October 30, 2008 @ 9:45 am
blubrry.com
I found an article recently that challenges the conventional wisdom about the common cold and influenze. It proposed 10 common misconceptions about cold and flu. This is a good thing to get a handle on as we slide in to the cold and flu season and need to adjust the way we approach both our own health and that of our patients. Check out the article here.
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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
October 29, 2008 @ 5:14 am
One of our friends down under, Jerry Barrett sent up some pics of a new piece of equipment he is working with, a rail ambulance. In the remote areas he is serving, sometimes the only road or access is by rail line. This vehicle gives the option to travel by rail line or land to get the patients the treatment they need.
Jerry was our special guest a few months ago for our discussion on Tactical EMS on the MedicCast Live.
Thanks for the pics Jerry! (click the thumbnails to see full size pics)
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Find more photos like this on MedicCast Listener Pages
I’ve also posted these over at the MedicCast Forums at here.
Send me pics of your new equipment, vehicles, and EMS toys!
October 26, 2008 @ 8:05 pm
Welcome to Episode 141
The MedicCast is a proud member of the ProMed Podcast Network.
Right Click here to download (Macs Ctrl Click)
Subscribe with iTunes here!
A podcast for EMT’s, Paramedics, and other medical providers of all kinds.
Fill out the New Survey!
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Sponsored by the MedicCast Extra –
Extra Content for MedicCast Listeners for less than $1 per day (via monthly subscription)
- NREMT Study and Prep Tips
- All Tips and Meds segments from the MedicCast and Nursing Show as separate downloadable files
- Special iTunes Podcast Feed for Members — Get the segments as a podcast
- Extra Members-Only content added monthly
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Try them out and get your piece of the internet at GoDaddy.com!
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Link of the Week:
Stayin Alive mp3
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News:
Nebraska Mother Sues EMT
Paramedic Death Preventable
Doctors Overestimate Patients’ Health Literacy
‘Low morale’ of Ambulance Workers
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Tip/Trick of the Week — Congestive Heart Failure (CHF)
Medline Plus LInks page for CHF
Medline Plus encyclopedia on CHF
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Med of the Week– Lasix (Furosemide)
MD medical protocols
Medline Plus on Pulmonary Edema
Medline Plus on Hypertension
eMedicine article on Heart Failure with Lasix Dosing recommendations
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Comment or share ideas at the MedicCast Forums forums.mediccast.com
Rate the podcast at iTunes and help others find the MedicCast
Visit the MedicCast Store
Get the MedicCast Newsletter — Sign up now — it’s free!
Other Podcasts:
Contact Me!
Call the Voice Mail Line — (941) 306-3342
email me at podmedic@mac.com
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This week- Los Lonely Boys with, “Heaven (Live)”
Los Lonely Boys
“Heaven” (mp3)
from “Live At Blue Cat Blues - Dallas Texas”
(Blue Cat Blues Records)
Buy at iTunes Music Store
Buy at Amazon MP3
More On This Album
Click here to check out other Songs from the MedicCast Network Podcasts at the iTunes Store.
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Until next time, Scene safety, BSI!
This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
@ 6:35 am
Last week’s MedicCast Live on special event EMS preparations left me with quite a few impressions. I thought it would be a good idea to recount them here and invite the other listeners to chime in with their own opinions and comments.
EMS Special Event Pre-planning
The number one lesson learned from our special guests on the show was that special event pre-plans are key factors in the successful provision of adequate and safe medical coverage. Alan Thompson, Assistant Director of Cabarrus County, NC EMS plans for multiple major events that bring hundreds of thousands of NASCAR spectators to the area. He cites the event pre-planning as the most important step.
Pre-planning starts with gathering emergency response stake holders to the table. This includes local law enforcement, the event planners, and local hospitals. It may also include federal authorities like the FBI, and Homeland Security as well as state agencies like the highway patrol, department of transportation, health department.
After identifying those agencies and businesses needed to assist with holding a successful event and provide for emergency response, the next step in the planning process is to contact other jurisdictions that have held similar events and find out what has worked worked for them. Ask for planning templates to use as starting points. Cabarrus County EMS, NC has some and you can also find and download templates from the San Francisco Fire Department site here that cover the planning process from start to finish.
Planning for an upcoming event continues with training. Crews who will be working the event should be given an opportunity to familiarize themselves with the venue and the operations plan for their part of the process. Crews need to know what their responsibilities are. For instance:
- Do they transport or just triage and treat?
- Whom do they report to?
- What is the communication protocol?
- Which radio channels are to be used?
- With which other agencies will they interact?
- What is the command structure?
- Will there be a medical director on site?
- What is the expected call volume?
- What types of injuries/illnesses are expected?
The EMS Special Event In Action!
Just because the event has started doesn’t mean that planning is finished. Supervisors and organizers should be keeping a running tally of what is and isn’t working. As they make their rounds, check in with crews about their areas and ask questions about impressions. The planning for the next even begins during the current event. Look at the list of questions above and ask them again with an eye towards how things might be changed. Of course, do all of this while managing the current event and unforeseen challenges.
Finally, planning cannot be complete without a thorough and complete debriefing. Optimally, the debrief meeting for the stakeholders and event planners should be set up ahead of time during the initial planning. Everyone should be expected to participate in some form of debriefing. This might include using evaluations turned in by crews, web conference meetups, conference calls, and traditional face to face meetings.
If you haven’t already done so, check out the recording from that live panel discussion here.
October 24, 2008 @ 6:33 am
Hallucinogenic Plants Encountered by EMS Providers
Emergency medical technicians and paramedics often encounter unusual and difficult to diagnose situations. This is especially true when discussing drug and alcohol abuse. It is often very difficult to figure out what the true nature of the overdose is because of patient fears and deception. Sometimes the drug of choice is more unusual than illicit pharmaceuticals. People may turn to readily available plants in their own back yards.
Check out this newsletter from our friend Lisa Booze of the Maryland Poison Center. Subscribe to the ToxTidbits newsletter for free at their link here.
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Jimsom Weed Overdoses
The Maryland Poison Center receives a number of calls each Fall about Jimson weed (Datura stramonium) exposures, usually in teens looking for a no-cost, easily accessible, hallucinogenic high. Other common names for jimson weed include devil’s weed, stinkweed, locoweed, thornapple, Angel’s trumpet, and Devil’s trumpet. Jimson weed grows along roadsides, in pastures and in vacant lots throughout Maryland, reaching 3 to 5 feet in height. The plant has purple or white trumpet or funnel-shaped flowers and prickly seed pods which split along 4 seams to reveal numerous small brown or black seeds. Poisonings from this plant are often seen in the Fall, when the plant reaches maturity. The seeds and dried leaves of jimson weed are ingested directly from the plant or in a tea, or smoked, to deliberately produce delirium and hallucinations.
All parts of the plant contain atropine, hyoscyamine and scopolamine. Exposure to these alkaloids produces anticholinergic effects, appearing within 30-100 minutes after ingesting jimsonweed seeds. The clinical effects include dilated pupils, diminished bowel sounds, urinary retention, dry skin and mucus membranes, flushed skin, tachycardia, hypertension, hyperthermia, agitation, delirium, hallucinations and seizures.
Most cases of jimson weed intoxication respond to basic supportive care. Activated charcoal can be given for recent ingestions if the patient is awake and able to protect his/her airway. Benzodiazepines may be used for agitation or seizures. Drugs with anticholinergic properties should be avoided (e.g., atropine, antihistamines, haloperidol). Physostigmine is a cholinesterase inhibitor that rapidly crosses the blood brain barrier resulting in reversal of anticholinergic effects. The use of physostigmine should be limited to severely affected patients, and only with poison center consultation due to the risk of seizures, bradycardia and dysrhythmias. If administered, long lasting reversal of signs and symptoms is generally not achieved because of the relatively short duration of action of physostigmine.
Call you local poison center for assistance in managing suspected cases of jimson weed intoxication (1-800-222-1222).
October 23, 2008 @ 1:23 pm
blubrry.com
One challenge seen by CPR instructors is getting the students to pump fast enough on the manikins. CPR is hard work. A news article out this week points out that the Bee Gees “Stayin’ Alive” from the Saturday Night Fever soundtrack is perfect for rate and rhythm training in CPR at 103 beats per minute. Check out the article here.
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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.
If you want this song for your own training you can pick up the Stayin’ Alive mp3 download at Amazon.com
.
Jamie
the Podmedic
October 19, 2008 @ 9:16 pm
Welcome to Episode 140 of the MedicCast
The MedicCast is a proud member of the ProMed Podcast Network.
Right Click here to download (Macs Ctrl Click)
Subscribe with iTunes here!
A podcast for EMT’s, Paramedics, and other medical providers of all kinds.
Fill out the New Survey!
—————————-
Sponsored by the MedicCast Extra –
Extra Content for MedicCast Listeners for less than $1 per day (via monthly subscription)
- NREMT Study and Prep Tips
- All Tips and Meds segments from the MedicCast and Nursing Show as separate downloadable files
- Special iTunes Podcast Feed for Members — Get the segments as a podcast
- Extra Members-Only content added monthly
Save 10% on Pepid EMS — a revolutionary EMS pocket field guide for providers of all kinds
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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Tip of the Week: Mass Gathering Medical Coverage
This past week’s MedicCast Live featured a very informative discussion on the challenges planning and implementing medical coverage at large planned gatherings like concerts, festivals, and sporting events.
Joining us on the panel of experts:
Dr. Craig Corey, ER Physician and EMS Medical Director Cabarrus County, NC
Dr. Corey also invented the Oxyphone, a pediatric nebulizer device featured as the MedicCast Top Product of 2008!
Alan Thompson, EMT-P, Assistant Director Cabarrus County EMS
Also, Jim Hoffman from EMS-Safety.com (check out the NREMT Skills Video series featuring tips from Jamie Davis, the Podmedic).
Links featured on the MedicCast Live Mass Gathering EMS Episode:
Cabarrus County - Emergency Medical Services
San Francisco EMS Plan for Mass Gatherings
American College of Emergency Physicians on Mass Gathering Medicine
EMS Responder.com on Mass Gathering Best Practices
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Contact the MedicCast EMS Podcast:
Comment or share ideas at the MedicCast Forums forums.mediccast.com
Rate the podcast at iTunes and help others find the MedicCast
Visit the MedicCast Store
Get the MedicCast Newsletter — Sign up now — it’s free!
Other Podcasts:
Contact Me!
Call the Voice Mail Line — (941) 306-3342
email me at podmedic@mac.com
————————————–
Until next time, Scene safety, BSI!
This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
October 18, 2008 @ 12:57 pm
Neonatal assessment is one of the skills a paramedic or EMT learns in their EMT school but don’t get a chance to use very often. Some EMS providers may never use the APGAR score assessment technique in their entire careers. That doesn’t mean that we don’t have to refresh our memories periodically.
This week’s Nursing Show episode takes a look at the APGAR score and reviews the components of this valuable newborn assessment tool. Check out this week’s episode at the links below.
APGAR Score Episode Links:
Nursing Show APGAR score episode shownotes page.
Episode mp3 file.
Subscribe for free to the Nursing Show:
October 14, 2008 @ 5:47 am
Tonight the show is Live!
Join us on the the MedicCast Live tonight as we discuss the issues surrounding special event EMS. We’ll have a panel of guests and commentators on and we’ll be checking in with our listeners on the phone lines and in the chat room!
Here’s how you can join the show live via a computer or by phone:
The phone and chat lines will be open for your comments and questions. So head on over to Talkshoe.com and check out the show. You don’t have to be online to join us, just call in on your cell phone if you are away from your computer!
Where: Talkshoe.com (MedicCastLive.com)
When: Tonight! Tuesday, October 14th at 10 PM ET (7PM PT)
- Visit Talkshoe.com and click on the “Live Now” button at the top of the screen
- Select the MedicCast Live!
- Listen live, chat live or -
- Call in LIVE!
- Phone Number: (724) 444-7444
- Talkcast ID: 18174
- Enter your Talkshoe Pin number (it’s free to register or participate as a guest)
October 13, 2008 @ 8:19 pm
I got an email from a high school student asking questions about the different EMS levels of care. I thought I would include some of my answers for her here on the MedicCast blog for EMTs and paramedics.
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What are the different levels of EMS care in the U.S.?
There are four officially recognized levels of emergency medical response training recognized by the EMS community. I say “officially” in quotes because they are not required standards nationwide. Every state and local jurisdiction has the responsibility to determine what the requirements are for those four standards. Many states recognize the National Registry for EMTs (NREMT) standard for the highest three (EMT-B, EMT-I, and EMT-P) but they are not required to do so.
What is a First Responder?
First responder is a certification that basically means that a person has basic first aid skills, CPR for healthcare providers (a little more involved version than the standard CPR), and some training in avoiding and treating patients in a professional emergency capacity. It is often a designation used for specially trained personnel at industrial sites where these employees would act as the initial emergency personnel (i.e. first responders) until the professionally trained fire, rescue, and medical providers arrived.
What is the difference between EMT-B and First Responder?
The difference between EMT-Basic and first responder is two fold:
Training
EMT-Bs take about 140 hours of training plus clinical time on an ambulance or in a hospital (versus about 30 to 40 hours for a first responder course). EMT-B is the lowest level of training allowed to transport a patient by themselves in the back of an ambulance in most areas. They have training in patient assessment, recognition and treatment of life threats, determination of medical priority and to which hospital to transport, and a short list of allowed medications they may administer on their own.
Association
EMT-Bs are associated with local emergency services and private ambulance transport companies. First responders may be either part of a corporate or industrial initial response plan or they may be a low level of training in a local fire department (although most paid fire departments are moving to requiring their fire fighters to be EMT-Bs as well).
Time line of EMS patient care
- Let’s look into the time line around a patient’s injury. first a patient gets ill or injured and a first responder or a bystander with first aid training offers immediate assistance. This helps the patient in the first 5 to 10 minutes of their injury.
- The fire dept. or ambulance arrives with an EMT-B who is there to assess the severity of the injury, determine how bad it is, stabilize any basic life threats, determine if higher help is needed (EMT-I or EMT-P depending on region), and transport the patient to the emergency department. This helps the patient during the first 10 to 60 minutes of their injury.
- The hospital takes over after that for the first 60 minutes to days or weeks.
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