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Tuesday, February 22, 2011

Put the Pedal to the Metal

And......Here we go....


Day four was heavy. The lecture was interdisciplinary with a focus on base concepts that we ABSOLUTELY HAVE TO UNDERSTAND to at all excel in the course and Paramedicine. It started out with some basic Cell structure/Microbiology, shifted to Chemistry, shifted to some Anatomy/Physiology, shifted to fluid balances and IV therapy, finishing off with the dreaded Acid/Base balance.

During one of the breaks, the instructor mentioned there is a shift towards requiring Anatomy and Physiology to become a Paramedic.

I completely agree with this direction. I'm sure that this stuff will be filled out as the course goes on, but learning about these different fields on a "need to know" basis, I don't think really makes for good education.

A lot of these concepts I remember covering in High School, so maybe I'm wrong.

Maybe its a wider societal opinion. It seems the attitude towards vocational education is something that you "get through" so that you can finally practice. I don't know why Paramedicine would be any different. And in part, it is sort of true. I'm fairly sure that I won't ever need to know that the cell membrane is composed of a phospholipid bi-layer. Maybe I'm just a nut because I am the type of person that just retains such information.

I am really excited that we are starting from the bottom up. After discussing intravascular pressure, I realized that malnourishment can cause edema. Maybe that was obvious or know by some readers already. But I'm glad that I was able to see that.

I already knew that albumin count in the blood was one of the ways that how well nourished a patient is measured.

Yesterday, I learned that it is large molecules like protein (albumin) that help water diffuse into the vascular system, due to their inability to pass through the cell wall.

I figured out that if a patient doesn't have enough albumin in their blood(malnourishment) then water will diffuse out of the vessels into the interstitial space causing....

Edema!!!

Where's my prize?


But anyway, I'm sorry if this is obvious, but it was relieving to know that I was able to take these parts of things that I am learning and able to use that knowledge critically, coming to new conclusions.

Which I think is really suppose to be the difference between a EMT and a Paramedic, its not just about the toys and drugs.

Thursday, February 17, 2011

Day Three - ethice and glauco area

Ethics vs. Morals and CYA...er...legal liability is what we covered on the third day.

My effort to become more comfortable with medical terminology has also paid off because some of that was covered as well. My previous fluency in Spanish helps with the latin roots of stuff, sometimes...

We received our pharmacology manual, time to get started with the flash cards. Its exciting because the course is starting to ramp up.

Luckily I have had plenty of training on liability and legal issues jammed down my throat from Ski Patrol. I think the most important thing to remember is to do weigh the consequences of your actions before you do them, and try to imagine defending your actions in a court of law. But in the end, there is a lot of gray area, and you can't go wrong contacting medical control and documenting your actions well, I guess.

Part of the liability of a paramedic stems from being the highest level of provider typically on a scene, so not only are you liable for your own actions, but a paramedic can also be held liable for those who are working underneath him. So far, that leadership aspect has been mentioned but only in passing, maybe it will be covered more later on.

A few more quizzes came through, I updated my average.

Study habits have been mentioned as well, I guess I mentioned the importance of that some already.

Tuesday, February 8, 2011

Day Two

Yesterday was the second day of class. We spent the whole day with a fitness/health specialist, discussing adequate nutrition and exercise. I have a lot of strong opinions about health and wellness based on my own personal experiences, the strongest of which is that there is a lot of bad information out there. But, he had a lot of good things to say. It was a change of pace for sure, because most of the time "wellness of the rescuer" type lectures tend to be just words, but we spent a lot of time doing simple exercises that could be done with minimal equipment.

The whole presentation was much more tailored for fire-fighters than paramedics, but then again, there are only so many exercises for lifting a stretcher into an ambulance.

I guess the guest-presenter is developing a health and wellness program for Public Service Workers, which I think is fantastic. There are plenty of perceptions out there about our field, most of them completely justified, that I think we all need to really work on.

One of his take home messages was that public safety workers really need to be more fit than professional athletes, because we will never know the "game" we will play, when we will play it, or for how long. His philosophy is definitely similar to Gym Jones or Crossfit but not nearly as intense. He had no love for "commercial gyms".

I like what he had to say about diet and nutrition. I find that it is so important to plan ahead if you want to eat well in this business, there's no other way about it.
 

We also took quizzes for Chapter 1, 2, and 3. I got a 90%, 94.3%, and 80%, respectively

Tuesday, February 1, 2011

Day One

It was really good.

It was spent like the first day of any class. The manager of the program (the guy who interviewed me) gave a little talk about expectations, then the main instructor explained who he was and his expectations, many opportunities were given to ask questions.

I like that policies and procedures regarding grades and attendance and everything was very well presented, and plenty of resources that were available were explained.

The educational philosphy of the school and the instructor was very much in line with what I believe, so I was really happy about that. The instructor said "This is Adult Education" no less than 4 times in the course of the day, which leads me to believe that his attitudes regarding some academic policies jive VERY well with my own.

Something that I found interesting was that they had the whole works split into separate "courses" so that if someone was very strong in the book work, but weak in pharmacology, then they wouldn't be able to squeeze by with a passing grade. Some folks may consider this harsh, but Medicine isn't a field that you want to screw around with, Emergency Medicine even less so.

I felt like the program is VERY much interested in establishing a core level of competency as a Paramedic, as opposed to just "teaching to the test".

I probably have the least time working on an ambulance, I guess we'll see how that goes. There was a good mix of folks from various areas and services, a lot of Southern New Hampshire and Boston. I might just buy and wear a Yankees cap just to be funny one day. But I should do that during baseball season for best response.

We covered the first three chapters in the book. There were powerpoint presentations, but luckily (unlike a lot of my college) the instructor didn't just read the slides, he kept the class relatively engaged.

There wasn't a lot of "war stories" either. Which is understandable, its kind of tough to get into those when discussing "the Well-Being of the EMT-P"