(29:10) It was finals week at the end of Ron’s first year of paramedic school. In this episode we go back do an overview of the classes he took and what we thought of them.

EMS Newbie EMSWorld Essay Contest

I have a question for your next episode. I had a call today, a woman in her early 30’s had some breathing problems. The patient had bilateral ronchi in lower lobes. No wheezing heard. The patient has cystic fibrosis. The senior paramedic did an albuterol treatment. Not that I really disagree with that treatment, I wanted to know what would be an ideal treatment for an acute CF attack. I checked on the patient later on and it turns out she actually had pneumonia. Was albuterol the ideal treatment, or could this made a patient worse?

(29:00) More trauma skills testing, EMS Ops test, and a volunteer shift, for Ron this week. He also has some questions about how long it is before the new paramedic becomes the in-charge. Clinical internship – should you do it with your own service?

EMS Newbie EMSWorld Essay Contest

(55:38) Ron is starting to think he’s on “Survivor: Paramedic School” as classmates seem to be leaving in droves. He took is National Registry EMT-I skills tests this week, listen to learn how he did.

In EMS Operations he studied Crime Scenes and asks Kelly “How do you handle crime scenes? What about cases where you aren’t sure there is a problem? How often does this come up? How do you keep your awareness up? How do you balance safety and paranoia?”

17yo Male that OD’s on grandma’s tricyclic antidepressants, in the garage where he get’s organophosphate poisoning and downs a bottle of benzodiazepines after getting bitten by a poisonous snake, then falls from a ladder and gets bilateral femur fractures?

(39:41) This week we talk about abdominal trauma, shock and weight, and Ron’s last EMS shift of the semester. We also answer a number of listener questions.

An article on Assessing the Abdomen by Kelly.

This incident got us talking at the station about your opinions on immobilizing the spine and how there is no evidence to support its use. Obviously we still backboard our patients because that’s what our protocols tell us to do, but we would like a refresher on how you think backboarding may harm a patient (which I know you’ve talked about before, but I can’t recall all the reasons), and if it would do harm to a patient, how would you move the person, assuming they for sure had a spinal injury.

I know this has been a long way to ask a question, so feel free to shorten it for the show. If you feel that you’ve covered this point a lot already and would rather not answer it again on the podcast, maybe you can point me to the show that it was in so we can listen to it there. Thanks for a great podcast.

(34:42) Kelly saves drowning woman! News at 11!

And other great EMS rescue stories.

Ron did some more scenarios and managed not to kill the patient this time, but most of his week was spent studying rescue in EMS Operations. Learn about the different kind of rescues Kelly has been a part of over the years.

EMS Newbie EMSWorld Essay Contest

(35:21) After obscure references to comedic science fiction, Kelly and Ron talk about Thoracic Trauma and answer some listener questions. Chest decompression, sucking chest wounds, and pericardialtamponade, oh yeah.

EMSWorld Newbie Essay Contest

Kelly & Ron, do I have a question for you guys this time.

I know this is a *oh so wonderful* subject close and dear to Kelly’s heart, but for spinal immobilization, if the patient has an injury on their back that prohibits you from laying them supine, how do you secure them to the backboard on their side? Honestly curious, because my EMT textbook shows nothing on how to properly immobilize a patient in that position, and well, even though research has proven backboards suck at their jobs, I don’t need a lawyer coming down on me further down the road. Especially in my state of Massachusetts.

(45:33) Has it only been a week since our last episode? For Ron it seems like a month. Here everything you wanted to know about spinal immobi….oops I mean spinal motion restriction. Kelly will tell you how he really feels about strapping people to backboards.

We also talk rural medicine. Get a cool tip on Rapid Trauma Assessment.

Ron also spent some time looking for the lost, hanging upside down, and falling down in 6 inches of water last weekend. Learn a little about search and rescue. Then he spent a day dealing with trauma at a big even in Houston on Sunday.

Enough with the teasing, this week we announce the EMS Newbie EMS World Essay contest.

CT staffing company

(38:41) This week we talk about the time Kelly stripped down in class. Ron’s trauma test and scenario. Learn how chest decompression really works. Handling belligerent bystanders, and HazMat. After the Harris County HazMat team talked to Ron’s class, he learned how a thumb has been replaced with a pinkie. Kelly informs us of the rule of donut.

Great show guys. Been an EMT -B for 5 years in NYS and worked for several volunteer squads and just signed on for a squad in NJ now. I was wondering if you have watched the show Trauma on NBC and in the last episode one of the paramedics who is trained as an MD did a few procedures in the field and saved the pts lives but in one instance gets caught and the pt although alive ends up being paralyzed from the neck down. Long story short, she gets her license suspended and possibly faces jail time. Although an unlikely scenario I wanted your thoughts in today world with malpractice rampant etc as a paramedic would you do procedures not allowed for example in your county but perhaps allowed in another state in order to save a patients live but lose your license. When you always taught that pt comes first, at what point do you put yourself and your interest ahead of them. If you did happen to save their life but left a debilitating disease or injury worthy of a lawsuit is it worth it. Rather than following the rules and if the patient doesn’t make it that’s just the nature of the job and situation. Reason I ask this is I had a recent call with a4th year medical student who refused to use his skills to because he was only a certified EMT-B but was ACLS certified but due to not being a paramedic or an EMT -I could not use any of his skills which related in the pt from an MVA ending up braindead. Let me know your thoughts guys. Great show again, even thought I am only an EMT-B i learn a LOT from the podcast and enjoy hearing about your journey through paramedic school. Keep up the GOOD WORK

I am an EMT-B and paramedic student in San Antonio. I had a patient a few days ago with contractures to all four extremities secondary to a stroke he had several years ago. The call was for HTN, so getting a blood pressure was a priority, but when I tried to put the cuff on the patient’s arm I found it to be nearly impossible. Even if I had been able to get it around the arm there would have been no way to listen to the artery due to the arm’s bent position. I was wondering are there any other places to listen to blood pressures of patients like this or with other similar difficulties? I ended up palpating the BP with the pediatric cuff around the patients forearm but I was not sure how accurate that method was.

Thanks!

Ep 20 – Maintaining Control Kelly’s hazmat exposure.

(55:55) While Ron is on Spring Break we bring you a special episode of the EMS Educast on Organ Procurement.

The EMSEducast Episode.

Buck Feris – http://gomerville.com/

Subscribe or review on iTunes.

(30:04) Ron did PHTLS this week and covered head trauma. We talk about the Hatchet manuver for intubation, the Parkland forumula, doing a Head to toe in the vehicle, and the Tickles test for pedi trauma.

Also, what’s your thought of pre-hospital autopulse cpr devices? The zoll monitor comes with one and i’m not sure if that’s a boon or a curse.

TICLS – Tone, Interactibility, Consolability/color, Look and gaze, Speech/Cry.