spenac

Click >>>THE ANSWER Actually I disagree. It costs you an extra 21 cents and an extra 30 seconds to add v4r and v8, v9. Plus there are many patients with no indications on 12 lead that end up having problems show up in one of the extra 3 leads. But even if it caught 1 person and kept you from pushing wrong drug or got them into cath lab quicker saving heart tissue that was a cheap way of helping a person survive. Per Bob Page and sorry I don't have the link to the study he mentioned with Posterior Wall Infarction 23% had normal 12 lead but on 15 lead showed stemi. Thats a big group of people we could miss to save so little time/money.

Pre hospital is less than 5% survival to release.

I see either you or your instructor is a fan of Bob Page and the "In lead two you don't have a clue" method. In lead two there is way to much missed. Better to monitor lead MCL1(V1) and get a 15 lead as 12 still leaves you blind to way to much of the heart. Wow did I just pull all the fun out of this one? Sorry.

Sure that wasn't the scotch? I have only heard of allergy to the dye. But I guess we could get the dye free give it to itku2er and see what happens. Trust me I'm a Paradork.

But the white OP is picking on the Minority boss. How dare you question us minoritys? Tell him crotch.

Wow I am going to take that as a complement. Yes we learned something similar to LEMON but a CRNA taught me LEMON and it was easier to recall for me. It does surprise me how few actually do more than what you mention, just lifting sticking, and hoping. In the field I have never missed, but I have decided to use combi instead based on how difficult they appeared.

LOL. I'll try harder, just thought you needed a break. So what do you think of the LEMON assessment prior to attempting intubation?

The Lemon method helps you determine difficulty. If you find a diificult airway and can properly ventilate w/o tube it is probably going to be better to wait until you arive at the hospital to intubate or have hospital staff intubate. http://www.pubmedcentral.nih.gov/picrender...mp;blobtype=pdf L Look externally Look at the patient externally for characteristics that are known to cause difficult laryngoscopy, intubation or ventilation. E Evaluate the 3-3-2 rule In order to allow alignment of the pharyngeal, laryngeal and oral axes and therefore simple intubation, the following relationships should be observed. The distance between the patient's incisor teeth should be at least 3 finger breadths (3), the distance between the hyoid bone and the chin should be at least 3 finger breadths (3), and the distance between the thyroid notch and the floor of the mouth should be at least 2 finger breadths (2). 123 === Inter-incisor distance in fingers. Hyoid mental distance in fingers. Thyroid to floor of mouth in fingers. M Mallampati The hypopharynx should be visualized adequately. This has been done traditionally by assessing the Mallampati classification. The patient is sat upright, told to open the mouth fully and protrude the tongue as far as possible. The examiner then looks into the mouth with a light torch to assess the degree of hypopharynx visible. In the case of a supine patient, Mallampati score can be estimated by getting the patient to open the mouth fully and protrude the tongue and a laryngoscopy light can be shone into the hypopharynx from above. Class I: soft palate, uvula, fauces, pillars visible Class II: soft palate, uvula, fauces visible Class III: soft palate, base of uvula visible Class IV: hard palate only visible O Obstruction? Any condition that can cause obstruction of the airway will make laryngoscopy and ventilation difficult. Such conditions are epiglottis, peritonsillar abscesses and trauma. N Neck mobility This is a vital requirement for successful intubation. It can be assessed easily by getting the patient to place their chin down onto their chest and then to extend their neck so they are looking towards the ceiling. Patients in hard collar neck immobilization obviously have no neck movement are therefore harder to intubate.

I smell class action law suits to recoup all those non refundable vacation packages. I guess I would be unemployed. Once I decide I need my time off with my family I am taking it either as vacation or as final check. This year our service told us no vacations. I was about to turn in my resignation and wow my supervisor found a way around it.

Yup we sure did harass you about your zombie bag. Yup we sure did harass you about your zombie bag.

LOL. Did I forget the sarcastic smiley? Sorry about that.

Hold the handle where the blade hinge butt is in the palm of your hand. Seems to help with the lifting while helping you fight the urge to leverage on the teeth.

OK I am know going to speak so everyone sit down shut up and listen. Now that I have your attention I feel we should still have intubation available. Why? Because I have had multiple patients that would have died prior to reaching the hospital if we had not intubated before the airway closed. So my question is based on most everyones over reacting should we remove the intubation ability and just watch these people die as their airway finishes closing? Perhaps we should start taking certifications away from Paramedics that fail to catch failed intubation's. Perhaps we should start closing services that fail to stay up to date with items that make it where there is no excuse not to catch a misplaced tube.

Congrats I think.

But Ruff why are you taking the easy way out? If we educate people about the need for ambulance and even ER we can help curb the delays in emergency care that take place because EMS is used as a taxi and ER's as a clinic. I don't get bent out of shape as like you say I get paid either way. It actually takes me longer to do a refusal/denial than it does to transport. I take time to help patients contact appropriate agency's for what they need. By doing this it saves abuse of systems.

RRRRIIIIIGGGGGHHHHHTTTTTTTTTT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! But he made sure and got out the police union side out in the media which is deny deny deny. Of course EMS being so disorganized and uneducated will take all the heat. Just look at the ignorant uneducated we take everyone even obviously dead statement.

EWWWWWWWWWW GROSS theres blood and brains I ain't touching them. They're dead hurry lets leave. Maybe we would just be better off being taxi drivers, its pretty obvious a lot of EMS people have no education.

I only execute the guilty ones. Thankfully every year I find a few that are obviously guilty and fill my freezer.

Should be a crime to use the ambulance just to get in faster.

But you felt better once he fried it up and fed you.

Especially with potatoes and smothered in cream gravy.

OK here is the most practical and simple solution. Remove the CRNA's and have the Paramedics come in and do all intubation and ventilation in the OR. This saves hospitals money and allows all Paramedics to maintain their skills. Sorry Vent could not resist. In reality we do need to remove the fire Paramedics and only have those that have proven to be focused on being medical professionals having advanced procedures .

Actually the test at the DMV is a test. Your education and training is done before you go to the DMV. Also DMV in my area make you pass the driving test on actual roads in traffic, not in a parking lot.

An actual EVOC course will require actual driving. If you find one that does not you are wasting your money as it would not be valid.

It would be impossible to have a complete EVOC online. I could see the book part but that is so few hours really makes no sense to go to the expense of starting it. Sorry looks like you will lose a weekend doing it live some where. If you are remote like me might require a little travel, hotel, and meals.