Welcome to Episode 47 — Happy New Year!

The MedicCast is a proud member of the Blubrry Podcast Network.

Right click to download this episode or click the little arrow to listen here.

A podcast for EMT’s, Paramedics, and other medical providers of all kinds.

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Rate the podcast at iTunes or at EMS Village

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Contact Me!
send me a note!
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Leave up to a 2 minute message with your onboard microphone right through your browser by clicking the link below.

MobaTalk Online Voicemail

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Link of the Week: Talk Shoe Netcast and Conference Site

I am planning on using this service in 2007 to host live conferences on EMS topics. Anyone who uses the site’s free registration service and software can listen in, IM within the conference, and call in to talk with me and the guests. Check it out!

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News:

EMT Talks About Tornado Scene

2 Ambulance Wrecks in 2 Days

Dispatcher Recognized

Veggie Nitrates

Sepsis ID Device (nanotech)

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Tip/Trick of the Week — Sepsis

eMedicine on Sepsis

MedicCast Antibiotics Episode 32

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Med of the Week — Dopamine

Ghetto Medic on Dopamine

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Visit the MedicCast Forums

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Thanks for Supporting the MedicCast!

Rate the podcast at iTunes or at EMS Village or Vote at Podcast Alley

Visit the MedicCast Store!

Check out the MedicCast News at the Podcaster News Network for EMS news updates during the week and check back here next week for the next Episode of the MedicCast.

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Podsafe Music by Caitlyn Smith from the Podsafe Music Network

Hear Me — available on iTunes here

Click here to get other Songs from the MedicCast at the iTunes Store.

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Until next time, Scene safety, BSI!

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 2.5 License

Funding for 9/11 rescuers’ health care is running out. Senator Hillary Rodham Clinton is proposing a bill to increase that funding reserve.

Read the article here.

The funding would be increased by 1.9 billion dollars, enough to provide coverage through 2011. In addition, Senator Clinton is proposing hearings about the status of the 9/11 rescuers in New York City.

Contact your representative in the House of Representatives and Senate to support our brothers and sisters who responded to the scene. We need to stay on top of this.

Jamie

the Podmedic

Medical News Today posted this article about a report on the effects of working long shifts on medical errors. The study looked at thousands of interns and medical residents who worked 24 hour or longer shifts in the hospital. The findings showed:

1. Working one long shift (24 hrs or more) 3 times more likely to commit an error
2. Working 5 or more long shifts in one month increased errors to a 7 fold increase
3. The errors translated into increased adverse patient events (700% in some cases)
4. Studies of ICU staff had similar results

What does this mean for EMS providers like EMTs and Paramedics?

As agencies consider moving EMS shifts to 24 on and 72 off schedules, they should take this into consideration. While such a set up works well for fire fighters who don’t run the volume of calls that the ambulances do, the EMS personnel stand a good chance of running 24 hours straight without a break even for meals.

The study clearly shows that such a change will increase medical errors and ultimately cost the agencies involved in personnel and lawsuits. Make sure your supervisors and medical directors are aware of this report.

Welcome to Episode 46 — Happy Holidays!

The MedicCast is a proud member of the Blubrry Podcast Network.

Right click to download this episode or click the little arrow to listen here.

A podcast for EMT’s, Paramedics, and other medical providers of all kinds.

Help the MedicCast out! Fill out our Survey!

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Rate the podcast at iTunes or at EMS Village

Visit the MedicCast Store! Click here to get Songs from the MedicCast

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Email — Listener Daniel on the Venoscope
Contact Me!
send me a note!
—- or —-
Leave up to a 2 minute message with your onboard microphone right through your browser by clicking the link below.

MobaTalk Online Voicemail

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Link of the Week: Talk Shoe Netcast and Conference Site

I am planning on using this service in 2007 to host live conferences on EMS topics. Anyone who uses the site’s free registration service and software can listen in, IM within the conference, and call in to talk with me and the guests. Check it out!

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News:

National EMS Advisory Panel

Dispatcher Pay in Maryland County

911 Treatment Money Running Out

Fibromyalgia Pain is Real

Interoperable Communications

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Tip/Trick of the Week — NIMS Training

Interview with Rick Russotti

• Fema NIMS Main Page
• Fema NIMCast
• Integrated Safety Solutions Training Site
• NIMS Community Forum

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Visit the MedicCast Forums

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Thanks for Supporting the MedicCast!

Rate the podcast at iTunes or at EMS Village or Vote at Podcast Alley

Visit the MedicCast Store!

Check out the MedicCast News at the Podcaster News Network for EMS news updates during the week and check back here next week for the next Episode of the MedicCast.

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Podsafe Holiday Music from Basic — Joy to the World

Click here to get other Songs from the MedicCast at the iTunes Store.

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Until next time, Scene safety, BSI!

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 2.5 License

We deal people in stressful situations all of the time but during the holidays people heap extra stresses on top of the pile. Family, shopping, travel, and traffic all contribute. On top of this, we in the emergency services fields deal with everyone else’s stress on top of our own.

• More suicides
• More MVA’s
• More domestic violence calls

I found this article on dealing with some of this extra stress in an online article from Medical News Today.

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Bruce Spring, M.D., assistant professor of clinical psychiatry and behavioral sciences at the Keck School of Medicine of the University of Southern California, offers these tips to curtail holiday stress:

Be realistic

People should realize that relationships will not change just because it is the holidays. Expectations that family, friends or loved ones will act differently often result in disappointment or unnecessarily strain a relationship. Look for the good and focus on enjoying that.

Plan ahead

Assess your financial situation and then decide on how much to spend on each person. This time of year, meaningful gifts can be more touching and healthful than expensive gifts. Remember gifts of service, such as helping with chores or a massage, are free and may be more appreciated.

Maintain exercise programs and continue to eat healthy

Just because it’s the holidays does not mean that exercise or healthy eating should stop. Coupled together, healthy living relieves stress and minimizes regret from overindulgence.

Give yourself extra time

Giving to ourselves allow us to better give to other people. Take a few extra minutes to complete a task or to just relax. Saying no to some requests can help avoid feeling overwhelmed.

Be aware of your feelings

Don’t suppress your feelings for the sake of the holidays. If you are depressed or angry, talk to someone. It is better to deal with situations now than to bottle up feelings that can later snowball. Turn to family, friends, clergy or professionals. The key is to turn to someone who listens to you and provides helpful advice. Inappropriate or ineffective listeners can make things worse.

Perfection is the enemy of good

The quest for perfection can often ruin a good thing. Don’t lose focus on the purpose of what you are doing. Realize that others will appreciate and enjoy your efforts no matter what.

Spring says another way to alleviate stress is to appreciate the positive aspects of the holidays. Approaching the season with this attitude can make the holiday experience more enjoyable.

For further information please go to:
University of Southern California

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Stay safe and stress free this holiday. I look at another holiday issue (Diabetes) in this earlier post to the MedicCast blog.

Jamie

the Podmedic

A study by researchers at Brown University reveals some interesting trends regarding the regular hospitalization of elderly nursing home patients. The study, described in this article, finds that policies set by the states influences the rate of hospitalization of residents.

The study looked at all nursing homes in the country with more than 25 beds. When the state had lower reimbursement rates for care, the resident was more likely to be sent to the hospital for care — an event that incurred much greater cost. Additionally, hospitalization rates were higher when the state paid the nursing homes to hold beds for patients that were hospitalized. This give the nursing homes an incentive to send a patient to the hospital and run less staff for fewer patients while receiving money to hold the beds.

For those of us who regularly take nursing home patients to the hospital, either by 911 call or routine transport, this is a very frustrating report. We have all taken in a patient who seems to have no valid complaint. The nurses at the ER get frustrated, knowing that this patient gets worked up with blood tests, xrays, and a probable overnight stay just because they’re old.

Every time the older patient enters a hospital they have:

1. higher incidence of infection
2. chance for increased dementia
3. increased out of pocket costs

On the medical side of the picture, this trend ties up resources and contributes to hospital overcrowding. Forward this one to your medical directors and state legislators.

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Jamie

the Podmedic

EMS providers have a unique opportunity to look at the living conditions of at risk patients in our communities including the elderly and the very young. What kind of things should we be looking for?

In this article from Pennsylvania Department of Aging, family members are urged to look in on their elderly family members at this time of holiday visits. It provides some great information for EMTs, paramedics, and other EMS providers as well. Here are the highlights.
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“The holidays are a great time to discreetly take notice whether older parents, relatives or friends are able to manage their daily affairs and are prepared for the cold winter months ahead,” said Eisenhower. “By tactfully showing your concern, you may be able to start a productive conversation about how to cope with the challenges of aging, as well as your loved one’s changing needs.”

Here are some of the suggestions for EMS providers to pay attention to:

1. Eisenhower suggested paying attention to whether the older person has experienced a change in their health condition, memory or ability to understand, living conditions, or finances.
2. Ask the older person if they are having any trouble with household chores or other tasks of daily living, such as managing their medications.
3. Make sure they have nearby relatives or friends who can help them in an emergency.
4. Be alert to any possible safety hazards or maintenance problems around their home.

Eisenhower noted that while it is essential to pay attention to an older adult’s physical, mental, environmental and financial situation, it is equally important to respect their need for privacy and desire for independence.

EMS providers should check with your state or local department of aging for more info on training oppportunities or this link to the U.S. Administration on Aging for links to resources and support.

I got this month’s update from the Maryland Poison Control Center. It has to do with increased Phenylephrine use due to the changes on Federal law regarding access to Pseudophedrine. Here’s the link to the Phenylephrine issue (pdf). You can subscribe to get updates via email here.

Phenylephrine

In 2006, the federal government imposed restrictions on the over-the-counter sale of pseudoephedrine products in an attempt to curb the clandestine chemical synthesis of methamphetamine. Manufacturers have responded by changing many of their decongestant product formulations to include phenylephrine instead of pseudoephedrine. Products such as Sudafed® PE and Contac® contain phenylephrine 5 or 10 mg per dosage unit.

As a result, pseudoephedrine overdoses are decreasing and phenylephrine overdoses are increasing in Maryland. Phenylephrine stimulates alpha receptors in vascular smooth muscle and causes local vasoconstriction of the nasal arteries. The alpha stimulatory effect of phenylephrine is superior to that of pseudoephedrine.

Phenylephrine overdoses may present with CNS excitation, hypertension, tachycardia (or normal chronotropy), mydriasis, and possibly hyperthermia. Severe phenylephrine overdoses will present with hypertensive crisis, bradycardia (reflexive), seizures, myocardial infarction, dysrhythmias, and cerebral hemorrhage.

Management of phenylephrine overdoses includes:

1. Administration of activated charcoal in addition to oxygen and ECG monitoring.
2. Benzodiazepines should be used first line to treat tachycardia, mild hypertension, agitation, and seizures. Hypertensive crisis should be treated with nitroprusside or nitroglycerin. These medications vasodilate both arteriolar and venous beds.
3. Phentolamine, an alpha blocker, is a second-line agent. Beta-blockers (or mixed alpha/beta blockers such as labetalol) should not be used in this situation because they can lead to unopposed alpha effects and exacerbate the hypertension and cause intracranial bleeding/ischemia.

Check back here for more poison control updates each month or subscribe directly at the link above.

Jamie

the Podmedic

Welcome to Episode 45

The MedicCast is a proud member of the Blubrry Podcast Network.

Right click to download this episode or click the little arrow to listen here.

A podcast for EMT’s, Paramedics, and other medical providers of all kinds.

Help the MedicCast out! Fill out our Survey!

—————————-

Rate the podcast at iTunes or at EMS Village

Visit the MedicCast Store! Click here to get Songs from the MedicCast

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Email — Joe on magnets and the Nintendo Wii

• Neodymium Magnets
• Nintendo Wii Product Warnings

Contact Me!
send me a note!
—- or —-
Leave up to a 2 minute message with your onboard microphone right through your browser by clicking the link below.

MobaTalk Online Voicemail
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Link of the Week: EMS Village YouTube EMS Vids
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News:

Medevac Helicopter Crash

Tough Trauma Talk to Teens

Another School Bus Crash

Blood Substitutes and Battlefield Trauma

Episode 5 on PolyHeme Trial

Pediatric Rules Exclude Kids of Illegals

Hispanic Infants Strain New Orleans Hospitals

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Tip/Trick of the Week — Practical Exam Prep

National Registry Site Skill Sheets

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Med of the Week — IV Dextrose

D-50 from the Ghetto Medic

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Visit the MedicCast Forums

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Thanks for Supporting the MedicCast!

Rate the podcast at iTunes or at EMS Village or Vote at Podcast Alley

Visit the MedicCast Store!

Check out the MedicCast News at the Podcaster News Network for EMS news updates during the week and check back here next week for the next Episode of the MedicCast.

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Podsafe Holiday Music from Geoff Smith

My Own Merry Christmas — Check out his music at the Podsafe Music Network
Click here to get other Songs from the MedicCast at the iTunes Store.

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Until next time, Scene safety, BSI!

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 2.5 License

Here are some tips for managing diabetes during the holidays. This article off of Medical News Today’s website has some good pointers for people surviving holiday dinners and parties while maintaining their diabetes regimen. When you make your rounds to your diabetic calls this holiday season, remember these seven tips and pass some along to your patients. It’ll save you some time with fewer calls in the long run. Your patients will end up having a better holiday.

Dr. Cecelia Sauter’s 7 Tips (University of Michigan Diabetes Education Center).

– Plan ahead: If you’ve been invited to a party and you won’t be preparing the food, call ahead to find out what they plan to serve, Sauter suggests. If you’ve got Type 2 diabetes, Sauter says that following a meal plan is important whether it’s the holidays or not.

– Keep counting the carbs: “Carbohydrates are what really affect your blood sugar,” Sauter says. “When it’s time to eat, look at the overall meal and ask your self, ‘Which foods contain carbohydrates? What do I really want to eat?’ Be careful with your portions and make sure the meal is balanced.”

– Sugar-free isn’t always carb-free: “We often get tempted by sugar-free products, but that doesn’t always mean they don’t contain carbohydrates. It’s extremely important to buy the real thing, watch what you are eating, look at the total carbohydrate levels and enjoy it,” Sauter says.

– Check blood sugar before cocktails: Alcohol can cause low blood sugar. Sauter suggests checking your blood sugar level before you drink. She also recommends eating foods containing carbohydrates, if you plan to drink. “Don’t just eat appetizers if you plan to drink. It’s best to drink alcohol after eating a full meal,” Sauter says.

– Make sure someone knows you’ve got diabetes: “The symptoms of low blood sugar and being drunk are pretty much the same. It’s really important that if someone knows you have diabetes and you begin to exhibit these symptoms, that they take you aside and have you check your blood sugar level,” Sauter says.

– Walk after your meal: Sauter often encourages her patients to go for a nice long walk about an hour after a meal. That’s when most of the sugar is in their blood stream, and exercise will have the greatest impact on lowering blood sugar.

– Plan for relieving the stress: Stress can be challenging for people with diabetes because it can increase blood sugar. “While walking helps to relieve stress, I often suggest that people think about stress management strategies that have worked for them in the past and use them,” Sauter says. She also suggests listening to relaxing music and being organized during the holiday season to alleviate stress.

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Have a great holiday!

Jamie

the Podmedic

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