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  1. WTEngel

    Funny one liners you've said to overheard to a patient

    This one isn't regarding a patient, but it was during the intubation of a it counts. A difficulty breathing comes into the ER and the resident steps up to get the intubation. He is having a difficult time getting the view and steps out. Attending says one of us from the flight crew...
  2. WTEngel

    med formulas revisited

    Dimensional analysis for the win... Learn the principle behind the math and the conversion of units, and then it will all fall into place. I am not a fan of tricks for med math, as they always seem to have a limit to their usefulness. I agree with the earlier poster who said "get better at...
  3. WTEngel

    Back to Basics FP-C, CCP-C Prep Course

    Welcome to the reality of advanced practice certifications and classes. $325 is pretty reasonable. It seems the more advanced you go, the more expensive things get....
  4. WTEngel

    Elite EMT academy in Hurst TX - any opinions/reviews?

    They are brand new, mainly fall out from the Methodist EMS program closing. The program is being headed up by the previous coordinator for the EMT program at Methodist. Laura Torrez always had her ducks in a row and all of her i's were dotted and t's were crossed at Methodist, so I am assuming...
  5. WTEngel

    EMS to Nursing. Any regrets?

    If I was interested in entering a profession, I feel like I would be doing a disservice to myself and my patients if I had the attitude of wanting to practice with the lowest amount of education necessary. I would not someone with that attitude treating my family member.
  6. WTEngel

    Dopamine in septic shock

    I think it is also worth mentioning that these infusions are not always an "either" "or" type situation. It is not uncommon to utilize one, two, or even three different agents when treating severe sepsis refractory to volume resuscitation. I have routinely transferred patients who were on both...
  7. WTEngel

    Dopamine in septic shock

    Think about where the different adrenergic receptors are located, and what medications would be most effective to stimulate those specific receptors. Dopamine will work to stimulate vasoconstriction, however norepinephrine is a much more reliable and potent vasoconstrictor. Also, dopamine...
  8. WTEngel

    Austin Travis County EMS hiring Paramedics and paying them as Basics

    I feel like I've been a paramedic too long to go back to being a medic sometimes. You know what I'm talking about Expat....
  9. WTEngel

    Nurse Arrested after Assaulting EMT who Asked Her to "Step Back"

    Congrats on residency JP. I'm starting OMS-1 this august up in virginia. Looking forward to filling in the checklist under my signature just like you did one of these days!
  10. WTEngel

    Homework Questiom

    If the patient has significantly increased intrathoracic pressure secondary to air trapping, then relieving this and reducing pressure on the heart (mild obstructive shock potentially) could be a plausible explanation of decreased heart rate, but it is not at the forefront of my mind when...
  11. WTEngel

    Homework Questiom

    This is just a poorly written question in my opinion. I tend to agree with a previous poster who stated that the reduction in anxiety would be the most plausible explanation. The main issue I have here is that the wording of the question leads me to believe that they attribute the reduction...
  12. WTEngel

    Sterile water VS. sterile saline

    Certain medications need to be reconstituted in isotonic saline (NS) and others are reconstituted in sterile water. This is a very shallow answer to a question that has a complex chemistry answer...DYODD and learn about it on your own or you can just press the I believe button. Also, as Tim...
  13. WTEngel

    London Ambulance Service recruiting 250 medics from overseas

    Shall we start working on our cockney accents Expat? I do believe this could be chapter 2 of our saga...the Sheiks of London!!!
  14. WTEngel

    London Ambulance Service recruiting 250 medics from overseas

    Wow! That's really great that we have someone from LAS! Welcome... I have a few questions. Why is there such a push for international recruitment right now? Why are there not enough UK nationals eligible or applying? As far as training, there are not that many 4 year degree programs...
  15. WTEngel

    I need to learn math!

    Math is one of those things that everyone just has to figure out how their mind wraps around it. I am pretty good at math, but really stick to a certain method (dimensional analysis) when figuring meds and labs and the like. Give me a formula and I am useless... Some people prefer using a...
  16. WTEngel

    Vasopressin/Epi question in arrest

    Is RVA under the BREMS Council or another district?
  17. WTEngel

    Vasopressin/Epi question in arrest

    Sandpit, you need to check the date on the algorithm you posted. Not that it changes anything you said regarding this particular conversation, your answer to the OP is correct...but the posted algorithm contains incorrect info regarding asystole care. You posted an ECC 2005 algorithm, not the...
  18. WTEngel

    Blakemore tubes?

    Tough break on the disaster airway man...what deity did you piss off to get that kind of call twice?!? My experience with ruptured varicosities in the esophagus has been overwhelmingly negative also, both in the field and in the emergency department. How long are your transport times? I...
  19. WTEngel

    What happened to paramedic students?

    This is not new, and it happens in many career fields, particularly in healthcare. If I could introduce you to some of the people I am fixing to start medical school with, who feel like they have some extraordinary amount of clinical experience because they have been a scribe for 2 years part...
  20. WTEngel

    The big question is...MD/DO, PA or NP?

    Thank you? While I have never actually sold snow to an Eskimo, I have been accused (but not found guilty of) making a profit from the distribution of sand and other useless commodities to Saudi nationals. How I made money off that deal I'll never know!