crotchitymedic1986

nice goin doc, please replace the question with another question.

thank you for your honesty itk -- it is a very difficult problem that would cause many to scratch their head, especially since the mix is not the standard concentration- -- no shame in admitting that Yes 7mcg/kg/min

Nah, I think I would rather just let people think I have some info on the topic, and then back out by saying this topic doesnt interest me.

Yes its real humurous until you bury one of your own. I wonder if after that funeral you will say, "yes we did all that we could to ensure our ambulances were of the safest design, and that we did all the training we could to ensure safer driving practices. I wonder if anyone in EMS has ever heard of the "Smith System for Driver Safety". Its only been used by major corporations since 1946. But luckily in EMS we have EVOC that everyone takes once in their career. Correction: some EMS people take EVOC.

sounds like a cop-out to me, if that were true there would be "0" views. Just be honest and admit you cant work out a dopamine drip unless it is one that fits into your "pocket field guide's parameters". But that is Ok, if you dont like my question, post your own --- it is no longer my thread once you post another question.

Would have thought one of the flight medics would have figured this one out by now, guess I made it to hard.

You make a good point, we may not need another study; WE NEED ACTION.

http://www.emsedsem.org/Prior%20Articles/E...from%20JEMS.pdf

you made my point exactly. Because ambulance accidents are the number one killer of our people, it should warrant further study. I would also like to note for all of you who dont believe anything until there is a scientific study: make sure you are being honest about that. Go back and read the threads about DC EMS (or any EMS) and patient deaths. Everyone was quick to judge and condemn those providers, without any scientific study. You read a news report, and made a conclusion regarding the quality of care at those providers. You had no statistics to back up your opinion.

You asked for more thoughts on relishing scientific studies. I think there is some confusion regarding what a scientific study is, especially in regards to data gathering. Many seem to be of the opinion that unless you have studied EVERY case, there can not be a scientific study, which is not true. Most scientific studies use a small sample of data (500-1000 cases) to come to a conclusion. As long as the sampling is done using the same format, you do not have to study every case. For example, if I wanted to determine the average number of fresh egg cartons that contained "cracked eggs", I do not have to look at every egg carton in every grocery store in the United States to determine that probability. Now as it relates to this current topic. I have in no way stated that my numbers are a scientifc study, but if I continued to tally the numbers from this one site over a year or so, I would say that the numbers would probably be fairly representative of the real world. Remember that this site lists "real accidents" that have occured, it is not a silly poll like mine, that just ask who has had an accident. Since all accidents are not mandated to be reported to a central authority, any study on the subject will be a sampling of "some" crashes, not "all" crashes. Then there are those on this site that want to discount any theory, that doesnt have a scientific study to back it up. That thought process would be fine, if a scientific study had been performed on every topic imaginable, but that has not happened. Most often, it happens the other way around: Someone says, "I think there is a problem", thens someone says "lets study it, and see if it really is a problem". I do not need a scientific study to know that we should be doing more to reduce ambulance accidents, since it is still the number one killer in our industry. That fact alone, tells you that we need to do more. Some may say, "accidents are unavoidable, and as long as the death rate is less than "x" we should be happy". I dont subscribe to that theory. In all of the topics I raise, my hope is that you will just take a minute to ask, "could we do it better in my little corner of the world ?" or "Are we really being the best EMS service that we can be ?". Sometimes I do that by showing the absurd, but most of the time it is based on real EMS issues. I probably will not phrase my questions/polls in a manner that everyone likes, but I am not interested in being the most popular poster here.

fair enough B --- I look forward to reading them all, thank you for offering fact instead of opinion.

I have no disdain for scientific studies, I relish them. The problem is, when it comes to EMS, there are few scientific studies. Dr levick was the first person to crash test an ambulance. Think about that. You would think someone would have done a scientific study on the crashworthiness of ambulances sometime before the 90s.

All I did was ask you to show us the studies you said you had, I didnt know you were lying about it. How is that my fault ? Not very mature, but that is OK. Have fun.

I would also note that any "scientific study" will be flawed to some extent. One of the issues that Nadine Levick brought up is that ambulance crashes are not reported to any "1" central agency, and often times the police report will not indicate that the vehicle was an "ambulance", it may just say Ford F-350 or Ford Van. Then think about how many minor accidents are never reported, and repaired by the company without an insurance claim (backed into a pole).

I still vote arrest, as you really only have 6-8 minutes to save brain cells, and convert the patient. There are numerous calls where the patient has greater viability, but I was referencing the act of responding to a call at time of dispatch, without knowing anything about the patient. A patient with croup or a CVA patient is still breathing (usually) at the time of dispatch, the arrest patient is not.

As usual for AK; too bad. Beorp: The site I am referencing is a site that lists all ambulance accidents that occur in the US that make the news. If you care to click on any of them, you will see that most are very detailed reports about actual crashes. It is quite possible that the two months that I looked at vary from the norm, as that is how you arrive at an average -- you have a high and a low. Please put a link to your "scientific studies" that prove that all of these "real" ambulance accidents are just myths, and must not have happened because you read a study 2 years ago. Also, I was referencing responding TO a cardiac arrest, not transporting an arrest L/S -- I am against that, and two of the accidents happened while transporting cardiac arrest patients.

I would love to see those facts AK, please open a new thread and share them

I guess I should have worded it differently in hindsight --- the call that requires the quickest response is an arrest, because of the limited time window you have to save them. Let us remember this is vehicle accident thread, if you wish to debate what is the most critical call then please PM me or start a new thread.

sherri I dont want to see you get hurt --- if your coworkers are telling you that you are going to crash, they are probably right. Slow down, no call is worth dying for, the most critical call you can respond to is a cardiac arrest, and they are already dead.

Modeled after the "take it or leave it game" post, I am suggesting a new game to challenge your knowledge or skills. I am posting this game under an EMT and Paramedic heading. Here is how it works: You challenge us by asking a hard EMS question; could be any EMT knowledge topic of your choosing. We are then challenged to answer it, WITHOUT CHEATING BY LOOKING AT THE INTERNET OR OUR OLD TEXTBOOKS. Once you answer the question, you then post a new hard question. Remember, you are on the honor system. Here is the first tough EMT question: You have just inserted a combitube in a patient and have ventilated the patient. Which balloon do you blow up first, and how many cc's of air does each balloon take ?

Modeled after the "take it or leave it game" post, I am suggesting a new game to challenge your knowledge or skills. I am posting this game under an EMT and Paramedic heading. Here is how it works: You challenge us by asking a hard EMS question; could be terminology, A&P, a drug calculation, pharmacology, whatever you think is a hard question. We are then challenged to answer it, WITHOUT CHEATING BY LOOKING AT THE INTERNET OR OUR OLD TEXTBOOKS. Once you answer the question, you then post a new hard question. Remember, you are on the honor system: I will post the first hard question: You have a 2kg premie infant that needs a dopamine drip. You have 1600mg of Dopamine in a 100cc bag of NACL (you dont want to overload the child with fluid). You want to administer 7mcgs with a 60gtt set. What is your drip rate ?

Yes i did break my promise, but it was only at the request of the crotchies who stated they could not go a week without my posts. So to make everyone happy, I am not posting any controversial topics until 2009. You will note that these topics are all warm and fuzzy, and not offensive.

This was going to be my next topic to post. I was going to suggest that we challenge each other with a similar format of the "take it or leave it post". Here is how it would work: 1. You post the hardest question you can think of to either EMTs or Medics. The rest of us could try to answer it (no googling, use the honor system). When you answered it, you had to post another difficult question. My original thought was to limit it to EMS textbook subjects, but then I thought, why limit it to that, maybe we could learn something new if we didnt have those boundaries. For instance: Challenge to medics - Please describe "Starlings Law".

OK, there were 3 more accidents yesterday, so I have updated the December numbers, and have now added the November 2008 numbers. A few things that I have noted as I read the reports: 1. The death count is probably much higher, as often times the persons or patient in the vehicle are noted as being flown to the hospital in critical condition, but then there is no follow up story as to the patient's outcome. I think it is reasonable to assume that some of these "injuries" turned into "deaths". 2. Most of accidents seem to occur at intersections, where the ambulance is using L/S to go through a red-light (I would say about 70%). It was also noted that a slim majority of these accidents resulted in ambulance roll-over (probably 50-55%). 3. The ambulance personnel are rarely seriously injured. December Numbers Updated: Ambulance crashes: 26 Ambulance personnel injured: 27 Ambulance pers. deaths: 0 Patient Injuries: 7 Patient Deaths: 1 Other vehicle injured: 11 Other vehicle deaths: 5 NOVEMBER STATISTICS: Ambulance crashes: 21 Ambulance personnel injured: 21 Ambulance pers. deaths: 0 Patient Injuries: 5 Patient Deaths: 0 Other vehicle injured: 25 Other vehicle deaths: 1 If you extrapolate those numbers out for just those who were injured, to an annual statistic, you would come up with 576 people injured on an annual basis, which on it's face seems low. But if I told you that a piece of equipment that was common to ambulances was going to have a malfunction this year that would result in close to 600 injuries, wouldnt you do something about that piece of equipment ? These accidents are still the number one killer of our personnel, what does your service do to reduce accidents ?

deer definitely count, they usually do more damage than hitting a car.