CAP Health Services Yahoo Board in Back Up

[RNOfficer]

https://groups.yahoo.com/neo/groups/CAP_HEALTH_SERVICES/info

[Holding Pattern]

I do wish this would be reborn on google groups.

[Eclipse]

The 90's were a great decade, I'm sure both members will have excellent discussions.

[RNOfficer]

The 90's were a great decade, I'm sure both members will have excellent discussions.

I'm certainly surprised to see such an ignorant comment from this frequent poster. A moment's research would have shown that the Yahoo HSO board has 169 members not two as this poster states.

Yahoo board technology may be old but it works.

[Eclipse]

Yahoo hasn't been a factor in the services sector for a decade.

How many of those 169 are still even in CAP and / or use their Yahoo address?

[RNOfficer]

Yahoo hasn't been a factor in the services sector for a decade.

How many of those 169 are still even in CAP and / or use their Yahoo address?

What no apology for denigrating the CAP Health Service Group by stating it has only two members?

Again, you write from ignorance. Yahoo Groups are not restricted to those with Yahoo email addresses. Notice of postings on this Yahoo group can be sent to any email that accepts Yahoo mail.

I suspect that if a member was no longer active in CAP, he/ she would leave the group to avoid the frequent postings. At least all of them were members when they joined.

[SMWOG]

I am in the HS PD track,very interested in HS but I dont have a yahoo email(not since 2005). How about a FB group?. I dont think Eclipse was insulting HS folks,just making fun of yahoo groups,its kinda like MySpace and AOL. 

[Pace]

As a member of the HSO group since near the beginning, my first thought is that CAP first needs to create a specialty track guide and a useful guide of how to integrate certain skill sets into the organization (health safety officer??, I know I'm reaching here)  before we (re)start a board. Sure we can share knowledge; however, I stopped acknowledging my professional training within CAP because there really isn't a routine place for it. Shock Pt on a mission; I'm your man until EMS can take over. Advising people on health issues, sure. Otherwise my medical background is useless in CAP. Just my two cents.

[RNOfficer]

I am in the HS PD track,very interested in HS but I dont have a yahoo email(not since 2005). How about a FB group?. I dont think Eclipse was insulting HS folks,just making fun of yahoo groups,its kinda like MySpace and AOL. 

As previously stated, a Yahoo mail address is not necessary to subscribe to the CAP Health Services Officer Yahoo group. You can use almost any email domain. A very few email domains will not accept Yahoo Group emails.

Just go to : https://beta.groups.yahoo.com/neo/groups/CAP_HEALTH_SERVICES/info and click "Join Group".

The CAP HSO Yahoo Group has existed since 2004, a very long time in CAP-time. We're proud of the contribution that the members of this board have made to the health and safety of CAP members. As previously stated, it would be awkward to transfer so many members to another medium. Facebook is certainly popular but it is primarily a visual medium which is not necessary for this group.

As for critics of the Yahoo Group: "Do You Create Anything Or Just Criticize Others?". 

http://thoughtcatalog.com/kovie-biakolo/2013/03/do-you-create-anything-or-just-criticize-others/

Have you created and maintained anything in CAP that has lasted for 12 years?

[Eclipse]

Have you created and maintained anything in CAP that has lasted for 12 years?

That.

Is.

Funny.

Right.

There.

[FW]

Have you created and maintained anything in CAP that has lasted for 12 years?

That.

Is.

Funny.

Right.

There.

I love CAPTalk...

[RNOfficer]

As a member of the HSO group since near the beginning, my first thought is that CAP first needs to create a specialty track guide and a useful guide of how to integrate certain skill sets into the organization (health safety officer??, I know I'm reaching here)  before we (re)start a board. Sure we can share knowledge; however, I stopped acknowledging my professional training within CAP because there really isn't a routine place for it. Shock Pt on a mission; I'm your man until EMS can take over. Advising people on health issues, sure. Otherwise my medical background is useless in CAP. Just my two cents.

I completely agree that the HSO status and role is poorly defined. I'm sorry to state that I believe that there has not been strong leadership on the National Level. You'll recall I suspended discussion on the HSO Board for just this reason - - the discussion was pointless with clearer guidelines from National.

I opened discussion up again just recently after I received numerous requests. It is on a trial basis.

The issue you raise is fundamental and I'll give it the attention it deserves.

IMO the role of an HSO is exactly that "heath" -- not medical care. Preventive medicine and health education are very badly needed in our society and in CAP. I am not qualified to give medical advice and I don't do it either on the board or in CAP. What I try to provide is information so that HSOs can help members make informed decisions on improving their health.

HSOs with varying qualifications can provide presentations on heath to CAP members. The issue becomes more problematic when an HSO is asked medical advice either in a group setting or individually. I'm willing to give rudimentary advice - - how long should one spend washing your hands? (sing "Happy Birthday to You" twice), what to apply to a small injury? (soap and water), which OTC pain reliever and fever reducer causes the least gastro upset (generic Tylenol, acetaminophen).

I also can direct members to useful, unbiased sites on the web if they wish to research something further and, of course, I can encourage them to see their PCP.

For example: I recently gave a Senior presentation on BPH, a condition that almost all men will experience if they live long enough. Some members did not know what the prostate was. Others had symptoms of BPH and had not thought to discuss it with their PCP. I didn't diagnosis anything but the members present knew what to ask their PCP. And BTW, I was able is dispel the common blief that there is a relationship between BPH and prostate cancer, a fear that keeps some men from seeking care.That's health education.

Advice that would require more medical information, such as "a guide to laxatives", I post on the HSO Yahoo Board. Some HSOs are qualified to provide this information.

In conclusion. IMO, Health Service Officers have a vital role in the CAP - not yet realized. Preventive medicine, heath education, exercise, and dietary advice are all areas that do not involve medical practice. Considering the dismal state of health knowledge among Americans AND the treacherous false information found throughout the web, I believe there is plenty for HSOs to do.

Finally, I think HSOs have a role in advocating heath issues. As you know, for example, I'm strongly in favor of training members to be able to treat traumatic injuries until EMS arrives. One in five trauma patients needless die because of poor pre-hospital care. Partially this is due to expecting too much of EMT-Bs (where I live EMT-P, paramedics, respond to each accident or medical emergency if EMS is indicated by first responders. But this is too expensive for many jurisdiction to provide.)

The other reason 1 in 5 trauma patients needlessly die is because on-lookers and even first responders are inadequately trained in trauma care. When there is a natural disaster or terrorist attack and EMS is overwhelmed, is when we we will see the fruits of our complacency.

As I said, HSOs have a variety of qualifications and this must always be considered, but information on the heath education, etc can be delivered by any HSO, so long as he/she is aware of their own limitations.

In good health I hope.

[Eclipse]

Everything above is true, to a greater or lesser degree, none of it is CAP's concern, and members are not looking to CAP to provide this
information. 

A fully staffed as to the brochures and regs, not to mention core-mission proficient CAP might have time to devote to
this kind of thing, CAP hasn't ever been that during my tenure, and certainly isn't likely to be any time soon.
That is the ongoing issue with the Health Services directorate in CAP.

I can't imagine where your unit finds the time to be presenting BPH seminars.  Mine doesn't have the time to complete the mission.

When MDs will give free flight physicals to pilots and annual physicals to cadets, you'll have my attention.

[FW]

Back in the day, properly trained HSOs (or medical officers, as they were then known) gave members valuable knowledge on "Universal Precautions" and "Blood Borne Pathogens".  It was popular to get this information in the early days of the "AIDS" epidemic.  We just don't seem to require that any longer for some reason.  Today, HSO's can work with safety officers in helping our members avoid those nasty personal injuries during encampments, special activities, and/or other such personal things we may worry about.

Personally, I agree with Eclipse;  Until we can get MDs to give free flight physicals to pilots, I'm really not interested in the HSO program...

[LSThiker]

Until we can get MDs to give free flight physicals to pilots, I'm really not interested in the HSO program...

Back in the day, CAP medical officers did just that

[stillamarine]

I am in the HS PD track,very interested in HS but I dont have a yahoo email(not since 2005). How about a FB group?. I dont think Eclipse was insulting HS folks,just making fun of yahoo groups,its kinda like MySpace and AOL. 

What HS PD Track??

[grunt82abn]

One in five trauma patients needless die because of poor pre-hospital care. Partially this is due to expecting too much of EMT-Bs (where I live EMT-P, paramedics, respond to each accident or medical emergency if EMS is indicated by first responders. But this is too expensive for many jurisdiction to provide.)

The other reason 1 in 5 trauma patients needlessly die is because on-lookers and even first responders are inadequately trained in trauma care. When there is a natural disaster or terrorist attack and EMS is overwhelmed, is when we we will see the fruits of our complacency.

I would like to know where your information comes from? I've never seen or even heard of statistics that bad, where 1 in 5 patient's deaths were caused by poor care provided by EMS pre-hospital. Also, Please explain how systems are expecting to much of EMT-B's and in what capacity and how we are inadequately trained? Please clarify, so I can go back to my EMS system and explain to them how CAP Health Services thinks EMS first responders are killing 1 in 5 patients pre-hospital, and another 1 in 5 on scene from being inadequately trained. I am sure National Registry would also like this information.

[RNOfficer]

One in five trauma patients needless die because of poor pre-hospital care. Partially this is due to expecting too much of EMT-Bs (where I live EMT-P, paramedics, respond to each accident or medical emergency if EMS is indicated by first responders. But this is too expensive for many jurisdiction to provide.)

The other reason 1 in 5 trauma patients needlessly die is because on-lookers and even first responders are inadequately trained in trauma care. When there is a natural disaster or terrorist attack and EMS is overwhelmed, is when we we will see the fruits of our complacency.

I would like to know where your information comes from? I've never seen or even heard of statistics that bad, where 1 in 5 patient's deaths were caused by poor care provided by EMS pre-hospital. Also, Please explain how systems are expecting to much of EMT-B's and in what capacity and how we are inadequately trained? Please clarify, so I can go back to my EMS system and explain to them how CAP Health Services thinks EMS first responders are killing 1 in 5 patients pre-hospital, and another 1 in 5 on scene from being inadequately trained. I am sure National Registry would also like this information.

Here ya go: http://bigstory.ap.org/article/60edc1db2da547cba8ea7c01779ef74f/1-5-trauma-deaths-could-be-prevented-study-says

"The report found a patchwork of results, from emergency medical systems — the often-volunteer first responders — that are considered more as transporters than health providers, to death rates that vary twofold between the best- and worst-performing trauma centers."

For those not familiar with EMS, there are three levels of EMT. EMT-B 110 hours, EMT-ii (or "A" for advanced or "I" for intermediate)) 306 hours, and EMT-P (Paramedic) 1090 hours. The query here is about EMT-B, the lowest level of training.

I have EMT-B training myself and have worked hundreds of hours as an EMT-B. I know how limited is the scope of practice and the training. Of course the scope of practice varies in different jurisdictions. In mine, EMT-B, for example, receive minimal training on removal of victims from vehicle, almost no  obstetric training, are not permitted to intubulate, and can administer no drugs except O2.and a victim's own MDI.

In general, EMTs provide what is considered basic life support and are limited to essentially non-invasive procedures. EMTs refer to it as "scoop and scoot".

EMT-B training is frankly minimal: "Under the NHTSA curriculum, students receive 110 hours of lecture and lab time covering anatomy, physiology, legal aspects of medical care, assessment, and treatment of medical, trauma, behavioral, and obstetric emergencies. In addition to class time, the NHTSA recommends clinical rotations on board ambulances and in emergency departments."

https://en.wikipedia.org/wiki/National_Registry_Emergency_Medical_Technician

Really, not much training can be done in 110 hours (my jurisdiction is 120 minimum) which is less than three weeks full-time> This is especially because there is no prerequisite training such as anatomy and physiology. So, EMT-B training is only 110 hours for someone who may well know nothing at all at the beginning.

This isn't a criticism of EMT-Bs. They are what they are. I'm sure you give the very best care consistent with your training and scope of practice. But many jurisdictions rely upon entirely EMT-Bs for pre-hospital care when higher standards of training would reduce trauma deaths.

Here's the full report from the NA

http://www.nationalacademies.org/hmd/Reports/2016/A-National-Trauma-Care-System-Integrating-Military-and-Civilian-Trauma-Systems.aspx

BTW, in California, EMT-B training is FREE for high school students through ROP and I encourage it for anyone considering nursing or medical training or who desire to be a firefighter or law enforcement officer. Good training for cadets also.

http://www.carocp.org/

I do not know if free training is available in other states. Ask your unit HSO.

[Eclipse]

Presuming everything you posted is true, how is this relevent to CAP in regards to Health Services?

CAP is explicitly barred from providing anything but basic first aid, and hasn't ever been capable of
being anything remotely resembling a "first responder".

Assuming the EMT system is broken, and I don't necessarily think it is except for maybe in rural areas,
CAP isn't in a position to impact that situation, nor is it tasked to.

You should be raising this awareness in forums that might be able to bring resources to the table and fix it.

[RNOfficer]

Everything above is true, to a greater or lesser degree, none of it is CAP's concern, and members are not looking to CAP to provide this
information. 

A fully staffed as to the brochures and regs, not to mention core-mission proficient CAP might have time to devote to
this kind of thing, CAP hasn't ever been that during my tenure, and certainly isn't likely to be any time soon.
That is the ongoing issue with the Health Services directorate in CAP.

I can't imagine where your unit finds the time to be presenting BPH seminars.  Mine doesn't have the time to complete the mission.

When MDs will give free flight physicals to pilots and annual physicals to cadets, you'll have my attention.

Contrary to what you state, CAP believes that "Our members are our best resource" and keeping them healthy is one way to keep that resource active. Contrary to what you state, members are eager for health information, but perhaps they are not as well-informed as you are.

Presentations such as the one on BPH I described don't take much time, perhaps a half hour. Our unit is well-run and the time is found.  We are mission-ready and have an active cadet and AE program.

[grunt82abn]

One in five trauma patients needless die because of poor pre-hospital care. Partially this is due to expecting too much of EMT-Bs (where I live EMT-P, paramedics, respond to each accident or medical emergency if EMS is indicated by first responders. But this is too expensive for many jurisdiction to provide.)

The other reason 1 in 5 trauma patients needlessly die is because on-lookers and even first responders are inadequately trained in trauma care. When there is a natural disaster or terrorist attack and EMS is overwhelmed, is when we we will see the fruits of our complacency.

I would like to know where your information comes from? I've never seen or even heard of statistics that bad, where 1 in 5 patient's deaths were caused by poor care provided by EMS pre-hospital. Also, Please explain how systems are expecting to much of EMT-B's and in what capacity and how we are inadequately trained? Please clarify, so I can go back to my EMS system and explain to them how CAP Health Services thinks EMS first responders are killing 1 in 5 patients pre-hospital, and another 1 in 5 on scene from being inadequately trained. I am sure National Registry would also like this information.

Here ya go: http://bigstory.ap.org/article/60edc1db2da547cba8ea7c01779ef74f/1-5-trauma-deaths-could-be-prevented-study-says

"The report found a patchwork of results, from emergency medical systems — the often-volunteer first responders — that are considered more as transporters than health providers, to death rates that vary twofold between the best- and worst-performing trauma centers."

For those not familiar with EMS, there are three levels of EMT. EMT-B 110 hours, EMT-ii (or "A" for advanced or "I" for intermediate)) 306 hours, and EMT-P (Paramedic) 1090 hours. The query here is about EMT-B, the lowest level of training.

I have EMT-B training myself and have worked hundreds of hours as an EMT-B. I know how limited is the scope of practice and the training. Of course the scope of practice varies in different jurisdictions. In mine, EMT-B, for example, receive minimal training on removal of victims from vehicle, almost no  obstetric training, are not permitted to intubulate, and can administer no drugs except O2.and a victim's own MDI.

In general, EMTs provide what is considered basic life support and are limited to essentially non-invasive procedures. EMTs refer to it as "scoop and scoot".

EMT-B training is frankly minimal: "Under the NHTSA curriculum, students receive 110 hours of lecture and lab time covering anatomy, physiology, legal aspects of medical care, assessment, and treatment of medical, trauma, behavioral, and obstetric emergencies. In addition to class time, the NHTSA recommends clinical rotations on board ambulances and in emergency departments."

https://en.wikipedia.org/wiki/National_Registry_Emergency_Medical_Technician

Really, not much training can be done in 110 hours (my jurisdiction is 120 minimum) which is less than three weeks full-time> This is especially because there is no prerequisite training such as anatomy and physiology. So, EMT-B training is only 110 hours for someone who may well know nothing at all at the beginning.

This isn't a criticism of EMT-Bs. They are what they are. I'm sure you give the very best care consistent with your training and scope of practice. But many jurisdictions rely upon entirely EMT-Bs for pre-hospital care when higher standards of training would reduce trauma deaths.

Here's the full report from the NA

http://www.nationalacademies.org/hmd/Reports/2016/A-National-Trauma-Care-System-Integrating-Military-and-Civilian-Trauma-Systems.aspx

BTW, in California, EMT-B training is FREE for high school students through ROP and I encourage it for anyone considering nursing or medical training or who desire to be a firefighter or law enforcement officer. Good training for cadets also.

http://www.carocp.org/

I do not know if free training is available in other states. Ask your unit HSO.

The AP is not a source I would consider highly credible reporting on pre-hospital EMS. JEMS, Firehouse, Fire Chief news articles are more credible, but I will not bite into the 1 in 5 unless it comes from a source like the CDC, AMA, or JHUMC study with real facts. Some of the best EMT's and Medics I know come from rural jurisdictions, and they are far from just transporters!!!   

[RNOfficer]

Presuming everything you posted is true, how is this relevent to CAP in regards to Health Services?

CAP is explicitly barred from providing anything but basic first aid, and hasn't ever been capable of
being anything remotely resembling a "first responder".

Assuming the EMT system is broken, and I don't necessarily think it is except for maybe in rural areas,
CAP isn't in a position to impact that situation, nor is it tasked to.

You should be raising this awareness in forums that might be able to bring resources to the table and fix it.

Thank you for your inquiry.

Firstly, I was responding to a specific query about "1-5 unnecessary trauma deaths" and EMTs. Even if it was not related to CAP, it was a legitimate question to which I believe I gave the attention it deserves.

Secondly, what is "First Aid"? Merrian-Webster defines it as: "emergency care or treatment given to an ill or injured person before regular medical aid can be obtained"

http://www.merriam-webster.com/dictionary/first%20aid

EMT-B scope of practice, as explained above is "basic life support and limited to essentially non-invasive procedures."  So, what an EMT does is basically first aid plus transportation. Leave out the transportation and EMT-B scope of practice is well within CAP regulations as First Aid.

As I explained, the ARC Basic First Aid with CPR course (a pathetic 6 hours!) does not deal adequately with traumatic injuries which by the above definition are included in "first aid". Better training is necessary to provide adequate "first aid". EMT is one way to obtain this training. I've many times used my EMS training, off duty, to provide "first aid" both in CAP and real life.

What I said was  "I'm strongly in favor of training members to be able to treat traumatic injuries until EMS arrives" That's first aid.

[RNOfficer]

grunt82abn  says: The AP is not a source I would consider highly credible reporting on pre-hospital EMS. JEMS, Firehouse, Fire Chief news articles are more credible, but I will not bite into the 1 in 5 unless it comes from a source like the CDC, AMA, or JHUMC study with real facts. Some of the best EMT's and Medics I know come from rural jurisdictions, and they are far from just transporters!!! 

Perhaps you missed this but I included a link to the actual NA report that the AP cites in my post.  Here it is again:

http://www.nationalacademies.org/hmd/Reports/2016/A-National-Trauma-Care-System-Integrating-Military-and-Civilian-Trauma-Systems.aspx

The source is the National Academies of Science Engineering Medicine

http://www.nationalacademies.org/

which is, without question, the most respected and competent research organization in America

http://www.nationalacademies.org/about/reputation/index.html

I enclosed the AP link because I assumed most readers would not want to read the full report.

[LSThiker]

which is, without question, the most respected and competent research organization in America

The NAS is not a research organization.  Rather it is an organization of leading researchers. 

It serves as defined in its charter:

The National Academy of Sciences charter commits the Academy to provide scientific advice to the government "whenever called upon" by any government department. The Academy receives no compensation from the government for its services.

provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

The Academies does not conduct its own research, except to form a public policy letter.  It only publishes research conducted by members and non-members. 

[Fubar]

Contrary to what you state, members are eager for health information, but perhaps they are not as well-informed as you are.

I disagree that the membership is clamoring for health information, but I do recognize not every unit or wing is the same.

[FW]

Contrary to what you state, members are eager for health information, but perhaps they are not as well-informed as you are.

I disagree that the membership is clamoring for health information, but I do recognize not every unit or wing is the same.

There may be a squadron or two in FLWG which would love having info on health.  Is there a squadron at or near "The Villages"? 

[LTC Don]

the ARC Basic First Aid with CPR course (a pathetic 6 hours!) does not deal adequately with traumatic injuries which by the above definition are included in "first aid".

I wish the HSO Corps would finally come together and develop a First Aid curriculum that meets the 'or equivalent' requirement in the SQTR for Ground Team Member.  It's been danced around for literally almost 20 years now with no resolution.  Many, if not most squadrons have someone from the medical or public safety industries that are competent SMEs, they just need something to teach and be able to issue a CAP-backed certificate that fulfills the SQTR requirement.

Thinking way out there, if the curriculum passes muster, it could even become an outreach program to be taught to other community groups, something the HSO Corps could definitely sink their teeth into.

Many of our cadets go into the medical or public safety fields.  Myself and at least three others from my old squadron all became Paramedics and/or Cops. Being a stakeholder in teaching first aid courses to their fellow members could be a great way to help them transition to senior status.  Right now, we lose so many cadets who later become excellent SMEs, but never make the jump to senior membership.  It's a terrible loss to CAP.  Grooming them early on to become instructors, teaching a topic comfortable to them such as first aid, definitely has some appeal, understanding that it isn't a good fit for everyone though.

Sorry for the disjointed thoughts, but in reality, we desperately need a vibrant, healthy HSO Corps and a team at national who understands this.

[FW]

One of CAP's problems is that we, from time to time, stray from our congressional charter of "missions".  As many have said before, we do NOT need a "vibrant, healthy HSO Corps".  WE, however need good solid partnership with the ARC, and other organizations which the "creds" and willingness to train our members in skills which are recognized universally.  We can not do everything "in house", nor should we. 

[Spam]

the ARC Basic First Aid with CPR course (a pathetic 6 hours!) does not deal adequately with traumatic injuries which by the above definition are included in "first aid".

I wish the HSO Corps would finally come together and develop a First Aid curriculum that meets the 'or equivalent' requirement in the SQTR for Ground Team Member.  It's been danced around for literally almost 20 years now with no resolution.  Many, if not most squadrons have someone from the medical or public safety industries that are competent SMEs, they just need something to teach and be able to issue a CAP-backed certificate that fulfills the SQTR requirement.

Thinking way out there, if the curriculum passes muster, it could even become an outreach program to be taught to other community groups, something the HSO Corps could definitely sink their teeth into.

That's a great point. What might be very helpful would be a state by state compilation of available courses/providers that meet the stated standard, perhaps to include online courses which meet the content.  The HSO team may not want to/may be ordered not to promulgate a CAP-endorsed course for the very liability reasons that led to the current situation, but the team could at least serve a valuable function as a resource organization.


So, in that spirit, how about some discrete tasks related to the GTM3 first aid curriculum, to stay constructive?

- Help unit level personnel find courses/post an updated listing by POC/agency/website/cost per student/discounts/et cetera.
- Screen courses for us to evaluate the degree of their compliance with the standard.
- Provide and update a list of volunteer instructors per Region/Wing that are dedicated to helping units comply.
- Perhaps coordinate to sponsor regular classes to that standard on a Regional basis, a few times a year, to reduce cost/improve standardization.
- Evaluate the potential for entirely web based instruction/testing to standard, vice in person, vice a blend of online learning and a final practical (perhaps tailored for CAP).

Just brainstorming,

V/R
Spam

[stillamarine]

As someone who was a FF/EMT-B for a very long time in both urban and rural areas. I'm a little peeved at the OP's attitude towards first responders. I've spent the last 20 mins starting and deleting replies to his posts. Thankfully I've installed a filter from my brain to my typing fingers, but I wonder if the first responders in his community know he thinks so little of them. I bet if he was having a medical emergency he would be happy with whoever was trying to save his life no matter what their certification is.

[grunt82abn]

As someone who was a FF/EMT-B for a very long time in both urban and rural areas. I'm a little peeved at the OP's attitude towards first responders. I've spent the last 20 mins starting and deleting replies to his posts. Thankfully I've installed a filter from my brain to my typing fingers, but I wonder if the first responders in his community know he thinks so little of them. I bet if he was having a medical emergency he would be happy with whoever was trying to save his life no matter what their certification is.

As a current FF/PM I am with you, and was also more than a little peeved!!! Thanks for the back up!!!

[grunt82abn]

grunt82abn  says: The AP is not a source I would consider highly credible reporting on pre-hospital EMS. JEMS, Firehouse, Fire Chief news articles are more credible, but I will not bite into the 1 in 5 unless it comes from a source like the CDC, AMA, or JHUMC study with real facts. Some of the best EMT's and Medics I know come from rural jurisdictions, and they are far from just transporters!!! 

Perhaps you missed this but I included a link to the actual NA report that the AP cites in my post.  Here it is again:

http://www.nationalacademies.org/hmd/Reports/2016/A-National-Trauma-Care-System-Integrating-Military-and-Civilian-Trauma-Systems.aspx

The source is the National Academies of Science Engineering Medicine

http://www.nationalacademies.org/

which is, without question, the most respected and competent research organization in America

http://www.nationalacademies.org/about/reputation/index.html

I enclosed the AP link because I assumed most readers would not want to read the full report.

The article mentioned the CDC, but used nothing to make the article anymore credible. I could write an article and throw all kinds of acronyms in to add legitimacy, doesn't mean the article is true or accurately written. You should not believe everything you read on the Internet!


Sent from my iPhone using Tapatalk

[RNOfficer]

which is, without question, the most respected and competent research organization in America

The NAS is not a research organization.  Rather it is an organization of leading researchers. 

It serves as defined in its charter:

The National Academy of Sciences charter commits the Academy to provide scientific advice to the government "whenever called upon" by any government department. The Academy receives no compensation from the government for its services.

provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

The Academies does not conduct its own research, except to form a public policy letter.  It only publishes research conducted by members and non-members.

You're correct. Thanks for the clarification..

[RNOfficer]

As someone who was a FF/EMT-B for a very long time in both urban and rural areas. I'm a little peeved at the OP's attitude towards first responders. I've spent the last 20 mins starting and deleting replies to his posts. Thankfully I've installed a filter from my brain to my typing fingers, but I wonder if the first responders in his community know he thinks so little of them. I bet if he was having a medical emergency he would be happy with whoever was trying to save his life no matter what their certification is.

I'm always disappointed when folks are unhappy with my posts but I'm supplying information and stated what the report said. As I have explained, I was a working EMT-B and I know the limitations of the training and the scope of practice.

Here's an example: suppose EMT-Bs arrive because a victim is having a heart attack. We all know that after calling 911 the next thing one should do is chew a full-strength aspirin. (BTW, this is not appropriate for a stroke or cardiac arrest.)

http://www.mayoclinic.org/first-aid/first-aid-heart-attack/basics/art-20056679

In my jurisdiction, an EMT-B cannot give that patient an aspirin or even suggest that he should take it without getting clearance from a physician for that particular patient. Fortunately where I live, EMT-Ps (paramedics) are sent to each accident or medical emergencies.

However, in many places however, EMT-Bs alone are the responders and they lack both the training and the scope of practice to provide sufficient life-saving pre-hospital care. That's what the report concluded.

You're perfectly entitled to disagree with the report but it's quite silly to blame me for reporting it or to conclude that I lack respect for emergency medical responders.

[arajca]

What can a paramedic do in a trauma situation that a basic cannot that will make that kind of a difference?

In my experience, extrication was done by firefighters, not EMTs.

[SMWOG]

As someone who was a FF/EMT-B for a very long time in both urban and rural areas. I'm a little peeved at the OP's attitude towards first responders. I've spent the last 20 mins starting and deleting replies to his posts. Thankfully I've installed a filter from my brain to my typing fingers, but I wonder if the first responders in his community know he thinks so little of them. I bet if he was having a medical emergency he would be happy with whoever was trying to save his life no matter what their certification is.

I'm always disappointed when folks are unhappy with my posts but I'm supplying information and stated what the report said. As I have explained, I was a working EMT-B and I know the limitations of the training and the scope of practice.

Here's an example: suppose EMT-Bs arrive because a victim is having a heart attack. We all know that after calling 911 the next thing one should do is chew a full-strength aspirin. (BTW, this is not appropriate for a stroke or cardiac arrest.)

http://www.mayoclinic.org/first-aid/first-aid-heart-attack/basics/art-20056679

In my jurisdiction, an EMT-B cannot give that patient an aspirin or even suggest that he should take it without getting clearance from a physician for that particular patient. Fortunately where I live, EMT-Ps (paramedics) are sent to each accident or medical emergencies.

However, in many places however, EMT-Bs alone are the responders and they lack both the training and the scope of practice to provide sufficient life-saving pre-hospital care. That's what the report concluded.

You're perfectly entitled to disagree with the report but it's quite silly to blame me for reporting it or to conclude that I lack respect for emergency medical responders.

Basics can do alot more in my area(BLS drug bag). Taking a EMT B  course in my jurisdiction does not make one a provider. There is a  FTO program and  many CME hours required before you can crew chief a bus. It seems like every year here,basics are taking on more skills(more drugs in the med control plan). Next new thing will be using King Airways. I cross the state line for mutal aide and its like night and day(no glucose adminstration allowed or use of monitor). I do see the vaule of HSO in CAP providing health info and monitoring  the health and safety of our members. Many providers and practitioners can identify signs and symptoms  that many people can not. We can also advise others to do no harm when they might think their intentions are good. 

[DakRadz]

What can a paramedic do in a trauma situation that a basic cannot that will make that kind of a difference?

Fluid. Normal saline. That's about it. If that doesn't work, maybe a drug to force your pressure higher. Oh, and chest darts needle decompression, plus airway maintenance for massive trauma. But I've seen (and been guilty of) medics taking time on scene without patient improvement to attempt ALS procedures when they could have done it en route to hospital and been halfway or all the way there. I've seen many more studies and articles that paramedics kill more than EMTs because we try to "stay and play".

Military findings suggest about 20 percent of deaths could be prevented with optimal care, Holcomb said. That translates into "81 patients a day dying in the United States — every day — that are potentially preventable," he said.

THEY DIDN'T STUDY the US population. They applied military statistics directly to CIVILIAN trauma.


Trauma arrest? My protocol says a bunch of trauma docs with fancy letters and the ability to certify new trauma docs has a recommendation- Non-Initiation of Care.
(The article doctor says we need to "resuscitate better")

Patient dies on the way from a rural area to a hospital? Unfortunately, we simply cannot save them all, and likely were going to do little for them no matter how hard we tried.

I take plenty of trauma patients- not nearly this number are so "gloriously deadly" (not how I feel, that's the sentiment the article gives me, because I know who goes in our trauma registry and I have NOT killed 1 in 5). Between my rural FT job, and my fast-paced city PT job, I rarely meet a patient who needs a paramedic. And that goes for ALL patients, not just trauma.


Either they are injured severely, and need intervention (rare)- or the timeframe of location, response, and speed of bleeding just doesn't add up well.




And finally- areas with a plethora of paramedics end up with a dearth of drug for our eager EMTs. If you aren't expected to act without a paramedic to either hold your hand or train you to do things their way, then EMTs will be restricted. (Regardless of how skilled an EMT, some systems do expect EMTs need their hand held- it isn't right, but it's true)

My semi-rural volunteer service EMT scope- King, LMA, ASA, O2, NTG, EpiPen, Narcan IN, baby-catching (same as a paramedic, and the nurse don't let you do ANYTHING during OB medic clinicals, so.), and transmit 12 lead (meaning I knew to apply one alone). Some of this was a "Call Medical Control," but NTG was the only thing you would have to have a good reason and prior history to administer. Everything else was a formality.

[LTC Don]

Another issue the HSO Corps can sink their teeth into --
Heat-related illnesses are a real issue we deal with every year during our various week-long activities.  Are we preventing them in the right way though?

Do we need a more formal 'protocol' that may buck the traditional prevention and treatment modalities that are decades old?

EMS Webinar -- long but very interesting:
https://www.youtube.com/watch?v=6YH8ZopxUdw   < Pay particular attention to the segment on hyponatremia as it relates to CAP's doctrine on heat illness and dehydration prevention during encampments and weekend activities.

Korey Stringer Institute:
http://ksi.uconn.edu/

KSI page on heat stroke -- watch the video:
http://ksi.uconn.edu/emergency-conditions/heat-illnesses/exertional-heat-stroke/  <The video was posted over two years ago, so this isn't ground-breaking or shocking information.

[Eclipse]

Heat-related illnesses are a real issue we deal with every year during our various week-long activities.  Are we preventing them in the right way though?

Do we need a more formal 'protocol' that may buck the traditional prevention and treatment modalities that are decades old?

No.  At least in the far-too many cases I'm aware of, those who fell ill ignored directives and acted against advice and training.

I can't tell you how many times I've dealt with cadets who get sick because they won't drink water, literally
faking the action but not taking any in, or worse show up to activities with known medical issues made
worse by heat or stress and don't mention them until they are lying cross-eyed on their rack.

At some point there's only so much you can do or monitor, even with cadets, we don't need more "hydrate, hydrate, hydrate".

[grunt82abn]

What can a paramedic do in a trauma situation that a basic cannot that will make that kind of a difference?

Fluid. Normal saline. That's about it. If that doesn't work, maybe a drug to force your pressure higher. Oh, and chest darts needle decompression, plus airway maintenance for massive trauma. But I've seen (and been guilty of) medics taking time on scene without patient improvement to attempt ALS procedures when they could have done it en route to hospital and been halfway or all the way there. I've seen many more studies and articles that paramedics kill more than EMTs because we try to "stay and play".

Military findings suggest about 20 percent of deaths could be prevented with optimal care, Holcomb said. That translates into "81 patients a day dying in the United States — every day — that are potentially preventable," he said.

THEY DIDN'T STUDY the US population. They applied military statistics directly to CIVILIAN trauma.


Trauma arrest? My protocol says a bunch of trauma docs with fancy letters and the ability to certify new trauma docs has a recommendation- Non-Initiation of Care.
(The article doctor says we need to "resuscitate better")

Patient dies on the way from a rural area to a hospital? Unfortunately, we simply cannot save them all, and likely were going to do little for them no matter how hard we tried.

I take plenty of trauma patients- not nearly this number are so "gloriously deadly" (not how I feel, that's the sentiment the article gives me, because I know who goes in our trauma registry and I have NOT killed 1 in 5). Between my rural FT job, and my fast-paced city PT job, I rarely meet a patient who needs a paramedic. And that goes for ALL patients, not just trauma.


Either they are injured severely, and need intervention (rare)- or the timeframe of location, response, and speed of bleeding just doesn't add up well.




And finally- areas with a plethora of paramedics end up with a dearth of drug for our eager EMTs. If you aren't expected to act without a paramedic to either hold your hand or train you to do things their way, then EMTs will be restricted. (Regardless of how skilled an EMT, some systems do expect EMTs need their hand held- it isn't right, but it's true)

My semi-rural volunteer service EMT scope- King, LMA, ASA, O2, NTG, EpiPen, Narcan IN, baby-catching (same as a paramedic, and the nurse don't let you do ANYTHING during OB medic clinicals, so.), and transmit 12 lead (meaning I knew to apply one alone). Some of this was a "Call Medical Control," but NTG was the only thing you would have to have a good reason and prior history to administer. Everything else was a formality.

Spot On!!! Thanks

[grunt82abn]

You're perfectly entitled to disagree with the report but it's quite silly to blame me for reporting it or to conclude that I lack respect for emergency medical responders.
[/quote]

It is not a report, it's a news article that some ignorant journalist wrote for the web, and tried to twist the story to meet whatever agenda they were trying to push. It's a garbage article at best

[stillamarine]

You're perfectly entitled to disagree with the report but it's quite silly to blame me for reporting it or to conclude that I lack respect for emergency medical responders.

I'm not disagreeing with any report. I'm saying you are a complete A**. You have such a low view of first responders like they are something you stepped in and need to be scrapped off your high and mighty shoe. You are the kind of RN that first responders hate to do hand off to. Most RNs have no idea how to deal with situations in the field. There are procedures in the field that medics perform daily that an RN may never perform. Nor do they have to deal with the stress of trying to save a life in a hazardous environment. In a major disaster how many RNs and MDs do you think are on the scene? I'll give you a hint, it's a number that resembles a goose egg. I don't know what kinda EMT work you did, but you apparently had a cush job. Forgot where you came from.

Also at least in the four states I've been a FF in, NO Medics are taught extrication in school. This is a FF task. Now, some medics do get taught but that's because they are dual hatted.

[Pace]

Take it to PM or this thread is done.

[grunt82abn]

You're perfectly entitled to disagree with the report but it's quite silly to blame me for reporting it or to conclude that I lack respect for emergency medical responders.

I'm not disagreeing with any report. I'm saying you are a complete A**. You have such a low view of first responders like they are something you stepped in and need to be scrapped off your high and mighty shoe. You are the kind of RN that first responders hate to do hand off to. Most RNs have no idea how to deal with situations in the field. There are procedures in the field that medics perform daily that an RN may never perform. Nor do they have to deal with the stress of trying to save a life in a hazardous environment. In a major disaster how many RNs and MDs do you think are on the scene? I'll give you a hint, it's a number that resembles a goose egg. I don't know what kinda EMT work you did, but you apparently had a cush job. Forgot where you came from.

Also at least in the four states I've been a FF in, NO Medics are taught extrication in school. This is a FF task. Now, some medics do get taught but that's because they are dual hatted.

Couldn't have said it better myself!!! I started to write along these lines, but after the heck of a day I was having dealing with what you just stated about ERN's, I went the other route. Thank God I am on the Truck tomorrow and just get to be a roof rat 

[Pace]

What part of take it to PM did you not understand? Leave the personal issues out of the threads. Last warning.

[stillamarine]

What part of take it to PM did you not understand? Leave the personal issues out of the threads. Last warning.

Pace, I respect where you are going with that. I'm done. I just want to point out one thing, the original poster is the one that attacked a profession with his demeaning remarks. I was only defending that profession. I felt that it was relevant due to his bringing the profession into the discussion in the first place.

So I apologize to you, and the rest of the board. Well minus one.

[RNOfficer]

You're perfectly entitled to disagree with the report but it's quite silly to blame me for reporting it or to conclude that I lack respect for emergency medical responders.

I'm not disagreeing with any report. I'm saying you are a complete A**. You have such a low view of first responders like they are something you stepped in and need to be scrapped off your high and mighty shoe. You are the kind of RN that first responders hate to do hand off to. Most RNs have no idea how to deal with situations in the field. There are procedures in the field that medics perform daily that an RN may never perform. Nor do they have to deal with the stress of trying to save a life in a hazardous environment. In a major disaster how many RNs and MDs do you think are on the scene? I'll give you a hint, it's a number that resembles a goose egg. I don't know what kinda EMT work you did, but you apparently had a cush job. Forgot where you came from.

Also at least in the four states I've been a FF in, NO Medics are taught extrication in school. This is a FF task. Now, some medics do get taught but that's because they are dual hatted.

I wouldn't respond to such a silly post.

[THRAWN]

All this over a Yahoo group? It is rare that I am ashamed of my CAP peers but seriously?!!?

Pace lock it or I will start swearing to force it. Clowns.

[LSThiker]

Can we stop the male anatomy measuring now?