Thursday, March 22, 2012

Medical Videos

Interesting resource. A blog of medical videos. Some live, some animated.

They didn't work for me using Safari, but did with Firefox, so be warned.

The one I watched (the cardiac cycle) was not great, but might have a useful bit in it. I'm most interested in the site because it is actively updated, meaning more videos are added. Something to keep an eye on.

It also suggests to me that there might be other such sites out there.

Wednesday, March 21, 2012

Albany Med EMS Outreach

Loving the folks in Albany today!

First, this morning they announced the schedule and topics for their EMS day during EMS Week.

May 22nd, register by May 11th.  $10 pre-registration fee.

The Difficult Patient
Brain Injuries from Sports
Trauma Case Scenarios
Live Cardiac Cath
Airway A&P

E-mail Art Breault at or Jessica Weir at for more information and/or registration forms.

And if that wasn't cool enough, this evening, they posted a link to join in a live EMS lecture on Toxicology, which was very interesting. They invite folks to join in these lectures every week- like them on facebook to get the announcements and links.
If you want, you can get CME credit for the lectures.

Saturday, March 10, 2012

A Case of Nerves

Practical Exams.

Why is it that nearly everyone gets nervous?

For my first practical, back in my original EMT-B class, I was very well prepared. I had excellent instructors, and ample time to practice. We went through the stations the day before, to get accustomed to the format, and have a chance to go through practice scenarios. It went very well.

In particular for the medical assessment, it went like clockwork. I walked in, was totally relaxed, went through the scenario without hesitation, without missing a beat. It felt great!

The next day, the medical assessment was the fourth station I did.
I walked in, and the moment I walked through the doorway, my mind went completely blank.

I took a few deep breaths. Took a few more.
I ended up doing just fine.

The next time I went through a practical exam, I had prepared extensively on my own. I went through each station in my head. I focused my practice on going through the station the same way every time.

When the day came for the actual exam, I started out the morning feeling okay, but as the day went on, I was more and more stressed. There was no particular reason, but there it was. I noticed everyone else was reacting pretty much the same way. The relief at the end of the day, when I passed everything, was tremendous.

Since then, I've talked to quite a few people during the time they were studying and practicing for their practical. Nerves seem to be pretty much par for the course.

But why?  Why is that?

Most people I know have been well prepared, and I know that they know the skills. Any trouble they have with the exam itself is more from the STRESS, than from anything else.

One could argue that we often need to perform skills in stressful situations, so duplicating that for an exam is a good idea. But I don't think it's really done on purpose. I think the way it's designed, we should all feel confident and prepared and float through it, no sweat.  But from what I've seen, most people don't.

Maybe it's simply that it's so important to us.

Thursday, March 8, 2012

Pertussis on the Rise

News articles are saying that pertussis is becoming more common.  Most articles urge people to get their children vaccinated, but most current information also says that the vaccine is not 100% effective, and that it wears off, so most people over the age of 18 are not immune, even if they were immunized as children.

I went looking for information about pertussis that might be helpful in the field. We aren't going to be treating it, but it would be good if we could recognize it, in order to both get that information to other healthcare providers for our patients, and to protect ourselves and therefore our families.

First, there is a page that has an audio file, so you can recognize the characteristic "whoop" of the disease. That said, it's important to know that not all patients will have that symptom. Once you hear it, you won't forget it. If your patient sounds like that, it is a near-definite diagnosis, but if they don't sound that way, you won't know if they have pertussis or not.

The CDC has a whole section about pertussis, and Wild Iris Medical Education has a Pertussis CME class online. You can read through the class for free; it's $6 to take the test and get credit. Both of those have an extensive list of references and resources.

Medscape also has an overview of pertussis information.

Hopefully, you won't run into it in the field, but as the number of cases rises, it's always possible.

Wednesday, March 7, 2012

The End of the Search

The search was called off yesterday afternoon, when they found her body in a field not far from her home.

Alzheimers Association on facebook

Alzheimers Association CME videos

Medscape's Alzheimers Disease CME Learning Center

Alzheimers Disease Information Center

Alzheimers CME
For MDs and nurses, but the information is still valuable

I sincerely hope this never happens to anyone again.

Monday, March 5, 2012

That Search Story

We were out searching for a missing elderly woman.

Our search team was four people, and the area we were assigned to search was fairly large, so we split into two groups of two. Mostly, we were walking along a little used road, searching fields, ditches, and some woods. It was several hours past dusk, so we were working with flashlights and occasionally, vehicle lights.

However. There was a complex of buildings that were in our area, too. One building had signs on all the doors, indicating it was unoccupied and unused. The entire complex had been "abandoned" a few years back.

My partner and I had the buildings to search, so we split and went around each one, one going clockwise, the other counter-clockwise, until we met on the opposite side.  Most of the buildings were, in fact, abandoned and locked up tight.

But not all of them.
On my search, I found an open door.
It opened into a boiler room. They were working, and the small room they were in was very warm. Nice, considering it was cold and snowy outside. A perfect place for a missing/lost person to get in out of the weather.  The problem was that the boilers sat in the middle of the room, and I couldn't see all the way around them. I didn't want to go in the building by myself to check around the other side, without my partner knowing where I was. So I didn't.

I continued on around the building until I met up with him, reported what I had found, and we went back to the open door.

On the other side of the boiler was another door, one I hadn't seen. It was labeled "Lady's Room" <sic>. Kind of odd, for a door leading out of a boiler room.
We opened it.
It was, indeed, an old (but apparently no longer functioning) restroom. With lockers.
And another door.
My partner searched the rest of the bathroom, while I opened the door.

The door opened into a hallway leading to the rest of the very large building.
All I could see from where I stood was a long hallway in one direction, several connected hallways the other direction, and lots and lots of open doors.

I chose to do a right hand search; my partner took the left hand search.

And that is when things started to get weird.

Down my hallway, the rooms were all very similar.
Not being used, but not empty, either.
Each was about ten or twelve feet square, with no windows. Most had utility sinks. A couple had desks, some had lab cabinets and counters. Most had various containers and junk scattered around.
As I continued down the hallway, the last several rooms were empty, and had some sort of exposed pipes. Gas pipes? Water pipes?

As I reached the end of the hallway and turned around, I saw a sign. There had been no signs going the other direction, but if I had come in the door at the end of the hallway, I would have immediately seen the sign that read "Infectious Agents. No children or pets past this doorway."

Crap. What does that mean?
And why did the very next room have a desk with a gas mask on it?
And the next, some sort of stainless steel tables, and a bunch of oxygen bottles? Blood stains on the floor?

What IS this place?

I met back up with my partner, and told him what I had seen, and that I was kind of creeped out. We had been in the building maybe 5 or 10 minutes, out of communication with our other pair. When we not only saw more hallways full of doors, but a door that opened to stairs, we decided to get outside, find our other team, and finish the search as a group.

They met up with us as we walked out- they had tried to reach us by cell phone, with no answer. No cell signal inside the building. We gave them a report, of what we had done so far. The crew chief called in where we were and that we would be investigating, we went back in, and split up the rest of the building.

My next find, near the base of the stairs, was the first aid station, with the MSDS sheets for all chemicals in the building, and a box on the floor labeled "Emergency Kill Box." There were containers with kits in them that looked to be atropine. (Surely those rooms weren't set up to... gas the occupants??)

The last room was a kitchen and laundry area, with refrigerator and washers and dryers still in place, but not connected.

The whole place looked for all the world like something out of a horror or disaster movie, that had been abandoned in a hurry, everyone just up and leaving. I half expected to find an unfinished plate of food still on the counter, or a television that was still on. I was imagining the Andromeda Strain. I was picturing clandestine operating rooms for illegal human organ trafficking.

It was creepifying. Seriously.

Dark, silent except for the hum of the boilers, and the footsteps of people going room to room, searching. Lit only by flashlights. (Didn't even think of trying a light switch! For all I know, the power was on.)

Clothing on hangers and in piles, left behind. Printed out e-mails taped to the wall behind a desk, as if someone had worked there only yesterday. Painted cinderblock walls, and glossy painted floors, all the easier to wash clean with a hose, if need be. But nothing, anywhere, alive. In the middle of the night, it doesn't take much to get the imagination going.  I had the feeling that if we went back later, it would all be cleaned out, nothing left behind, no evidence of... whatever went on there that no one was supposed to know about. Right out of the X-Files, or the Twilight Zone.

The truth is, we knew what the building had been. A research lab that had closed a couple of years earlier. No big secret.

But if I ever wanted to film a horror movie, I know where I'd go. It was PERFECT. You could almost hear the soundtrack.

Looking back on it a couple of days later, I wish I had put the gas mask on, wrapped a coat around myself, and jumped around the corner to scare the crap out of my partner. He was making fun of me for being creeped out.

He said it was good that I didn't, because he might have called a Mayday before recognizing me. I asked him what he would have said. Name, yes. Location, sure. Problem and resources needed?

He said he would have said "Being murdered."

As creepy as the place was, I wish we had found the missing woman there.
We didn't.
She still has not been found.
It doesn't look good.

Sunday, March 4, 2012

I Haven't Disappeared

After posting every day for three months, suddenly I've missed several days in a row.

I have a ton of things to write about from EMS Today.

I had planned to start writing about them today, but the world had other plans.

I've spent the last six hours out in the cold and dark on a search. No luck yet. Home to get some sleep, and then we'll be back out there in the morning, if the over night crews don't find her.

I have a story about the search, but I'll have to write it later. We found the perfect horror movie set!

Thursday, March 1, 2012

Here We Go

About to head out the door to go to Baltimore.
Yesterday's crazy weather seems to have subsided. Started out with snow, progressed to ice, and ended with a huge thunderstorm.
Now, it's... dark. Very dark.

Planning to make the best of the next 48 hours or so. We printed out schedules and maps and directions.

Decided, based on an unfortunate experience out of town last year, when my car was broken into, not to take anything with us that we wouldn't want to carry around all day. Which means I'm not taking the laptop.

Which means that at the premier blogging event of the year, I won't be able to post.

I'll make up for it when we get home. Once I catch up on some sleep, that is.