mobey

Basically we are discussing administering the infusion to take one step out of the equasion. It is just as easy to put 1mg into a 500ml bag giving you a 2mcg/ml concentration and having a constant infusion rather than incremental dosing. There is no literature to support this as far as I know, it was just a discussion we were having. The only answer to "why?" I can give is convienience, as there is no study on continuous infusion vs incremental dosing. If you were a lone medic, once the atropine is in you are free to do whatever else may need done because you are not pushing a drug every 5 min. Yes I am very aware this is all anecdotal! I am just a student with lots of questions LOL.

Any...... (Atropine/Amio used in thier appropriate places)

Hmmm... not sure about Dopamine (gotta think on this) We were discussing loading the Pt with 1mg, then set up an infusion and continue atropine/Amiodarone respectivly. Then after 15 min or so set up a bicarb drip.

I have 2 problems with this statement Problem #1 - KED is NOT for rapid extrication. Problem #2 - If they have a C-Spine fx and you manipulate it it does not matter if you bring them back because they will never get off the ventilator. Put the patient on a LSB with head immobilised and work the code. Again I will say - Spinal Immobilization is NOT life over limb..... It is life over death.

Well.... squint said everything I wanted too, but I will add this. I was told by our town mngr how much this community donates to STARS annually. The amount donated is enough to top up my wage to a Paramedic, but instead we give it away to the "life savers" and when I finish school I am out of a job, and this service stays BLS. Hmmmm, wonder how many patients would benefit from this being an ALS service vs the 6-8/year that ride in STARS. Side note: Out of the 6 people whom we sent flying in 2008, only 1 actually went straight to surgery for internal bleeding, 1 went to ICU for chest injuries and the other 4 were discharged the same or next day! However, every single patient that was in pain when we picked them up stayed in pain, all our codes stayed dead, etc, etc.

Wondering if anyone uses Epi infusions during codes? We were discussing it in school today and I thought it would be interesting to find out. Mobey

I dunno how to direct paste a vid..... but here is the link http://www.youtube.com/watch?v=8hPCNmxuMbk

This is a real pet-peve of mine. I LOVE to teach.... but for some reason in EMS (and related fields) we have the above mentality that hinders me from getting too serious about instructing. My Pharmacology instructor is a 12 year full time RN at UofAlberta Hospital and a casual EMT-P with 2 rural services.... he can DO better that most medics out there, he is also a full time Pharm instructor! OK time for more coffee.

Damn...... I hate being a thick headed Canadian from a cave!! What is the significants of the watermelon? Totally missed the joke

This recent thread pretty much covers your question.... My opinion is on page 2. I don't believe suicide is always selfish! If a mental health patient spirals to the point that they believe thier death would end thier pain and suffering (mental or physical) they are experiencing a psycological emergency, not just "being selfish". Considering psycology takes like 4-6 years to get a degree in I don't expect you to ever comprehend what these patients are feeling, I do however expect that you will treat EVERY patient with compassion and dignity, even if you have no understanding of what they are feeling. If you are diagnosing suicidal patients as just attention seekers or selfish, and treat them that way, you are practicing out of scope and should be pulled of the ambulance!! Treat the symptoms and give the patient whatever they need to get through the crisis while they are with you, that is your job as a health care professional. http://www.emtcity.com/phpBB2/viewtopic.ph...ide&start=0

I have always been a fan of the "Vial of life" or something similar. If you are not familiar, it is basically a vial placed in the refrigerator that has a med list, DNR if applicable, and diagnosis of current illness. It is really handy in the live-alone elderly who really have no idea of thier past med history.

I am taking the U of A course at Augustana.

Hey Arctic. I believe you are seeing that education more and more in the quality schools. I am just finishing Pharmacology and Paramedic emerg, I have covered specific antibiotics, antiviral, antiretroviral, Antineoplastics, Hormones, Antigout meds.... etc etc. I am also learning CT scan abnormalities (like the CT nurse would know.... basically gross abnormalities), X-Ray reading 101 (specifically air/fluid levels, neumo, Fx, ET, chest & NG tube placement. We really are being prepared to work in facility as I believe that will become a big part of our job. (During scenarios we are even given labs once we arrive at the hospital instead of just ending the scenario)

My thoughts are with you and your co-workers neighbor. Don't hesitate to pm if ya wanna chat. Mobey

Are we talking long responce times from home to the ambulance bay to begin the call? or ambulance from the hall to the scene? You really can't do much about ambulance hall to scene times, If you choose to live in remote saskatchewan, then you get what you ask for. I had many calls that were 1/2 hr + just to get to scene, if you want to live an isolated lifestyle then that is your choice.

I am with the majority with this one: Try a Narcan if no effect that rules out Morphine OD. It is highly unlikely she had enough Lorazepam to OD on but I would do the math on the perscription anyway, in absence of missing pills and waking up with Narcan I would not be scared to give a little MS. (Remember pupils were normal) As far as the chest pain..... I too would have a strong suspicitian of aneurism, however the bilateral arm pain leads me down the Cardiac trail.... but I would still withold the ASA. I would definatly have given Nitro, as you did, even if it is a aneurism (dissecting or not) decreasing the BP and taking some pressure off the system can only do good. I am not sold on the CVA, TIA with this patient, as was mentioned this sounds like global weakness and decreased LOC. I am not saying there is no chance of a CVA, but it seem less likely than the other 2 options. Was she on home O2.....

Nope... no acronyms from me, but I will offer a one pointer. Start calling a 3rd degree a "Complete AV block" helps you remember that one anyway!

Ya ... the only reason I watch porn is for anatomy review! :shock: :shock:

I thought it was because they spend too much time polishing thier poles

WOW some places are allowed to think and use aeromedical as needed instead of being forced to call them to justify thier existance!

WOW, look at all the pockets!! You can carry all kinds of stuff in them! Combine those with a light bar on your car and you could save the world!! /sarcasm

Ya it would probably cover half your thumb! I don't see how this is even possible, didn't he feel terrible compliance with the BVM?

With cap Without cap Obvioustly this guy has never done a complete unit or kit check either, in my books that means checking operation of all equipment

I wonder if someone is keeping an eye on the legalities of overpopulating the hospital with patients.... things like evacuation plans, fire codes, emergency exits being congested etc...

http://www.edmontonsun.com/News/Alberta/20...27/7219406.html When you watch the video it sounds like this may be a "Monkey" thang. Specifically the line made by the health minister "This used to be a common practice" So it is the same needle being used pt to pt, for injecting into I.V. lines..... well at least it isn't directly into tissue, so there should be less infected people if any. I would love to say this is unbelievable..... but unfortunatly it is not..... The monkey force can be powerful! Is it just me, or is this a hospital failure? Anyone who saw this monkey buisness go on is just as much to blame.... Doc's other nurses, Nurses aid's, Students, RT's, anyone.....