Should deaf people be allowed to be EMT'S or Medics

[emt3225]

Are the 21% who said "yes" serious, or are they just being PC? THINK about it......

I'll throw in my .02.....assuming someone is deaf - cannot hear - , not HOH .....

there are entirely TOO many things to worry about (for lack of a better word) on a scene to have to also worry about trying to get my partners attention by having to tap them or wonder if they can feel vibrations or something. seriously...can you picture it? Think about the times when you have a multi car MVC or something and people are scattered everywhere, asking questions, stating complaints, etc-patients, FD,PD etc. HOW is a deaf person going to handle a situation like that?? Or a medical call even....think about how much communication you have with your partner, family, patient...I cannot even imagine it. I try to picture a deaf crew member, and I can't get past what I'd do when the tones went off-go find partner, tap on shoulder--then what??

People who cannot or no longer do the job, need to bow out.....and those are the ones I respect. I do not believe the sense on entitlement some people feel....

My daughter has 20/200 vision, a fighter pilot she will never be. Should she expect to be let in to the service and fly planes because she wants to, because she loves it, because she wants to serve her country?? - absolutley not!

and that is meant with no disrespect at all.

I think asys said it best in his previous post.

Well said...... =D>

[Xiaomei559]

To the hearing Impaired

Here's a thought... do you want to be a medical professional because you have a passion for it or are you doing it just to prove that you can. If it's the latter, then you could have super hearing and you would never succeed. If you're doing it because it's what you truly want to do then go for it, but do it knowing that you will have a lot of obstacles to overcome. Also keep this in mind, not all obstacles are meant to be surmounted.

[Dustdevil]

Amplified stethoscopes aren't a problem, or they wouldn't be so popular among doctors and others using them in the industry.

As a nurse, I spend a LOT of time around doctors, and I have never noted them to be particularly popular. They are certainly not taking over the industry. Regardless, doctors are listening to very different things than a field medic is listening to. Pretty darn rare to see a doctor taking a BP. Yet, that is the number one thing we do with our scopes. If you are practicing in a nice quiet office and listening to heart sounds all day, then yeah... more is better. That's a great gig, if you can get it.

I counter with, well then, how can you trust the automated BP cuff?

I don't. Several of us here are on record saying we don't.

But again, hearing bowel sounds, breath sounds, and heart sounds are not analogous to auscultating a blood pressure. The former are qualitative measurements. The latter is a quantitative measurement. If amplification does not skew the quantitative results, then I am all for them. I'm just looking for some reliable and validated comparison to tell me if amped scopes give different BP readings than acoustic scopes. Asys' theory is sound, and it is the reason that I am not convinced that amped scopes would give different readings. But again, until somebody actually tests it, it's just a theory.

[mysticlakecasinoemt]

Things have changed in some facets of the industry. You did mention that you are retired as an RN. In just the past year, some private company areas of Minnesota are still at the cutting edge on this very issue of acoustic versus electronically amplified stethoscopes concerning performance in noisy settings prehospital and inhouse.

Found the following in someone else's blog.

3M began testing the new stethoscope on people about a year ago around my city. They brought doctors and patients to its headquarters in St. Paul, Minn. In a reverberation room -- a concrete chamber about the size of a one-car garage -- scientists re-created hospital cacophony from recorded sounds. Bells rang. Carts rolled. Bed rails squeaked. Respirators hummed. Voices mumbled incoherently in what 3M calls "hospital babble." and then did the same thing with equivalent ambulance and rescue scenes noises in 3D, faithful to actual conditions.

Heart specialists and other doctors then conducted exams on real patients suffering from a variety of conditions, including a heart murmur and asthma. As doctors pressed stethoscopes to the patients, researchers assaulted the room with volumes of background noise from 60 to 80 decibels, even during vital signs taking.

The new versions of these stethoscopes reduced ambient noise by 75%.

I agree with you, it's tough to evaluate for Beck's Triad in the noisy ED let alone outside working an MVA, but some of the newer stethys are now working well.

From what I've seen, they've finally seemed to have created the good one for at least some of us in EMS.

The 3M designers experimented with a thin slit (0.040 of an inch) carved around the diameter of the chestpiece on theirs last November. Its purpose? Ambient noise, say a squeaky gurney, enters the device from the outside through that hole. There, it meets the same noise, which has been conducted through the patient's body. Because the scope is receiving the same vibrations from two different places, it cancels them out, leaving heart and lung sounds audible. Works the same way with rubbing noises of clothes and bumping during BP readings, according to a coworker at the firehouse.

Side Note.. For those of you joining into this vein,..

In an acoustic stethoscope, the sounds are picked up by a membrane and transmitted to the ear via a flexible tube made of rubber or plastic.The quality of the membrane, the length of the tube and any irregularities in the equipment may cause sound distortion. Moreover, sound cannot be amplified and external noise cannot be filtered. You are right, there, Dustdevil. That this type is the inferior one for field noise.

With an electronic stethoscope the sounds are picked up by a microphone located in the membrane behind the bell.The sounds are amplified and transmitted through wires to the speakers inside the ear pieces. There is no distortion and the user can adjust the volume himself. Furthermore, electronic filtering means that many external sounds are eliminated, such as those created by hand movements, rubbing and any surrounding noises. This is the second species of animal that is what the 3M newbie was when the new ground was broken and published in the Wall Street Journal just recently.

I think they covered the ground you're seeking about BP readings and these spiffed stethys.

I ran across it in the Wall Street Journal under the title article The stethoscope enters the 21st century: When a Heart Beats In a Noisy Hospital, Who Can Hear It? Hope this covers the info you're seeking. It sure opened my eyes a bit. Patti

[Dustdevil]

I think they covered the ground you're seeking about BP readings and these spiffed stethys.

I ran across it in the Wall Street Journal under the title article The stethoscope enters the 21st century: When a Heart Beats In a Noisy Hospital, Who Can Hear It? Hope this covers the info you're seeking. It sure opened my eyes a bit.

Thanks. That's great info, but none of it really covered the question I asked, which is:

If I take a blood pressure with an amplified scope, will it be any different from the reading I would have gotten with an acoustic scope? And if so, how much different?

The way to check this would be for two people to check multiple BP's using a teaching scope, to establish that both people are consistently getting the same reading. Once that is established, then those same two people would need to check multiple BP's simultaneously while one wears an acoustic and the other an electronic, then see if their range of consistency remains the same.

There's a nice little project for anybody whose medic school is making them do research.

[mysticlakecasinoemt]

I believe the article addresses exactly that. Did you read it yet?

Thanks. That's great info, but none of it really covered the question I asked, which is

If I take a blood pressure with an amplified scope, will it be any different from the reading I would have gotten with an acoustic scope? And if so, how much different?

[Ridryder 911]

I always wondered when you document should it be different ? Like you do for Doppler ?...

R/R 911

[Dustdevil]

I belive the article addresses exactly that. Did you read it yet?

I'm afraid I don't get the Wall Street Journal. And the article does not come up in an online search of their website.

[mysticlakecasinoemt]

Similar topic and study. Might prove delvable into your question. Approachable format.

This done by Biomedical Engineering Lab. I have having trouble, too, on locating better

specific locales on this. You've peaked my curiosity, too. I shall keep looking.

Blood Pressure Measurement in Noise Intensive Environments Using Adaptive Interference Cancellation

http://www.ingentaconnect.com/content/klu/...000005/00482716

I'm afraid I don't get the Wall Street Journal. And the article does not come up in an online search of their website.

[mysticlakecasinoemt]

This is the stethoscope I'm using now. Dust Devil, there is a graph that might interest you on

the bottom of page two. I was used as the guinea pig for this company in testing HOH

for a discount in a survey at the inception of this line.

http://www.pmsinstruments.co.uk/pdf/PMS%20...pe%20110705.pdf

If I take a blood pressure with an amplified scope, will it be any different from the reading I would have gotten with an acoustic scope? And if so, how much different?