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Atropine is a recognized treatment for bradycardia, even that caused by heart block. ACLS teaches this nation-wide. It is part of prehospital protocols in many jurisdictions. It would not be difficult to defend in court at all. This statement is closed-minded, dogmatic, intentionally inflammatory, and wrong. It is not malpractice, and I don't know who convinced you of that. As illustrated in previous posts, there are clinical indications for atropine in heart block. Intentionally causing pain to elicit a physiological response is a draconian way of practicing medicine. If you want to increase sympathetic tone, you can administer a sympathomimetic agent, like dopamine or dobutamine or norepinephrine or epinephrine, which I see as far better than torturing the patient. Increasing sympathetic tone, by drugs or by causing pain, carries the same risks that you ascribe to atropine of increasing myocardial oxygen demand. And so will TCP. I've given quite a bit of atropine, and I do not see it as "dangerous" in the proper clinical setting, and is very well tolerated overall. TCP carries issues as well, if the patient is in such severe pain that they are trying to rip the pacer pads off their chest, then it's not "more efficient" than atropine. Then why do any treatment at all? Just load them in the truck and take them to the hospital if that is the way you want to go. Your differential diagnosis must guide therapy. You have to think critically about what is causing the patient's condition and act accordingly. 'zilla

If you include ultrasound guided IV insertion, I would say the number is about accurate IF you used it for every IV, but most here would probably agree that's not necessary most o the time. I agree that it is overstated for most other indications. EFAST for trauma would have application for the critically ill trauma patient if they have hypotension to elicit the cause of the hypotension (hypovolemia, pericardial tamponade, or tension pneumo?). In a remote setting, with prolonged transport times, it may help the medic determine which mode of transport or destination would be most appropriate in a trauma patient without outward sign of serious injury (like hypotension, evisceration, etc.). Volume status in a patient with abnormal vitals might be helpful. Diagnosing appendicitis or cholecystitis or kidney stones in the field would not benefit the patient, significantly alter transport destinations, decrease time to OR, or change treatment. Same thing with diagnosis of fractures. We taught this at the CAP Lab one year. It generated a lot more interest than we thought. 'zilla

Hey INF, how about trying this: After you have actually administered atropine to 10-15 patients, you can come in here and tell us all about it.

Sorry dudes and dudettes, this IS NOT VTACH. Treat your patient, not the monitor. And you may be amazed to know that there are patients who go in and out of VTACH, SVT, and have arrests that last greater than 6 seconds several times per day, and live without a Paragod's intervention (although they usually get a pacemaker or internal defibrillator shortly after it is found).