Tom Reynolds in London has another good post about a patient with an insect (or arthropod) infestation and how it basically gave him the heeby-jeebies.

I have to wonder about what I’d do in a similar situation. You know — you start getting that itch between your shoulder blades. Then you start imagining things crawling across your skin. Before you know it you are in the showers, scrubbing like there’s no tomorrow.

How do you clean up your unit after such an infestation? I took a moment to google for info and here is what I came up with:

CDC Site/Fact Sheet on Ectoparasites (sounds like something from Ghostbusters)

When we pick up indigent people or the homeless, we might find that they have some of these infestations. Take standard precautions, read up on the signs and symptoms of lice, pubic lice, and scabies infestations. There are some tips for cleaning up so check it out!

I found another great article over at the Mayo Clinic site that does a good job of sorting through all of the hype surrounding the stem cell debate.

You can find the article here.

The article does a good job of defining the key issues and debunking some false understandings without taking a stand for or against stem cell research. You can learn some of the different ways stem cells are harvested, how they can be reproduced, what are the real (an unreal) hopes for treatment research, and a whole lot more.

If you have a strong opinion one way or the other about the issue on ethical grounds this site won’t affect your opinion. If you are on the fence or just cloudy on the details, then this site is packed with good factual information posed in such a way as to allow you to formulate your own decision.

blubrry.com

North West Ambulance Service in the U. K. has compiled a dispatch list of addresses where their providers have been attacked or threatened in the past. This list will be used to alert units inbound to those locations. They will stage and wait for police escorts. This is a bold move.

What would you do in the situation of a serious high priority call to such addresses in your call areas?

Here’s the story.

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I report on this and other EMS news in the most recent episode of the MedicCast News at the Podcaster News Network.

Jamie

the Podmedic

I found this amusing entry from Tom Reynold’s blog over in the U.K. His blog is about everyday experiences, concerns, and gripes about his service as an EMT with the London Ambulance Service. This entry has Tom trying to reach an elderly woman who is visible on the floor in her apartment through a window but the door is locked.

The police are there and are calling a ram to knock down the door. Nobody wants to do that but there doesn’t appear to be another option. Tom, ever the innovator, sees an open window and decides to squeeze through. The window is narrow and Tom admits he’s not. The description that follows is priceless.

A lighter moment for all of us to chuckle over and to remind us that “there, but for the Grace of God, go I!”

He didn’t get stuck but, according to his description of the mighty feat it was a close call.

Way to go Tom!

We all have patients we run to the hospital on a regular basis. They often have chronic or terminal conditions. We get to know their families and see the effects provding long term care in the home has on these people.

I found a resource you can pass on to them. It is the Strength for Caring website, sponsored by Johnson and Johnson, Inc. Here is a resource for your patient’s caregivers to help them cope with providing long term care for their loved ones.

It encourages them to take care of themselves, too. To eat healthily, exercise, take breaks, financial tips, caregiving tips, and more. Add this one to your list of community resources to offer families of chronic and terminal patients. This a place where prevention goes a long way. Many elderly caregivers face a decline in health while attending to their loved ones — if this can be slowed or prevented by providing a little bit of information, you’ve done a lot with a only a little work.

The alternative is that they become the next frequent flyer on your list. We can do better than that!

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Link of the Week: EMS Live Video Podcast

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News:

400 Pounds of Pot

NAEMT releases PSA video

Watch using Quicktime

Watch using Windows Media

Quitting Smoking and Arterial Stiffening

Transmucosal Drug Delivery

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Tip/Trick of the Week — Pain Management

American Association of Pain Management

EMS Responder on Pain Management

MedicCast Episode 14

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Med of the Week — Nitrous Oxide

EMS Responder on Nitrous Oxide

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

Eric from the EMS Haiku website wrote a very long and informative journal of his time at the conference in Baltimore. If you want to get a sense of why these conferences are worth every penny spent — check out his blog post.

He outlines every class he took and the key tips and lessons he learned from each. Eric also talks about products he looked at on the expo hall floor and more. Check it out — there’s a ton if information in there.

Thanks, Eric, for sharing with the rest of us!

blubrry.com

New South Wales Ambulance in Australia has plans to increase the number of their special bariatric transport units. These units include lifts to assist in loading either stretchers or wheelchairs. The number of calls to which they respond has more than doubled since the first unit was put in service three years ago.

Here’s the story.

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I report on this and other EMS news in the most recent episode of the MedicCast News at the Podcaster News Network.

Jamie

the Podmedic

Blue Ridge Medic makes some comments in his blog on why nursing homes are so limited in their treatment of patients with problems like respiratory distress. He poses the question:

Respiratory distress and the patient is on 2 liters with a mask, calls for confusion and the patient has diagnosed dementia and various other incidents. But I’ve given this nursing home thing a lot of thought. Why do the staff at these places do what they do? Are they really that stupid? Or are they just un-educated?

I guess it maybe the optimist in me, or maybe the lack of experience, but I just can’t believe they are all total idiots. I mean every now and again you get a good nurse or tech and they are actually on a first name basis with the patient and know their history and why they are going to the hospital when we arrive.

He has some good points here. One of the most important ones is to make sure you take them seriously when you get a vague report like “they’re just not acting like themselves” on a patient who has dementia or Alzeheimer’s. To you there may not be much to judge that by but most of the techs, nursing assistants, LPNs and RNs spend a great deal of time with these patients.

Often subtle changes in mental status can be an indicator of a decrease in cardiac output, an unseen change in respiratory status, or a stroke. In a patient with decreased mental status anyway — they nursing home staff will pick up on things that we’d never see.

1. Find out who made the report — it’s not the RN you’re talking to.
2. Ask the tech, assistant, or LPN who first noticed the change what exactly they noticed.
3. Ask them to spell out the baseline and what is different now.
4. This is your report to the hospital.

This all comes back to taking an accurate history — from the correct caregiver. In most cases, the RNs will give meds and assess things but its the techs and assistants who spend the day out among the residents.

Stay safe!

Jamie

the Podmedic

The Mayo Clinic site is putting out a series of educational and informative podcasts about a series of topics. The first one I found talks about “pre-hypertension.” There is an audio file and an associated transcript.

Here’s the link.

I find that we need to be aware of prehypertension but I don’t think we’re likely to diagnose it in the field. Patient’s have a spike in BP when we get there anyway. The way we can use this is when we take a history and ask the question: What is your normal BP range?

We may find a patient who states that their BP is in the prehypertension range and we can focus them on getting to their primary care physician to follow-up on this after the current emergency.

Prehypertension — Systolic between 120-140 and Diastolic 80-90

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