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    How can I get better?

    I have a BS in Biology and an AS in Paramedicine. Currently looking at MS programs. I’m at a somewhat busy suburban dept. apprx 5-10 calls per 24 hour shift. Been on the job 3 years. I’m truly valuing all of the input and opinions!
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    How can I get better?

    What courses/certifications can put me at the top of my game for my PT's? I'm a newer paramedic and am current in all the alphabet courses. I'm taking ACLS-EP this weekend, and am registered for ACLS, PALS, PHTLS, BLS instructor courses, along with a Handtevy Peds course later this year. What...
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    ACLS-EP.....

    Anyone taken this yet? Can you chime in on your experience with the content and your view on the value of the course? I'm current in ACLS, just taking it to hopefully learn more/deeper. I'll be driving about 4.5 hours each way, so I'm hoping to gain a lot from it. Also, is the textbook...
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    Laughter after dextrose?

    Interesting.... did you follow up later on? Did it resolve?
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    Falling O2 sats.....on CPAP?

    Curious, what would the SpO2 level look like for someone who became unconscious due to a respiratory emergency? For instance, in this example the patient broke out in a sweat and appeared to really be tanking around 70%. Would he remain conscious if it hit 60%? 50%?
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    New Member

    Welcome! I recommend MedicMindset, MedicCast and The Ditch Doc
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    Serious Question: Why Does Fire-based EMS sometimes produce such low results?

    I asked one of the guys who has been in the fire service for a while why it is that way. He stated to me there was " no masculinity in EMS." I guess its not "manly" to have a desire to actually help others vs. sitting in a recliner all day watching porn on your phone except for the once a day...
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    45 YO M Pt unconscious, no pulse, on bike trail

    Hiked in carrying the supplies needed with the idea that the ATV would just surpass them whenever it arrived and carry in the supplies needed. Its been clarified that the trail was just a simple one-way in, one-way out trail with no branch off's (unlike a hiking trail) which would reduce and...
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    Serious Question: Why Does Fire-based EMS sometimes produce such low results?

    I know I'm late to the party, but as a new "brother" (gag me) to a Fire-based EMS system, patient care is often times an atrocity. I'm in one of the biggest career departments in my (large) state. If you enjoy EMS you are looked at as a p**s* who must be scared of fire or mentally deranged. Were...
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    45 YO M Pt unconscious, no pulse, on bike trail

    Just as an FYI, it was a confirmed DOA. Perhaps us rehearsing these events both mentally and physically can help facilitate an efficient response. However, just as another poster noted, when individuals go off the paved path (figuratively and literally) there is only so much we can do for a...
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    Falling O2 sats.....on CPAP?

    Got it! That made it click. I thoroughly appreciated this response and accompanying picture. Extremely informational! Thank you! How is this proven? (I imagine nothing we can do to know this pre-hospital)
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    Falling O2 sats.....on CPAP?

    Another question: once NTG vasoldilates the pulmonary vasculature allowing more “space” for the accumulating blood, how does the pulmonary edema get back into the vessels? Would lasix be a candidate for treatment even without peripheral edema?
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    Falling O2 sats.....on CPAP?

    So, is it safe to say that in any hypertensive crisis NTG could be administered? In school and in my text it says the indications are for stable and unstable angina.
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    Falling O2 sats.....on CPAP?

    I understand the need for the heart to relax and not “red line” itself, but isn’t that a necessity to get th fluid out of the lungs? If nitro alone is given to relieve the oxygen demands on the heart, how does that improve the overall outcome of the Pt? Wouldn’t that equate to more fluid...
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    Falling O2 sats.....on CPAP?

    Absolutely! I love learning and have read all of the studies on the links provided. I cannot get enough of EM. I want to be the best clinician I can. so for future reference, SL NTG would have been a much more beneficial and appropriate form of treatment alongside the CPAP?
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    Falling O2 sats.....on CPAP?

    Absolutely agreed. When I said "why not" I meant that in a "why would it not be a treatment option" context. I would never just think "why not?" when administering any medication. My medic initiated that treatment. With all of that said, I am aware that there is no contraindication to...
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    Falling O2 sats.....on CPAP?

    Would EtCo2 readings change treatment choices? Anyway to construct my own NC type EtCo2 detector, via combining the top half of a NC and the bottom half of the EtCo2 connector piece hose that inputs into the monitor? To no surprise, my medic called the hospital a few hours later and the Pt's RN...
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    45 YO M Pt unconscious, no pulse, on bike trail

    Real call that came in yesterday. It was not my territory and my station did not respond. Just asking you guys to arm chair quarterback this one. Call comes in: 45 YO M PT found unconscious, unresponsive w/ no pulse in the middle of a mountain bike trail by another rider. The rider calls 911...
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    Falling O2 sats.....on CPAP?

    Also, forgot to add HTN to PMH. Upon loading into the truck: BP: 250/110 P: 105 RR: a lot and shallow BGL: 195 Breath sounds: bilateral, muffled uppers w/ bilateral rales and "wet" lowers. Again, I'm so new, it sounded to me like someone blowing bubbles through a straw into a glass of Coke...
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    Falling O2 sats.....on CPAP?

    I've been practicing EMS for only 5 months, so forgive me if this is a dumb question. My medic and I responded to a DIB call. 65 Y/O M Pt with PMH of CHF, Type 2 DM, and Renal failure. Pt is tripoding upon our arrival and appears very anxious. We get him on the rig and give him 3 rpm nasal...

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