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That is purely your own logic, but there is no difference in real life on assessing a pt of a one car crash vs multi.
Health care providers will always make sure that there is no underlying medical problem once the apparent threats to life are taken care of.
Assessment is ALWAYS, ABCs, airway (patent or established), Breathing (spontaneous or Positive Airway Ventilation and Make sure there are no signs of tension Pneumo), Circulation (control any bleeding, and maintain MAP of at least 60)
Depending on the findings, further assessment is done according to the situation. For example if pt is is still unresponsive after stabilizing ABCs , BGL 12 lead and if possible Neuro exam.
The same is for Patients from a one car or multi car MVA. the fact that you believe (and could very be true) that pts from single car MVAs are more likely to have an underlying medical that caused the accident does not change the assessment or treatment at all.
Regardless of the fact if there is suspicion of a medical, the receiving facility will level the trauma accordingly, if necessary consider CT Scan, FAST if suspicion of internal injury and have sub specialties as needed and resources the facility has.
this is a cookbook scenario, of course each case is different and should be assessed and treated accordingly but in reality there is no difference in the amount of cars involved.
Thats incorrect, there is no protocol that states any difference in a one or multi car accident. the fact that you believe that there is a higher suspicion that there is an underlying medical problem that caused this accident is not relevant, since the same suspicion should be when assessing a multi car MVA.
Feivel that is not correct, first as Popa pointed out, all of these factors can be the cause of a multi car MVA.
Also, assuming its a trauma pt unless there is reason to believe that there is a medical cause, pt will not get a medical workup such as 12 lead, especially if its a multi system trauma pt.
All of that changes if there is suspicion of a medical cause.
So you are only interested in going the distance to show everyone that they dont know and its just you that knows?
But to just write (what you believe is) the correct answer, thats already to much for you?!
You make it sound as if your an attending ER doc in some trauma center and its only you that knows something, you dont come across as someone in the know..
so we agree on somethings..
That is incorrect, there is no difference.
instead of acting as if you are in the know, just spill the beans and lets see what you are referring to.
It’s not a segula, he writes that since he doesn’t have children as his only son past away, whoever learns his Sefer will be a zchus for his neshama, and in return he should have children.
Agreed. And the sefer is a very difficult one to learn. It is more of a “gift of hakaros hatov” than a segula
To answer your original question.
By maintaining and securing ABCs. Taking spinal precautions loading the pt and transporting to a trauma center.
Large bore iV in route. Other treatments would be splinting, needle d, as needed.
In hospital, based on the MOI and injuries a level 2 or 1 trauma will be called with sub specialties called as needed.
The same is done if it’s a one car MVA or multi car. One difference would be if another pt in same car died, it will automatically be upgraded to a level 1 trauma. But that goes under the category of MOI.
Is there something specific your asking?
There is no difference in treating a pt that was involved in a one car accident vs a multi car accident, unless it becomes an MCI which means that the pts get triage’d and treated according to their injuries.
If you truly want an answer you must give a more detailed scenario.
No different than a pt from a multi car accident.
If you are referring to EMS (usually the ones treating pts at car accidents), after making sure they are safe, ABCs and transport to an appropriate facility.
so your saying that you really dont know of any fix, and what you mentioned was bogus?
it take a few minutes of my time trying to google what you wrote, found a wall within seconds and moved on.. still not able to sync my blackberry on windows 10
Posting this again, does anyone know of a way to have blackberry link sync with my blackberry device using Windows 10?
Someone posted a fix, however i have no clue how to work that, I tried google but with no success.
thanks for posting this information, can you please simplify the steps for me.
How do I download the 6S3.4?
Thanks
Blackberry’s software does not work with Windows 10.
Being that I am very familiar with the process of most sites that were doing IV, some had the IV lock inserted before Yom Kipur, others had a non Jew establish the line on Yom Kipur.
No one had a Yid establish the line on Yom Kippur, most poskim hold that creating IV access is a ???????? and any patient that is sick enough that requires IV should probably not be fasting.
Getting flashback while creating IV confirms IV placement so its not really a mekalkel.
As posted above, most places that did IVs only did it after making sure that the person consulted with their doctor as well as their rav.
People that are not able to fast do not get IV,IV fluids is just normal saline not other nutrients that they need.
Its mainly done to help people that would otherwise fast, yet have a difficult time fasting, keeping them hydrated makes it easier for them to fast.
In the news they said that there were no video cameras.
what I find amazing, that they needed a tools and a detailed plan. they probably had outside help yet the plan did not leak.
This is so unreal, not sure how they were able to pull off all the planning preparations and the actual work without this getting out.
interesting that each day the news has something to add, just to make sure that this stays on the front page, so people dont forget about this.
ubiquitin,
I agree with your closing argument, most clinicians techs and nurses are wonderful people, they have dedicated years of their life only to enter a field that deals mainly with treating sick people.
However, there are some health care providers that are not like that, they do not share this same passion and they stand out. They make the rest look bad.
ubiquitin,
diversions can be instituted for a lot of reasons, however this again has nothing to do with the individual cases that were noted in this thread or what a lot of people have witnessed.
The funny thing is, that this is not even a secret among health care providers.
You mentioned that you are not referring to the bigger or general picture, yet you brought up the argument of diversions. Diversions, short in staff or drug shortages has nothing to do with this attitude. using the general argument as a means of mistreating a patient is what this discussion is about.
ubiquitin,
I am very familiar with hospital diversions as well as its laws.
However, that is usually when they either have an overloaded ER or ICU, they are recommending that patients go elsewhere otherwise they might not get the care they deserve.
You are making the point that in the bigger picture healthcare money should be spent for people with a longer ypll. that is not the discussion here, rather how some health care providers treat patients that are not young or have terminal illnesses.
Doctors are rarely faced with having to make a decision of giving a medication or treatment to one patient over the other. nor are other staff, be it with feeding or giving vasopressors so that the post arrest pt should have a chance. its an attitude that anyone that deals with health care industry is very familiar especially in emergency medicine or ICUs.
As I mentioned earlier, there are a lot of great doctors nurses and other providers that have a passion helping sick people and do what is right
ubiquitin,
that is not true. everything IS tied to money, money buys more beds and more staff.
No doctor is faced with the decision of treating one patient over the other one.
There are a lot of good people in health care, but some are lazy and uncaring. I know that because I am in the field.
just my 2scents.
The health care industry is designed to help people. Its sad that some that have entered this field are in it more for themselves than for others.
Regarding elderly, its no secret that a lot of doctors and nurses treat a younger patient different than they would an older patient.
If an older pt arrives to the emergency room with trouble breathing. if the pt has a DNR, they will send the pt to one of the back rooms without taking care of the patient.
I have personally witnessed doctors witholding life saving drugs which resulted in the patients death. only because the patient was a nursing home patient so who cares.
The argument that when faced with helping a younger person with a longer ypll or an older person that might not live long is not relevant, since there usually is enough resources to treat both.
Anyone that deals with medicine really knows this.
Bump.
This is for Stam.
if you do a quick google search for The New England Journal of Medicine, November 7 2002, A population based study of measles mumps and rubella vaccination and autism,
You will find the exact study for which you have been looking for. the study was done on over 500K children over many years.
Bump
I think that they are doing this on purpose!
Lior,
How can you separate the individual from the population? what is good for the population is good for the individual.
VM,
First you establish that there are serious side effects to the vaccines, based on that fact you go on with your explanation.
This is not the case, there are no established studies showing that vaccines are dangerous, if there were, pediatricians would not advocate for it.
You are using the argument that the CDC is flawed and does not have our best interest in mind, it appears that you are not familiar with the CDC, however even if that is the case, there is much more than the CDC, all the studies and articles published in The Lancet and in Pediatrics, as well as the recommendations of the American Association of Pediatrics.
In fact some of the people advocating against vaccines (Such as Dr Palevsky) have personal monetary interests involved. They use this as platform to advance their agendas.
VM,
You are off point, the main discussion is the MMR vaccines, not the ones that you mentioned.
I do not know why you say that doctors do not reveal the fact that the flue vaccine handed out each year is only against one strain of the virus, this is something that is well knows and well discussed.
The doctors hope that the researchers and scientists did their homework in predicting which strain of the flue virus will hit us, and encourage us to vaccinate ourselves, so that we are protected against the potentially deadly virus.
Most years they are more or less on the ball in predicting which strain would hit us, this year they were off, they miscalculated the strain that hit us.
This is a fact and no one is hiding it.
I have not researched the chicken pox vaccine well, however I believe that most pediatricians believe that the VZV vaccine does immune the patient, and one shot is more tolerable than having the actual virus.
Again, this has nothing to do with the MMR vaccine, which was well researched, and determined to be safe.
As I posted above, the people who published the studies showing that the MMR vaccine was unsafe, not only were they ‘discredited’, it was a huge fraud, and the study was proven to be false, it was a very small study and the results were manipulated, this was proven.
The Lancet stated that the ‘study’ against the MMR vaccine was the biggest medical hoax in the past 100 years.
Bump
Brian Deer, was the journalist that uncovered Wakefields fraud, he personally interviewed some of the parents of the children that were part of the study. He revealed that the results were twisted and actually proved the contrary, that there was no link between the MMR vaccine and autism.
Brian, interviewed the co authors of the study, and Nick Chadwick who worked for Wakefield at the time, Chadwick revealed that the entire study was a fraud, and the tests proved that there was no link at all between the MMR vaccine and autism.
Brian also revealed that nine months before wakefield released his study, he filed for patents in a few different countries for vaccinations that would not cause autism. These Patent applications were filed in USA, UK, Japan.
Wakefield
These are facts.
I think that the weather should be your least of your concerns.
By happy and thankful that were not in the Cafe when all of this happened.
Comparing teh vaccination controversy to holocaust deniers is a very good comparison.
If one is truly concerned about the well being of their children and wants to know the truth, then just go out and do your own research.
The entire vaccination controversy was started by Andrew Wakefield, who at the time surgeon and medical researcher in Britian.
In the year 1998 he published a study in the Lancet linking the MMR vaccines to autism.
In the following few years there were thousands of articles and comments mainly by non experts based on Wakefields study, this helped ignite the vaccination controversy, and people began having a fear of vaccinating their children.
After many attempts at duplicating Wakefields findings were unsuccessful, investigations revealed that the entire study was funded by trial lawyers and the legal aid fund, for the sole purpose of litigation.
Wakfields partners and all the co authors then came out and revealed that not only were there no links between the vaccines and autism, the lab results actually showed that there were no links.
The Lancet fully retracted the study, Wakefields license to practice was revoked, and his study was named the biggest medical hoax in the past 100 years.
This is the short version.
Francorachel3,
I am not really sure to what you are responding, the last time i commented here was a while ago..
However of course no one should break the law as it is illegal and is a big chillul hashem.
On the other hand, people should be dan lkaf z’chus. I recently got yelled at for using lights and sirens “just to pass a busy intersection”, someone was cursing and yelling at me through their open window, do I really owe this person an explanation? that the parent of a child choking called back to cancel, so should i keep my lights on? or what else should I have done? What is a different unit responded that he if closer, should I not cancel? This happens quiet often.
I am sure that there are some people that break the law, however they are not the majority, Hatzolah would never tolerate this, Hatzolah is under a lot of scrutiny and there are a lot of people that would pounce on any opportunity to inform and close down hatzolah.
I am sure that some have already stated this,
Withholding a Get is Evil, however so is killing someone, but everyone understands that there is a time that we have to use an evil act, such as to kill someone.
I think the same can be said in a Get, although it is an evil act, if however the wife is being unreasonably evil, and the husband is losing everything in his life, such as rights over his own children, I think there is a place for withholding the get.
Why should the husband be a victim to the wife?
Now of course, who will decide if this is the case or not, that is an issue.
I disagree, EMTs are the one helping the patients breath.
It all starts with the ABCs, its not the meds it is the ABCs! Basic CPR or bleeding control is more important than ALS.
Thats from an ALS provider..
thats if the skin is broken. But what if the skin is intact?
I googled it, there is something about it online.
Is anyone familiar with the ‘potato thing’? there are some people that put raw potato on a burn site, they claim that it heals rapidly.
There is a ‘burn lady’ in monsey that assists people with it.
Anyone heard about this?
Burns should be cooled with water to stop the burning process.
However, you must be careful to dry the burned area to avoid hypothermia. So cool with water, then dry.
Also, if the skin has been broken, try keeping the area clean, as it can easily become infected.
Another point, when a child gets Ch”v burnt, check for trauma, trauma is the leading cause of death in burn patients and is often overlooked.
It is a mixed crowd, mixed between Yeshivish, Litvish and Chasidish.
It is a very decent quiet neighborhood.
Cost of living, would depend on how much you plan on spending.. real estate market is good, prices are pretty decent over there.
I used to work out everyday for over an hour at the kosher gym, I really got upset when it closed.
Now i workout at home or in a different gym.
I believe that when borrowing something, you are obligated to pay, even when it is not your fault.
On the other hand, he would have to prove that the leak started on your premises, for all you know there was some tiny leak which started before he borrowed you the car.
as a regular reader (and infrequent poster) just it up, we need your life and color in the CR
Come on, they cannot plow the entire NY at once!
Thats why they call it ‘practicing medicine’.
I remember there was one post that actually had [closed] on its tittle. just to track attention.
you want info regarding the requirements or about schools?
you can browse the NYS Gove website, (EMS Section).
typically the entire program should be around 1200 hours.
I copy and pasted this from the LaGuardia website:
The program is approximately 1400 hours in length: