So, what did you learn today?

Ridryder911 said:
There are numerous studies that have proven that PASG are not as effective as one once thought. That is if application was that as the current procedure & application was followed at that time.

Studies does not prove that they do not work, rather they have no increase in outcome survivability. The same could be placed on other various treatments we now perform routinely.

New research is demonstrating that it does increase TPR to a small degree, but with this also comes the harmful side effect of lactic acidosis. I do believe we will see PASG return on specific injuries and conditions with a new different application and inflation procedures. As just part of the treatment of shock and definitely recognizing it is only aiding in treatment but it maybe a while as it was slammed very hard in the early 90's.

R/r 911
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The PASG makes for a nice splint... however, you would not be doing the patient any good if you just release the pressure from the garment... Vacuum splints actually work better and are less uncomfortable for the patient when you try to remove them. The down side is that people in the ED don't know you can "shoot through" them nor how to remove them, so they cut the vac splints off. The PASGs do work for splinting pelvic fractures and multiple long bone fractures. However, a properly used bedsheet can splint a pelvic fracture pretty well.

What, specifically, do you see the PASG being used for in the future?
 
Akulahawk said:
The PASG makes for a nice splint... however, you would not be doing the patient any good if you just release the pressure from the garment... Vacuum splints actually work better and are less uncomfortable for the patient when you try to remove them. The down side is that people in the ED don't know you can "shoot through" them nor how to remove them, so they cut the vac splints off. The PASGs do work for splinting pelvic fractures and multiple long bone fractures. However, a properly used bedsheet can splint a pelvic fracture pretty well.

What, specifically, do you see the PASG being used for in the future?
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I don't think you should make such a blanket statement about ED people. We do portables all the time on traumas with vacuum splints in place. We don't remove field splints until we are ready for one reason,patient comfort. Usually a splint will stay in place until someone from the ortho service arrives and makes a determination as to what treatment path to follow. I'm sure its been a problem in some ED's but we do know a thing or two about those fancy tools you all use in the field. I second the pelvic wrap with a sheet,simple but very effective. We see more unstabilized pelvic fractures than you might think. I would wrap anytime there is even the slightest possibility of a pelvic fracture.
 
Akulahawk said:
The PASG makes for a nice splint... however, you would not be doing the patient any good if you just release the pressure from the garment... Vacuum splints actually work better and are less uncomfortable for the patient when you try to remove them. The down side is that people in the ED don't know you can "shoot through" them nor how to remove them, so they cut the vac splints off. The PASGs do work for splinting pelvic fractures and multiple long bone fractures. However, a properly used bedsheet can splint a pelvic fracture pretty well.
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What are your thoughts on the SAM sling for Pelvic fractures?
http://www.sammedical.com/sam_sling.html
 
Level1pedstech said:
I don't think you should make such a blanket statement about ED people. We do portables all the time on traumas with vacuum splints in place. We don't remove field splints until we are ready for one reason,patient comfort. Usually a splint will stay in place until someone from the ortho service arrives and makes a determination as to what treatment path to follow. I'm sure its been a problem in some ED's but we do know a thing or two about those fancy tools you all use in the field. I second the pelvic wrap with a sheet,simple but very effective. We see more unstabilized pelvic fractures than you might think. I would wrap anytime there is even the slightest possibility of a pelvic fracture.
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I do apologize if you think I'm slighting ED staff. I'm actually glad your ED actually has experience with vacuum splints. You really have no idea how happy that makes me! Most of the EDs I've been in quite literally have no idea about how to deal with them as they never or very rarely see them. (And I've been to about two dozen EDs over the years.) I'm not exactly naive of ED equipment either...
 
dmc2007 said:
What are your thoughts on the SAM sling for Pelvic fractures?
http://www.sammedical.com/sam_sling.html
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The idea sounds good. It appears to provide a similar function as the bedsheet method. If it does what they claim it does, I can see that being added as a field device for stabilizing pelvic ring fractures. I would like to see the metal removed from the device to allow for use in MRI units >3 Tesla. My feeling is that if it does become part of regularly fielded equipment, providers will also have to be trained in stabilization of those fractures using field expedient methods as the SAM Sling won't fit all patients nor is it designed for peds.

It seems to be a relatively new device... that I'd like to see more info on.

So.. I'll reserve my own judgment on this till I get more info on it.
 
Akulahawk said:
I do apologize if you think I'm slighting ED staff. I'm actually glad your ED actually has experience with vacuum splints. You really have no idea how happy that makes me! Most of the EDs I've been in quite literally have no idea about how to deal with them as they never or very rarely see them. (And I've been to about two dozen EDs over the years.) I'm not exactly naive of ED equipment either...
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No apology necessary just keeping you on your toes. I want nothing but goodwill between the ED and our field providers. Its true that some staff don't know how to deal with field equipment like traction and vacuum splints. During trauma assessments I have seen PA students take shears to vacuum splints much to the dislike of the trauma surgeon leading the call. We are a teaching hospital and I think some things get overlooked.

I can tell you that I wish agencies would do a better job of marking their splints, after I remove any equipment be it a splint or a backboard it goes out to the bay for pickup at a later time. I seldom see vacuum splints with agency markings which makes it hard to get the equipment back to its home. Field equipment and ED equipment are alike in alot of ways and knowing that is why field providers make such great additions to the ED staff.
 
dmc2007 said:
What are your thoughts on the SAM sling for Pelvic fractures?
http://www.sammedical.com/sam_sling.html
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I don't have it on me (waiting for dinner typing with my thumbs on my iPod) but I recall a study that debunks some of the ideas behind using SAM splints or pelvic wraps.

The pressure that is generated is not typically enough to create any effective tamponade as blood continues to seep into the retroperitoneal cavity.

I don't recall specifics about reduction in pain or anything else though.
 
I learned that I hate embryology.
 
28sak4p.jpg


I learned all about PPE, courtesy of a chubby 10 yo boy, in online orientation for my new job.

Don't child labor laws prohibit the employment of children in environments in which they will be exposed to hazards that necessitate the use of full face shields and protective earmuffs? :rolleyes:
 
Catilage is 3x more slick than ice.

And if it's true, I have some faith that a gym teacher just might be able to teach health, still not convinced though.
 
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Akulahawk, you know my coworkers!

I wasn't there, but I had to refill a 250 liter cylinder after O2 given via "NRB NC" per the med record. Tx times and time pt was taken under wing by EMS was ten minutes...hopefully they just left the cylinder on, or that pt 's gonna need chapstick up their nose.
 
spisco85 said:
Thanks. So I had the basic understanding down.

VentMedic- I agree college level A&P would be helpful, just can't start the class till the class starts :)
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Actually I think she was implying (and if she wasn't- which I doubt- I am) that you should have had it BEFORE your EMT class. No offense to you but it's just another reflection of the sad pathetic state of EMS education in this country.
 
Ah, nevermind.
 
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I learned we can survive w/o emtlife.:P
 
medic417 said:
I learned we can survive w/o emtlife.:P
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Speak for yourself. If I wasn't at work, I could have died, but after talking to my partner about EMS I was too afraid to arrest next to him, I would've been a goner.
 
Cory said:
Catilage is 3x more slick than ice.

And if it's true, I have some faith that a gym teacher just might be able to teach health, still not convinced though.
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i think the EPC book says 5-8 times more slippery than ice? all the obscure facts learned in lecture class
 
the 2 different wave lengths used in a spo2 detector are 650 and 805 nm, if anyone ever wanted to know
 
I learned that I may as well move to the most barren, deserted part of Africa and practice EMS there... since I live in LA County :glare:
 
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