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  1. C

    To Propofol or Not to Propofol?

    @Remi — how does this apply to Ketamine which does not interact with GABA receptors? My understanding is Ketamine offers mild analgesia but it is strongly recommended -and I always did- add Fentanyl for patient comfort.
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    To Propofol or Not to Propofol?

    What’s the benefit/association/etc of Propofol with therapeutic hypothermia?
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    To Propofol or Not to Propofol?

    I did my Paramedic training in an area where Propofol was a Critrical Care only drug, so while I was familiar with its purpose but I did not receive any specific training on its use. I have now transferred to a different region where Propofol is within my scope, however despite completing the...
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    NTG and Morphine I’m Inferior AMIs

    [I believe] we’ve framed the issue of Nitro’s efficacy incorrectly. So far I’ve only read people measuring its efficacy based on mortality. We should instead consider quality of outcome as measured by heat muscle preservation. [I believe] Nitro’s therapeutic medhcnism of action is increasing...
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    Dopamine & Tachydysrthmias

    My pharmacology textbook identifies Dopamine as the precursor to Norepinephrine and suggests it has the same pharmacodynamic profile. To the best of my knowledge, we do not typically associate NorEpi as causing tachydysrthmias. Some internet-based sources suggest Dopamine shares equal...
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    Diluting Meds in Flushes? *poll*

    Years ago I was shown to dilute Diphendramine in a 10ml Saline flush (1ml drug + 9ml saline). Recently however I was told that’s bad practice and to always draw my fluid from a saline bag. The person correcting me suggested there was something in the saline flush that could interact with the...
  7. C

    Hypoglycemic Seizure — Anticonvulsant before Dextrose?

    @Peak — thank you for the response. I’ve read it twice already and will look at it again in the morning once I’ve digested it some more. @DrParasite — if we’re doing an IFT, we can get a CBC en-route or available upon request at the sending. That’s interesting angle on the follow-up neuro...
  8. C

    Preoxygenation

    appropriate What do you mean by ‘maximize’? If you are achieving adequate tidal volumes with an OPA and SPO2 is 100% (or whatever standard your protocols call for or patient pathology allows for), what is there to ‘maximize’ with the addition of an NPA? I can see an argument being made for...
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    Hypoglycemic Seizure — Anticonvulsant before Dextrose?

    I’ve been noodling about this for a while now. It’s an issue I’m pretty amped-up about, but feel like it might create a polarizing response. The issue is this... I have two seizure protocols that effectively state for any patient experiencing a seizure in presence of hypoglycemia, they are to...
  10. C

    Preoxygenation

    @TXmed @E tank — My ‘objection’ to the OPA + dual NPA ethos is the NPA by its very nature and the way we size it terminates in the upper oropharynx which anatomically contains bony supporting structures. My understanding is the upper airway obstruction seen in obese persons are in areas...
  11. C

    Preoxygenation

    *double post*.
  12. C

    Preoxygenation

    OPA + 2 NPAs + NRB (15 lpm) + N/C (15 lpm) or BVM (15lpm) + N/C (15 lpm) for 2-3mins to achieve SpO2 >95% (target 100%) terminating attempt @ 93%. Can you elaborate more on this please? - C
  13. C

    What personal-gear bag do you use?

    On the aircraft.
  14. C

    What personal-gear bag do you use?

    I’ve seen a lot of different styles; some shoulder-sling bags, others repurposing camera bags so they can stand their coffee mug up in them. I’m curious what you use. *if possible, please include a photo of your set-up* - C
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    What helicopter do you fly in? *poll*

    It’s a publically-funded private company that offers interfacility transport and scene call services. We will rendezvous with land services on request and are auto-dispatched on high-acuity calls. - C
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    What helicopter do you fly in? *poll*

    I forgot about the EC135. Poll is updated. ...and yeah, she’s a big bird but that angled headrotor and space inside is amazing. My only criticism is the significant vibration getting out of and back into the ‘bubble’ during take-off and landing can be a bit much. Some of the pilots do...
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    What helicopter do you fly in? *poll*

    I’ve been flying on the AW139 as of late. Man that is one sweet rig, but I’m told by the senior guys that it makes a significant difference if you got the ‘air medical’ unfitting completed by the manufacture or third-party. - C
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    What do you carry? - The mega thread

    @michael150 — second the 511 Tac pants (I think they’re the Taclites, but I honestly can’t remember). I wear a Propper shirt though. WAY more features than the 5.11.
  19. C

    Disposable ETT cuff manometer

    We check it on every intubated patient. I picked up a patient last week whose cuff pressure was about 60cmH20.
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    ECG’s Made Easy vs. ECGs Made Incredibly Easy?

    Turns out the Williams ‘ECGs Made Incredibly Easy 6th ed’ only covers the basic arrythmias and doesn’t include ‘advanced’ ECG content like Wellens and Brugada syndrome. @Gurby @StCEMT — does Garcia cover the aforementioned?
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