What is Modified Rankin Score (mRS)?
In the original Rankin score proposed in 1957, there were 5 grades of stroke severity ranging from “no significant disability” to “severe disability’ [1]. Modified Rankin Score (mRS) has been used to quantify disability after recovery from a cardiac arrest [2]. The score ranges from for 0 with no symptoms to 6 which would mean mortality. In between there is 1 with no significant disability and 2 with slight disability. Moderate disability requiring some help is 3 and 4 is moderately severe disability in which the person is not able to walk or attend to bodily needs without help. Modified Rankin Score 5 indicat...
Source: Cardiophile MD - November 20, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Errant Missiles and Errant Hawks
Jordan CohenOn November 15, 2022, a Russian ‐made missile hit the Polish city of Przewodow and killed two civilians. Immediate reactions from think tankers and policymakers followed. There were arguments about whether this would lead toinvoking NATO ’s Article 5 – the Article that calls all NATO countries to provide collective defense if one member is attacked – and, if so, whether things like a No‐Fly Zone and retaliatory strikes would be an effective response.In fact, the Latvian Minister of Defensetweeted that the “criminal Russian regime fired missiles… on NATO territory in Poland.” Moreover, U...
Source: Cato-at-liberty - November 16, 2022 Category: American Health Authors: Jordan Cohen Source Type: blogs
The Three Collision Rule
I imagine it was probably my first Prehospital Trauma Life Support class back in 1990 that I first heard of the three collision rule. Since then, it has remained a useful tool in examining the mechanism of injury after auto accidents. If you haven’t heard of it, please allow me to elaborate.
The three collision rule states that, in any auto accident, there are three collisions that occur and the keen EMT needs to be aware of all three. The next time you walk up to a vehicle accident, instead of imagining two large objects colliding with each other, imagine three separate collisions occurring with each respective vehic...
Source: The EMT Spot - November 15, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
The S.O.A.P. Reporting Break Through
The objective portion of the report is the time when you state your case and tell everyone the stuff you found during your assessment. It’s time to become the CSI investigator and talk about your investigation and you findings.
This will tend to be almost entirely objective information, however, don’t be scared to throw in the occasional subjective tidbit if it helps to paint your picture. “She thinks this bruise may be old.” or “His ankles are always a bit swollen but not this much.” If a subjective addition adds to the picture, include it.
When telling my objective story I tend to start with the le...
Source: The EMT Spot - November 15, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
7 Signs That Say “Do Not Resuscitate”
It is a moment in time that you will certainly face at some point in your EMS career. Most of us will face this decision many times over throughout our tenure. Should I attempt resuscitation?
The question may be complicated by family, friends or bystanders who have, in good faith, started CPR prior to your arrival and fully anticipate that you will continue. Or perhaps other members of emergency services arrived before you and declared the patient not workable. They may advise you of their findings, without much further detail. “This guys dead.”
Often, responders who aren’t responsible for documentin...
Source: The EMT Spot - November 14, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
When do you consider workup for hyperaldosteronism?
Important situation in which hyperaldosteronism is suspected is when there is hypertension with hypokalemia. Hypertension with spontaneous as well as diuretic induced hypokalemia may be an indication of hyperaldosteronism. Another reason for workup is refractory hypertension in spite of three antihypertensive medications. Hypertensive patient having hypokalemia while on angiotensin converting enzyme inhibitors or angiotensin receptor blockers should also alert us.
Yet another group is hypertensives with adrenal masses detected on imaging studies. First degree relatives of patients with primary hyperaldosteronism need work...
Source: Cardiophile MD - November 12, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
4 Questions to Help You Succeed In EMT Class
I was searching around on Twitter today for tweets using the acronym “EMT”. I was struck by how many EMT students were discussing their current trials and tribulations with EMT class on twitter. EMT students talk with each other about EMT class differently than they talk to me about it. Perhaps because I’m the instructor they downplay how difficult the curriculum can be.
Maybe they don’t want to be honest and show vulnerability to me since I also evaluate them on test days. Or perhaps they don’t want to seem like the class is to much for them. I talk with students about my views o...
Source: The EMT Spot - November 10, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
L.C.E.S. For EMT ’s
Some of you who are familiar with wildland firefighting are already well versed in the safety acronym L.C.E.S. It was developed in 1981 and continues to be taught in wildland firefighting curriculum as a handy checklist of things we should have in place when operating in dangerous environments where conditions can change fast.
L.C.E.S. came about when retired U.S. Forest Service Superintendent Paul Gleason looked at fatal fires over the previous 20 years and identified the four elements most likely to save your butt when stuff goes really wrong. The acronym he created is simple and it works.
In wildland firefighting ...
Source: The EMT Spot - November 9, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Overcoming EMS Burnout
Yeah, It’s been a ride… I guess I had to go to that place to get to this one. Now some of you might still be in that place. If you’re trying to get out, just follow me. I’ll get you there.
Rapper Eminem, I’m Not Afraid, Recovery
I’ve been there.
Sure, I’d like to say that I was always a positive, proactive and optimistic EMS employee but that isn’t the case. I’ve been through periods of burnout. More than once to tell you the truth.
I know what it’s like to dread getting up in the morning and going to work. I also know what it’s like to feel like you aren’t valued by your employer. I’ve b...
Source: The EMT Spot - November 9, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
I was shown this ECG without any information. What do you think?
I was shown this ECG; " Steve, what do you think of this? " :What is going on?I said: " This is pulse tapping artifact and a long QT " Why did I say that?Whenever you see a very bizarre EKG, you should think about pulse tapping artifact. This is when one of the limb lead electrodes is placed over an artery, especially when placed over a dialysis fistula.When you suspect this, your next task is look for the one lead among leads I, II, and III which is NOT bizarre. Lead I in this ECG is not bizarre [though it does show a very long QT (or QU)].Leads I is formed by the right arm and left arm electro...
Source: Dr. Smith's ECG Blog - November 8, 2022 Category: Cardiology Authors: Steve Smith Source Type: blogs
Mass Casualty Incident Reality
I’ve been to a few mass casualty incidents over the years. They have ranged in severity and acuity from a large group of bored teenagers with chemical eye irritation to an active shooter in a crowded school. One lesson I’ve learned is that the real events never look or feel anything like the mock training scenarios that we often create for training purposes. Real disasters tend to present challenges that we just can’t account for in mock scenarios.
This makes the lessons learned at real MCI scenes incredibly valuable.
Recently, I was able to listen to Dr. Jonathan Apfelbaum MD, one of our local ER physicians, t...
Source: The EMT Spot - November 7, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Symani Microsurgical Robotic System: Interview with Mark Toland, CEO of Medical Microinstruments
Medical Microinstruments, a medtech company with offices in Pisa, Italy and Delaware, USA, has developed the Symani Microsurgical Robot. The robotic system is designed to assist with microsurgical procedures, and it boasts a variety of advanced features to achieve this goal.
These include a suite of the world’s smallest wristed surgical instruments, tremor reducing technology, and motion scaling (7-20X), to allow surgeons to perform very small and precise movements. The company has also paired with a software company to develop a surgical simulator to help with training surgeons on the system.
Medical Microinstr...
Source: Medgadget - November 3, 2022 Category: Medical Devices Authors: Conn Hastings Tags: Exclusive Neurosurgery Vascular Surgery @mmimicro_inc microsurgery Source Type: blogs
Understanding The SAMPLE History
The SAMPLE history usually comes up in the first few weeks of EMT class. It’s such a widely accepted standard that it appears in the National Registry medical and trauma skills station as well as the EMT National Standard Curriculum. As far as subjective patient history’s go…SAMPLE is the gold standard.
Like anything else in medicine, widespread utilization also comes with widespread misunderstanding. The SAMPLE history is an educational gold standard for a reason. It’s a very effective tool for remembering the major components of a medical history. It’s also often misused and highly inadequate when taug...
Source: The EMT Spot - November 2, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Promises Made – Promises Kept: President Biden’s Support for “Obamacare.”
BY MIKE MAGEE
As the saying goes, “History repeats!” This is especially true where politics are involved.
Consider for example the past three decades in health care. It is striking how many of the players in our nation’s health policy drama remain front and center. And that includes President Biden who recently commented on the 12th anniversary of the passage of the Affordable Care Act (Obamacare):
“The ACA delivered quality, affordable health coverage to more than 30 million Americans — giving families the freedom and confidence to pursue their dreams without the fear that one accident or il...
Source: The Health Care Blog - November 2, 2022 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Affordable Care Act Biden Obamacare Source Type: blogs
