HellsBells

Looks like a 3rd degree block, judging by the bottom lead

MONA, right... That's some textbook medicine.

Lol, nice humblebrag.

Interesting, this is not a pt I would like to have to try and intubate. I'm actually thinking that this may be a case where digital intubation might be a reasonable option.

This is standard practice where I work now, I think the main advantage is that it provides an oxygen source during the intubation attempt.

I feel somewhat conflicted about the OP. I do feel that this career needs to be more professional. However, I'm not really too worried about the public at large. While they may not give us much thought when we are not needed, I think that society at large has confidence and trust in us when we are needed. Oh, and I really, really do not want to be compared to politicians, our professions reputation would have to take a serious hit to be brought down to their level of public trust. The area where I think we need to step up our game for professional recognition is with other healthcare providers. I feel that we still play second fiddle to RN's and in a lot of respects our relationship with doctors is one of being dictated to, instead of collaborating with. I'd like to see more avenues for paramedic degrees, research, and upper management and supervisory roles. Oh, and for god sakes, can we please stop wearing the star of life T-shirts on our days off?

I had a similar problem when I first became an EMT in 2004. I was lucky to have understanding preceptors and mentors to help me through my rookie phase. There is no easy way to get over this situation, you have to do assessments repeatedly until you develop confidence and competence in your practice. The good news is that it gets better with time, now that I'm ten years into it doing assessments is second nature and I don't have to worry about freezing up on calls any more. The one piece of advice that helped me was to not think of the assessment as a rigid set of questions you have to ask, but instead a problem you have to find a solution to. I found initially when I first started I was trying to rush through a series of predetermined questions without really listening to the patients answers, then getting stuck when I forgot what the next textbook question should be and also realizing I hadn't listened to anything the patient had told me. Try to really listen to what the patient says, then integrate that into your line of questioning. Generally that will get you out of your head and help with those awkward brain freezes. Also, don't be too hard on yourself, others have been where you are and got through it, so can you.

My first thought was that he passed out drunk and had a foreign body inserted in his rectum, Ala Jakass. However his presentation doesn't go along with that. Maybe get a D-dimer. Possible DVT from sitting around watching TV all day?

I don't know, should they be? There seems to be something Trollish about this post.

What about the fall in the dispatch notes? Is this relevant, or did she just slide off the couch? Allergies? Pill bottles? lets make sure that there are no extra pills missing BGL?

Yeah, I'm afraid that, as Mobey states you'll get differing opinions on all schools from different grads. The advice that I do have is that if you are based out of BC and want to work in BC, its not too bad of an idea to pick a school in Alberta, as its close logistically, and registration transfers over fairly easily. Additionally, if you're thinking of taking school in Alberta, I'd also recommend you take a look at PMA, they have classes out of Sherwood park and Calgary.As a Paramedic in Southern Alberta, I get most of my students from either PMA or SAIT. There doesn't seem to be a particular difference in the quality of students each produces, I find its more the attitude of the individual that makes the difference. As you mentioned, the selection process at SAIT doesn't seem to be that strict, they also have bigger classes and go to school full-time monday-friday. PMA has a rotation of classes that is two weeks on two weeks off, smaller classes, stricter selection process and a shorter length for the program. NAIT I can't really speak to, as I don't get any students from that program. So... its up to you to decide what the best fit for you is. I think the best thing to do would be to go to an open house and/or talk to the instructors at each school, see if you like the facilities and also the philosophy of the teaching staff there; ask what their pass rate for ACP exams. I would really not put too much stock in one off opinions of ex student from each school, as they tend to reflect personal bias, rather than the reality of the institution.

Yes, why? Are you implying that's a contraindication?

I think it would be safe and reasonable to take Bretylium off this list.

I agree with ERDoc that if this is to work, certain Medics need to be properly trained. We have Tactical Paramedics in the city I work in who are trained, and have the proper vests/armor for this scenario, although there are usually a max of 4 on duty at any given time.

Ok Mobey, you're gonna have to give more detail on that one...