C-spine... a joke?

[Ridryder911]

I'm really glad I read all this before paying my 600 dollar deposit for the med program I am looking at ! I am going to need to give some serious thought to my career plans based on these damning articles.

Im willing to work hard, get educated etc, but not if I am going to end up in a position that does not increase patient outcome, or perhaps worsens it!

Maybe Ill go to Nursing school instead.

Remember nursing is nursing, not medical. They have their own studies as what they can do to increase the nursing emphasis on patient care. It is much different than emphasized by medical diagnosis as the emphasis is placed upon nursing care and nursing diagnosis of what can be improved.

In all reality you need to examine yourself more then and learn what medicine is and what it is not. Medicine is science given by a form of art. With that saying medicine is ever changing and evolving and even some methods return after more studies. For example the PASG that was mentioned is actually being considered to be possibly helpful but the application and method is different than once before.

EMS is not 100% fool proof. Medicine (even if you were a M.D.) is not either. Where do you believe we get the protocols and ideas for treatment? From the current medical treatments utilized by physician practitioners. Who's orders do you think we work under? In fact, just because one works behind hospital walls improves does not mean they give the best or current treatment. Many times, your hands are tied unless you have a license to practice medicine and even then one better treat carefully and within in the medical community standards. Until proven research is accepted and then put in place, current therapy is considered to be the best.

Be careful reading journals. One of the reason(s) one should have to take advance statistics and research to interpret if the method is sound and non-biased and credible. How well was the study? Was there bias and well population range within it? Just because it has a bunch of physician names or even came from a prestigious University means little. There are poor studies and scientific junk. Just because a study or studies reveal a point, does not always make it so as well. That is why there has to be multiple and repeated studies. Again, the PASG studies never revealed it endangered patients but rather never changed the outcome (even doubtful any treatment would had changed many of those studied outcomes). As new studies have demonstrated the effectiveness of using them in certain conditions under different means of application.

That is why multiple studies done by and under scrutinal scientific methods has to be done over and over, until we have totally proven or disproven a treatment regime.

If you are looking for a fool proof and only being able to provide care that has high outcomes, emergency and critical medicine is not the choice to enter. EMS and or Nursing as well is not a good choice as we change our treatment to improve continously changes. Look at CPR, one of the poorest outcomes in medicine < 6% (and worse in hospitals) you not want to perform this? Remember, not doing so has a worse outcome.

R/r 911

 

[SeeNoMore]

Ridryder911, as always your post is thoughtful and poignant. I guess Ill leave the medical journals and this thread alone and do some thinking about why I want to become a Paramedic, and what medicine is.

 

[Smash]

Lack of evidence isn't evidence of lacking.

One of the most exciting and most challenging things in EMS today is research. If there isn't evidence that something is good, do some research. If it turns out it is not good, then we have improved our understanding and our patient care.

EMS, and medicine is evolving constantly; what was accepted practice 10 or 5 or 2 years ago is now not. We've seen the introduction of exciting new treatments such as CPAP in CHF, goal directed therapy post ROSC including therapeutic hypothermia, 12 lead ECG and thrombolysis in some areas and (maybe) RSI for TBI, as well as many many somall incremental improvements.

As ridryder911 points out, and as I hope I demonstrated before, you can't just read an abstract and take the study as gospel. Look at it critically and see where it stands up or falls down before running off in tears.

You go to a good medic school and join a progressive service to set yourself up to become part of this evolution and extend the knowledge and ability of all paramedics, or you can go to a diploma mill and be a cookbook medic or you can go do nursing.

 

[SeeNoMore]

The truth is at this point I do not have the understanding of statistics or medcial studies to even really draw an opinon from so many sources. I just had my bubble burst over the thought of no intubation, IVs, ALS for Trauma etc for all the wrong reasons. I don't know why I felt the need to post on it.

But the thread has been interesting, I would be curious to hear more about how people feel our standards should/or will change in the near future and many years from now.

No matter what I don't want to be a cookbook/subpar medic.

 

[Dominion]

The truth is at this point I do not have the understanding of statistics or medcial studies to even really draw an opinon from so many sources. I just had my bubble burst over the thought of no intubation, IVs, ALS for Trauma etc for all the wrong reasons. I don't know why I felt the need to post on it.

But the thread has been interesting, I would be curious to hear more about how people feel our standards should/or will change in the near future and many years from now.

No matter what I don't want to be a cookbook/subpar medic.

I don't know how new you are to EMS but I think many people do get into the field and are excited over the prospect of using neat and exciting interventions, etc. I won't lie and say that I still don't find the prospect of doing these interventions interesting. But at this point I feel I've learned to realize the difference between performing the skills and actually needing to perform the skills. (treat the patient not the machine etc)

I don't think anyone says "I want to be a cookbook medic", but there are many who think their :censored::censored::censored::censored: doesn't stink. I don't think I would have ever been ready to enter paramedic school if I didn't have a background in college level biology, chemistry, mathematics, statistics, etc. Having taken courses which required research, statistics, lab work, etc has helped me immensely. Don't give up but definitely take a look at why you want to get into the medical field.