Patient Management

Thought Exercise: Pain Management

Debating with some folks on the various EMS social media forums lately, I was struck with the cognitive dissonance apparent in some providers’ attitudes about pain management. To wit, a distressing number of EMS providers still cling to 1950’s era myth bullshit legend dogma that providing analgesia to patients with abdominal pain complicates the physician’s assessment in the Emergency Department. ...

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Spinal Immobilization: You Make The Call

Now, an 80+ minute trip strapped to a spine board isn't the cruelest thing I can think of doing to this man, but the other two possibilities involve nipple clamps and a live ferret. He weighs less than his age, and his chart already includes orders for a Fentanyl patch PRN and gel seat pads for his wheelchair. I don't like the idea of boarding him if I can help it. But we're not talking about what I would do. What would you do?

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Nurses: Not So Different From Us After All

One of the most ludicrous assertions in the endless Nursing vs EMS debate is that paramedics are somehow more skilled than nurses. It's simply not true, and just as insulting to the nursing profession as it is to us when some snurse calls us ambulance drivers. I've lamented before on the skills-centric thinking endemic in EMS, and how it holds ...

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EMS Today: Product Reviews

So, for a guy that no longer believes in spinal immobilization for the vast majority of our patients, I find it rather ironic that I choose a couple of pieces of spinal immobilization equipment for my EMS Today 2011 New Product Showcase:

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EKG Geekery

TOTWTYTR posts an EKG and case history for that most elusive  of creatures, Brugada Syndrome caught in the wild. Very cool when you can very possibly save a life by using your brain, and not your hands. Those are the kind of EMS calls I love.

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Bigfoot, Aliens, and Occult Spinal Injury

Question: What do the above things all have in common? Answer: All of them are things in which some people desperately wish to believe, despite the utter lack of credible evidence of their existence. Now, before you roll your eyes and say, “There goes AD again, making unsupported blanket statements just to make his point,” I will cop to just ...

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How Do You Do That Airway Voodoo That You Do So Well?

On a side note, the next time a colleague blames his difficulty intubating a patient on that "anterior larynx," check the patient's thyromental distance to see if it truly is anterior. The anterior larynx is one of the biggest "run home to Momma" excuses in paramedicine, right on up there with "looks like atrial fib" and "I was up against a valve."

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