tag:blogger.com,1999:blog-4505990433916682663.post8361171291743174271..comments2024-03-13T02:04:31.476-04:00Comments on Paramedicine 101: 94 yom CC: Chest PainAdam Thompson, EMT-Phttp://www.blogger.com/profile/18107359165856983910noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-4505990433916682663.post-26356705906089422152010-01-06T11:58:05.773-05:002010-01-06T11:58:05.773-05:00Adam -
I guess it's all relative. I was neve...Adam - <br /><br />I guess it's all relative. I was never trusted as much as I wanted to be trusted, but I was probably more trusted than most!<br /><br />We are just getting our STEMI Alert protocol off the ground here (although we have been transmitting ECGs for a long time).<br /><br />I'm not entirely sure the average ED physician is familiar with Sgarbossa's criteria or the "rule of appropriate T-wave discordance".<br /><br />ED physicians judge EMS according to the lowest common denominator, and I can't say that I blame them sometimes.<br /><br />I sure wish it were different, though! <br /><br />TomTom Bhttps://www.blogger.com/profile/18291404904437933272noreply@blogger.comtag:blogger.com,1999:blog-4505990433916682663.post-38621475538409850062010-01-06T11:38:49.113-05:002010-01-06T11:38:49.113-05:00I thought this was a great read. Can't believ...I thought this was a great read. Can't believe you haven't gotten in comments on here. You teach this very well. I have a difficult time explaining these findings Sgarbossa's criteria/rule of discordance. The problem is that they are not accepted by our STEMI centers to call STEMI. I guess appropriate triage to a cardiac facility is of obvious importance. However, the activation of the cath team will be delayed until the cardiac markers are present. <br /><br />I have found that, on many occasions, our clinically significant findings on a 12-lead may be dismissed by an ER physician. Patient outcome becomes completely dependent on that physician's ability to trust what he is hearing from the paramedic. I once showed Wellen's changes to a ER physician, only to be told that I was looking for Zebras. The patient's troponin came back and he was cathed... <br /><br />I guess the moral of the story is that it isn't often when we might know something that the ER physician doesn't. When it happens, it sucks, and even if we do everything right, we might watch our patient receive delayed care. <br /><br />Tom, have you ever had an experience like this when you were on the road, or were you pretty well trusted by the receiving physicians?Adam Thompson, EMT-Phttps://www.blogger.com/profile/18107359165856983910noreply@blogger.com