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Always tricky to give absolutes with a vent as there are so many factors. In general if you were delivering a Vt of 450 like you say an I time of 2 seconds would be very long leading to crazy low flow. However, the underlying pathology and reason for ventilation in the first place must be...

Man, 0.3/kg of midaz is a crap-ton. I've cardioverted numerous times over the years and I'd say rarely do you ever need more than 5 mg. No need for analgesia in cardioversion (and I'm a big pain med fan) but the pain is so short lived that the analgesia won't really do much. As for pacing...

An Autovent is a bit of a simplistic vent. A Ti of 2 seconds for an adult is quite long, especially for lower volumes. This results in a very low flow which can be extremely uncomfortable for a patient. Also, volumes of 1200 are huge in the vent world and could easily lead to volu- and...

No questions that PEEP is generally useful in refractory hypoxemia. I guess the only thing I caution against, especially in a BLS context given that there may be many out there who are newer and still gaining experience is that one should not overthink a call. For instance is the SpO2 reliable...

36 EMS for 17 years. Just be nice to people. And don't ask inane questions while someone is doing a 12-lead.

To be honest this climbs into a more esoteric place in the context of BLS/EMT BVM. While there is great utility to PEEP it is generally applied in a case-specific fashion to patients that require it. Altering BVM techniques to try and maintain some PEEP has the potential to negatively impact...

Hey, I'm sure I'll get roasted for saying this but to be honest, I wouldn't worry about it. TRAPS can be easily found a search on a medical site and on Up To Date the article is one of the smallest I've seen. It's possible that perhaps the seizures themselves were related to the fever which...

What's down time?

Well put, BigBad. Drugs are the same whether an ABX or narcotic - pick the right one at the right time for the right patient. We speak of onset and duration and argue the difference between them. The name of this post concerns me in the same way that one titled 'Imapenem, why even carry...

I'm thinking that the idea of a rural doc deciding to drill a hole into a patient's head is probably a bad idea. As was eluded to earlier, a small burr hole will likely do nothing to relieve ICP as there are other places for brain matter to go (i.e. foramen). Also, a burr hole will likely...

I'm not sure that I would use CPAP in an acute exacerbation of asthma. In my experience 95% of patients can be controlled with the usual nebulized meds. Those that are not usually respond admirably to judicious IV beta-lovin'. (i.e. epi). In the rare event that these are successful and/or...

There's something you shouldn't see - a 12 lead of VF.

I would really suggest that you shadow a crew. Doing a ride-along can be a great way to see if it's for you. Of course, whenever we have someone come along we're usually inflicted with what we call 'the curse of the thirds', meaning that you generally spend the day doing calls so routine they...

You guys are making me jealous. RSI has been a long standing argument for us. To date, we haven't been licensed to use it it in the field (save for the airevac qualified folks). Sadly, we usually just overdose people on midaz and possibly morphine if we need to knock them down. Interestingly...

Hey, thanks for the hello. To answer a few of the questions, our shift pattern in dispatch rocks - 4 on, 6 off. 12.5 hour shifts - 2 days, 2 nights. On car it's 4 on, 4 off. During the day, we have up to 12 dispatchers with 4 of the positions radio positions that divide our area. At peak...

Hey folks, Just thought I'd do the cordial thing and introduce myself. From Vancouver, BC - Recently 'signed off' as an ALS paramedic for the BC Ambulance Service (http://www.healthservices.gov.bc.ca/bcas/). Currently the Charge dispatcher of one of the 5 teams in our dispatch centre, which...