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I'm constantly ranting on my current EMS pet peeves here at the MedicCast TV Weekly Commentary but what I want to know this week is:

What's got your EMS panties in a bunch?!?

That's right. I want to here from you about some issue that, as an EMT or paramedic, you want to vent some time on. Send your emails in to me here at Podmedic@Mac.com and I'll pick from these topics to share some of my questionable wisdom with you.

Don't wait, email me right now at podmedic@mac.com!

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Talking this week about online education and distance learning restrictions on EMS continuing education. Up until now, the EMS community has been limited to a very small amount of online credit for continuing education. Specifically the NREMT and CECBEMS folks who determine what is allowed and what is not are stuck in the stone age and want us to be locked in to a curriculum on repetitive classes that rehash old knowledge and skills.

The gang at Acadian Ambulance and their EMS Academy online program have come up with an acceptable solution by providing live web based education that doesn't require face to face learning time but still is considered a "LIVE" classroom for the purposes of distance learning.

I want to applaud them for thinking outside of the box here and promoting the options that modern technology give us by coming up with a solution to this problem and pushing the accrediting bodies to accept it. You can check out what they are offering by visiting them at www.onlineNEMSA.com.

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This episode of the MedicCast TV weekly commentary is about Confidence. What should you do if things start to fall apart around you?

Take a deep breath. This sounds a little cliche, but it works. It gives you chance to step away from the situation, so to speak, and see it from a different perspective. By remaining calm, or appearing to remain calm, will give you more control of the situation and allow you to react better to the situation.

So, take that deep breath, calm down and keep going. Remember, the only thing you really have control of is yourself, so just focus on staying calm and what you can do to help the patient.

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As you can figure based on the title above, this episode of the MedicCast TV weekly commentary is about sharing. What should you, the EMT, paramedic, student or educator be sharing?

You should be sharing the name of your favorite podcast with the other providers and EMS community members you know.

So I ask you. "Are you sharing the EMS programs that influence you with others?" If you need some assistance here are a few options to get you started.

Mitigation Journal with Rick Russotti

EMS Garage with Chris Montera

Gen Med Show with a panel of hosts

EMS Educast with Greg Friese

Chronicles of EMS

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There's always a lot of complaining around EMS stations between the paramedics and EMTs working there. They complain about their bosses, the scope of their practice, how the medical director hands down protocol changes without thinking about the hard earned skills possessed by the providers on the streets and their frustration when those skills are reined in by rules and restrictions.

The solution is to stop complaining and learn to read and support research that will prove or disprove the claims made on both sides of these issues. Blogger extraordinaire, Rogue Medic, takes it upon himself to bring up the level of discussion by pointing out research when it is done well and giving a study a big "Thumbs Down" when it's done wrong.

Do yourself a favor and read the RogueMedic.Blogspot.com blog to give yourself an education in the research that goes along with emergency medical care in the field.

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WAIT A MINUTE!

It’s not like he’s dead or anything. Mark will still be around and hopefully we can do a transatlantic arm twist to bring him on the MedicCast from time to time. In any case, I expect Mark will return to the social media arena in some capacity and I look forward to the journal articles and the blog post collection he is rumored to be putting out in book form.

Kudos to you Mark! Thanks for sharing your wisdom and insight into the world of pre-hospital medicine.

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On last week’s MedicCast TV, I discussed the elusive Wolf-Bare-Taylor syndrome with you. As more providers are being called to the nation’s theatre’s for unusual cardiac related calls, I thought it would be prudent to continue this week with a look at the cardiac syndrome known as “Cullen’s Arrhythmia.”

This should not be confused with Cullen’s sign.

“Cullen’s sign is known as bruising around the umbilicus seen as evidence of intraperitoneal hemorrhage such as might be caused by intra-abdominal bleeding following a traumatic injury or ruptured ectopic pregnancy.”

Cullen’s arrhythmia is much more insidious since it often causes diversion of necessary EMS resources for an “unknown” cardiac event. Evidence is most often discovered with careful history taking, noting of surroundings and history of events leading up to the current medical problem.

The arrhythmia is most often seen as a brief period of complete AV block in lead two bracketed by unusually large, peaked, negative deflections of consecutive p-waves. Patients will most often complain that they felt their heart “skip a beat.” Unlike last week’s wolf-bare-taylor syndrome which affected 30-45 year old mothers, this disorder exclusively affects teen and pre-teen females.

The best way to identify this rhythm in the field is to take the strip with the negative peaked p-waves and draw a short line over the space in between them to mark the area. Draw two small circles above the p-waves and then draw a large oval around the entire period of arrhythmia.

It looks like you’ve got a case of Cullen’s arrhythmia. Treatments include standard palliative care, parental signature on the patient refulsal and informing the patient’s boyfriend that he can’t possibly compete with Edward.

Hopefully, by spreading the word about Wolf-Bare-Taylor Syndrome and Cullen’s Arrhythmia over the last two weeks, we can avoid the issues seen last year with the widespread M-Fox-Priapism outbreak that occurred just following the release of Transformers II.

Again, the American Heart Association could not be reached for comment.

Don’t forget, you can sign up for free updates and download of all MedicCast TV episodes in iTunes and the Zune marketplace. Don’t miss the weekly MedicCast EMS radio show and podcast posted each Sunday night and ready for you to listen to each Monday morning.

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With the release of the latest installment in the Twilight movie saga this week, I thought it would be important to cover some of the unusual injuries and medical presentations EMS providers might see over the coming weeks.

Some of you may have already seen some of these unusual effects following the release of “New Moon” last holiday season. Because of that I will start off with the new syndrome known only as Wolf-Bare-Taylor Syndrome.

This should not be confused with Wolff-Parkinson-White syndrome.

“Wolff-Parkinson-White syndrome is a heart condition in which there is an extra electrical pathway or circuit in the heart. The condition can lead to episodes of tachycardia and is one of the most common causes of tachycardia in infants and children.”

Treatments are mostly palliative and include oxygen, splashing cold water on the face, cold shower, or just leaving her the heck alone so she can finish the movie. A 12-lead ecg is NOT necessary as nothing of note will show up in most cases.

EMS providers may test for the disorder by adding any recent promotional pictures of Taylor Lautner to their EMS bags and showing them while noting increases in pulse and respirations.

The American Heart Association could not be reached for comment.

Come back next week when I’ll look at the newly discovered “Cullen’s Arrhythmia.”

Don’t forget, you can sign up for free updates and download of all MedicCast TV episodes in iTunes and the Zune marketplace. Don’t miss the weekly MedicCast EMS radio show and podcast posted each Sunday night and ready for you to listen to each Monday morning.

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But what prompted Mark, and co-stars Justin Schorr and Ted Setla to open this up to the community anyway and what names did they try to come up with and fail?

Top Ten Failed CoEMS Names

You can try your own hand at this by heading over to ChroniclesOfEMS.com and suggesting your own ideas. You could win and iPad 3G and if you're over 18 you'll also win a free walk-on role on a future episode of the "Reality Series" with Justin and Mark.

Super Sexy CPR Commentary

Will using alternative training methodology result in better training and more widespread application of bystander CPR in the field? That is the topic of this episode of the MedicCast TV weekly EMS commentary video.

Super Sexy CPR Video link

Sure these folks get some of the details wrong and the positioning is more for scandalous effect that effective CPR but that said, it does show one thing very well. It doesn't take very long to show the basics of CPR and train a layperson on how to do it.

If you can keep them as interested in watching as this video did, they will probably NEVER forget what you (or your shapely manikins) teach them!

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Apparently the TV bigwigs think that "the Reality Show" (Chronicles of EMS: the Reality Show) is not a good name to catch the public eye. Ted Setla, Mark Glencorse and Justin Schorr have decided that YOU should pick the new name. They've offered up a really cool grand prize, too!

A new iPad and a guest spot on Chronicles of EMS with free round trip and accomodations!

Find out more at ChroniclesOfEMS.com/name-the-show.  Enter with as many ideas as you want. Rules and entry guidelines are available at the link above.

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Check out this episode of the MedicCast TV where I got a chance to have Mark skype in for a video conference about the news and to tell me how all of the EMS community could help get the word out and vote for the show at ChroniclesOfEMS.com/vote.

Find more EMS TV shows like this one at MedicCast.TV or check out our channel at MedicCast.Blip.TV.

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Since then, I realized that it's not only us who are confused. Our patients are confused about whether they are a patient or not.

In a nod to the great comedian, Jeff Foxworthy, I give you my list of ways you can help pick out the patients from the non patients while working as an EMT or Paramedic in the field.  Feel free to add your own in the comments to this post below.  Maybe I'll share them in a future video installment here at MedicCast TV.

You Might Be A Patient If . . .

• If you have ever refused to go to the hospital after your children called 911 because you didn't want to inconvenience anyone - you might be a patient.
• If your drug dealer cut your heroin with something "really rad" and you just stopped breathing - you might be a patient.
• If your best friend just dared you to ride your bike off the roof of the garage and you did it - you might be a patient.
• If your cell phone is ringing and you can't answer it because you just blew your hands off with an illegal firework - you might be a patient.
• If you just set fire to your face because you had to have a smoke while on oxygen for your emphysema - you might be a patient.
• If you can scratch parts of your back you've never been able to reach before after riding your skate board - you might be a patient.
• If you've been out in a thunderstorm and you can't let go of your golf club because it's fused to your hand - you might be a patient.
• If the paramedic in front of you knows your last four days of blood sugar readings better than you do - you might be a patient.
• If your five day bout of indigestion gets even worse after 5 hours of yard work without a break - you might be a patient.
• If you just stocked up on pharmacy's remaining supply of diet pills just recalled by the FDA for "supposedly" harmful side effects like "black, tarry stools" and "explosive flatulence" - you might be a patient.

Share Your "Patient Moments"

Have your own ". . . you might be a patient" sayings, record them yourself and tag them on YouTube with MedicCast or leave them as a comment below.

You can also email them to me here at podmedic@mac.com.

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EMS Week Is a Joke!

(. . . and the joke's on us!)

The question is, what are we doing wrong? We are celebrating the EMS system, which Chris Montera and the gang over at the EMS Garage and others have been saying is hopelessly broken for a long time. We are fractured in to multiple systems and models, most often lumped in with public safety services whose primary mission is to keep order and protect infrastructure - NOT perform medical services.