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  1. Akulahawk

    Can we talk about these ketamine doses

    For ketamine, my "home" county currently uses 0.3mg/kg (max of 30mg) in 50-100 mL, infused over 10 minutes. May repeat once if pain remains, or returns to, moderate to severe. Bear in mind that most of our transports take less than 15 minutes. The pain protocol does specify Fentanyl 1 mcg/kg...
  2. Akulahawk

    the 100% directionless thread

    I don't think that part will change much, if at all for a certain segment of the market. Sure, you'd be able to get MJ, USP from retail pharmacies with an actual prescription (MJ "card" cottage industry evaporates) but for more boutique blends, any non-USP stuff would still be sold through the...
  3. Akulahawk

    the 100% directionless thread

    Making MJ a Schedule 3 drug could actually be a brilliant idea… If it gets reclassed then it’ll be able to be actually prescribed, it’ll be able to be dispensed through a retail pharmacy system, and most importantly, all those “dispensaries” that sell MJ would have to be licensed as a pharmacy...
  4. Akulahawk

    the 100% directionless thread

    Yeah, but at least be thankful that you no longer have to flap your arms that much... ;)
  5. Akulahawk

    Interesting study on taking Blood pressures

    I see this all the time as well. Size (bp cuff) does matter... it can make for an artificially high or low reading if it is not correct especially with NIBP machines. If you're treating or titrating stuff by strict numerics, then size of cuff is absolutely critical. If you don't have this, at...
  6. Akulahawk

    Choosing EMT course

    I have to reiterate this... doing EMT school is a time commitment. Community college classroom/home study ratios (typically 1:3) are designed for the average college student. The information itself is not all that hard, nor is it all that complicated, but there is a LOT of it presented in a...
  7. Akulahawk

    Well that really sucks, I failed at 120 on the home/online NREMT

    This is, unfortunately, true. This type of exam is quite unlike most that a person will take in their professional/educational career. NCLEX questions and that exam is built in a very similar manner and have been around for a very long time. This means that nursing schools have learned to teach...
  8. Akulahawk

    A corspman at the squad level

    In theory, that's a good idea. I suspect that in practice, it'll have a similar result as putting a Paramedic on every apparatus... I think a better idea is to make sure there's a well trained first-aider in every squad and a Corpsman available at the Platoon level.
  9. Akulahawk

    Death of a frequent caller

    This was a bit of a necropost... but that being said, often getting to sit down with people familiar with the particular incident (EMS or hospital) and doing an informal debrief can be a good thing to maintain a healthy level of insanity that is EMS. Years ago, we had a patient that was a very...
  10. Akulahawk

    the 100% directionless thread

    Haven't been in the PNW in many years. Likely truly >20 years.
  11. Akulahawk

    the 100% directionless thread

    Just in case anyone is wondering, I am temporarily inhabiting the area about Seattle for the next few days.
  12. Akulahawk

    the 100% directionless thread

    That explains a lot... including things beyond EMS wrt California's issues...
  13. Akulahawk

    the 100% directionless thread

    That Federal Installation may have an agreement in place with the LEMSA that extends the local EMS policies/protocols onto that installation. That establishes a "concurrent jurisdiction" that allows this to occur. In the absence of such an agreement, if transport is initiated on the...
  14. Akulahawk

    Paramedic vs RN

    You will have to find out if she's officially recognized in some manner by the EMS system. No EMS certs, then she's a First Responder. A very well educated and experienced First Responder, but a FR nonetheless. While I'm also licensed as a Paramedic, if I'm working as a CCT-RN I have to gain...
  15. Akulahawk

    Ambulance Crew Configuration: Are Two Paramedics Better Than One?

    For most 911 calls, I think 2 ALS providers on scene is ideal. How those two providers get there is where things can be a bit murky but as long as they arrive in a timely manner, who cares how they get there. I also think that a couple of good EMT/AEMT providers are worth their weight in gold. I...
  16. Akulahawk

    the 100% directionless thread

    Started a new (2nd) job this week! I accepted a part-time job as a CCT-RN. I'm not going to name the company that I'm working for until I feel comfortable there. The good news is they, so far, seem to be very understanding with them being a 2nd gig for their nurses. Hopefully this will end up...
  17. Akulahawk

    the 100% directionless thread

    Leave that to (and for) the Marines. They love their Crayons...
  18. Akulahawk

    Renal failure and Sepsis/hyperglycemia

    This is very much the case in my experience. I have never seen CRRT done in the ER. Emergent dialysis on patients that already have a port or shunt already in place, yes. WRT diuresis in CRF/sepsis patients, I have not seen that done in the ED either. What I've seen with CRF/hyperglycemic...
  19. Akulahawk

    AI and Medicine

    Well, I personally think our biggest challenge will be having to deal with an AI teenager...
  20. Akulahawk

    AI and Medicine

    I would say that even with all the advances in AI, the "machine" is going to be unable to perform actual "hands-on" assessment of a patient and is therefore completely at the mercy of whomever inputs information that it can use. That alone puts a major limitation on utilizing AI as a replacement...