Monday, November 29

t-day and stuff

Sorry for the delay in posting. Been crazy busy…

Just got back from medic class. Spinal trauma. Whoo Dog!

The lecture for medic class last Wednesday went well (according to my fellow students and the instructor who sat in on it), though I wasn’t really happy with it as I was a bit rough in a couple spots. Doc Shazam (see Mr. Hassle’s Long Underpants link at the right) suggested that maybe I should farm out some of the trauma part due to my lack of experience in that area. If such a person existed around here who was willing to do it, I am sure they would have been asked already. Doc, I have been to lectures aimed at medical students and MDs (both at Hopkins and NIH) and I likely have an understanding of the types of lectures you attended (and continue to attend) to learn your craft. Pre-hospital care teaching, at least where I live, is VERY, VERY different (sadly). Most of our lectures stick with the state outline for the class (the state effectively mandates what they teach) and re-cover what was in the text point-by-point. I tried to do you proud (for example, I talked some about the “sweat spot” in terms of CO2 and O2 concentration and the adverse effects that can come from hyperventilating our brain damaged patients), and the fact of the matter was that I did a better job on that lecture than the alternative (his claim, not mine, though I believe him). Is that sad? Maybe. There is considerable “cognitive diversity” among the students in my class (and providers in the field), an unbelievable amount compared to a class of 1st year medical students. Maybe the modal teaching style in EMS is what it is because of this. In any event, I did much more than give them an “outline” lecture, and I am certain I did not misinform them while I tried to make an interesting and and important contribution to their understanding of the brain and field management of head and brain trauma.

T-Day itself and surrounding days were good, though my wife and son were wicked sick with hand, foot and mouth. It hit them harder than me and they were both miserable for a while, and any of you with a significant other and kids knows how that pain can be spread around so that EVERYONE feels it, sick or no.

Ambulance calls I remember (with the students gone, I took a lot of call):

90’s female – Possible Transient Ischemic Attack (ministroke). Memorable to me fore two reasons. First, she went from not being able to talk or move her right arm and leg to doing fine on the Cincinnati Stroke Scale within 20 minutes. Second, the third sentence out of her mouth when she could talk again was “BASTE THE TURKEY”. I’m not kidding.

80’s male – Respiratory distress secondary to cardiac event (at least that’s what I think it was…) Walked in to see a patient that makes you go, “OK folks, TIME TO GET GOING”. His pulse ox was 82 ON his home oxygen. We did not stay long.

Male with injuries from a fight. Both eyes swelling shut, split upper and lower lips, typical deal EXCEPT for the neck pain and “Buzzing” in all four extremities. Caught my attention, that's for sure. Collar wouldn’t fit around his neck (think of a VERY short neck the width of which is equal to the thickest part of a basketball) so we used the rolled up towel trick for head and neck stabilization. Board, blocks, and trip to the hospital (took help from the firefighters to lift this guy into the rig). I never did see the size of the guy who whacked our patient, but he must have been HUGE.

70’s female with unilateral weakness and “I’ve fallen and can’t get up” syndrome. Memorable as when I told her what her blood pressure was she said, and I quote, “it must be up because I have my hand on your leg”. And that, ladies and gentlemen, is the most action I got all weekend.