Things you've missed

[MedicMal]

Oh, and MedicMal, yes we have strayed from the original topic but I find this one so much more interesting don't you?

Haha yeah I guess I do!!!

And hammer, I agree with your whole post!!!

MedicMal

[akroeze]

Akroeze you are contradicting yourself, and thus I am having a hard time taking your word for anything. You said initially that you have never seen or used chest percussion in the field, and then you say that you do have enough experience in using the skill that it can help you as a diagnostic tool. WTF? A monkey (if monkeys could talk) could describe what sounds they expect to hear/not hear when a certain condition is present. Does that mean that they can recognize those particular sounds when they hear them? No. Does it mean they can apply a certain sound to attain a working diagnosis? No. I call bull chit.

Let me clarify. I have not seen it used in the field, no. I have however used it quite a lot as a nurse, therefore I PERSONALLY feel comfortable with percussion. Therefore yes I do have enough experience in doing the skill. My "specialty" in nursing is surgical floor... percussion is quite common. So I feel that my statements in no way contradicted themselves.

As far as nursing goes, you are not trained to the same level as an RN.

Never said I was trained to the current level of RN.

To call yourself a Nurse to the public or people from a different system is misleading. Maybe this is inadvertent dishonesty but I doubt it.

I may be reading this wrong but according to your logic, a PCP calling themself a Paramedic on these boards is misleading because they would not be called so in other systems...? That's what you're saying. Although even then it's not true as an LPN in other systems can still call themself a Nurse. So if anything I'm misrepresenting myself less than a PCP calling themself a Paramedic.

Just because nurses "used to" only have two years of college training is irrelevant. Ambulance attendants used to have only first aid, and before that they had only a driver’s license. CPR used to be a designated medical act. I could go on and on but I won't. I hope my point is clear.

Not going to side track this into a nursing thread... just made those comments as a point of interest. Not trying to say anything by them.

If you feel that you can use chest percussion effectively as a diagnostic tool in the field, be my guest. But don't misrepresent your training or skills. It is very unattractive.

I suppose I should have specified that I am personally comfortable with it from my nursing experience.... although to be honest, since the amount of training I received was the same in either course, why can't a PCP do it? You never get good at it until you actually do it a bunch of times.

I think Lithium did a great job of describing his point. Maybe when you get out in the field your question will get answered to your satisfaction. As of now the best thing may be just to take peoples word for it that a half hour scene time is not uncommon and is not necessarily detrimental, in fact it can be quite beneficial to the pt. We did give ACP's all these extra toys so that they can use them in the field. Ultimately, it is in the pt's best interest to get treatment as fast as possible. And if they are receiving this treatment while still at home then what is the problem?

You're misrepresenting me. I am NOT taking issue with 30 minute on scene time, I have NEVER taken issue with this. I have said many times that I am taking issue with him saying that an ACP should take DOUBLE the amount of time on scene that a PCP does.

Oh, and MedicMal, yes we have strayed from the original topic but I find this one so much more interesting don't you?

Actually... I kinda wanted to hear if I was the only one who missed obvious things. While I am perfectly willing to continue this conversation, in hind sight it deserved its own thread.

[hammerpcp]

Well, that’s terrific if you feel comfortable using percussion in the field and it can be beneficial in your field assessment, great. But, as I said before, it is very seldom if ever (other then Lithium) used in the field for the afore mentioned reasons.

A PCP calling themselves a paramedic to someone in he US who is unaware of the differences in training and assumes that any paramedic is an ALS provider, is misleading, yes. I find you calling yourself a "nurse" with no validation, to be a misrepresentation of your skills. I thought I had made that clear by now. You should be aware of that, if you are not already; to the lay man a nurse is a nurse is a nurse. They don't know that an RN has a four year university degree and an RPN has a two year college degree. Perhaps this was in fact inadvertent on your part; I will give you the benefit of the doubt. It is the same problem as when some one calls an EMT an "ambulance driver", or calls a PCP an EMT. It is not accurate and is in fact overtly offensive because.....well that has already been discussed in detail on this board.

As far as saying something as a "point of interest", implying that you are not interested in discussing it, it would probably be a better strategy not to bring it up in the first place.

I thought that your repeatedly asking why ACPs can take extended periods of time on scene was taking issue with it. No? In any case, blah. If a PCP takes an average of 15 mins on scene and an ACP takes 30 mins on scene doesn't that equal the ACP taking DOUBLE the scene time of a PCP? Oh, forgot, you weren’t taking issue with that. :roll:

PCP's could easily take it upon themselves to learn how to effectively use percussion. Simply put, we don't get enough clinical experience in school so it would be independent learning, as far as recognizing and interpreting different sounds. Also because it is so seldom used, hospital personnel would probably not take your word for it. (I don't think I have ever even seen an ER nurse perform percussion). But really, anyone can teach themselves to use any diagnostic aid as long as it isn’t an invasive procedure and they can somehow get their hands on the equipment. Spirometry, for example. :wink:

Finally, of course you wanted to hear about people missing things. It was your original post. Perhaps this conversation will meander back in that direction, although like I said, I far prefer this tangent.

[Lithium]

So do I Hammer, so do I. :wink: