Month: November 2009

Or, how do you teach a medical class without mentioning parts of human anatomy?

Last week, I was teaching a class on intubation to a group of aspiring paramedics. I was covering the class for another instructor who was out sick. When discussing the procedure, I used the following youtube video to teach the anatomy:

I pointed out that the landmark the students would be looking for was anatomically similar to the vagina (I actually said vagina, and did not use any vulgarities), and then went on to explain the procedure.

A female student, an 18 year old who finished high school 6 months ago, and who became an EMT less than a month ago, filed a complaint. When the director of the school spoke to me about it, she said the student had been in tears, and stated that no one had ever spoken to her like that before, and she felt violated.

The administrator knows me. We are friends, and I have been teaching for this school for going on 5 years. My wife and I have gone on vacation in the past with her and her husband. She is good people. To her credit, she knows nothing about medical procedures, so I showed her the video. All of our lectures are taped. She viewed the tape. She agreed that I had done nothing improper, but the girl is threatening legal action.

I was upset, and offered to resign, or take a leave of absence. She then told me that she has no desire to terminate me, and does not want to see me leave. She asked if I would promise to stop saying controversial things, but I pointed out that you cannot teach a medical class without mentioning parts of the anatomy, and that being adult education, the girl should get over it. What will happen when the class gets to the OB/GYN lectures? At any rate, I will not be teaching paramedic for awhile. It looks like I will be back to doing ConEd (for the same school) until this girl (and I mean girl, she certainly isn’t a woman) either graduates or fails out.

Teenage girls seem to thrive on drama, and what is better than the drama of watching everyone jump at your command?

The latest from Britain, the Doctors who make housecalls now will inspect your home to make sure it is a safe place for you to live in. They are looking to make sure you have smoke detectors, stair gates, hot water temperature restrictors, oven guards and window and door locks.

The guidance aims to “encourage all practitioners who visit families and carers with children and young people aged under 15 to provide home safety advice and, where necessary, conduct a home risk assessment”. It continues: “If possible, they should supply and install home safety equipment.” British officials claim that this will safeguard about 100,000 children that are admitted to hospital each year for home injuries and save £146m.

Since Britain is already the most security camera heavy country in the world, it makes me wonder how long it will be before big brother installs video cameras inside homes.

I take two lessons from this:

1 Government run healthcare will allow the government to intrude upon every aspect of your life, all in the name of spending money. That is the cost- loss of your freedom.

2 Once the right to keep and bear arms goes, as it did in Britain a few years back, the rest of your rights will begin to disappear as well.

Recently, I was called to a local apartment complex for difficulty breathing. When we arrived, I entered the apartment and I could hear the wheezing from the entry hall. The patient is a 58 year old male who is sitting at his dining room table, puffing on a nebulizer. He looks pretty bad- JVD, cyanosis, accessory muscles, the works. This guy could have been a picture in a textbook on respiratory distress.

His roommate tells us that he has used 3 breathing treatments in the last 2 hours, and has been getting worse. My partner asks the roommate if our patient has ever been intubated before. The patient uses what breath he has to say “No tube” and goes back to huffing his inhaler.

Since I am the engine paramedic, there are 5 of us there, including the rescue crew. Of the 5, four of us are medics, and I am the senior ranking of the four. I remark to my partner that we are probably gonna need some Mag Sulfate for this one. The problem is that our protocol specifically states that we need orders to give Mag for asthma.

We get him in the truck, and his vitals are: HR: 120, BP 189/154, RR 36, SaO2(room air) is 67%, EtCO2 is 80 (that is the highest I have ever seen on an actual patient). We place him on CPAP and give 125mg of Solumedrol. His EtCO2 is now 65 and his SaO2 is 84%.

I call dispatch and get them to page our medical director. I want him, because you never know what Doc is on duty in the ED, and they don’t always want to give orders for meds. After a few minutes, the medical director still hasn’t answered, so we call the receiving hospital for orders. Denied. Instead, he orders .25mg of sub-Q Epi. (I had considered that, but I thought the Mag would be a better choice, especially in light of his hypertension)

When we get there, our medical director is standing in the entry to the ED. Assuming that he was the ED doc, I walk up to him as the rest of the crew is unloading the patient, intending to give a report. Before I can say anything, ha says, why didn’t you give Mag? I told him the protocol says I need orders. He tells me, “Funny, you ignore protocol all the time, why start now? Next time, if he needs it, give it. Just give me a call later and let me know, so I can cover for you.” I love him. He is the best medical director ever.

The patient is fine. He was discharged 2 hours later.

Edited to add: 24 hours after he was discharged, another crew brought him in while he was in full respiratory arrest. He was intubated, and sent to ICU.

This article claims that the citizens of Atlanta are about to elect a white mayor. The claim is that Atlanta’s demographics have changed, and the citizens are about to elect a white mayor.

The contest is posing some delicate questions for a city that has long prided itself on its progressive racial attitudes – the “city too busy to hate.”

The funny thing is that the white candidate leads in the polls- even among black voters (who make up 59% of the electorate). Of course, the black politician’s supporters had this to say:

[A] memo, written by political science professors William Boone and Keith Jennings, warned that black Atlantans need to act quickly to thwart a Norwood victory and maintain black political control of the top job in the city.

“With the ‘Black Mayor First’ approach, there is an unstated assumption that having a black mayor in Atlanta is equal to having a black social, economic and political agenda, or at least someone in office who would be sensitive to that agenda if not a full promoter of that agenda,” the memo said.

The ad hoc group, called the Black Leadership Forum, suggested that blacks unite around Mrs. Borders, calling her the most electable black candidate.

This is a racist attitude that I find reprehensible. Can you imagine the outrage if a white candidate’s supporters circulated a memo espousing a “white Mayor first” approach? Why can’t we have a pro-citizen approach? A minimum government approach? Why does American politics equal screwing one group to the benefit of the other?