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Do you wear adequate eye protection?  Maybe not.  An article I found, discusses the dangers of prolonged UV exposure to the eyes.  Wearing sunglasses can stave of vision disorders that may not manifest for years.  Cataracts, macular degeneration, and photokeratitis are just some of the long term disorders that are affected by long term exposure to sunlight.
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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

A question came up regarding the handling and transport of patients who are also victims of a sexual assault. I discussed it on both the latest episode of the MedicCast Live with Dr. Fran Babiss, and in a recent MedicCast episode, as well.

Listener Victoria was able to expand on this topic in a recent email. She works with a rape crisis center and offers some great tips on this difficult topic.

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I work for a rape crisis agency. We advocate for victims immediately following an assault, in the ED, with law enforcement, throughout the legal system if they choose to go that route (many do not), and through their own physical and emotional healing.

A large part of the work that we do is educating people about sexual assault - assault prevention, the need to more funding to support victims and to train providers, community education and, particular to what you spoke about on the podcast, we educate other professionals about their role in a sexual assault situation. We explain what to expect with a victim, we also discuss the legal ramifications of some choices, the emotional state and rape trauma syndrome. Most parts of the country have sexual assault centers just like the one I work at and I would STRONGLY encourage all EMS services to contact their local center and arrange a training to help them be prepared for this call and to be able to serve that patient well. Their local agency will also be able to educate them about specialized services available in their local area.

There is never any charge for our services, and I’m willing to bet that most sexual assault/rape crisis agencies are the same. We are glad to be able to help prepare first responders! The way a first responder communicates and advocates for their patient will have a tremendous effect on their healing, and that alone is well worth the time investment in some training.

Also, we like to see first responders carry our contact information with them. Often a victim will not initially want a report and often will not agree to go to the ED, but they will certainly need some support and other services. When those who are called to the scene can provide that patient with a card with a single number for victims to access an advocate 24 hours a day who will work on their behalf, the chances of that person getting the help (medical, legal, emotional) that they need is increased dramatically.

The one other thing I wanted to mention on this subject is regarding the decision of how/if to transport. Remember always that the victim literally is a crime scene and evidence needs to be protected. Most of the victims I see in the ED (who did not have extensive physical wounds needing immediate treatment) are transported by the PD in an effort to minimize loss of evidenciary material. Just something to keep in mind.

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Thank you, Victoria, for taking the time to educate all of us on this important topic.

Welcome to Episode 68

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.

Fill out our Survey!

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Link of the Week: A Day in the Life Photo Essay

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News:

Pure Oxygen Study

Polyheme Study Under Review

Hepatitis-C Cures

Virtual EMS Museum Online

Museum Link

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Tip/Trick of the Week — NREMT Skill Test — Spinal Immobilization

Seated — KED/Short Board pdf

Supine — Long Board pdf

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Med of the Week — Activated Charcoal

eMedicine on Activated Charcoal

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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!

Get the New MedicCast Newsletter — Sign up now — it’s free!

Other Podcasts: MedicCast News and MedicCast Live!

Contact Me! — Call the Voice Mail Line — (941) 306-3342

send me a note at podmedic@mac.com

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Music from the Podsafe Music Network with Will Tang — “Everything Changes“

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

From the March issue of the Maryland Poison Control Newsletter:

download the PDF here.

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DID YOU KNOW THAT… prehospital administration of activated charcoal by EMS providers may reduce time to gastric decontamination by 1 hour or more?

Activated charcoal reduces the absorption of many drugs and toxins when given in a timely manner. Studies show that when activated charcoal is not given by EMS providers, there is an average time delay of 50 minutes with as long as 90 minutes before it is given in the emergency department. Activated charcoal administration by EMS should be considered if the toxin is adsorbed by charcoal and the patient can adequately protect their airway.

Activated charcoal is a BLS drug and this data is another piece of evidence to support BLS providers as being more than just ambulance attendants. They are important, life-saving medical professionals. Find out more about the importance of activated charcoal at your local poison control center.

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I found this excellent editorial on changes in the professional nature of EMS over the last few decades. It’s written by a doctor who started out as a paramedic. He was speaking about the evolution of EMS into a team of highly trained professionals. From dispatchers, to EMS response teams, to the docs, nurses, and other medical professionals at the ER, we all have evolved into a highly coordinated team of focused medical care.

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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

From Maryland Poison Control Newsletter

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Hydroxocobalamin (Cyanokit®)

Cyanide is a potent and ubiquitous toxin that can cause rapid clinical deterioration and death if not recognized quickly. The most common etiology of cyanide exposure in the U. S. is through smoke inhalation from house or structural fires. Cyanide causes its toxicity by binding to the ferric ion in cytochrome oxidase and inhibiting oxi- dative phosphorylation, thereby halting cellular respiration.

For many years the only antidotal therapy available in the U.S. was the Cyanide Antidote Kit. This three- component kit contains amyl nitrite, sodium nitrite, and sodium thiosulfate. While effective, the Cyanide Antidote Kit also has many drawbacks. The nitrites induce methemoglobinemia which can be deadly in patients with concurrent carbon monoxide poisoning. Additionally, the nitrites are potent vasodilators which cause hypotension and reflex tachycardia. There are case reports of pediatric fatalities from dosing errors which resulted in profound methemoglobinemia and hypotension. This has led some healthcare providers to disregard the nitrites altogether and use only sodium thiosulfate, although it has a slow onset of action.

The FDA approved hydroxocobalamin for use as a cyanide antidote in December 2006 and it has recently become available for widespread distribution. It is marketed by Dey, L.P. as Cyanokit®. Hydroxocobalamin chelates cyanide and forms cyanocobalamin (a form of vitamin B12) which is excreted in the urine. The kit contains two 2.5 g vials of hydroxocobalamin as a lyophilized powder. Each vial should be reconstituted with 100 mL of normal saline.

Dosing for adults is 5 g administered as an IV infusion over 15 minutes. A second 5 g dose can be given if an incomplete clinical response is observed. Pediatric patients should receive 70 mg/kg as an initial dose. Due to its red color, hydroxocobalamin causes self-limiting skin reddening and chromaturia in most patients that may last up to a week. Hydroxocobalamin also causes a transient, relative hypertension which resolves within 4 hours. Allergic reactions are possible, including pustular rash and face swelling. These effects can effectively be treated with antihistamines and steroids.

Cyanokit® is a safe and effective alternative to the Cyanide Antidote Kit and has the potential to become the mainstay of therapy for cyanide poisoning victims. Call the Maryland Poison Center for assistance in diagnosing and managing all poisonings, including cyanide.

DID YOU KNOW THAT… poisoning by cyanide is thought to be as common as carbon
monoxide poisoning in smoke inhalation patients?

Hydrogen cyanide is a gas that is generated by the combustion of nitrogen and carbon containing polymers and fibers such as plastics, nylon, wool, cotton, paper and silk, all commonly found in homes and buildings. In studies, cyanide has been found to be directly associated with fire deaths. Cyanide poisoning should be suspected in all fire victims, especially those exposed to closed-space fires (high heat and low oxygen conditions), and in patients with altered mental status, hypotension, or metabolic acidosis.

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This is from Maryland Poison Control’s ToxTidbits email Newsletter. You can subscribe here. It is a great resource for all medical providers.

My mom always told me that “if I can’t say something nice, don’t say anything at all.” This goes for how to handle irate patients, bystanders, drunks, other providers and medical professionals as well. It applies when they’re standing in front of you and twice as much when they are not.

Peter Canning wrote a great column in his blog on this topic with a wonderful story to back it up. Check it out here at the Streetwatch: Notes of a Paramedic Blog.

The long and the short of it, nothing good will come from antagonizing anyone when you are on a call. We are healers and leaders. This week, take the time to think of the people around you that you respect the most. It may be a mentor, a parent, or a pastor. What do they do that you respect? How do they handle their interactions with others? What do they say to build up others?

Make a list of these things you admire and then choose two to try to do every day. Make a habit of the things you chose. Become the person you admire (at least in a non-creepy way).

Stay Safe,

Jamie, the Podmedic

Welcome to Episode 67

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.

Fill out our Survey!

—————————-

MedicCast Listener Deals at GoDaddy.com –

Code BLU27 gets you 10% off your order at checkout
Code POD27 gets you 10% off any web hosting order at checkout
Try them out and get your piece of the internet at GoDaddy.com!

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Link of the Week: My Trivia Podcast

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News:

Traumatic Brain Injury in Kids

Younger Women Fail to Spot Heart Attacks

EMS Study Game

Disaster Un-Preparedness

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Tip/Trick of the Week — Pediatric Airway and Intubation

Interview with a pediatric anesthesiologist about pedi airway management, ET tube sizing, and more.

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Visit the MedicCast Forums

———————————–

Thanks for Supporting the MedicCast!

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

Visit the MedicCast Store!

Get the New MedicCast Newsletter — Sign up now — it’s free!

Other Podcasts: MedicCast News and MedicCast Live!

Contact Me!
Call the Voice Mail Line — (941) 306-3342

send me a note at podmedic@mac.com

————————————————

Music from the Podsafe Music Network by Carrie Cunningham — “Smile Again”

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

As the growing season advances here in North America, I have to get ready to deal with one of the peskiest plants around — Poison Ivy. Most of us here have one variety or another of Poison Ivy, Poison Oak, or Poison Sumac around where we live and work.

I think we should bone up on some of the facts about these misunderstood skin irritants and what they can and can’t do.

• How much contact will affect you?
• Is the rash contagious?
• How long does it take to get rid of the oil on clothing?
• Does anyone with a poison ivy hypersensitivity need ALS intervention and hospitalization?

I found a great series of articles over at Medicine Net. They cover these three plants in great detail and how we can improve our treatments of people affected by them. Check it out!

blubrry.com
I stumbled upon a story that said that iPods may cause some interference to implanted cardiac devices, like pacemakers.  Apparently, there had been no studies like this before and a high school student decided to team up with a local doctor to find out if there was a problem with iPods and implanted electrical devices.  Pretty cool stuff.

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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

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