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Agree with everything above. You must've been paying attention during OB month. ;) I remember on OB/GYN those crash cesareans were complete organized chaos and was amazed when I saw my first one how quickly they got that baby out.

This is where experience and education make a huge difference For things like PMH/PSH, social history, meds, ROS, etc... I usually ask those the same way each time. There's really not trick there besides coming up with a pattern/order that you follow each time so that you don't miss something...

Yea documenting "physical exam normal" essentially tells me nothing as far as what you did and did not examine.

Even in hospital setting we have EZIO if needed for emergency access. Most of the time everyone already has at least a periph site but during a code or other urgent situation if that's not working we'll usually drill in an IO real quick. Sometimes may do a quick femoral line but those are...

I agree in that I don't see a need for prehospital central lines when an IO can fill the role of an emergency line much quicker and safer than placing a line in that environment. I place them routinely in the hospital and the standard of care now is full body drape under sterile technique...

I don't carry at work. Personal decision with many factors.... Just not practical for what I do, I'm sure hospital admin would not "approve", and I'm at times back and forth from a local VA hospital (federal facility so legally no weapons). But what bad situations are you referring to? Are...

What's the significant risk? You bring it up like there's would be a known, significant risk JUST from the act of concealed carry. The act alone just doesn't bring that risk in my opinion. In just about every state you have a large number of citizens who routine concealed carry or open carry...

Generally the subjective portion is just that, the "subjective" findings and thus things the patient/family/staff/ bystanders tell you. Objective is what you objectively see/observe, so vital signs, physical exam, etc...

Doesn't sound like he's obtaining the actual consent or signing anything in the medical record, but more of introducing himself to the patient and what his role is. By that time I'm sure the anesthesiologist or CRNA has already obtained the official consent.

I agree with everything said above. It's going to be tough to get "difficult airway" experience like you said and I don't know a good answer to that. I certainly think initially the OR experience is good because you need to start with the basics on straight forward, controlled airways to...

It's good to know which ones the patient is on, but unfortunately with a lot of these newer ones there isn't a reversal agent like there is with warfarin. That said I like the data so far on xarelto and with it's approval now for DVT/PE treatment in addition to afib I see it being used much...

That and narcotics are not drugs of choice for fibromyalgia anyway....

I don't doubt the DKA, or that there are likely multiple things going here at once. Keep in mind whenever you have someone in DKA you should be wondering WHY they went into DKA to begin with..... noncompliance, infection, new onset diabetes, medical/surgical "stress", myocardial infarction...

Ultrasound is one of the tougher imaging modalities to learn and master, there are whole fellowships based around it. At this point, at least, I'm with most others in thinking this isn't a tool needed in prehospital setting at this time. Maybe down the road the landscape and technology will...

Common things being common, and since she has history of it...probably asthma exacc. Does she use inhalers at home? Has she recently been having to use rescue inhaler more frequently? Does she test her own peak flows? Is she currently on coumadin? You know what her INR was in ER? Or...

Yea, I don't see MRSA colonization itself justifying or necessitating BLS transport.

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Efficacy wise there's really no difference between bolus dosing and continuous infusion of loop diuretics. Main advantage is most likely decreased risk of ototoxicity with the continuous infusion. So if they start complaining of tinnitus or trouble hearing then you may need to make some...

I've been using vec more and more lately, mostly due to some sux shortages we've had on our RSI kits. Also have roc available but I've only seen it used by some our pulm/CC guys who use it when they're doing a bedside trach in the ICU. I'm not familiar with this suggamadex nor have I ready...

Had the exact same thought/joke in my mind...