Get Anyone To Go With You To The Hospital
I’m going to share with you a very powerful technique to convince just about anyone to go with you to the hospital, and I’m going to ask a favor of you. Please only use this technique in the patient’s best interest. This isn’t a technique to drag out when your service pressures you to increase transports or you’re not in the mood to call in for a proper refusal. This is a technique for when you really honestly believe that the patient needs to go, but they refuse.
Steve
It’s an interesting contradiction in prehospital medicine. The people who don’t really need an ambulance insist on transp...
Source: The EMT Spot - November 15, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
The Art of Using Trauma Shears
I got a request recently from a maker of trauma shears to give their product a test drive and see what I think. I’m more than happy to give their shears a few turns around the block and kick the tires a bit. Who knows, maybe they’ll be really good. Maybe they’ll be my new favorite set.
All the shears I’ve ever owned have come and gone. I don’t have a particular set that I’m really attached to right now. I’ve had some great sets of shears over the years. I think my longest running favorite pair lasted around five years. I don’t remember the brand now, but they were good. Black handle with a bit of cloth t...
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
Understanding Combative Head Injuries
Big biker dude strained against the double layers on tape across his forehead and it occurred to me that the act of c-spine seemed pointless if the patient insisted on fighting violently against the tape and straps. Three firefighters were still holding big biker dude (BBD) down and the firefighter closest to his head was yelling, “calm down. … CALM DOWN!” This wasn’t working, but I understood. Sometimes the urge is irrisistible. For his part, big biker yelled back in disorganized consonants and vowels, “uaaaaghhh”.
BBD had laid his Harley down just before an inte...
Source: The EMT Spot - November 14, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
EMS Response To Sexual Assault
The EMT Spot would like to welcome Jimmy Futrelle to our guest post roster. Jimmy s a Paramedic hailing from Scurry County Texas. Jimmy has been responding on calls long enough to remember the Lifepack 5 and using D50 as a diagnostic tool.
His unique background working for private and public EMS as well as for local law enforcement makes him uniquely qualified to teach on the subject of sexual assault.
This detailed guide to responding to these challenging calls is well worth reading. I sincerely thank him for this contribution.
Contents
Responding To Sexual AssaultIntro...
Source: The EMT Spot - November 14, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Rapid Diagnosis: Vomiting Blood
The dispatcher reports that the patient is vomiting blood. Hemataemesis if you want to be technical about it. It could be a whole bunch of things right? … Well yes it could. Before you e-mail me to say that you can’t believe I missed Bolivian Hemorrhagic Fever, here’s one web site that lists 113 possibilities.
But if you want to play the numbers, it’s going to be one of four things. And if you want to play “stump your partner” you can narrow it down quite a bit based on your patients age and disposition.
There are four things that tend to cause a person to vomit blood. Before you click on the little ...
Source: The EMT Spot - November 14, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Sometimes even STEMI is not enough
Written by Emre AslangerA 50 something-year-old man with a history of newly diagnosed hypertension and diabetes, for which he did not take any medication, presented a non-PCI-capable center with a vague, but central chest pain. His vitals were normal and his first ECG was as shown below:There is obvious ST segment elevation (STE) in anterior leads. STE in lead I and II are more subtle. The presence of J notch in V6 might have deceived the physician into thinking of early repolarization, but this can also be seen in anterior OMI. Note that QRS amplitudes are somewhat lower than expected and there is poor R wave progression....
Source: Dr. Smith's ECG Blog - November 13, 2022 Category: Cardiology Authors: Emre Aslanger Source Type: blogs
Sometimes even ST Elevation meeting criteria is not enough to be convincing
Written by Emre Aslanger. Emre is a new Editor of the Blog. He is an interventionalist in Turkey.A 50 something-year-old man with a history of newly diagnosed hypertension and diabetes, for which he did not take any medication, presented a non-PCI-capable center with a vague, but central chest pain. His vitals were normal and his first ECG was as shown below:There is obvious ST segment elevation (STE) in anterior leads. STE in lead I and II are more subtle. The presence of J notch in V6 might have deceived the physician into thinking of early repolarization, but this can also be seen in anterior OMI. Note that ...
Source: Dr. Smith's ECG Blog - November 13, 2022 Category: Cardiology Authors: Emre Aslanger Source Type: blogs
The Dangers of EMR-Defaulted Prescription Stop Dates
By HANS DUVEFELT
It happens in eClinicalworks, I saw it in Intergy, and I now have to maneuver around it in Epic. Those EMRs, and I suspect many others, insert a stop date on what their programmers think (or have been told) are scary drugs.
In my current system all opioid drug prescriptions fall into this category. For a short term prescription that might perhaps be a good idea but for a longer-term or occasionally needed prescription it creates the risk of medical errors.
In Epic there is a box for duration, which is very practical for a ten day course of antibiotics. If I fill in the number 10 in the duration bo...
Source: The Health Care Blog - November 10, 2022 Category: Consumer Health News Authors: Christina Liu Tags: Physicians EMR Hans Duvefelt Medical Practice prescriptions Source Type: blogs
Types of Brain Hemorrhage
In our last post (part one) we introduced the subject of head injuries with an overview of trauma patterns typically found in head injury patients. Today let’s talk about bleeding inside the skull or intracranial hemorrhage.
Brain hemorrhage occurs when blood vessels inside the skull rupture. There are some non-traumatic causes as well. Ruptured aneurysms and hemorrhagic strokes would be a few examples of non-traumatic intracranial hemorrhages.
We classify bleeding in the skull by location, using the layers of the meninges as a guide. You may recall from EMT class that the meninges are fluid coated membranes that s...
Source: The EMT Spot - November 10, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Beyond The 1-10 Pain Scale
How bad does it hurt? I’m willing to go out on a limb and say that this is, quite possibly, the most common question we ask in EMS. And it can be a difficult question to answer. How bad compared to what? How do we reconcile the patient with significant pain who winces and says it only hurts a little. Or what about the patient who is relaxed and seemingly comfortable while reporting the worst pain they have ever felt?
Not everyone feels pain the same way. Some patients feel pain more than others. And, perhaps even more significant, some patients fear pain more than others. What’s a clinician to do?
You and I aren...
Source: The EMT Spot - November 10, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Wrong Medicine
Some of the stacks of trip reports were nearing four feet high and they filled the musty closet. Dividing them up, we started sorting through them in earnest. The dates indicated that the calls had been run between 1972 and 1978. Most of the narratives were as brief as the treatment lists.
Hall Ambulance’s station one was an older house in an early residential area of Bakersfield, California. It had been, at one time, the residence of the company’s owner, Harvey Hall. In the early days of the ambulance service, Harvey had both lived in the home and run his fledgling ambulance service out of it.
One of the crews s...
Source: The EMT Spot - November 10, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
In-Office Pediatric Ear Tube Procedures: Interview with Preceptis Medical ’s Greg Mielke
Preceptis Medical, a medtech company based in Minnesota, created the Hummingbird Tympanostomy Tube System. The device allows ear, nose, and throat (ENT) surgeons to insert ear tubes in the comfort of their office. The procedure requires only local anesthetic and is intended to be less distressing for pediatric patients than the conventional approach, which requires general anesthesia.
The Hummingbird device provides a “one-pass” approach to ear tube placement, with an ear drum incision and tube placement occurring with a few simple manipulations of the device. Medgadget spoke with Steve Anderson, CEO of Preceptis Me...
Source: Medgadget - November 8, 2022 Category: Medical Devices Authors: Conn Hastings Tags: ENT Exclusive Pediatrics hummingbirdears 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
