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Broadly speaking the reasons to intubate are: Airway compromise. Failure of oxygenation. Failure of ventilation. Predicted clinical course. Humane reasons. Or a combination of these factors. WildlandEMT89, that may be an option in some patients, however it is not always as simple as that...

Not something we see in my neck of the woods. However, we have standing orders for up to 40mg of midazolam and 4mg/kg of ketamine. More if we ask. We can RSI for pretty much anything, but it would be very rare to see RSI happening in this setting.

You are correct, I have not. The medics doing that sort of thing should be commended for their humanity and humility, it is highly admirable. You are right that not all calls (indeed very few calls) are well orchestrated, perfect or groundbreaking, although we should be striving for these...

Too much trouble to answer a few simple questions? Fair enough, I don't mean to tax you so much. Sorry about that. Enjoy the show.

Whether they want to be, or you want them to be, they are indeed ambassadors for EMS. They are on an internationally screened show purporting to show the real life experience of working EMS in New Orleans. Like it or not, they are what people the world over will think of when they think of...

Well, once, and then I responded to people who responded to me. That's how a conversation works. Now that we are having a conversation, rather than assume I know the answer, I will ask you outright: do you think that it is acceptable for medics to act in the ways depicted in the first two...

I'm sorry if you like to see your profession depicted as unprofessional, uncaring, and stupid. You may not care, but I do, hence my distaste for the way we are portrayed in this show.

Been there, done that and there were plenty of cringe-worthy moments, but nothing that made me embarrassed to be a medic. Drunks getting a lights and sirens trip was one of the least offensive things (although it is dangerous and unnecessary). I'm willing to accept that it's a cultural thing...

We thrombolyse in rural areas. Metro areas generally have plenty of access to PCI in short timeframes.

Why are you not thrombolysing with that sort of prehospital time?

No: http://www.ncbi.nlm.nih.gov/pubmed/25277343

I have had the misfortune to see the first 2 episodes so far, and in general I think this is an excellent guide for how not to be a paramedic. I can't believe NOEMS allows it to be shown.

Given that this was a true randomized trial it would be remarkable to randomize a higher risk population to one arm of it. I imagine that having another MI, be it in hospital or later, would be an important patient oriented outcome. I know it would be for me! What is ridiculous about 8l/min of O2?

Nice. Is there a reason for using a sux drip rather than say roc with a suggamadex chaser? Just curious (edit: aside from the cost of suggamadex)

16 years in, I'm still not sure that I am.

If you don't mind Christopher, I would like to put a link up to this on my blog.

Would not work on Chrome running on Android device. Would go through the quiz, would not display results. Just curious regarding Wellen's for this, are you considering this a STEMI equivalent or sub-acute/reperfused? Our cath labs don't want us activating for Wellen's.

Why on earth would you choose just to use midazolam when you have the option of doing it properly?

I have no doubt that EMS folk from the rest of the world read these threads with no small measure of both bewilderment and despair.

Thanks for that, much appreciated. Not sure why I put this in ALS discussion; I'll blame nightshiftitis.