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No. I am not missing the point at all. I get the advancement part but that must come with the appropriate education and training. Just because you have the "technology", it does not mean you should just use it however and whenever if not appropriate. How many codes how you worked where...

No. I suggest you get access to the manual and read it. Then I suggest your company get a qualified clinical representative to go through how to use this machine appropriately and not just however you "think" it might be okay. It is in inappropriate to dismiss someone using it in a way which...

I was attempting to show you that maybe you should re-examine your own understanding of that ventilator before calling this other guy lazy, dumb, stupid and an idiot. It doesn't sound like your company has provided much training and education about ventilators. There should have been some...

That might be okay but some might not look at that section. A separate journal section would give some a chance to see many other professional journals rather than JEMS. Also, one article might be discussed at one time or a literature review might be done. Almost every health care...

Define use well? How do you determine how effective your ventilator is? Some have been so proud of their ventilator's performance only to find they have a pH of 7.0 and a PaCO2 of 80. Sometimes they got that by chasing their ETCO2 without understanding or knowing the disease process or anything...

This ventilator can do all of those modes but should you? What is "true" ventilation? Pressure and timed are how the ventilator cycles or terminates flow. SIMV is a mode whose cycle can be also be determined by pressure and time just like AC and PC. BIPAP is not to be used on an...

Overview of acid-base disturbances with the calculation for anion gap. http://www.thoracic.org/clinical/critical-care/clinical-education/abgs.php

If a patient is in cardiac arrest with CPR being performed, you probably should bag because the ventilator will end the cycle with a chest compression and will be out of sync during chest compressions. This means the patient will not be ventilated even with the ETT. Yes, that will not help with...

You are incorrect about all OB or all neurosurgeons. Not all have the same skill set. Most all can deliver babies but some might be competent to do high risk deliveries and advanced procedures like fetal scalp monitoring which is not mandatory in all hospitals. You should also check out what...

Is this a literature review or will you actually being doing research with participants?,

With a glucose of 2000 how would you (or doctor) determine this is DKA and not HHNS?

You probably didn't get all of this from just OJT. The a&p classes in RT school probably helped.

EMS is considered a trade and is largely done in tech schools with hours of training as the standard rather than being measured in college credit hours. Tech schools do not have the expectation that you had a 4.0 high school record or that you took college prep courses. It is meant for easy...

You can try to sue but it is doubtful you will get anywhere. I want a truck with 2 Paramedics but get one with just 1 and an EMT because of staffing issues. Can I sue? Probably not. I want to go to the cath lab at the hospital 2 blocks further when I have chest pain but your protocol...

How about Lactate? Do you run? Most runners will understand muscle fatigue and the by product. A DKA patient with a pH of 7.20 will fight a ventilator. You would probably need a paralytic. Some DKA patients will take their PaCO2 down to the single digits. ALWAYS verify the ABG yourself or...

How long do you think the body can keep that up? Also, what happens when muscles are on overload? What do the muscles produce?

With hypothermia protocols, fevers from brain injuries and rewarming phases we do think about shifts more in the ICUs and maybe EMS should be more aware of the shifting curve if they do hypothermia or believe in the SpO2 rule of 94% as a definite marker for not giving oxygen.

Ventilation alone is still a bad way to correct some metabolic imbalances. For every action there may be a reaction which is not always wanted. ABGs alone will also tell you very little and that is where a chemistry panel for electrolyte info or the anion gap is needed. Nursing and some...

How is ETCO2 going to show this? ETCO2 does not show pH. You can have respiratory alkalosis and metabolic alkalosis. You can have compensated and partially compensated or a mixture of just about everything. You can have a large gradient for the PaCO2 and PetCO2 for several reasons...

I looked at the price of some private Paramedic sshools lasting 6 - 8 months which cost $12 - $22k. That is 2 - 3x more than a 2 year degree in some states. Some EMT 110 hour programs are well over $3k especially if they are 3 - 6 weeks. So, I don't think it is the money but rather the length of...