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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช
Battalion Chief of EMS โ€ข Paramedic โ€ข Quality Improvement โ€ข System Performance โ€ข Human Factors โ€ข Just Culture โ€ข Patient Safety โ€ข Time Sensitive Diagnoses โ€ข ENTP
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช retweeted
CenterforPtSafetyEMS 7h
EMS Communication Openness: If you made a mistake, would you tell someone about it?
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช 8h
Recreating things that caused problems is wonderful especially when paired with the solution that solves the problem. videos of the SALAD procedure are a good example. I would personally avoid posting poorly performed medical procedures.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช 8h
That's an interesting question. I'm not familiar with that technique. Managing the airway after a submersion event can be extremely challenging. If I was unable to establish ventilation with basic techniques then I would intubate using VL and SALAD.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช 8h
My daughter suffered a non-fatal drowning and required CPAP for over 24 hours so I'm aware that wet lungs are common after submersion events. The question is how we should resuscitate.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช 10h
Iโ€™m very fortunate to be working with ! NPs add much to EMS capability. Would recommend to any EMS Chief.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช retweeted
Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช Aug 3
Are you a fully qualified firefighter/paramedic looking for a progressive fire-based EMS service with a culture of caring? If you answered yes, then Hilton Head Island Fire Rescue might be the department for you. Click here to apply:
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช 11h
Replying to @MedialApproach
When you want to feel respected but have no problem calling professional colleagues midlevels.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช Aug 12
You definitely want to avoid poor positioning of the airway and excessive pressure in the BVM. It's a good way to make sure air goes into the esophagus and distends the stomach which can cause fountaining but not from the lungs.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช retweeted
k Aug 10
I could watch them do this all day
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช Aug 12
Replying to @medicmike18b
That's sort of my point. Using CO2 monitoring is great and I support it. But it's not everything. It's natural to have a "there is no excuse" mindset when things go wrong. It happens to me almost every time because I feel hurt and angry. But it's not a helpful mindset for admin.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช Aug 12
Replying to @george6188
A service mature enough to put in the effort -- and make no mistake, it's doing it the hard way -- to perform a root cause analysis using the just culture template is 100% more likely to treat the employee with compassion and justice.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช retweeted
ResuscitationAcademy Aug 11
Grab some popcorn and settle in, because this video gives a great snapshot into the history of EMS and resuscitation.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช Aug 11
Replying to @JoshuaStilley
We certainly train them to pull the tube for a flat waveform or a CO2 reading of 0.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช Aug 11
Replying to @amerelman
I agree wholeheartedly with using waveform CO2 monitoring 100% of the time.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช Aug 11
Replying to @amerelman
I agree the situations are different although it's doubtful that the treating paramedic made a conscious decision not to use it. Regardless, as a system administrator I try to make a conscious decision to go into patient safety investigations with humility and an open mind.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช Aug 11
My service had a sentinel event where CO2 monitoring was used and ignored. The reason? A trusted paramedic "knew" he had the tube. No matter what happens on EMS call we must begin the investigation with an open mind. That's hard sometimes but necessary if we want to understand.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช Aug 10
Replying to @tbouthillet
Since the first three respondents to this poll voted no, I invite you to watch this video. It will blow your mind.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช Aug 10
I am familiar with the Antikythera mechanism and how the ancient Greeks used gear wheels to, among other things, mimic the elliptical movement of the moon around the Earth and to predict eclipses thousands of years ago.
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช retweeted
Miroslav Krstic Aug 10
Ovo ne ลพelite da vidite na deลพurstvu!
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Tom Bouthillet ๐Ÿ‡บ๐Ÿ‡ธ๐Ÿ‡จ๐Ÿ‡ฆ๐Ÿ‡ฎ๐Ÿ‡ช Aug 10
Replying to @theHappyMedic @gfriese
Absolutely!
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