Trauma or Medical

[frdude1000]

Are you more interested in trauma or medical?

 

[94H]

Medical is so much more intriging, especially on an ALS unit where you have so much at your disposal. The 12-Lead and glucometers mean you can administer alot more treatment and see the effects.

In trauma its still basically board, collar and tx.

 

[KY_EMT]

I do a lot of medical emergencies but still love the trauma as well LOL It doesn't really make much of a difference to me. Just as long as I keep in practice with both

 

[DrankTheKoolaid]

re

Medical without question.

Nothing like trying to figure out your treatment course on a semi critical patient when your deep in the woods with a patient with multi system complaints with no support.

 

[MrBrown]

Medical

 

[Aprz]

I find splinting and boarding quite boring.

 

[Smash]

I find splinting and boarding quite boring.

Once you start adding some pharmacology, some chest decompressions, some RSI'ing of head injuries, it gets more exciting. Maybe in the future we will be adding some hypothermia for isolated head injuries, some tranxemic acid for ongoing hemorrhage and who knows what else. But still, there are infinitely more variables in medical patients, more detective work, more scope for treatment, so medical gets my vote too.

Not that I don't love a good bit of blood and guts mind you!

 

[MrBrown]

You just like spacing people off into orbit on drugs and shoving a tube down thier throat dont you ... its ok Brown would too

 

[the_negro_puppy]

You just like spacing people off into orbit on drugs and shoving a tube down thier throat dont you ... its ok Brown would too

Dont laugh, I went to a job the other day where a psych pt had rammed another car at 60 km/h. No major injuries (minor scalp lac) but couldnt get near psych pt to assess him due to psychosis. Our medical director ended up showing up, gave him ketamine then RSI'd him. Apparently they would have done that at the hospital to CT scan his head anyway.

 

[Veneficus]

The seperation of trauma and medical is artificial.

All trauma is medical, all medical is trauma. The worse the patient gets, the more similar the molecular and biochemical events become.

Just like most people with medical conditions don't need emergent help, neither do most trauma patients.

I like complicated patients who are really sick. The mechanism of it is really inconsequential.

 

[MrBrown]

Our medical director ended up showing up, gave him ketamine then RSI'd him. Apparently they would have done that at the hospital to CT scan his head anyway.

Your medical director has too much time on his hands, I want his job.

The seperation of trauma and medical is artificial.

The worse the patient gets, the more similar the molecular and biochemical events become.

I like complicated patients who are really sick. The mechanism of it is really inconsequential.

All medical I suppose is "insulting" to the body in the way that trauma is, the etiology is just a bit different. If I hit you in the head with a bit of wood or if you have a stroke it'll probably have a simmilar outcome.

But ... WHY, WHY must Medicine come back to bloody chemistry? WHY?

*Brown breaks down and cries, hurling his chemistry book at the wall and hopes the QAS Medical Director or ICPs will show up to give him ketamine

 

[emt seeking first job]

The seperation of trauma and medical is artificial.

All trauma is medical, all medical is trauma. The worse the patient gets, the more similar the molecular and biochemical events become.

Just like most people with medical conditions don't need emergent help, neither do most trauma patients.

I like complicated patients who are really sick. The mechanism of it is really inconsequential.

What this poster said.

It really is about taking care of things for the patient and getting them to the hospital in the best possible condition in the fastets time.

 

[abckidsmom]

Trauma is fun, but straightforward. I think my ideal call is a sick as snot medical patient an hour from the hospital in the pouring down, blowing rain so we can't fly them.

Stretching the brain is so much fun.

 

[medicRob]

Patient crashes into a tree as a result of a heart attack.

Trauma or Medical?

Don't put on the trauma blinders and miss a medical situation. Always be aware that the underlying causes of a situation can very well be a simple emergency that resulted in a large trauma.

 

[mar7967]

I agree with abckidsmom...trauma is pretty much straightforward, but I like it for that reason.

But when my mind needs a good workout, I love medical calls.

 

[the_negro_puppy]

Patient crashes into a tree as a result of a heart attack.

Trauma or Medical?

Don't put on the trauma blinders and miss a medical situation. Always be aware that the underlying causes of a situation can very well be a simple emergency that resulted in a large trauma.

That's what I like about the EMS job, the variety. You get both medical and trauma. Though I would have to say ( a wild guess) 90% of our work is medical, with 10% trauma.

I actually went to a job a few weeks back similar to what you mentioned. We were driving through a small tunnel on our way to do an IHT. Inside the tunnel 3 cars were pulled over with the lead car parked right against the inner tunnel wall. As we drove past a woman on phone waved us down. As we stopped I saw someone leaning over the driver of the front car doing compressions with one hand. My night went from listening to music and cruising to suddenly <_< then -_-

Guy had arrested while driving. Was in VF, gave him a few shocks, adrenaline etc, but no dice.

 

[Veneficus]

But ... WHY, WHY must Medicine come back to bloody chemistry? WHY?

Do not distress Brown.

If learning gen chem from the bottom up is giving you trouble, just go to biochem and learn from the top down.

Get yourself a copy of Lippincotts illustrated review of biochemistry. Simple, lots of pictures, and all you will ever need.

Blood chemistry is only one part of the chemistry in trauma. I assure you, a trauma patient who is critical with have issues that can equal any medical patient.

Normal saline is for fools. Give me somebody with a antigen reaction from multiple type O blood transfusions, the impaired digestion of nutrients from pancreatic damage, With a head injury and multiple organ and ortho injuries, whos liver is not able to produce albumin or clotting factors, early onset rhabdo, and throw in some burn and bacteria (something nasty like p.aeruginosa or C.perfringes,) and the game is on.

For extra fun, add in a history and current high dose B blocker that cannot be acutely withdrawn.

who says trauma is easy or straight forward?

*Brown breaks down and cries, hurling his chemistry book at the wall and hopes the QAS Medical Director or ICPs will show up to give him ketamine

That will not help with chemistry. Try going with a female undergrad chemistry tutor instead. (and learn some anatomy while you are at it )

 

[Shishkabob]

I prefer the ones where I can do interventions that help.

 

[lightsandsirens5]

I prefer the ones where I can do interventions that help.

Same here. And A just an Intermediate, I cannot do much. I can do stuff that helps in a few medical cases and a few things that can help in a trauma case. Fluids for hypovolemia secondary to trauma is about it for trauma cases. Other than that, for medical, all I got is stuff like Narcan, D50, NTG, etc.

 

[abckidsmom]

I prefer the ones where I can do interventions that help.

Same here. And A just an Intermediate, I cannot do much. I can do stuff that helps in a few medical cases and a few things that can help in a trauma case. Fluids for hypovolemia secondary to trauma is about it for trauma cases. Other than that, for medical, all I got is stuff like Narcan, D50, NTG, etc.

Beyond interventions though, honing those assessment and pathophysiology skills actually help too. Learning from the presentation of one patient to apply the physiological concept to the next one is really where I get most of my fun, because I've had to come to grips with the fact that my fluffy white cloud will prevent me from EVER seeing a critical patient more than once a year.

The time I sniffed out a mild organophosphate poisoning from a 3 am rash call was enough to keep me happy for a year. The lady was complaining of a mild rash on the medial side of her arms at the elbows/top of forearms. She wined and complained, and wiped her nose which was running even though it was 3 am in July. I saw a tear run out of her eye and had a flash. Asked her where she worked, and it was at the tractor supply company. Where she carries bags of fertilizer from pallet to shelf all day. With gloves and a short sleeve shirt on.

I swear, when I heard her finish telling me about her job, the heavens had opened up and the angels were singing. The attending was highly impressed, and 2 years later I still count it as a good time.

The burnout medics would have schlepped her to the hosp, groaning about her wasting their time. Sure...she didn't really need an ambulance, but it was fun while I was there, right?