Grand Rounds Vol. 5 No. 51, comes to Paramedicine!

Welcome one and all to this weeks edition of Grand Rounds, which comes to you from the world of EMS blogs!

It really is an honour to be hosting. I have only been blogging since the beginning of the year, but have been reading many of your blogs for the last couple of years, and its great to now be part of the medical blogosphere.

Whilst you are here, I would like to invite you to browse my blog, and my blogroll over there to the right, and maybe cast an eye of some of the many EMS blogs that grace this wonderful world wide web. I try to read as many blogs as possible from all specialities, as I believe it gives me a great insight into the same patient, but from many different view points. It helps me to see the all elusive ‘bigger picture’ and I honestly feel that it makes me a better paramedic!

I have a selection of my favourite posts in the tab at the top of this page, so if you have time, go and have a look. This is my favourite one, its a bit of a tough read but im proud of my ramblings in the post ‘Suicide’

And one last shameless plug before I start with the wonderful posts that have been sent in. We have our very own blog carnival for EMS/ER and emergency services blogs, ‘The Handover’. If you have never heard of it before, the home page can be found here, and the most recent edition is here. If you are in any way shape or form involved in EMS or emergency medicine/nursing or have been a patient who has had experience of the emergency medical services, please stop by and consider joining our family of contributors to ‘The Handover”

So without further ado, lets get cracking…..

I suggested a theme for this edition, along with an open section. The theme was ‘The time when it all fell into place’. I have only had a few submissions under the theme, so I feel they should have pride of place in today’s edition (I can assure you that there is no bias here, it just so happens that it was my brothers in EMS who submitted the posts based on the theme):

• Ben from the Insomniacs guide to Ambulances shares a two part story with us of a shift he has on the ‘Baby Bus’ (otherwise known as the Baby Emergency Transfer Service) and the team work that came together on that day to provide a happy outcome from one very premature baby. Part one is here, then part two, here.
• CKEMTP from Life Under the lights, relives a patient episode where seconds really did count and the training and provision of service was just at the right place at the right time to make all of the difference to Earl
• Lt Michael Morse over at Rescuing Providence shows us how when things really go well and the multidisciplinary team work well together, amazing and efficient results can be achieved. How about this for a call to cath lab time!
• OTR, who writes The Road to Paramedic, gives us all an insight into the chaos that is a cardiac arrest in the community, however this one was special, it was his first, and his first successful return of circulation. Sometimes, things just click into place. Click here to read ‘Losing my virginity’
• My current partner in crime for a transatlantic trip in November to share ideas on the provision of EMS in both the UK and the U.S, writes about one of the defining tools of being a good paramedic – the art of improvisation. Happy Medic brings us his New Airway Technique in a post describing the ‘non-standard’ method of clearing an airway of vomitus
• Mac, at UK street Medic, gives us a rapid flowing and brilliantly titled post, “Bang and the dirt is gone” which really takes you on the fast moving journey that is a a successful resus followed by clot busting drugs, all done in the back of  the ambulance.
• And finally in this section, a kind of antidote to the feel good posts above. Barbara Olsen from Florence dot com, kindly lets us into her personal life and shares the struggles she had to be heard as a mother of a very poorly child. Sometimes in all the high tech gadgetry of modern healthcare, we forget the basic, most fundamental skill of good communication. Her story can be found at ‘Before there were rapid response teams’

Now, onwards to the open submission section. Take a deep breath……ready?…….Right then, lets jump in!!

• RveBlade from 24 hour people, shares his experience of the first time he has had to pronounce someones death, and the necessity to get on with the job in hand at the same time, in Te moriturum saluto
• Dr Philip Hickey from Behaviourism and Mental Health, makes a statement  to make you ponder – “Bipolar disorder is not something a person has, but is rather something that a person does”, in his post ‘Bipolar disorder is not an illness’
• In another posting based on learning and starting out in a career in medicine, TOTWTYTR provides some sage advice for new Paramedics in his post “Advice for new Paramedics”. Some of the points he discusses could be used in any profession, not just paramedicine, so make sure you pop in and have a look.
• Sheepish at The Paper Mask, gives us his opinion of Cosmetic Physicians and the state of their profession. Sheepish is obviously a shy fellow, with the title of his post being Botox?, Bollocks!
• Over at How to Cope with Pain, you can read a fascinating post on the benefits of hypnosis in the management of chronic pain. Click here to read more.
• Child Psych provides details on a disturbing study on the relation between child abuse and infant homicide. Catherine Busch discusses it further here.
• Mack 505, the author of Notes from Mosquito Hill, writes ‘Its 9 O Clock, Do you know where your children are?, which leaves me with a little chill down my spine and a hope that we arent part of scenarios like this too often.
• Henry is a physician who has a novel take on the prevention of further spread of the dready piggy flu! He published a post recently on his blog ‘Henry’s Webicosm Blog‘ entitled ‘Knucks – the official handshake of the 2009-2010 flu seasons‘ to spearhead his new campaign.
• The Chronic Babe blog shares a ‘meme’ with a difference in the post ’30 things you may not know about my illness: fibromyalgia’
• David E Williams asks the question ‘Do today’s girls face more pressure to be thin than their predecessors from the mid-80s?’ in his post ‘skinny and skinnier‘ from his blog, Health Business Blog
• Next we move over to Insure Blog, where the contenscious issue of healthcare insurance and the new US health care reform plans are discussed. Any who read my blog regulariliy know how much I struggle to get my head around this type of thing, if you are like me, then head over and have aread of ‘Paging Dr John Galt’
• Also tackling the thorny subject of healthcare reform in America is the Colorado health Insurance insider. In this post they discuss the possibilities of ‘Outcome based incentives for doctors’
• Jeffrey, a medical student from Melbourne,Australia looks back over his psychiatry rotation in his blog, Vagus Suricalis. He comes to terms with some of his preconcieved notions of pyschiatric patients, and his Christian beliefs in the post ‘Of shock therapy, schizophrenics and the obssessive-compulsive medical student (part 1)
• Nancy Brown from Teen Health 411, shares some information on the first US treatment centre for internet addiction. As she so rightly states, it was only a matter of time... Now all I need is a specialist clinic for blog addiction and I will finally be sorted!!
• Moving on to ACP Internist who describes a recent study to look ino the effects that a full and frank apology can have in avoiding a potential law suit….surprising little as a matter of fact!! Click here to read more and get a link to some of the sample videos used in this piece of work. We also have a second posting from ACP internist, this time under the title of their ‘Mindful Medicine’ series where they ask readers to submit case studies where they have had to dig beyond the obvious to get to the true root of a problem. In this case study, they describe how a simple ‘so-so’ comment can spark the mind of those doctors willing to take the time to delve that little bit deeper.
• Coming from the same stable is the ACP Hospitalist, who tells us of a unique and modern way of keeping relatives informed of thier loved ones status in ‘hospital tweets updates to surgical patients waiting family‘. Why stop there though, whats wrong with having a live web cam feed from the surigcal mask cam of the operating surgeon??
• Alison over at Shoot up or Put up (subtitle – ‘Comatose and Rotten Toes’, fantastic!!) is a type one insulin dependant diabetic who despite living successfully with diabetes for over 23 years, only really had everything fall in to place once she got the right technology.
• Supporting safer healthcare is a blog written by Rita Schwab. In this vintage post, see shares with us the benefits that she has gained from reading and being part of the wonderful medical blogosphere (and even the EMS blogs get a mention, all the way back in 2006!!)
• Dr Paul Auerbach from Medicine for the Outdoors has taught me something new in his post ‘Mechanical Supports for Ankle Sprains’ where he discusses a recent study from the UK which could change the way that a very common and often poorly treated injury is managed in the ER or Accident and Emergency department.
• The blog ‘Highlight Health‘ discusses a recent study published in the journal of Science that describes a mutation in the DEC2 gene that is associated with a short human sleep phenotype. The finding may help scientists better understand the regulatory mechanisms of sleep and lead to treatments for a variety of sleep disorders. Click here to read more.
• Laney over at Nursing Student Chronicles reminds us of the little things that make us put up with the tough times in her post ‘Feel good moment’. It certainly brought a smile to my face, click here to see if it has the same effect on you (or if you are bitter and twisted and jaded now 😉 )
• Dr Am Ang Zhang comments on the recent $2.3 Billion settletment by the pharmaceutical giant Pzier in his post ‘Pfizer, Geodon (Ziprasidone) & The Twist, in his blog ‘The Cockroach Catcher‘
• Dr Ves, at his blog, Clinical Imagaes and Cases – Blog, takes time out to dispell some rumours used against the use of social media in medicine, in his post ‘One of the top reasons Doctors dont use social media – It takes too much time’
• Allergy Notes, looks at the subject of Phosphodiesterase-4 inhibition for the treatment of COPD : Roflumilast, in this post….QUICK DUCK!  Phew, that was just something going way over my head!! 🙂

And finally, last but certainly not least, and gaining the award of Best Blog Name for this edition is the “Hippocratic Oaf”, a med student from the UK, who discusses the impact (or not) that the European Working Time Directive is having on Junior Doctors in the UK. Click here to read more.

Phew!!! Thats all folks, the end of another edition.

Thanks to all of those who submitted posts, and thanks for making me increase my subscriptions on bloglines to 127 now!! (thats a whole lot of toilet reading on my iPhone……is that too much information?????)  How am I ever going to keep up. Please come back and check on us EMS types from time to time. I sometimes think we are the forgotten branch of medicine, but we really are part of the modern healthcare environment, and I personally love to be part of the bigger health team.

Next week grand rounds moves to Suture for a Living

See ya!!

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