Earlier this week I was honoured to be able to chat to the designer of the fantastic ECG Quiz that took the #FOAMed world by storm, Christopher Watford.
So a few weeks ago I was called to attend a car crash. A male had been seen driving at high speed in a high end sports car, before apparently suffering from an acute loss of talent. This resulted in him losing control, spinning out, bouncing off several curbs (which left his wheels pointing in 4 different directions – sub-optimal in terms of cornering performance I believe) before coming to rest in a fence. Witnesses then watched as he climbed out of the window, ran across the road, climbed a 2 meter high chain link fence and legged it through industrial inner west Melbourne (no idea why, I’m sure he was the lawful owner of said car…) Whilst admiring the athletic ability of the now absent “patient” I felt no need to remain at scene and instead raced off to
palliate resuscitate a 97 year old nursing home resident who had abruptly and unexpectedly succumbed to one of the 8 different listed terminal medical issues she had (sadly I was not successful: my necromancy clearly needs some work)
I have a bit of a love/hate relationship with ECGs. I find them very interesting, but I despair of how poorly I learned how to read them in my early career (pattern recognition anyone?) I therefore spend a lot of time being terrified that I am missing important, but subtle findings.
Fortunately a US paramedic Christopher, from Wilmington, North Carolina is on hand to remind me of just how hopeless I am! Christopher is a computer programmer by day, paramedic by night, and is a bona fide ECG guru. He blogs at Paramedicine101 and My Variables Only Have 6 Letters and is very active at EMS12Lead.
If you’re a paramedic pretty much anywhere on this planet, you’ve almost certainly got a booklet/app/eight-volume encyclopedia that is you prehospital bible. These are your clinical practice guidelines, or whichever nice name your service gives them. I’m very happy that ours are called guidelines, and we’re told they are just that. That’s all well and good, until of course you deviate from them, in which case you find out very quickly that they are in-fact protocols.
As all Ambulance Victoria paramedics will be aware, the Mental Health Act governing our actions in relation to the care of patients with mental health issues, changes on the first of July this year. Changing an Act of parliament, particularly one as far reaching and dealing with such sensitive issues as mental health is a major undertaking. Fortunately my friend Alan has been involved in this process and is able to give us a good run down on the changes and how they will impact upon us. Alan also provides some invaluable commentary on specific parts of the act that will be of special interest to paramedics.
For those who do not know Alan, he is perhaps the only person I know who out geeks me in terms of his passion for prehospital care. Unlike me however, Alan uses his powers for good, not wittering away on the interwebs. Alan is indefatigable in his pursuit of improving the care of patients and is active in many different areas of professional development of prehospital care providers.
Be warned, this is a very large post, as it must be to cover the pertinent changes to the act. Nonetheless it is important for paramedics to have a good grasp on what is changing in an area of prehospital care that takes up a very large part of our time and energy, and that many of us find challenging.
(There may be formatting errors in this post from me transcribing it to the web. These are my fault, not Allan’s)
Today’s post is a little different from some of my others – today I’m asking you, the readers to tell me what you think. There is no right or wrong answer to this problem but I’d be keen to know how other paramedics and student paramedics have tackled the problem and what their thoughts are.
One of the big issues that anyone producing FOAMed runs into at some stage is the cost of “free”. Of course nothing comes for free and to produce any kind of FOAMed (even of the level I do!) requires a sometimes substantial commitment of time. As a result posting can be a bit sporadic. I would like to think that I am the EMS equivalent of Reuben Strayer from EMUpdates, who doesn’t post often, but what he does post is gold. I am of course kidding myself, so I am pleased to announce that I have taken on some hired help to raise the tone of the joint.
My friend Minh from the PHARM blog has been hit hard by the news of a ketamine shortage. I haven’t the wherewithal to set up a benefit concert for Minh, but the least I could do was record this number to help ease his pain (although in a way that ketamine never could)
Hang in there brother!