So I'm sitting in AMLS class...

[Aidey]

and I'm going to either have a stroke or piss everyone off.

There is only so often I can hear "HIGH FLOW O2!!!" before I start getting urges to strangle someone with the NRB tubing.

I really have no idea why I'm in this class beyond it will look good on my resume. Sigh.

 

[Veneficus]

and I'm going to either have a stroke or piss everyone off.

There is only so often I can hear "HIGH FLOW O2!!!" before I start getting urges to strangle someone with the NRB tubing.

I really have no idea why I'm in this class beyond it will look good on my resume. Sigh.

Apparently there is nothing advanced about that class or it is being taught by a protocol monkey or EMT-Basic.

 

[fast65]

I was reading the description of it on the NAEMT website and it said it teaches to "think outside of the box", apparently not...

 

[usalsfyre]

The card classes are pretty much a waste of time after you've taken them. The AHA and NAEMT have sold EMS on the idea of BS certifications hook, line and sinker. The only one I've enjoyed lately was ACLS EP, and even that was just a very, very basic course in concepts surrounding periarrest and preventing full arrest.

 

[Veneficus]

The card classes are pretty much a waste of time after you've taken them. The AHA and NAEMT have sold EMS on the idea of BS certifications hook, line and sinker. The only one I've enjoyed lately was ACLS EP, and even that was just a very, very basic course in concepts surrounding periarrest and preventing full arrest.

Then you have a standing invite to come and have EP class with us in Ohio this summer.

I'll bet my collegues and I can make it worth your while.


Just the idea of a 2 day course in "advanced medical life support" should sound stupid.

 

[Aidey]

The main problem is the updated class materials aren't available yet, so we are using to 2006-2007 stuff. The scenarios in the book talk about stacked shocks and drugs down the tube.

It has potential, especially if they focused more on pathophys of stuff we don't see often or abnormal presentations of stuff we do see. Right now it is feeling like a review class.

 

[Veneficus]

The main problem is the updated class materials aren't available yet, so we are using to 2006-2007 stuff. The scenarios in the book talk about stacked shocks and drugs down the tube.

It has potential, especially if they focused more on pathophys of stuff we don't see often or abnormal presentations of stuff we do see. Right now it is feeling like a review class.

That stuff should have been out by 06

 

[Aidey]

Ahhhhhhhh!

Septic shock with a BP of 68/P - 300ml bolus, if it doesn't work, go to dopamine!
(But wait, you can't have a BP of 68/P because you can't have a radial pulse with a BP under 70).

Mag for asthma? Huh how does that work? Glucagon for BB OD? Does that work?

I will not have a stroke....I will not have a stroke.

 

[usalsfyre]

Ahhhhhhhh!

My reaction to certain CE sessions as well.

Septic shock with a BP of 68/P - 300ml bolus, if it doesn't work, go to dopamine!
(But wait, you can't have a BP of 68/P because you can't have a radial pulse with a BP under 70).

This is just bad medicine. From inadequate fluid resuscitation to a poor choice of pressor it stinks all the way around. What's really scary is it's being taught a gospel to medics who will go back and practice this way.

Mag for asthma? Huh how does that work? Glucagon for BB OD? Does that work?

Let me guess, the instructors are medics who have "been around the block" (what they don't realize is the block is on Sesame Street).

I will not have a stroke....I will not have a stroke.

Don't forget adequate sedation for agitation, including your own!

 

[usalsfyre]

Then you have a standing invite to come and have EP class with us in Ohio this summer.

I'll bet my collegues and I can make it worth your while.


Just the idea of a 2 day course in "advanced medical life support" should sound stupid.

Generous offer and I wish I could. I wouldn't say the class I took was a waste by any means, the part I enjoyed the most is the fact that it was physician led, meaning when we did delve into more advanced topics the instructors could keep up. It just seemed that outside of 3 or 4 of the scenarios most people with exposure to medicine at a higher level were able to pick up where the scenario was leading you pretty easily.

AMLS is a way for someone to sell books and cards, and a merit badge for medics and services. If you could learn how to manage medical emergencies in two days then why would we need physicians.

 

[medicRob]

Apparently there is nothing advanced about that class or it is being taught by a protocol monkey or EMT-Basic.

My PHTLS was taught by an MD, EMT-P, the AMLS I want to attend will be taught by him as well. He pissed a bunch of the medics off in PHTLS, I overheard comments like
"We dont need to know that", "That is too much damn detail for something as simple as dropping an airway"... I assume it was in response to his riveting explanation of cellular physiology and molecular biology.

 

[usalsfyre]

My PHTLS was taught by an MD, EMT-P, the AMLS I want to attend will be taught by him as well. He pissed a bunch of the medics off in PHTLS, I overheard comments like
"We dont need to know that", "That is too much damn detail for something as simple as dropping an airway"... I assume it was in response to his riveting explanation of cellular physiology and molecular biology.

Yeah but when the guy that wrote the text book is faculty it would make sense it's going to be a decent class .

 

[medicRob]

Yeah but when the guy that wrote the text book is faculty it would make sense it's going to be a decent class .

bwahahha, you got me there.

 

[Aidey]

I was reading the description of it on the NAEMT website and it said it teaches to "think outside of the box", apparently not...

That is what they keep telling us. It would be a heck of a lot easier if 1. They taught disease pathologies that are "outside of the box" and 2. If any of the scenarios had solutions that were not the most common/obvious disease.

This is just bad medicine. From inadequate fluid resuscitation to a poor choice of pressor it stinks all the way around. What's really scary is it's being taught a gospel to medics who will go back and practice this way.

....

Let me guess, the instructors are medics who have "been around the block" (what they don't realize is the block is on Sesame Street).

...

Don't forget adequate sedation for agitation, including your own!

Everyone was like "the lungs! the lungs!" over 300 ml of fluid. If 300mls overloads your septic shock patient, you have more problems than you think you do. Unfortunately dopamine is all we have, unless we want to call for orders for an epi drip.

The instructors 1/2 way admitted that the class is outdated and there have been changes, but they are sticking to the power point like glue.

Versed is a good thing

 

[medicRob]

Aidey, would you like me to find out when Dr Guy is teaching the course again? I would be more than happy to get you some details. He wrote the PHTLS textbook and several other books, he is our burn director, and a paramedic.

 

[usalsfyre]

Yeah there's some paranoia among medics over fluid, I've never figured out why. Not counting renal failure and already overloaded patients I've yet to find anyone who can't take a liter like a champ. Heck I gave 1100mls of LR to an early sepsis patient over 40 minutes yesterday.

I guess we're lucky, we've got levo. They should still teach the appropriate med though, even if it's not commonly carried.

 

[medicRob]

I guess we're lucky, we've got levo. They should still teach the appropriate med though, even if it's not commonly carried.

They should also teach the importance of MAP instead of referring to it as that "little number in parenthesis".

 

[usafmedic45]

Then you have a standing invite to come and have EP class with us in Ohio this summer.

I'll bet my collegues and I can make it worth your while

Oh really?

 

[usafmedic45]

Not counting renal failure and already overloaded patients I've yet to find anyone who can't take a liter like a champ.

Trauma patients?

My PHTLS was taught by an MD, EMT-P

Was it Corey by any chance?

Septic shock with a BP of 68/P - 300ml bolus, if it doesn't work, go to dopamine!
(But wait, you can't have a BP of 68/P because you can't have a radial pulse with a BP under 70).

....and if they lose their fingers from excessive vasoconstriction, at least you didn't give them *gasp!* "pulmonary edema"! *shock!* *horror!*

 

[medicRob]

Was it Corey by any chance?

Nope, Dr. guy, not Dr. Slovis, but Slovis is a genius!