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There are many things that we as paramedics would need to do in order to bring about change in Paramedicine as a whole. The way I see it it would take education, paramedic leadership, individual identity, public awareness, and higher pay. Education, a BS program in Paramedicine is the only way...

This isn't really ground breaking. There was a huge retrospective study of penetrating trauma during the Vietnam war, (tens of thousands of patients) which concluded that penetrating trauma (unless to the neck) posed nearly no risk of spinal injury. It's another one of those things that we...

Here is some research supporting what most everyone has said. Pain management has no effect on the accuracy of diagnosis. And withholding it is arcane and poor medicine. http://www.ahrq.gov/CLINIC/ptsafety/chap37a.htm In fact according to one study (and this is just one study, I realize...

Yes! Thank you for bringing that up as well. I think you understand the point I was trying to make. Great post, with good references! This was helpful and educational to everyone following the conversation. Adam

Great points! I agree.

Did you actually read any of my posts vent? I never said anything about the prevalence of spinal injuries. I have seen MANY they happen all the time, once again you have replied to a conversation that I didn't know we were having. I said: Meaning, not every spinal injury is unstable...

Vent, I think we are having a miscommunication. You didn't address anything from my post. I said; You then said that you were right because there are lots of examples in law which prove so; Please provide an example, substantiated by a medical authority if possible. Then you...

Actually yes, I have been working in ED's around the San Diego area for the better part of a decade now. If you have any research, please post the research, not just you scoffing about what you think you know. Here is a link to a lecture by spinal surgeon Dr. John Burton who has been...

Ummm, A GSW to the chest is for sure an indication to cspine. Now in reality the odds of the PT having an unstable spinal injury which any amount of movement would exacerbate is one in a million. In fact regardless of the MOI the great myth of movement will worsen a spinal injury has...

I'm glad someone brought that up! I got extensive training on the US in my ED clinical rotation in medic school, and looking for free air and blood was fun and all, but even with negative US findings, if the VS were out of whack (the article stated something about elevated heart rate) in the...

Ummm I hate to break it to your doctor, but an AED would have no problem analyzing a PT with dextrocardia. Looking at the 12 lead that you posted an AED would simply say "shock not indicated". If the PT happened to be in vFib or vTach, the fact of the matter is that there is NO...

I feel your pain my friend. But we are not doctors. Will knowing the details of cellular physiology make a difference in your patient care? Maybe not on every call no, but ultimately you will have a more in depth knowledge of pathophysiologic mechanisms of injury and disease. You will be...

An AED could not tell the difference, it would never know. There is NO electrophysiological difference in ventricular tachycardia, or ventricular fibrillation of a Dextrocardia PT that can be identified on an ECG. Again, you CAN NOT tell the difference if a PT is in vTach or vFib. I...

I just saw your second question about recreating a Dextrocardia ECG. Just put the Right Arm Lead on the left arm, and the Left Arm Lead on the right arm. You will get everything you get with Dextrocardia, EXCEPT you will most likely have positive R waves, Dextrocardia would not, AND you...

Dextrocardia can be one of a few types... Dextrocardia (dextroposition) alone means that the heart is more on the right side of the thorax than the left, but does not necessarily mean that it is anatomically reversed. Dextrocardia Situs Inversus, on the other hand means a true mirrored...

I don't see that as much of a concern to be honest, the person shouldn't be laying into the patient with all their weight. The hand should be placed over the flail segment by a rescuer, with elbow bent, and gentle pressure applied. It's just the ability of a person to regulate pressure, and...

I'm telling you guys, a "bulky dressing" isn't going to do anything at all but cover up the flail segment. You need a persons hand on there applying just enough pressure to keep the flail segment inline with the rest of the chest wall. I know what the book says, and frankly, it's wrong. it's...

Congrats!!! Remember to study, and have fun. I've seen you post a few times, and it's cool to see your enthusiasm! Correct me if I'm wrong but it sounds like you are doing some sort of EMT class that takes place at an active station, and you get to go on calls with the guys working /...

To treat a flail segment, someone should place their hand over it gently, preventing the segment from moving outward from the rest of the chest. There isn't much you can do from the outside in order to keep the segment from moving inward. This should be done by a rescuer, and maintained all the...

It's called a heterotropic heart transplant. Pretty rare.