Needle Chest Decompression

A tension pneumothorax is an immediately life threatening injury. In the hospital setting, placing a chest tube is the definitive treatment. It requires a scalpel and is a surgical procedure. In the field that is not possible, so EMS providers have been taught to use a needle instead. This approach has some limitations. You need a longer than typical IV needle to reach the plural space on a large patient. The catheter sheaths on an IV needle are soft because they were designed to ride in a soft vein. They are prone to kinking and collapsing within the chest wall musculature. More

Muriel Battle High Opened

Today a fourth High School opened in Columbia, Missouri. Muriel Battle High is named for a friend of my fathers and a personal inspiration to me.I first met Elliot & Muriel Battle when they came to our house for dinner when I was maybe 5 or 6 years old. At the time Muriel taught at Douglas High School, which was the black school.

The Battles are a black family and mine is very pale. It was a huge bold move of our parents, but to all the children at the time it seemed pretty normal. I remember being more nervous about how pretty the Battle girls were than about the “race-mixing”.

After integration Muriel worked in the Columba Public Schools. She was a major influencer of my life. Maybe even more so was her husband Elliot.I never knew anything else. We had a big family, and so did they. My parents were teachers, and so were theirs.

Elliot Junior was just plain cool. He was the baby, and life of the party. He was always the entertaining kid in the room of near-genius children. Now he is a famous dermatologist in Washington, DC. Ask me if I am surprised.

Muriel cared about one thing, kids doing good. She allowed and encouraged children to define doing good in their own way. Then she challenged them to meet their own expectations. She was a powerful motivator and agent for personal change.

She was always less interested in creating a box for you then helping you define your own personal sphere of influence. She made circles out of boxes. It was brilliant and decades ahead of it’s time. She was Michelle Ree 3 decades before she was born.

Today, I am so proud to have known Muriel Battle. I’m even more proud of my dead father. He looked past color to see people for what they were in a time when few other white men did.

He knew who was going to be the important people. He knew Muriel would be on Wikipedia, 50 years before Wiki even existed. 
http://www.connectmidmissouri.com/news/story.aspx?id=904960#.Ua1Nq2RASIk

Later in Life, I was exposed to Racism. It had trouble-taking root in soil tilled by the Battle Family.

Today Muriel Battle High School Opened to 1,200 eager new students. They get her legacy. I was luckier, I knew her.

 

Update; one week after cutting the ribbon on Battle High, Eliot Battle, Muriels husband has died in an accident. One week.I am overcome with deep sadness. http://www.columbiamissourian.com/a/162756/eliot-battle-columbia-educator-involved-in-desegregation-dies/

This headline is inaccurate. He was not involved in desegregation. He did it, almost singlehandedly.

B2 Paramedic Helmet Review by Tom Little

I was asked to provide a review and evaluation of the B2 EMT-1 helmet.  When the helmet arrived it was packaged in a nicely constructed cardboard box with padding inside to protect helmet during shipment.  It was enclosed in nylon bag for storage.  The helmet required no assembly and was ready for wear.  The clear adjustable visor had a protective cover protecting it from scratches.  The helmet comes with a ½ inch reflective band that encircles the helmet along the bottom edge.

Inside the helmet is a 1 ½ inch band of protective cushion attached to the helmet.  The interior top has a mesh pad with additional cushion in the very top.  To wear this helmet, it fits sung and very comfortable.  The helmet is lightweight and weighs just at 2 pounds.

I have a particular interest in EMS safety and specifically provided all my employees with safety helmets in the 1980’s.  They were to be worn anytime the vehicle was in emergency mode or while attending patients in the back.  Although it wasn’t popular then, after several accidents, staff who should have sustained critical head injuries were able to walk away uninjured.

Now 30 years later the discussion surfaces again.  In the NAEMT Safety Course, class participants are asked to think about the advantages of wearing helmets while in the patient care compartment.  We often think when an aero medical medic is mandated to wear a helmet; we think it is pretty cool.  When fire fighters wear helmets while responding to a scene, we think it makes sense.  So why when we talk about ambulance personnel wearing helmets, it is dumb?  This helmet is stylish and professional looking. Plus it will definitely save your head in case of some type of impact.

I continue to be surprised how many people in EMS ride motorcycles.  The numbers are far more than most would suspect, so I’ve been asked, “if I get one of these helmets, can I also wear it as my motorcycle helmet when I ride back and forth to shift?”  Absolutely!

The helmet is DOT Certified (FMVSS No. 218).  Since I am a motorcycle rider, I took this helmet out for a ride.  Although the clear adjustable visor shield is generally in the up position, I found at highway speeds the visor did not vibrate or fly off!  In fact, if you are one of those people who do not wear glasses, this shield in the down position for night riding provides ample protection from eye injury.  There is almost no distortion in the down position and produces no noticeable headlight glare.  It easily adjusts up or down while riding.

I don’t normally wear a full face helmet so I found this helmet to be comfortable and just the way I like wearing a helmet.  In fact, during a stop for fuel and refreshments, I placed the helmet on the seat and the wind blew it off onto the ground.  There were no noticeable scuff marks that usually accompany this action.  This is a quality helmet and is constructed well.

In summary, I will be taking this helmet with me to my NAEMT Safety Courses I teach and encouraging the participants that helmets have a definite place in EMS with an example to show them.  Good luck and stay safe!

More Information 
http://headprotech.com/

Thomas Little is an EMS Consultant.  He has been licensed as a EMT-P since 1975, is certified as an Emergency Manager (CEM) in Missouri and an Affiliate Faculty for the NAEMT EMS Safety Course.  He was former owner of Medevac Medical Services, Contractor for MAST in Kansas City and former AMR V.P.
http://www.linkedin.com/pub/thomas-little/13/a7b/235

Ultimate Online Paramedic Refresher

DistanceCME.com is a great online training site. I have taken the EMT-P refresher class and really enjoyed it. It was one of the best of the 10 or so EMT-P Refreshers I’ve ever taken in about 35 years of EMS.

Ok, I’ll admit it. I have been in EMS do long I don’t really remember how long anymore. I don’t even know how many of these courses I’ve been through. Yes I could probably pull out my old certs but the truth is I’m enjoying the ambiguity. When you cannot remember how many times you have done something, you have probably done it a lot.

DistanceCME.com provides live distance learning courses, designed to provide high quality and convenient education for the busy EMS professional. Our classes meet the NREMT’s requirement for live learning. 100% online, 100% live.

Most courses on the web are pre-recorded and count for no more than part of the required hours toward your re-certification. At DistanceCME our Refresher Course is live and interactive. It not only meets all didactic requirements, it’s actually fun.

Imagine a program where everyone can interact with both the other students and the instructor. It’s just like a brick & mortar class, only on your sofa or in your bunk room. No more driving, no more lost work hours that really make you pay twice. I’ve even been in classes with SSM Medics, taking the class while sitting on a street corner post with their smartphones.

All 48 online hours can be applied toward your National Registry re-certification. This is the ONLY place on the web where you can find a live course taught be real live people with the true flexibility of scheduling to meet your busy schedule. For more information e-mail me at dwhite@distancecme.com. For details of my personal experience in the program check out my review here. 

Translation Tools for EMS

One of the biggest challenges in EMS is communicating with people and patients who do not speak English. A language barrier can be an enormous problem preventing accurate assessment and good quality care. Fortunately, we have some good solutions in three basic flavors. Continue

New Junctional Tourniquet by SAM Medical

There is a new high-tech tourniquet from SAM Medical. SAM is famously known for their SAM Splints, SAM Chest Seal, CELOX Trauma Gauze, the SAM Pelvic Splint, and other great EMS products.

The SAM Junctional Tourniquet or SJT does things no other tourniquet can; it occludes the femoral artery in the inguinal area at the junction of the torso and legs. When blast injuries take off legs like in Boston and every day in combat zones, it can easily be fatal. It is frequently difficult if not impossible to stop the bleeding in time. Sometimes there is just not enough leg left to get a tourniquet around. More

Use Your Head by Jim Love

Have you heard? More than 4200 retired players are suing the NFL over concussions and head injury. The suit alleges the league didn’t do enough to warn players that they risked permanent brain damage if they played too soon after a concussion and that it hid evidence about the risks for decades.The players all wear helmets and the defense argues that the players all knew the risks.

For years, many in EMS have been aware that a leading cause of death and injury among medics following a collision is from a head injury. This is not really surprising as medics, while in the patient compartment, admittedly are often unrestrained and in a completely vulnerable state. Continue