Kushigs syndrome

[fyrfitrmedic]

See also: "Cushing's Triad."

[manfredvonrichthofen]

That's why I didn't fight the Army when they told me I was done, I knew I would end up being a hazard on the battle field. The big thing to me now is that I know I wouldn't be on a battle field as a cop, but I do understand there would be risks. I also know I am not legally obligated to inform an employer of my disability, but I don't know if that is true for a police force, and I don't care, I would feel obligated to tell them. But, until I can find a replacement  I will serve any way I can. I love CAP, and I think it is a good fit for me.

Thank you to those of you who are able to protect us at home and thank you for giving yourself to us.

And good luck CAP4117, it's not an easy test so far as I can tell. But at least the next one is the final, and then We are done, until the state testing.

[Flying Pig]

Not legally obligated to inform them of disabilities?  OK maybe not on the intitial application.   There will be plenty of other phases of the process where it is legally required.

No, fortunately the US isnt a battlefield, until you walk up to the front porch of a domestic violence call and end up on the recieving end of a hail of gunfire coming through the front door, end up pinned behind you patrol car by some gangster with an Uzi wearing body armor or get sucker punched on your blind side.  Just because this isnt Iraq dont underestimate the need for the same abilities. 

However....what you need to do if its something your interested is start calling around to departments and talk to their HR.  Dont ask the regular desk Sgt.  Most will say on their recruiting documents "Must have vision in both eyes" or "vision correctable to 20/20 in both eyes"   You may find one.  Or you may be able to get a hole of veterans services and see if there are agencies that dont care. 

[manfredvonrichthofen]

I meant that not every day is a battle field, oh believe me, I don't underestimate that it gets rough and violent.

[SJFedor]

Cushing's Triad (increased B/P, decreased HR, irregular respiratory pattern) is indicative of severe intracranial hemorrhage, and moreso it's typically present during herniation of the brainstem out of the foramen magnum (opening in the base of the skull). You get this "triad" of symptoms because the brainstem contains a lot of the body's control centers that manage respirations, heartrate, and blood pressure, and it subsequently causes alterations. If you're seeing Cushing's, you're not far from seeing cardiac arrest.

Cushing's disease, on the other hand, is a disorder of the pituitary gland where it's releasing too much ACTH.

How much longer do you have in EMT school?

[manfredvonrichthofen]

I have one two weeks left, my final is on Thursday, and then we meet two more times and we will be going back over the assessments. Then our state testing is on Saturday the 5th. I will take the written state on that Monday.

Thank you guys for the info! I passed that last test and I even got the Cushings questions right. You guys were a lot of help!!!

[SJFedor]

Rock on. Best of luck, and if I can help you with anything, let me know.

[manfredvonrichthofen]

Just thought I would let you guys know, thank you for the help with Kushings, it really helped me on my final this morning. I passes with a 92%! CAP4177, how are you doing in EMT?

[commando1]

I would love to be a cop, if I find the right agency that will take someone with one eye, the EMT cert can only help.

One of the fine gentlemen I work with was let go from the police dept for political and budget reasons. He had gone to school to be a EMT-IV and turned around and got hired by the ambulance service within a week.

[CAP4117]

Just thought I would let you guys know, thank you for the help with Kushings, it really helped me on my final this morning. I passes with a 92%! CAP4177, how are you doing in EMT?

Congrats!! That's awesome. Our final is next Tuesday, and I'm really nervous about the practical portion. It's hard to believe the class is almost over!

[Major Lord]

Just walk around for a few days narrating everything you are doing. "I am unlocking the door, and being cautious of family members who may be standing inside, I open the door, listening for creaking hinges, and any indication that the door may be unstable"

When you do your practicals, narrate your actions and if you forget something, make sure you say out loud that you have gone back to check it, without apologizing or making excuses. Make sure you don't do any of the big safety no-no's, which they are looking to ding you for; Think tactically. Don't stress or panic, you'll be fine. Congrats on your test!

I remember that my instructors stuck me with a one man response multi-trauma, and no gear. I used a pen to write on peoples foreheads to triage them., note vitals, etc. (resp, pulse, blown pupils, etc.) I lost points for using a permanent marker though....... It was good experience for when it really happened a number of times.

Major Lord

[manfredvonrichthofen]

I plan on going in and doing whatever I want...

It's mostly common sense stuff, other than the medical assessment, and that is mostly memorizing the sheet. other than that, assessing someone medical is all learned, and you will only get better at it as time goes on. Biggest thing to remember is to just chill when you are in the assessment and remember you have ten whole minutes.

The hardest thing is getting your combi tube in the patient and only allow 30 seconds between stopping respirating while doing it... Putting the combi in itself is easy, but in 30 seconds is tough.

Indiana has also made it a critical fail on the medical and trauma assessment if you don't actually pick up the stethoscope.


But hey so this doesn't get locked due to having noting at all with CAP... While we were at the GTE this past weekend with Indiana Kentucky and Illinois, our team actually had an EMT kit with them, but didn't know how to use it, no one was qualified, but luckily it didn't have anything advanced at all, no adjuncts either.

But I have been thinking of getting a kit for myself and was thinking if it made it to a mission with me... Some of that just might end up being useful. I would like to see us able to use some of it, EXCLUDING THINGS LIKE COMBITUBES, in the field, I know of one mission I was a cadet on, that now looking back on it it would have been a nice thing to have that stuff just in case.

I already carry trauma shears, and butt loads of curlex, along with a Sam splint, but nothing else other than Israeli dressings. But an AED would be really nice as well as some OPs and NPs. There are many units that have backboards already, and some that have bag litters. I would like to see it become a requirement that if your team has a litter, it must be a rigid one, and it be against regulation that you must also secure the head if you use it. You shouldn't use a litter without securing the head anyways, but I see it happen a lot.

[Spaceman3750]

SAM splints are good stuff. I talk about those at every first aid class I teach, yet I keep forgetting to pick one up for my gear.

HINT: If you're bored, curl the SAM splint to make it ridged, ball up a piece of paper, and play SAM splint stickball.

[fyrfitrmedic]

Just walk around for a few days narrating everything you are doing. "I am unlocking the door, and being cautious of family members who may be standing inside, I open the door, listening for creaking hinges, and any indication that the door may be unstable"

When you do your practicals, narrate your actions and if you forget something, make sure you say out loud that you have gone back to check it, without apologizing or making excuses. Make sure you don't do any of the big safety no-no's, which they are looking to ding you for; Think tactically. Don't stress or panic, you'll be fine. Congrats on your test!

+1000

As both an instructor and an evaluator, I can't agree with this strongly enough.

[ProdigalJim]

^^^ this.

As if you needed any more affirmation, do what m'lord says. I used the same procedure when I was preparing for my medic practicals a few years ago, and it absolutely works.

It drove my wife and kids bonkers after awhile, though, so beware. We wound up making a family gag of it: "I'm throwing this wet rag at my unsuspecting Dad, after determining that the scene is safe and I have at least two escape routes." *FWAP* (That's the best text-approximation I can come up with for getting hit with a wet rag...) 

[manfredvonrichthofen]

SAM splints are good stuff. I talk about those at every first aid class I teach, yet I keep forgetting to pick one up for my gear.

HINT: If you're bored, curl the SAM splint to make it ridged, ball up a piece of paper, and play SAM splint stickball.

Nice, I'll do that with my old one.

[manfredvonrichthofen]

Ok, first round of state testing this morning.

[sarmed1]

Sometimes over narration can sink you too; so be carefull.  My previous EMT partner failed the IO station of his paramedic exam because of over talking his actions.  He performed the skill appropriately but while talking his way thru the measurements he said tuberal tuberosity instead of tibial tuberosity...even though he measered appropriately.  Fail!!! for not knowing the proper landmarks.  If he had just done the skill and not narrated his way thru it he would have passed.

Indiana has also made it a critical fail on the medical and trauma assessment if you don't actually pick up the stethoscope.

I agree and disagree with these type of actions:  I assume this is in relation to lung sound assessment.....assessment tool in an assesment station ok  My problem comes in with treatment tools. You are required to voice treat all injuries/illness.....once you start to use to much equipment you increase the risk of station failure for "...providing a dangerous intervention...." ie you oopsed and put the collar on upside down you fail the assessment station.  There is a seperate station for immobilization...its almost like double jeapordy.

mk

[fyrfitrmedic]

Sometimes over narration can sink you too; so be carefull.  My previous EMT partner failed the IO station of his paramedic exam because of over talking his actions.  He performed the skill appropriately but while talking his way thru the measurements he said tuberal tuberosity instead of tibial tuberosity...even though he measered appropriately.  Fail!!! for not knowing the proper landmarks.  If he had just done the skill and not narrated his way thru it he would have passed.

Indiana has also made it a critical fail on the medical and trauma assessment if you don't actually pick up the stethoscope.

I agree and disagree with these type of actions:  I assume this is in relation to lung sound assessment.....assessment tool in an assesment station ok  My problem comes in with treatment tools. You are required to voice treat all injuries/illness.....once you start to use to much equipment you increase the risk of station failure for "...providing a dangerous intervention...." ie you oopsed and put the collar on upside down you fail the assessment station.  There is a seperate station for immobilization...its almost like double jeapordy.

mk

I had to break someone of the habit of saying "tubular tibiosity" all the time; this was the same guy who also described cleaning an IV site by using a "clavicular motion" - paging Yogi Berra... I've seen verbal diarrhea sink more than one test candidate.

Speaking from my experience as an evaluator, there's sometimes a troublesome amount of latitude in interpretation regarding a "dangerous intervention"; I know of an evaluator who was failing people on the oral station based on hair-splitting answers on the pathophys-related questions he asked after the scenario. His rationale was that if he didn't like the answer to the question then obviously anything in the scenario related it to it, no matter how correct or appropriate in that context, must therefore then be dangerous.

[Flying Pig]

When I did my EMT I got myself into trouble by over-expanding my answers and ended up getting things confused with other areas.  Then I tried to salvage it while the evaluator just smiled at me.   I was relieved.  He told me he'd be back around in about 20 minutes and I could try it again.     Kinda like an FAA check ride when the examiner sits back, folds their arms and says "Really, why dont you tell me more about that."