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  • #1116916
    Health
    Participant

    Ubiq -“About which part was I wrong?”

    This part:

    “You also said that it was something that could be “researched” i.e. that it wasnt your own chiddush – turns out that too is a lie”

    What I quoted from Avram was after I quoted from IIHS:

    This what I meant by “research it”!

    But your whole goal is to put me down, so you ignored that posts that I’ve posted a few times!

    #1116917
    Health
    Participant

    2scents – I already made my point, you really think Ubiq will admit that he was incorrect?

    It’s apparent from his & your posting that he & you will never retract, defending your so called degree in medicine and make sure to have the last word.

    #1116918
    πŸ‘‘RebYidd23
    Participant

    I am an amateur non-certified pioneer emotion therapist specializing in people who entered first grade at six years and four months old with a pet turtle and averaged at %95 until third grade, at which point in November they were told that their turtle went to live on a farm, and their grade average dropped by three points, so they never felt quite right again, and then after they graduated they wanted to get a pet cat but they missed their turtle too much so they were afraid it would be wrong to have another pet. I always tell my patients it’s their parents’ fault they feel so bad, but they can fix it.

    #1116919

    According to IIHS, there were actually more deaths from multiple-car accidents than single-car accidents in 2013, 6,975 to 5,664.

    Not that it should affect treatment (or even diagnosis).

    #1116920
    ubiquitin
    Participant

    Health

    Im sorry I dont follow

    you said there is a difference between one car and multiple cars. and that 2scents should research it

    where should he have gone to research it.

    What you quoted from IHSS is entirely irrelvant to the subject at hand as I have replied to you several times.

    ” so you ignored that posts that I’ve posted a few times!”

    Are you for real?

    see here:

    http://www.theyeshivaworld.com/coffeeroom/topic/treatment/page/3#post-590297 (the very next post after you first posted it!)

    and here:

    http://www.theyeshivaworld.com/coffeeroom/topic/treatment/page/3#post-590505

    “you really think Ubiq will admit that he was incorrect?”

    When incorrect, even if there is room for disagreement I admit see here:

    http://www.theyeshivaworld.com/coffeeroom/topic/treatment/page/3#post-590297

    This has absolutely nothing to do with any degree in medicine I may have. As mentioned earlier, I know close to nothing about the EMS protocols nor the managment of trauma victims.

    That being said I am always eager to learn more. And since you began with an interesting question regarding a difference in managment based on the number of cars involved, I followed thethread., though only as an observer since I didnt have what to add.

    I only got involved once it became apparent that you are a fraud.

    my continued interest is perhaps a morbid one to see what sort of pretzels (new definitions of thread was particularly cute) you twist your words into to avoid a simple apology along the lines of I’m sorry for being rude when I actually made all this up.

    In fact almost every post of yours has a lie in it. some more minor than others can you admit any of them were untrue?

    Eg in your most recent post “so you ignored that posts that I’ve posted a few times!” As Ive demonstrated above I did NOT ignore your post regarding IIHS.

    #1116921
    Health
    Participant

    DY -“According to IIHS, there were actually more deaths from multiple-car accidents than single-car accidents in 2013, 6,975 to 5,664”

    So what’s your point? Your not in medicine, are you? This whole thread started because No one checks for medical causes at every MVA. So I theorized at least they should do it at single MVA’S. It was based on death rates of single vehicles. Why would you change that because cars have a different statistic?

    #1116922
    Health
    Participant

    Ubiq -“you really think Ubiq will admit that he was incorrect?”

    I dont. But I find it fascinating when a person can be shown to be wrong in black and white using his own words agaisnt him. over and over and over (and on several different points) and still inist he is right.

    It truly amazes me. Discussions thta are merely a difference of opininon dont interest me as much, since we can agree to disagree.

    #1116923

    Your OP was about a car accident, not a vehicle accident.

    #1116924
    ubiquitin
    Participant

    Health

    I dont follow.

    Are you saying I was shown to be wrong? where and how

    Is this another lie of yours

    “Ubiq -“you really think Ubiq will admit that he was incorrect?””

    You do know that was YOUR question, are you answering your own question and pretending it was attributed to me?

    (It is also plagirism since you didnt attribute my post (typos and all to me or even use quotes)

    I dont think you have a single honest post on this thread

    “So I theorized at least they should do it at single MVA’S.”

    Lie! you theroized they should ONLY do it at single MVA’s

    see here “But let’s say the pt. is unconscious, in a single car situation – you’d follow the AMS protocol, but not with a multi-car crash!”

    “The point I was making is that you evaluate for both medical & trauma at the same time. This is only for a single car accident.”

    Can you admit those two staments are poorly worded and in stead of “only” and “but not with” should have said “at least ” or “especialy” and “is less important with”

    (Of course you still dont have a source for that but that is a side issue at this point)

    #1116925
    ubiquitin
    Participant

    I took the liberty of gathering up all the lies youve told in this thread. (OK I’m lying it isnt ALL the lies, it is most).

    Now to be fair, Ive included staments thta contradict each other even though only one may actually be a lie.

    Please let me know which quote youd like me to demonstarte why it is a lie (though many I have done so already)

    Also please note I havent included simple direct questions that you ahve ignored, since while dishonest isnt quite the same as lying.

    Here we go:

    “It’s a question to refresh people’s memories – how do you treat a patient from a 1 car accident? “

    “Now s/o is getting warmer! But you’re wrong. It is different than

    a multi-car crash! “

    “Ah, but there is a difference! Nothing to do with a MCI. This was the purpose of this thread.”

    “Go research it & then come back and let us know what you found out”

    “Look there is a difference in the assessment between a 1 car accident and a multi- car crash.”

    “Go research it! “

    “There is a difference. I’m not Mechuav to teach you medicine. I was nice enough to get you started”

    “Look there is a difference in the assessment between a 1 car accident and a multi- car crash”

    “The point I was making is that you evaluate for both medical & trauma at the same time. This is only for a single car accident. “

    “But let’s say the pt. is unconscious, in a single car situation – you’d follow the AMS protocol, but not with a multi-car crash!”

    “If there was AMS you’d give narcan with one vehicle, even if the pt. had normal breathing and normal pupils!”

    “I’m not surprised. Anything liberal with Israel or life – you go for!”

    “I already dealt with this -“Trauma – Are there medical causes? (e.g. diabetes, CVA, MI, etc.)””

    “I can’t tell you – Copy infringement.”

    “The fact is – no one does! “

    “I didn’t make this up “

    “The only things that I ever put in exclamation marks was something quoted from elsewhere or that me or others have already posted on YWN! “

    “This is true.” (In response to “the idea that a medical cuase is more likely when one car is involved,”)

    ” True!” (In response to:”THAT is what we are discussing you said MULTIPLE TIMES that there is a difference between 1 car and multiple cars.”)

    “What you don’t understand or want to understand is that there should be no difference in treatment. “

    “I was pointing out that at least it should be treated as such when it’s a single MVA!”

    “And for the umpteen time,…”

    ” …all trauma calls have to be evaluated as if the’re a medical issue also!!!”

    “You’re the one who’s dishonest!”

    “Stop with the lying! I never pretended that this was protocol!”

    “And I still say that!” (in response to “”! you outright said (several times) that there IS a difference between the two.”)

    “I already posted to Ubiq the difference:”

    “Do you know the purpose of this thread? It wasn’t to tell e/o that they should check for medical causes at every trauma, because that’s what the book says. It was to deal with the reality that they don’t. So I suggested at least check for medical causes at a single MVA.”

    “The word THREAD over there meant something else.

    In other words there are at least 2 threads here!”

    “What I quoted from Avram was after I quoted from IIHS:

    This what I meant by “research it”!”

    “But your whole goal is to put me down, so you ignored that posts that I’ve posted a few times! “

    “It’s apparent from his & your posting that he & you will never retract,”

    “So I theorized at least they should do it at single MVA’S.”

    If youre not sure why any of them is a lie, Id be more than happy to explain it to you. Of course if I cant I’d be happy to admit my mistake

    #1116926
    Health
    Participant

    Ubiq- “Lie! you theroized they should ONLY do it at single MVA’s”

    When I said “only”, it wasn’t 100% accurate.

    “This is only for a single car accident.”

    Starting to think that the only purpose that you post on YWN is to knock down Frum people! I don’t think that you know anything about medicine.

    But I made sure that no one would think it was 100% accurate!

    From page 3

    “IDK if you have treated accident victims, but I have.

    The book says -“Trauma – Are there medical causes? (e.g. diabetes, CVA, MI, etc.)”

    I haven’t seen anyone look for medical causes in MVA’s. From before – “There isn’t time to do it at every MVA, but it’s imperative at least to do it at a 1 car MVA!”

    #1116927
    Health
    Participant

    DY -“Your OP was about a car accident, not a vehicle accident.”

    When you start a topic, e/o talks/writes the way you converse, not exactly 100% accurate!

    #1116928

    More like 100% inaccurate.

    #1116929
    ubiquitin
    Participant

    Health

    “When I said “only”, it wasn’t 100% accurate”

    Kudos! that took a while but congrats on admiting your error. (Though a bit understated)

    “Starting to think that the only purpose that you post on YWN is to knock down Frum people!”

    wha? what does this have to do with frum people? I wasnt even aware you were frum! in past discussions I was under the impression that you werent (yet)!

    “I don’t think that you know anything about medicine.”

    More lies! heres what you said earlier “It sounds like you’re in the medical field ” (not really a lie you are of course free to change your mind)

    what changed your mind?

    The book-that-must-not-be-named that you keep citing is irrelevant. I am not doubting nor have I doubted that there are medical causes for trauma.

    #1116930

    Ummm… I think right now EMTs do bear in mind in all trauma situations whether there may have been a medical cause. Whether it was a train wreck or a little old lady falling off the curb, there is always that possibility. Are you encouraging EMTs to ease off on that?

    #1116931
    Health
    Participant

    DY -“More like 100% inaccurate”

    What you too??? You’re joining the bad crowd??

    E/o says car accident, not vehicle!

    #1116932
    Health
    Participant

    Gamanit -“Ummm… I think right now EMTs do bear in mind in all trauma situations whether there may have been a medical cause.”

    Ummm – No Way! It sounds like you are trying to do what’s right, no matter what others are doing.

    #1116933

    If you’re basing your approach on statistics which specifically distinguish between cars and SUVs and pickup trucks, you had better be more specific.

    #1116934
    πŸ‘‘RebYidd23
    Participant

    Sometimes you have to improvise.

    One of my less real patients was stepping into the streets when a car hit his foot. We all know that a few hairs of the car that hit you applied to the wound are the best medicine, but this car happened to be bald. So we used a bit of paint from the car instead. The patient is as alive and healthy as he ever was.

    #1116935
    Health
    Participant

    DaasYochid -“If you’re basing your approach on statistics which specifically distinguish between cars and SUVs and pickup trucks, you had better be more specific”

    What don’t you understand? I wasn’t arguing on the protocol. But since a lot of providers don’t seem to follow it, I surmised at least they should follow it when it’s a 1 vehicle crash! It doesn’t matter which type of vehicle.

    #1116936

    Why don’t you just say that they should always follow protocol? Or at least when the vehicle was manufactured after 2007 (in a MVA, average the years)?

    #1116937
    2scents
    Participant

    Rebyidd, reminding you to always make sure the patient is not allergic to the hair before applying it.

    Btw, whoever mentioned narcan for AMS, really doesnt know emergency medicine, assuming that the only presenting medical is AMS the patient should NOT get narcan, as long as the patient as a patent airway and spontaneously breathing with no cardiovascular compromise.

    Now if that same trauma patient is not breathing, please dont reach for the narcan, just secure the airway as the distraction and the time wasted for the drug administration might waste precious minutes, instead make sure the trauma team has been notified and do rapid transport.

    Further more, the patient that is apneic from opoids (hence the narcan you mentioned) would first have an altered mental status and would have crashed their car much sooner.

    Before you start lecturing others on your anecdotal findings make sure you know what your talking about, its never to late to begin med school.. As I pointed out previously, emergency medicine is (hopefully) not your specialty.

    #1116938
    ubiquitin
    Participant

    2scents

    I was the first who mentioned Narcan. I used it as a question to Health when he was still insisting that there was a difference in managment based on the number of cars involved.

    I assked if the driver was found with pinpoint pupils and respiratory depression whether narcan should only be given if one car was involved?

    (His response “If there was AMS you’d give narcan with one vehicle, even if the pt. had normal breathing and normal pupils!”)

    Now I readily admit I dont know much Emergency medicine and even less about EMS protocols. But Wouldnt they give Narcan in that case?

    #1116939
    2scents
    Participant

    Also, it’s important to point out, in an MCI it’s one patient per crew the care the pt gets is the same in a single car mva as would be in an MCI.

    So for those that claim to be knowledgeable enough to teach others.. And wrongly pointed out that by a multi car accident there will be to many patients to be able to focus on possible Medicals, resources are based on the need and most ems systems can manage to have multiple crews if needed

    #1116940
    sholomrov
    Member

    maybe time to close this completely inane discussion? it ha long since ceased to be about anything important, and is just about proving health wrong, and he’s admitted it, so fini.

    #1116941

    I thought about it. There is still some valid discussion. See posts above yours [which were not yet visible when you posted].

    #1116942
    2scents
    Participant

    If there is any reason to believe that the cause and underlying issue is medical, pt would be treated medically. That goes for opiod suspicion with respiratory depression and for example seizures.

    As I mentioned, trauma is not an illness (there are rare condition and syndromes that are the exception) there should always be a suspicion of an underlying medical. Especially if the presentation does not fit the mechanism of injury. No one should be a cookbook provider, each and every patient is different and so is each scenario. EMS always looks for clues they are like the eyes and ears of the ER and play detective in trying to put together the puzzle. The trauma team relies a lot on the information the first responders have.

    The entire note that EMS should change what they are doing is wrong, EMS now days follow evidence based medicine, gone are the days they did stuff that made sense. Its all based on the data at hand. so when someone comes and makes the claim that he is someone with medical credentials yet undermines the entire system, shows who he really is NOT.

    #1116943
    2scents
    Participant

    I think that this thread is a very important thread, when someone establishes themselves as a medical provider and provides medical advice it is very important to expose them for who they really are.

    Its one thing to have an informative discussion (which I dont think this blog is made for, there are a lot of other blogs in which cases are presented and debated geared towards people involved in medicine) yet dangerous when one has an online persona as a medical authority so whatever they write should be accepted at face value.

    #1116944
    Health
    Participant

    DY -“Why don’t you just say that they should always follow protocol?”

    That’s very funny! If they don’t listen to the book, they’re going to listen to an anonymous poster?!?

    So I came up with a practical solution that they can implement.

    Just search for medical causes at a single MVA.

    #1116945
    Health
    Participant

    2scents -“Btw, whoever mentioned narcan for AMS, really doesnt know emergency medicine, assuming that the only presenting medical is AMS the patient should NOT get narcan, as long as the patient as a patent airway and spontaneously breathing with no cardiovascular compromise.”

    Who says?? You?? Prove it! According to Wiki EM (from Harbor MC) the coma protocol is still in effect. That means you give sugar, vitamin B1 & narcan.

    I think that this thread is a very important thread, when someone like 2scents, establishes themselves as a medical provider and provides medical advice it is very important to expose them for who they really are.

    Its dangerous when one has an online persona as a medical authority so whatever they write should be accepted at face value!

    #1116946

    If they won’t listen to an anonymous poster, why would they implement it?

    #1116947
    Mammele
    Participant

    I vote that this thread be closed.

    If we want to fight on Chanukah let’s argue about terrorism. Or better yet agree for once and fight against those that want us dead. I have no clue how to do it here though…

    #1116948
    2scents
    Participant

    Are you for real?!

    Give sugar for a comatose trauma patient? I guess TBI is of no concern to you?!

    Unresponsive Trauma patients do not come in to the ER with Dextrose bags hanging or with narcan on board. In fact there is no coma protocol in EMS (at least NY and the surrounding states) EMS should assess and if they find a problem refer to the appropriate protocol as a guideline and treat accordingly.

    All changes if there is an indication or detailed assessment (which should be done in route to the trauma center) reveals underlying medical issues. Then again, EMS should not administer Narcan for the comatose patient that has a patent airway and is spontaneously breathing, there is nothing wrong with an overdosed patient that is sleeping, but the same cannot be said with the patient that has internal injuries or massive brain trauma that can only be corrected in the OR.

    The more you post, the more evident it is that you are very unfamiliar with the entire preshopital and in hospital emergency medicine approach.

    #1116949
    Little Froggie
    Participant

    Should we listen to an online blogger who says not to listen to an online blogger who says not to listen to an online blogger who says not to listen to an online blogger who says not to listen to an online blogger?

    #1116950
    2scents
    Participant

    You always have the choice not click on this thread, there are many threads that focus on topics such as latke recipes or shidduchim issues.

    #1116951
    feivel
    Participant

    I vote not to close this thread.

    I’m fascinatedly enjoying watching to see if it will just peter out eventually, or will it be the longest ridiculous conversation in CR history.

    #1116952
    2scents
    Participant

    This from a former insider?

    #1116953
    feivel
    Participant

    Yes. That’s why I left, so I could give my mischievous side full rein

    #1116954
    Health
    Participant

    DY -“If they won’t listen to an anonymous poster, why would they implement it”

    Of course they won’t do it because I said so. But maybe they’ll read this post and at least check for medical causes at a single MVA!

    #1116955
    ubiquitin
    Participant

    I’m surprised it wasnt closed.

    Though see no real reason it should be.

    “it ha long since ceased to be about anything important,”

    News flash: 99% of topics discussed in coffee room arent importnant

    ” and is just about proving health wrong,”

    why is that a bad thing?

    ” and he’s admitted it, so fini.”

    He sort of admited, so thats good enough for me. I’m hoping it’ll peter out. Though as mentioned I have trouble letting things go so if Health replies to me it will be hard to let it go.

    #1116956

    Maybe if you tell them to follow protocol, they’ll read your post and follow it. If you post a random distinguishing factor (a small percentage of overall more deaths because of a much higher number in accidents involving pickups and SUV) anyone reading is unlikely to take you seriously.

    #1116957
    Health
    Participant

    DY – They might take me seriously because deep down they know to look for medical causes at every MVA. So they might remember this blog about a single MVA.

    #1116958

    So talk about recent model vehicles – if deep down they know it’s true for all vehicles, maybe they’ll follow it for recent models.

    #1116959
    Avram in MD
    Participant

    This point by 2scents:

    Also, it’s important to point out, in an MCI it’s one patient per crew the care the pt gets is the same in a single car mva as would be in an MCI.

    combined with this point by DaasYochid:

    Maybe if you tell them to follow protocol, they’ll read your post and follow it.

    provides the check and mate to this discussion.

    #1116960
    Avram in MD
    Participant

    I think this thread is interesting because it provides what might be the biggest trove of crazymaking and countering I’ve ever seen in writing.

    #1116961
    Health
    Participant

    DY -“So talk about recent model vehicles – if deep down they know it’s true for all vehicles, maybe they’ll follow it for recent models.”

    That’s funny. I know nothing about recent models. I never owned a recent model car. I’m not from the rich folks!

    #1116962

    So talk about older vehicles.

    #1116963
    Health
    Participant

    2scents -“Are for real?”

    I just think, & sometimes it’s out of the box!

    “Give sugar for a comatose trauma patient? I guess TBI is of no concern to you?!”

    Funny! So you wouldn’t give dextrose to a pt. whose BGL is 30?!?

    Oh, that’s right you don’t check glucose levels?!!

    “Unresponsive Trauma patients do not come in to the ER with Dextrose bags hanging or with narcan on board. In fact there is no coma protocol in EMS (at least NY and the surrounding states) EMS should assess and if they find a problem refer to the appropriate protocol as a guideline and treat accordingly.”

    Oh that’s right – you can’t save the pt. unless you have a written protocol!!!

    That’s why I wrote at the beginning of the topic:

    “ok there is a difference in the assessment between a 1 car accident and a multi- car crash. In any car crash, even though there’s the possibility of a medical cause, it’s Not probable!

    But in 1 car crash, it has to be treated as a medical call, along with trauma.

    #1116964
    Health
    Participant

    To E/O:I got this from Wiki pedia. I first looked it up in the ATLS manual. It basically says the same thing, but it’s a problem with copyright. Just ask Ubiq.

    “Disability/Neurologic assessment

    During the primary survey a basic neurological assessment is made, known by the mnemonic AVPU (alert, verbal stimuli response, painful stimuli response, or unresponsive). A more detailed and rapid neurological evaluation is performed at the end of the primary survey. This establishes the patient’s level of consciousness, pupil size and reaction, lateralizing signs, and spinal cord injury level.

    The Glasgow Coma Scale is a quick method to determine the level of consciousness, and is predictive of patient outcome. If not done in the primary survey, it should be performed as part of the more detailed neurologic examination in the secondary survey. An altered level of consciousness indicates the need for immediate reevaluation of the patient’s oxygenation, ventilation, and perfusion status. Hypoglycemia and drugs, including alcohol, may influence the level of consciousness. If these are excluded, changes in the level of consciousness should be considered to be due to traumatic brain injury until proven otherwise.”

    #1116965

    So?

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