Arizonaffcep

Never been offered monitary stuffs, but I have accepted food stuffs, home made cookies and the likes. Thankfully, when they dropped it off, I was usually on a call, so it was outside my control. Good cookies though...

Terr, I'll have to ask my wife (or you can... ) if she's got a pic...

You do know they drive the big trucks as compensation, right?

When (edit for spelling) I was FT at UMC, we had the Phillips monitors, which ETCO2 was incorporated into them. I would assume that the separate machine is because it's not part of the Pt. monitor? At that point, are the monitors that are used outdated-or they just opted out of the ETCO2 portion?

Capnography is not mandated by DHS in AZ (ya ya...we're a little behind the times...), but most departments have moved to include it anyway, as they recognize the importance of it. 4 hospitals in the Tucson area don't have it in the ED, which is troublesome for me. After all, how well can you relay on a pulse ox only...after all, they will show 80 something percent for a POx...when UNATTACHED! I'm disappointed that my service only has CO2 ability for intubated patients. I would like to see it for breathing patients (asthma, COPD, etc.).

Another fun piece of the puzzle, today is also Albert Einstein's Birthday! (3/14/1879)

But it should always be reviewed by a person who knows how to read them...CEP, MD, RN, whomever to be able to give an advanced notice for the ED and the cath lab. But...keep in mind, it CANNOT RULE OUT MI...for that, blood work is needed.

Doc, be honest! The movie sucked. Books were great...movie didn't do it justice.

Resultant hypoxia from high altitude....

So wouldn't it have passed already? 3.14159..., could be somewhere between 0159 and 0200 today?

As long as it doesn't interfere with your cert, I'm not sure my company has one...as the pilots are the ones driving

Has anyone figured out the question?

So...um, do I know you

Boy! Hadn't given that much thought! Well, I can tell you what I'm going to change next shift!

My friend has a saying "do unto others before they do unto you." Never like it, but applicable for this thread.

Ok...but that was a very specific one for septic shock Pts...and the conclusion was that either Etomidate or Ketamine should be used due to their lack of hemodynamic effects, when compared to things like Versed. So...even though it did notice that from 4-12 hrs there was transient adrenal issues, the levels still remained the same when measured during a 24 hr period. In looking up the older thread on etomidate in single dose for RSI, it was also fairly interesting, but not big enough to mean too terribly much I think (18 pts). http://www.emtcity.com/index.php?showtopic...mp;hl=etomidate Sorry to hijack the thread.

One of mine was within the first few weeks of being a medic. I was pulling a reserve shift with a neighboring FD, and dispatched to a "sick person, difficulty breathing," Pt being around 16 yrs old, female. Enroute, my experienced and fulltime EMT-B partner (FT with this department), we got turned around and zigged when we should have zagged. By this point, dispatch came back and told us they were dispatching a second unit and giving CPR instructions. U/A, found pt supine and unc./unresp. Nice sinus rhythm, maybe SLIGHTLY tachy (it's been awhile), and basically everything "within-normal-limits." Then...Pt wakes up, starts to talk, and goes out again! She does this repeatedly several more times, and I finally said we need a helicopter (C-3 transport to nearest hospital about 25 min away). I called for the helicopter within 5 minutes of getting o/s. So...QBing this with the more seasoned medic (and one I HIGHLY respect), we figured out she was hyperventilating, and it was the lack of CO2 that was causing her to black out. My justification for the helicopter was that she was 16(ish) and I couldn't figure out what was going on...so err on the side of the patient for the quick transport time. I'd have hated to be in her house when she got the bill and the cycle repeated itself! Now...I took what I learned from this and have not made this "mistake" again!

Can anyone post some studies that show a direct link between etomidate and RSI (specifically)? I have found many studies that show PROLONGED use inhibits the adrenal steroidogenesis, but nothing that shows a single use for RSI is detrimental at all.

I seem to remember an almost identical thread a while ago...

Oh come on! Pushing a clear fluid into a clear fluid can't possibly have any ramifications! The best advice I can give for starting clinicals is this: Ask as many questions as humanly possible, and volunteer for EVERYTHING! Seriously, even though "wiping ass" might not be what some here think is part of our job description (even though it is), the hospital staff WILL remember you...either good or bad, and those that they tend to like and find helpful, they can and will go out of their way to get you cool stuff. Also, don't just focus on the "hows" but also the "whys." And what is most important: HAVE FUN!

I agree with Spenac! Get out while you can! The quicker the better--remember, even though you will not have built up much in retirement, you can always roll it over to an IRA!

Ok...I follow.

ROFLMAO!

I can confirm AZ doesn't do daylight savings crap! However, I would assume that the economy of CA has shrivled like a guy in a cold pool.

Ok...I've seen you use this saying before, but perhaps it's just me, but I'm not understanding it.