Podcast 1: The Myth of Pulse Palpate (Discussion)

Armchair medics and parsing too thinly.

1. Education and science try to discover, then rapidly impart, correct information by breaking down gestalts into discrete elements.
1.a. Science tries to pare away variables not affecting the hypothesis (peeling the onion).
1.b. Education tries to clearly impart knowledge by breaking down subjects into discrete steps or segments (parsing the lunchmeat, aka, baloney).

2. Complex systems with interdependent multifactorial gestalts become unrealistically simplified in their teaching since in each approach these interdependencies are trimmed away to try to "get to the gist of things". Like the little kid who peels the onion (see above) to find the middle, and winds up with lots of onion rings and no middle after all.

3. Teachers, armchair paramedics, protocol writers or lobbyists or lawmakers, will seize on these partial truths and try to make them fit reality, or vice versa.

I can take a pulse while I'm talking to someone, looking at them, smelling them, listening to them, and gathering my thoughts/imparting reassurance, and use that data, but I'm sure not going to read more into any one datum than it deseves.
 
Then again, if you are a good provider, you are NEVER going to rely on one thing alone, especially not a number. You are going to use your critical thinking skills to put several pieces of information together to come to a conclusion. Some examples include:

The patient's color, does the extremity feel cold, are Resps increased? Are they experiencing difficulty with breathing?
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Exactly.

Rather than trying to engrain these so called rules, teachers should be trying to expand their student's critical thinking skills.

As we all know, when it comes to vitals, you need more than one piece to solve a puzzle.
 
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Impressed! The Podcast feature is a great new addition to EMTlife and nicely executed. Great job to all involved.

I am definitely looking forward to more Podcasts in the future.
 
Just checked it out. Very good work Rob. The exasperated sigh halfway through was hilarious. Seriously though it was great information. I can't wait till you get rolling on some more.

The audio was outstanding the playback was good.

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I just wanted to mention that when we have medicals on board the aircraft and there is nobody on board that can us a BP cuff I have been asked by ground medical control to check pulse points to estimate blood pressure. I did not realize back then why I was being asked to do it. Obviously this was before I got my basic.
 
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Wow....medicRob sounds nothing like I thought lol

Love southern accents <3

As far as the podcast. It was great. Except it sounded like you were just trying to read really fast. Slow it down.

I'm looking forward to listening to more. ME LIKE!
 
Anjel1030 said:
Wow....medicRob sounds nothing like I thought lol

Love southern accents <3

As far as the podcast. It was great. Except it sounded like you were just trying to read really fast. Slow it down.

I'm looking forward to listening to more. ME LIKE!
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That's my normal talking tempo. I am always being yelled at for talking fast, lol. It is something I am working on.
 
Good first podcast. Just a question, how often are you going to try and release these? Can't wait for the next one.
 
MassEMT-B said:
Good first podcast. Just a question, how often are you going to try and release these? Can't wait for the next one.
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After discussing that very question with the administration here, we have decided to release one a month, maybe more over time.
 
Enjoyable first podcast, if a little rushed. Not going to make the mistake next time of focusing on something else while listening in the background, almost got lost on what was being said.
 
So, a short story on this topic in which Aidey almost got herself in trouble.

We ran a heroin OD arrest today, and drop the guy off at the ED with a BP of 72/31. ED gets 60 something. I hear someone say "Well, I have a strong radial pulse, so his BP is at least 90".

I get as far as "Well, actually..." before I realize that 1. It isn't a good time, and 2. The guy who said it is the MD in charge of the ED.

I figured I should probably keep my mouth shut, especially since I had already irritated him. It still bugged the crap out of me though.
 
Bah, Consultant Emergency Physicians are fair game for Brown have a productive discussion with .... maybe not right now, but at some point. Just because this bloke is a Consultant doesn't mean you cannot question him in a professional, collegial manner.

And since when Aidey is a girl? :D
 
I am debating whether the broach the topic with him later or not. He is not one of those warm and fuzzy MDs who likes talking to us, so I haven't decided.

And Aidey has always been a girl, I can't figure out why everyone thinks I'm a guy. :(
 
Aidey said:
I am debating whether the broach the topic with him later or not. He is not one of those warm and fuzzy MDs who likes talking to us, so I haven't decided.

And Aidey has always been a girl, I can't figure out why everyone thinks I'm a guy. :(
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I may or may not have thought you were a guy at first.... Sorry lol. But then I saw "Forum Deputy Chiefette".
 
Aidey said:
And Aidey has always been a girl, I can't figure out why everyone thinks I'm a guy. :(
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very cool podcast looking forward to more :)
 
Aidey said:
So, a short story on this topic in which Aidey almost got herself in trouble.

We ran a heroin OD arrest today, and drop the guy off at the ED with a BP of 72/31. ED gets 60 something. I hear someone say "Well, I have a strong radial pulse, so his BP is at least 90".

I get as far as "Well, actually..." before I realize that 1. It isn't a good time, and 2. The guy who said it is the MD in charge of the ED.

I figured I should probably keep my mouth shut, especially since I had already irritated him. It still bugged the crap out of me though.
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Yeah I try my best to keep my mouth shut. Sometimes for patient sake I will still say something someone may not agree with. Then later I will either feel good about it, or think that the staff thinks I don't know what I am talking about.
 
I usually can't keep my mouth shut. Probably why there's a percentage of people who think I'm an inflamed hemorrhoid...:D

Although I DID manage to keep my mouth shut the other day on this very topic. The medic spouting "his B/P couldn't have been in 70s" was in the above percentage, and I simply didn't have the strength to argue with her that morning.
 
usalsfyre said:
I usually can't keep my mouth shut. Probably why there's a percentage of people who think I'm an inflamed hemorrhoid...:D

Although I DID manage to keep my mouth shut the other day on this very topic. The medic spouting "his B/P couldn't have been in 70s" was in the above percentage, and I simply didn't have the strength to argue with her that morning.
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The strength of her fail was too much eh :D
 
MrBrown said:
The strength of her fail was too much eh :D
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Pretty much, think "Empire Strikes Back" to my usual "A New Hope"..,

(can you feel the geekdom radiating outward right now :D:D)
 
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