Search results

I might share the joke with the chaplain. Anesthesia, not so much. By the way, there's a great on-going discussion in the EM and trauma worlds about who should be doing the "trauma activations" in the future. While there is a small bit of a turf war going on, the surgeons also realize that the...

I take it you read the article in Time? It's ironic - at a time when hospitals in CT are looking at a huge drop in revenue from the state (used to compensate for uninsured care), we're being described as hugely profitable. What a sticky subject... Anyway, it's a long way from the...

I caused this once in an elderly female - gave her nitro, and watched her brady down to the 30s for a few minutes. Of course, being in the ED, it's hard to get a "STAT" ECG. Irony. One of the AMR medics coming to our ED, fortunately, was a little quicker on the draw, and managed to get a great...

For some reason, the chaplains at our hospital are usually johnny on the spot. Certainly have a better response time than anesthesia!

Very well done, great production!

Well, that's the conclusion of "Effect of high flow oxygen on mortality .." Austin et al. found an absolute 5% increase in in-hospital mortality (or a 42% relative) after COPD patients received high-flow oxygen during the pre-hospital phase. As I said, I find this result out-sized and...

I am inclined to believe in the potential harm of hyperoxia, and am quick to dial down the FiO2 in my patients, but the available clinical evidence seems, well, thin. The authors apparently tend to agree on the current state of the literature - I lightly edited their review of the clinical...

The authors followed that study up with Cervical spine motion during extrication. No full text available, but I did a review with pictures and witty commentary at In order to protect the c-spine, should we stop helping?

Wish we had some numbers to back up that impression, as I obviously agree!

If you were truly "across the street," then you rock. It seems that all too often we hear the explanation "we were right around the corner," when EMS shows up with some syncopal octogenarian, but no ECG. I'm starting to think that the population density within a one-block radius of our ED...

Just gave 25 of morphine to someone with facial burns last night. Haven't heard officially, but I think I passed.

Plus, there's always the possibility that you'll get called out to a backcountry rescue in the White Mountains! NH Fish & Game love the extra labor.

Congrats - I assume this is for the wilderness EMT? Sounds so good, maybe I need to go take a refresher. I think my WEMT for SOLO in New Hampshire is expired.

Well, not too personal! It's not an official outlet for my hospital or local medical control, but I try to keep it local - good cases, new policies. But I also use it it to talk about stuff beyond local protocols and policies. Gotta look forward in EMS!* *As with backboards...

I know that the discussion has revolved around the prehospital treatment, but sometimes there is an incomplete understanding of what happens (or ought to happen) in the ED and hospital. In the scenario described by the OP, regardless of whether a board was used by EMS or not, the patient with...

The evidence suggests that the "hypoxic drive" is (as many people have said) of little clinical importance. They have done studies where they took COPD patients, either at high risk of intubation, or in the process of being weaned from the ventilator, and watched what an increase in inspired...

That would be good - I just have to wade though my pile of properly de-identified ECGS... I don't really have a system for organizing them.

I had a similar patient, with a similar ECG recently. She showed a classic aVR STE with profound ST depression in at least 7 leads. She adamantly denied any chest/back/belly complaints, and had good v.s. I got cardiology on-board pronto, but the Hgb came back before they got in. Hgb was 5...

"Customer service" gets short shrift in EMS, but it's going to be a fact of life soon enough (see How do patients view our care? for a recent discussion of this topic). It's already a fact of life in the rest of medicine. But this shouldn't be much of a big deal. Whether it's doctors, nurses...

Indeed.