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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.
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).
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.
Your OP was about a car accident, not a vehicle accident.
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)
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
More like 100% inaccurate.
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.
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?
If you’re basing your approach on statistics which specifically distinguish between cars and SUVs and pickup trucks, you had better be more specific.
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.
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)?
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.
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?
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
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.
I thought about it. There is still some valid discussion. See posts above yours [which were not yet visible when you posted].
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.
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.
If they won’t listen to an anonymous poster, why would they implement it?
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…
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.
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?
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.
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.
This from a former insider?
Yes. That’s why I left, so I could give my mischievous side full rein
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.
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.
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.
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.
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.
So talk about older vehicles.
So?
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