Appendectomy for Paramedics

mycrofft said:
Halos, along with nitrous oxide, in the field were being expounded around 1980.
We had someone here a couple years ago say his service would allow them to open the chest in the field. Booed off.
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I can see an escharotomy being authorized at some point in the future, but somehow I don't see "cracking the chest" being authorized specifically for the purpose of doing internal cardiac massage... however I can see teaching ICM for the purpose of restoring circulation if the heart is already exposed. I can also see that in such an instance, the possibility is strong that it would likely be a futile effort...
 
Akulahawk said:
I can see an escharotomy being authorized at some point in the future,
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Lol! I actually just got out of our week-long CME class this week. Our medical director and our area trauma guru both told us that if we have a patient requiring one, they fully expect us to perform it... :ph34r:
 
Akulahawk said:
I can see an escharotomy being authorized at some point in the future, but somehow I don't see "cracking the chest" being authorized specifically for the purpose of doing internal cardiac massage... however I can see teaching ICM for the purpose of restoring circulation if the heart is already exposed. I can also see that in such an instance, the possibility is strong that it would likely be a futile effort...
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Escharotomy is already and has been for ages in the paramedic guidelines here.
 
PoeticInjustice said:
Lol! I actually just got out of our week-long CME class this week. Our medical director and our area trauma guru both told us that if we have a patient requiring one, they fully expect us to perform it... :ph34r:
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medic417 said:
Escharotomy is already and has been for ages in the paramedic guidelines here.
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I was referring to the procedure being part of a Paramedic's education and authorized for use in all locations/states. It may not be done very frequently, but like other things we do, when it's needed, it really is needed right then. If you're authorized to do it and you're current, WOO HOO!! because if your patient needs it, you can provide what is needed.
 
We can't even get everyone in EMS a friggin associates degree or a real A&P class. Surgical intervention sounds like a GREAT idea!
 
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TatuICU said:
We can't even get everyone in EMS a friggin associates degree or a real A&P class. Surgical intervention sounds like a GREAT idea!
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Yup just as good as giving 120 hour rescue rickie hero want a be the right to do advanced procedures.
 
medic417 said:
Yup just as good as giving 120 hour rescue rickie hero want a be the right to do advanced procedures.
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You leave Ricky Rescue out of this. Oh btw, speaking of that, I think for my next paper I'm going to design some sort of mathematical model that describes the inverse relationship between how much crap a person carries on their belt and how much experience they have. Thoughts?
 
thought I was on 4chan for a minute, had to double check and make sure this was EMTLIFE. :P
 
Would that be by weight of the belt, number of gadgets, a ratio of those versus carrier's body weight, or all three?
 
TatuICU said:
You leave Ricky Rescue out of this. Oh btw, speaking of that, I think for my next paper I'm going to design some sort of mathematical model that describes the inverse relationship between how much crap a person carries on their belt and how much experience they have. Thoughts?
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Probably setting dependent as well. While most ground medics shed their belt accessories rather quickly, several of the better flight providers I've known required vest to lug around all their extra stuff
 
Appendectomy in the field? I would say only under extreme circumstances. When a patient is opened up in any type of invasive procedure they are exposed to the external environment which is loaded with bacteria and other organisms. Not saying we don't clean our trucks to the best of our ability, but what makes you think opening someone up in the back of an ambulance is a good idea? Highly unsanitary.. I would expect most patients having an appendectomy done in the back of a truck to come back some sort of a nasty infection. Bad idea in my opinion, there's a reason surgeons do these types of procedures in a controlled and as sanitary as possible of an environment.
 
hawkinstyler said:
Appendectomy in the field? I would say only under extreme circumstances. When a patient is opened up in any type of invasive procedure they are exposed to the external environment which is loaded with bacteria and other organisms. Not saying we don't clean our trucks to the best of our ability, but what makes you think opening someone up in the back of an ambulance is a good idea? Highly unsanitary.. I would expect most patients having an appendectomy done in the back of a truck to come back some sort of a nasty infection. Bad idea in my opinion, there's a reason surgeons do these types of procedures in a controlled and as sanitary as possible of an environment.
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/facepalm

Read the rest of the thread.
 
Melmd said:
I don't think that is possible, simple as it looks like in you tube but only surgeons can do it. Even doctors cannot do it if not trained in surgery. :P
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But we could install a flat screen TV where the clock is so we could play the video for prompting during the procedure.


FLdoc2011 said:
Only if you also take on the liability, post op care and any complications that may arise...... ;)
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No worries there. We could just print something out and hand it to the patient.
 
hawkinstyler said:
I have read the thread. Thanks for a most thoughtful reply =]
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Good =] So you were able to decipher that the thread was a joke and the OP was by no means suggesting that paramedics perform appendectomy =] But thank you for pointing out some excellent reasons of not performing surgery in the field; I honestly wouldn't have thought of any of that =]



=]
 
medic417 said:
Not stirring we need more skills. Plus think how much money we could make. Instead of ambulances we will be called mobile surgical suites.
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Surgical suite driver sounds so much more professional than ambulance driver
 
PoeticInjustice said:
Good =] So you were able to decipher that the thread was a joke and the OP was by no means suggesting that paramedics perform appendectomy =] But thank you for pointing out some excellent reasons of not performing surgery in the field; I honestly wouldn't have thought of any of that =]



=]
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Okay so I was simply expressing my opinion, something unheard of these days. But I digress, I'm no paramedic. So sorry to even bother, have a nice ego trip =]
 
Melmd said:
I don't think that is possible, simple as it looks like in you tube but only surgeons can do it. Even doctors cannot do it if not trained in surgery. :P
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I missed this earlier. Actually in the US if you have an unrestricted license (MD + one year post grad training) you can do whatever you want. Now facility credentialing is a separate issue.
 
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