AnthonyM83

I'd like to think this place started it all, though. The idea of EMS people coming to a place to not only bond, but also to mentor to provide advice from an academic perspective, instead of the ricky rescue perspective. It was the #1 largest influence in my EMS career, as it set up my foundation.

Was just going through my Amazon EMS Wishlist and realized I had some real old books there with descriptions from a bunch of you guys. I think I must've asked for advice when prepping for medic school (or maybe I just kept a running list form the threads). Some from dusty, ridryder, firemedic1, outbach, and sjslennon, too. Funny, most of them I couldn't afford to buy the and forgot them, but came around to re-finding and buying a lot of them on my own years later.

Man, Dust, AK, Ruff, the Docs, VentRT (what happened to him/her), and some others really left an impression on me as a new EMT in EMS working in a really crappy system. Gave me the mindset of not letting my surroundings dictate my level of knowledge or patient care. I owe a lot to this forum...

Was cleaning out my mailbox and saw a notification for this thread... Good to see some familiar faces...

Could you be more specific? "What you are getting is actually the MAP"? The MAP is usually a single number, and when you take a blood pressure it gives two numbers...which is the MAP Also, there should be a phone number on the device with a 24-hour support line that can lead you through working any cardiac arrests or critical situations with these patients. They're your best bet!

Welcome from Los Angeles. The ambulance driver's cert takes like a day. Look up some study guides online. Then start applying right away!

Croaker, I gotcha now. Yeah, definitely a trend away from GCS, from good reason... I do like the comment Busy made, though. When giving a report, either EMTs to arriving ALS, or ALS to arriving EMTs that are going to be helping us move them, it paints a better pictures saying, "He's like a 3-4-6" right now. After awhile, it gets pretty easy to use. Just gotta practice calculating it in your head without looking at the cheat sheet... it gets easier with time the more you use it in conversation. Gotta get that working knowledge experience and you won't have to guestimate.

Miscusi, I think the original poster wanted a little more info/discussion on its potential for causing further injury. DocBob, I've never heard of that move, but I don't know how dangerous rolling your shoulders back to create a flatter? position would be... Like you said, it means one muscle moving another affecting another possibly affecting the neck... Whereas we full on move the neck in order to put it back into neutral in-line position, right? That's way more movement...?

Various chemical imbalances.... ammonia, potassium, sodium, glucose, metabolic, etc. Drug poisoning / overdose. Hypoxia.

I think of him often... BEorP, he has some better pics on his FB...I don't know if you're friends on there, but if not I can try looking through them when I get to my home computer tomorrow... let me know

I don't know about these Bieber? I might have missed some past conversations on this, but what pain management procedures are good for patients in a state of shock? I also don't know how we'd survive without lights/sirens in Los Angeles. For my local fire station it takes about 15+ minutes to cross some 2-block stretches... lights/sirens can cut down a transport time from 45+ minutes to under 10 minutes in a number of areas (more in some specific areas)....no speeding involved either..

I'd highly suggest ART and BART training. It's a system showing increased one year out results after cardiac arrest. Highly recommend it. http://health.ucsd.edu/medinfo/nursing/edr/education/Pages/resuscitation.aspx

Croaker could you support your claim that most agencies are going to the SMS system? I'm not refuting its value, just the claim. Also, there's been studies showing how inconsistent GCS scores are when done on the same patient by different providers. One reason might be the true exam has criteria we never hear about like patient crossing midline to localize pain. Question: what do people mean by taking the time to do a proper GCS assessment? You look at your patient, ask him a question, and ask for his arm for a BP or IV.... Or pain to see if any change. You end up doing that at least twice for all calls even if not thinking about it, no. Once at beginning and at least some other time along the way...?

Wondering how many people here have had the chance to diagnose WPW with AFib in the field ... I can see this a bit difficult to catch... Though would be the time you'd really not want to use adenosine....

Okay, finally have some downtime to write. CAP Lab was freaking awesome as usual. Unfortunately, I was a bit under the weather for this one, but still had a blast. I rummaged around in some chest cavities, found a gallstone, ran a code on the gazillion dollar simulations man, got to see some interesting broken bones, and finally found someone to discuss heart sounds with. Oh, and a badass MCI in nightclub...felt like I was in a movie. Doc, next time it should be a Zombie MCI...go in and find out who's dead and who's walking dead And how does it always happen that you one makes random connections. The Doc has some fun friends...we went out for some drinks, and let's just say there was plenty of adventuring about town! (Unfortunately the Doc needed his beauty sleep so was only able to join us for dinner.)

AK, Sad to see you leave. Believe it or not you were one of the bigger influences as an EMT since the very beginning. You were one of the ones in that core group whose advise I try took to heart and whose mindset about EMS I tried...strived...to adapt. Thanks for everything, directly and indirectly! I feel weird now...a lot of the old guard has been moving on / retiring / disappearing...

I'm actually pretty interested to see how this develops. Seems like you have yourself a situation in which they're at fault in so many ways. If the billing company doesn't see it that way, I'm sure you could call the doctor up directly, too...If the billers aren't worried about it, he definitely should be...

Anthony is checked in to the hotel, ready for tomorrow. Katie's going to both, so she's finishing up the first day. BEorP is currently driving down from Canada and arrives in a few hours. EMTCity has officially invaded Dayton, Ohio!

What you might do is simply talk about each type of call or situation in a non-skills setting. Ideally, they'll get a little A&P and background on the topic first, but that can be really hard to do when new teaching. What's easy for me when teaching a new topic is to talk through a call, then stopping to explain things as they come up. For example, childbirth. Lead them through a scenario...there'll be a lot of chance to stop and talk about additional BSI, knowing what's in their OB kits, how the call might be dispatched, how the patient might present (emotions of patient...fears students may have), questions you'll want to ask mother about current pregnancy, about past health/pregnancy, and about events that led to the call (signs of birth, etc). Then progress to how you'd set up for delivery, the actual process, and complications they might come across, caring for both afterwards, post-delivery stuff (placenta, etc). While you should never teach to the test, it's helpful to look at a skills testing sheet when setting up for it to make sure you cover each part. Maybe try to find a video on childbirth (youtube?). After, some discussion and questions. Then maybe a break, then get to the skills. They'll probably want to go over it again. So talk through it again. and/or do one live version with a role-player mom, so they get to see the EMR-patient interaction. Then, I personally like to do the first practice run all together as a class (I do it in front of the class, they do in their small groups), step by step, pausing so everyone catches up, so they don't all start skipping stuff. Having an outline on the board where they can all look up and see instead of trying to remember (or looking down at their skills sheet) is helpful too. After one run together, they get free practice. If they start getting bored or distracted or feel they "got it", have those students do it in front of the class without their papers. Through some curve balls (breech, prolapsed, etc) Then definitely a wrap up at the end for any questions. Rinse and repeat for each topic/skill...might combine some if they're real short ones. Oh, and as a new teacher, don't forget to practice it all yourself. Both the skills and teaching it. Practice the presentation. EMT partners make good practice audiences. They can think of some good questions to ask you that they had when they were students or that they think might be asked of you. And if you choke up or mess up, play it cool, and just keep going. Correct yourself when needed, but just keep flowing. I always find it easier to teach if I get some informal chatting time with the students before class starts too...it helps break the ice on both ends (and so they'll be more interactive with you).

But then his statement would be almost pointless, since you're never going to look at respiratory rates just by itself. Might as well throw out pulse quality. If you were to look at it just by itself, it's not very useful (some patients naturally have weak pulses...doesn't mean anything bad). But because the pulse quality by itself doesn't tell us much, we don't then imply that it's a useless sign.

The comments we're leaving are attempts to alleviate that itch. Something about the results you got seemed weird to you, so maybe there's a good explanation. Or maybe not...but the more comments you get, the more angles you might find to it...

Oh, so I'm assuming it can't be very in-depth, then. I'm taking one now that has anatomy and physiology as pre-reqs, one quarter class, and getting more in-depth than medic school, but not that much more. Overall class time on pathophys topics was less or similar to medic school.

Tequila AND rum for all of you! Anyone feel free to drop by! Don't even need to be going to the conference!

What I was trying to get at is, how are you judging the doing "better"? Better at passing a paramedic exam? The integrated one might teach to the test more, because you're worried (understandably) on making sure you teach them what they need to pass... and thus extra material is left out (again understandably). Passing the exam does not necessarily translate to having a better grasp of A&P and having a better foundation to learn about other topics like pharmacology or being able to use the information in the field (or remembering new information they might get from a journal article or an explanation by a doctor). Or hell, it might be that an integrated class allows them to only remember what they need to know and that actually does make them better medics? Doubtful, but can't rule it out. Also, what grades are the students getting on the A&P classes? An A student with integrated A&P knowledge might do better than a C- student with stand-alone class knowledge.

Did you consider the difficulty level of the exam? If the exam covered only concepts limited to what was covered in the integrated class, then obviously the integrated class students will do well since they had less material to cover and it was more directed. The stand-alone class students might do similar, because they knew the same material, but more. Also, the stand-alone students might have had more time from when they learned the material to taking the test. Does the exam test their ability to have working knowledge of A&P? Scenarios asking what might possibly be going on with a patient based on signs/symptoms you might get in the field. Might the A&P Standalone students do better in pathophysiology overall because they have a better foundation?