JPINFV

http://www.cdc.gov/swineflu/

Or someone can run the title through Google or Pubmed.

Comparison of clinically significant infection rates among prehospital-versus in-hospital-initiated i.v. lines. STUDY OBJECTIVE: To compare the risk of infection for i.v. lines placed in the prehospital versus in the in-hospital setting in a midsized emergency medical service system. DESIGN: A retrospective analysis was made of all i.v. line site infections among patients admitted to ward beds from a university hospital emergency department in 1992. METHODS: The hospital's infection control team conducted daily ward rounds and a surveillance of all wound and blood cultures. Patients with signs and/or symptoms consistent with Centers for Disease Control and Prevention guidelines for skin and soft tissue infection were reported to the responsible medical team. Infections were documented based on consensus opinion between the infection control team and the physicians responsible for the care of the patient. IV lines placed in the prehospital phase of care were identified by electronic retrieval from the prehospital database. RESULTS: Three thousand one hundred eighty-five patients who had a prehospital or an in-hospital i.v. line placed were admitted from the ED. Eight hundred fifty-nine i.v. lines were prehospital placed (27%), and 2,326 were in-hospital placed (73%). There was one infection in the prehospital group and four in the in-hospital group (infection rate: .0012 for prehospital patients and .0017 for in-hospital patients; P = .591 by Fisher's exact test). CONCLUSION: Both cohorts had exceptionally low infection rates. No clinically or statistically significant increase in the risk of infection among prehospital- or in-hospital-initiated i.v. lines was identified.

Oh, sure, ABC means ambulate before carry. That doesn't mean that it's the rule for every patient with two good legs or the ability to hop.

Epic fail on the title. Massachusetts has a hard on for using Mass____ for their government offices (MassHealth, MassHighway, etc). Title should be MassFail.

Does anyone know about immigrating to Madagascar? (for those that don't get it, play this game a few times through. http://www.addictinggames.com/pandemic2.html

What, you didn't get the memo? Heck, better to be an alien than be some lazy EM physician swine. /me looks at signature. Oh crap.

...but some how working on 110 hours of training and being able to administer 5 or so drugs, including patient assist medications, of which only 1 gets any serious use, is supposed to make up for medic schools apparently not having a long enough field internship?

Do the medic schools in your area not require a field internship and do the ambulance companies not provide their employees with field training?

http://www.ems.gov

^ I believe the proper term is "European American." /or you can call me white if I can call you black.

I don't think that the article was that clear cut. To me, the psychological argument that they set forth was that genetics predisposed some people to become psychopaths, but the environment has the final say. It's like the genes put people on the edge of becoming psychopaths, an edge that MOST people aren't on, and the environment gives that final push. Similarly, due to the genetic differences, two siblings can have the same initial pressures, deal with those pressures differently which causes, especially by high school, two completely different experiences growing up.

Wow, that article is just a complete train wreck. Thank you Captain Obvious for that little insight. So kids who go and shoot up their class mates, regardless of what leads up to it, aren't normal? Sounds like most teenagers I've seen. Who hasn't, at some point in their teenage years, thought that they were God's gift to the world, felt like doing something just to screw with adults because you could, and hated being told what to do? Err, contradiction much? So basically it sounds like they're trying to say that "Shit happens and sometimes people get wired wrong?" Sorry, I don't think most people are willing to chock it all up to nature and say no environment.

Ahh, the solution to this issue; depends.

...and there we have it. It's better to demonize 2 for their deeds than look inside our culture as a whole that makes it OK to make outcasts over some thus making the true root cause of Columbine. To the 15 victims of Columbine, may you all rest in peace.

That internship is, in most cases, the first year of residency. That said, it's not really applicable. A more proper analogy would be to say that physicians would have to work as physician assistants before going to medical school. Residency would be likened to internship/ride time that a paramedic student does.

Ahh, good old flash mobs. The best story I've heard of these was where a New York group crashed a little league base ball game and essentially turned it into a major league game complete with Jumbotron and announcers. http://improveverywhere.com/2008/04/07/best-game-ever/

First paragraph of the article mentioned in the title and linked to.

No POA:HC or conservatorship, then they can't sign for the patient. Yes. You would also be able to discuss your concerns with the patient's physician. Unless there is a POA:HC or conservatorship, and altered patient is going to the hospital.

I never understood how someone could forget to fill in history, allergies, medications, signatures and the like. Either there's something written in the box (even if it's the UNK box marked) or not. Don't providers at least do a once over look at their PCR before turning it in? Now laziness I can understand. Solution: Until we become professionals with a professional work ethic, I say companies start paying their employees minimum wage with differentials based on doing their job. Let's see how many people "forget" to get a signature when a dollar or two and hour depends on doing paperwork properly.

That's pulse pressure. MAP (mean arterial pressure) is either 1/3(pulse pressure)+diastolic pressure or 1/3 systolic plus 2/3 diastolic pressure or (systolic+2*diastolic)/3. All are mathematically equivalent. Personally, I find the last one the easiest to do in my head. Double the diastolic, add the systolic, round to a number divisible by three (remember, a number divisible by three is one where each component adds up to a number divisible by three. For example, 123/3=41. 1+2+3=6. 6 is divisible by 3) and divide by three. MAP should be at least 60. 70-110 is normal.

Without getting a source for the study/review article, we may never know. Machine readings (invasive and non-invasive BPs) will give readings in odd numbers. What struck me is that the 'new' numbers are with in the margin of error for manual BPs anyways.

∞

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