New? Questions? The EMTLife Abstracts Service

[Meursault]

The search function: your best friend, but perhaps not the only resource you have. As I've learned from the experience of others here, complaining about its underuse doesn't do much except make you unpopular, and even when you do use it, you can sometimes end up with pages of results to sort through.

Therefore, I've decided to compile a list of good threads and frequently asked questions for the benefit of our newer members. This is a work in progress; there will be more posts with more topics as I think of and compile them.

HAY GUISE I'M NEW!

The introduction thread is here: http://www.emtlife.com/showthread.php?t=9731
To post your photo, go here: http://www.emtlife.com/showthread.php?t=7877​

I'm taking the National Registry test tomorrow and...

Look over your notes quickly and go to bed. Nothing we say or you do can help you at this point. Get some sleep and trust that you've done enough studying.​

I'm shopping for a lightbar for my POV. Any recommendations?

http://www.emtlife.com/showthread.php?t=833 The definition of "whacker".
http://www.emtlife.com/showthread.php?t=11443 Differing opinions on lights for POVs, and why you shouldn't start another thread.
http://www.emtlife.com/showthread.php?t=11420 This thread deals more generally with the use of sirens and code 3 driving.
http://www.emtlife.com/showthread.php?t=3035 Rid shares his opinion on POV lights
http://www.emtlife.com/showthread.php?t=5240 Fatalities related to speeding in a POV.
http://www.emtlife.com/showthread.php?t=6905 15 additional pages of this argument.​

 

[Meursault]

Feel free to PM me topics I haven't covered. I'm still working on most of the big ones.

So how do you feel about drugs?

http://www.emtlife.com/showthread.php?t=7802 Why you shouldn't start another thread on it; Flight and I go toe-to-toe with LE-EMT and Vent; much mud is slung.
http://www.erowid.org/psychoactives/testing/ Erowid is, in general, a good resource on psychoactives. Their “Testing Basics” page is a straightforward explanation of what most drug tests cover. However, you'll have to deal with questionably accurate user-contributed sections, like everything about “beating” drug tests.
http://www.emtlife.com/showthread.php?t=4953 Testing for nicotine?!
As for your individual state/county/company, it's best that you check with them if you have legitimate questions about testing. Most of the time, users here don't know better than they do.​

All these flamewars depress me. I need some humor:

http://forums.studentdoctor.net/showthread.php?t=257985 This is SDN EM's “Things I Learn from my Patients” thread. Well worth the read.
http://www.emtlife.com/showthread.php?t=4141 Dispatchers Say the Darndest Things.
http://www.emtlife.com/showthread.php?t=10452The unwritten rules and laws of EMS.
There are a lot more threads in the humor forum. Browsing by thread length is a good way to find the interesting ones.​

 

[Shishkabob]

Someone was bored tonight!

 

[Meursault]

Since it just came up; I'll deal with C-spine clearance later.

Prehospital C-spine stabilization:

http://www.emtlife.com/showthread.php?t=12256 Sasha finds some studies; MSDeltaFlt weighs in
http://www.emtlife.com/showthread.php?t=11148 A scenario where boarding may or may not be indicated.
http://www.emtlife.com/showthread.php?t=3386 A scenario where boarding wasn't indicated... or was it?
http://www.emtlife.com/showthread.php?t=8830 KEDs and why you should use them;
http://www.emtlife.com/showthread.php?t=5551 Tips for the KED on the practical exam and in the field.
http://www.emtlife.com/showthread.php?t=10368 Head immobilization methods
http://www.emtlife.com/showthread.php?t=2484 Securing patients: spider straps, quick clips, or webbing?
http://www.emtlife.com/showthread.php?t=6968 ED staff removing patients from the board and why it's sometimes justified.
http://www.ncbi.nlm.nih.gov/pubmed/17613902 How well are devices being applied?
I'm not going to cite all the studies, but a quick Pubmed search indicates that immobilization on long boards frequently causes pain, that the pain can take time to develop, and that padding the boards doesn't relieve the pain or prevent further symptoms very well.
http://www.ncbi.nlm.nih.gov/pubmed/15748015 A lit review: prehospital “immobilization” techniques do reduce movement, but they produce a number of well-documented adverse effects.​

 

[fortsmithman]

How about EMS wearing police type badges. EMS buying trauma bags. EMS going to scenes in POV. EMS that is fire based. I can't think of anything else.

 

[Meursault]

Thanks for the sticky, mods.

Trauma bags, jump kits, and personal equipment in general:

http://www.emtlife.com/showthread.php?t=12323 A recent thread on the topic; anecdotes and opinions; theft from EDs; emt.dan sums it up on the first page
http://www.emtlife.com/showthread.php?t=11811 Flashlights
http://www.emtlife.com/showthread.php?t=3376 Knives; Rid and others on why you shouldn't carry one; tips from DT4EMS on page 3; the more tactically-minded members discuss theirs.
http://www.emtlife.com/showthread.php?t=4774 Oxygen; emt.dan on his (diving) setup; questions to ask yourself.
http://www.emtlife.com/showthread.php?t=5271 Trauma kits; Vent outlines some legal issues associated with oxygen
http://www.emtlife.com/showthread.php?t=783 POV equipment, lights, and loadouts, if you were still curious about what a true whacker's vehicle looks like.
http://www.emtlife.com/showthread.php?t=21 What members carry on their person; the lowest thread number you're likely to see here; radios and communication equipment.
http://www.emtlife.com/showthread.php?t=8649 Things you and your ambulance probably don't need

There are innumerable stethoscope threads, all saying largely the same thing. I'll break it down by certification level:
Student/below EMT-B: Take what you're given, and wait a bit before buying anything.
EMT-B or equivalent: How clearly do you need to hear those Korotkoff sounds? Get something reasonably-priced. I use an ADC ADSCOPE 630 which cost me about $30. It's heavier and slightly less comfortable (stiffer earpieces) than the Littmann scopes I've had a chance to use, but it's more than adequate for my needs. Littmann lightweights are also in the <$100 range. The consensus is to stay away from dual-tube (Sprague-Rappaport-style) scopes, which aren't to be confused with dual-lumen scopes.
ALS providers: Why would you be listening to my lowly opinion?
For identification, get a color that doesn't look completely ridiculous, but isn't black or navy blue. Put your name on it securely; Littmanns have tags, one poster suggested attaching an ED patient bracelet with your name on it, and there are always Sharpies (my method) and tape.

Even if you have equipment in your POV, there are a host of practical, legal, and ethical issues related to providing care while off-duty. The legal issues vary by location, ethical discussions on this forum are always terrible, and several discussions of the practical issues have been inconclusive. This issue probably merits a separate abstract, but it's low on my list.​

 

[ffemt8978]

Thanks for the sticky, mods.

You're welcome. I think this is better than telling somebody to use the search feature.

 

[mycrofft]

How about a thread about MrConspiracy's Guide to EMTLIFE?

Right on!!

 

[Meursault]

Addenda and Miscellaneous Notes:

• Forgot to include this for stethoscope shopping: http://www.forusdocs.com/reviews/Acoustic_Stethoscope_Review.htm Even if you already own one, check it out. The authors did both lab and field testing of several popular models. It seems I should have spent a bit extra after all.
  
• Journals and resources for our more academically-minded members (read: bored college students with institutional access to basically everything). There are a few EMS-oriented journals, like Prehospital Emergency Care, but I don't have access and they're fairly infrequent. JEMS is sort of a joke, except for the columnists. A lot of research on prehospital treatment is published under the auspices of EM journals anyway, so search first. When in doubt, try PubMed.
  
• EMS-related blogs I read:
  Siren Voices
  Random Acts of Reality
  A Day in the Life of an Ambulance Driver
  Street Watch: Notes of A Paramedic

 

[el Murpharino]

could we get an "official" BLS vs. ALS thread?

 

[ffemt8978]

could we get an "official" BLS vs. ALS thread?

Sure...the thread would consist of one post and then would be locked.

 

[medicdan]

Conspiracy-- as I have said to you before, this is enormously helpful, thank you! I am going to start linking to this, or when I cannot, I'll email you additions...

 

[Meursault]

By request, NREMT exam stuff. I'd like to be able to put more in here, but the overwhelming majority of the threads in that forum are about the same things and don't last more than a few posts. EMT students in general will get another topic

How do I study for the NREMT-B?

The NREMT forum has a number of helpful stickies. Read those first, then come back. Having at least looked at all 302 thread titles and postcounts, there's not much else in there to help you.​

I just got out of the exam...

Wait for your results, and please don't post another thread simply to state that. If you have a specific concern, I have a feeling it's somewhere in the 16 pages of threads. I could extract every question from there, but I don't care nearly enough.

http://www.emtlife.com/showthread.php?t=7121 If you're wondering about your test stopping, go here​

I just failed the NREMT. What do I do?

You're not the first person. If it was the CBT, it's unlikely that your situation is unique, so read back a bit on the forums.
http://www.emtlife.com/showthread.php?t=11599 A big thread; Rid weighs in quickly, AJ Hidell has an especially useful bit of advice that I'll reproduce here: “Fail once: your school sucks. Fail twice: you suck.”

http://www.emtlife.com/showthread.php?t=10979 The practical; one person's experience and advice from that; debate on whether finding out why you failed is a good thing, even if it's possible.

http://www.emtlife.com/showthread.php?t=12467 You probably shouldn't do this. Though if you keep posting about it, I might secretly wish it.​

 

[Meursault]

BLS vitals:

http://www.emtlife.com/showthread.php?t=5997 and http://www.emtlife.com/showthread.php?t=5909 Tips for taking BP and other vitals in the back of an ambulance
http://www.emtlife.com/showthread.php?t=5474 Another thread about automatic BP monitoring; reasons why you shouldn't rely on it
http://www.emtlife.com/showthread.php?t=12749 BP and mastectomies
http://www.emtlife.com/showthread.php?t=12656 A short thread on dialysis graft/fistula sites. Useful if you work for a private.

Pulse points: I've seen a few short threads, but I'll summarize. Practice when not at work, and if you're really unsure and they don't look dead, auscultate (over the heart, that is). For practice, it helps to start with someone skinny and, once you know where everything is, to try a variety of patients.

Understanding how vital signs are produced and why they change can be very helpful. If you haven't already, taking a college-level A&P course will help with that.
For a quick, basic review/overview, try the “Vital Signs: A New Look” presentation here: http://www.911learning.com/course_materials​

EKGs and other ALS assessment tools will require another abstract (and possibly another author; experience helps).

http://www.emtlife.com/showthread.php?t=10990 An ETCO2 thread with lots of good links.​

 

[Meursault]

I haven't died or gotten too busy to post, yet. We'll see in a few months, when I'll have a work-study job and an internship, be working per diem for a private service, going up for crew chief in a volunteer service, and taking a reasonable courseload. Before that happens, it's time to tackle some of the big stuff.

Volunteer vs. Paid EMS:

This is a pointless argument repeated ad nauseam. I'll provide a few examples, but let me summarize the arguments:
Side A: “Prehospital care needs to be provided by professionals. Volunteer services frequently set lower standards of professionalism and attract precisely the sort of people that are not qualified to deliver emergency care. EMS, just like fire and police departments, is a service that communities should be prepared to pay for. Likewise, EMS is not a hobby. If you are dedicated and professional enough to provide prehospital care, you should be willing to treat it as a career. The services of an emergency medical professional should be worth something. 'Giving them away for free' disrespects the profession and hurts those people who have chosen to make their living in EMS.”
Side B: “The financial and logistical situation in many communities makes full-time paid EMS impractical. Moreover, if people are willing to devote the time and effort required to provide competent prehospital care, and they're willing to do it for free, why should we stop them? Suggesting that they need to be paid insults their motives. [obvious whacker defensive polemic about needing the gear in their trunk and being first on scene when off-duty snipped]”
Side C: “HAY GUISE LET'S ALL BE FRIENDS”
The handful of reasonable people: “By the Manes, another thread about this? No one's changing any opinions.”

http://www.emtlife.com/showthread.php?t=4438 lol, New Jersey.
http://www.emtlife.com/showthread.php?t=9454 Toasty!
http://www.emtlife.com/showthread.php?t=12524 Rid gets a bit snarky; toes get stepped on
http://www.emtlife.com/showthread.php?t=9454 Volly chest-thumping; KEVD18 mounts the “drunken soapbox” to deliver what sounds suspiciously like a balanced take on the issue. Those posts, at least, are worth reading.

I should really do a literature search on this. I'll post anything I find.​

 

[Meursault]

Still haven't done that lit search.

Abbreviations:
Google is, as in all things except privacy, your friend here, but there's a faster way.

http://www.emtlife.com/showthread.php?t=11290 A great list of the common abbreviations, courtesy of tydek07.
​

Shortest abstract EVAR.

"Hai guise I'm new..." part 2: The EMT-B Student

http://www.emtlife.com/showthread.php?t=13820 Some advice from forum members. Please don't start another thread like this, the enthusiasm is almost painful.

http://www.emtlife.com/showthread.php?t=10778 The big, meandering thread for fellow EMT-B students.

"What should I buy?": I've seen a few of these, and I'd suggest that you buy absolutely nothing that isn't required. Some good pens, maybe.

http://www.emtlife.com/showthread.php?t=6489 Some of the deficiencies of EMT-B education. This is a common theme, and if you stick around, you'll see many of these same posters elaborating on it. Pay attention.

Honestly, there's not much to add. I've covered the NREMT, vitals, and sundry other things you might find interesting. Please search before starting a thread about anything having to do with this topic. More specifically, before starting a thread about the grading of your last test, your performance on it, or your issue with your instructor/classmates, consider whether people here can help you. If you need to vent, try the students thread above. If you need advice, I suspect someone else has been in the same predicament and did start a thread. If you're afraid the answer will be "I'm sorry that your school's terrible, and that you're out $800.", it probably will be.
​

 

[Meursault]

Fire Departments, Volunteers, Third Services, and You: A Very Special Word from MrC

I could have, in keeping with my original format, dredged up a representative sample of the innumerable threads about third-service vs. fire-based EMS, volunteer vs. paid services, private contract-based 911 coverage vs. a public safety model, and all the other nasty dichotomies.

However, the threads I recall don't really contain any useful information or any particularly cogent arguments. At this point, it's worth remembering something one of my American Healthcare lecturers tried to impress on me: The US, let alone the world, is a very diverse place. One solution is not going to work for every city, town, township, county, or miscellaneous other municipality. It's entirely possible that there's a place for properly-constructed versions of all of these systems. Well, except for combined LE/EMS. That's just silly. (No, really, there are legal, ethical, and practical conflicts if you don't separate the two duties).
Posters are still going to discuss these things, though, and with good reason. So I've written something more general.
​

How to Make a Decent Argument:

• Form a coherent opinion. If you don't understand how you feel about an issue, who will?
• Narrow your scope. Arguing over generalities doesn't work for these issues. If you can't come up with a useful argument that avoids the exceptions, try defining the exceptions. E.g. "Volunteer departments are an acceptable feature of rural EMS, but their use should be limited to areas of low population density and limited local funding, and they need a combination of expanded scope, strict QI, and plans for definitive care to work properly."
• Research. Feel free to regale the board with tales of how your department totally saves lives and stuff, but back it up with something meaningful. Pubmed and Google Scholar are good for this. If you need access to a journal, try your library system or a college library.
• Don't butcher the English language. If it's your first language, you'll look like the idiot you probably are. If it's not your first language, you'll be somewhere between an annoyance and an object of pity.
• Address criticisms. Try not to let the fact that there are gaping holes in your argument wound your pride. You are, after all, only/barely human. I've spent a surprising amount of time having my carefully crafted, finely honed, nearly airtight arguments shredded by professors in front of the class. Now it's time for an ICS-style miniquiz!
  The proper response to criticism is:
  
  A. Personal attacks.
  B. Screaming your fury to the stony skies and refusing to participate in the discussion.
  C. Taking the time to think about the criticism and come up with counter-arguments.​
• Learn when to quit. Clearly, I haven't.

 

[Hyperlight381]

Noob

Hey everyone, new to this site and was wondering if anyone worked up in the San Francisco/Bay area??? Do you like it??? Considering moving up there in a year and curious about the companys up there

 

[MrBrown]

What teh heck is this thing Brown and why does it haz Cat in the Hat hat?

Brown defies all logical understanding of the space time continuum, laws of physics as well as known and experimental science and religion.

It is best to just not pay attention to it or the funny words it says like:

- Bugger
- Bloke
- Scrote
- Ambo
- Resus
- Adrenaline
- Drip
- Suxamethonium
- Nunngered
- Bikkies
- Cuppa
- Shav

... oh and ignore that thing called Mrs Brown

 

[wolverine]

It always make me scratch my head when kids 17 or 18 year old volunteer in EMS or FD so they can put strobe light&drive crazy getting to their station to respond to a call of someone who twisted their ankle like a bat out of hell light&sirens on. Are U Kidding Me??? I work in 1 of the highest crime city in Northern NJ and sometimes I don't even turn on the siren if I am responding to a medical call that's not critical.