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Ambulance: My Life Likes To Kick My Ass and Hand It Back To Me

Written by RSS Poster Minimedic's Blog


Mix in the fact that this is an accelerated course and my ever-present paranoia that I’m one step away from killing someone as a student, and outside social and family issues…

…and it’s no wonder that I had “the talk” with my primary care doctor about going back on seratraline aka Zoloft. After about a month, I’m soooo much calmer and clear-headed, and most of the nastier side effects have subsided.

So yeah, still around. Just trying to keep my ducks all in a row.

However, my return to squad-based EMS is going well. Still haven’t thought of a clever name for the organization…meh, I’m sure it’ll come back to me.

Weekly updates, self. Weekly updates.

Ambulance: Health Education England, Fiona Patterson and Situational Judgement Tests (SJTs)

Written by RSS Poster Garth Marenghi
  I got a bit distracted this morning when I started reading HEE's latest idea on medical selection called 'valued based recruitment' (VBR).  Here is HEE's long and shiny briefing on VBR.  I was particularly interested to read their evidence summary section in which it is stated:   "Situational Judgement Tests: high reliability and high validity"   (high validity in context of 'only if

Ambulance: Perhaps It's Just Me

Written by RSS Poster InsomniacMedic
"Is it really possible to have a career in EMS and be emotionally unaffected by the things we see?"

This is the question I posed on Twitter a few days ago. Many seemed to think that it's an impossible task, that, after all, we're human too. However, there were some who seemed to think it possible. To work through a career and remain untouched. Unharmed.

It seems I have joined an ambulance service where macho-ism, for all its pros and cons,  appears paramount, or at the very least, a lot more visible. Whereas in my previous place of work the male-female ratio was split almost straight down the middle, my new place of work is staffed mainly by males. Perhaps that lends itself to a culture of bravado. Perhaps having more females around allows for everyone to be braver with their emotions, whereas having fewer means that those left must be impressed. Perhaps I'm imagining it or over-analysing it. Or perhaps, as I'm beginning to suspect, it's just me.

Other thoughts have taken root. Paramedic burnout seems faster here. Turnaround...

This ambulance blog continues,

Ambulance: Thoughts on Ebola

Written by RSS Poster Medic ScribeMedic Scribe

Working at the hospital and on the ambulance, it has been heavy duty Ebola lately. Memos, flyers, posters, policies, and lots of questions. I have even, along with two of my daughters, played an Ebola patient in a hospital drill.

photo (50)

I have written power points, given talks and had many conversations on Ebola. Every day I read the CDC site for updates, which are numerous. Ebola hasn’t been with us long, but already I am hearing a lot of people have Ebola fatigue. While the actual number of cases in the US is likely to remain small – at least in the near term — we likely haven’t heard anywhere near the last of Ebola.

Ebola is like a serial killer assassin who we believe is coming here to do some killing. We are not certain his target, but we believe, based on his rap sheet, he will most likely come after health care workers. We have set up roadblocks at airports, the most likely place Ebola is going to enter the country. We are quarantining people who are coming from in West Africa. In some states like...

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Ambulance: Connecticut Limits Long Boards

Written by RSS Poster Medic ScribeMedic Scribe

On February 21, 2013 I wrote the post In Praise of CEMSMAC, to celebrate the courage of Connecticut’s top EMS doctors to back the draft document on spinal boards proposed by the National Association of EMS Physicians (NAEMSP), and to use that document as a guideline to developing statewide guidelines limiting the use of long boards for spinal immobilization instead of backing the final watered down version of the NAEMSP/American College of Surgeons Joint Position Paper.

This week, after a year and a half of meetings and review by various state EMS committees, the state Department of Public Health released the final document that both enables BLS practioners to utilize selective spinal immobilization and radically changes the treatment for those who merit spinal restriction. The new document effectively eliminates the long board board for anything but assistance with extrication and movement.

Check it out here:

Connecticut Spinal Motion Restriction Guideline

Ambulance: STEMI Call

Written by RSS Poster Medic ScribeMedic Scribe

Years ago my favorite calls were the traumas– the shootings, stabbings, high-speed MVAs. You were on the clock and there was a task list. You had to c-spine immobilize the patient, get their vitals, put in two large bore IVs, open up the fluids wide, and do it all on the go, as well as getting name, date of birth and social security number on your race to the trauma room.

After the initial rush, they were unsatisfying because the calls were over almost before they even started, and there wasn’t a real sense that what you did for them made any real difference. Their injuries were their injuries. It is hard to fix a bullet to the head, a broken spine or a torn aorta. And eventually we learned that the fluids wide open and even the c-spine were bad for the patient.

Today, my favorite call is the STEMI. It is also a clock and task call, but there are so many more tasks. Plus your recognition abilities are tested and the outcomes are much better. Do your job well and can make a huge difference. Screw up, either missing...

This ambulance blog continues,

Ambulance: The Shape of Training review: a bizarre analysis of ‘evidence’

Written by RSS Poster Garth Marenghi
I have taken the time to review the ‘evidence’ that the Shape of Training review has relied upon in order to make some rather sweeping recommendations about the future of UK medical training.  One would hope that such major reforms would have been based on solid evidence, analysed in a robust and systematic fashion.  All my comments relate to the Annexes andAppendices document that is linked

Ambulance: A Bad Habit

Written by RSS Poster Trying My Patients
"50 year old female, back pain, #111"

I pulled up outside the house, grabbed my bags and a full PRF and headed in. On the car, we use mini-PRFs as we normally hand over to the crew. If we leave someone at home then a full size PRF is completed enabling you to go into further detail. This patient was not going to be going to hospital! A one week history of back pain in the middle of the night was not an emergency, nor did it need to waste the time of a busy A & E, a heaving walk in centre or a snowed under out of hours GP. 

I listened careful to every word about the back pain and followed up with a long list of probing questions. Sometimes it only requires a few, others it requires an very in depth history. This was somewhere in the middle. I assessed her pain, her mobility and decided she, as predicted, had non-traumatic back pain with no relation to the heart. I did an ECG, and all her observations. All were absolutely fine. She hadn't taken pain killers or anti-inflamatories so I gave her both and left her with advice for now and...

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Ambulance: Open letter to the BOA president

Written by RSS Poster Garth Marenghi
Dear BOA President, I am writing to express by disappointment at the BOA's recent move to force Orthopaedic surgeons into training to become BOA members by making BOA membership compulsory in order to sit the UKITE exam. This move is a regressive and short sighted move that will alienate a whole generation of Orthopods from the BOA.  Instead of forcing trainees to join, you should be trying to

Ambulance: Kids, Buses, Bikes and Helmets

Written by RSS Poster Trying My Patients
"RTC, bus vs child, age unknown, ? trapped, screaming"

I'd just left the house of a 35 year old man with a temperature. I was his second 999 call of the day and to be quite honest, I was fed up. Fed up with the constant stream of time wasters who abuse the right to have a 'free at point of contact' service. I gave suitable advise for his temperature and suitable advise on appropriate use of the service. I sat back in my car, slumped back into my seat and closed my eyes in sheer frustration. This kind of annoyance I was feeling has been becoming a daily feature and to be brutally honest, has made me consider my career options of late. Sure, some of the people we go to need us, but as the weeks, months and years pass, it seems the percentage of unwell people decreases. There doesn't seem to be light at the end of the tunnel, nor any feasible solutions to stop the rot.

"General broadcast, all mobiles, currently have an uncovered RTC, child vs bus, possible entrapment, no units assigned, please make yourself...

This ambulance blog continues,

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Hampshire & Isle of Wight Air Ambulance (806)
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Medic ScribeMedic Scribe (30)
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Emergency Egg (19)
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