WolfmanHarris

Which one, the "Mighty World Ambulance"? Got that from the local educational toy store. Did a quick google of Whacker and found this site. Made me laugh and realize, that there's always someone worse. In some of these cases, far, far, far FAR worse. PolicePosers.com

PCP = Primary Care Paramedic ACP = Advanced Care Paramedic CCP = Critical Care Paramedic Paramedic Association of Canada has a pretty good breakdown of the levels. Though there is some variation as to how closely each area resembles this. National Occupatioal Competency Profile The Professional Paramedic Association of Ottawa also has a decent breakdown of the levels for Ontario. There is some variation service to service and the list isn't complete in some areas. PPAO Mr. Meaner, I didn't take it as a dig. Just thought I might have missed a joke. Were I operating in a service that had ALS, they would likely be sent to this. Also it's becoming more and more common for there to be PCP/ACP crews. I agree they need a higher level of care.

ACP's can give D50. As a PCP I can't unless my Base Hospital allows for IV therapy, which we're taught in school, but aren't necessairly able to do. My glucagon standing order states that dosage may be repeated if necessary 20 min following the first dose. I've got that and oral glucose in my bag so those are my options as a BLS provider. Afraid I'm not seeing the joke though.

WHACKER ALERT!

No it was full size, actual working truck. I kinda wanted the Code 3 one for my shelf. But it's out of production. Crap that may have been another whacker confession.

On ebay I stumbled across a replica of Squad 51 made and restored by this guy. Equipped with all the proper period equipment (biophone included) and two 51 helmets in the front signed by Mantooth and Tighe. $70k.

Okay. If that's her argument, then I'm going to go out on a limb (I promised Spenac I wouldn't hide behind "I'm a student" anymore.) and say she's out to lunch. If the iv is started, give D50 and forget glucagon. If the glucagon's given and no IV, give oral glucose or food. If the first dose of glucagon doesn't work such that food can be given, give another dose 20min later. If the second dose doesn't work and you can't give D50 (which PCP's here can't) then you're SOL and you manage what you can until the hospital.

No. I do not want to know who's significant other or co-worker you felt up while drunk at a Christmas party. Well, I do, but not in this thread. Today I'm coming to you with a confession. I have whacker tendencies. I am what you call Whacker-curious. I have been in the closet on this and trying to fight my urges for a lightbar or set of awesome LED sunglasses and in that spirit I encourage others fighting this affliction you share your whacker secrets. 1) On my desk right now, is this. It was a Christmas gift from before I went to Paramedic school. I press the L&S button on it from time to time, and even roll it around on my desk. (Usually it just sits on stand-by due to SSM) 2) I still look every time an emergency vehicle goes by AND comment on it to those around me. 3) A large number of my t-shirts refer to my old Volunteer Campus team or my school program. (Though I've gotten better and only wear them around the house.) This is the burden I carry and I know I'm not alone. Through the healing that comes with sharing, we can all hope to control and live with our secret whackerisms. - Matt

Isn't the point of glucagon to deplete those glycogen stores by having them break down and release glucose through glycolysis? Now I can understand that once they are making use of that released glucose that a long transport time may result in their BGL dropping again and glucagon being ineffective due to no glycogen to work with, but wouldn't they have to be pretty bad off for that to happen. I mean wouldn't their glycogen stores have to have already been low such that the body made use of both the glucose freed up by glycolysis and the glucose converted from fat and protein during gluconeogenesis? And wouldn't the follow-up with glucose gell once they have a patent airway and can swallow help prevent this, especially if followed up some complex carbs? Plus if you're monitoring them closely (S&S as well as BGL) you shouldn't be surprised by another hypoglycemic episode as you should see deterioration and consider countering it with more glucose gel before they need glucagon again. Not to mention that more than a few minutes doesn't make much sense as glucagon takes a few minutes or more to work, does it not? Not to mention that if you have IV access, why are you giving glucagon to begin with and what benefit would the IV be, if there's not D50 running through it? Maybe D5W would help keep the sugar up, but I don't see it doing crap all to increase glycogen in someone who's already hypoglycemic. Not saying your colleague is wrong Reddfrogg, just saying that these are why that makes no sense to me.

Check out this at "our designs".

You win Pond Life! That's some excellent, sorely needed research that I hope the rest of the world will promptly rip off. Response times are far more arbitrary then they are treated but we need good research to push them aside a bit. I hope you'll post your research when it's finished. I'd be interested to read it. - Matt

I'm in a difficult position to influence change, not being in EMS yet. Crotch, you're no longer in EMS, how have you been able to affect change and demonstrate leadership from outside of EMS?

I don't think I'd want to. Good luck, by the time you catch up you'll have a few hundred more new posts. And welcome back!

That was my friend's plan for awhile. His wife doesn't like it. Now I'm trying to convince him to chat nicely and mention in conversation, "Oh ya and my wife. She has her masters in forensics and genetics. I'm sure you're a nice kid, but if you screw up, we will NEVER get caught."

Crazy doesn't usually need a good reason to act crazy. Any old drop of the hat will do. I got something slightly similar when I started talking to a new hire at the camp I worked at. I saw her info sheet and came up and introduced myself and promptly asked "so where about's did you grow up?" Got an odd look like who the heck is this before I could finish. "Because you have the same first and last name as someone I was in first to third grade with." She was a little flustered. (and it wasn't who I thought it was)

In my hardcore wannabe (potentially whacker) I received from a friend one of the Toronto EMS summer uniform T-shirts. I loved the thing but the closer I got to deciding I wanted to make EMS my career after school, the less I wore it. Now it's a pajama or around the house only shirt.

Good song by Aaron Lines [web:4a003205ca]http://www.dooballoh.com/cgi-bin/display.cgi?id=41837[/web:4a003205ca]

Your EMS director is an excellent singer/songwriter?

Good thought but, the pressure in the RV only goes as high as ~30mmHg and only needs to go as high as ~20mmHg to open the pulmonary SL valve so I'd imagine that the RA pressure would be lower still. Not saying you're wrong, I'm just not seeing it.

Vest, sure. My biggest debate is whether I'd rather have a stab vest or ballistic. Even in a small town someone can be unstable and violent, and I'd prefer to have that last line of defense if I don't see something coming and diffuse or avoid it. Firearm, no. I cannot for the life of me rectify the combination of a firearm with healthcare in the standard civilian setting in my head. (Meaning I understand being armed in the Military, SAR, etc.)

Never heard of it. But now I have to look for it so I can see how bad it is. Once.

Why should people have to see you driving your POS-POV with the lightbar to know what a tool you are? They shouldn't that's why. Tired of not everyone knowing the instant they see you just how important you are? Worried that while you're lightbar gets you to the scene in style you may not be able to make it through a crowd? Well than this is the product for you! [web:e553ee0abd]http://www.911supplyinc.com/index.php?act=viewProd&productId=110[/web:e553ee0abd] Now when you get out of the car with your jump bag you can still have lights right up to the patient's side. Okay I know these are novelty items on the site, but the first thing I thought of was whacker usage.

It does help a bunch. I'd figured that from your previous help, but the confirmation is nice too.

Okay, so maybe I should just discount the part on "without greatly increasing muscle mass"? Now here's something I don't quite understand, if the pectinate muscles are helping to increase strength of contraction in the atria, why does the anterior wall of the RA have pectinate but only the auricle of the LA does? Wouldn't you expect more musculature on the left side pumping into the LV? Edit: I hadn't even considered evolutionary basis for this. Thanks Ruff! I'll take a look at that link. So does that mean that the pectinate muscles are more an evolutionary hold over from before we developed the atria we have now and that their purpose is less important than it once was? Maybe I'm jumping the gun. I'll read that now. Edit 2: I think I get it now. Two quotes from that link put it into focus for me. AND Once I drew a conceptual relationship to the trabeculae carneae it made more sense. I still don't quite know why there would be more pectinate muscle in the RA vs. the LA but I definitely have a better handle on this one. Thanks Ruff, this little part of the heart's been bugging me all evening.

So I mentioned earlier being curious about the effects some alternative/natural remedies would have on treatments/interventions in western medicine. While reading up on dysrhythmias tonight I came across a note on verapamil (Ca+ channel blocker) with regards to grapefruit juice and hawthorn. Apparently grapefruit juice can increase varapamil levels, which didn't surprise me too much, but I had to look up hawthorn. Hawthorn Apparently Hawthorn is used to So when a Pt. on a Ca+ blocker also has a long list of supplements and is presenting with hypotension, this might be something to look for when considering underlying cause.