Podcasts about level i trauma center

In this episode of the STL Bucket List Show, Luke welcomes Jen Garnica, Chief Nursing Officer at SSM Health St. Louis University Hospital. A St. Louis native and proud leader in local healthcare, Jen shares her story — from growing up in the city to leading one of its most advanced and mission-driven hospitals.Located in the heart of downtown, SSM Health Saint Louis University Hospital is a Level I Trauma Center and a teaching hospital affiliated with Saint Louis University. The hospital boasts state-of-the-art facilities and plays a pivotal role in delivering life-saving care to the most critically ill patients in the region.Jen talks about the unique culture of the hospital, where learning and growth happen every day alongside residents, and why people love to work there — it's the best of the best.Interested in learning more or joining the team? Follow @SSMHealthJobs on social media, slide into their DMs on any platform, or visitjobs.ssmhealth.com to explore career opportunities.Tune in to hear how Jen's deep St. Louis roots continue to inspire care, leadership, and community impact.Support the show

03/02/25The Healthy Matters PodcastS04_E10 - Controlled Chaos: A Day in the Life of an Emergency NurseThere are a lot of important people in healthcare, but the medical system itself simply would not exist without one essential piece of the puzzle: NURSES.  It might be impossible to give them enough credit for the many important jobs they do - from the Emergency Department to the clinics.  They literally see it all, and regardless of how intense the situation might be, somehow always seem to keep their cool.Emergency Department nurses are a special breed and the backbone of hospital emergency care, and in Episode 10, we'll be joined by one of these unsung heroes.  Kara Fussy (BAN-RN, CCRN) is a Critical Care and Emergency Medicine nurse, working in the Emergency Department of HCMC, a major Level I Trauma Center. In our conversation, we'll get insights and stories from what can be one of the most intense places in the hospital.  We'll learn about the personal and professional challenges of the job,  what it takes to thrive in this position, and also hear stories about a few of the more interesting patient cases she's seen over the past few decades.  It's safe to say this job is not for everyone, and this is an excellent chance to learn about the role and experience from someone who lives this job day in and day out.  We hope you'll join us.We're open to your comments or ideas for future shows!Email - healthymatters@hcmed.orgCall - 612-873-TALK (8255)Get a preview of upcoming shows on social media and find out more about our show at www.healthymatters.org.

About our guest … Mason Van Houweling Mason Van Houweling serves as the Chief Executive Officer of the University Medical Center of Southern Nevada (UMC), providing leadership to a diverse team of nearly 5,000 employees who dedicate their careers to delivering Nevada's highest level of care. While guiding Nevada's most respected academic medical center and its many off-site clinic locations, Mason's strategic vision supports the organization's ability to save and improve the lives of community members. UMC remains dedicated to offering exclusive and highly specialized services, including Nevada's Level I Trauma Center, only Verified Burn Center, and only Center for Transplantation. As a result of his commitment to innovation, UMCnow serves as Nevada's most sophisticated healthcare system, offering the latest breakthroughs in clinical technology. Mason brings 30 years of healthcare experience to UMC, from small community hospitals to those with more than 1,000 beds. He has a proven track record of balancing a hospital's financial performance while providing uncompromised patient care. Mason's hospital administration career began at Orlando Regional Medical Center and continued progressing with Tenet Healthcare, CarolinasHealthcare System, and Universal Healthcare. Before joining UMC as Chief Executive Officer, Mason was a Senior Leader at Spring Valley and Valley Hospitals in Las Vegas, Nevada.

Top neurosurgeon Dr. Nimesh Patel reveals why emotional intelligence, not technical expertise, is the true key to medical excellence. From his humble beginnings to becoming one of the country's leading brain surgeons, Dr. Patel shares how developing EQ transforms both patient care and personal growth. Learn why this neurosurgeon focuses on understanding a patients heart just as much as their mind. About Our Featured Charity: This season, Alex Perry On Fire is making a monetary contribution to each guest's charity of choice. Nimesh Patel's charity is Methodist Health System. Methodist Health System is a faith-based organization with a Mission to improve and save lives through compassionate, quality healthcare. For nearly a century, Dallas-based Methodist Health System has been a trusted choice for health and wellness. Methodist has a network of 13 hospitals (through ownership and affiliation) with nationally recognized medical services, such as a Level I Trauma Center, multi-organ transplantation, Level III Neonatal Intensive Care, neurosurgery, robotic surgical programs, oncology, gastroenterology, and orthopedics, among others. Your turn to start the fire. Like what you heard today on Alex Perry on Fire? Tell us about it. Want to share what has helped you on your journey? We want to hear about that, too. Comment on social, DM us or give us a call. Instagram: @alexperryonfire    TikTok: @alexperryonfire Call: 214-506-8023

11/26/23The Healthy Matters PodcastS03_E01 - Real Talk with An Emergency Medicine DoctorThere are seemingly as many careers in medicine as there are lakes in Minnesota (and we're talking well over 10,000 of those...), but many of the most intense jobs in the field are found in the Emergency Department.  It takes a certain kind of person to want to become a physician, and on another level to want to practice Emergency Medicine in a Level I Trauma Center!  Thankfully, there are doctors like this, and for our first episode of Season 3, we'll be joined by Emergency Medicine Physician and Toxicologist, Dr. John Cole to help us get a glimpse into this highest-of-stakes and stressful environment. What's life like there?  What are the biggest challenges healthcare professionals in the ED face?  And how does one cope with the stresses of such place?   Join us for a conversation addressing these questions, plus a few of Jon's most memorable cases and the debut of an all-new segment for Season 3 - Magic Wand!  Tune in!Got a question for the doc?  Or an idea for a show?  Contact us!Email - healthymatters@hcmed.orgCall - 612-873-TALK (8255)Find out more at www.healthymatters.org

Authors Asa Peterson, MD and Howard Place, MD of Saint Louis University's School of Medicine discuss their recent article, "Isolated Thoracic and Lumbar Transverse Process Fractures: Do They Need Spine Surgeon Evaluation? A High Volume Level I Trauma Center Experience with Cost Analysis" with NASSJ deputy editor Tobias Mattei, MD.

Do you need to work in a Level I Trauma Center to get into CRNA School? In this episode we dive into what IS a Level I Trauma Center, why people often recommend it for getting into CRNA school, and why you DON'T necessarily need to work in one to get into CRNA programs! Tune in to learn more. Comment what you'd like for us to talk about on the podcast next time! ◽️◽️◽️◽️◽️◽️

Happy February from the PEC podcast crew! Even though Punxsutawney Phil's shadow predicted another 6 weeks of winter, the PEC podcast team is happy to keep you company while you're keeping warm.  In this episode, we cover the Prehospital Emergency Care Journal Volume 25 Number 5 where we cover manuscripts like: Impact of a Standardized EMS Handoff Tool on Inpatient Medical Record Documentation at a Level I Trauma Center Documentation of Child Maltreatment by Emergency Medical Services in a National Database Clinical Care and Restraint of Agitated or Combative Patients by Emergency Medical Services Practitioners Click here to download today! As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH (@gradyMED1)  

In this episode of the Share Your Power podcast, we take you inside a Level I Trauma Center for a fascinating conversation on the staggering amount of blood transfusions needed to save trauma victims and how it can mean the difference between a patient living or dying. We talk with a trauma doctor who shares real-life insight on the massive efforts to save lives and why people with a particular blood type are a crucial part of the lifesaving team. That's available now, on the Share Your Power Podcast.

Nicole B. LaBerge, PT ATP is a Physical Therapist with 15+ years of experience working in a variety of clinical settings. She currently works at Hennepin Healthcare's Clinic and Specialty Center, which is part of the Level I Trauma Center in Minneapolis, MN. Her practice includes seating and mobility for adult and pediatric populations, with a focus in neurological rehabilitation and wound care. Nicole has presented at the State and International Levels, has had her personal research published and enjoys sharing her passion for patient advocacy, clinical outcomes and efficiency within a clinical setting. Karen and Nicole discuss the importance of standing for people with disabilities. We discuss what the data says about standing. We also talk about the functional and medical benefits of standing for wheelchair users.  Standing has kept Karen healthy as a wheelchair user for 34 years and Nicole's patient's have experienced the same benefits using standing technology.

Megan Iseman is a Physician Assistant at Prisma Health- Richland; a Level I Trauma Center here in Columbia, SC. Megan has been in practice with the Acute Care Surgery and Trauma team for the past 6 years and finds extreme fulfillment in practicing critical care medicine and helping those impacted by life-changing events. What Megan enjoys most about trauma is being able to see patients through their full hospitalization – from injury to recovery. The demonstration of resilience and growth are amazing reminders to her and her teammates daily. When not working extreme hours, this Floridan native enjoys any activity that can get her outside or close to water. Hallmarks of her life are her faith, friendships, and family time. Also, recently engaged to Dr. Tom, Megan has been planning their wedding and pursuing a deeper interest in holistic and functional medicine.

Megan Iseman is a Physician Assistant at Prisma Health- Richland; a Level I Trauma Center here in Columbia, SC. Megan has been in practice with the Acute Care Surgery and Trauma team for the past 6 years and finds extreme fulfillment in practicing critical care medicine and helping those impacted by life-changing events. What Megan enjoys most about trauma is being able to see patients through their full hospitalization – from injury to recovery. The demonstration of resilience and growth are amazing reminders to her and her teammates daily. When not working extreme hours, this Floridan native enjoys any activity that can get her outside or close to water. Hallmarks of her life are her faith, friendships, and family time. Also, recently engaged to Dr. Tom, Megan has been planning their wedding and pursuing a deeper interest in holistic and functional medicine.

Today's guest is Matt Speier. Matt has 20 years of EMS experience and has worked in New York City as a FDNY Paramedic in Midtown Manhattan, in the Emergency Department of a Level I Trauma Center, as well as a technical rescue specialist on multiple USAR teams. He also served as a ski patrol paramedic, mountain rescue technician and is currently volunteering at a local rescue agency on a 911 truck. This episode is all about how complacency kills, and how it can hurt our patients. Matt shares some tips on how to avoid getting caught off guard and how we as a culture can “Default: Aggressive” (Willink, 2020) remaining combat ready.

Today’s guest is Matt Speier. Matt has 20 years of EMS experience and has worked in New York City as a FDNY Paramedic in Midtown Manhattan, in the Emergency Department of a Level I Trauma Center, as well as a technical rescue specialist on multiple USAR teams. He also served as a ski patrol paramedic, […]

Emily Mazurak was an RN in a busy PICU at a Level I Trauma Center. She was ready for a change and took her talents on the road and because a traveling PICU nurse. Through that experience, and feeling like she didn't fit in to some of the cliques within the units that she worked in, not having a sense of community, she felt that is where her burn out began. She loved taking care of her pediatric patients and their families, but was spending too much time at work, and not spending enough time taking care of herself. When she realized that she had many of the symptoms of burn out, such as dreading work and not sleeping, she decided to take care of herself and start her Fill Up Your Cup project. Emily's Fill Up Your Cup project is a way to help other nurses find a way to put themselves first. Her first tip is that “No” is a complete sentence. When you are asked to do something but you don't have the desire or time to do it, like picking up an extra shift at work, the only answer that you need to give is no. About Emily MazurakEmily Mazurak is a second degree, critical care certified nurse with experience in both the inpatient and outpatient settings. After four years of working in high paced, high intensity PICUs around the US, she was forced to come face to face with her own crippling burnout during a job interview. On the car ride home she realized that if she did not make a change, and fast, her career as a nurse would be over just as quickly as it began. She started to put as much emphasis on personal development as she did on professional development and slowly redefined what it meant to be a “real nurse.” Emily, the creator of the Fill Up Your Cup Project, is now helping other nurses reignite their spark and their love of nursing by helping them pour into their own cups before helping everyone else around them so they can live a life they love on and off their shift. Learn more about supporting the Don't Eat Your Young Podcast with a membership — visit Don't Eat Your Young's membership page!Links & Notes Follow Emily on Instagram Connect with Emily on Facebook The Fill Your Cup Project 00:00 - Welcome to Don't Eat Your Young 00:25 - Emily Mazurak 01:06 - Emily's Nursing Journey 05:01 - Burnout 10:41 - Treatment Leading to Burnout 13:38 - What Emily's Up to Now 16:27 - Last Advice 19:43 - Current Work in Maine 20:57 - Closing Thoughts 22:41 - Wrapping Up

Join us on The Holistic Kids' Show today as we talk with Erika Gray, PharmD, UCSF, about kids' nutrition and their genes. Dr. Erika's children will join in and even share a few funny stories! Erika Gray, PharmD, UCSF trained pharmacist, educator and national speaker is the co-founder and Chief Medical Officer of ToolBox Genomics and MyToolBox Genomics. She has spoken extensively about the role of genetics in various health conditions on a variety of platforms, including national television. Having had several years of experience at a Level I Trauma Center in both the in-patient pharmacy and emergency room, Dr. Gray has a firsthand understanding of the terrible manifestations of chronic disease and the importance of preventative/precision medicine.   Visit My Toolbox Genomics here! https://www.mytoolboxgenomics.com/  Prefer to watch? Click here! https://theholistickidsshow.com/episode/  Follow our mom, Holistic Mom, MD, on Facebook here: https://www.facebook.com/HolisticMomMD

Today we tackle the "A & B" in ABCs. Airway is one of the most crucial components of any EMS run. Our Medical Director, Doctor Wendy James joins us to talk about the things everybody should be thinking when dealing with the airway and breathing. Doctor James completed her residency in Worcester, MA while working as a 911 scene flight physician. Her experience includes 27 years in EMS, paramedic education, and medical direction. Doctor James now is an attending physician at a Level I Trauma Center. From EMT to critical care, this episode goes in depth to what you need to know and why you need to know it. *Check out the bonus content for this episode: "When to Act"

Crystal Cabrera, who is known on social media as The Brainy OT, became an occupational therapist in 2015. Her first jobs were in pediatrics; she worked per diem OT positions at a private outpatient clinic and at a prescribed pediatric extended care clinic (PPEC). After a little more than a year as an OT, Crystal sought out opportunities to work with the adult population. In 2016 she accepted a position at a large community hospital with a Level I Trauma Center and Certified Comprehensive Stroke Center. Since then, she has dedicated her practice to the neurological population and attained the certification of Certified Stroke Rehab Specialist.For more details including how to connect with Crystal, visit the podcast website at www.ontheair.us

Crystal Cabrera, who is known on social media as The Brainy OT, became an occupational therapist in 2015. Her first jobs were in pediatrics; she worked per diem OT positions at a private outpatient clinic and at a prescribed pediatric extended care clinic (PPEC). After a little more than a year as an OT, Crystal sought out opportunities to work with the adult population. In 2016 she accepted a position at a large community hospital with a Level I Trauma Center and Certified Comprehensive Stroke Center. Since then, she has dedicated her practice to the neurological population and attained the certification of Certified Stroke Rehab Specialist.For more details including how to connect with Crystal, visit the podcast website at www.ontheair.us

Dr. Jeffrey Fine serves as Vice Chairman of NYU Langone Health Brooklyn Rehabilitation & Rusk Rehabilitation Network Development. He is a clinician educator and administrator who has been practicing in academic medicine at Level I Trauma Center teaching hospitals for over 20 years. Dr. Fine is chairperson of the VBM ICU early mobilization program at NYU Langone Hospital Brooklyn and also chairperson of the  Brooklyn brain injury outpatient care planning team. He holds four certifications from the American Board of Medical Specialties in the following areas: Physical Medicine & Rehabilitation; Spinal Cord Injury; Brain Injury Medicine; and Pain Medicine. He also has published several articles regarding patient safety during transitions of care including communication during handoffs, and identification/reconciliation of barriers to safe community discharge with resultant enhanced patient satisfaction. His medical degree is from New York Medical College and he completed his residency at Mount Sinai School of Medicine in New York City. Among his many prestigious awards, on more than one occasion he was honored as Best Teacher Of The Year in the Department of Rehabilitation Medicine at the Icahn School of Medicine at Mount Sinai. In this interview, Dr. Fine discusses the following: kinds of patients he is treating for COVID-19; patient pathways to arrive for treatment; differential susceptibility of patients entering the health care setting on the basis of age, gender, socioeconomic factors, genetic variations and other characteristics, such as preexisting conditions like diabetes; whether accurate predictors are being employed, along with any kinds of measures or rating scales to help distinguish patients who can expect to be discharged to their homes compared to individuals with more life-limiting medical conditions; access to all necessary therapies, including those considered still at an experimental stage of effectiveness; role of telehealth in treating COVID-19; possible impact on daily activities of wearing full-body PPE by clinicians in the hospital; and how as a health professional life may have changed since the appearance of COVID-19.      

When faced with trauma, you have a choice in where you'd prefer to receive treatment. Dr. Michel Aboutanos, Chief of Acute Care Surgical Services and Medical Director of the Adult Level I Trauma Center, discusses the care available at the VCU Health Level I Trauma Center.

Catherine Pallozzi, CHAM, CCS is the current President of NAHAM, the National Association of Healthcare Access Management; an organization which supports patient access services across hospitals and other access points, with the purpose of networking, educating, and supporting the patient access position. She also serves as the Director of Patient Access at the Albany Medical Center Hospital, a Level I Trauma Center which serves 25 counties in New York, where she has worked for 30 years. In this episode, Akshay Birla and Cathy Pallozzi explore the ties between patient access and the medical revenue cycle. They examine both the need for patient access staff to inform and educate patients on insurance and financial responsibility for the sake of organizational ROI, but also to provide positive patient experience all around and deliver on patient expectations. Moreover, Cathy provides three predictions on what we can expect to see down the line with patient access and economics: the importance of “pre-service,” financial clearance and education, and price transparency.For more from Radix Health, follow us on Twitter @radixhealth or visit our website at www.radixhealth.com.Guest: Catherine PallozziHosted By: Akshay Birla

On this week’s episode of the Healthy, Wealthy and Smart Podcast, Jenna Kantor guests hosts and interviews Lynn Rivers on Robert’s Rules. Dr. Rivers is currently the Speaker of the Assembly for the New York Physical Therapy Association (NYPTA) and sits on the Board of Directors for the NYPTA. She strives to facilitate the active engagement of the students in becoming advocates for the patients/clients they will serve and their profession. In this episode, we discuss: -What are Robert’s Rules and how debate is conducted at the House of Delegates -Different ways to collect votes from the delegates -Point of Order, Point of Inquiry and Point of Information -Can a guest speak during a meeting? -And so much more! Resources: Email: riversl@dyc.edu Robert's Rules for Dummies For more information on Lynn: Dr. Lynn Rivers has 25 years experience as a clinician and 20 years as an educator in higher education. Her clinical experience has focused on adults with neurological disorders and traumatic injuries such as head injury and spinal cord injury while working in a Level I Trauma Center. Before becoming chairperson of the department in 2001, Dr. Rivers was Director of Clinical Education for the physical therapy program. Dr. Rivers is currently the Speaker of the Assembly for the New York Physical Therapy Association (NYPTA)and sits on the Board of Directors for the NYPTA. She strives to facilitate the active engagement of the students in becoming advocates for the patients/clients they will serve and their profession. For more information on Jenna: Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas (www.jennakantor.com) until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University’s Physical Therapy Program. She is also a co-founder of the podcast, “Physiotherapy Performance Perspectives,” has an evidence-based monthly youtube series titled “Injury Prevention for Dancers,” is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt   Read the full transcript below: Jenna Kantor:                00:00                Hello and good morning. This is Jenna Kantor. I'm here with healthy, wealthy and smart and I get to interview Lynn Rivers who knows so much about Roberts rules. Okay. Robert's rules. You know I'm going to actually hand over the mic because I can already imagine me describing it and Lynn going, well not exactly. So would you mind first just defining what Robert's rules is and where it is in applied within the APTA? Lynn Rivers:                  00:26                Sure. Well Good Morning Jen. Thanks for the opportunity. Thank you for the opportunity to be able to share just about 28 years that I have sort of gotten myself involved and love Robert's rules of order. So what is Robert's rules of order? It goes back hundreds and hundreds of years. It is the philosophy and the construct of how do organizations, any organization, whether it's a small church board or it's Congress or its parliament in England, how does a civil society with lots of divergent opinions, how do we conduct our business so that there are two principles that are met and the two principles are that the will of the majority will rule, but we must protect the rights of the minority. So it is for the voices of everyone in whatever society, whatever group, whatever meeting that every opinion gets heard and heard with respect. And that there is civility so that when very strong, strong opinions can equally be heard, both sides of the debate can be heard. Lynn Rivers:                  01:41                But there is civility and respect. And then when the decision is reached that the minority will agree that the will of the majority will rule. So that those are the two principles. So then the rules, holy smokes, there's, you know,  I'm sure if people have looked into it, the 11th edition is 800 pages long and there are so many minutia rules. But the bottom line is that the rules guide how people make decisions about what gets heard and how we make choices. So there are just the word motions is a tenant of Robert's rules of orders. So what is a motion? A motion is just an ask. It is an idea that someone has, that they want the society, the group, the organization to do. I want to ask that we pursue buying a piece of property or I want my APTA to look into this or work on this legislation, create a document for us to help us write. Lynn Rivers:                  02:56                It's an ask and then there's a way to make the ask. And so they give guidelines on how you make the ask. And then there are rules of then how do people debate. So you have to write out your ask. It becomes a motion. And then it's agreed during the meeting. It will be, they call it lay it on the table, but it just means say it right. Make the ask for the whole body to hear. And then there is the leader of the meeting who is neutral and just trying to facilitate the discussion and they have different titles. Then everyone respectfully just raises their hand or makes a motion. They have to be recognized to speak. And then when you speak to the motion there are just rules of civility meeting respect that you aren't shouting that you are just speaking to the facilitator of the meeting and you are making your case but you tend not to speak only about the motion, not who made the motion and don't speak ill of any other opinion. You just state your own opinion and the debate goes back and forth and then there's a vote. Jenna Kantor:                04:16                Actually could we go on this a little bit more with the ask, cause there's some things in this that I think is so fantastic with the civility that you are discussing and you guys, anybody listening, all you new grads, anybody who hasn't done house of delegates or been to any of these type of meetings before. You know how easy it is for things to get heated when it should, when it's a touchy subject. And of course within physical therapy we're extremely passionate about what we do. So those issues can get personal very easily. So would you mind going into the process of who is actually getting the eye contact, when you are standing up to speak about something and say it might be something you are quite passionate about, you have a written out exactly what you want to say. Who do you make eye contact with? And how do you address or refer to somebody who may have spoken before? Would you mind giving an example of that so people can get a better idea of how important and valuable it is to keep this going? Lynn Rivers:                  05:18                Be Glad to Jenna. So I'm just going to think back to the most recent house. The American Physical Therapy Association taking a stance against firearm violence. And there are some very passionate opinions in the room. So what will happen is in order to not hurt feelings or offend anyone, what happens is that the individual who wants to now speak passionately against the APTA taking any kind of social stance, they make direct eye contact, the room is full of 400 people, face forward. You're looking directly at the speaker of the house, which is the title of the individual who's standing up in the front, who has recognized you to speak and you say, Madam Speaker, I would like to speak vehemently against this. I respectfully disagree with the previous speaker from Oregon who made this claim. Lynn Rivers:                  06:22                And I disagree with that. So you don't say, I think Henry is an idiot. You say, I respectfully disagree and you speak about people in the third person and it's amazing how that sort of takes the emotion out. You can be emotional, you can feel passionate about your stance and you could be angry about the thought of an action being taken, but you are looking at the neutral speaker of the assembly and you are referring only in the third person to previous speakers or to a speaker from another state. And it is amazing how that can really deescalate the emotion. Jenna Kantor:                07:08                And then for such a very important debate and which I'd like to say that, you know, it's nice that there's an opportunity for every single motion to be debated on. So whether or not you think it's important, it still doesn't obliterate the opportunity for other people to debate on that, which I think is wonderful as well. But of course these things can go on forever. So how is it handled to end, you know, as a group cause you have a group of 400 people you know, for us at the house of delegates. So how is it handled, you know, to rightfully decide when it's appropriate to stop the discussion and move on to a vote? Lynn Rivers:                  07:48                Yes. So again, what happens is, you know, people have raised their hand or we do it electronically now in the house of delegates with a blackberry, you can put yourself what they call in the queue. So you're in line to speak. And so the speaker will monitor and you must indicate to the speaker whether you're speaking for or against it. So they try to balance debate. And at times after a bit of discussion, the speaker will say, at this time there appears to be no one who is in line or in the queue to speak. Are you ready for the vote? Other times, the speaker that we do have an opportunity and in Robert's rules there is a motion it to what is called call the previous question. And all that means is that person has put a motion to say, I think I've heard enough. Lynn Rivers:                  08:38                I have heard both sides of the debate. I am ready to vote. And so then if the speaker of the house, the leader of the meeting, observes that there are many people who think it's time to vote, then he or she will ask the body, that group at the meeting, are you ready for the vote? And if there's no objection, then you move to the vote. So it can either be everyone has stopped talking or there has been a lot of balanced debate hearing both sides of the story and enough people have spoken that the group feels they can make a vote. Jenna Kantor:                09:16                I also saw in the meeting, and we're not gonna hit all 800 pages of the book, but I'm just pointing out some interesting things. Sometimes the voting switched between standing between saying Aye and then also the electronic vote via the device. So how does, in this case, the speaker of the house who was running the meeting, how does the speaker of the house decide which way to do the vote? Lynn Rivers:                  09:43                Yeah, so certainly, what happens is each organization has also something that's called the standing rules. So we use set rules at the beginning of the meeting. And one of the key rules you decide is how much agreement does there have to be in order to pass that motion to say it's going to go. So for normal business, the actions of the house, we agree in the house of delegates, a simple majority, so just over 50%, 51% of the group. So the default or easiest for 404 was our voting strength yesterday, that the speaker starts with a voice vote. All those in favor say Aye. So she listens to the volume of the ayes compared to the volume of the no’s. And many times it's very clear if 300 people say Aye and 100 say no, then it's pretty clear by voice. Lynn Rivers:                  10:42                And that's the simplest and quickest. If it's still a vote for simple majority and she couldn't tell by the voices, then we have to use the electronic voting. Within that everybody has their clicker and they vote Yay or nay and it comes up. The standing vote is typically done when there is a vote that is more precious than just a normal business action. It's any vote that is going to hurt the rights of members. And I'll give the example then if you need to know, if two thirds of the people agree, many times the speaker will do a standing vote because that is much easier to see two thirds clear by standing. And that is when there is an objection to calling the question, meaning stopping debate. And because that is a right of the minority to continue to be heard, that is when the speaker calls for a standing vote. And then there was one time, even in the standing vote, she was not 100% sure it was two thirds. So she had us sit back down and do the clickers. Jenna Kantor:                12:05                This is great. So, you know, it's so funny, earlier you mentioned the word Henry and now I'm thinking of the Henry Bar, the candy. And I'm like, oh my gosh, what do these conferences do to me? I'm like, I need sugar all the time to like stay awake. Can we get into some of the language, just the intro that people say when they say parliamentary inquiry, like why do we say that instead of something else? Does it make it more efficient? Lynn Rivers:                  12:35                So again, there is a protocol to how one introduces a motion. And one of the first again for civility is whenever you are recognized to speak, you start by introducing yourself so speakers know who you are. We also ask them to state what component they are from, component or state. So I'm Lynn Rivers from New York would be how I would start. And you must be recognized in order to speak. There are three instances, and someone can shout out and not wait to be recognized. Point of order, point of inquiry and point of information, point of order. They there is shouted out and you are allowed to shout it out if you believe what is happening right now is not following Robert's rules of order. We are not doing it correctly and we believe that we have to ask the speaker that. Lynn Rivers:                  13:45                So if someone shouts out point of order, all debate stops immediately and the speaker says state your point and that person comes up to the mic and says speaker, I believe it is not in order for this motion to be heard. And there is a reason why we did not have due notice before this motion came. I don't think it's right that we are hearing it and then they would confer and decide whether that member is correct or the speaker rules. No, I do believe it's in order point and I'm sorry I misspoke. Point of inquiry or point of information are very similar. There is no real difference between that. A point of inquiry is sometimes said because people are really wanting data and facts, point of information. People tend to say they just have a question. They don't really understand why the makers of the motion wrote it this way. They don't really understand the intent of the motion. So they are asking a question to better understand the motion point of is just a little more precise if they want to. If someone wants to ask someone else other than the maker of the motions, they understand the motion but their point of inquiry is we'd like to hear from legal counsel is what the maker of the motion asking us to do. Is that legal in all 50 states? So then the speaker will say, is there an objection? Does anyone object to legal counsel addressing the body and answering this person's inquiry? Jenna Kantor:                15:16                Yes. That honestly makes more sense for me. Now listening to that because there was a motion on creating a virtual historical museum and there was a lot of point of inquiries to the board to find out how much work would this be putting on them. Would this be possible for them to take on? And also what would the game plan, where would the financial resources come from? What would we be taking away from? So that makes even more sense. And it's also respectful way to be like, it's just clarification. It's not going to be an attack. We just have a question to like know what this means. And of course, it's pointed in a very professional way of just saying, we really just need to know to get the full picture on if this is a good thing to vote on. So, I'm getting some massive light bulbs here right now. And then I think I want to finish with one more or the Lord knows we could go on forever with Robert's rules. And, honestly, if I really do recommend, yes, it's an 800 page book, but if you're interested in it, read it. Why not? Lynn Rivers:                  16:30                Well, and I'm going to say the caveat. Please don't start with that book because you will run away screaming, but please know, and you can just Google it. Robert's rules for dummies is one version. There are about four levels of books. There's Robert's rules simplified, right? So Google Robert's rules and look at the different books and start with the first one and then move up to the next one. That gets a little deeper into it. If you really think you want to fully understand it, you want to join be a member of the national parliamentarian society. That's when you buy the 11th edition of Robert's rules. Nearly revised. Yes. Jenna Kantor:                17:17                Awesome. Thank you so much. And See, this is a perfect example. Why bring the expert on to help? Correct me as I'm going, why don't we just do this? You're like, Whoa, whoa, Whoa, whoa, Whoa, whoa. Well, thank you for helping prevent people from walking away and pulling their hair out. Trying to read it going, oh, I give up. So that's good. I love those dummy books. Those are amazing, Lynn Rivers:                  17:36                I guess. But I just want to say the dummy books are not always helpful. Right. But I can assure you for Roberts rules, that book is a great start. If you just want to be able to be a voice at a meeting, not necessarily run one yet. You know, you just want, you want to write a motion, you want to get up and state your opinion and don't want to look foolish. Start with Robert's rules of order for dummies. Jenna Kantor:                18:03                Love it. Love it. Oh, I've been forgetting what my last, Oh yes. So for those who don't know, so at the house of delegates, I'm not sure if this is elsewhere, so you can definitely clarify this, Lynn. So at that house, all the people who are elected delegates sit in, I want to say an organized clump with their states and everything. But then there can be guests attending the event and they are sitting in the gallery in the back. And these are, it's separated in the back of the room. Is it true that they can come up and say point of order or speak to a motion or ask a question and so on and following Robert's rules and when or how, if that is appropriate? Is it appropriate? Lynn Rivers:                  18:49                Yeah, no, that's a good question. And the short answer is no. A guest in the gallery does not have the right to state point of order. Point of inquiry, they cannot shut out. But with the permission of the group permission has to be asked, can a guest speak? So guests can be invited to speak. A guest in the gallery can ask a member of the group to request permission for them to speak. So, so there's two things. There may be a member in the audience that knows there's a lawyer in the audience or in the gallery and they may initiate the request, but the lawyer may be sitting there antsy thinking, I have something to contribute. There are guests in the gallery. They are allowed to walk up to a member and say, would you ask the speaker of the House to request permission for me to speak? Because I have something to say. And almost always the body would say yes. If someone really wants to speak. I've never seen a guest be denied, but there must be permission given. Jenna Kantor:                20:07                Thank you. That's very helpful. Well, me as a performer first I see this mic sitting in front of us that's clearly not pointing to the people. You know, anybody sitting in amongst the delegates. And I remember staring and going, I mean, do they want us to sing? What is this opportunity? This mic Beholdeth on us? So no, they give them one for clarifying. But thank you Lynn, thank you so much for coming on and clarifying. Just even giving people a little glimpse of what Robert's rules is and just really learning how valuable it is. I think this will be such a good thing for so many, even experienced physical therapists to really know more of and understand what goes on behind the scenes and why we are following such rules. I'm new to this, but honestly, I really do believe in them because it is not easy to have these hard discussions in a nice manner. Jenna Kantor:                21:01                You don't want to leave pissed off. You want to leave like, okay, that was fair. That was a discussion. I can see why we might be moving a little slowly on this matter or why we might move quickly on this matter. It was eye opening in a very positive way. So I was wondering, Lynn, if people wanted to reach out to you or find you to learn more or maybe even get more guidance if they start finding themselves passionate about getting much more involved in this whole parliamentary process, how could they find you? Lynn Rivers:                  21:31                Thanks Jenna. Well, I'm in Buffalo, New York at D’Youville College and I am happy to share my email. It is riversl@dyc.edu. Jenna Kantor:                21:48                Thank you so much for coming on.     Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!

  We talked about his background as a paramedic and currently working as a Trauma Surgery PA. We laid down so many points for anyone looking into getting into the medical field. We covered so many topics during our chat he wondered if there was any value to it, but I know due to his background and personality we were covering really important information when we were chatting. This is the whole reason for Maybe Medical! Please visit Maybemedical.com to leave comments and please rate us on your podcast feed to get the word out! Thank you Tyson!       Physician Assistant Stats:* Physician Assistants practice medicine on teams with physicians and other healthcare workers. They examine, diagnose, and treat patients autonomously and as part of a team in all various specialties of medicine.   2017 Median Pay: $104,860 per year ($50.41 per hour)   Educational Degree: Masters Degree   Number of US jobs in 2016:106,200   10 Year Job Outlook: 37% growth, much faster then avg.     *Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Physician Assistants, (visited August 5, 2018).     Terms Covered in Episode M.D. (Doctor of Medicine) - Requires completion of a (usually) four year graduate medical school training program to become a Physician.  They examine patients; take medical histories; prescribe medications; and order, perform, and interpret diagnostic tests. They counsel patients on diet, hygiene, and preventive healthcare.   Psychiatry - Medical specialty focusing on Mental and Behavioral Health.   Salary - Opposite of hourly pay.  Salary is paid no matter how little or excess work is performed.  Does not fluctuate based on productivity or hours worked unless previously agreed upon.   Production Bonus - Extra pay for seeing more then the require amount of patients, or some variation of productivity.   Attending Cosign - Legal signature and acknowledgement of a Physician Assistant's note.  Agreeing with their interpretation of diagnostics, medical diagnosis, and treatment plan.  Requirement of number of cosigned notes varies by state with many asking 10% of charts be reviewed by the Supervising Physician.   Reimbursement - Payment for services and medical supplies from insurance companies.   Third-Party Reimbursement   RVU (Relative Value Units) - Measure of value used in the US to determine services provided by practitioners to gauge the value, and thus the reimbursement from insurance companies, for care given to patients. Trauma Surgery - Surgical field dealing with acute traumatic injuries such as falls, motor vehicle crashes, gunshots, blunt and penetrating injuries, etc.   "Scut Monkey" - Slang term for an inexperienced medical student.  Responsible for much of the paperwork and other undesirable duties...also the subtitle of an EXCELLENT book.  Seriously, buy it!   Discharge - To be released from the hospital and given specific follow up instructions, support services, and pertinent medications. Admit - To be brought in to the hospital for medical care, surgical care, or recovery.   OR (Operative Room) - Where surgeries take place. ICU (Intensive Care Unit, Critical Care Unit, or Intensive Therapy/Treatment Unit) - Part of the hospital with the sickest patients requiring the most intervention from both staff and equipment.   May consist of intubated, sedated, and ventilated patients.   Pre/Post Op - The phase just prior to or after surgery for a patient   Inpatient/Outpatient - Inpatient is someone staying, at minimum, overnight in the hospital, outpatient generally refers to a clinic patient.   Level One Trauma Center - A Level I Trauma Center is capable of providing total care for every aspect of injury – from prevention through rehabilitation and includes teaching residents and medical students in all fields.   Resident - Physicians who have graduated from an accredited medical school and hold a medical degree who are now enrolled in a post graduate medical program, with varying years, with the focus on a specific medical/surgical field.   Chest Tube - A tube placed in the chest cavity to evacuate blood, pus (exudate), or air.   “Bronchs” (Bronchoscopy) - Surgical technique of visualizing the inside of the airways for diagnostic and therapeutic purposes using a flexible camera/suction device (bronchoscope) inserted into the airway (mouth, nose, trachea) of a sedated patient.   Supervising Physician - Each PA has a Supervising Physician on state record who has partnered for medical care.   Subspecialty - Specific medical or surgical focus.  For example bariatric surgery instead of general surgery or pediatric neurology instead of pediatrics.   EMT/Paramedic - Emergency medical technicians and paramedics care for the sick or injured in emergency medical settings by responding to emergency calls, performing medical services, and transporting patients to medical facilities as needed.   ER Tech - Staff who work in all aspects of patient care under the supervision of the Practitioners and Nursing staff.   Many have a paramedic/firefighting background.   “Ride-a-long” - Volunteer position to ride with EMS staff seeing the real world day to day duties of their career.   On Scene - On location of the medical event.   Aaron - Super Amazing Guy and Critical Care Nurse Practitioner.   Certificate Program - Generally around a two year program at a local community college.   EMS (Emergency Medical Services) - Services that treat illnesses and injuries that require an urgent medical response, providing out-of-hospital treatment and transport to definitive care.   Paramedics, Police, Firefighters, etc.   Undergrad - Generally refers to a Bachelor program (four to five years) after high school.   Monitor Tech - Trained technicians who observe and interpret a patient's heart status and other vital signs remotely in the hospital.   Phlebotomist - Staff skilled at drawing blood/obtaining labs.   ER (Emergency Room, Emergency Department, Emergency Ward, Accident & Emergency Dept) - Department that must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention that arrive unplanned by walk-in, private vehicle, or ambulance.   Urgent care - Walk-in clinics focused on the delivery of acute care in a dedicated medical facility outside of a traditional emergency room. Urgent care centers treat injuries and illnesses that are not serious enough to require an emergency department visit.   Auger - A large helical drill bit used often for drilling earth or wood.   Prerequisites - Classes you may need to take before further applying to a program.   Usually a focus on science/math for the medical flied.   Bachelor’s Degree - On average four to five year University Program to pursue a degree in a specific field.   Intubate - When an ET Tube, or similar artificial airway, is placed, either in an emergency, where there is loss of respiratory function, or planned such as in surgeries.   MI (Miocardial Infarction) - "Heart Attack" refers to a blocked coronary artery that has caused, or is moments away from causing, irreversible cardiac (heart) tissue damage.   Mapping Navajo Nation: Vice News Tonight on HBO (watch it!)   Protocols - Specific guidelines that allow EMS to treat patients en route to the hospital based on the medical situation and skill of staff.   EMS Transfers - Often non-emergent transfers from one medical facility to another.  May be as simple as a hospital to nursing home transfer a few mins away, or a half day trip to a metropolis with better medical services.   Pension - A regular payment made during a person's retirement from an investment fund to which that person or their employer has contributed during their working life.   Colleen - Supportive Wife and Amazing Flight Nurse   Travel RN - Nurse who travels for limited contracts working in all variety of places and roles.   On average 8 to 13 week contracts.   Wake Forest Physician Assistant Program   PAEA - Physician Assistant Education Association   List of PA Programs   PA History   Prescription - Legal written order for prescribed medications from a medical practitioner and dispensed by a pharmacy.   Surgical Programs   American College of Surgeons List of Surgical Specialties   A1c (Hemoglobin A1c) - A blood test that measures your average blood glucose, or blood sugar, level over the past 3 months.  Hemoglobin is a protein found inside red blood cells that carries oxygen to the body.  Used during the evaluation and treatment of diabetes.   Diabetes -  Refers to a group of diseases that result from an inability to utilize or produce insulin (naturally produced hormone) and thus unable to process glucose (sugar) appropriately.  This leads to a large variety of complications.   Byetta - A medication used for type 2 diabetics that promotes insulin secretion by the pancreas.   Vascular - A surgical subspecialty focusing on arteries, veins and lymphatic circulation using medical therapies, minimally invasive procedures, and surgical intervention.   Orthopedics - Branch of surgery concerned with conditions involving the musculoskeletal system.   Plastic Surgery - Surgical field specializing in restoration, reconstruction, or alteration of the human body.   Transplant Surgery - Surgical specialty in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ.   List of PA Residency Programs   Montefiore PA Surgical Residency   Consult - When asked to weigh in officially with your medical opinion from your specialty on a patient managed by another team.   Didactic Phase - Refers to the classroom aspect of medical education.  The opposite would be clinical phase working with actual patients.   “Steps” - Refers to the USMLE   Schwartz's Principles of Surgery   Staff PA - Hospital employed Physician Assistant.   CT Surgery - Cardiothoracic surgery deals with issues of the thorax, generally the heart and lungs.   Vein Harvest - Generally endoscopic removal of a vein to replace a coronary artery (cardiac bypass).   "Pimping" - Refers to the process of getting questioned, sometimes spontaneously, on random medical topics until failure by your preceptor.   Pathophysiology - The processes associated with disease or injury.   Neurosurgery - Surgery dealing with the Nervous System (brain and spine).   Pathology - The area of medical focused on conditions typically observed during a disease state.   Foreign Body - An object that is not supposed to be there.   IM (Internal Medicine) - The medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. AKA “Internists.”   Hospitalist - Practitioners who focus on the treatment of hospitalized patients.   Follow up - The scheduled visit to see how the patient is progressing in their recovery or disease state after a hospital discharge or clinic visit.   Pneumothorax - AKA “Collapsed lung” is when air leaks into the space between the lungs and chest wall.  This may be due to blunt or penetrating trauma, or spontaneous due to congenital (developmental) or disease origin.  Treatment is a chest tube.   OR Device Rep - Professional representative who assists and educates the surgeon during a procedure with an expertise in their area and their company’s equipment (knee replacements, defibrillators, etc).   Each and every episode of Maybe Medical is for educational purposes only, not to be taken as medical advice.  The opinions of those involved are of their own and not representative of their employer.  

Rounding out the trifecta of wonderful nurse guests this month on Maybe Medical is Flight Nurse Colleen R.! We covered how she feels you need to be able to fly by the seat of your pants to perform in her role, as well as have an emergency and critical care background. We talked about work and home partnerships and how to balance it all while supporting each other. She was extremely inspirational and I can not express my gratitude enough for her taking the time to sit down with us. Thank you Colleen!   Registered Nurses* Registered nurses (RNs) provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their family members.   2017 Median Pay: $70,000 per year ($33/hour)   Educational Degree: Initially Associate's Degree or Bachelor's Degree   Number of US jobs in 2016: 2,955,200   10 Year Job Outlook: 15% growth, much faster then avg.   *Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Registered Nurses, on the Internet at https://www.bls.gov/ooh/healthcare/registered-nurses.htm (visited November 16, 2018).       Terms Covered in Episode American Nurses Association Trauma Surgery - Surgical field dealing with acute traumatic injuries such as falls, motor vehicle crashes, gunshots, blunt and penetrating injuries, etc. Pulmonology - A medical specialty that deals with diseases involving the respiratory tract. Consult - When asked to weigh in officially with your medical opinion from your specialty on a patient managed by another team. Perforated Bowel - Opening in the intestines due to trauma (knife, bullet, etc) or disease (infection, cancer, etc).  Is a surgical emergency.  Yuck. Sepsis - A potentially life-threatening condition caused by the body's response to an infection. Ventilator - To move breathable air into and out of the lungs, to provide breathing for a patient who is physically unable to breathe, or breathing insufficiently. "Coding" - What we casually use to describe a cardiopulmonary arrest in which there is a sudden loss of function of the heart or loss of respiratory function that requires immediate intervention in a life or death situation. IR (Interventional Radiology) -  A subspecialty of radiology that uses minimally invasive, image-guided procedures to diagnose and treat diseases in nearly every system or organ of the body. CVA (Cerebral Vascular Assault, Stroke) – Possible permanent damage to the brain from a loss of blood flow from either rupture of a blood vessel or obstruction from a tumor, clot, plaque, etc. MI (Miocardial Infarction) - "Heart Attack" refers to a blocked coronary artery that has caused, or is moments away from causing, irreversible cardiac (heart) tissue damage. ET (Endotracheal) Tube - A tube of varied sizes that is inserted into the trachea for establishing and maintaining a patient's airway. Choose Your Own Adventure Books ER (Emergency Room, Emergency Department, Emergency Ward, Accident & Emergency Dept) - Department that must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention that arrive unplanned by walk-in, private vehicle, or ambulance. ICU (Intensive Care Unit, Critical Care Unit, or Intensive Therapy/Treatment Unit) - Part of the hospital with the sickest patients requiring the most intervention from both staff and equipment.  May consist of intubated, sedated, and ventilated patients. Bachelor's Degree - On average four to five year University Program to pursue a degree in a specific field. Sacred Heart University College of Nursing Bridge Program - A postgraduate program that is usually shorter then traditional programs that take into account previous experience. Physical Therapist - An important medical provider and part of the rehabilitation team to help assist with treatment, recovery, and overall well being of patients with chronic conditions, illnesses, or injuries. Prerequisites - Classes you may need to take before further applying to a program.  Usually a focus on science/math for the medical field. PA (Physician Assistant) - Providers who practice medicine on teams with physicians and other healthcare workers. They examine, diagnose, and treat patients autonomously and as part of a team in all various specialties of medicine. On average a Master's level degree of education. NP (Nurse Practitioner) - A nurse practitioner is trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose illness and disease, prescribe medication and formulate treatment plans.  They may work in a solo practice independently or they may work within part of a hospital system.  They graduate from a Master's or Doctorate level medical program. ASN/ADN - Associate’s Degree in Nursing.  Usually around two years. EMT/Paramedic - Emergency medical technicians and paramedics care for the sick or injured in emergency medical settings by responding to emergency calls, performing medical services and transporting patients to medical facilities as needed. ER Techs - Staff who in all aspects of patient care under the supervision of the Practitioners and Nursing staff.  Many have a paramedic/firefighting background. Travel RN - Nurse who travels for limited contracts working in all variety of places and roles.  On average 8 to 13 week contracts. Smart Pumps Compact Nursing States NCLEX (National Council Licensure Examination) - A standardized exam that each state board of nursing uses to determine whether or not a candidate is prepared for practice. Wake Forest School of Medicine PA Program Harborview Medical Center King County Medic One "Board & Collared" - Refers to the practice of placing a patient on scene on a very hard and rigid backboard to immobilize them and place a neck collar on them to prevent any head movement in the event of a spine injury while they are transported to the hospital.  They are incredibly uncomfortable. Intubated - When an ET Tube, or similar artificial airway, is placed, either in an emergency, where there is loss of respiratory function or planned such as in surgeries. First Responder - Generally refers to the first on scene in an event.  May be police officers, firefighters, or paramedics for example. "Packaged" - Patient is ready to be transported.  IVs are in, airway is secure if one is present, patient is strapped in, paperwork is read.  Let's roll!   EZ-IO - Used to gain access for medications or fluids when unable to get a line in a blood vessel.  Using a drill a hollow bore is inserted into the broad side of a bone.  Yeah, you drill into bone. "Push Line" - An IV that gives you access for medications that need to be administered over a short amount of time.  Pain meds, sedatives, cardiac meds, etc.   Vasopressors - Class of Antihypotensive medications that are used to raise blood pressure by contracting blood vessels.   EJ - An IV placed into the external jugular of the neck.   Central Line - Larger then an traditional IV placed into veins in the neck, chest, groin, or through veins in the arms.   EMS (Emergency Medical Services) - Services that treat illnesses and injuries that requiring an urgent medical response, providing out-of-hospital treatment and transport to definitive care.  Paramedics, Police, Firefighters, etc.   Level One Trauma Center - A Level I Trauma Center is capable of providing total care for every aspect of injury – from prevention through rehabilitation and includes teaching residents and medical students in all fields.   Med/Surg/Floor Nursing - Refers to what you would think of "general hospital patients." Those with pneumonia, new cardiac issues, skin infections, etc that do not require focal subspecialty involvement (cardiac, neuro, ortho, etc) or critical care support.   Nocturnist - Hospital-based practitioner who only works overnight.   Admit - To be brought in to the hospital for specific medical care.  Entails obtaining a medical history, making a medical diagnosis, writing orders for treatment and other diagnostic procedures, diet, activity, etc.   Post-Op/Recovery Room - The period right after surgery.   GI (Gastroenterology) - The branch of medicine focused on the digestive system.   Orthopedics - Branch of surgery concerned with conditions involving the musculoskeletal system.   Neurology - The area of medicine focused on the nervous system.  This includes the nerves, brain, and spine.   Potassium - A naturally occurring mineral and electrolyte consumed in our diet.  Involved in metabolism, hormone secretion, blood pressure control, fluid and electrolyte balance, and more.  Normal standard range is around 3.5-5mEq/L. Critical Values - Any values considered to be too high or low and requires immediate medical attention to prevent further issues. "Bagging" - The act of using a manual balloon like bag that is squeezed for each breath to a patient. "Titrate a Drip" - To adjust the flow rate or dose delivered of medication in a IV or central line. Peggy Sue - Badass Patient Advocate "Shake and Bake" - Hyperthermic Intraperitoneal Chemotherapy is a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen during surgery. Patient Advocacy - Doing what is best for the patient in all facets of care provided. Listening to and understanding their needs. Multi System Organ Failure - A cascading domino like effect where multiple organ systems start to shut down due to injury/illness. Krista Haugen and Survivors’s Network Post Resuscitation - The fragile period after performing CPR or similar resuscitation of a patient. M&M (Morbidity and Mortality Meeting) - Where we dissect individual challenging cases to identify what other choices could have been made for possible alternate outcomes. Off-Label - Using a medication that may not necessarily be the indication that it was originally intended for.  For example Demerol that is a pain medication is excellent for post-operative rigors (shakes).  A small dose works like magic...fun! IV Fluids - Intravenous fluids are given through an IV, central line, or IO and usually consist of normal saline or lactated ringer's solution. Levophed (norepinephrine bitartrate) - Medications used to raise blood pressure in critical patients. Used to be referred to as "Leave 'em dead" as any patient sick enough to require norepinephrine to manage their shock, then they were most likely going to die.  Very commonly used nowadays. Epinephrine - Endogenous hormone that is given to patient's to treat a number of conditions including anaphylaxis, cardiac resuscitation, and bleeding.  Inhaled epinephrine is used to help treat symptoms of croup.  Is used in the ICU and cardiac unit to help maintain a high enough blood pressure.   PRBC (Packed Red Blood Cells) – Blood that is transfused after finding the right compatible blood type for the patient.   Plasma – Fluid in blood that is responsible for carrying red blood cells, white blood cells, platelets, etc. Is often used during blood transfusion to help stop the active bleeding by adding pro-clotting factors.   Credo Cube   Transfusion Guidelines Airlift NorthWest   MONA - Morphine, Oxygen, Nitroglycerin, and Aspirin are all meds that should be administered to a patient experiencing chest pain.   Emergency Nurse Association   Balloon Pumps - Intra-Aortic Balloon Pumps use a thin flexible tube that is inserted into the aorta of the heart to pump blood artificially in a heart-like fashion.   ECMO (Extra Corporeal Membrane Oxygenation) - Treatment that uses a pump to circulate blood through an artificial lung back into the bloodstream of a very ill patient.  Provides heart-lung bypass support outside of the body.  You are damn near dead at this point   Skills Lab/”Sims” - Focused area to learn new medical techniques or further practice known skills.   Society of Critical Care Medicine PFCCS - Pediatric Fundamental Critical Care Support ACLS - Advanced Life Support PALS - Pediatric Advanced Life Support Certification NRP - Neonatal Resuscitation Program ATLS - Advanced Trauma Life Support Certification   CCRN - Critical Care Registered Nurse CEN - Board Certification of Emergency Nurses Each and every episode of Maybe Medical is for educational purposes only, not to be taken as medical advice.  The opinions of those involved are of their own and not representative of their employer.  

Yun Cee Dirsa is the podcast host and blogger of Resus Nurse.  She is also an emergency department nurse.   Yun Cee is a resourceful board-certified RN with experience in critical care emergency nursing care within a Level I Trauma Center. Goals include mentoring, further education, and creating positive experiences for patients and families who receive care in an emergency and trauma setting.   The nursing podcast and blog is primarily for emergency nurses learning how to apply critical care techniques to patients in the emergency department and reduce their morbidity and mortality. Yun Cee shares how creating her podcast and blog gave her the confidence to believe in herself and realize that her voice and opinions do matter.  She also shares tips that will help you in your own journey to self confidence.  Tune into her episode to listen to her story. Check out thetaoofselfconfidence.com for show notes of Yun Cee's episode, Yun Cee's website, resources, gifts and so much more.

This podcast covers the JBJS issue for October 2018. Featured are articles covering Osteosynthesis with Parallel Implants in the Treatment of Femoral Neck Fractures; recorded commentary by Dr. Zelle; Anterior Spinal Growth Tethering for Skeletally Immature Patients with Scoliosis; Pediatric Lawn-Mower Injuries Presenting at a Level-I Trauma Center, 1995 to 2015; recorded commentary by Dr. Bielski; Perioperative Tranexamic Acid Treatment and Risk of Cardiovascular Events or Death After Total Hip Arthroplasty.

This podcast covers the JBJS issue for October 2018. Featured are articles covering Osteosynthesis with Parallel Implants in the Treatment of Femoral Neck Fractures; recorded commentary by Dr. Zelle; Anterior Spinal Growth Tethering for Skeletally Immature Patients with Scoliosis; Pediatric Lawn-Mower Injuries Presenting at a Level-I Trauma Center, 1995 to 2015; recorded commentary by Dr. Bielski; Perioperative Tranexamic Acid Treatment and Risk of Cardiovascular Events or Death After Total Hip Arthroplasty.

Pump the brakes on your week and take 10 minutes to make your life as a surgeon just a little better…This week, we are welcoming to the mini-Podcast Dr. Ann Marie Warren, a licensed psychologist and Associate Investigator of Trauma Research. Dr. Warren talks to us about PTSD and associated self-care tips. We've chosen to talk about PTSD because the description of PTSD extends to people that experience the repeated or extreme traumatic event of others, including healthcare givers and their patients. Depending on how intimately involved someone is, reactions can include: disbelief, shock, sadness, anger vulnerability, fearful, being on edge, difficulty with keeping normal routine, sleeping well and changes in appetite. Dr. Warren gave us a series of self-care tips and strategy to help manage stress from trauma. Which active strategies does she suggest? The following:1. Talking to others who can offer support and not doing it alone2. Maintaining self care by getting adequate sleep, healthy eating and doing regular exercise3. Practicing mind relaxing strategies to reduce stress and process the trauma in a positive wayMost importantly, start creating a plan today and get in the habit of talking to others, self-care and thinking about 'things done right'! If you’re not familiar with Dr. Ann Marie Warren, Ph.D., ABPP, she is a licensed psychologist and Associate Investigator of Trauma Research at the Level I Trauma Center at Baylor University Medical Center. She is also a Clinical Assistant Professor at Texas A&M in the Department of Surgery. She has been the principal investigator of several funded research projects and multi-site collaborations pertaining to the psychological aspects of physical injury, including depression, posttraumatic stress, and resilience. She is also interested in the psychological outcomes and rehabilitation of patients with traumatic brain injuries and spinal cord injuries.The PTSD Self-Care Tips are perfect examples of how surgeons can improve their effectiveness inside and outside of the OR.

  Join hosst Amy Zellmer as she chats with brain injury survivor and author, Mark Glasser. Mark Glaser, author of 58 Feet: The Second That Changed Our Lives, grew up in the small ranching town of Calhan, Colorado, surrounded by airplanes and motorcycles. His love of motorcycles followed him into adulthood. When he met his wife, Robyn, through a mutual friend, he often took her on long dates on his motorcycle. In 2010, Mark and Robyn’s lives were unexpectedly changed when they were involved in a motorcycle accident. Robyn sustained a concussion, but Mark collided with the car that had turned into them and sustained a traumatic brain injury. He was airlifted to a Level I Trauma Center in Lakewood, Colorado where he spent 30 days in the Neurosurgical ICU before being transferred to Craig Hospital for rehabilitation. He has since welcomed two children, and lives in Denver.  Find Marks book on Amazon: http://amzn.to/2tUMrIl This episode is sponsored by: Minnesota Functional Neuorolgoy 

Babak Sarani, MD, FACS, FCCM, explains what the designation of a Level I Trauma Center means to patients in need of emergency care. He discusses the staffing, equipment and procedures that go into providing care for the most critically injured patients.

The UVM Medical Center is Vermont's only Level I Trauma Center. Here to tell us more about what this certification means for patients, families and physicians is Dr. Ajai Malhotra, division chief of acute care surgery.

Background Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF) as well as augmentation with autologous-bone-grafting. However, there is morbidity associated with the bone-graft donor site and some patients offer limited quantity or quality of autologous-bone graft material. Since allogene bone-grafts are introduced on the market, this comparative study aims to evaluate healing characteristics of ununited bones treated with ORIF combined with either iliac-crest-autologous-bone-grafting (ICABG) or demineralized-bone-matrix (DBM). Methods and results From 2000 to 2006 out of sixty-two consecutive patients with non-unions presenting at our Level I Trauma Center, twenty patients had ununited diaphyseal fractures of long bones and were treated by ORIF combined either by ICABG- (n = 10) or DBM-augmentation (n = 10). At the time of index-operation, patients of the DBM-group had a higher level of comorbidity (ASA-value: p = 0.014). Mean duration of follow-up was 56.6 months (ICABG-group) and 41.2 months (DBM-group). All patients were clinically and radiographically assessed and adverse effects related to bone grafting were documented. The results showed that two non-unions augmented with ICABG failed osseous healing (20%) whereas all non-unions grafted by DBM showed successful consolidation during the first year after the index operation (p = 0.146). No early complications were documented in both groups but two patients of the ICABG-group suffered long-term problems at the donor site (20%) (p = 0.146). Pain intensity were comparable in both groups (p = 0.326). However, patients treated with DBM were more satisfied with the surgical procedure (p = 0.031). Conclusion With the use of DBM, the costs for augmentation of the non-union-site are more expensive compared to ICABG (calculated difference: 160 €/case). Nevertheless, this study demonstrated that the application of DBM compared to ICABG led to an advanced outcome in the treatment of non-unions and simultaneously to a decreased quantity of adverse effects. Therefore we conclude that DBM should be offered as an alternative to ICABG, in particular to patients with elevated comorbidity and those with limited availability or reduced quality of autologous-bone graft material. Introduction