#paramedicine

[sunbreak-studies]

cardiology readings catch-up 😅 have fallen painfully behind because of clinical placements the last two weeks

[birthmarkedbabyblues]

Listen, I’m not saying Buck was in the right about trying to take the drugs…

But he shouldn’t have had the opportunity in the first place.

It was 👏🏻 INCREDIBLY 👏🏻 IRRESPONSIBLE 👏🏻 AND 👏🏻 STUPID 👏🏻 for Eddie to leave those drugs unattended & the drawer open when he left the ambulance.

It doesn’t matter that it was with Buck. It doesn’t matter that someone else was watching the drawer. It doesn’t matter if it was only for a second.

As a paramedic & a nurse, leaving scheduled drugs unattended & not locked away is dangerous. He could have lost his license if Buck had taken them. He could have been suspended or fired if something happened. He could have been charged with negligence if Buck had taken them & died.

I’m not saying it’s Eddie’s fault, but it’s incredibly stupid that it even happened in the first place.

[ranahan]

Free tactical medicine learning resources

If you want to learn first aid, emergency care or tactical medical care for real, you will need to practice these skills. A lot. Regularly. There’s no way to learn them just from books. But if you’re looking to supplement your training, can’t access hands on training, are a layperson doing research for your writing or otherwise just curious, here are some free resources (some may need a free account to access them).

TCCC

The current gold standard in the field is Tactical Combat Casualty Care (TCCC), developed by the US army but used by militaries around the world. There is also a civilian version of the system called Tactical Emergency Casualty Care (TECC). Training materials, Standards of Care, instructional videos, etc. can be accessed at deployedmedicine.com. You’ll need a free account. This should be your first and possibly only stop.

Deployed Medicine

There’s also an app and a podcast if those are more your thing, although I haven’t personally tried them.

More TCCC (video) resources

STOP THE BLEED® Interactive Course

TCCC-MP Guidelines and Curriculum presentations and training videos

EURMED’s Medical Beginner's Resource List has suggested list of video materials (disclaimer: I haven’t watched the playlists, but I have been trained by nearly all of the linked systems/organisations and can vouch for them)

Tactical Medical Solutions training resource page (requires registration; some of the courses are free)

North American Rescue video downloads

Emergency medicine

WHO-ICRC Basic Emergency Care: approach to the acutely ill and injured — an open-access course workbook for basic emergency care with limited resources

Global Health Emergency Medicine — open-access, evidence-based, peer-reviewed emergency medicine modules designed for teachers and learners in low-resource health setting

AFEM Resources — curricula, lecture bank, reviews, etc.

Global Emergency Medicine Academy Resources (links to more resources)

OpenStax Anatomy and Physiology textbook

Open-access anatomy and physiology learning resources

OpenStax Pharmacology for nurses textbook

Principles of Pharmacology – Study Guide

Multiple Casualty Incidents

Management of Multiple Casualty Incidents lecture

Bombings: Injury Patterns and Care blast injuries course (scroll down on the page)

Borden Institute has medical textbooks about biological, chemical and nuclear threats

Psychological first aid: Guide for field workers

Prolonged field care

When the evac isn’t coming anytime soon.

Prolonged Field Care Basics lecture (requires registration)

Aerie 14th Edition Wilderness Medicine Manual (textbook)

Austere Emergency Medical Support (AEMS) Field Guide (textbook)

Prolonged Casualty Care (PCC) Guidelines

Wilderness Medical Society Clinical Practice Guidelines

Austere Medicine Resources: Practice Guidelines — a great resource of WMS, PFC, TCCC, etc. clinical practice guidelines in one place

The Wilderness and Environmental Medicine Journal (you can read past issues without a membership)

Prolonged Field Care Collective: Resources

National Park Services Emergency Medical Services Resources

Guerilla Medicine: An Introduction to the Concepts of Austere Medicine in Asymmetric Conflicts (article)

Mental health & PTSD

National Center for PTSD

Psychological first aid: Guide for field workers

Combat and Operational Behavioral Health (medical textbook)

Resources for doctors and medical students

Or you know, other curious people who aren’t afraid of medical jargon.

Borden Institute Military Medical Textbooks and Resources — suggestions: start with Fundamentals of Military Medicine; mechanism of injury of conventional weapons; these two volumes on medical aspects of operating in extreme environments; psychosocial aspects of military medicine; or Combat Anesthesia

Emergency War Surgery textbook and lectures

Disaster Health Core Curriculum — online course for health professionals

Médecins Sans Frontières Clinical guidelines

Pocket book of hospital care for children: Second edition — guidelines for the management of common childhood illnesses in low resource settings

Grey’s Quick Reference: Basic Protocols in Paediatrics and Internal Medicine For Resource Limited Settings

The Department of Defense Center of Excellence for Trauma: Trauma Care Resources (links to more resources)

[stupidityismyjobsecurity]

End of shift handoff report

Me: “Some fucking dumbass left our garbage can at [far as fuck away hospital] but other than that It’s got six tires and gas so you should be fine.”

Oncoming crew: “… was it… y-“

Me: “Yes. It was me. I’m the fucking dumbass.”

[sahlosacarver]

Forcefully yanking ‘Take Me Out’ by Franz Ferdinand away from the military propagandists and returning it to the paramedics and ED RNs where it belongs

[jaywalkers]

paramedics and the role of storytelling

people around me tend to find it funny that i'm studying to be a paramedic/working in sar but that my main hobby is creative writing.

but the thing is, they're way more connected than you might originally think. storytelling is a defining characteristic of paramedic practice. 

paramedics (and those in emergency services) are "immersed in narrative" according to timothy tangherlini, who's a folklorist. it's a key part of the work and the environment. among ambulance personnel, storytelling stands as one of the most developed aspects of the occupational culture. it influences how emergency workers cope with the psychological trauma associated with their work; how they interact with the environment and the public, and how they interact with each other, management and other closely related agencies.

 lazarsfeld-jackson, who's done some really cool work on paramedic's oral traditions, also notes that for paramedics/ems, storytelling is a method of /debriefing/. it's informal and a way more to fill time in long hours on a rig, but it's still become part of the job. there's also more to be said about the very cynical, self-deprecating, anti-hero tone of these stories as well as the competition like narrative pool that occurs on stations — "such stories are not fit for public consumption" she goes on to say. 

oral tradition is a HUGE part of wider ems, too. i'm saying this from my own experience — i've been a surf lifeguard since i was fourteen, and storytelling is a massive part of filling time on long days, as well as proving your abilities. it's how we learn from and teach e/o. and it carries on. there's stories from years ago that still get used to teach us concepts and warn us of things, there's always the 'oh i heard about this guy' stories, there's a long, interconnected web of stories in surf lifesaving that's an inherent part of the environment. it's also a more consumable form of lessons for younger guards than the traditional kind. for them, too, telling their own stories is a kind of rite of passage. storytelling plays a role in the formation of identity for ems workers. 

also from a structural pov, those in ems and services are responding to incidents that are constrained, have a defined climax, and have falling action. most of the situations we respond to have a clear narrative arc, which makes storytelling such an easy way of debriefing. 

all that said, because of the nature of the job and the environment, paramedicine and emergency services are strongly connected to storytelling as a discipline for various reasons, and have super strong oral traditions. so it's kind of not strange that i drifted toward it. 

references

Lazarsfeld-Jensen, A. (2014). Telling stories out of school: Experiencing the paramedic’s oral traditions and role dissonance. Nurse Education in Practice, 14(6), 734–739. 

Furness, S., Hanson, L., & Spier, J. (2021). Archetypal meanings of being a paramedic: A hermeneutic review. Australasian Emergency Care, 24(2), 135–140. 

Timothy R. Tangherlini (2000). Heroes and Lies: Storytelling Tactics among Paramedics. Folklore, 111(1), 43–66.

[paraletic-paramedic]

I have nowhere else to put this so here I am screaming it into the void.. BUT AS OF THIS WEEK I AM OFFICIALLY A STUDENT PARAMEDIC WOOP

[penaltybox14]

Erik Koper - Cross for LifeFlight

Welcome to my Cross for LifeFlight Fundraising Page! This summer, I will be swimming a 6.6km "Crossing" to support LifeFlight of Maine, a challenge that will symbolize the difficulties of providing lifesaving emergency medical care to Maine's many island and rural communities. I have selected 6.6 for a special reason: in 1966, the report "Accidental Death and Disability: The Neglected Disease of Modern Society" was published in the United States. This report identified a need for organized, trained pre-hospital medical personnel to treat and stabilize patients on-scene and in transit, and is regarded as the impetus for the creation of modern Emergency Medical Services. Today, trained providers work on the ground and in the air to care for all people who call for help, and are a special and integral part of contemporary medicine. LifeFlight of Maine is a nonprofit organization and the state’s only emergency medical helicopter service. With three helicopters, an airplane and ground ambulances, LifeFlight brings ICU-level care directly to the patient. Last year, LifeFlight cared for more than 2,300 patients. People who live in Maine and people who visit Maine—including me—depend on LifeFlight to be there for them. I’m comforted to know that they’ll be there for me, and for my friends and family, should the unthinkable happen. Since 1998, LifeFlight has touched the lives of nearly 33,000 critically ill and injured people from nearly every community in Maine. I’m going to make my crossing to support this important cause. Won’t you support it, too? Just click on the “donate” button. Any amount is greatly appreciated. Thanks so much for supporting my efforts, and mostly, for supporting this critically important service.