spenac

PETA doesn't make a fuss if you kill the people.

Really this made me think back to an old topic: http://www.emtcity.com/phpBB2/viewtopic.ph...71&start=45 While it was agreed not all need to be naked, based on what people are saying here definitly need to expose area of compaint, touch, and listen.

extremely

yeast

I prefer manual at least for first set and if serious prefer manual confirmation prior to any meds. For long transports auto is nice to keep an I on patient but never rely fully on them. I don't touch patients so guess machine for pulse. Just kidding hands on even helps confirm in some instances your EKG to some extent. We have to invade peoples space. Do so in a confident manner explaining what your doing and most have no problem because other healthcare professionals do it so they expect it.

Thank you. so many new people and even supposedly experienced people listen thru clothes, even heavy sweaters. This muffling could cause you to miss a click or perhaps decide that sounds are diminished, or maybe you miss the popping. If you are going to do this job do it right.

Thank you Ruff. That is exactly the point of this scenario to help drive home that we need to get hands on. I am surprised the looks on other medics faces when I go to touching and looking at patients to evaluate area of complaint. It surprises me how few look at the chest of patients with chest pain.

To drive home the need at times to be hands on during FR class I was checking lung sounds on an older rather large breasted instructor. To avoid touching I went lower than normal for lung sounds. She grabbed my hand and using the back of my hand said lift, now listen where you are supposed to. She then explained you can ask women to lift or you may have to do it but you never do an improper evaluation. That one change might be how something vital is missed. Point is if you are afraid to touch, to look, to listen maybe this is the wrong field for you. Do you listen to lung and heart sounds thru the patients shirt or do you get to the skin?

atherectomy

therapy

On a couple of other topics I was just surprised at how hands and eyes off people are in treating their patients. I was taught in all 4 levels of EMS school I have taken or taking that to do a good exam requires all our senses except taste, and sometimes taste comes into play as odor is so strong you taste it. What do you see, feel, smell, hear? I was taught that if a person complains of something say stomach pain you expose and see if anything visible, then you palpate starting on the areas w/o pain moving to the painful area, finally you auscultate the area. During this you may note various odors. Even in clinicals a the hospital I was asked to do all the above and even had Docs bring to my attention some of what I was feeling or hearing. So my question is am I the only one taught this way? While it may not affect our immediate care of the patient do you feel it is still part of a proper EMS exam? What are your thoughts?

So it is possible that checking dilation, checking baby position could actually be beneficial in the descion making process especially on long transports. I agree with Dusts many months ago post that it would require much more education, which seems to be the theme on this site when we discuss making any progress in EMS.

Man I see why we have so much trouble being seen as Healthcare Professionals. My medical director might let me get away w/o actually palpating because as somebody mentioned we really would not be sure what we are feeling and honestly would not affect our treatment. But to not visualize. That is just not doing your job. How serious is it? If you fail to look and turns out it is turning black and you don't know it you can not give an accurate report to the hospital, perhaps even delaying important care needed as they may just laugh it off as just another viagra complication. Personally I was taught day one of first responder class that EMS is a eyes and hands on business. That w/o seeing and touching you are missing vital information that might affect even hospital care as they may base their triage based on what we say. So back to original patient he gets to ER and thankfully ERDoc is on duty and bored so he immediately asks you what did it look and feel like. Those that took a look say appeared bigger and normal color but no one descibes how it feels. ERDoc asks did you check all sides of it? No just saw the front. As ERDoc lifts and looks he sees that on the backside it is getting dark colored. He immediately gets patient into surgery and repairs what had been a simple hernia that had just gotten twisted and started strangulating. With ERDocs excellent skills your patients pride and joy remains in tact and in working condition.

rheometry

VentMedic wrote "I also have made suggestions that EMTs and Paramedics venture into some of the many classes that the hospital offers on various clinical things like assessing different central line ports, pacemakers and new medications on the market. More often than not, I get a screech from them like I asked them to venture into enemy territory. " I wish more hospitals would invite EMS inside. It could be beneficial for both sides to get a better understanding and could lead to better working relationships. VentMedic wrote " By stereotyping other professionals, EMS workers have built their own wall and have also allowed their profession to become stereotyped. " Very true. Any time we attack another we cause division. We do not fully understand what each other does and sadly we build dividers that instead of making things better lead to more problems.

Thanks itku2er and otherphil. I like the looks of the one otherphil posted. The ones we have have the lock but not the port. But ours have led to several attempts for each patient by everyone. You almost want to get up and dance when we get a successful stick. Thankfully we are switching over to another style and finding out we all did not just forget how to start IV's. I'll try and post the brand of the bad ones when on duty Tues or Wed. I'll also go into more detail of what goes wrong to see if anyone else has ran into this problem.

I always keep my wife extremely close to me. Remember the age old saying Keep friends close and enemys even closer.

guy

While in your paramedic course 911 work will benefit you the most. Do not delay your paramedic course to work.

Howdy

ovary

I hate when family ignores wishes. It is a selfish response made in a moment of fear. Sadly they allow emotion to override even what they know is best.

try

I guess tonight I am lost and have no clue, so I will PM you for more info thanks.

My understanding was that wife wanted everything done so she is the one that voided the DNR even if it had been available. As far as calling all to often familys and nursing homes freak out and call. Many times they have still honor the DNR. Sometimes as mentioned they want them taken to hospital for more aggressive pain measures. I also know that I have gone to confirm death many times.