bbledsoe

It is so nice to see the positive influence Rob had on people. He was passionate about EMS and was always a proponent of increased education for EMS providers. He was among the first to stand up for me when I took on some controversy. I worked with Rob in the 1970s in Fort Worth. He disappeared for several years and we reconnected after the funeral of a former co-worker. When another former Fort Worth EMS worker died in solitude in Mississippi (Jerry Harness), Rob went to Gulfport, got his ashes, and arranged a memorial service in Fort Worth. He wanted to assure that our colleague was honored. In terms of his diagnosis, I knew this day was coming. Still, it is a sad day. Rob was very proud of me and I was humbled. He would call periodically and tease me about something or ask about “those damn books.” He was so proud my life that I wish I could have found a way to see that he too was making a difference. He’d be humbled for the kind accolades detailed here (or pissed off!). He was truly an advocate for EMS. But, he could stir the shit (and I never figured out why he took to spelling the British way—probably just to piss off his naysayers). Like him or hate him, Rob had a sustained passion for EMS. We need more Robs. It has been great following this thread. I have to star a clinical block tomorrow in trauma and will try and look in when I can. Bryan Bledsoe

Many of you know Rob Davis from these EMS forums. He often posted and would have a picture of John Wayne or Chuck Norris as his avatar. Rob passed away last night after a long and horrendous battle with Lou Gehrig's disease (ALS). I actually diagnosed him after the last EMStock and he asked that I not tell anybody (which I did not). He died at his mother's house in Mansfield, TX. I heard less and less from him toward the end. Like many with ALS, he was angry. Many of us from Fort Worth worked with Rob in EMS. He was a bright and passionate guy. He did like to stir the sh*t as well. Per his request, no funeral will be held. There may be some memorial service later but I have not heard. Thanks. Bryan Bryan Bledsoe, DO, FACEP, FAAEM, EMT-P Professor of Emergency Medicine Director, EMS Fellowship University of Nevada School of Medicine Las Vegas, NV

Please vote for our Las Vegas Emergency Medicine residents' video. We need you to vote daily with every email address you have. The link is: http://www.emp.com/video-voting EMS Expo is in Las Vegas next August and we are working on some neat stuff in the valley! Thanks BEB Bryan E. Bledsoe, DO, FACEP, FAAEM Clinical Professor of Emergency Medicine University of Nevada School of Medicine Department of Emergency Medicine University Medical Center of Southern Nevada Medical Director, MedicWest Ambulance Las Vegas, Nevada

Ah...the conundrum of EMS textbooks. We pushed Brady to let us push the envelope with our 5-volume paramedic texts--and we did. Then, we started to lose some business to the one-volume Mosby text--so we developed the Essentials book. I pushed hard to modify Ric Martini's college A&P book for EMS. It worked and has sold well but we continually get requests for a lower level A&P book in addition to Anatomy and Physiology for Emergency Care, Second Edition. The lower level book will be out later this year. We are finishing a pathophysiology book and I am again trying to push the envelope. It seems we push forward with content only to have a segment of the EMS community push back. I wish I had a nickel for every time I've heard. "Just give us a book that will get us through the test." Interestingly, I've never heard that phrase in the world of medicine. My congratulations to you for attempting to push the educational envelope. I've about given up. I've been often asked, "Which comes first? Improved EMS pay or improved education?" While it is a "chicken or the egg" argument, I would say that education has to come first. It is hard to believe that some oppose accreditation of paramedic programs. What's the deal? BEB Bryan E. Bledsoe, DO, FACEP, FAAEM Clinical Professor of Emergency Medicine University of Nevada School of Medicine Department of Emergency Medicine University Medical Center of Southern Nevada Medical Director, MedicWest Ambulance Las Vegas, Nevada

I am simply the medical director for the program at UNLV but have been active in development. We bought the rights to use Danny Limmer's EMT book (Brady's Emeregncy Care) and my EMT-I book to use as the base for the programs. It was primarily designed for the military but will be opened up for civilians. There are two options for skills/clinicals. Students can come to Las Vegas for an intensive boot camp of skills and clinicals and testing. UNLV will be partnering with local programs (US and worldwide) to provide the online content and the local schools will do the testing and skills and clinicals. Once beta testing is complete the program will come on line. Certificates will come from the University of Nevada at Las Vegas. The clinical experience in Las Vegas is tremendous (what happens in Vegas doesn't always stay there). The costs of staying in Las Vegas (if you stay away from the casinos and Joël Robuchon's restaurants and the strip clubs) is fairly inxpensive. Our companion program on the military side is: http://www.jtmlasvegas.com/ BEB

Queen's English? AAAABBBBUUUUURRRCCCCEEEEEEEOOOOOOEEAAAAAAA Put 'em where you want in the book and you have the Queen's English.

Just a follow-up. I did a presentation with Randy Mantooth yesterday in Beverly Hills. he absolutely loved the "Somebody Does Not Like Trauma Video" and said it was one of the funniest things he had seen in a long time. I promised feedback on his response although it is a month late...

Everybody should make their own decision about the vaccine. I don't believe that any vaccine should be mandatory UNLESS failure to vaccinate puts the rest of the population at risk. I remember, as a grade schooler, going to my elementary school and getting the flu vaccine in the 1960s (it was mandatory). I am taking the shot as soon as I get to Las Vegas early next week. As a group of emergency physicians (at UNSOM), we decided not to take the nasal vaccine because it is a weakened (attenuated) form of the H1N1 virus and we were afraid that we would shed some of the virus which might adversely affect some of our patents who may be immunocompromised. But, we are taking the injection. I am making sure my two kids (in their 20s) and my son's pregnant wife (also in her 20s) get the injection vaccine. I intubated two people last shift at UMC who had H1N1. I had one patient, a male in his 20s, who was in the hospital for 7 weeks, spent 5 weeks on the vent, had bilateral chest tubes, a DVT, and ARDS. He was low sick. This H1N1 is scary and if you are in your early adult years or pregnant, you should be concerned. The Obama administration has done a horrible job of providing information about the H1N1. While in Texas last Friday (I am in San Jose now), the TDSHS web site showed that two pharmacies near my Texas house was supposed to have the vaccine. I went by both to try and get the vaccine for me and my family. Neither pharmacy had the vaccine and neither knew when they would get it. It is available in Clark County, Nevada. Go figure. I was in Mexico when this H1N1 emerged several months ago. The way it affected children in the Mexico City area was scary. Although the predominant strain in the US appears to be less virulent than the one on Mexico City, it is still a bad deal. Vaccines save lives. If you give people enough of a substance, be it vaccine, drug or placebo, a few will have an adverse effect. This does not mean that the vaccine is dangerous. The links between childhood vaccines and autism are pseudoscience. Far more kids will die from not being vaccinated than will suffer ill effects from the vaccine itself. Look at the evidence and make your own decision. I, for one, will get my vaccine next Monday.

I'll see him in about 2 weeks and will ask. I imagine it was an LACoFD rule at the time. I'll ask.

Figures... http://www.iafc.org/associations/4685/files/ems_ltrFromNBCreTramaShow091005.pdf

I had a 4th year student from COMP in the ER last week doing his EM elective and was quite impressed with him. The students from that school in California seem quite good (at least in the ED at UMC). It's called parody. Month Python made their fortune doing it.

I have never seen Gray's Anatomy (but my daughter loves it). Some of the medicine in House is pretty good (although everybody gets a brain biopsy). First, Princeton does not have a hospital and a team of diagnosticians sitting around waiting for zebra cases would be quickly unemployed. But, the diagnostic decision-making in house can be OK (most internists could not do the microscopic work that occurs on that show). But, in the real world, despite House's apparent genius he would be run off. Such behavior (although attractive to some of us in medicine) would not be tolerated.T I watched the first episode of Irauma where ever I was that week (Laughlin I think) and it was atrocious. There is no way it will last. I know Seb Wong at San Francisco Fire has tried to guide them in the right direction but it has been all for naught. Any of these television shows (even Mother, Jugs and Speed) have some reality--but very little. I only watched one episode of ER and thought the medicine was OK. I don't have to watch television to see weird things--I work a Level I ED in Las Vegas. There are levels of weird in that city heretofore unseen.

I tried to download on my iPhone coming back from Boston today and couldn't. I finally downloaded it at home and laugh every time I watch it. I don't know who Nick is but he has won my respect. What a great video. It is screaming across the internet in EMS and emergency medicine circles. A physician friend from Oregon sent me the link a few minutes ago. BTW, I got pictures of Dust's latest girlfriend. Like him, she loves those helicopters.

Dust forwarded this video. IT IS SHEER GENIUS. What a great way to vent frustration and identify an issue. I have told everybody to boycott the trauma show and A.J at JEMS is doing the same. I have emailed the link to everybody I know and they love it. I could not resist the chance to send the link to Randolph Mantooth. He'll laugh his ass off. I'll let you know what he says (he loves this kind of stuff). Again, sheer genius lurks somewhere in the confines of this list. Thanks for letting me in on it. Bryan Bledsoe, DO, FACEP P.S. There is an "E" at the end of "Bledsoe" (e.g., Drew Bledsoe). But, it's all good.

What kind of ajenda are you guys thinking? Perhaps there is someone here *wink wink, nudge nudge* that could get Dr. Bledsoe to do some sort of speach. Give me enough notice and, if possible, I'll be there. Consider EMStock for an EMT City meeting. Bryan Bledsoe Fajardo, Puerto Rico

I did not steal the idea off of DD, I stole it from all of ya'll!! Come to EMStock September 25-28, 2008 (http://www.emstock.com) and we will make DD walk the plank (or tell old tales)!!! BEB P.S. Thanks for the nice comments about the article. It was written a few months ago and based on some thoughts from this and the Field Medics (sp?) website.

I did not steal the idea off of DD, I stole it from all of ya'll!! Come to EMStock September 25-28, 2008 (http://www.emstock.com) and we will make DD walk the plank (or tell old tales)!!! BEB P.S. Thanks for the nice comments about the article. It was written a few months ago and based on some thoughts from this and the Field Medics (sp?) website.

We usualy give away 3-4 sets as dor prizes at EMStock. BEB Also a Cowboys Fan

You are smart to do that. One book can never supply every bit of information needed for every student. In medical school, we were usually given 2-3 books to choose from and we chose the ones that were best for us. Other than a few (physiology, pathology, pharmacology), several books were always used. We try to be the best, but are human. A day does not go by that I don't make a note or copy a page with plans to update or improve material in the next edition or printing. Our 5-volume, 3rd edition will publish in March. This has been the most extensive revision to date. I completely rewrote cardiology and spinal injuries. Virtually every chapter was updated. BEB

Please contact me directly at 972-775-2612 or cell 817-690-3679. We always appreciate suggestions. When you are dealing with books of this magnitude, errors and inconsistencies will slip in. There are just as many, if not more, errors in the Mosby and AAOS book. No book is perfect--each has their strengths and weaknesses. Believe it or not, we usually get only 5-6 complaints a year and have remained the best seller for nearly 2 decades. But, one never rests on their laurels. Bryan Bledsoe, DO, FACEP, EMT-P UNLV

http://www.bryanbledsoe.com/data/pdf/mags/Golden%20Hour.pdf

The 5-volume series has 700 or so more pages than the 1-volume text. The 5-volume covers all of the DOT minimal and extra material while the 1-volume covers the DOT minimum (e.g., no RSI, no research). We originally planned the 1-volume text to be a refresher book but started to lose sales to Mosby strictly for cost issues and thus released it as an abridged text. The 5-volume book sells better. The third edition of the 5-volume book is in production now and will be out in March. It has been significantly revised. For example, the cardiology chapter has been totally rewritten as have several others. These are the last books we will publish under the old curriculum and are starting on the new curriculum materials soon. Hope this helps. BEB

Thanks for the heads up. I have been making similar comments to the staff. I will relay your concerns to the Publisher Jeff Berend. They do listen. In answer to "where has that guy been?" Brisbane Gold Coast Cairns Tokyo Los Angeles Panama City Orlando San Antonio Syracuse Chicago (twice) Las Vegas That is just the last six weeks. I am sitting in Chicago and literally beat. IAFF is over Thursday and time off is coming soon as soon as conference season slows down. Thanks for asking. Bryan

I could probably get the article through GWUMC but the point is moot. One animal study in the 1960s is not going to trump the idea that there is no scientific basis for the "Golden Hour." The point of the "Golden Hour", allegedly developed on a cocktail napkin in a bar overlook Baltimore's Inner Harbor, was to market the newly-opened Maryland Shock Trauma unit--nothing more, nothing less. Besides, the whole paradigm in prehospital trauma care has changed. We used to flood people with fluids--probably worsening outcomes. Today, we give little if any fluids. So, an animal study 50 years ago is meaningless. The concept is not rooted in science and should be removed from our lexicon. BEB

Read the following article (the URL is to the abstract): http://www.ncbi.nlm.nih.gov/sites/entrez?D...Pubmed_RVDocSum