Never a dull moment

It's been a frenetic two weeks (more to come soon on Dartmouth's Homecoming). Paramedic school has been a whirlwind of patient assessment lectures, labs and exams. Patient assessment is often referred to as the cornerstone of EMS care, because it is impossible to decide on a course of treatment without an accurate impression of the presenting condition. In addition to traditional, prehospital patient assessment, we also learned something called expanded scope assessment. This is a more detailed, physician-level set of assessment techniques that is intended for the clinical setting (i.e. a doctor's office).

Some states, such as North Carolina, have an "Advanced Practice" paramedic respond in lieu of an ambulance. He performs an extensive evaluation of the patient and determine if the emergency department is truly the most appropriate destination. If so, an ambulance is called and the patient is transported. If not, the paramedic calls the hospital and makes an appointment for the patient with the appropriate department. This prevents the waste of both ambulance and emergency department resources while simultaneously directing the patient to the most appropriate care. New York does not have such a system in place yet, but we're receiving the training now so that we'll be prepared when it does arrive.

Outside of class, my clinical rotations are continuing in earnest. I spent Wednesday morning in the Erie County morgue observing autopsies, which was a fascinating experience. It's not every day that you get to see a heart being prepared for transplant! Being able to actually see the internal organs instead of simply labeling them on a diagram makes a big difference. And the sound of the bone saw was a bit unsettling, but fortunately they weren't using it for long. This Wednesday I'm heading back to the operating room for more intubation clinical, which I'm looking forward to.

Updating a previous item, the NYS Health Commissioner has rescinded the mandate for all healthcare providers to receive the H1N1 vaccine because of an inadequate supply. This preceded President Obama's declaration that the swine flu outbreak is a national emergency, which has implications only for hospital treatment procedures and has no bearing on the vaccine. The seasonal flu vaccine, of which there is no reported shortage, is still a requirement for NYS healthcare providers.

In other news, the Yankees beat the Angels last night to advance to the World Series. This is the Bronx Bombers' fortieth pennant! The Yankees will host the Phillies on Wednesday night. You can bet I'll be watching.