Kiwiology

See! THAT is the exact kind of image Doctors here do not have .. Wait, what about Fran Drescher? She is like 100x worse than Skeletor combined with the bubonic plague ....

In the same night; Young bloke drank 12 beers and decided to jump a retaining wall on his bike so his mate could video it with his phone; got half way up and came crashing back down Young girl who got really drunk and went for an after hours swim at the pool with her friends, got caught by security, tired to scale the fence and fell from the top and broke her ankle, the police came, drove past in their car, slowed down, pointed and laughed and said the ambos are on the way then drove off again Mind you this was in the middle of May so it was freezing cold winters night, I wouldn't want to get out the car either ..

That is pretty awesome mate, do you make your own honey and whatnot? Authentic Hoosier honey, awesome

I reasonably think there is enough evidence to conclude that intubation is not the best idea anymore; in fact I hypothesise that it is physiologically plausible that the need for ventilation in cardiac arrest is minimal; the cardiocerebral resuscitation presented by Ewy et al strongly suggests the body has adequate oxygen reserves for up to ten minutes following cardiac arrest and that if we don't cram oxygen down their gob that patients have a higher rate of survival to hospital discharge. Locally it is believed that ventilations are not a priority and that if ventilating the patient interferes with CPR don't do it

Most importantly, does the patient have a history of hypertension?

Mmm this pepperoni pizza is pretty damn good, not like the authentic local stuff you get in Brooklyn where the crust is so thick you can feed the world on one slice but still the best Italian food you're going to get at 11pm cooked by an Indian guy in New Zealand right? I was watching this thing on NOVA; a PBS doco called Doctor's Diaries about these seven medical students in 1987 and what they've done since then; one of them is a big, fat, salty New Yorker who tawks like this yo showin off the old neighbawhood living on pizza; funny as hell and you know the best part he is now an emergency physician; I think you two might be related http://www.youtube.com/watch?v=qMvsF3OJclI http://www.youtube.com/watch?v=fnrjZ5qztv4 Oh and the reason I didn't want to go to the Motel 8 on 26th St was because it's where I am cheating on you with a Dentist from Kalamazoo and I didn't want the clerk to say something like "oh where's your other friend you come here with?"

Yes, the FAST ION was looked at for introduction here as well but it was decided against, I have seen it once and gosh it was awfully traumatic wasn't it

Excellent post, I will add more after I get some sleep otherwise if I do it now I might die from my brain shutting down

I never said you were undertrained And I thought perhaps some pathologic basis for your question existed that would explain his symps And this is the third post ive made from my phone after being interrupted trying to sleep after being up twelve hours already, I shall be well prepared for my acute call registrar days lol

I knew I wanted to move to canada for a reason, can you overlook the no class 4 (class F in Ontario) drivers license thing?

You want to know about his poo? Damn Emergentologists and their super secret medical knowledge

Something tells me youre auctually serious ...

Ah the great nation of Texas where if your medical director says you can do brain surgery by God you can do it! I dream of the day I get my big cowboy hat, hip pouch of suxamethonium and can blast Dixie Chicks music on the way to a job in my huge ass Ford F450 ambulance .... ah wild wild west ambo Say, any y'all know any single Texan chicks?

I have not heard anything personally but it is certainly plausible given the high amount of force exerted from the BIG

10 minutes; the original study used 12 minutes Yes, and I should say that its now called the National Ambulance Clinical Working Group and contains an Anaesthetist, an Intensive Care Medicine Specialist, two Emergency Physicians, a GP who is the Director of Defence Health and a bunch of other clinical people. Last year we went to issuing national Guidelines for civilian Paramedics and the Defence Force Medics

Yes, a very high failure rate was another reason it was withdrawn here

Sounds more like some sort of hyperadernergic problem

The Clinical Management Group are on record here stating adrenaline is probably going to be removed at the next guidelines update (September 2013)

Threw the BIG out a few years ago here now and introduced the EZ IO It was removed because it is not adjustable and is reasonably traumatic to insert

Some more Rapid sequence intubation - consistently for ten years now 96-99% success without (as of 2009) the need for cricothyrotomy Replaced the BIG and Cooks screw in IO needle with the EZ IO Combat application tourniquet Introduction of size 1 and size 5 LMA's Intranasal fentanyl Ketamine - absolutely love, love, love, love teh kettymainz Entonox

Can we please not derail this topic and start a thing on this?

Correct evidence of absence does not extrapolate with absence of evidence however we should really have evidence something is beneficial before we decide to do it (or keep doing it in the case of things where we had no evidence to begin with) There is no evidence showing that placement of an advanced airway improves neurologically intact survival in patients who suffer a cardiac arrest and evidence showing no difference in survival between intubation and the LMA. Furthermore, there is evidence showing that delayed ventilation and avoidance of hyperventilation improve neurogenic outcomes in cardiac arrest patient (1, 2) So that begs the question of why people bugger around trying to tube a cardiac arrest? Because it makes theoretical physiologic sense and because it's tradition. I wouldn't loose any sleep if that was the case My limited resuscitation order is getting updated to include no intubation, no adrenaline and no ventilations until after ROSC or 5 cycles of CPR (1) Kellum MJ, Kennedy KW, Ewy GA. Cardiocerebral resuscitation improves survival of patients with out-of-hospital cardiac arrest. Am J Med 119:335–40, 2006. (2) Aufderheide TP, Lurie KG. Death by hyperventilation: A common and life-threatening problem during cardiopulmonary resuscitation. Crit Care Med 32:S345–51, 2004.

Volunteers will always be the group to which the standard is lowered to suit.

You found the ambition to complete an undergraduate degree, four years of medical school, an intern year and three years of residency to become a specialist emergency physician but you cannot find time to put up a flag? For shame Emergentologist; for shame ....

Sounds to me like he is having some sort of thermoregulatory event