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deterrent medicine - - excellent terminology there.

KEDs by themselves are not really effective immobilization. They are devices for safer extrication. However, I have used one as ad hoc immobilization for a pt with severe CHF and pulmonary edema when they had a fall down some stairs. Protocol required immobilization because of MOI but the...

Oreo, one county service I applied to had a physical test of carrying a 200 lb mannikin, loading in onto a stairchair, then bringing it down a couple flights of stairs, transferring it to a cot, then loading the cot onto the truck. The service I work for now didn't have such a test - just a...

And other curious new additions to our profession.... When I first started, I was worried about how I would react to the first major trauma, or code, or other shock situation. Then I found that when the extreme occurred, I was so concerned about and focused on my patient that there was simply...

Answer is null answer. There is never enough experience. Great paramedics are always seeking more experience to improve their skills. Philosophy aside. I recommend to our basics that are considering moving on to paramedic level to get at least a year in the back of a truck. It is an arbitrary...

Big reason for that - Medicare/Medicaid does not recognize the intermediate level of care and will only pay basic rates for it.

Hypovolemia in hypothermia - you're headed in the right direction. The cold injury causes the nephrons of the kidney to stop reabsorbing water plus ADH levels fall. Also, the body sometimes reacts to the shunting of blood to the triunk as hypervolemia and stimulates diuresis that way. Massive...

My first reaction is no. You're dept would be a nontransport, supportive response in the realm of mutual aid. The primary responsibility would be the full time, transporting EMS agency.

How much do you want to know and how much biochem have you taken? LOL The GABAb receptors are G protein coupled, dimeremic (2 subunits - alpha type and beta or gamma type). GABAa are heteromultimers of alpha, beta, gamma, delta, epsilon types. GABAc do not interact with benzodiazepines...

I also volunteer for my town's fire dept (work for the county ALS ambulance service). Our FD has a BLS truck that responds to our area calling for ALS intercepts when needed. Our setup is straitforward - we talked to the system EMS coordinator for acceptance into the system for their...

Alcohol potentiates morphine's effect of CNS depression which can lead to increased risk of respiratory depression.

Generally, the pain tolerance has been attributed to CNS endorphin release and the gate control theory of pain in which a inhibitory opiate link at the spinal cord cuts in and blocks the pain at that level.

Thanks for the post. Have you run across anything on energy drinks and altering LOC? Reason for asking - I have had a couple calls this year with older pts consuming large amts of Red Bull and other energy drinks. Last one, a gentleman was stopped by PD for erratic driving. PD called EMS as...

I think that's a valid fear. Remember the study of hospital stethescopes and the nasty little cultures they produced.... More alarming to me are the number of transfer pts I've picked up lately in which I find from the receiving facility that the sending facility failed to inform or document...

Are we talking three or twelve lead? If three - don't worry about being near the breast. Three leads originally were done with leads on the right and left wrist, then the left ankle. So that third lead can easily be placed low on the rib cage nowhere near a breast. If twelve lead, like others...

Well, I have points of agreement and disagreement with some posts. Our system protocols for a CHF crisis state: CPAP if available, Lasix can be 0.5mg - 1.0mg/kg, or standard dose 20-40mg, 2.5mg Albuterol NEB, 0.4mg NTG SL. As to why, CPAP is proving to be effective in maintaining...