So, what did you learn today?

[Lifeguards For Life]

I learned that I may as well move to the most barren, deserted part of Africa and practice EMS there... since I live in LA County :glare:

they both sound like interesting places to work

 

[PapaBear434]

the 2 different wave lengths used in a spo2 detector are 650 and 805 nm, if anyone ever wanted to know

Hey, I just learned that a couple days ago! Get out of my head!

 

[MIkePrekopa]

The "I can't wait to shove tubes into dummies" line was meant to be humorous. I prefer the hands on learning over reading textbooks. Sorry if my immaturity showed, ill do me best to keep it covered up next time.

I know not everyone needs O2. I know its not the first thing you reach for. I know there is more to giving O2 than turning it on. Just let me state I have only been in class 2 weeks (a total of 18hrs.) I know I still have A LOT to learn. We went over COPD, and were told how O2 can neg. effect someone. When it was said to us (the 15L NRB, ect.) it was more of "never hold back O2 if you think it might help".

 

[WannaBeFlight]

I learned in the first 3 days of class... "If you are sick and running a fever, DO NOT COME TO CLASS!" Unfortunately someone didnt take note of that, and decided to sit in class for three days this week running a fever and coughing, and was diagnosed with the Flu!!
WTF! we are all adults, why do we still not listen... Now I am sick and pissed off...<_<

Other than that, learned to Intubate patients on Friday!

 

[JPINFV]

That's the problem with a strict attendance policy. If I'm sick and I have the choice of:

A: Staying out of class while sick and run the risk of being kicked out for missing too many days.

or

B: Going to class

I'm going to pick B. Considering EMS's general hard on for clock hours and forcing people to sit in the classroom no matter what (note: medical students accross the country regularly skip lecture if they learn poorly in lecture and the average graduation rate for medical students is somewhere in the 95% range), I doubt most instructors would work with someone who is sick, but missed too many days. At my school, it was drilled into us that if we're sick, call the Office of Student Affairs and leave a message for the assistant dean because the school will work with students over missed exams and quizes.

It sucks, but that's what happens with strict requirements like clock hours.

 

[Melclin]

Today, whilst in four more hours of respiratory physiology, I learned that I'm incredibly thankful that I did all the sciences in high school.

Honestly, if I didn't already have a grounding in concepts like Boyle's law, osmosis and diffusion in general, concentration gradients; chemical equations and scientific notation; the behaviour of substances in different states and in solution.....I'd be so lost. I feel for the mature age students who haven't touched that stuff recently in high school.

 

[Jinx]

Funny, we are covering Resp system at uni atm to. Albeit the physiology side of things is only touched on lightly because the class is Clinical Practice so it is more treatment based. Today we covered chronic obstructive bronchitis, emphysema, asthma, anaphylaxis, and different types of drowning both dry and wet and fresh and salt water. Along with all the different treatments h34r:

 

[Smash]

and different types of drowning both dry and wet and fresh and salt water. Along with all the different treatments h34r:

So, what can you tell us about the difference between salt and fresh water drownings?

 

[Lifeguards For Life]

So, what can you tell us about the difference between salt and fresh water drownings?

in a saltwater drowning, the lungs fill with salt water which draws blood out of the bloodstream and into the lungs. This liquid build up in the alveoli stops oxygen from reaching the blood
in freshwater, the water filling a person's lungs can enter the bloodstream quickly causing blood cells to swell and burst. Also, the fluid filling the person's lungs will prevent the body from taking in enough air. This leads to cardiac arrest.
freshwater drowning, most likely you will be unconscious by the time heart stops

 

[Akulahawk]

Fresh water also will wash away surfactant...

 

[BossyCow]

I was once again reminded never to assume that because someone has their EMT cert that they have retained anything at all from their class pertinent to the call in progress.

 

[WannaBeFlight]

That's the problem with a strict attendance policy. If I'm sick and I have the choice of:

A: Staying out of class while sick and run the risk of being kicked out for missing too many days.

or

B: Going to class

I'm going to pick B. Considering EMS's general hard on for clock hours and forcing people to sit in the classroom no matter what (note: medical students accross the country regularly skip lecture if they learn poorly in lecture and the average graduation rate for medical students is somewhere in the 95% range), I doubt most instructors would work with someone who is sick, but missed too many days. At my school, it was drilled into us that if we're sick, call the Office of Student Affairs and leave a message for the assistant dean because the school will work with students over missed exams and quizes.

It sucks, but that's what happens with strict requirements like clock hours.

But our instructors set the attendance policy and it is their policy that if you are running a fever, do not come to class. They will consider illness with a note an excused abcense and will work with you to catch you up. We have great instructors and they do nto want to be sick either.

 

[Jinx]

in a saltwater drowning, the lungs fill with salt water which draws blood out of the bloodstream and into the lungs. This liquid build up in the alveoli stops oxygen from reaching the blood
in freshwater, the water filling a person's lungs can enter the bloodstream quickly causing blood cells to swell and burst. Also, the fluid filling the person's lungs will prevent the body from taking in enough air. This leads to cardiac arrest.
freshwater drowning, most likely you will be unconscious by the time heart stops

Beat me to it

 

[mycrofft]

I learned about drownings twice....1972 and 1981


1981: Freshwater drowning=haemodilution with attendant swelling, lost clotting and lost oxygenation. Seawater drowing=haemoconcentration and more fluid in lungs.

1971: in virtually all drownings, two factors apply: even a teaspoon of water will slam the glottis shut, preventing more water (or air)from entering until the central nervous system is so shut down that the reflex is gone; and that since it takes as long for that to occur as brain death to start, most survivors of immersion accidents ("drowning" is literally a death, not a "condition") have relatively little, if any, water actually in their lungs, and that the rest are usually dead, either there and then, or later on. A slim minority fall between the two extremes, especially in cold water-mammalian diving syndrome cases.

Finding water filling the lungs is signifcant for a medical examiner, very significant.

 

[Seaglass]

Not really EMS-related, but I learned that saltatory conduction isn't limited to vertebrates.

I also learned that I'm better at distracting screaming toddlers than I thought.

That's the problem with a strict attendance policy. If I'm sick and I have the choice of:

A: Staying out of class while sick and run the risk of being kicked out for missing too many days.

or

B: Going to class

I'm going to pick B. Considering EMS's general hard on for clock hours and forcing people to sit in the classroom no matter what (note: medical students accross the country regularly skip lecture if they learn poorly in lecture and the average graduation rate for medical students is somewhere in the 95% range), I doubt most instructors would work with someone who is sick, but missed too many days. At my school, it was drilled into us that if we're sick, call the Office of Student Affairs and leave a message for the assistant dean because the school will work with students over missed exams and quizes.

It sucks, but that's what happens with strict requirements like clock hours.

Every school I've attended has been very strict. One of my jobs is too. If we're sick, we're supposed to either trade shifts or just show up and wear a mask. Ignoring the whole contagion issue, it still sounds like a great way to increase patient care errors to me...

 

[Smash]

Great answers regarding near drowning! (Near drowning is all we are interested in; drowning means they are dead)

Not at all relevant, but great nonetheless

In order for alterations in blood volume to occur the near drowning victim needs to have aspirated over 10ml/kg of fluid, and for electrolyte imbalances to occur they need to aspirate over 20ml/kg.

Most near drowning victims aspirate less than 5ml/kg of fluid. If any electrolyte imbalances occur they are likely to be as a result of ingestion of large volumes of fluid, not aspiration.

Near drowning is primarily a problem of hypoxemia and should be managed as such. There may be complications from atelectasis due to aspiration of fluid, however this is unlikely to affect prehospital providers, but rather be a consideration further down the track. This is not to say it will never be an issue, but it is unlikely

By far the biggest prognostic factor for near drowning victims is how dirty the water is. Microorganisms like aspergillus can cause catastrophic problems when aspirated.

The salt/fresh water thing has been discussed for generations, but it is really an entirely academic subject and not really useful to paramedics.

 

[Melclin]

Great answers regarding near drowning! (Near drowning is all we are interested in; drowning means they are dead)

Not at all relevant, but great nonetheless

In order for alterations in blood volume to occur the near drowning victim needs to have aspirated over 10ml/kg of fluid, and for electrolyte imbalances to occur they need to aspirate over 20ml/kg.

Most near drowning victims aspirate less than 5ml/kg of fluid. If any electrolyte imbalances occur they are likely to be as a result of ingestion of large volumes of fluid, not aspiration.

Near drowning is primarily a problem of hypoxemia and should be managed as such. There may be complications from atelectasis due to aspiration of fluid, however this is unlikely to affect prehospital providers, but rather be a consideration further down the track. This is not to say it will never be an issue, but it is unlikely

By far the biggest prognostic factor for near drowning victims is how dirty the water is. Microorganisms like aspergillus can cause catastrophic problems when aspirated.

The salt/fresh water thing has been discussed for generations, but it is really an entirely academic subject and not really useful to paramedics.

hmmm nice. Interesting. Got any resources or articles of interest?

 

[mycrofft]

I learned that the hammer saying is true.

If you'r good with a hammer, every solution involves nailing something. (Or bashing it).

People who work in hospitals then get put in primitive conditions panic if they can't do their accustomed things and are very uncomfortable with waiting. Every pt requires O2, labs, an IV or two, spine board and manual transport to a place the responder feels comfortable in.
Corollary: doctors tend to make either really bad , or really good, EMT's or first-aiders, depending upon their age and background.

 

[mycrofft]

Last drowning shot:

http://emedicine.medscape.com/article/908677-overview

 

[Lifeguards For Life]

hr typically increases by 10bpm for each 0.6 deg celcius increase in body core temp