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At a certain point, yes. Giving poor care to many isn’t better than giving adequate care to some. In a limited resource environment rationing becomes the ethical decision at some point, and you have to consider how to do the most good for the most number of people. That may mean those over 75...

11: When you have to pack it all in you realize how much junk you carry every day. 12: Real wilderness environments typically don’t have cell signal/radio reception. 12.5: Your sat phone will die when you need it most. 13: The wilderness sucks when you are stuck in the middle of nowhere with...

I think the advice about not drinking and driving is pretty solid.

Alcohol is not the problem with a DUI, it is the decision to willfully place others at risk of death or serious injury. It wasn’t a few beers that gorked or killed so many of the kids I’ve cared for, it was the person who decided to get behind the wheel.

Idk about other states, but where I live they won’t issue a nursing license if you have had a recent DUI, typically in the past 5-7 years. The board considers it a show of poor judgment and character inconsistent with those of a professional.

Got a nice doe this afternoon.

What stroke assessment tool were you using? Unfortunately many used in EMS are not very thorough and do miss a decent number of strokes. Even the NIHSS which is typically considered to be the gold standard is not very good at detecting posterior strokes. Clarly something was wrong, you...

I’ll throw a couple thoughts at it, but to be transparent for anyone reading this I never had FP-C. I do have a myriad of other critical care certs relevantly including CEN and CCRN. When I think of CO2 I mostly consider their bias flow/sweep/minute volume. If their other parameters are...

Fire department politics while extremely frustrating are far better than working as a corporate servant.

Not a single patient in the ED or call for the Transport team after 0100 last night. None of those cursed words brought anything.

If I’m forced to work on Christmas I’d rather have it in a heated building with a potluck than posted on a street corner with a sack lunch.

Apparently we are in PPE heaven. I no longer have to give away my firstborn to get PPE, and we are no longer reusing any supplies.

Unfortunately IDLH environments are a bad mix with seizures, I wouldn’t risk working fire. I’m surprised someone didn’t say something sooner. It’s not just a matter of having a second patient, if you seize you are no longer able to provide them care, essentially unintentionally abandoning them.

You can easily assess early and without invasive lines by using a nicom or clearsight

I think that's hugely variable on how ill the patient actually is. The more critically ill the patient is after resuscitation the less often they have a normal or increased CI. Those who are fluid responsive and less ill do tend to maintain a normal or increased CI.

Depends on your intravascular fluid balance and if your heart function has taken a hit. Often in adults we see a sv of 20-45 before fluid resuscitation, and most adults just don’t tach up enough to get back to a normal CI.

Well, that website just told me that cardiac index increases in septic shock so...

What’s the plan of the state takes away ketamine?

Just keep the patients alive and support your staff.

Younger patients are generally less sick period. There is a reason we see the extremes of age in critical care, the very old and the very young. There certainly are adolescents and young adults who are sick and medically complex, but they are much smaller proportionately.