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climbingnurse
Dec 1, 2004, 3:33 PM
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Registered: Oct 30, 2003
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Didn't mean to bash Docs, tgmd. Just trying to point out to people what the typical roles are in healthcare for doctors vs. nurses. I still think that, in general, nurses are more trained for education and looking at the whole person/situation. That's not to say that some doctors haven't learned to do those things quite well.
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tgmd
Dec 1, 2004, 4:23 PM
Post #102 of 108
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Registered: Oct 8, 2004
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Climbing nurse-
My wife is a Family Nurse Practitioner and is the best educator I have ever encountered. There is a big difference between the roles of an RN and a NP. Nurses that work in the ED, on the hospital floors, OR, or Recovery as a general rule have little experience teaching other providers and aren't given enough time to teach patients. As you complete your training and work full-time, I think you will see a big difference between nurses in your program and nurses who work outside of a teaching institution. Although this thread was about epi and wilderness settings, I will close by saying that I want folks here to work with folks like you who want to educate, take classes and learn about how to help their climbing partners in emergency situations. Please don't generalize about what doctors and nurses are until you have worked in the field. I think you will be surprised. By the way, take the Epi-Pen if you think its a life or death situation, take the Benedryl immediately, get off the rock and call for help, and consider seeing an allergist/immunologist for discussion of allergy testing and de-sensitization therapy. Good luck!
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mtn_eagle
Dec 1, 2004, 5:08 PM
Post #103 of 108
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In reply to: I'm terribly sorry you both feel this way. mtn_eagle, I agree with your comment about an allergist. In fact, I am fairly certain I mentioned something about an immunologist in one of my posts. addoil, I'm not sure what you've posted that contributed to this thread. You've not offered your input on the medical treatment side at all, actually. Please, if you think I gave bad advice, then I invite you to point out the bad advice (where did I go wrong,) and post your correct advice. Also, be certain to share your medical credentials, as you must obviously be a physician of some sort.
Trained in internal medicine and subsequently sub-specialized in critical care, pulmonary and sleep medicine. I worked as an ER doc for 2 years in an academic level 1 trauma center where I was an ACLS instructor for medical students and house staff. I taught and rode with paramedics on a regular basis and was the voice on the radio when they asked "Doc, this isn't working...what should we do now?" I was a hospitalist for a while working in an open ICU when I realised I didn't have enough training and went back for 3 more fellowships. I've given televised lectures concerning high altitude medicine. I recently signed with a private practice group in CO.
As for NP's, my wife in an NP working for a heart failure/transplant group. She is incredible at her job and her patients love her. Her NP training was broad and the cardiologists frequently turn to her concerning vaginal discharges, rashes and other non-heart issues that they are clueless about, but she doesn't pretend to be a cardiologist and frequently runs things by them to make sure she's doing the right thing. Even though she worked in an ER for 5 years, she'd still defer questions about anaphylactic shock to me. If you asked her, she'd tell you to go to PA school rather than NP school because the programs are designed by doctors and tend to be more hard science rather than theory. But to each his own.
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brundige
Dec 1, 2004, 6:12 PM
Post #104 of 108
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Registered: Apr 5, 2004
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In reply to: reconbeef wrote: Quote: it should be the national standard for wilderness training And therein lies the rub. There IS no national standard for wilderness training, and this is somthing that everyone on this thread (well everyone in general, but I'm realistic) should realize. If you take an American Red Cross first aid course or American Heart Association CPR course in Maine, it will be the exact same course that you would get in Nevada. It is a national standard, to which all other courses are held. No (to my knowledge) CPR courses are being offered that don't confirm to the AHA guidelines. Not so with wilderness medicine. As I said, there is no national certifying body. Reno, you could hang out a shingle tommorow and open Reno's wilderness medicine boutique and start teaching you students trepanation and to cric anyone who got stung with a bee. And you could do it. At least until some guy shows up at your door with a hole in his head and his neck wanting a few words. Case in point, there is a guy in DC who runs a (fairly lucrative) wilderness first aid school that doesn't have the first damn idea what he's doing, and it's caused some real problems. I can't believe the guy hasn't been sued, but he keeps on doing his thing. This is why I advise people to a) take a class from one of the big three or barring that b) make sure you know who it is that is teaching your class. The closest we have in the States to a 'standard setter' is the Wilderness Medical Society (www.wms.org). The publish a set of wilderness guidelines (which is well worth having) but do not endorse a standard, and most likely never will. So it's sort of everyone for themselves. The cirricula of the big three schools are pretty much the same, except for a few style points, but they are in agreement on the big issues (holes in head: bad). So this is why you won't get a standard. And, to repeat something I've said here before, multi-dose epi is a bad idea for 90% of those taking these classes and performing medicine in the outback. Climbingnurse is in an institution that has decided to put time and money towards maintaing this standard (with an MD to oversee it). But most people coming to get their cert aren't. They show up once every three years to recert, and man, some of them are just there to punch the clock and get their card. You can tell they are going to forget everything the next day. While having their drawbacks, Epi-Pens are the safest option for lay providers. I'm actually waiting for the first camper to die after being coded out by too much epi and see how long these amp programs stay around. I just think there's too much to go wrong, and epi-pens work great. They've saved thousands of lives. Can't argue with that. -James I would also agree to say that, its very important that people get their WFR from one of the Big Three schools. WMA, WMI, or SOLO. Since also the closest thing you can get to a standard is found in those three schools. Not joe-schmoe's wilderness medicine "school" _________________
if your interested in wilderness medicne consider courses taht fufill state requirements for the subject matter and then add onto it bt including the wilderss aspects of it
FOr instance WFR .make shure that you are certified by the state as a first respoder those courses usually have a set standard as you have to pass exit exams . the same goes for WEMT , wich fufills EMT-B requiremensts in 45 states
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karlbaba
Dec 1, 2004, 7:33 PM
Post #105 of 108
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Registered: Jul 10, 2002
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I've done an EMT and a few years later a WFR. Now my certs have expired. Even though I tended to score "at the top of my class', I'd like to agree that this stuff leaks from your head pretty fast if you aren't in the rescue and patch biz. The more idiot proof things can be made the better.
Maybe this stuff will come back into my brain in a pinch, maybe not. Even if I don't recert, I'd like to make a point of reviewing my material each season
PEace
Karl
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reno
Dec 1, 2004, 7:40 PM
Post #106 of 108
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Registered: Oct 30, 2001
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In reply to: I'd like to agree that this stuff leaks from your head pretty fast if you aren't in the rescue and patch biz.
Karl:
It leaks pretty fast even if you ARE in the "Body and Fender Repair" business.
I still look things up to double check myself on certain things. Some of the things are so common and "routine" that it's not needed, but some things are so infrequent that a little refresher is helpful.
Good thread, everyone. Thanks for participating.
(No, I'm not locking the thread ... just remembered I wanted to say "thanks" to everyone, so figured I'd do it now.)
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napoleon_in_rags
Dec 1, 2004, 10:55 PM
Post #107 of 108
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Registered: Oct 31, 2004
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In reply to: are you doing WEMT instead of WFR for a reason? i see a lot of WEMT students who really wish they had done WFR instead. i wont talk you out of it. just want to make sure everyone makes the right decision. wait- you said recert. which course are you looking for? anthony
I am on the National Registry EMT - I am curious to the "W" perspective in WEMT. And I believe that will maintain my qual for another year. Maybe I am wrong.
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cjstudent
Dec 2, 2004, 1:21 AM
Post #108 of 108
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Registered: Oct 21, 2003
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In reply to: In reply to: are you doing WEMT instead of WFR for a reason? i see a lot of WEMT students who really wish they had done WFR instead. i wont talk you out of it. just want to make sure everyone makes the right decision. wait- you said recert. which course are you looking for? anthony I am on the National Registry EMT - I am curious to the "W" perspective in WEMT. And I believe that will maintain my qual for another year. Maybe I am wrong.
Well the W part of WEMT is to give you the wilderness aspect. Also the W stands for the WFR, because i think the courses are the same. You would be learning how to deal with emergencies in the backcountry, away from definitive care. Improvised traction splints, spinal injuries, having to bivy, navigation, doing evacs, common injuries in the wilderness like sprains and strains, and how to properly splint broken bones (w/o commercial splints), and it addresses illnesses found in the back country like high altitude pulminary adema, acute mountain sickness, dehydration, heat stroke...etc etc etc. you also deal with anaphalyxis which is what got this started.
Above is just some of the topics covered. I think you are right about that qualifying for the recert for EMT. I did it the other way, I have my WFR now and am enrolling for EMT basic next semester.
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