Very effective PR piece put together by Barnes Jewish Hospital (@BarnesJewish).
If you visit the webpage and watch the videos on the right-hand side of the page you’ll see that this hospital understands the power of social media.
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Thanks to firefighter/paramedic John Wright for sending in this interesting rhythm challenge.
There are some interesting clues in this ECG strip to help you identify what’s happening.
What say you?
In a somewhat rash move I ordered Rosetta Stone French yesterday at Amazon.com. I opted for the full package, which includes Level 1, 2, 3, 4, & 5 Set with Audio Companion. Cost: $599.00.
I’ve always been somewhat of an autodidact, and I’m hoping that Rosetta Stone will appeal to my atypical learning style.
If you’re familiar with the Myers-Briggs Type Indicator (MBTI), my personality type is Extraverted Intuitive Thinking Perceiver (ENTP).
If you’re not familiar with the MBTI, you should take this TEST to find out what your type is. Once you get your 4 letters (e.g., ESFP, INFJ, INTP, ESTJ) you can read up on your profile HERE and HERE.
It’s sort of like astrology based on science.
I had heard of Rosetta Stone previously, but I was particularly fascinated to find a Rosetta Stone kiosk at the airport in Baltimore (BWI) on my way home from the EMS Today conference earlier this month. I took some pictures of the kiosk which I can’t seem to find right now, but I will post them to the blog soon.
If it seems strange to you that I would photograph a software kiosk, you should know that I also took several pictures when I redeemed 7072 pennies in a Coinstar kiosk at the neighborhood Bi-Lo last month.
Then I visited my parents in Florida last week. One of the reasons I drove down was help create a DVD for my grandmother’s 100th birthday. My grandmother (we call her “grandmama”) is French Canadian and has a French accent. In fact my father was born in Quebec and moved to the United States when he was only 4 years old, so he spoke French before he spoke English.
After several glasses of red wine, I found myself singing O Canada in French with my Dad at the kitchen table for the video. Actually, it was the bilingual version so only the second verse was in French. Regardless, I realized that the French language is part of my heritage, and if I hurry, I might actually be able to speak French to my grandmother at her 100th birthday party. To me that’s worth $599.00.
Speaking of O Canada (with the understanding that some of you may still be sensitive about our loss to Canada in the Olympics) here is a really cool video I found on YouTube. Apparently it’s the old “sign-off” from CBC-TV.
Anyway, since I’m going through the trouble of performing this experiment, I decided to blog about it. According to some of the reviews I’ve read, it’s possible to become fluent in about 2 1/2 months. If it really works, my plan is to order Latin American Spanish.
Wish me luck! Or should I say, “Bon chance!”
I feel embarrassed.
Mark Glencorse (@UKMedic999) from the Medic 999 blog contacted me on Twitter the other day and mentioned that his “save” appeared on Episode 6 of A Seat at the Table (Chronicles of EMS).
For some reason I interpreted this (wrongly) to mean that he had saved someone in cardiopulmonary arrest that had subsequently appeared on the show.
In actuality, Mark was talking about a blog post from last November entitled The Power of the EMS Blog!!!
Basically, he credits something he learned here at the Prehospital 12-Lead ECG blog with positively effecting a patient outcome in England!
So it’s EMS 2.0′s first “blog save”! 
http://vimeo.com/moogaloop.swf?clip_id=10211506&server=vimeo.com&show_title=1&show_byline=1&show_portrait=0&color=&fullscreen=1
Chronicles of EMS – A Seat at the Table (Ep 6) from Thaddeus Setla on Vimeo.
Mark, I apologize for the delay in acknowledging this. I’m getting a bit slow in my old age.
So please watch Episode 6 of A Seat at the Table (embedded above).
Speaking of which, I shouldn’t assume that all of my readers are knowledgeable about the Chronicles of EMS.
In addition to being a very cool reality TV series, it’s a burgeoning web-based EMS 2.0 community.
Find out more here:
Chronicles of EMS – Social TV for the EMS Community
Please join this community!
Encourage what these guys are trying to accomplish with this grass-roots movement (or initiative or phenomenon — I’m not sure what to call it just yet).
If you haven’t seen the premier episode of Chronicles of EMS, you really need to watch it RIGHT NOW.
No, seriously. Right now.
http://vimeo.com/moogaloop.swf?clip_id=9055077&server=vimeo.com&show_title=0&show_byline=0&show_portrait=0&color=&fullscreen=1
Chronicles of EMS – The Reality Series (Season 1 Episode 1) from Thaddeus Setla on Vimeo.
Spread the word!
Here’s a fascinating case submitted by Geoff Dayne.
EMS is called to a VA clinic for a 23 year old male who came in to get checked into the system. Somewhere in the exchange, he mentioned that he had been experiencing chest pain off & on for just over a month.
Onset: Today’s pain came on gradually.
Provoke: Nothing makes the pain better or worse.
Quality: Pain described as “pressure”.
Radiate: Occasionally radiates to the jaw.
Severity: “Mild” (no pain scale)
Time: Several previous episodes over the past month.
The patient denies shortness of breath. There is no nausea and the patient has not vomited.
A 12-Lead ECG is captured at the clinic.
And another.
9-1-1 was contacted.
The patient was given O2, ASA, and NTG at the clinic.
EMS arrives and performs their own assessment.
The cardiac monitor is attached.
The paramedics capture their own 12-lead ECG.
Are you concerned about this ECG?
Why or why not?
Should a STEMI Alert be called from the field?
Why or why not?
Would you bypass the local non-PCI hospital for a STEMI receiving hospital?
Why or why not?
*** Update 03/25/2010 ***
Here are some serial ECGs captured in the field.
Does this help?
For the past several days I’ve been working on my department’s submission for the Heart Safe Community award sponsored by the International Association of Fire Chiefs and Physio-Control.
Here’s the finished product. Wish us luck!
Part I
Part II
Here’s a case submitted by Bob Sullivan, NREMT-P from New Castle County EMS in Wilmington, DE.
The case occurred six years ago so certain details are missing. However, there is more than enough here to discuss the most relevant points about the case.
The patient was a 12 year old male whose only complaint was palpitations.
The patient’s pulse was extremely rapid. However, he appeared to be perfusing adequately and the blood pressure was stable.
A 12-lead ECG was captured.
And another.
Online Medical Control was contacted and the treating paramedic was advised to watch the patient’s blood pressure and cardiovert if the patient became unstable.
The patient converted after the ambulance went over a bump. Unfortunately, a post-conversion 12-lead ECG was not recorded.
At the time, Mr. Sullivan was a new paramedic. He states that his co-workers felt that he should have given adenosine, since a 12 year old “could not be in VT.” He also mentions that he’s gotten different interpretations from each doctor he’s shown it to.
The case has been bothering him ever since.
What do you think is the best field treatment for a patient like this?
What do you think of Online Medical Control’s advice?
What do you think is wrong with this patient?
This is the final episode of my continuing coverage of the EMS Today conference in Baltimore!
I was on the verge of continuing the festivities from the Fire/EMS Blogger Meet-up on Friday night when I became separated from a group of bloggers as we were walking out of the Pratt Street Pavilion.
I seem to recall walking next to Justin Schorr (@TheHappyMedic) who was wearing a pea coat and a navy blue knit hat looking very much like David Keith (Major Matthew Coonan) from the movie U-571.
I walked down the stairs and out the door before I realized I had left everyone else behind. I also realized it was getting late, I was in downtown Baltimore, and I had hit my therapeutic range of ETOH.
Common sense prevailed and I double-timed it back to the hotel. I ran into a good friend from Physio-Control in the lobby, had a couple of gin and tonics, and headed up to the room for some well-deserved sleep.
Saturday, March 6
Once again I woke up at 7:00 a.m. and briefly considered attending the closing ceremonies. The closing keynote address was to be delivered by Gordon Graham, JD who is one of my favorites! If you’ve never heard him talk, you owe it to yourself. But even Gordon Graham couldn’t get me out of bed before 9:00 a.m.
After a very slow start and several cups of coffee, I finally made down to breakfast by 10:00 a.m. I’m not sure what was better: the fried eggs, bacon, and toast or the Bloody Mary. Either way, I felt much better when I headed to the exhibit hall.
In the Philips section I ran into an old friend named Dan Carlascio who was the first person to hire me to teach a 12-lead ECG class! That was at Loyola University back in 2001. Now Dan works for Philips as the Clinical Implementation Manager. We caught up for a little bit and then I made the rounds.
At 11:30 a.m. I showed up for my 12:00 a.m. appointment with Jamie Davis of the ProMed Network and the MedicCast.
I ran into Mike Ward (@FossilMedic) who went out of his way to introduce me to Bill Schumm (@FireGeezer), which I really appreciated. I wish I would have had a mug for him to sign!
Next I found out that another special guest would be joining us on the MedicCast! None other than Tim Phalen of ECG Solutions. I’ve always thought that Tim Phalen was a class act and a really good guy, but I think Jamie Davis was even more excited than I was!
We would also be joined by Cees Verkerk of Physio-Control, Angel Burba from Howard Community College, and Rory Putnam of Northern Essex Community College.
I’m sure he was just being polite, but Jamie Davis referred to our discussion about 12 leads and ECG education as “one of the best segments he’s ever recorded.”
Listen for yourself and see if you agree!
Note: Please ignore the facial tic. That’s what happens when you cure a hangover with 6-cups of coffee! I’m not normally Parkinsonian.
12:00 p.m. MedicCast live from the floor of EMS Today!
Unfortunately, the connection reset at 26:42 which means that the video stream for the second half of the MedicCast was lost, but Jamie Davis tells me the audio was preserved, so I’ll update you with a link to the full podcast as soon as it’s available.
*** UPDATE ***
Here is a link to the full audio stream.
Angel Burba, Tom Bouthillet, Tim Phalen, and Jamie Davis
Angel Burba and Rory Putnam
Tim Phalen and Jamie Davis
I had just enough time to make it to the next educational session!
1:30 p.m. – 3:00 p.m. Fire-Based EMS: The Issues, the Challenges
IAFC EMS Section
Gary Ludwig (Chair), John Sinclair (Immediate Past-Chair, International Director), David Becker (Vice Chair), J. Robert Brown, Jr. (Treasurer), and Norris W. Croom III (Director-at-Large)
Gary Ludwig (Chair), John Sinclair (Immediate Past-Chair, International Director), David Becker (Vice Chair), J. Robert Brown, Jr. (Treasurer), and Norris W. Croom III (Director-at-Large)
I had been looking forward to meeting Gary Ludwig (Deputy Chief of Memphis Fire Department) for some time. I didn’t realize I was going to have the opportunity to meet the entire executive staff of the IAFC’s EMS Section! That was an unexpected pleasure.
It’s usually not all that difficult to get one person to pose for a quick picture after an educational session, but there were five of these guys! They were all extremely nice and didn’t seem put out at all. Gary Ludwig even suggested that I let someone else hold the camera so I could get in one of the pictures; an offer I gladly accepted. I used this picture because as a photographer, it’s just a much better shot.
I wasn’t sure what to expect with this session, but it ended up being a very informal discussion about a wide range of issues including the economy, transport and billing, ambulance wars, social media in the fire service, tattoos, body modification, the right to free expression, and customer service.
I was shocked to hear how many participants thought a paramedic should be allowed to have tattoos on their face and rings in their nose if that’s what they wanted
to do, as long as the patient care was adequate! News flash: when you’re on duty and wearing your department’s uniform, you’re not in a “free speech and free expression” zone! I thought that was well understood but apparently not.
There was also some Generation Y bashing which seemed to be a common theme this week. One participant went so far as to say that texting is bad because it breeds separatism which is the enemy of teamwork! I think that was a little extreme. The rationale was that “EMS is a team sport” so anything that takes you away from the team is bad. I don’t know if EMS is a team sport or not (I’m sure you could argue it) but firefighting definitely is!
Before someone sends me hate mail about the previous comment, is flying a jet plane a team sport because the captain has a co-pilot? Just asking.
Regardless, I’m not sure it’s fair to say that someone who is introverted, prefers to be by himself during his down time, or texts his girlfriend isn’t a team player. I also don’t think it’s fair to say that an extrovert is automatically a team player simply on the basis that he hangs out in the dayroom watching football with the guys.
I’ve read enough military non-fiction to know that many special forces types have insular personalities, but they are highly driven, technically proficient, and they perform very well as part of a very high functioning team. Isn’t that what matters?
Overall an interesting discussion, but I don’t think any of it rose to the level of the biggest issue or challenge faced by fire-based EMS. In my mind, the biggest issue by far is how to do both things well, but that was a discussion for another day!
3:15 p.m. – 4:15 p.m. EMS and Public Health Collaboration: A Model for the Future
Norma Battaglia, RN, MS
I got out a little bit early from previous session so I made a beeline over to Norma Battaglia’s session!
For those of you who don’t know who Norma Battaglia is, she was one of JEMS magazine’s top 10 innovators in EMS for 2008. She’s also the Prehospital Manager for Tuscon Fire Department.
Norma gave an overview of Tuscon’s practical, collaborative solution for the problems of high-volume, low acuity 9-1-1 calls, which included a unique collaboration of EMS with various public health resources.
I took away some awesome ideas and I found Norma to be very congenial. It’s not easy teaching a Saturday afternoon session on the last day of a conference. Attendance is low and everyone is ready to go home. But we got through it and Norma patiently answered questions after the class was over.
With this session and the overview of Wake County EMS’s Advanced Practice Paramedic program I have a lot to think about!
Sunday, March 7
It was finally time to head home after having thoroughly enjoyed myself and forged many new friendships that I hope will last for a lifetime.
I had a chance encounter with Gary Ludwig at BWI and we talked for a while about paramedic recruitment and retention, and how Memphis Fire Department has a liaison officer who helps new paramedics get settled. He gave some examples and I thought it was a very thoughtful solution to a common problem for fire departments like mine that often recruit paramedics from out-of-state.
After some problems with my seat assignment I made it home comfortably with the assistance of a competent gate agent in CVG and an awesome flight attendant on the home stretch to SAV (not to mention some highly skilled pilots).
Maybe you should go undercover, Mr. Anderson.
See also:
Here’s my continuing coverage of the EMS Today conference in Baltimore!
Friday, March 5
I had all the intentions of attending one of the 8:30 a.m. sessions, but when I woke up at 7:00 a.m. the rationalizing started. Suffice to say, I ended up going to one of Physio-Control’s educational sessions instead! It was taught by “the Pope” of 12-lead ECG interpretation Tim Phalen.
“The Pope” Tim Phalen
Physio-Control’s education area in the exhibit hall
The session was called “Got STEMI? Identifying the top 5 STEMI impostors”.
Once that was done I walked over to the ZOLL area which was right next door!
That’s where I ran into several bloggers that I had never met in real life!
Update: I’m taking a play from Rhett Fleitz’s play book and adding the Twitter IDs and links.
There was “The Godfather” Kelly Grayson (@AmboDriver) A Day in the Life of an Ambulance Driver, TOTWTYTR (real identity is classified), Chris Kaiser (@Ckemtp) Life Under the Lights, and April Saling (@Epi_Junky) Pink Warm and Dry, Rhett Fleitz (@FireCritic) The Fire Critic, and John Mitchell (@firedaily) Fire Daily. Also present were Ted Setla (@setla) and Chris Eldridge (@thedridge) Chronicles of EMS, Chris Montera (@geekymedic) The EMS Garage and Jamie Davis (@podmedic) MedicCast.
Of course, Mark Glencorse (@UKMedic999) 999Medic and Justin Schorr (@TheHappyMedic) The Happy Medic were also there, since they were ZOLL’s honored guests.
Special thanks to ZOLL (@zollemsfire) for sponsoring the Chronicles of EMS!
If I missed anyone, please drop me a line and refresh my memory!
I know there was a photograph or two taken of this coincidental meet-up, so if it’s on your camera, please share the wealth!
Update: The photo can be found HERE at The Fire Critic’s blog.
1:30 p.m. – 2:30 p.m. Advanced Practice Paramedics: One Year Later
Brent Myers, MD, MPH, FACEP, EMT-P
Dr. Brent Myers – Medical Director for Wake County EMS
I talked Chris Kaiser into attending this session with me (it didn’t take much persuading).
Dr. Brent Myers seems like a really cool guy! He gives off a distinctly military vibe, but I asked him and he said he wasn’t military-trained. Maybe he’s just a Texan! Turns out he’s a 100% North Carolinian!
This was a really great session where Dr. Myers gave us an inside look at Wake County’s Advanced Paramedic Program (Respond, Reduce, Redirect). This is one of the initiatives that makes Wake County EMS one of the best in the nation!
From there I got myself some lunch and went back to my hotel room to recuperate and blog about Thursday’s activities. By the time I was finished it was time to gear up for the Fire/EMS Blogger Meet-up!
8:00 p.m. – 10:30 p.m. Fire/EMS Blogger Meet-up
This was an awesome event! I don’t think I could do it justice, but here are some photos.
Update: Some additional bloggers I met included:
Mike Ward (@FossilMedic) one of the FireGeezer crew who helped co-sponsor the event through The George Washington University – Emergency Health Services Program. It was an honor to meet you, Mike! Thank you for being so welcoming and cordial!
Seb Wong (@sebwong) from Really?…Why?…Ok! (or Seb and his Musings — not sure what the actual name of his blog is). However, he’s the EMS Chief from San Francisco who came to the event along with The Happy Medic. I already knew Seb from various discussion forums and listservs and it looks like his new blog is off to an excellent start!
Ronnie Grubb “The Gatekeeper” and First Due Medic. I really appreciate the comments he’s left at Prehospital 12-Lead ECG over the past year and it was great meeting him in person, although as things turned out we didn’t get to spend enough time getting to know each other.
I also met (briefly) Dave Konig (@davidkonig) co-founder with Greg Friese (@gfriese) of PIOSocialMediaTraining.com (@PIOSMTraining).
Incidentally, my Battalion Chief Mick Mayers (@truck6alpha) Firehouse Zen couldn’t make it but he was sending some Zen vibes our way Friday night!
Just a reminder, if I left you out, it was inadvertant! Please contact me at ems12lead@gmail.com if we met Friday night, especially if you have a blog! It’s entirely possible that I didn’t make the connection.
Mike Ward (@FossilMedic), Rhett Fleitz (@FireCritic), Dave Statter (@STATter911), and John Mitchell (@FireDaily)
April Saling (@Epi_Junky) and Kelly Grayson (@AmboDriver)
Chris Hebert (@chebert13) and Dave Iannone (@cooldavej) Go Forward Media and FireEMSBlogs.com.
(For reasons that are still unclear to me, this photo took 6 takes! They were good sports about it.)
(For reasons that are still unclear to me, this photo took 6 takes! They were good sports about it.)
Carissa O’Brien (@carissao) Baseline Vitals and Chris Kaiser (@Ckemtp)
Ted Setla (@setla) and Paul Andrews – Chronicles of EMS
A.J. Heightman (@AJHeightman) Editor-in-Chief of JEMS and Justin Schorr (@TheHappyMedic)
Mark Glencorse (@UKMedic999) and April Saling (@Epi_Junky)
Justin Schorr (@TheHappyMedic), Denis Rubin (Chief DC Fire & EMS), and Mark Glencorse (@UKMedic999)
Tom Bouthillet (@EMS12Lead) Prehospital 12-Lead ECG, Jamie Davis (@podmedic), and April Saling (@Epi_Junky)
You can see the rest of the pictures HERE.
I told a lot of you that I would be uploading the pictures to Flickr. I had a problem using Flickr (long story) so I’m using my Facebook fan page instead.
Speaking of which, if you’re in one of the pictures or know the people in the pictures, please leave a comment or tag them appropriately!
Also, please contact me if I’ve made any errors or if I inadvertently left you out. For example, if you were at the impromptu blogger meet-up at the ZOLL booth and I forgot to mention you!
See also:
I’m having an awesome time at EMS Today!
I thought I better start blogging about it before I get too far behind.
I’ll spare you the details of my trip up here. Suffice to say there were numerous flight delays and I probably could have driven here faster!
Regardless, I checked into the Hilton Baltimore, a very nice (albeit overpriced) hotel right next to the Convention Center. I wasted no time making some new friends at the Diamond Tavern!
Thursday, March 4
8:30 a.m. Opening Ceremonies and Keynote Address
I almost didn’t attend the opening ceremonies but I’m glad I did! The pipes and drums are always nice, but against all odds I actually enjoyed the keynote address by JEMS Editor-in-Chief A.J. Heightman. In a talk called “Climbing your own personal Everest” he conveyed his own personal struggle with weight loss in an entertaining, informative, and inspirational way.
10:30 a.m. – 12:00 p.m. From Technician to Clinician: The Art of Critical Thinking in EMS
Raymond L. Fowler, MD, FACEP
Jeff Beeson, DO, LP
Jeff Beeson, DO, LP and Ray Fowler, MD, FACEP
Dr. Ray Fowler was an early supporter of the Prehospital 12-Lead ECG blog. He wrote me a very nice and encouraging email after reading my article on R-wave progression. He also gave me a link to his website at http://www.doctorfowler.com/ where I found some outstanding lectures which you can find HERE.
When I saw he was presenting at EMS Today I decided to sign up for his breakout session. I wasn’t disappointed! Dr. Fowler and Dr. Beeson discussed many of the pitfalls that can trip us up when we evaluate patients (things like diagnosis momentum) and they made the case that EMS needs to transition from a technician to a clinician mindset. Of course, this can only happen through enhanced education.
One of my favorite quotes from the session was when Dr. Beeson said, “The eyes cannot see that which the mind does not know.” I think that’s especially true when it comes to 12-lead ECG interpretation.
12:15 p.m. – 1:15 p.m. Networking Lunch
A.J. Heightman (@AJHeightman) JEMS Editor-in-Chief
This could have been a disaster. I signed up for the Networking Lunch (which cost an extra $37.00 and was limited to 100 people). Unfortunately, this event was not well attended and the lunch didn’t show up when it was supposed to.
Fortunately, JEMS Editor-in-Chief A.J. Heightman was there to improvise. He identified the problem and ran interference until the food showed up. He also led some discussion about various issues ranging from Generation Y to best practices from around the country.
Obviously this man is used to putting out fires! He took a situation that could have been bad and made it tolerable. Was it worth $37.00? No, but it could been much worse.
1:30 p.m. – 3:00 p.m. 10 Case Studies! 10 Brand-New Cases
Paul Werfel, BA, NREMT-P
Paul Werfel, BA, NREMT-P
I first saw Paul Werfel in this story in the Washington Times about Washington D.C. paramedics (click the link and watch the video). He struck me as a no-nonsense guy who isn’t afraid to “tell it like it is.” I admire that trait so I signed up for his case studies.
It was definitely a worth-while session! The case studies made you think. He was funny, too, in a dry sort of way. At one point during the session a student asked (in reference to a case study), “How about a 12-lead ECG?” Paul answered, “The ECG looks normal. Would you like to see a right-sided ECG?” The student said, “Sure.” He said, “That also looks normal.”
Paul is the kind of EMS instructor that everyone should have. It’s obvious that he cuts no slack but it’s equally obvious that he turns out qualified EMS professionals, and that’s what’s really important! You shouldn’t “pass” if you don’t know what you’re doing. Once upon a time in American history that would go without saying!
3:30 p.m. – 5:00 p.m. Lightning Round: Ask (some of) the Eagles, National Urban EMS Medical Directors
Jeff Breeson, DO, LP
Ray Fowler, MD, FACEP
Jeffrey M. Goodloe, MD, NREMT-P, FACEP
Corey Slovis, MD, FACP, FACEP
Paul E. Pepe, MD, MPH, FACEP, MACP, FCCP
Jeff Beeson, Do, LP, Corey Slovis, MD, FACP, FACEP, Jeffrey Goodloe, MD, NREMT-P, FACEP
This was interesting for me, especially since I didn’t get to attend the A Gathering of Eagles conference last week in Dallas (I chose EMS Today instead).
Many interesting topics were covered, including diversion of controlled substances, cardiac arrest management, advanced airway devices, and the use of lights and sirens.
Apparently Dr. Slovis uses “five” a lot when he teaches residents at Vanderbilt (e.g., five causes of this or that, five reasons for this or that) and Dr. Fowler likes to tease him about it.
The banter between the physicians was funny, but it actually turned out to be a great teaching moment when Dr. Fowler asked Dr. Slovis to name the “five steps of cardiac arrest management”. Dr. Slovis didn’t disappoint when he came up with this impromptu list.
Five Steps to Cardiac Arrest Management
- Pre-arrest – get the word o
ut in the community about compression-only CPR! - Get to cardiac arrest patients quickly. Too many EMS systems are wasting up to 3-minutes processing the 9-1-1 call.
- Our first responders are indispensable partners in our chain-of-survival and need to be treated as equals.
- Advanced responders need to know what works and utilize evidence-based techniques.
- EMS needs to partner with our other emergency partners inside the hospital by using things like therapeutic hypothermia and other best practices.
5:00 p.m. – 7:00 p.m. Opening of the Exhibit Hall
Justin Schorr (@TheHappyMedic), Tom Bouthillet (@EMS12Lead), and Mark Glencorse (@UKMedic999)
I entered the exhibit hall and almost immediately ran into Justin Schorr (@TheHappyMedic), Mark Glencorse (@UKMedic999), Ted Setla (@setla), and the rest of the Chronicles of EMS gang including Jamie Davis (@podmedic) MedicCast and Chris Montera (@geekymedic) The EMS Garage. These are obviously some really great guys. I was impressed with how friendly everyone was.
I also ran into “The Godfather” Kelly Grayson (@AmboDriver), another blogger I like to read who prefers to remain anonymous, as well as Dave Iannone (@cooldavej) and Chris Hebert (@chebert13) from Go Forward Media (the brains behind JEMS Connect and FireEMSBlogs.com). I also met several other bloggers today (Friday March 5) that I will tell you about tomorrow if I have time.
To wrap up the evening the good folks from Physio-Control treated me to a very nice dinner at The Oceanaire Seafood Room! What an awesome restaurant! Thanks, guys! I really appreciate it.
Speaking of the Podmedic, I will be a guest on the MedicCast live from the floor of EMS Today this Saturday at 12:00 p.m.! You can find details HERE.
The Fire/EMS Blogger Meetup is this evening and promises to be epoch! If you’re here at EMS Today, I hope you can stop by.
See also:
This is an interesting case submitted by Tom Bernesser who is a paramedic from North Carolina.
I got to know Tom through the EKG Challenge forum at the EMS Village where he always posted fascinating case studies.
Here’s the story.
63 year old male presents with acute onset of dyspnea.
He reported 4 previous MI’s with similar presenation, only dyspnea – no pain or discomort as was the case on this morning.
Past medical history:
NIDDM, HTN, MI, CHF, CVA and is bed-confined for the most part. He’s also fairly obese.
Vital signs:
BP of 146/90
HR 104
RR 24
SpO2: 87 on RA, 100 on O2 via NRB mask @ 15 LPM
BGL: 141 mg/dL.
He did have diminished lung sounds bilaterally, maybe some rales in the bases but was able to speak in full sentences.
He also had some pedal edema, but wasn’t taking any diuretics.
He’s at a Skilled Nursing Facility (SNF) but of course there is no old EKG on site for comparison.
Another note, he did have occasional bouts of multifocal PVC’s probably about 10-15/min.
Here is the 12-lead ECG.
Here is the computerized interpretive statement.
As you can see, it’s giving the >>>> ACUTE MI <<<< message.
Would you activate the cardiac cath lab?
Why or why not?
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