 2015 Excuse me? you said what? "In patients with cardiac arrest presenting in a shockable rhythm during the ROC PRIMED trial, shorter pre- and peri-shock pauses were significantly associated with higher odds of survival. Future cardiopulmonary education and technology should focus on minimizing all peri-shock pauses." (Cheskes et all., 2013) Decreasing peri-shock pauses is a good thing.  Fig. 2. Cheskes et all., 2013 The less time we are squeezing the chest, the less time the victim is perfusing and the less their chances of survival.  To  maximize perfusion, the 2010 AHA Guidelines for CPR and  ECC recommend minimizing pauses in chest compressions.  Expert consensus is that a Chest Compression Fraction (CCF) of 80% is achievable in a variety  of settings. ( Meaney et all., 2013) A viable...

 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...

(Please comment! If you want to comment on the paper in Google docs then I will happily share the link! Thank you!) Helicopter based emergency medical services (HEMS) are an essential part to any EMS system.  The first benefit noted with HEMS is that it gives prehospital providers access to rapid transport without the difficulties of traffic or terrain. HEMS utilizes staff ranging from a critical care paramedic to a physician led team. Working under an expanded scope of practice compared to the traditional ground ambulance. However, HEMS can be misused and abused like the rest of the EMS and emergency response system. According to Taylor, C. B. (2010) annual cost range from $115,777 to $5,571,578.  The LifeFlight Foundation annual report states that in 2013 alone Maine’s very own “Green Angels” had expenses equalling $9,109,732 (2013, p. 22). That cost can be placed with the patients and insurance or absorbed by the government and citizens. No matter where the funding co...

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...

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...

** Please comment and let me know your thoughts, if I'm wrong I want to learn why and how to be better** Roles & Responsibilities My three good qualities are preparation, response, and return to service. The only one I would say I’m strong in is Preparation. My thought process is that every call is critical until proven otherwise. I know this isn’t entirely true, but It’s much easier to motivate myself to check every nook and cranny of the truck and house bag if I think I’m going to work a code. I always find question to ask the medics I work with about calls I’ve done or stories I’ve heard. I read and listen to people like EMCrit to try and learn more about medicine and hope I get something I can use in my daily assessments and treatments of my patients. I feel my response is good, I’m almost always in the truck first. I drive to every call as quickly as I safely can with regard to traffic, road conditions, and weather. At the end of every call I work hard to get my t...

** Please comment and let me know your thoughts, if I'm wrong I want to learn why and how to be better** What Does Professional Mean to you? professionalism: Possessing the required abilities, knowledge, and self-discipline to effectively perform a specialized action or work. As a paramedic I have to be able to quickly and accurately assess and treat a Patient. Not only do I need the knowledge and physical ability to do the work, but I need to have the self-discipline to do it appropriately, effectively, and compassionately. Because our work is so publicly available it is essential that we show ourselves in a confident, competent manner. If my patient doesn't think I’m competent because I lacked the self-discipline to tuck my shirt in and fix my hair at O’dark thirty they won’t be as receptive to my assessment or treatments. As someone who doesn't have a lot of volunteer experience I have mixed thoughts of “professional” volunteers. On the first day of orientation at ...