RE: MAST

[Guest guest]

We test them on prisoners and EMT students.

Not really, you use it under controlled circumstances and compare it to a

similar group that does not receive the intervention. Then, at the end you

compare. I meant no disrespect for Jane, just typed too soon. I have been 8

days in the frozen North and a little dull I guess.

Bledsoe, DO, FACEP

Midlothian, TX

Be good and you will be lonesome.

-Mark Twain (from " Following the Equator " )

Don't miss EMStock 2004!

http://www.emstock.com

RE: MAST

, in your original foot into mouth response to Jane you wrote, " Instead

of using them until we prove they don't work, shouldn't we not use them

until we prove they do work? "

While this isn't specifically about MAST, my question is until somebody uses

" it " , how can you prove " it " works or doesn't work? ( " It " being whatever the

new/old product/procedure is that is under discussion/consideration.)

Sort of a chicken and egg question I know, but realizing that with any

evolving field there will be some trial and error in order to facilitate the

learning and growth of the field. Unfortunately there are some risks (i.e.

acts which will produce and protect income for lawyers) involved when

dealing with human subjects but outside of small scale research involving

primates there's not a lot of acceptable substitutions for humans when it

comes to EMS practice research.

Your thoughts?

Also, and this may sound tacky (for which I apologize), but in your initial

response to Jane I had flashback to Jane Curtain and Chevy Chase doing

Weekend Update on the original SNL. Thanks for the fun memory.

Barry

[Guest guest]

I have a book " Ambulance No.10, Personal Letters From the Front " by

Buswell, 1916. In it he describes his duties as an ambulance

driver in France during WWI. Very interesting - he describes in one

hospital helping surgeons put 'balloon trousers' on wounded soldiers to

control lower extremity bleeding.

>>> wb2pcv@... 4/5/04 1:42:59 PM >>>

You know, I may need to ask some of you

-- Re: MAST

I do not know who is telling you that MAST is being removed from the

curriculum " due to the number of deaths " associated with their use.

PASG

have fallen out of favor in many areas based on one or two small

research

projects which did not prove or disprove their efficacy in the rural

setting

with long transport times nor did they disprove their efficacy for use

to

splint pelvic fractures. They have NOT been proven to INCREASE the

number

of trauma deaths. As for whether or not they will be in the next PHTLS

book

after its revision (which is entirely based on the physician's ATLS

revisions) remains to be seen.

Jane Hill

[Guest guest]

Mack, as a long-time EMT-B, let me take a non-scientific stab at trying to

answer your question.

The wonderful world of EMS has, and still is, emerging as a field. It's a

colorful quilt, if I may use that analogy, that is stiched together with a

little bit of the old Red Cross first aid that we learned back in scouts and

that our father learned in the service (can any of us ever forget the

lifting of arms for drowning victims or using magazines as splints);

military field hospitals during every major war; military field medics

(particularly since Korea); civilian emergency physicians (who say what

works in those nice clean hospitals should work in the upside down car in

the ditch in the rain at midnight); clinical researchers who try to

hypothesize, study and make really intelligent sounding guesses about what

works and how; and the old-time ambulance drivers (who started out having a

Red Cross card and a funeral home car that have evolved to the paramedics

and rigs we know now).

That said, with all of these influences we have made great strides in

furthering our craft, held death grips on traditional activities and done a

really poor job of high-quality research and evaluation of out-of-hospital

procedures. Much of our lessons are a mixture of trial and error on our

part, " we've always done it this way, " watching what others do and then

imitating it and a little bit of wait-and-see when something really radical

comes down the pike. We approach things on what's best for the patient while

still hoping to retain some of the " this (fill in the blank for your latest

tool or procedure) is really cool " for our self satisfaction.

So our practice is as much " art " as it is " science " . The really special part

of our practice is that we go to where the patients are and provide relief

and comfort - no matter what our level of certification. And no level of

gadgetry, magic potions or fee whiz will ever, ever replace the touch of our

hands, the comfort of our voice and the hope in our eyes as we reach out to

others in their times of need.

While I know this probably didn't answer your question, I'm not sure if

there is a simple answer to your question due to the nature of the beast

that is EMS.

Barry S.

Re: MAST

I do not know who is telling you that MAST is being removed from the

curriculum " due to the number of deaths " associated with their use. PASG

have fallen out of favor in many areas based on one or two small research

projects which did not prove or disprove their efficacy in the rural setting

with long transport times nor did they disprove their efficacy for use to

splint pelvic fractures. They have NOT been proven to INCREASE the number

of trauma deaths. As for whether or not they will be in the next PHTLS book

after its revision (which is entirely based on the physician's ATLS

revisions) remains to be seen.

Jane Hill

[Guest guest]

So what will the suit do for you>

Bledsoe, DO, FACEP

Midlothian, TX

Be good and you will be lonesome.

-Mark Twain (from " Following the Equator " )

Don't miss EMStock 2004!

http://www.emstock.com

Re: MAST

brian here we have a lot of trauma like for farm trauma I could see the use

or for a prolonged extrcation as well if your going to be on scene that long

whats the point of running so much fluid in to them it turns into water

[Guest guest]

But don't prisoner's have rights? I thought the Geneva Convention created

rules about using prisoners for medical research.

Barry

RE: MAST

, in your original foot into mouth response to Jane you wrote, " Instead

of using them until we prove they don't work, shouldn't we not use them

until we prove they do work? "

While this isn't specifically about MAST, my question is until somebody uses

" it " , how can you prove " it " works or doesn't work? ( " It " being whatever the

new/old product/procedure is that is under discussion/consideration.)

Sort of a chicken and egg question I know, but realizing that with any

evolving field there will be some trial and error in order to facilitate the

learning and growth of the field. Unfortunately there are some risks (i.e.

acts which will produce and protect income for lawyers) involved when

dealing with human subjects but outside of small scale research involving

primates there's not a lot of acceptable substitutions for humans when it

comes to EMS practice research.

Your thoughts?

Also, and this may sound tacky (for which I apologize), but in your initial

response to Jane I had flashback to Jane Curtain and Chevy Chase doing

Weekend Update on the original SNL. Thanks for the fun memory.

Barry

[Guest guest]

Velcro is a TradeMarked name for Hook And Loop closure. One mustn't use the

trademarked term. But one can use the generic terminology. For example,

hook and loop technology can, when used in conjunction with Baxter Healthcare ,

Abbott Labs Wart displasia protocols, and Farber succinctly Optimized

regression studies, frapingingding technologies developed in view of Optimum

Outcares,

be out responsively respressive.

Let's see it.

GG

[Guest guest]

" and Gandy, " aren't they wine makers? Thank you very much.

Barry M.

In a message dated 4/6/2004 1:54:41 AM Central Daylight Time,

lnmolino@... writes:

Also, and this may sound tacky (for which I apologize), but in your initial

response to Jane I had flashback to Jane Curtain and Chevy Chase doing

Weekend Update on the original SNL. Thanks for the fun memory.

And I thought I was the only one that was that old on this listserv (except

for and Gandy of course).

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

LNMolino@...

(Home Office)

" A Texan with a Jersey Attitude "

[Guest guest]

See, couldn't this start a whole new thread... If your idea of birth control is

a set of MAST pants, you might be a redneck paramedic... Just a thought.

--

Joe T. Kiff, EMT-LP, EMSI

Cy-Fair Volunteer Fire Department

Houston, Texas

--

[Guest guest]

Barry, I was just this close 1 " to answering Dr. Bledso's post when I decided to

read another post. I think you are exactly right. If EMS waited to see if a

procedure or equipment worked prior to implementing it, We would be running

funeral home ambulances today. I have mixed feeling about the MAST. I am from a

time where the MAST was considered a plus for trauma. Had I known Houston was

going to do a study, I would have kept track of the patients that I applied the

MAST to. Now anything I could say in regards to the MAST would be written off as

incidental. We still carry the MAST. Have I seen our Medics use them? No, not in

the last few years. Of course I have not responded as back in the same time

period.

KEDS - No Study

C-Collars - No Study

Fracture Packs - No Study

Demand Valves - No Study

Vac U Splints - No Study

Oral Airways - No Study

Of course when I say No Study, I really mean that I can remember hearing about

or reading. CRS (Cant remember _ _ I _ disease can be used for good or bad.

Henry

Barry Sharp wrote:

> , in your original foot into mouth response to Jane you wrote, " Instead

> of using them until we prove they don't work, shouldn't we not use them

> until we prove they do work? "

>

> While this isn't specifically about MAST, my question is until somebody uses

> " it " , how can you prove " it " works or doesn't work? ( " It " being whatever the

> new/old product/procedure is that is under discussion/consideration.)

>

> Sort of a chicken and egg question I know, but realizing that with any

> evolving field there will be some trial and error in order to facilitate the

> learning and growth of the field. Unfortunately there are some risks (i.e.

> acts which will produce and protect income for lawyers) involved when

> dealing with human subjects but outside of small scale research involving

> primates there's not a lot of acceptable substitutions for humans when it

> comes to EMS practice research.

>

> Your thoughts?

>

> Also, and this may sound tacky (for which I apologize), but in your initial

> response to Jane I had flashback to Jane Curtain and Chevy Chase doing

> Weekend Update on the original SNL. Thanks for the fun memory.

>

> Barry

>

>

>

[Guest guest]

" Use the formula P=40 to 70, in which P stands for the probability of

success and the numbers indicate the percentage of information acquired..

Once the information is in the 40 to 70 range, go with your gut. " - Colin

's advice is don't take action if you have only enough information to

give you less than a 40 percent chance of being right, but don't wait until

you have enough facts to be 100 percent sure, because by then it is almost

always too late. His instinct is right: Today, excessive delays in the name

of information-gathering needs analysis paralysis. Procrastination in the

name of reducing risk actually increases risk. - GovLeaders.org