"Skip,
Since the customer has very little idea of what we do (from taxi to mobile emergency department), we need to educate them.
."
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Robert Valdora
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- Woodbridge, NJ
- United States
- EMT-B
Last On: 1:13PM, 30 Apr 12
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Robert Valdora's Discussions
Cardiac Arrest. BLS or ALS job?
111 Replies
Okay so in my town my buddy and I always question if a cardiac arrest is necessarily a need for ALS or if more BLS hands on is what it will take to make resuscitation more likely. For those who are…Continue
Started this discussion. Last reply by Rogue Medic May 3, 2012.
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Skip Kirkwood replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"I don't (and haven't) "claimed" anything. I merely asked a question.
"Demand evidence"? What does that mean? Pound on our chests and shout loudly? I'm a practical guy, and I know that…"
Neil White replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"A lot of what I wrote is clearly presented as opinion.
An opinion which like a bad TV show we wish we could switch off, but alas the remote is just that little bit out of reach.... you stretch and stretch, you use your feet and everything but…"
Rogue Medic replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"Ben,
That is a valid point. Evidence is not what would be used to debate something that is asserted without evidence.
It would be debated according to the logic of the assertion.
However, if there were evidence that addressed the topic, that…"
Ben Waller replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"That statement was asserted without evidence. There is a great deal of irony in that.
"
Rogue Medic replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"Skip,
Why do you keep claiming that we have to have the best evidence for what we do?
Applying evidence is about using judgment.
A lot of what we do does not have evidence, so we need to demand evidence.
I wish I could give you a good…"
Skip Kirkwood replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"The philosophy is great, Rogue. But tell me how you would put that in to practice.
Stuff proven harmful, junk it. I'm good with that.
Stuff proven helpful, keep it. Of course.
Stuff not studied or not studied with adequate…"
Rogue Medic replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"Skip,
Without evidence, what basis do we have for making decisions about treatment?
Expert opinion?
Expert opinion is considered evidence, just the lowest form of evidence. Right next to puns.
Unless a treatment can be shown to consistently…"
Skip Kirkwood replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"Thanks, Neil! It's nice to see some much-needed humor in here.
Much of what we do in EMS has not been studied at all. So, do we make it up as we go along, doing random things, or do we let evidence acquired elsewhere be…"
Rogue Medic replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"dr-exmedic,
It is interesting that the epinephrine studies published in the last couple of years show that patients had ROSC about three times as often with epinephrine as without epinephrine, but even with three times the ROSC, they were not any…"
dr-exmedic replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"It's behind a firewall, unfortunately, but if you can get it:http://www.annemergmed.com/article/S0196-0644(10)00142-3/fulltextInterestingly, now that I go back and read it, the reference Dr. Kellerman gives is the infamous USA Today spread,…"
Rogue Medic replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"Tom,
I have not been referring to just resuscitations.
The same number of skills divided by more medics equals a need for more training to make up for the skill dilution.
The quality of the paramedics may be much more important in things…"
Tom Bouthillet replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"Assuming a patient who absolutely requires prehospital tracheal intubation in order to survive, I see no additional value in having a dozen paramedics on scene who are not proficient at the skill. You could say the same of heart surgeons who have…"
Rogue Medic replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"Tom,
If paramedics are not well educated, how does it improve anything for the patient to have more of these poorly educated people on scene?
Suppose that you are right, that the paramedics' lack of skill is not being diluted. Is there any…"
Duncan Hitchcock replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"I would hope, that at this level, we could agree to disagree without being disagreable.
Even with my limited formal education and limited real-world experience I, too, have many opinions about the state of the our…"
Neil White replied to Robert Valdora's discussion Cardiac Arrest. BLS or ALS job?"Rouge, in fairness we can discuss opinions and carry discussions on without the line by line analysis and hatchet quoting that goes on. I think most of us would rather have a discussion and raise questions not copy and paste paragraphs which prove…"
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Comment Wall (1 comment)
- At 9:36am on March 12, 2012,
Michael Lee Reisman Maj-Ret RNNP said… - Learn from my lesson. Don't depend on a handshake, most of us, including me are honorable. Some are not. The Dark Side of a Las Vegas Male ED ClinicPlease check out my you tube it's only 5 mins long
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