Mendham Borough First Aid Squad
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Be still my beating heart...

2/23/2016

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Well, actually... don't!

There's no doubt that we've got to master the signs and symptoms, and associated interventions, of both respiratory and cardiac emergencies. Every situation we face starts with assessing the ABC"s -- Airway, Breathing, and Circulation -- as these represent true emergencies, where it really can be a matter of life-or-death.
EMTs in NJ have a relatively limited scope of practice when it comes to actually treating medical issues.  Other than supplying Oxygen and providing or assisting with a very limited set of medications, we mostly provide comfort care and transport for most medical issues. 

Of course, CPR is also a critical skill we can apply... one that we always hope isn't actually needed by any of our patients.
Respiratory and cardiac emergencies are very closely related, as issues in one area can have a detrimental, even fatal, impact to the other.

While the heart is responsible for pumping blood through the lungs for oxygenation, and then moving the oxygenated blood itself to the tissues and organs throughout the body, it is itself a muscle that also requires oxygenated blood to effectively pump. So any disruption in how the body is obtaining and utilizing air through the upper and lower airways (including the lungs) can cause issues for the heart as well.

And things roll downhill quickly from there on... Because having to perform CPR means that someone is having a really, really, really bad day....

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Practice is vital, and vitals take practice

2/3/2016

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Part of the practical skills we've been focusing on in class are the primary and secondary assessments that EMTs do on patients. While the primary assessment is done on scene, and focuses on managing life threats, the secondary assessment can be done on scene or in the back of the ambulance while we are transporting a patient to the appropriate medical center.

The secondary assessment, if we aren't still actively managing life threats (like performing CPR), allows for a more through inspection of the patient, either for a specific injury or illness symptom (assuming they are conscious and alert enough to talk with us), or a full-body scan intended to ensure we don't miss any additional injuries (which is especially important with an unconscious or unresponsive patient, or even a conscious one with an altered mental status).

This also includes taking critical vital signs, including pulse and blood pressure, in order to determine if our interventions are producing the right positive results, or whether our patients are sliding towards dangerous grounds, such as shock.

So ... Who would have thought that one of the best study aids I could get for this stuff would be my 8-year old son and his imagination?

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The head bone is connected to the neck bone....

1/25/2016

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With the basics of the EMS system and moving/lifting skills under our belt, we turn our attention to perhaps the two most critical elements of the EMT course: Human anatomy and development, and the overall plan of patient assessment necessary to determine appropriate treatment and transport priority.

EMTs are not doctors. We're not asked, expected, or required to diagnose what ails our patient. Heck, we're pretty much told to avoid jumping to any conclusions, and look to treat life-threats and transport safely to a higher-level medical care facility as our primary responsibility.  While we may suspect kidney stones or gallstones, a broken toe, or an allergy to a specific food based on what a patient has told us they are experiencing by way of pain or discomfort, or what they were doing prior to the start of pain, at best we're told to maintain an "index of suspicion" rather than attempting to reach a conclusion and diagnoses. That's simply not the function of being an EMT.
Skeleton and bone names
The keys to providing effective care, however, requires us to understand human anatomy and how all the systems within our bodies both work and inter-relate. And while it is a major amount of stuff to learn, it's probably not much more than the average 8th grade health class or high school biology class.

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    Author

    Jon Alperin, one of our MFAS volunteers, shares his journey to becoming an NJ certified EMT.

    Picture

    from the Start

    Here is Jon's journey, presented in time order:
    • T-30 & counting
    • A look back at my first year with this squad
    • 1500 pages of EMT know-how
    • Class is in Session!
    • We pick things up, we put things down
    • The head bone is connected to the neck bone...
    • Questions? We've got a million of them...
    • Practice is vital, and vitals take practice
    • Getting ready for the 1st test
    • Taking a breather
    • Be still my beating heart
    • Gearing up for mid-term exams
    • A peak inside a PSAP
    • Urgency, not emergency
    • Paramedics - Our partners in success
    • Under pressure
    • Around the bend, the end is in sight
    • From beginning to end
    • A grim way to learn
    • The toughest lesson
    • One behind, one ahead
    • Tom Petty had it right...
    • Just gonna let this speak for itself
    • The end of the beginning

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