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You may find in this website that this has been discussed in detail by another smart RRT. I would and do promoted the use of Bi Level Support over CPAP, just mention in passing oxygenation is dependant on MAP (Mean Airway Pressure) Lets also not forget the Atrovent with the COPD component. cheers

Bhwaaa Haaa Ha .

Just being polite is all.

Would you like to borrow my AXE ... I have a couple spare. http://www.lifesupportintl.com/products/Axe_Aircraft_Crash-946-107.html cheers

It depends on the individual, is EMS experience essential to be a manager ? I would hazard a guess that it would be helpful understanding some of the daily requirements as in peak hours, and the politics. cheers

Just to add, there are very few cross trained RRT / REMT-P .. if you wish to land a job flying this is a good option. cheers

http://en.wikipedia.org/wiki/Hinton_train_collision (a few minor errors in link re the real story) 96 triaged and transported into facility 15 miles away (winter) in 1 hour 50 minutes, no helos used. cheers

Nope Mav is my little brother, my call sign is Squint ... for very good reason, its the look on my face when the BS "tones" go off, so I have been told. I am so Crappy at poker ... Off topic just for a bit: The swagger in most cases is most cases earned and sometimes the difference between confidence in oneself and arrogance, viewed by some that have never had to wear Nomex 3A, as arrogance (some cases its true)this can be difficult to determine from a distance. If you pick up what I am saying is a backassward way. I teach "walk with purpose" doing triage at an MCI often the way one holds themselves (body language) tells a lot ... just for fun can you pick out who is IC in this picture ? cheers

Ruff .. isn't that what one could call gross generalization or stereotyping ? No Camp 3 ? Just saying that this thread has focused and pretty much beaten to death, the adrenaline junkie aspect .. most seriously when tones go off (and in Ontario Canada)in Fire Halls and Ambulance Halls. The physiological response was and can actually measured, the findings were very clear that with loud tones a "startle reflex" kicks in (btw it also is associated with increased cardiac risk) but the human body no matter what anyone on this board eludes there is a conditioning that one goes through. A counter argument / position could be taken that when an individual does NOT have a physiological response then they should get out of this profession, a lack of response could indicate true burn out or a pathological situation ... look to 4c6 he's loosing his mind because of NO calls (and others in comments areas) Lets look at the background this poster states he has, lets forget that he at least has 4 years of University, think B.Ed is a cake walk ? Compare that to I'm a silly student First Aider girl ...te hee hee and I like flowers but I want to be a SWAT medic and pack a .40 cal glock ... he he he ... put things into perspective. jeeze uzz. 1- ATF ... well if anyone has had any experience in that area thats totally "cool under pressure" and while multitasking this is the entire goal of that training. Hundreds of lives in the balance, just say runway 320 Alpha vs runway 320 B ... think about that please. 2-A teacher in Phys ED, hmmm ... thanks not my cup of coffee (I have 2 teenagers thanks that is more than enough) but leadership, tolerance and supportive, would be I highly suspect be some attributes, then dealing with soccer mums .. yikes. ps How can you tell a pit bull from a soccer Mom ? ... umm lipstick. I am just damn happy he's not an English lit teacher .. because we would all be screwed for grammar, punctuation and especially myself as the KING of the run on, and on sentence. In Closing .. I have to call you all on the Flight Paramedic (yes there are lots that are good at what they do) but please after actually doing the Flight gig, 4000 hour with patients documented, Rescue Helo Long Sling and on to specialized ICU transport team's. Your all full of shit ... these flight suited guys and girls have the biggest egos on the frigging planet ... check out any of the "flight" sites and tell me I am wrong . <insert puking smiley> cheers <edited to make post look better and include reprimand >

Well if you have some of those pink fuzzy handcuffs, hey please count me in. I have been very bad too. cheers ... and Hearty WELCOME from the Republic of Alberta ... ps look up and to the left.

Bhwaaa Haaa Ha ... I get it

<edit>Re: gender referencing. How true that is.

Thanks for playing ... nope not Equipment Operator.

Lets see .. out of the top ten of most stressed careers in the workplace ATC, Education of (hormone induced hysteria) school and now EMS ... ah you will fit in nicely with this tribe of loonitics. Welcome aboard highly motivated one, and btw doing the dope on a rope thing, is a blast anf a high on the CDI scale. chicks dig it ! cheers

Perhaps you should evaluate the need for your adrenaline fixation, if in an interview situation just my advice, if question of why you are getting into EMS the best answer would not be as previously noted, i.e. it was my second choice or adrenaline junkie. Typically SWAT or CPS details or pararescue a military background is preferential (DwayneEMT-P) our token para-rescue ninja will see this post and comment. There is one civilian Helo sling/winch rescue in Canada (look north) from long island with Cougar Helicopters specialising off shore oil platform stuff as in Hibernia but those ninjas are transplanted US military or ex CAF SAR techs ... the toughest of the tough. What did you do before you thought of a career change ? ps love your tea cheers

Is there a please stop torturing me button ?

Most correct: MOST interesting question as in REMT "GAP" there is no mention of transdermal delivery of medications. That said I have added an excerpt from those public domain on ACoP website, point being local/physician order under HDA one can deliver said medication,1- with documentation of course addressing this medication 2- tested and approved "local" MD (how this applies with AHS Medical Direction umbrella I dont know. Its curious how AHS is getting around these regulations and expanding scope of practice in the intermediate level but restricting at the Advanced level ... perhaps some "forshadowing" of things to come ? But that would be just conjecture on my part as I hide way out in the bush where the police can't locate me .

Good idea ! bcc my email .. you know just to have an independent professional association member be kept in the loop.

GDay mate ... you will find lots of good stuff here ... we have a few S.A. that visit the site, when they are not running from poisonous snakes, lions, and hippos. Welcome

Firstly Welcome: Some pretty broad statements here. I would dispute that statement. You may find that around 46% of CHF patients have associated COPD, the study by singer is suggestive that is an increase in mortality with the use of "albuterol" in the CHF with no pre-existing COPD. In the combined COPD / CHF (the 46 % club) the mortality was decreased, other studies footnoted in this link may help. http://www.medcontrol.com/omd_pub/bronchodilator_and_chf.pdf Could you explain in your statement that all CPAP is PEEP, can one positively say that a PEEP valve on a BVM (spring loaded valve) is true PEEP ? Squeezing the bag will apply PEEP most interesting, as I thought (as in your statements above) that PEEP was Positive "END" expiratory pressure, not PIP Peak Inspiratory Pressures. (the squeeze part) When you stated "fluid around the heart" as I always though that was called an effusion ? Are there any other choices if diuretics or other rx used in your practice perhaps that are potassium sparing ? Furosemide is being looked at with a more critical eye these days in CHF. Are there no J receptors triggered to respond when pulmonary oedema is present, this leading to an increase in hypoxia and that Bronchospasm in the CHF patient never occurs, as a result. http://en.wikipedia.org/wiki/Juxtacapillary_(J)_receptors Taken from an RT book (Dr. Creed) As one can see there is quite a bit of controversy in the medical field regarding the use of bronchdialators in CHF. cheers

Yes a excellent methodology applied here, insert one airway then subject the "survivor" to yet another invasive procedure. Ok So some ONE screws up (or was needing a few OR days) and the majority have do: Mother may I ? wtf ? fuzzy logic applied again.

I believe I have worked with that very same intensivist, why they do what they do, some days defies rational thought. One must wonder if one does have any control over their own life . Agreed with chbare, yes its easy to say but I would have supported you Doczilla. cheers

Not being a member of either the elite AHS or the Integrated services (hey I thought this was a take over of all EMS services for improved utilization centralization standardisation and efficiency?) I do not have access to AHS protected website, I tried but was politely denied (maybe access was denied because of that parking ticket in 1996) so without timely information it is difficult if not impossible to keep up. I don't know the secret handshake either <sniff> which is very upsetting. I did manage somehow to obtain my BCAS ACP licensure and managed to pass the BC OFA level 3, whoo hoo look at the big brain on me ! I can hardly contain my exuberance in my new found skill set. ps BCAS has a secret website too its called CUPE. I guess I have been hiding away from the confusion although I still do converse with Raj Sherman on occasion perhaps I am waiting around for a change to responsible government, as its just a matter of when. As you could predict I have been questioning some of the Wisdom in EBM protocols (they are more akin to meta studies with some personal preference's in some cases) oddly enough very little timely feedback at all when I ask those that wear white shirts and scrubs. Like ketamine at a odd dose, no etomodate and CPAP devices chosen based on cost not if they actually work ... you know minor stuff like that. Kev: I still don't understand "many" things about this "transition" it seams the dribble down effect and info I receive is just "reactive" to local politics, as of late. Just how AHS gets around the Health Disciplines Act, is most curious. Then this Con Ed for AHS or contracted providers, here I thought that our regulatory body was responsible for that concept ? I still have to report directly to my medical director, although we have adopted most of new AHS protocols (for continuity) but we have had forced to address the needs in industry. The guidelines I have developed for one company just may be more comprehensive and inclusive of all of the scope of practice. In my gut wagon I have bedside troponin, myoglobin, and a RAD 57. Sutures, antibiotics +++ (looking to improve my ophthomalogical knowledge base)that forshadowing for a new thread I am working on. I HAVE to thank OH+S for legislating Paramedic's in Industry, to deliver emergency health care by means of a private provider .... most interesting eh what ? cheers