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Of Classrooms, stairchairs and 'Saved' [September 13, 2006 @ 11:00pm]

Sorry for the delay in posts...the first week of school has been a lot more hectic than what I anticipated. However, that being said I wouldn't trade it for the world, it's been a great week so far. Let me elaborate.

I managed to get moved in and my wonderful and loving boyfriend helped me get all settled in to the house that I am living in (on a quick notes my roommates are a pharmaceutical student and a dental hygienist). Went out for dinner at Swiss Chalet before he had to go back home and leave me here to officially start my journey as a paramedic student. I got all my textbooks in order (a whole $900 worth) and started to get things ready for school. 

So far things have been a bit of a review. Been working out quite a bit at the gym to get strong...like they say, it's not the normal people that get sick, it's the overweight ones. So I can't count on all my patients being 120 pounds on average. Nope, I'm going to assume that average will be about 250 - which to be honest, for a 5'2'' 118 lbs person is a lot to deal with. Speaking of which, I had my first experience with a stairchair today. That was quite the venture. Being the person on the bottom of the chair going up a set of stairs was fine, that didn't create a problem for me. But let me tell you...put me on the back of the stair chair when we are going up stairs which gives me all the weight and I'm in trouble. Definitely have to get into the gym and practice some of my dead lifts with the barbells.

And on my final note (you were expecting this to be longer..weren't you?? Admit it) I watched the premier of Saved tonight. Its a show about a paramedic named Wyatt Cole (Tom Everett Scott) who is a great paramedic, but has a not so great life. Anyhow, I have to say that parts of it had me cracking up but others had me really thinking about what I was getting myself into. You're always going to get calls that hit you hard. That little boy who was abused or the parent wanting you to move heaven and earth in order to save her child that was hit by a drunk driver. Still, I wouldn't change it for the world.

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Trauma Kit 411 [August 29, 2006 @ 12:29pm]

Because I'm a member of St. John Ambulance I've decided to start my own trauma kit. If I'm going to be using it, I might as well have my own so that I know where things are, I know its stocked and I can keep it on me at all times. A lot of people use the common trauma kits and you can't always guarantee that they are properly stocked.

I bought a bag from Pacific Safety (the A600 Comprehensive Trauma Kit) which is apparently one of the best bags out there and made sure it had room for a D size oxygen tank when I decide to put one in. I'm starting to get it pretty much stocked now, but there are a few things I need to get still.

- Oral and Nasal airways
- Paediatric Blood Pressure Cuff
- Oxygen Tank and Regulator
- Suction (Manual)
- Saline Bags (Great for Irrigation)
- Sting Kit
- Nasal Cannula
- Partial Non-Rebreather

So as you can tell I'm pretty much getting there. I find it funny through I already have an Adult and Child/Infant Bag Valve Mask without the oxygen tank or even airways! Yes, I know, shame on me for not having airways yet. For some reason I keep forgetting them. If anyone knows of some great things to keep in the trauma kit (aside from basics of course) let me know!

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EMS Food for Thought [August 27, 2006 @ 11:28pm]
[ mood | curious ]

I was checking out my textbook for class today (Mosby's Paramedic Textbook: Third Edition) and happened to notice a section with landmarks in the development of emergency medical services. Reading through it I thought some of them were pretty neat, while others were irrelevant as I am a Canadian and it is an american textbook so some of the advancements are american only. But less talk, more food for you.


+ 1958: Dr. Peter Safar demonstrates the efficacy of mouth-to-mouth ventilation
+ 1960: Cardiopulmonary Resuscitation is shown to be effective
+ 1967: Dr. Eugene Nagel trains Miami firefighters as paramedics at the University of Miami School of Medicine
+ 1973: The star of life is adopted as the official symbol for EMS. The six blue bars of the star of life represent the six systems of function of EMS: detection, reporting, response, on-scene care, care in transit and transfer to definitive care.

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The Torture of Textbook Purchasing [August 25, 2006 @ 1:13pm]
So I've got all but one of my textbooks for the September semester and I have to say - they are bloody expensive! Two of my textbooks cost over $200 a piece while even something so simple as my physical education book was $99. I'm almost certain now that I will end up spending almost as much money on textbooks for a year as I do for tuition. That's just...absurd. The total I have spent on Textbooks so far this semester has been $668.48 and I'm still a medical dictionary short. 

All I have to say is that I sympathize with anyone else who has to pay just as much for textbooks. Even buying used textbooks when you can isn't a cheap venture either. But of course me being me, I wanted all new textbooks so I knew the CD's that come with them are in perfect condition as well as there being no marks at all inside. I plan on keeping these textbooks for a long time...especially after spending as much as I have.
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Push Hard, Push Fast - CPR Guidlines [August 25, 2006 @ 12:08pm]

So anyone in the first aid field knows about the new CPR Guidelines which is a huge change from what they used to be. Some of it seems to be a good idea, but other things I'm not so sure about. I mean, the whole change is great if you are learning CPR for the first time or may not use it often (if at all ever) but for those of us in the medical field I feel it could mean less care for our patients. 

For those of you who haven't heard, here is a brief overview of the new CPR changes to the protocol as well as changes to ECC.

- 30:2 is the new compression to ventilation rate (changing from 15:2 for adult) and will be used for adult, child and infant
- No pulse check once you have established there are no respirations
- Five cycles should be completed for infant and child CPR before calling 911
- One second breaths
 - Nipple-line landmarking for child and adult
- Compression Depths
- Head-tilt chin lift for spinal victims (was modified jaw thrust)

I'm sure there are a few more but this is just what I am coming up with off the top of my head. Now like I said, there are some things I don't agree with if you are more trained then your average person who may never use it. 1) No pulse check and 2) Head-tilt chin life for spinal victims. I mean, what? How hard is it to take 10 seconds and establish a pulse or do a modified jaw thrust. If you have a bit more of an education, use it! Then again if you like me and A-MFR trained you could just drop an airway adjunct in to your spinal victim and not worry about too much of a head-tilt chin lift.

Such is life I guess.

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We are NOT a Band-Aid Brigade [August 22, 2006 @ 10:48am]
[ mood | aggravated ]

So here's my rant for the day, and it comes from what several people that I work with at my night job have said to me. Once upon a time St. John Ambulance had a reputation for being nothing more than a band-aid brigade. However, like almost everything else in this day of age, thing evolve. We are not even considered to be a brigade anymore but an emergency medical response team!

Anyone who volunteers (that's right, we don't get paid either) their time with St. John Ambulance is required to take their Advanced Medical First Responder's course in order to even be able to touch a casualty. This is an intense two week course that teaches you more advanced skills and gives you a higher education than someone with only a Standard First Aid certification. Also, as an Advanced Medical First Responder we are considered to be part of the EMS system. That's right, we are considered in that category along with police, fire and ambulance. But back to how this involves St. John Ambulance...

We are a volunteer organization that provides first aid response at events (sporting, fairs, carnivals, concerts, events) because you can't guarantee that paramedics can be there 24/7 since they are on call and have to respond to other things in their area. We are trained to insert oral and nasal airways, use SAEDs and oxygen, collar and board spinal victims..etc. We are constantly practicing our skills and using them properly when needed. We are the bridge between the incident and arrival of the ambulance so that it cuts down their time and allows them to get the patient to the hospital as quick as possible. 

We need to work as a team and not ignore one another! Yes, we at St. John Ambulance realize that paramedics have more training than us - two to three years of schooling to be exact - but that does not mean we don't know what we are doing. I find nothing more frustrating than when paramedics arrive on the scene and completely ignore the advanced medical first responder and anything they have done. 

Now, I know someone is going to call me on this, so I shall deal with it now. Yes I know that paramedics have their own protocols to follow and that they may end up re-doing a splint we put on or changing airways and that's fine. In this field you really need to cover your ass. This is not what I have a problem with. But at the same time, is it really that hard to listen for a few seconds while we give you a quick history on what has happened, what we found out and what we have done? This information could be of use to them. Hell, even a thank-you would be nice to hear.

However, people I know and work with seem to think that just because we aren't getting paid and don't have the schooling behind us gives the paramedics permission to ignore us completely. That we are just doing kid's stuff. In some sick twisted way I hope that if they ever have a medical emergency it is in a place where St. John Ambulance is on site for duty that way they can see just how skilled we really are. 

On another note, I don't imply that all paramedics act this way either. I happened to be blessed to volunteer in a community where there are quite a few paramedics who know how serious we are about what we do and how accurately we figure out the problem and deal with it. If they notice something isn't quite right, then they tell us and help us correct it for the next time. If they notice something done well, they compliment us. Hell, even a time or two we've done stuff that they sit back and watch how we do it just to see a different technique. This is the way I like to see things happen! It's not about who has the better education or who gets paid...it's about working together as a team to get the best done for the patient!

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To Save or not to Save? [August 21, 2006 @ 9:10pm]
[ mood | confused ]

Here's the dilemma, I'd like to know what your opinion on what you would do in the situation.

I was talking to a co-worker of mine who happens to ride motorcycles. He was talking to me about how he had been told once upon a time that if there were a multi-casualty incident he would be one of the last people to be checked up due to his helmet (It is a full face motorcycle helmet). We got into talking about how it takes two or more rescuers depending on the helmet to take it off if needed. My co-worker then brought up his concern about becoming paralyzed if it wasn't done right and how some people he knew were now wearing stickers that say "Do not remove unless by medical physician" 

So, the question of the day is, if the person is unconscious do you save them no matter what or go by what is written on the hemlet as it is a refusal from the person. 

I know that protocols around here say that you don't go by DNR's you just save the person and let the hospital deal with the situation after the fact...so one would assume you would follow the same criteria when it comes to helmet....right? Also, you could have scenarios where the victim was using someone else's helmet and would want you to save them. Of course, if you took the word of the sticker, you wouldn't be able to help them and they could possibly die. 

See the dilemma?

What are your opinions on this? I've asked a few people that I know about what they think and I've heard different things so I'm interested in hearing the opinions of other people.

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A-MFR From Class to Reality [August 21, 2006 @ 3:34pm]
[ mood | pleased ]

A little background information for those of you who do not know. The A-MFR is the Advanced Medical First Responder course offered through St John Ambulance. It is higher than what is considered your Standard First Aid Course and allows you to insert oral and nasal pharangeals as well as use oxygen and a SAED (Semi-Automatic External Defib). It is a two weekend long course and was required for me to continue to be part of the St John Ambulance Emergency Response Team. 

A few weeks ago, I finally had the opportunity (which is a good thing, but a bad thing at the same time if you know what I mean) to put my skills that I learned in the classroom to work. This was my first bite of the on scene life and I have to say, I loved every moment of it. I now have no doubt in my mind that I am destined to become a Paramedic. This is the life that I want.

Onto the scenerio. My partner and I were working a sporting even when one of the head co-ordinators came rushing over to us explaining that we had a player down. Immediately I grabbed my trauma bag and was on my way over by foot while my partner started the ambulance so that we would have the additional equiptment if required. 

Arriving on scene I found myself coming up to a girl who was complaining of a sore neck. Apparantly during the game she had been hit by another player a suffered from a "whipping" of the neck as she described it (think of the whip lash you get when in a car accident, it was pretty much the same thing). She was sitting down in a chair, though I was somewhat annoyed that they had moved her around before I showed up, and since I'm trained to suspect a spinal injury in that situation and she was complaining of a sore neck I had someone come over and steady and support her head for me. While my partner was bringing the rig over I made quick work through my primary survey assesing her breathing and circulation and took a quick history having yet another bystander record down the information for me to later fill out in my report.

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Every New Beginning Comes From Some Other Beginning's End [August 21, 2006 @ 1:51pm]
[ mood | anxious ]

At first it was life guarding, from there it was St. John Ambulance and now my friends it comes down to this - my journey to become a Primary Care Paramedic. It is my hope that through this journal I can document my journey through all the highs and all the lows that I will experience through my education and career. I want to share with you my experiences as I grow with success and learn through failure. 

I have been accepted to a school in Ontario, which one I will not disclose, and am set to start September 5 2006. In two years time it is my hope to graduate from my program with honors and successfully write and pass my A-EMCA testing in order to become a fully qualified Primary Care Paramedic (PCP). I will be living with two roommates which will a whole new experience for me as well. The curriculum for my course includes theory, skill practicing and actual ride alongs in an ambulance with a paramedic company.

It is my hope that other people in the field as well as those interetested in becoming a paramedic will be able to share their own stories and communicate through this journal is correspondance to my own journey. But for now I shall leave it at this.

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