Archives for December 2011

Five Years Since One of My Worst Calls

Tweet For the past five years, each New Year’s Eve I am sadly reminded of a call. During that holiday season we had a series of busy nights.  It seemed like call after call was for a nasty patient who combined his or her stupidity with alcohol and violence.    Around 4 AM on December […]

ET Tubes Should Maintain, Not Fix

Tweet On EMS Office Hours, Jim Hoffman JD Graziano (co-host of EMS Standing Orders) discussed how “always” and “never” protocols hinder good airway management. One such protocol is the ridiculous “intubate if GCS is less than 8,”  and another is to never use nasal intubation. JD discussed how he managed the airway of CVA patient […]

Did Breaking the Rules Save the Girl?

Tweet MD Responders Broke Rules to Save Girl. A five year old girl reportedly went into cardiac arrest after an asthma attack, and was transported on board a fire engine to the nearest hospital while CPR was being done.  According to a Prince George’s County Fire/EMS Press Release, she began breathing on her own before […]

Keeping Scenes Safe From FLEAs

Tweet On the latest EMS Standing Orders Podcast, the panel discussed EMS scene safety issues and whether or not EMS providers should be allowed to carry weapons.  One of the panelists was Eric Dickinson, whose article  Survive Your Next Shift appeared in the July, 2009 issue of JEMS.  Dickinson has experience in both EMS and […]

Punishing Your Best People and Longevity

Tweet Last week I listened to a great discussion on the EMS Educast about how a service’s best providers can be punished by its continuing education and protocols.  Mic Gunderson, an EMS system consultant, described how both are often geared towards maintaining minimum competence levels of the lowest performers.  A few days later I had […]

A Cardiac Arrest Is Not the Time to Learn CPR

Tweet I’ve been following Rogue Medic’s excellent discussion about how Cardiac Arrest Management is a BLS Skill.  If the role of ALS is defined by advanced procedures, the only benefit of ALS would be from manual defibrillation instead of an AED.  This is only because shocks from a manual defibrillator can be delivered with less […]

Smarter Assessments

Tweet Sunday night I had the opportunity to discuss one of my favorite topics on EMS Office Hours, patient assessment.  During the show Jim and Josh mentioned Greg Friese’s EMS1 column about applying non-linear approach to assessment.  The next day I read the first part of Dan Limmer’s series about thinking and intuition on his […]

Smarter Spinal Immobilization

Tweet I’m teaching con-ed next month about spinal immobilization, so Rogue Medic and Ambulance Driver have given me lots of ideas about what to talk about.  Here’s my less-than-expert opinion about it: 1. Very few patients who get immobilized have a spinal injury. 2. Very few, if any,  spinal injuries can be made worse with […]