chbare

I agree with ERDoc, this should be treated as a SAH until proven otherwise. He needs rapid transport the hospital. These patients can be up and talking, then suddenly decompensate. You need to be very judicious when considering correcting HTN with these patients. Not only do we have a bleed and HTN, but vasospasm and secondary injury is also a primary concern with the SAH patient. Take care, chbare.

It can. You can see multiple rhythms transiently develop following adenosine. I have seen high grade AV blocks, ventricular escape beats, and even runs of ventricular tachycardia. Take care, chbare.

Try Google, Emedicine, and Pubmed. Take care, chbare.

Good point. In both my EMT-B and EMT-I courses, nothing was mentioned about professional development and professional organizations. However, in Nursing school membership in organizations and active involvement in professional development was strongly encouraged. As a new nurse, I had no desire to involve my self in this aspect of health care. However, now I see many benefits as a result of professional development. You can appreciate and possibly take part in the politics of your profession, learn about new developments, liaison, network, and gain a broad understanding of health care and the implications to your practice. In addition, you can use the involvement to communicate, work on solutions, and consult with multiple resources. Take care, chbare.

I cannot see how any of that would be fun. Codes always equate to hours of paperwork, bad patient outcomes, and possible litigation. In addition, I would rather not light up and be thrown around in the back of the ambulance. Honestly, I love interfacility transports. The more mundane, the better. I can actually talk with patients and family and possibly make a difference. This may just be the "Muse" in me talking however. Take care, chbare.

Perhaps it would be best to hold off on this debate and let people deal with this tragedy, then revisit the topic at a more appropriate time. I have a feeling the finger pointing and search for accountability has not even started. Take care, chbare.

It was pretty obvious that the goal of the scenario was to have people use lethal force, then try to make a point by adding additional information. This scenario could easily be changed to support any view you please. Take care, chbare.

Asysin2leads, if possible, I would have left the area with the other people. If he was just swinging a knife around and everybody was able to safely leave, then I would have let the police deal with the person. Please note that I want to emphasize that I will try to leave if possible. However, I have not changed my stance. Take care, chbare.

Don't worry about all of the big words. However, after the class and national/state registry, I would strongly urge you to take a college level anatomy & physiology course and a college level microbiology/molecular biology course. You will not get any cool guy skills or patches, but I promise, your understanding of your patient's condition and your overall knowledge as a provider will be greatly enhanced. Take care, chbare.

Just a side note of useless knowledge. With the widespread use of the HIB vaccination, epiglottitis in children is most often the result of G+ cocci. (streptococcus pyogenes & staphylococcus aureus) Sorry, I do not have the ability to change the text style for you microbiology sticklers. Take care, chbare. Take care,

Furosemide is in fact a sulfonamide, however, minute structural differences exist when you compare sulfonamide abo's and non abo sulfonamides. While cross reactions are a concern, this is not absolute. In addition, "allergy" is an often misused term. What reaction did this patient have? Many people will take a med, develop nausea, and assume they have an allergy. If possible, asking about the "allergy" and about how the patient reacted can provide additional information. Take care, chbare.

I think another serious pulmonary disease must be considered as a DDX in patient one. Look at some of the S/S. Very suspicious for a problem we see frequently along the southern border. I think AZCEP is thinking along similar lines. Ascites is is not a sign caused by albuterol over use. A comorbid disease process may cause this finding, however, the Hx makes no mention of this. This patient may have some complex medical problems. The signs and symptoms suggest problems other than or in addition to albuterol overuse. I have also seen patients with conditions other than epiglotitis drool. This is a good DDX, but try to think out of the box and consider other causes as well. I also agree that these scenarios are not appropriate for an EMT-B student. Take care, chbare.

"THEY ARE TWO COMPLETELY DIFFERENT PROFESSIONS WHICH CANNOT AND SHOULD NOT BE LOGICALLY COMPARED." Dustdevil, + 5. If people would realize this fact, we could finally put the RN/Paramedic debate to rest. Take care, chbare.

Regardless of your stance, Asysin2leads brings up some good points. Having a gun will not automatically make you safer or suddenly prevent you from being a victim of a violent crime. Look at how many police officers are shot with their own gun, and they are the ones who actually receive firearms training. I have not changed my stance, however, I agree that people should receive training and have a safe and realistic mindset regarding weapons. I think the current 2 day shake and bake CCW courses are inadequate for preparing people to face the reality of carrying a gun. I have never used lethal force, so I suppose some of this is nothing more than opinion. Take care, chbare.

Sorry, off topic. Spock, this case was discussed at a work shop I attended. The term "Rapid Sequence Airway" was discussed. What are your thoughts on this concept? Take care, chbare.

As AZCEP stated, much will depend on the facility and the job description for the medic. Currently, I would recommend nursing school if you want to work within the hospital. You will be able to easily transfer into other units and have many career advancement options avaliable. I have no problem working with a medic or having medics provide care at their level of education, however, employment opportunities within the hospital can be quite limited for the paramedic. I know several medics who work in the ER on the side for extra money, but they all still work on the ground and have much more autonomy in the field. Take care, chbare.

I have seen many aspiration pneumonia patients. This patient's history puts her at very high risk for this condition. Yes, it can present with CHF like signs and symptoms. In addition, it can involve both lungs and involve upper and lower lobes. Think of the cause and physiology in this case. This may contrast from your generic lower lobe pneumonia presentation. If at all possible, follow up information would be very helpful. Take care, chbare

Perhaps he was talking about nasal intubation. You are not ventilating the patient, however, you are using the patient's respiratory drive to assist with the procedure. In fact, you need a patient with spontaneous respirations in order to consider nasal intubation. Take care, chbare.

Firefighter523, I am not sure why you had to make an issue with Ruffems. This is a thread relating to critical care courses and Ruffems simply stated he thought critical care courses are a good idea and that he would have benefited from one when he took a critical care patient. I agree that patients deserve the highest level of care possible; however, this is not the reality. Most of us realize that reality and are involved in trying to change EMS. Take care, chbare.

Scaramedic, welcome to the club. You should do fine. Take care, chbare.

What my general impression of the patient? Is he wake and responsive? Is his airway patent. Any stridor or evidence of angioedema? Is he breathing without difficulty. Any new onset skin lesions or rash? Heart rate and quality along with a set of baseline vital signs and a blood sugar? SAMPLE history as per above. Take care, chbare.

Ridryder 911 makes some very good points. CCEMTP was part of my flight orientation and I thought it provided a good overview of the CCT environment and also provided a basic foundation of CCT knowledge. I have known misinformed nurses that thought CCEMPT credentials would make them a "critical care paramedic." Take care, chbare.

Asysin2leads, I apologize if I took the prior statement wrong. I wanted to emphasize the fact that I am attempting to have a professional discussion regarding this topic. I think my stance on this subject is well known; however, I hope that people who disagree will at least consider my points and realize that I do not advocate violence or vigilantism, nor am I uneducated or intolerant. If anything, I hope we can appreciate each other's views even if we disagree. Take care, chbare.

Asysin2leads, I have been respectful and far from paranoid. I have agreed with some of your points and I never mentioned minorities or discussed the middle east in relation to the topic. In addition, I never mentioned my personal view on politics or gun magazines. I think we can disagree and still respect each other. Take care, chbare.

Asysin2leads, people die when they carelessly drive a vehicle. Most of the trauma we see is blunt in nature. (ie MVC's) We still let people obtain drivers licenses when clearly the outcome of driving carelessly can deadly. In addition, I am still alive and well today. I do not think we can agree on this subject. Take care, chbare.