RichmondMedik

Check NORTHFIELD LABS they should have all the info you need Paul

Devin -- I am no critic but I know what I like and I laughed way to hard with BOTH your books thanks for the personilized copies Paul

Yes We us it !!!!!!!!! J.P Ornato is our Medical Director who pushes us to be aggressive and do what is right for our patients -- our protocol for cardiac arrest is different from anywhere else I have seen VF/Vtach Vaso 40u WITH 300mg Amio 5 minutes later Epi With Amio 150mg 5 minutes later Vaso 40u WITH Amio 150mg of course that is just our drug regime .. We can keep going till we either call it, get ROSC or run out of Vaso and Amio - of course we can also push,if indicated,Narcan,Sodium,Calcium Etc... when we have a workable arrest we put the AUTOPULSE on first ( defib pads at same time) and get it running for 60 to 90 sec ( takes approx 3 minutes to deploy), intubate ( with ETCO2) ,IV and by that time we are checking the rhythm (we don't shock first unless it is witnessed by us)shock,if appropriate, and then start the drug regime. Dr.O. has explained to me plenty of times that there is no magic bullet for out of hospital SCA but they are all little pieces of a pie/puzzle that help one another to work better any ??? PM me I will be more that glad to pass on what I can Paul

ACTUALLY if you do a little research on Boston H&H you will find they are run by Boston University and are no longer under the city -- so technically they are a private service with a real big ego Paul

My Medical Director is part of the ACLS committee -- his picture is in the top left hand corner of the old acls book ( stripe is covering him in the new one) so with all the studies being done he adapts what we do in the field to the information avaliable -- reread a couple of posts up were the statement is made about being a thinking cook --- that is what we are encouraged to do -- think on our feet --- the only thing taking a class does is give you the info needed to understand the job -- it is up to us to tailor it to our patients needs -- the first time one of my fellow providers heard that I "bagged" a neb treatment in he told my I was going to get fired --- what would you do if you heard from family members that the patient was on the way to get a breathing treatment and after he was inubated you had lousy compliance with the BVM ??? just because something is not done in one area that is done in another makes it neither right or wrong -- just happens to be the way it is as always follow your own med directors protocols and you will be covered Paul

We have a slightly diffrerent protocol confirm arrest 90 sceonds of QUALITY CPR ( autopulse ) as the autopulse is applied put the patches on check rythym --shock if indicated ( with autopulse running ) ETT -- IV -- leave autopulse running as much as possible Vaso AND Amio ( if Amio indicated ) Epi AND Amio ( if Amio indicated ) alternate between Vaso and Epi every 5 minutes shocking when appropriate and Amio when appropriate and yes as always check for a pulse and ventilate where appropriate as we get into the code we can give the standard meds of atropine, bicarb,calcium, et al -- we have also been known to bag neb treatment or 2,depending on the patient we shock our patients with the autopulse running and time it to the downstroke of the machine. We have a very forward thinking Medical Director --- hell he is involved in half the studies for cardiac arrest going on out there Paul

amazing what a few adjuncts can do to the QUALITY of cpr -- AUTOPULSE -- SMARTBAG and a medical director on the cutting edge -- if we were to believe half the posts and opinions out here there would never be any changes to any of the treatments we perform ..... I believe Richard has on the bottom of his post -- treat people the way you are suppose to in your area -- just cause it is different doesn't make it right,wrong or indifferent -- just happens to be the way it is done EDUCATION -- find out what the latest that is being done in the area you are interested in -- who are the names doing the research ?? Pepe??Ornato???Halperin?? or go to the granddaddy of them all CASTELLI -- what has he found for the what 4th or 5th generation of families involved in his study The last code I ran we had 2 students that couldn't believe the drugs we pushed-- how we shocked with the autopulse running -- how little we ventilated -- and it was the first one they were involved in that achieved ROSC how are we going to know what works unless the studies are tried and info passed along ??? Paul

Vasopression is actually our first line drug we alternate between that amio and epi -- my Medical Director has found that it is the actual combination of the drugs that work best and not one or the other Paul

polyheme is from humans and hemopure is from bovine(cows) Paul

what he said !! Paul

so having the distinct pleasure of the most uses in the United States --35 plus and counting I highly recommend it -- wouldn't even want to attempt a code without one now -- the local hospitals are now using them also -- any info you want I can e-mail you some stats just PM me Paul

March 19th 1963 -- yup just turned 42 and feel like I am just starting to live -- had a better time with life in general since I hit the big "40" Paul

Were you can't tell the patients from the employees !! Paul

If I have no students I am a black cloud -- to the point when I walk into the level 1 trauma ctr -- the staff looks at me and says " no students today?? " -- when I have the students I can't even beg a good learning call Paul

I tell people on my rig the closest "APPROPRIATE" facility -- may not be the one the patient wants and I explain out how they will have to be transported a second time to go to the right facility -- it is usually recieved pretty well when explained properly Paul