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I always wondered why promethazine is given to potentiate narcotics. Is it because it is a prophylactic for nausea and vomiting, which could be detrimental to the patient, or does it actually promote binding of the narcotic to opiod receptors or something?

I would recommend getting the patient's mouth open as wide as possible before inserting the blade. On intubation mannequins I often find that there is plenty of room for the blade to be inserted into the vallecula without manipulation of the mannequin's mouth. On real people this usually isn't...

I'm not even sure if BLS is a requirement. When I took ACLS there was a basic CPR station and I believe this was included in lecture as well. The point of ACLS is to teach the current standards of cardiac care by the AHA (i.e. teach you how to implement the algorithms), not the skills to do it...

I don't see the problem with using a camera phone during patient care. I routinely send picture messages to the hospital radio room of patient injuries as well as accident scenes. These pictures are then sent to the doctors and can aid in whether they want to call a trauma code or not. When I'm...

I love wearing these with my jumpsuit...I feel like I being in Top Gun. :P

I would just like to point out that there is no point in spending this kind of money on a stethoscope if you haven't been properly trained in the assessment of heart and lung sounds and how that affects the clinical treatment of your patient. You don't need a $150 scope to take a blood pressure.

http://www.emtlife.com/showthread.php?t=5825

Both of the devices are intended to be places in the esophagus. The way both devices work is to have cuffs at the distal and proximal ends of the tube. If the device is placed in the esophagus, air is blocked from entering the stomach by the distal cuff, and blocked from exiting the oropharynx...

So this product works by preventing air from passively entering the lungs during CPR which helps keep intrathoracic pressure down which helps create a negative pressure on the up stroke of CPR which the heart expands into, increasing cardiac output? Don't most BVM's have a one way valve that...

Let's talk about the pathophysiology of this patient's treatment for a minute... I understand how CPAP works in terms of adding PEEP, increasing inspiratory volumes which decreases work of breathing, stenting open alveoli that are under pressure from fluid which helps improve gas exchange, etc...

Epic fail on my part then. So what was the etiology of the syncopy and respiratory depression? The beer? He couldn't drink a case of beer without dying? Haha...someone needs to learn to hold their liquor. :P I don't know about the AED not being able to analyze his rhythm in cardiac arrest...

I really don't feel that this is an ERAD due to the positive deflection of the inferior lead III. If this was ERAD we would most likely be seeing a ventricular arrhythmia and this is clearly a supraventricular rhythm. Per the heart sounds I believe the patient has had a massive pulmonary...

12 lead shows a right axis deviation with a posterior fascicle block, which is not normal in any patient. I think he had a syncopal episode from a dysrhythmia per cardiac history. I would like to know his EtCO2 as well as heart and lung sounds, and SpO2. A neurological event is another...

None of the services I have ever worked at have carried cardizem for (what I suspect are) these very reasons (misdiagnosing wide complex as SVT). We have metoprolol for SVT's unresponsive to adenosine. What do the veterans here think about giving adenosine to a wide complex tachycardia that is...

On drug therapy for VT vs. SVT... I understand that lidocaine is a sodium channel blocker, which decreases the action potential of the myocardium, which makes it less likely impulses from the pacemaker in the ventricles will be transmitted to the myocardium to depolarize, but I don't know why...

Here's more: There is certainly conflicting literature on the subject and the articles I quoted were from the early 90's. I realize the standard of care has probably changed since then but as some in this thread have said NTG can be used cautiously in RVI. The key word is cautiously, and in...

I've posted two articles so far. NTG is beneficial in ACS, but in a proximally occluded RCA it needs to be titrated IV with fluids to keep the patient hemodynamically stable. Also, remember that I said this is how some patients are treated in hospital. I agree that a sublingual bolus of nitrates...

Virginia as well. It is evidently a state's prerogative to keep their current levels and virginia choose to keep the Intermediate level (scope of practice is NREMT-I/99). My protocols are literally identical to the paramedic level except for RSI and crichothyrotomies. I believe Virginia is...

I disagree; you're just speculating about the interval between dosages and since we know the patient was having an inferior STEMI we should assume the patient has a proximal occlusion of the RCA, and the right ventricle is infarcted (this occurs in 40-50% of inferior MI's). NTG is usually well...

I drove 10 hours round trip once a week for 6 months for my ALS program. It'll be worth it in the end and having to work harder than others because of your distance from the school will make you work harder and take it more seriously and you'll probably learn more. Good luck!