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Sorry SCUBA. I didn't know or remember that you lived on the area. I certainly didn't want to leave anybody out.

I have completed a comprehensive overview of the subject in the form of YouTube videos in several playlists. The setup mirrors what I went through during the mechanical ventilation block of respiratory school. You will find them associated with the user "TheAncientScholar" on YouTube. In all fairness and to avoid shameless self promotion, the only other user I know on you tube to provide a comprehensive overview is "Drifter120" and I'd say his production value is a bit higher in some cases.

I had the distinct honour of meeting a couple of people from the city in the flesh over the past week. Thank you Dwayne and Wendy for a great meeting. Thank you Wendy for making the trip all the way down to the springs and during the evening nonetheless. Dwayne, it was incredible meeting you and your wonderful family. Thank you for taking my wife and I in and treating us like one of your own. Hopefully, we can return the favour some day.

Hypothermia is indeed a major concern in the trauma patient. Significant hypothermia (somewhere less than 35 C) in a trauma patient can be disastrous. Proteins in the body like many of our enzymes have a special shape known as conformation. This shape is in part responsible for how a protein works or performs it's specific job. Hypothermia may induce conformational changes resulting in a bleeding dysfunction broadly called a coagulopathy. This results in impaired ability to clot. This appears particularly pronounced in acidotic patients (not uncommon in hypovolemic shock). This creates somewhat of a dichotomy. Controlled hypothermia can decrease post arrest morbidity and mortality but can increase trauma morbidity and mortality. Therefore, it is important to be sure what kind of patient you are dealing with. Trauma versus post medical arrest. Also, hypothermia can be devastating in children but may also be helpful in paediatric patients who are post medical arrest. I'm not sure there is significant data at this point however. Hope that helps. (Bonus points for figuring out how many times I said "this.")

It's apparently not a waste of time to other people however. In addition, the dialogue has been pretty respectful in spite of some people having diametrically opposed view points on a subject involving the interpretation of a fundamental right in the United States.

"I understand people saying: "I have a gun, I'm not crazy, I'm not stupid, why would you take away my gun?" I agree, there are people who are no danger with a gun. But if you want to have your gun, it means you allow everybody else to own one, thus allowing all the events that make big news. You can't have your cake and eat it." I am not sure I understand your argument. You seem to take an all or nothing approach? You seem to recognise that at least some people are safe gun owners but that nobody should have a gun because other people are unsafe owners, or everybody should be allowed to have a gun regardless?

I never said anything about how to regulate anything nor should should you assume or imply that I have presented an official opinion, I only said the statistics in regards to some of the topics probably have large uncertainties.

Let us also not forget that the very nature of doing a transaction without a background check will typically mean that said transaction is probably going to be difficult to document when it comes to publishing statistics. Therefore, it is reasonable to ask how accurate the sale without background check statistics really are? It is probably reasonable to suspect the number may be much higher.

Take feelings and pejoratives out of the mix and look at the evidence. In spite of perceived or actual deficiencies within the EMS system as a whole, can we say that some of these new toys have in fact improved care and decreased the incidence of problems?

Do you routinely perform learning style assessments and have resources for learning disabilities? This is not an uncommon issue I run into as instructor, and if we can identify learning issues we may be able to intervene and help people through the learning process.

It's not a CT scanner. It uses infrared and near infrared light to identify possible blood consolidations following traumatic injury. It's utility in this setting will be tested in time, so I cannot comment on its efficacy as of yet, but it's promising and may be of use in special situations. Unfortunately, I'm not sure it can identify intraventricular consolidations or perhaps subarachnoid bleeding in certain areas, so it's utility in identifying ischaemic stroke versus hemorrhagic stroke is probably limited. STEMI's are being treated in some areas with prehospital fibrinolytics but I'm not sure what the data says about these services and the other countries where it occurs more often.

Congrats!

n=1 Saw it used in Afghanistan on a person who had been shot in the pelvis and it failed miserably. Ended up packing the wound curlex and holding direct pressure manually while the patient was flown to a military hospital. Haemostatic agents ate not effective if you cannot get to the source of bleeding. I'm not impressed.

Thoughts go out to all involved. A medic who I flew with back in the day lives there with his wife and child. Apparently, their house was very close and sustained significant damage but all made it out safely.

However, our gun laws have been in a state of flux over the years, particularly at the state level. In that, I mean, they have been changing. I have a suspicion this video really wants to say, "we need to change the constitution because the second amendment was created during a different time when we had different weapons." It's unfortunate that the people who made this video perhaps did not clarify or were too wimpy to actually come out and say it because clearly, gun laws have changed since the foundation of our country. (Maybe my suspicion is wrong?) Also, the video doesn't say anything about what changes should occur or what solutions could be implemented.

Actually, public education should be an important component of EMS. Injury prevention, public outreach, public health issues, disaster management and other areas are important and working in the "field" gives us unique perspective and can allow us to being said perspective to the public. If anything, public outreach is sorely lacking in the United States at least. This may be as simple as teaching CPR and first aide courses or complex as working with the public to develop a comprehensive community disaster plan.

Another consideration is the fact that the NREMT-P is being phased out and you will in the next cycle or two have to take an officially recognised paramedic transition course or risk having your credential dropped down to AEMT. The course requirements vary from state to state, but such a course may be difficult to find overseas.

My thoughts are with all involved. I have nothing else to say as its such a new and unknown situation.

Dwayne, if it is what I think, I've seen a few cases come through the ER. I'm not saying it is common knowledge and my suspicion may very well be incorrect. Remember, as an ER provider I may see a couple dozen people a day with a variety of problems, so these primary care issues are more likely to be appreciated by someone like me. Again, I could be completely wrong and honestly, one of the first things I would have considered would have been gout.

I believe I know what you are talking about. The underlying problem is not uncommon but I don't want to say anything else.

It does have the ability to change your mind about the role of traditional education. I never took any higher level undergraduate math classes, I simply watched the videos, did the exercises and challenged the the course exams. Was able to quickly get all my undergraduate math out of the way in that fashion. There very well may be something to the idea of autodidacticism.

In a nut shell, the PolyHeme study was discontinued early due to poor outcomes associated with the PolyHeme groups. Unfortunately, the ethics revolving around how people were actually enrolled and allowed to opt out of the study were a bit...dubious. Nothing overtly illegal, but ethically dubious nonetheless.

Khan academy had a great set of tutoring videos on statistics and probability. Pretty much anybody doing a science degree will have to take an undergrad statistics class. As stated it can be helpful for understanding literature and very helpful if you ever look at doing research.

Unfortunately a similar situation is currently unfolding outside of Atlanta where five firefighters responding to a call are currently being held hostage. I have no additional details at this point.

Another consideration is the fact that we have a patient experiencing significant tachycardia and significant instability. When faced with this situation, how much time are we going to take to ask and answer incredibly detailed questions?