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    Cardiac Arrest Education

    If you had an hour to teach some cardiac arrest management strategies, what message would you want to get out there? I'm tired of dry and bland CEs, so I volunteered to develop a cardiac arrest training. I also think the "provider discretion" that we allow when it comes to individual...
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    Pediatric Drowning Airway Management

    During our monthly continuing education from the hospital system, a pediatric drowning scenario was brought forth. Nothing out of the ordinary, 3 year old in a PEA arrest after being removed from a pool. We don't intubate pediatrics in this system, instead we have iGels down to pediatric sizes...
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    A Whole Litany of Issues

    You're dispatched to a residence for a 60 something male with shortness of breath. The patient's wife brings you to a basement living room where you find the patient seated in a recliner, alert, oriented, and mentating appropriately. Patient is on home oxygen at 2lpm. Wife tells you that the...
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    Neonate Restraint Post-Delivery

    You deliver a baby, things are fine for both mom and baby. How are you going to transport the two of them in your ambulance? Let's take away having a sick patient here, mom or baby. If at all possible, that warrants a two ambulance response. So what do you do? Skin to skin contact is...
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    Guideline Updates

    Our system is in the midst of the yearly guideline update. Thought I'd share some interesting changes for the sake of discussion. Of most note, epi and amiodarone/lidocaine were removed from the cardiac arrest guideline for patients 19 years and older. For most "garden variety" cardiac arrests...
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    3YO Male, Sick

    You're called to a pediatrician's office for a 3yo male "sick person, possible flu." You find your patient in an exam room, seated with no assistance on the table. He tracks you as you walk in and interacts appropriately. You note his skin to be quite pale and he is on a simple mask at 4lpm...
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    What's your "line" on refusals?

    Generally speaking, I write or ensure a refusal is written for anyone with a complaint or apparent injury. So, you are dispatched for a suicide attempt. Law enforcement is on scene, at which the party's significant other says the party walked away from her with a medication bottle and returned...
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    Full-Time Paramedic: Ute Pass Regional Health Service District, Woodland Park, CO

    Join Our Growing Team! Ute Pass Regional Health Service District (UPRHSD) in Woodland Park, CO has several full-time Paramedic positions open. Thanks to the overwhelming support of district residents, a sales tax was recently approved allowing these positions to increase daily staffing to meet...
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    Head Positioning for Intubation During CPR

    Had an arrest today secondary to a hanging and a large amount of alcohol. Anatomically this patient did not appear to present as a difficult airway, but given the first two things, we planned for difficultly. I struggle with finding ways to stabilize the patient's head while they are...
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    Needle Decompression Landmarks (Or Lack Thereof)

    While interning I ran a mid 20s female who was ejected during a rollover. She was very combative and required a BVM to prevent her from going apneic, had a variety of orthopedic injuries, and I guess what you could call a flail segment on her left chest, except really her left chest was the...
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    Radio Harness

    Yesterday we did a great backcountry rescue, and I beat the crap out of my radio on some rocks. In need of a chest harness since our communal ones have gone missing. Note: Only wish to wear for SAR type calls, I am not that whacked out.
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    RSI Checklist (And Other Checklists)

    Does your service use an RSI checklist? What's included? Would you mind sharing it? I had an RSI as an intern that did not go particularly smoothly and am thinking a more organized process would have gone a long way. Paramedics from three different agencies (us, the vollie FD with a paramedic...
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    "I'm Having A Heart Attack"

    Your ALS ambulance is dispatched on an unknown medical sometime after midnight to a private residence located approximately 20 minutes away. Enroute you are advised that the patient is being exceptionally impatient with the call taker but says he is having the chest pains. BLS Fire is also...
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    Foaming At The Mouth

    I've temporarily removed a thread that I recently created that would totally give this away, so if you already read that maybe don't spoil this immediately. Your ALS ambulance and two person BLS fire unit are dispatched on a 31D2 Subject Unconscious--Severe Respiratory Distress, patient is a 16...
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    Single Gas CO Meter

    We recently ran an unconscious party in a rental house, decorticate posturing, leftward gaze, and responsive to only significant painful stimuli. Following a clear CT the patient's ABGs apparently revealed significantly elevated CO levels. They called us, we called fire, fire opened the front...
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    Reasons NOT to Switch to D10

    This article recently appeared in my newsfeed. http://epmonthly.com/article/d10-may-be-better-than-d50-for-acute-hypoglycemia/ For a time, we were unable to order D50 prefills, so we switched to 250ml 10% Dextrose bags. I only gave it twice (its in the EMT scope in Colorado), but both patients...
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    Atrovent for Pediatrics

    Had a pretty good asthma exacerbation today, 11yo female with global inspiratory and expiratory wheezing in all fields. Albuterol rescue inhaler used twice prior to arrival and we provided 2 additional nebulized albuterol treatments along with 100mg of Sol-Medrol. The albuterol had zero effect...
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    Paramedic Program Employer Contracts

    My agency will pay for paramedic school (minus books), provided you sign a contract for several years of service as a paramedic. I am curious how other agencies go about this as well, so: How many years do you sign on for? Does your service commitment start the day you sign it (before school...
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    Paramedic - Ute Pass Regional Ambulance District, Woodland Park, CO

    Ute Pass Regional Ambulance District (UPRAD) is accepting applications for a full-time paramedic position. Candidates should have at least 2 years’ experience in a 911 ALS transport service, be Colorado State certified, CPR/ACLS certified. Experience with rural/backcountry medicine, Mobile...
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    Staff Systems with More EMTs and Fewer Paramedics

    This article generated a lot of activity on a facebook page that I occasionally find myself on. Please do us all a solid and be better than them and read the article before you comment. The crux of the article...
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