1EMT-P

OzMedic, I have to respectively disagree with you when you say that people should not be transported on backboards... Have you ever taken care of an injuried skiier with bi-lateral femur fractures & a fractured pelvis on a ski slope? Also vomiting is not an issue if you manage the airway & pre-medicate your patients with an anti-emetic like Phenergan!

Are any of you currently using DuoNeb (Ipratropium Bromide/Albuterol Sulfate) in the field for the treatment of Asthma/COPD/Shortness of Breath?

This is why we should never allow bean counters or politicians to make health care decisions.

Doc, Pericardiocentesis is an invasive procedure that is generally done under the guidance of ultrasound to minimize complications & risks. Since it is not within my scope of practice & I am not trained to do the procedure & do not have the recommended equipment I would not do the procedure. Possible Causes of PEA: P= Pulmonary Embolism A= Acidosis T= Tension Pneumothorax C= Cardiac Tamponade H= Hyperkalemia (4) Hypokalemia Hypoxia Hypovolemia M= Myocardial Infraction D= Drugs ( Herbs, Illicits & Rx ) S= shivering

I would not have done the procedure, instead I would have started ACLS & transported the patient to the ED.

As I understand it, Fentanyl is very lipid soluble & has a much faster onset than Morphine Sulfate does. It also causes less respiratory depression & histamine release than other narcotic pain medications.

It varies depending where you are in the US, I have seen Ads anywhere between $ 11.00 - 23.00 per hour.

Are any of you currently using Fentanyl for ACS or Chest Pain in the field? A friend of mine who is a PA in the ED told me that they use FONA instead of MONA where he works.

I agree with your treatment..... Did you check her blood sugar? If so what was it? Also is there any history of Asthma, Diabetes, Hiatal Hernia, HTN or GERD?

You have a couple of options, you could offer the Farmedic class or you could put together your own class... Check with your local aeromedical providers to see if they would be willing to help... If you do decide to offer a class I would suggest that you talk with your local emergency department, local fire department & local police department... You also might want to check with your local college thearte department or community thearte to see if they would like to play victims.

Vs-eh, Let me get this straight your telling us that you would sedate the patient, instead of giving them pain medication :?:What's your rationale?

As I understand it the officer was chasing after the suspect prior to his injury, so yes I would have immobilized this patient based on his H & P & MOI.

:roll: :?: .

Dust we could be like Podiatry & have our own Doctorate... Doctor of Pre-hospital Emergency Medicine (DPEM)... .

Do any of you currently use Dimenhydrinate or Gravol in the field for motion sickness?

According to the FDA there has been cases of Severe Tissue Injury with the administration of IV Promethazine ( Phenergan ). Please see the FDA's website for additional details.

Maybe they didn't go over the difference between IM & IV administration when they were in school .

I have seen an MD & two PA's give Vistaril IV, but they diluted it with normal saline first!

From a medico-legal point of view the answer is no we cannot practice outside of our scope of practice, because that my friends would be considered practicing medicine without a license. It would be nice if we were allowed to have a more flexible scope of practice, but the truth of the matter is that the lawyers & politicians have limited what we can & cannot do in the field.

I think you did the right thing given your patient's history & presentation. Epistaxis can be a life threatening emergency, especially in patients with CAD & HTN. Many patients with CAD & HTN are on Aspirin or other NSAID related therapies which can make epistaxis worse.

Are any of you currently using IM Hydroxyzine ( Vistaril ) if the field for allergic reactions, antianxiety, nausea, pain or vomiting?

I don't have a problem with off duty providers assisting with the care of family members as long as they are calm and can think clearly.

I don't think that I would have cardioverted in this case, instead I think that I would have focused on airway management & rapid transport.

The EMT in this case was practicing outside of his scope of practice :roll: & the Paramedic delegated a task for which he had no legal right to do so plus he also filed a false patient care report :roll: ... The bottom line is it doesn't matter how busy the Paramedic was in this case what he did was wrong :!: :!: :!:

1. What are the requirements to become a Paramedic in the UK? 2. Is it possible for a US trained Paramedic to become registered in the UK?