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  1. J

    Difficult new partner

    Never seen a problem with double medic trucks in my county, but that's probably because there are very few "brand new" medics and when people have been doing this for a while they are perfectly happy to let their partner take any :censored::censored::censored::censored: call that comes up.
  2. J

    North Carolina going to National Scope?

    Just got an email from NCOEMS... The NCOEMS is currently working with the NC Association of EMS educators, NC community college educators and NC EMS agency educators to develop a transition course to satisfy National Registry requirements and to develop guidelines regarding the new EMS...
  3. J

    Capnography with Ketoacidosis

    However, were they breathing at a normal rate, their ETCO2 would likely be elevated.
  4. J

    Let's hope this works

    Hell no! You really want Kathleen Sebelius as the head of EMS. She's a joke. This would be far worse than we are now. Lets wait until there's a competent person at the head of HHS.
  5. J

    Turn over of care from school nurse

    Worry not, I noticed the mistake, and I wasn't responding directly to your post. Its fairly obvious what you meant to say.
  6. J

    Turn over of care from school nurse

    A school nurse does primarily preventative/community health type work. Besides immunizations, I doubt they can do much more treatment wise than bandaids... Nursing home staff are at an entirely different level. I recently realized that LPNs in nursing homes really aren't allowed to do much at...
  7. J

    Possible CVA call

    Related question. What kind of response in hospital does a "code stroke" receive at arrival, in reference to everyones different experiences? Unless they call in the neurologist and open the cath lab, I can't see it being a big deal to call the code ahead of time.
  8. J

    Being a EMT after spinal fusion

    Apparently not...
  9. J

    65 y/o male respiratory distress

    Satting at 100% and Tachycardic already? How do you plan to give the Epi? I'm not criticizing, just want to know your reasoning on this.
  10. J

    Clonidine and Narcan

    From a quick look around the internets, it does not appear that this effect has anything to do with opiate binding sites. Short Version: Clonidine causes CNS depression, respiratory depression Naloxone competitively inhibits opiate receptors (lowering effects of natural opiates) leading...
  11. J

    Physicians' Impression of Pre-Hospital Pain Management

    Experience. We don't use Toradol very often at all. Its usually, "suck it up" or Morphine...
  12. J

    You know you are an EMT/Paramedic when...

    I explained this to a doctor when I was taking care of a cardiac patient off duty the other day. He wanted to know why I was waiting to give him the pulseox reading...
  13. J

    Flash Pulmonary Edema

    Cardiogenic shock leading to respiratory failure precipitating cardiac arrest... I don't think it really would have mattered, no point in moving deoxygenated blood around the body in circles. You had no chance without a miracle to clear out the lungs.
  14. J

    Here Ye, Here Ye, All Ye Para-God's, Gather 'Round.

    I need to confirm this with the medics from my local Opticom enabled city, but I believe we only use it here when we're going L&S anyways.
  15. J

    Prehospital use of Ketamine

    I know the hospitals in my area use Ketamine readily for pediatric sedation, but not for adults for that very reason. I do like the idea of using it with Benzos to prevent this, but I also don't like overdosing patients with psychoactive drugs...
  16. J

    What kind of analgesic do you use?

    Technically paracetamol, toradol, and nitronox are within my scope as a (soon to be) intermediate in NC, however we don't carry Nitronox, we generally only give toradol for kidney stones, and paracetamol is used primarily for fever reduction and rarely for pain. To that end, pain management...
  17. J

    How freely do you use Naloxone?

    And this is why opiate ODs don't get to refuse in Wake County...extreme risk of secondary OD when the narcan wears off, or worse, we release them and they redose themselves because we killed their high, the narcan wears off, and then they're dead.
  18. J

    Physicians' Impression of Pre-Hospital Pain Management

    As a WakeEMS employee, i'll mention that Tylenol is given only very rarely, and generally for patients with very minor injuries. Severe pain from any condition for which surgery will not be required will get Toradol, and if there is any chance of surgery in the pts future, Morphine or Fentanyl.
  19. J

    New EMT-B

    If you are brand-spanking new they aren't going to expect you to do brain surgery on day 1, so don't worry too much about it.
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