chbare

What exactly does the literature say about these people and how dangerous they are?

Personally, I've enjoyed doing short procedures with propofol. The doc administers, I monitor, the procedure is over very quickly and I have less time monitoring and so on. From a logistical standpoint, my propofol experiences have gone quite well.

Mental patients the worst threat?

It is to an extent. I do not drink alcoholic beverages; however, I will on occasion take NyQuil if I am sick and need to get some sleep, therefore it would probably not be truthful to say that I am never exposed to alcohol because I believe certain formulations of NyQuil still contain alcohol (ethanol). However, I do not consume alcohol recreationally. This is not to say that I am pretentious and believe people who drink are necessarily wrong; however, one of the greatest gifts of nature has been a 1.3 kilogram organic computer stuffed between my ears. I am not all that keen on recreationally altering billions of years of evolution.

I don't drink alcoholic beverages either.

+1

They are not uncommon. Since about 2005, over 6,000 Heartmate 2's have been placed into patients. This does not include all the other manufacturers. I am most familiar with the HM 2 because of my "fairly" close association with Mayo Clinic in Arizona. Therefore, most of my LVAD patients have the HM 2.

One of the biggest problems that you run into with LVAD's is a decrease in preload. These devices are highly dependent on receiving adequate preload to maintain cardiac output. You may need to give fluids to assist people who are not volume optomised. This is not uncommon with relatively active people who are in warm climates. Additionally, many LVAD's have two basic modes of operation. The first mode is known as fixed mode and maintains a set rate regardless of the patient's demands. The second mode is known as auto mode where the rate can vary according to several factors. However, you may see patients transition to fixed mode and manually set the pump according to specific problems or demands.

Richard: Apparantly the OP has been masquerading as an acute care nurse practitioner who works with Dr. Jeff Guy, a big wig surgical intensivist at Vandie. Apparantly, he (OP) swindled a few people into thinking they could make a trip and visit him only to find nobody waiting for the meet up. This is a cautionary tale for anybody considering a personal meeting or relationship with a screen name. It is probably best you take time to read the thread.

I don't understand why we have to go from peptidoglycan to people's personal lives? Not trying to be the censorship police, but are we not representing our profession when we make comments here?

Also, is the patient spontaneously breathing? Spontaneously breathing with a sucking chest would would make it exceedingly difficult to tension.

Have had good experiences. Ketamine is interesting and is known as a dissociative anaesthetic agent. You may have a patient appear to be awake, but their conscious mind has been completely separated from their body. Additionally, ketamine also has analgesic properties.

I understand some will probably not appreciate my taking this thread off course. However, the point of the thread as an introduction apparently ended following a few revelations. Sorry Kiwi, it sounds like you were really hurt by the OP's actions. However, I saw an opportunity to present a different point of view. I did so not with the intention to fight or argue semantics. Additionally, I wanted to include an anecdote not to prove I'm better but to highlight the fact that I am human and have said things I regret. Hopefully people can take away something from my past failures.

Thoughts and prayers.

PM received. Can I go off on a big tangent with an anecdote? When I was in Afghanistan, part of my duties involved repatriating people who were killed. It was not a pleasant job. One such job had me dealing with aide workers who were ambushed and executed. We were dealing with the situation during the worst time of the day for IED/VBID attacks and I was frustrated. I made a very stupid comment. I said that I "wish these granola, tree huggers wouldn't come to other countries and get themselves killed at my inconvenience." My ops manager quickly said to me, "maybe, but this world needs people like them, millions of people like them." I was instantly ashamed and humiliated. I made a careless comment about a person who gave up their life trying to make a child's life better. I deeply regret making that comment to this day.

I am not sure I understand your point? I never accused you of committing violent acts. You are free to appreciate my comments or completely disregard them. Believe it or not, I am actually trying to look out for you. Sometimes silly statements can come back on us, or we look back on our past actions and statements with some regret after we have lived, matured and have been able to appreciate life from different viewpoints.

I do not disagree, I do not believe he meant actual violence and was probably joking. I am simply presenting another point of view and also want to place emphasis that people can take things in many different ways. We are free to say many things in this country but the interpretation and consequences of what we say must be considered. As I have stated in the past, I will likely say something without thinking at some point and hope people will call me out on it.

You assume I do not live along the border or that I did not spend several years working in a border ER.

I understand you are young and perhaps this is in jest; however, allow me to retort if I may? These so called "border jumpers" while entering the country illegally, are still human beings. They suffer, feel pain, know sorrow and most are genuinely trying to improve their life situation. I often wonder what I would do if I were placed into a desperate situation and could improve my circumstances and my families circumstances by entering a neighboring country to work schyte jobs that many in that country are too lazy to do. However, I do not wish to digress too far off course. (Additionally, I do not condone the illegal entry of foreign citizens into the United States.) Early in my career, I treated one of these illegal aliens. He was working a dangerous job and got his head crushed. His family was in the ER and devastated, his wife and kids had lost their dad and husband. Guess what? They reacted like many of us United States citizens would given the same situation. Unfortunately, I've had the displeasure of seeing many more of these people suffer and die in front of me. I've seen them raped, left for dead, mugged, stuffed full of drugs and executed. They included men, women, boys, girls and even babies. They all died and suffered the same brother. My point being, sometimes you really need to think before you start throwing out words that imply the use of violence against another human being. It may be all in good fun, but should you stay in EMS, you will find a plethora of violence and suffering out there occurring "naturally" without having to make snide comments that reference said violence.

Tamponade is a concern; however, the etiology, it's consequences and treatment are my primary concerns. Also, I do not want to insinuate that I have any negative thoughts regarding your instructor.

Pericarditis is not exactly a benign condition however.

First, nearly every "group" of people are frequently ridiculed. For example, shows like South Park and the Family Guy frequently poke fun at mentally and physically challenged people. One issue that we will always face in this country is how far do we allow our freedoms to go? At some point, a decision has to be made on what types of expression can be allowed. This definition is by no means static and is in constant flux. Often, the rational for many decisions are based on flawed logic or may even be arbitrary I remember homosexual expression was a crime when I first joined the military. In fact, I still remember the Mr. SAM (statements, acts, marriages) assessment for people who were potentially homosexual from PLDC (primary leadership development course). In my lifetime, this has changed significantly and for the better IMHO. Next, I've read the story and have even seen a few videos and news casts regarding the situation at hand and I cannot make definitive sense of it. There are allot of words and allot of "he said she said" interpretations going on here. I cannot say what occurred definitively. However, the audio that I have heard is rather disturbing regarding the judges statements. Again, I don't have entire conversation or context and it would be myopic to make a stand here, especially since we have such heated discussion over something so ill defined. I do think the judge had a very clear interpretation of the law and the situation and I am not sure that is consistent with what many other people in his shoes would conclude. We will see how this ultimately pans out. Additionally, it seems that we are injecting assumptions or extra details into the situation to make it fit with our personal view of the situation. We often warn people against doing this when they take an all important exam but seemed to miss the mark in this situation. If the kid was simply walking in a parade wearing a Zombie Muhammad costume then an unprovoked attack is probably not kosher. However, if the kid went out provoking people, then filmed the reaction, we can debate the subsequent behaviour. With that, we have to inject data into this situation that may or may not be valid.

http://www.hpc-uk.org/apply/international/ It will be exceedingly tough. The UK paramedic is a very different animal in terms of education and regulation. Additionally, your chances are minimal given the fact that you would be a new graduate paramedic with limited experience, references and educational credentials. Good luck in any event.

A few times a year, I do a telescopic survey with an amature astronomy group. I have a small telescope of my own, (Celestron Astromaster 114EQ) but don't use it very often. I have a few good shots of the moon, Jupiter, the Jovian moons and of Saturn however.

If I had a life I'd let you know. I enjoy hiking when I get the time.