akroeze

*confused* Maybe I'm missing something but I have no clue what this has to do with protocols?

Here is a question for people. PCPs in Ontario generally follow the following guidelines for Nitro (your exact mileage may vary): History of prior nitro use S/S consistent with either prior angina or s/s consistent with cardiac ischemia >40kg Conscious and alert HR >60 and <160 BP >100 systolic Discontinue nitro if systolic drops by >1/3 Monitor and O2 We DON'T have an IV established, monitor consists most often of just Lead II and there is a pretty good chance that if they have no nitro use but you have a long transport time you just have to patch and they'll let you go ahead with it. How do people feel about this?

Sorry, I shall try to clarify what I mean... hopefully. It seems to me that many people seem to be working on the (potentially flawed) assumption that ACLS MUST be better because we're doing more for the patient. It seems to me that people equate more procedures to better outcome just because we're doing more. Bah, I don't know if I'm explaining this right. Basically, people want ACLS to work (for whatever reason) so they grab studies like this and say "HA! I told you it worked, see??" But they need to look at it objectively, scientifically. People seem to let egos get involved.... they're trying to take away my skills, my drugs! But if I'm giving less drugs, I CAN'T be providing better care! Sorry if this is confusing, I may have just made things even less clear but it's hard for me to explain this. I'm not even sure how I feel on this issue, these are just thoughts I'm having.

I don't know if I already responded here and I'm too lazy to check The truck The unit 6093 93 If I know certain dispatchers are on that can take a joke: Six Thousand Ninety Three If it's specifically 93: The tank (see the photos here: http://s147.photobucket.com/albums/r298/akroeze/Base/ for why )

Why do people feel that ALS HAS to be beneficial? Should we be focusing on what is best for the pt, not what adds to our skill set? Note: I'm not saying that this relates specifically to anyone here in this thread, just that it's a prevalent attitude I've noticed. And yes, I realise it goes both ways.

We have all those amenities at all of our bases (often private bedrooms) plus if you live close enough you get to go home for the 12hrs at night

My thinking is it would go like this: "Holy crap, that patient I'm assessing just went unconscious!" ABCs "Holy crap, they're in arrest! Partner, get the pads out!" Glance at ECG Notice v-fib Give thump If works: Hooray.... I wonder if I can document that I gave a thump and not get in big sh*t for it since I'm not ACLS trained. If not: Start protocols

Wow, you're comparing apples to inter-dimensional spacecraft here :shock:

So it would be considered wrong to thump the patient if you saw v-fib while your partner was getting out the pads, plugging them in, etc? To me that's giving an intervention up to 30 seconds sooner.

... it all makes so much sense!

I'm thinking they do LOTs of things for themselves where those lights are involved. Wink wink, nudge nudge, say no more say no more.

Agreed. Half of the stuff on my belt is my communications equipment (portable and keynote pager) Then I have a glove pouch and a holster (with shears and a flashlight.) And I only put that crap on when I'm out of the base.

A 13 year old could potentially refuse their own care assuming they were competent. Atleast here, there is no age that is set in stone in regards to the age of consent for medical treatment. It's on an individual basis. If the youth can understand the seriousness of their condition and understand the possible outcomes of refusing treatment then they can. As an example, I signed my own paperwork for my tonsilectomy when I was about 13. My parents didn't sign any of it.

FYI Salbutamol = Albuterol

Hey guys, the '60s called and they want their joke back. [/burn]

Kind of Off-topic but I've seen the concept of two nasals and an oral mentioned many times on here. I get the feeling that if I were to bring a pt in like that they would look at me strange due to excessive airways. Isn't one or the other sufficient if you're getting good air flow?

2 x Nitro spray 1 x bottle 80mg ASA 3 x Glucagon 3 x Glucose Paste 12 x 1mL 1:1000 Epi Amps 2 x Ventolin MDI 10 x 2.5mg Ventolin Nebs Various syringes Glucometer

Fair enough. Like I said, I just didn't know Out of curiosity, is there a big time difference between central line and IO?

Just wondering what benefit these are in the field? I truly don't know and want to

So basically an ACP has roughly double the time put into their education that an EMT-P does and they have slightly less "skills"? vs: Some colleges do take admissions with little to no PCP experience (Algonquin for one). I'm thinking of applying to it for this coming session, although admittedly by then I'll probably have 1500-2000 hours under my belt.

Just wondering, are you taking into account that you must be a PCP before ACP? Combined the hours would look like this: 1100-1400 didactic 260-340 clinical 830-1220 precepting Which is: 2190-2960 total (54.75-74 40hr work weeks, personally it means more when I look at it that way) Just wondering how these combined totals compare to some EMT-P programs?

Just curious, but would D5W at an increased rate also be appropriate or would the rate be simply too much? Just wondering cuz I'm not even sure at what rate the D10W would be run at.

He's in Iraq at a military posting If you're interested in seeing Canadian (Ontario) EMS let me know. Our service allows "ride outs" and I would love to see a non-north american perspective on things

The physical restraint may or may not have been needed (it's hard to tell) but the kicks are pretty obviously unwarranted.

Rambo-dust!