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Its called the "Startle Response" a study was conducted in Ontario for Fire Fighters, the conclusion of was that loud tones flashing lights +++ did have a negative effects re: increased cardiac issues. I in fact knew this topic would resurface so I saved the study, but where in my files Yea Ok Right Then, this from the the President GEEK SQUAD .... mobey: Ever think of buying a Klapper or a motion detecting light for 20 bucks from Kanukistanian Tire ?

To the OP: The IMPROVED OUTCOMES in the very short time that one attends to this or that patient in EMS is going to be VERY difficult to prove or disprove as most studies are "To Door" discharge, involving a huge cascade of Health Care Providers. To answer the question for the BASIC look to the pulse ox (if you have one) If you improve saturation you doing something for whatever the "slot" the patient one believes, ie say a COPD, with a Cardiac PmHx and throw in a community acquired pneumonia. But then withholding O2, with some study in hand and you may find your head in a guillotine for not following accepted practice, just saying. http://www.google.ca/search?hl=en&rlz=1C1CHMA_enCA347CA347&q=controversy+in+Oxygen+therapy+scholarly+studies&btnG=Search&meta=&aq=f&oq= As Vent notes: It would be a full time job just to read all the latest research about oxygen as it is used in various specialties and disease processes. Then introducing the PLACEBO effect, a hotly contested subject in latest issues of NEJM and the conclusions draw from meta studies vs some of the more dated studies that state empirically that this is even measurable. One certainly opens up a can of worms for the ethics types as delivery of Oxygen Therapy has never been studied, just medication(s) In regards to sword rattling, I provided for you as requested an anecdotal comment AND provided as much information concerning Pulmonary Physiology and the physics behind the rationale. I am and will continue to throw a gauntlet down in the spirit of an interesting debate, but taking it to my friend said level and emotional level ... FAIL. I do not have a degree I just make stuff up Mixing an "ethical dilemma" and the asking for "anecdotal comments" and toss in "human physiology and physics" you are going to get more conjecture than science. http://en.wikipedia.org/wiki/Ethical_dilemma

Nice Ride BEB. Perfect for an "E" response in the "skeg" cheers

SA_medic: Well the WHO site is back up and running: WHO Regional Office for Africa (AFRO) Cases reported 14868 Deaths reported 103 So besides the fact that the FLU season typically is seasonally influenced these cases reported and deaths for the entire continent of Africa are quite insignificant based on the population, your getting off lucky.

It wasnt ... dang now I am HURT. First: PUT THAT ROAD TAR DOWN , hell the frustration will kill you first, then your knocked up wife will benefit from the insurance Pfft: You have to read "High Times" Man ... British Columbia has the best BUD ... the fans know ... the fans know

Clinical presentation and evaluation,and good observation in the field: Pallor, look to mucosal membranes (pull lower eye lid and observe the color) PMHX: say like a possible GI bleed upper or lower, sickle cell anemia,iron deficiency anemia,(a Pt. may be on iron suppliment (ask are they self medicating or are they prescribed by an MD and this some times is overlooked) heavy menstrual bleeding, in pernicious anemia (they receive Vitamin 12 on a regular basis)I could go on if you wish http://www.emedicinehealth.com/anemia/page2_em.htm hemacrit ok, lets understand that first, a pecentage of RBCs to Blood Plasma. http://www.google.ca/search?hl=en&rlz=1C1CHMA_enCA347CA347&defl=en&q=define:hematocrit&ei=jqb9Sq-PFIa0swPXs-WdCg&sa=X&oi=glossary_definition&ct=title&ved=0CAcQkAE So just what does your Board Certified MD wife do to correct this? If you go down the path before a clear understanding of terms well it could be a bumpy road ... just saying, again look to Vents Post re: types of Hemoglobin. I highly suspect you are referring my post split hairs or provide educational links and ask a simple question ? See Vents post: Where to start Ok I will do the leg work for you in regards to PaO2 this is an arterial sample, hence the a part, then analysed by a Clark electrode and actally measures the partial pressure of oxygen dissolved in the blood plasma a linear and direct relationship is made.(see chbare equation its the .0003 part) Then with all the factors ODC calculated and value is determined IN some ways bedside Pulse oximetry used to trending device is a extremely valuable tool, even in the light of an anemic hypoxia. http://www.google.ca/search?hl=en&rlz=1C1CHMA_enCA347CA347&q=pulse+oximetry+measures&meta=&aq=3&oq=pulse+oximetry http://www.google.ca/search?hl=en&rlz=1C1CHMA_enCA347CA347&q=pulse+oximetry&btnG=Search&meta=&aq=f&oq= One of the biggest concerns of mine In EMS is the serious misunderstanding between oxygenation and ventilation. So a little side bar, 2 years ago now RNs treated my mother post op major GI surgery, and even though I attempted to explain the difference of hypoventilation and oxygenation, studies indicate post op geriatric patient that supplemental O2 may increase mortality morbidity ... It did in My Mothers case, unrecognized Hypoventilation (but Pulse oximetry by their protocol, and all was good ) this lead to pre renal failure and my mother died, yes anecdotal but now clearly backed by EBM, btw the Board Certified MD Anesthesia did contribute in passing, urine output during surgery and post op (this on a RENAL unit to boot)then oxygen absorbortion atelectasis a post mortum finding. The RN said they were just following (protocol post surgery orders) (I was not in the employment as an RRT in that facility) the RNs have since received a very serious lecture since that time by the manager of respiratory department, the protocol has now been CHANGED, Respiratory Therapy department is now consulted. In part thanks to VentMedic an PM's I will always be in Vents Debt besides having a personal relashonship with the associate professor of ICU did not hurt either. There are much controversy now with researchers in regards to High levels of O2 vs Low levels in the CHF patient, just what I do is in cases of CHF and in Pulmonary odeama (when no anemia suspected) is watch the pulse ox trends. And as Ventmedic just touched upon many other areas, it boils down to this EMS initiates O2 therapy, RRTs then wean patients off O2, with all the hospital toys we get to play with: YES O2 is a toxic gas but not over the very short time in contact in the field, it has not been proven to be harmful (in vast majority of cases) that said the jury is not completely in lots of research to do yet. Did you note the time of my post? I get crabby when I am sleep deprived. Oh the O2 treats Nausea? Nope I disagree the EMS provider in that case used the gift of the GAB, body language, and confidence this relieved anxiety .... the placebo effect is huge and a tool in the EMS provider should NEVER forget. Anecdotally I have had some patients that have very seriously survived because they were convinced that they would, comments like hey I have seen way worse and their still walking and causing grief. One case comes to mind an elderly Woman on every Cardiac Med Know to man, in flash Pulmonary odeama ... 5 stents, LEF about 12% so I was honest with her, things are not looking great here: Her comment to me: cheers

blunt Is that spy talk SA_medic: the World Health Organisation website is FUBAR as I post this, when I posted the information the Continent of Africa was not reporting H1N1, perhaps where AIDs, Leprosy, and Malaria deaths daily H1N1 it is not really worth reporting ? Hey don't shoot the messenger cheers

Firstly a query just how does one evaluate PaO2 in the first place ? hint: there is no such critter as PO2 unless it is in a Math formula, may wish to goggle at PAO2 as well. mobey is not just technically correct this exactly one of the reasons that one initiate's supplemental O2 in events of "anemic hypoxemia" please note the difference between hypoxia and hypoxemia as well. Content and Capacity should be reviewed as well on can increase oxygen delivery to tissue using chbars equations by up to 2 volume % in fact at sea level with supplemental O2. The Oxyhemoglobin dissociation curve illustrate affinity and shifts of the ODC something called "postage stamp effect" in regards to affinity of O2 http://en.wikipedia.org/wiki/Oxygen-haemoglobin_dissociation_curve#Factors_shifting_curve This link to some Power Point Education look around you will find Oxygen therapy productions. http://www.ccmtutorials.com/rs/oxygen/page06.htm http://www.templejc.edu/dept/ems/Pages/PowerPoint.html In regauds Could you explain that particularly in regards to dang near every protocol guideline, for shock or blood loss, oxygen is first line drug in suspected cases of all "Anemic Hypoxemia" cheers

Thanks mobey and chbare ... I was starting to twitch when I read the first few posts.

CDC Estimates of 2009 H1N1 Cases and Related Hospitalizations and Deaths from April-October 17, 2009, By Age Group http://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm Scroll down and check out the graph, SO NOT the predicted by age demographic breakdown. cheers

Perhaps but really I can see PPPP as a joke gift to many medics (those that come factory with a penis)

Is this official Canada Fluwatch site accurately reporting? CTV News Reported 34 Deaths Total in AB alone tonight Nov 12. Put this into perspective CAF in Afghanistan we have lost 136 KIA in 5 years.

see last post http://www.emtcity.com/index.php/topic/16836-alberta-bill-60/page__st__40__gopid__229237&#entry229237

OK wrap your head around this all you wannabe investors: Register this All EMS Patch World under not-for-profit society, yah know just like "STARS" is a healthy wage for all investors. I get pension / RRSP fund out of this because I am old, feeble of mind/spirit and the paperwork maybe has been already started, if I can do it once, I can do it again A portion of profits (well thats if it goes big) donated directly to a NEW national ASSOCIATION, a non regulatory body, non -union affiliated, for the Advancement of Profession of Paramedicine and improved communications for members, thinking out loud here use EMT City as official Forums discussion (hell we already have more Canadians on this Site than all the other websites combined) So with the purchase of say a bakers dozen or so patches a free membership in the society and voting privileges on goals and objectives just as political parties do. Throw in a benevolent society, education, convention organisation and beer fund for "special" meeting's at my residence so all travel would become tax deductible, hey this is sounding better. Ask one of our "noted" EMT City members already to become honorable Medical Advisors, maybe that B. E. Bledsoe guy if he could just learn to write books or something in the Queens English ... ahem SLAM For the first EMS Patch / T shirt Convention get Dustdevil, AKflightmedic, Ventmedic, and others with a post count being the criteria to be speakers, the proviso that they bring their own dang "Stanfield's" just goggle that image. With a mandatory attendance shooting range/archery competition with a MOOSE as the mascot and moving target, maybe Lone Star gets to ride the Moose while target practice is ongoing. Oh yea, a kissing booth (Volunteer Wanted) so apply early, aussiephil to be official organizer ... The only question remains, Just what the heck do we call it ? We can't use Paramedic Association of Canada as someone used that already I think. Advancement of Profession of Paramedicine in Communications APPC ? Brothers and Sisters of Paramedicine = BSP I have to work on the First Patch ... this one needs LOTS more work My bet is Paramedic Princess Patch will be the biggest seller.

Agreed sounds like Ireland has learned from some of the other Gong shows. Have you been following all the other related topics posted ? As promised I report in with my Flu shot,it appears that I am alive and kicking, no adverse reactions other than typical very minor soreness equal left vs right arms. cheers

mobey: I simply just have no words .... so very sad to hear of this news my brother.

Kaisu http://www.carta.ca/home/default.aspx Any others that may be interested, click on H1N1 now ... then go to Pandemic Educational Materials. Great Power Point Productions. cheers

Ever hear of perfluorocarbon, try ventilating with a liquid high or low meniscus research studies or rebreathing CO2. http://content.nejm.org/cgi/content/full/335/11/761 Google this: cyclopropanes related fatalities in operating rooms.

I think its a very important thing that our children understand that this is not a holiday it is a day of remembering.

For my Children on Remembrance Day. Members of Your Family that Served I would hope that you will remember your Grandmother, whom you knew and her service to this Country as an Nurse in the RCAMC Korean War. Your Grandfather Charles Frederick Kilpatrick in WW I, Fort Garry Calvary Corporal and a Prisoner of War (he could never speak of the hardships he had to endure) Your Grandfather who you never got to meet, RCAF Flight Officer in WW II Your Uncle who died defending Canada in WW II and whom after I am named: RCAF Flight Officer. Paramedic Friends Cpl. Andrew Eykelenboom, of 1st Field Ambulance CAF Cpl. Glen Arnold, of 2 Field Ambulance CAF Clp. Micheal Starker of 15 Field Ambulance CAF All Killed in Action in Afghanistan Never Forget: The 11 Hour. The 11 Day The 11 Month [ THE FINAL INSPECTION The soldier stood and faced God, Which must always come to pass. He hoped his shoes were shining, Just as brightly as his brass. 'Step forward now, you soldier, How shall I deal with you ? Have you always turned the other cheek ? To My Church have you been true?' The soldier squared his shoulders and said, 'No, Lord, I guess I ain't. Because those of us who carry guns, Can't always be a saint. I've had to work most Sundays, And at times my talk was tough. And sometimes I've been violent, Because the world is awfully rough. But, I never took a penny, That wasn't mine to keep... Though I worked a lot of overtime, When the bills got just too steep. And I never passed a cry for help, Though at times I shook with fear. And sometimes, God, forgive me, I've wept unmanly tears. I know I don't deserve a place, Among the people here. They never wanted me around, Except to calm their fears. If you've a place for me here, Lord, It needn't be so grand. I never expected or had too much, But if you don't, I'll understand. There was a silence all around the throne, Where the saints had often trod. As the soldier waited quietly, For the judgment of his God. 'Step forward now, you soldier, You've borne your burdens well. Walk peacefully on Heaven's streets, You've done your time in Hell.' Author Unknown~ It's the Military, not the reporter who has given us the freedom of the press. It's the Military, not the poet, who has given us the freedom of speech. It's the Military, not the politicians that ensures our right to life, liberty and the pursuit of happiness. It's the Military who salutes the flag, who serves beneath the flag, and whose coffin is draped by the flag. If you care to offer the smallest token of recognition and appreciation for the military, please pass this on and pray for our men and women who have served and are currently serving our country and pray for those who have given the ultimate sacrifice for freedom, they paid in blood

Ah an old friend ... sweet, he knows me by my first name with the Long Gun Registry . I KNOW the Feds have jurisdiction over Bill 21 it does violate the Canadian Charter of Rights and Freedoms As IF EMS would ever walk OUT en mass we aint the ferry workers or the postal workers Gorden Campbell do yourself a favour and please remove: HEAD FROM RECTUM.

Well the public media initial feeding frenzy got stopped in its tracks when the clinics ALL got shut down, looking like its getting triaged now ... good news for Fist responders in AB in my area but this is a rather large field(s) we play in up here. Just trying to make sense from media, government and a few quakes voicing there 2 cents (btw thats 1.2345) at the conversion rate to USD Well at least NYC is doing its best, one can lead a horse to water but ... cheers

First off to answer the Question: EMS works in Canada ? hmm ok ... We have a strike on the WEST coast, a strike on the EAST coast. Transition, correction take over to perfection in Alberta. meh. (no one has any idea what happens in Quebec because we have no idea what they are saying) Our biggest issue in Canada has no active national association.