tniuqs

I am a huge fan of Swiss Army WENGER ... this is mine, really bullet proof I have tried to break it as an excuse to get a new flashier one but that hasn't happened in 7 years and it has never been off my wrist for anything. Battery lasts about 3 years, the metal band for easier washing as it drys way faster after washing than fabric/ velcro, I have even soaked in alcohol and betadine too.

Ok first don't hang the messenger! I introduced this note I received to stimulate some brain cells as I have stated many times substituting a plastic "gizmo's" instead of improving skills and success rates ETI should be the FIRST GOAL, ALS in a "perfect world" should become the new basic level for all communities, as I dare to have a dream. Using any "rescue" device WILL cause complications in the continuum of care very simply stated. I have yet to see one Combi, LMA, nor King LT used on any ventilator for any period of time the patient the is ALWAYS ET Intubated in ER hence subjecting the "possible salvageable patient" to yet another procedure. A patients on vents after EMS hand over is an indication that patient possibly will survive, now to be called the positive ventilator sign. Now that said on the EMT/PCP er BLS ... with previso that an serious educational / in-services precede implementation. Yes by all means use the "gizmos" as the criteria for usage is Apneic and Pulseless and most cases just a impending cadaver anyway. If they pull airway adjuncts off a strictly BLS car ... well that would be folly IMHO. Question remains are these "devices" improving outcomes/ to door discharge as that is criteria is imposted on all "field" ETI studies ..... is it not ? Mateo_1387 An interesting spin on the topic, so if I read it right "reclassification" of this device to an Esophageal Obturator is the basis for the discussion ? Bottom Line for the HUGE Marketing schemes this has the potential ie Combi/LMA/KLT to take away from the profession and become just a "market share" and don't think for a millisecond the developers use every possible crappy little study OR better yet FUND the studies to prove their device is superior based on success rate of "dropping" a tube instead improved outcomes. I hypothesize there is even a lower chance of to-door-discharge with any obturator device than with ETI ps (as this indicates there is ALS on Scene) I bet my bottom dollar that survival rate LT King vs ETI are far lower the more obturators are used the more the "the cadaver crowd" and working social arrest by BLS will sink "those" studies like the Bismark. In closing I highly suspect that any obturator device used and have just one complication of Esophageal hemorrhage contributing to death and the lawyers will make huge "precedent", funny how that works with those more concerned with liability than life. cheers

Toronto where's that ? OMG another dang Kanukistanian. cheers

Ok Ok ... do I have to do a little Dinozzo head slapping here .... I have absolutely no issues either sex and Siff if you think for a mini second nor you Hells Bells ! Urban vs Rural is no difference than: Women are from Venus and Men are from Mars. What you BOTH seam to forget that a very experienced Paraidiot in the Rural/ Remote can be a good resource, it just too bad the Government(s) can nott get a grip on that "concept" cheers

Bite me upside down roo breath ... get a life !

Ahem ... root veggies are all the rage this time of year !

WELL: I was compelled to give 4c6 one negative ... the reason he lead us down a garden path and then spanked us in his typical twisted view ... bad bad 4c6.

I prefer the newer plastic tanks ie Nalgene I just looked I think wajax made mine but it is worn off, the older brass pumps are field "fixable" I do not like the new ones made out of composites. 4c6 the tin ones are sooo freaking old and way heavy, hard to fill in a crick and the straps cut in huge, galvanized are from when Smokey the bear was still sucking on mommas teat in the den ... Wildland Firefighting clothing no bunker gear even with interface fires even "sprinkle or foam protection crews just wear coveralls, in Alberta it is manatory that "fire resistant" is used as we do a lot of Chopper Time. ASRDthe standard issue is "Proban Coveralls in Yellow " they suck but are better visibility from the air unfortunatly do get blacked out really fast. In BC issue it 2 piece Nomex pants and coined "the red shirt's" there quality of Nomex is by far better. As a medic attached to WFF teams by regulation must be "easily identifiable" so I wear a "Old Blue Nomex flight suit" with a Hi Vis Trauma vest. http://www.scottyfire.com/ link to new gack. LMFAO ... so who pulls his hose ? So Phil gets to you ... you should hear the nasty things he calls ME <insert sniff, whining> Inter agency cooperation is mandatory if you sir can not understand and that a sense of professional humour exists gentle ribbing can actually be a moral booster, btw you missed "bucket fairy" a favorite of mine. Sometimes these are just terms of endearment: YOU NEED to wear thicker Bunker Gear like really, hell, I have been called bandaid counter, ditch doctor, Para-site, mattress holder, oh oh my favorite hey get the LAB as in Labrador dog or = Lazy Ass Bandaid. Ever hear Sticks and Stones may hurt my bones but words never will hurt me ... This Forum is called EMT CITY and even though we do tolerate fire based services perhaps look to your IAFF for stirring the pot first, you do know that North America is about the only place in the world that uses a FF/Medic model ... try thinking out of the box present facts and studies evidence based medicine (because many of the US FF/MEDIC services get a big fat fail, and then again some are stellar)there are many models that deliver Pre Hospital Care Medicine and far more efficiently <insert gasp> cheers

Dwayne that one of the best satire's I have ever seen Got to love the part; "The beard, the packages, flying without a passport ... I know what it looks like" But isn't this racial profiling ? Bwaaa Ha Ha ... Ho Ho Ho

Well besides your personal view of Pulse Oximetry, this device is now considered a vital sign and if one goes back in the history and development many studies have proved quite conclusively that even experienced practitioners (all levels) are no where near as close to accuracy to even recognize life threatening condition based on the term "cyanosis" related to hypoxia: the previso being that one understands just what this tool is telling you. Or would you prefer to use a portable transcutanious PO2 probe ? I wonder what your partner says that about of yourself or do you just have more "years of experience" ? Time for a partner change I would suggest if one has no confidence in ones partner this is a true "cabin" atmosphere that can lead to a wreck. Lets not rain on kiwimedics parade shall we and with over 400 views on this thread by many that wish to learn lets not go off the tracks PLEASE. Query(s) So with a toddler in respiratory extremus and very, very close to arrest we should jump right to nebulised epi when we have not ruled out a FBAO ? 1- The half life of epi is very short and can lead to "rebound" do we want that to occur ? (a) Can BLS deliver Epi Side stream neb to a toddler ? 2- In a very stressed toddler (we do know that kids respond positively chonotropic ie faster heart rate) Epi is not selective beta affects ... could we be putting them over the top and cause them far more harm than good ? 3- Delivery of "said" SVN mask can cause a drop in FiO2 delivered can it not ? (a) So just the change over from a NRM perhaps could bottom this kid ... tick tick tick. 4- In passing this is inspiratory and expiratory stridor (auscultated) So if was it was a migrating FBAO could this lead to a check valve and cause a pneumo ? 5- Have any of the ALS providers considered lidocaine nebulised for this Toddler ? If you see a big beefy looking epiglottis it may NOT be croup and even anesthesia guys I have worked with get a major "pucker factor" if they see this cardinal sign. Versed ? just Versed that is NOT RSI and do we even have a line in yet? Then cric'ing a toddler? More bravado than brain very easy to say a tad more complex besides just what does your service provide you to do a cut down for peads ? Correct me if I am wrong kiwimedic this is a BLS crew and no intubation available in the first place perhaps revert to some BLS strategy first ? WRONG and way bad attitude <insert Dinnozo head slap> and a WTF for good measure. Agreed ... or this kid is not going to get his presents from under the tree... hmm what to do ? cheers <late edit for verbal reprimand, place in ambodriver's file under bad attitude for a period not less than 12 months>

Bah Humbug ..... well some one had to say it cheers Ebenezer Squint .

I WISH I did NOT have a cell phone ... And does your service HAVE on line access, last I heard you ran out of PCRS ? cheers ps Who is ICE T ... thats a beverage their mate, all my friends (ok 2) have you know, like real names =)

This IMHO is reinvention of the wheel and actually could slow care .. this is in my opinion another way to make a buck. Bracelets work WELL (a necklace is the best) A ONE time purchase. ICE works WELL (just who does not carry a cell phone these days) entering info cost nothing. Looking through a Patients wallet, and back pack, or purse "ON SCENE" hmmm not so good with public watching. Then IF the provider has access on line (is someone selling something here) is it easy access to information that needs to be accomplished, within seconds of patient contact, contacting NOK is not in my job description either. Sorry this is just another way to make a buck. cheers

TMI

Happi: Go on line, get a picture of the Opium Poppy its colour is simply beautiful, show it to her ! The "Great Spirits" gift to mankind. All narcotic meds are derived in one way or another from the poppy ... Advil is not holistic in any way. Why do people believe that they should suffer when they don't have to, because narcotics can lead to addition ? cheers and good luck. Oh nausea ... BC bud (prescribed)and its not narcotic either.

<Late edit> BS Rasping cough, high pitched stridorous sound insp/exp, sounds diminished in all fields Hmmm interesting ? Nice what are we hearing .. back to a systematic evaluation and attempting to eliminate a "few" other underlying possible pathologies first ?If this is a BLS crew ... get the ass enroute, perhaps an information patch to ER ???? Have FF remove frantic "teacher" and show her the big red truck .. take the rest of the class too, heck might as well promote the Fire Service .... The ONSET of the symptoms may be a hint of what may happening, was this sudden onset or was this kid sick when he showed up at the child care facility ? And if one choses to jump on the "inhaled meds" SVN (what is the scope of practice on site if ALS was enroute and then diverted?).. with sats of 80 would "tusks" be a good idea ? Ok I will take a pretty picture for yall dumb ass Paraidiots ... So Epi has been suggested (this kid is already stressed) would anyone want to go the salbutamol or atrovent or even inhaled steroids route first ? cheers

Or premature dirt naps ?

Lisa that is cute ... did anyone tell your brother why one should NOT drop the soap in the first place ? cheers

Have to agreed this sounds very fair perhaps a good guidelines to be adopted by EMS services, (I would include if proven contact with a disease resulting in death) my question is the IAFF behind this just who provides the funding ? cheers

So its acceptable to support VANOC in one capacity over another, has your Paramedic union released a policy ? Just wondering is all. Well intentioned, thats awesome but now that you are becoming more informed of the real issues and how VANOC has affected the long term the whole province for their "15 minutes of fame" .... have you Tented in the Whistler Mountain Area its not a easy feat and do me a favor and check in with Whistler SAR Rescue room (it can be located in the village) I am a past member btw. I was watching the news and because of limiting Venue Tickets to our US neighbor's the 2 RV lots proposed in Vancouver area have been "closed" due to lack of interest. Yeah think, apology accepted. Ok define Natives ? In some eastern provinces the First Nations they have refused to allow the "Flame" to cross on their land. Many natives live in true poverty and the cost to the taxpayers running a Flame across 5000 kms to promote the "Olympic Dream"would be better spent to address the issues of POVERTY. The vast majority on First Nations would never ever get to compete with the worlds "elite" let alone attend. I believe in the entire Canadian History of the Olympics only the Firth sisters (out of Inuvik) in cross country skiing were the only First Nations to ever compete ! (Not an Expert in that) Do you know VANOC had "homeless" in Vancouver um whats the PC word Yes "relocated" the majority or the homeless are from native background. meh another huge FAIL. Maybe the best idea to "pull the pin" let Arctickat give the real inside skinny. I take issue with that: MY BP goes through the frigging roof when my brothers and Sisters get screwed over huge, when human rights are tromped upon and a huge waste of taxpayers moneys in the first place. Here is another "tidbit" the Mayor of Vancouver office renovations will cost more than the Womens Ski Jumping (estimated cost) to be included in the EVENT. cheers

And here is the proper way to negotiate terms: Note this is the "tentative" agreement to ORNGE no word as to final outcomes.