Weekly Roundup - Tax Week 4/18/2014

My apologies to you, gentle reader, (I'm sure there is at least one person who reads this blog, surely?) and I apologize for the "Weekly Roundup" being the only thing you hear from the Ambulance Ranger these days.  More content to come, I promise.
The short update?
Lots of calls, then none.
Still plodding through Paramedic internship.
Still studying.
Still working.
yep, that's pretty much it.  Hope you enjoy this week's finds:

I think I will link to the NEW Ferno iNX stretcher every week.  Forever.  Or until we get a grant to buy them for our service.  Then I will post videos of us using them.  Or at least a picture of me sleeping on one.
http://www.jemseditorblog.com/2014/04/17/ferno-introduces-revolutionary-patient-transport-loading-system-at-the-fdic-conference-in-indianapolis/

Teaching tips - that awful moment when you realize everyone's asleep...
http://www.ems1.com/education/articles/1878798-6-training-tips-to-reach-unengaged-EMTs/?utm_source=newsletter&utm_medium=email&utm_campaign=exclusiveBlock1&nlid=1881013

Blood pressure - how to do it the right way
http://www.ems1.com/blood-pressure/articles/1882581-5-errors-that-are-giving-you-incorrect-blood-pressure-readings/?utm_source=newsletter&utm_medium=email&utm_campaign=exclusiveBlock4&nlid=1882308

I know a couple people who would be great at motorcycle medicine...
http://www.emsworld.com/article/11393194/motorcycle-paramedics-provide-faster-ems-response-at-special-events

Strokes, under-diagnosed:
"Analyzing federal health care data, a team of researchers led by a Johns Hopkins specialist concluded that doctors overlook or discount the early signs of potentially disabling strokes in tens of thousands of American each year, a large number of them visitors to emergency rooms complaining of dizziness or headaches."
http://www.emsworld.com/news/11398693/stroke-assessment

Furosemide - No, No, and No
http://www.emlitofnote.com/2014/04/pre-hospital-furosemide-no-no-also-no.html

Specifically targeting abdominal pain, another sacred cow gets slain:
"In this era of iPods and digital media, EMS pain management seems stuck in the days of boom boxes and cassette tapes. It’s time we tossed the old attitudes about pain management, like those old boom boxes, into the dustbin of history."
http://www.emsworld.com/article/10862823/ems-relief-of-abdominal-pain

$40 that might save your life, via Kelly Grayson - LET RESPONDERS FIND YOU!
The porch lights flashing switch is very cool, and something I had not seen:
http://www.ambulancedriverfiles.com/2014/04/16/when-you-need-the-good-guys-can-they-reach-you/

Kelly has been busy this week!  Great podcast discussion with Chris Cebollero on hot topics, clinical issues, and operational leadership lessons:
http://www.ems1.com/fire-ems/articles/1882760-Inside-EMS-Podcast-Reducing-spine-board-usage-EMS-leadership-styles/

And finally, a shout-out to our awesome dispatchers (you know who they are, the ones when you hear their voice on the line you KNOW you will be taken care of for your shift)
http://psc.apcointl.org/2013/03/21/so-you-want-to-be-a-dispatcher/

Weekly Roundup 4/11/2014

Important, for many reasons.  Not a "how-to" but more of a "how we got here"
http://www.jems.com/article/history-ems/how-heal-after-responding-tough-call

Active shooter EMS -- Discussion
"During an active shooter/active killing response, the first-arriving Fire/EMS responders, not special operations or tactical medical teams, must accept the responsibility for life rescue and medical operations and must work with first-responding law enforcement assets to rapidly deploy into the areas that have been cleared but not secured (warm/indirect threat zones) to initiate treatment and rescue injured victims."
http://www.jems.com/article/supporting-paradigm-change-ems-operation

Wake County EMS Evacuation pre-plan (outline) and A.J. Heightman's freaky night in a hotel:
http://www.jemseditorblog.com/2014/04/08/twas-the-night-before-mci-class/

Simple thoracostomy - a case for incision rather than needle decompression
(will be interesting to see what the study yields)
"To avoid the complications associated with needle decompression, a number of services in Europe have adopted simple thoracostomy as an option for chest decompression. Simple thoracostomy is a technique similar to the placement of a chest tube, traditionally done in the ED. It utilizes an incision with a scalpel and penetration directly into the thoracic cavity with forceps and a gloved finger to relieve the tension pneumothorax. The only major difference is that the chest tube isn’t inserted."
http://www.jems.com/article/patient-care/simple-thoracostomy-moving-beyond-needle

Ferno's new cot.  If it works, it's a game-changer for EMS:
http://www.fernoems.com/inx/
VERY similar to one we played with at EMS World, but this is all auto and will load into our tall 4wd ambulances.  I might be in love.

AND A little video crazed this week

How an EMT gets ready for work:
https://www.youtube.com/watch?v=ahCuA6DsSGE#t=155

Forget the egg in a skillet "this is your brain on drugs" commercial.
Just show this to the kids, and they will stay away.
https://www.youtube.com/watch?v=UePInKAKgTA

It's so funny, because it's true...
https://www.youtube.com/watch?v=V9G5CfrQN4w#t=55

Weekly Roundup 4/4/2014

CHECK!  Checklists to reduce deaths...quite the concept.
http://www.jems.com/article/administration-and-leadership/ems-checklists

Because we're all nerds
http://www.ijreview.com/2014/04/126134-girl-asked-wil-wheaton-respond-bullies-call-nerd-perfect-answer/

Ambulance safety and design, one of my geeky passions:
http://www.emsworld.com/article/11325292/ambulance-safety

Emergency Medicine (as in MD) Literature of Note - University of TX, Houston
http://www.emlitofnote.com/

NeuroEMS -- Strokes and Hearts, what can we learn?
http://www.neuroems.com/2014/03/24/12-lead-ecg-and-stroke-pt-1-overview-lit-review/
http://www.neuroems.com/2014/03/29/12-lead-ecg-stroke-pt-2-culprits-in-the-brain/
http://www.neuroems.com/2014/03/31/12-lead-ecg-stroke-pt-3-case-studies-conclusion/

more, because I'm falling in love with NeuroEMS...
http://www.neuroems.com/2014/03/15/blood-flow-through-the-brain-pt-1-overview/

Trauma Triad of Death - more understanding
http://www.emsworld.com/article/10565011/hypothermia-acidosis-coagulopathy

Weekly Roundup 3/28/2014 (sorry it's late)

YESYESYESYESYESYESYES
I will be reading this, printing it, and re-using it:
http://theemtspot.com/2014/03/22/101-things-we-should-teach-every-new-emt/


Simulation -- not just for EMS
http://www.emsworld.com/news/11359882/la-doctors-practice-speeding-up-trauma-care

Funny, because it's too true:
http://www.savortheessenceoflife.com/2014/03/23/30-things-nurses-almost-say-but-then-dont/
I had the, um, privilege of working with some DC Fire/EMS folk a couple years ago.  They are getting focused, for sure, with bad press.  But you don't get smoke without...
http://www.jems.com/video/news/dc-woman-leaves-ambulance-while-crew-arg

Field Microscopy - 50 cents each

This is a very cool item, probably one of the neatest inventions I've seen in a long time.

http://news.yahoo.com/blogs/this-could-be-big-abc-news/super-cheap-paper-microscope-could-save-millions-lives-133616732.html?vp=1

Paramedic Clinicals, Part 1 -- Getting There

I got lucky.

See, when I started this Paramedic adventure a few years ago I knew it was going to be a struggle to get it all done.  Back in 2006 when I was diagnosed with cancer, I used up all my sick and vacation time (as well as a few people who donated their time to me).  Truth is, in the 7 years since, I did not build up much of a "bank" of time.  Vacation days became more precious than work to me and I spent them with my family and friends.

Once I started this Paramedic education, however, I knew that I would be taking a ton of "vacation" days from my normal job in order to do my EMS education on the side.  So I saved up time and money.

Optimistically, I saved enough for Base Camp and EMSWorld Expo, with a few days left over for the slop, figuring I could do my clinicals every other weekend.  You see, I work 5 days then 4 days, then get a 3-day weekend.  I figured I could leave after work on a Thursday, drive 3+ hours to the hospital, work part of a night shift, sack out in the car/shower at a truck stop, work Friday night, sack out in car/shower at truck stop, work Saturday night, sack out in car/shower at truck stop, work Sunday night, drive home (nap in car along way somewhere), shower at home and work 8 hour shift at regular job Monday.  I would get every other weekend at home to recoup, and I could be finished in 14 weeks.

That may have worked...when I was 22, but at nearly double that age I'm just not able to swing it. 
It took 2 nights sleeping in my car to realize I needed:
1.  a bathroom. 
2.  to stand up, stretch, and do yoga
3.  a coffee pot
4.  a fridge with some real food
5.  sometimes a shower AND a bath to soak away 12 hours in the ED
6.  a decent internet connection
7.  someplace I could call "home" away from the hospital

There was no way my original plan would work.

Lo and behold, the idiocy of the Federal Government saved me.  They shut down the government for a few weeks.  I managed to score a fabulous serviceable room at the local Motel 6 for the duration, and managed to knock out 14 shifts of at least 12 hours each.  Although I hated the whole mess, the shutdown really worked in my favor.

Next time:  Paramedic Clinicals -- Day 1

NeuroEMS -- new page to me

And raises some interesting questions (along with good literature review):
http://neuroems.wordpress.com/2014/03/24/12-lead-ecg-and-stroke-pt-1-overview-lit-review/

Color me intrigued

Weekly Round-up 3/21/2014

OK, so I've decided to add a new section, for all the articles and web pages I've read this week, that might interest you, gentle reader.
So here we go:

Provider Suicide.  I've written about it a few times.  A good editorial.
http://www.lifeunderthelights.com/2014/03/14/provider-suicide-a-letter-from-someones-coworker/

Teamwork...a laudable goal:
http://www.jems.com/article/major-incidents/how-foster-teamwork-shooting-incidents

Upstroke ventilation in CPR (and ventilation in general)
http://www.jems.com/article/patient-care/using-upstroke-ventilation-optimize-coro-0

Lone Star tick bite causes some to become allergic to sugar in red meat.
http://www.outsideonline.com/fitness/bodywork/the-fit-list/Tick-Bites-Blamed-for-Red-meat-Allergies.html?utm_source=facebook&utm_medium=social&utm_campaign=facebookpost

Firsthand account of caring for your colleagues:
http://www.jems.com/article/health-and-safety/firsthand-account-stresses-caring-your-c

A good reminder on equipment checks:
http://www.emsworld.com/article/10319289/ambulance-equipment-checks

EMS Movies
http://www.emsworld.com/article/10319212/ems-movies

Mercedes/Freightliner 4x4 model to USA!!! (Ambulance Ranger REALLY wants one...)
http://www.leftlanenews.com/mercedes-sprinter-4x4-likely-headed-stateside.html#xP2f7J348WYh6wR8.01

Emergency Vehicle Safety - report shows...
http://www.emsworld.com/news/11351664/usfa-releases-updated-emergency-vehicle-safety-initiative

Vegas - "War over emergency response" in Las Vegas - Vegas fire wants to take 75% share...
http://www.jems.com/video/news/concern-grows-over-private-ambulances-ve

Distance learning...frustrated with the process

The learning part (didactic) was great.  Going to Paramedic Base Camp was great.
Trying to get someone in rural America (within driving distance) to sign on for my clinical internship took months.  Even after almost a year of pre-planning and discussion.  First choice backed out at the 11th hour, second choice did not communicate well.

Getting intubations was nearly impossible.  I'll save the gory details for later, but approximately 3 months elapsed from my last clinical shift to the week at the Big Eastern hospital OR I had to travel to in order to get my 10 tubes.

Field internship is not proving easy to navigate, either.  Had the site set up over a year ago, and just now am finding out that my school needs to be licensed in the State for me to do my field time (which they are not).

I haven't had the heart to tally my expenses so far, but for you, gentle reader, I will do it and get you an update.  Let's just say that Big Credit Card Companies are in love with me right now, and my diet is far less varied than it used to be.

I'll try to be upbeat in my next posts, but for now I'm just bummed.

Thank you for your service, officers

K9 Maros United States Department of Agriculture - Forest Service Law Enforcement and Investigations, U.S. Government End of Watch: Wednesday, March 12, 2014 Cause: Gunfire

Read more: http://www.odmp.org/officer/22038-officer-jason-crisp#ixzz2vtDob7gl

Officer Jason Crisp United States Department of Agriculture - Forest Service Law Enforcement and Investigations, U.S. Government End of Watch: Wednesday, March 12, 2014 Cause: Gunfire

Read more: http://www.odmp.org/k9/1527-k9-maros#ixzz2vtE5uh4d

On waiting...

http://jenuinereflections.wordpress.com/2013/12/18/confessions-of-an-er-nurse/

Yes.  Precisely.

So long, and thanks for all the fish!

Mostly because I've been too busy/lazy/tired/discouraged to post anything lately:

How those of you who decide not to vaccinate are killing people:
http://www.latimes.com/business/hiltzik/la-fi-mh-antivaccination-movement-20140120,0,5576371.story#axzz2rMwGoaYf

And a cool online map of preventable disease:
http://www.cfr.org/interactives/GH_Vaccine_Map/#map



And these, just for fun
 How to survive being married to a medic: http://voices.yahoo.com/tips-survive-being-married-paramedic-3700116.html

Sirens - new EMS show, really Dennis Leary?
http://connect.jems.com/forum/topics/sirens-another-ems-television-show