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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...

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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...

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Ambulance: The Good, The Bad and the Ugly

Written by RSS Poster Trying My Patients
"66 year old institution, near collapse."

I don't really know where to start on this one. Usually I am ready to commentate on all things ambulance, especially when we are in the news, being thrown under the bus or maligned. A few months back The Spectator published the first of two articles regarding the current crisis within the ambulance service. It touches upon the amount of frontline staff leaving in their droves, and asks the very simple question, why? Fast forward a month and a second article was published, in what was a hard hitting, painful accurate portrayal of the crisis facing Londoners and all the ambulance services up and down the country. The official line, was that everyone was leaving because of pay and cost of living. Sadly, this couldn't be further from the truth. Whilst the article had some inaccuracies and was biased in some areas, the theme and overall mood of the piece was spot on. 

As I sat doing paperwork after dealing with a total time waster I listened to an urgent request for a...

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Ambulance: Ebola

Written by RSS Poster Medic ScribeMedic Scribe

spillover

I first read about Ebola from the 1995 bestseller The Hot Zone by Richard Preston, which recounted how monkeys in a government lab in Reston, Virginia suddenly started dying from what turned out to be the only strain of Ebola that doesn’t affect humans. A great read and thriller that I highly recommend.

Over the years I have followed the periodic outbreaks of the Ebola virus that all were fairly quickly extinguished. I also read another great book called The Coming Plague: Newly Emerging Diseases in a World Out of Balance by Laurie Garrett about emerging infectious diseases, which I also highly recommend.

There are few who are not aware of this current outbreak of Ebola, which continues to escalate and for the first time reached this county with a patient found in Texas, although most believe this additional cases that may reach us, will be fairly easily contained because of the health care structure here, higher sanitary standards and the cooler climate. Let us hope so.

Let me try now, based on what I have read to describe...

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Ambulance: Behind Closed Doors

Written by RSS Poster InsomniacMedic
Midnight. The normally quiet residential street is a hive of activity, as busy and bustling as a midday marketplace. People have gathered from all over; neighbours, friends, relatives, all standing outside trying to make sense of the unfolding drama. We can see it all, hear it all from the bedroom, each of us taking turns to peek out to the street a dozen floors below as we rotate over and over again, each of us briefly the centre of the chaos, standing pumping his heart, then taking a break, a breath of fresh air and a glimpse out the window. 

The bedroom is tiny, the furniture within taking up the vast majority of the space, leaving us with very little room to work, yet somehow we all fit in. Through the closed door we can hear the sounds from the lounge. It too is packed full of people, some who heard the initial shrieks and screams for help, some who received the panicked phone-call. Some were further along the communication tree, receiving word as the news branched out exponentially. 

We know how much this means, how much...

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Ambulance: In Case of Emergency – Tax Disc Replacement Idea?

Written by RSS Poster ambcontrol999

ICE tax disc

Above is a link to a document containing an idea for a Tax Disc replacement since your Tax Disc Holders became redundant today due to a change in UK law.

Please feel free to use and share amongst all your friends!

Thanks to @TonyMoule47 for the suggestion!




Ambulance: Behind Closed Doors

Written by RSS Poster InsomniacMedic
Midnight. The normally quiet residential street is a hive of activity, as busy and bustling as a midday marketplace. People have gathered from all over; neighbours, friends, relatives, all standing outside trying to make sense of the unfolding drama. We can see it all, hear it all from the bedroom, each of us taking turns to peek out to the street a dozen floors below as we rotate over and over again, each of us briefly the centre of the chaos, standing pumping his heart, then taking a break, a breath of fresh air and a glimpse out the window. 

The bedroom is tiny, the furniture within taking up the vast majority of the space, leaving us with very little room to work, yet somehow we all fit in. Through the closed door we can hear the sounds from the lounge. It too is packed full of people, some who heard the initial shrieks and screams for help, some who received the panicked phone-call. Some were further along the communication tree, receiving word as the news branched out exponentially. 

We know how much this means, how much...

This ambulance blog continues, Read More...



Ambulance Blog List

Hampshire & Isle of Wight Air Ambulance (806)
InsomniacMedic (216)
Trying My Patients (194)
Trauma Queen (168)
Street Watch: Notes of a Paramedic (158)
Xf (89)
Garth Marenghi (85)
Minimedic's Blog (68)
A Life In The Day Of A Basics Doc (57)
Brian Kellett (dot) Net (49)
StorytellERdoc (48)
Medic ScribeMedic Scribe (29)
Jerome Mowat (26)
Emergency Egg (19)
Hampshire and Isle of Wight Air Ambulance (14)
ambcontrol999 (13)
Purpleplus (11)
BrianKellett.net (10)
Random Acts Of Reality (6)

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Emergency Shorts:
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