EMT Learning Resources

To start off Birth Control Appreciation Day, I decided to make an informative masterpost on contraceptives! I hope this helps anyone who may want more information on their birth control or someone trying to decide what kind of birth control is best for themselves! Happy (birth control) hunting! - Paige

DIFFERENT TYPES OF BIRTH CONTROL:

Birth Control Pills - [x] [x]

Mini Pill (Progesterone-only Pill) -  [x]

The Patch (Ortho Evra) - [x] [x]

The Shot (Depo-Provera) - [x] [x]

Birth Control Sponge - [x] [x]

Vaginal Ring (Nuva Ring) - [x] [x]

Spermicide - [x] [x]

Implant (Implanon and Nexplanon) - [x] [x]

IUDs (Mirena, Skyla, and ParaGard) - [x] [x]

Condoms (Male and Female) - [x]

Withdrawal (Pullout Method) - [x] [x]

Diaphragm - [x] [x]

Breastfeeding - [x]

Cervical Cap - [x] [x]

Sterilization (Male and Female) - [x]

Abstinence - [x] [x]

Fertility Awareness-Based Methods (FAMs) - [x] [x]

COMMON QUESTIONS ABOUT BIRTH CONTROL:

Do certain medications make my birth control less effective?

Can I delay or eliminate my period with my birth control?

Will my pregnancy tests come out with an accurate result while I’m on birth control?

Can I use several birth control pills at once in replace of an emergency contraceptive?

Does birth control cause weight gain?

What should I do if I miss a pill?

What should I do if the condom breaks or slips off inside of me?

If I’m on the ring or the patch and I forget to replace it on the right day, do I need to use backup?

I’ve heard that the birth control ring can pop out. What should I do if this happens?

Can birth control increase my risk of getting cancer?

Can you change your mind after having a tubal ligation or vasectomy?

Is it normal to spot or bleed in between periods while on birth control?

Does certain hormonal birth controls affect my blood pressure?

Can being overweight affect my birth control’s effectiveness?

Can certain birth controls lower my libido?

EMERGENCY CONTRACEPTIVES:

Types of EC: Plan B / Ella / ParaGard IUD - [x] [x]

What are emergency contraceptives?

How do they work?

How well does it work?

What are the side effects?

When should I take an emergency contraceptive?

Are emergency contraceptives less effective the heavier you are?

If I am under the age of 18 in the US, can I buy emergency contraceptives without my parent’s knowledge or consent?

If I take an emergency contraceptive today, am I covered if I have unprotected sex tomorrow?

Will taking emergency contraceptives too many times affect my fertility?

To find more questions and answers about emergency contraceptives, you can go here.

Información anticonceptivos de emergencia es disponible en Español, aquí.

OPTIONS FOR PEOPLE WITH ALLERGIES AND/OR CERTAIN PREFERENCES:

Condoms for people with latex allergies.

Condoms for vegans. [x] [x] [x]

Other vegan contraceptive options.

Different types of birth control without estrogen.

Contraceptives without any hormones.

Birth control methods that are useful to people with religious concerns. [x] [x]

OTHER BENEFITS OF TAKING BIRTH CONTROL:

Taking oral contraceptives can help lower the risk of endometrial and ovarian cancer.

Using birth control helps treat acne.

Birth control can help treat the pain caused by Endomitriosis.

Contraceptives offer relief to people with Polycystic Ovarian Syndrome (PCOS).

Anemia can be avoided/treated by using birth control.

Irregular periods can become more regulated by using birth control.

The pill can lead to fewer ectopic pregnancies.

MYTHS ABOUT BIRTH CONTROL (All the myths below are dispelled through the links given):

Emergency contraceptives and birth control pills cause abortions.

Free contraceptives and/or condoms makes people participate in risky sexual behavior.

The pill makes you gain a lot of weight.

Douching after sex prevents pregnancy.

You have to start your birth control on a Sunday.

Taking the pill for a long time can make you infertile.

Hormonal contraceptives protect you from contracting STIs.

You don’t need to be on birth control while breastfeeding.

I won’t get pregnant my first time having sex.

The Pill is effective immediately after you take it.

I won’t get pregnant if I shower or pee after sex.

My body needs a rest from birth control at least once a year.

Family docs do ALL THE THINGS.

We work in hospitals, clinics, urgent cares, and ERs.

We take care of babies, pregnant ladies, kids, grown ups, and old people.

We manage contraception, pregnancy, post partum care, GYN issues, and erectile dysfunction. 

We focus on both preventive care and acute & chronic disease management.

We manage heart failure, liver failure, and kidney failure. All the failures.

We take care of patients with heart attacks and bad lung function and strokes and infections and endocrine and rheumatic disorders.

We treat psychiatric disorders, tackle complex social environments, and deal with law enforcement and social services regularly.

We cut off moles, lance abscesses, sew lacerations, remove toenails, splint breaks and sprains, inject vaccines and steroids, do Pap smears and colposcopies, and sometimes do colonoscopies and minor surgeries.

Types of Anemias: 

1. Anemia Secondary to Renal Disease: Anemia d/t lack of erythropoietin.

2. Iron Deficiency Anemia: Anemia resulting from low iron levels; the iron stores are depleted first, followed by hemoglobin stores.

3. Aplastic Anemia: Bone marrow suppression of new stem cell production resulting in deficiency of circulating WBCs, platelets, and/or RBCs. Can be d/t medications, viruses, toxins, and/or radiation exposure.

4. Pernicious Anemia: anemia d/t lack of dietary intake or absorption of vitamin B12.

5. Folic Acid Deficiency Anemia: Anemia d/t folic acid deficiency. Symptoms similar to vitamin B12 deficiency, but nervous system functions remain normal.

6. Hemolytic Anemia: A group of anemias that occur when the bone marrow is unable to increase production to make up for the premature destruction of RBCs. Sickle cell and Thalassemia are hemolytic anemias.

7. Sickle Cell Anemia: A genetic defect found in clients of African American or Mediterranean origin, in which the Hgb molecule assumes a sickle shape and delivers less oxygen to tissues; the sickle cells become lodged in the blood vessels, especially the brain and the kidneys.

Wound Healing Wound healing is a natural restorative response to tissue injury. Healing is the interaction of a complex cascade of cellular events that generates resurfacing, reconstitution, and restoration of the tensile strength of injured skin.

Healing is a systematic process, traditionally explained in terms of 4 overlapping classic phases: hemostasis, inflammation, proliferation, and maturation. While platelets play a crucial role in clot formation during hemostasis, inflammatory cells débride injured tissue during the inflammatory phase. Epithelialization, fibroplasia, and angiogenesis occur during the proliferative phase. Meanwhile, granulation tissue forms and the wound begins to contract. Finally, during the maturation phase, collagen forms tight cross-links to other collagen and with protein molecules, increasing the tensile strength of the scar.

There are a few signs you’ll see when it comes to sever respiratory distress. This is an acronym I use to know what to look for and I will help you by showing what this just might look like to!

F - Flaring (Nasal)

A - Anxiety

T - Tachypnea

R - Retractions

A - Accessory Muscles

T - Tracheal Tugging

These are a few signs of severe respiratory distress. If you have a patient with any of these, you might want to pay attention to them. This means they need help NOW.

One more time the acronym is:

F- flaring nasal

A - anxiety

T - tachypnea

R - retraction

A - accessory muscles

If you crash at 120 mph…

We see seat belt signs at our trauma center with some regularity. There are plenty of papers out there that detail the injuries that occur and the need for a low threshold for surgically exploring these patients. I have not been able to find specific management guidelines, and want to share some tidbits I have learned over the years. Yes, this is based on anecdotal experience, but it’s the best we have right now.

Tips for trauma professionals:

Common injuries involve the terminal ileum, proximal jejunum, and sigmoid colon. My observation is that location in the car is associated with the injury location, probably because of the location of the seat belt buckle. In the US, drivers buckle on the right, and I’ve seen more terminal ileum and buckethandle injuries in this group. Front seat passengers buckle on the left, and I tend to see proximal jejunum and sigmoid injuries more often in them.

Seat belt sign on physical exam requires abdominal CT for evaluation, regardless of age. The high incidence of significant injury mandates this test.

Seat belt sign plus any anomaly on CT requires evaluation in the OR. The only exception would be a patient with minimal fluid only in the pelvis with an unremarkable abdominal exam. But I would watch them like a hawk.

In patients who cannot be examined clinically (e.g. severe TBI), a rising WBC count or lactate beginning on day 2 after adequate resuscitation should prompt a trip to the OR. This is an indirect method for detecting injured bowel or mesentery.

Laparoscopy may be used in patients with equivocal findings. Excessive blood, bile tinged fluid, succus, or lots of fibrin deposits on the bowel should prompt conversion to laparotomy. Tip: place all ports distant to the seat belt mark. The soft tissues are frequently disrupted, and gas may leak into this pocket prohibiting good insufflation of the peritoneal cavity.

If in doubt, open the abdomen. It’s bad form to put in the scope, see something odd, and walk away. Remember, any abnormal finding after trauma is related to trauma until proven otherwise. It’s almost never pre-existing disease.

Related posts:

The seat belt sign

Seat belt sign: 20 years ago