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  1. P

    Paracetamol and Hepatitis C

    Had a call recently that came in as possible flu like symptoms. Pre arrival was nausea and vomiting, increasing lethargy, leg pain, and onset of shaking ? rigors The patient in question was post OP x 6 weeks liver surgery removal of tumors. Other co comorbidities included chf, hep c and lung...
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    Life after front line ?

    So any pointers, experience or anecdotes for an alternate career pathway for someone looking to step away from frontline ems after 25 + years Training or dispatch not a preferred option Thanks
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    Physician Assistant ?

    What are peoples thoughts or experiences on becoming one from an ems background ? What routes are out there for paramedics to study for the position ?
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    CPAP for COPD ?

    Thanks NPO Just to clarify BIPAP and CPAP are not the same Correct ?
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    CPAP for COPD ?

    A further question At what point do you resort to cpap in an exacerbation Do you jump straight in with it or do you use it if patient not responding to standard salbutamol and combivent nebulizer treatments ?
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    CPAP for COPD ?

    Thanks guys
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    CPAP for COPD ?

    The consensus of opinion is that this is the reason the treatment is contraindicated in exacerbations Is it a case of the benefits out weighing the risk for those systems that use cpap for these patients ?
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    CPAP for COPD ?

    Can it cause a pneumothorax in these patients ?
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    CPAP for COPD ?

    We have CPAP in our system solely for APE We cannot use it for exacerbations of copd although we can use it in APE regardless of a history of copd Have been reading some articles and saw a recent podcast advocating its use for exacerbations of copd Is it a safe and effective treatment in...
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    How many services use Fentanyl instead of Morphine for Cardiac Chest Pain?

    Thanks guys I will give the fentanyl a go in my next acs patient One more question we also give intranasal fentanyl and I've been very disappointed as have nearly all my colleagues with its lack of effect with adults although it's very good with paediatric pain What are your experiences with...
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    How many services use Fentanyl instead of Morphine for Cardiac Chest Pain?

    We've just got fentanyl with the very same dosing limits plus the restriction that we cannot give both iv morphine and iv fentanyl to the same patient it has to be one or the other. We've been told that the fentanyl is stronger but at those doses it may wear off quicker than morphine so we...
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    How many services use Fentanyl instead of Morphine for Cardiac Chest Pain?

    are we talking in an adult just 2 dose administrations with the fentanyl ie 100mcg x 2 to a max total of 200mcg
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    How many services use Fentanyl instead of Morphine for Cardiac Chest Pain?

    just wondering how do you titrate to effect,particularly in cardiac chest pain , with those fentanyl doses
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    How many services use Fentanyl instead of Morphine for Cardiac Chest Pain?

    Out of interest what are the dosing administering protocols with fentanyl compared to morphine We use morphine initial loading dose 4mg iv and 2mg increments titrated to effect (BP permitting) max 16mg
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    Morphine for headaches ?

    In our cpg's morphine is not contraindicated but is also not recommended for a headache Does anyone know why ? Thanks
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    Pain relief and Alcohol intoxication

    Thoughts and experience with managing pain in a drunk patient with severe pain from a traumatic injury. Morphine contraindicated in acute alcohol intoxication. Is IN fentanyl ok This patient in question has a dislocated shoulder and a head laceration from a fall from standing, GCS 15 and vital...
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    Online CME

    Thanks guys...
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    Online CME

    Thaughts and opinions ? Any recommendations ?
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    Sepsis and exacerbation of copd

    This was pre hospital in a rural setting I suppose the question is how aggressive in the field should we be with sirs markers in a situation like this I needed initially to use the copd exacerbation protocol/cpg. My sepsis protocol is paracetamol if temp warrants it. Benzylpenicillin and fluid...
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    Sepsis and exacerbation of copd

    Thanks Had a patient with copd exacerbation that had expected sirs markers ie resp and pulse rate added to an elevated blood glucose not a diabetic. I treated the copd with nebs and hydrocortisone but was wondering on reflection should I have treated her also as as sepsis. pt was Apyrexic.

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