Recent content by VinBin

I think you're still missing the point. It is a liability that should not be placed on EMS to document they used a field ultrasound and made a decision based on that (if it turns out to be incorrect). You are definitely right that the vast majority of trauma patients do not need a trauma center...

I have actually worked in rural EMS. What statements have I made that make you think that?

It opens up a host of liability that I don't think EMS is structured to take on. We should have a RULE OUT method to not taking a patient to a higher level of care instead of a RULE IN method. Having a young female with "classical abdominal pain" with a "negative" field ultrasound who then...

Yeah, definitely spot on. There are advances in LMA's to a point where they are not only easier to insert but allow a "rescue" intubation through the tube if necessary, suction ports for gastric tubes, temperature probes, etc. We are trialing new LMA's that have a pilot balloon that has a built...

If you have belly pain and a high suspicion for pregnancy related issue in your differential, you should go to a hospital which has capacities of managing an OB emergency. I don't understand what is confusing about that statement? My question is how would an ultrasound dictate your decision...

I don't think your reasoning is logical or justified in the realm of EMS. You should not consider a non-OB destination for a female who is pregnant with belly pain or presents with likely symptoms of an ectopic pregnancy. Even if it presents as a classical appendicitis or cholecystitis, any...

Correct destination in what regard? Are your potential transport destinations so exclusive that you could not take a patient with a couple differential diagnosis in for further evaluation?

It's not a question of "dirty vs clean." You can prevent contamination in a sewer if you prep the patient and use strict sterile technique. It's a matter of which environment can accommodate that for a majority of blood draws. I have seen many contaminated blood cultures from the ED, but...

I think rather than focusing on antibiotics in sepsis with hemodynamic changes (which is really the only reason I see to rush to abx in pre-hospital medicine), focus on stabilizing patients first with good BLS/ALS and fluid management. Trying to do lab tests to evaluate renal/liver function...

In the ED, the main purpose of ultrasound is to triage different pathology on findings (trauma/FAST exam, OB, abdominal organ pathology, etc). In EMS the focus should be on stabilization and transfer to the ED. Fooling around with an US in a seemingly benign case (questionable appendicitis...

If you guys really want to raise the wages of EMT's just start colluding with each other to stop applying for jobs and/or pursuing it as a career. It's supply and demand, just reduce supply and you'll find that the "minimum wage" starts to go up magically... As far as I can tell, there doesn't...

It's just a matter of risk reduction and cost savings to the taxpayer. It's a lot cheaper to hand out narcan to drug addicts than go through the drama that involves admitting and caring for an overdose. Even if it saves one person from a prolonged hospital stay requiring EMS response, ED...

I admire your enthusiasm and don't want to sound cynical or jaded but what you have is probably more than enough for anything you could even remotely "encounter" as a civilian in everyday life. Also, there is an old saying that I've heard several times that the amount of items you carry (on...

I'm biased against most "crossfit" exercises and videos, and the Bear Squats look like a mediocre workout for general fitness (probably more towards endurance than pure strength). But I would urge caution due to the extreme stress this exercise can put on the rotator cuff if done without very...

Anytime you go "under" or are put in a "less conscious" state, there are inherent risks, why take them if you don't have to? I've had all four wisdom teeth taken with just local (all were impacted, if that makes any difference). I'll be honest, it was relatively painless after the initial...