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The current guidelines for TPA is 4 1/2 hours which was pointed out that in a NH that can mean anywhere from a day to a week depending on when they get aroung to looking at there patients. If you feel that going L/S was in this patients best interest and it was done as safe as possible hold your...

In this instance I do think that it is like any other scene because the school is not a facility in the same way a hospital or NH is just because they have a nurse. Its sad that "higher level of care " has to be defined by a piece of paper rather than knowledge and skills sets. I've had care...

Yeah I think there are better alternatives for chemical restraint personaly but to each his own (I guess)

Your protocols allow for it to be used as a chemical restraint? Ive never heard of that being done just seditaves and haldol that sort of thing.

I agree this patient was at a point were you were being forced to race the clock. It would be nice to have a 12-15 lead which would have been easy.....if you had 10 hands so you could intubate....start a line.....hang a dope drip......get your 12 lead....load your patient.....and drive to the...

I actually never meant this thread to be about looking for "new" medications (not sure if you are refering to ketamine since its been around for awhile) or "scope expansion" I wanted to talk to people who use the medication in therapy of the ill and injured. In my opinion the amount of drugs...

Hey smash do you usually drip in helicopter or pump it and I assume doses are given in kilograms(I laughed for 15 min straight after reading this comment)

I dont belive anyone said that it did not. infact it was mention to use benzo's for the emergence reactions So far very good info thanks everyone

i agree completely that fent will not replace MS however due to its quick action and short halflife i think it will and should be used more. However to take away MS completely is to take away a tool and a great tool at that.

The justification for using it in asthmatics is due to its bronchodialatory effect right. Do you the the sedative effect of the med helps out as well. And what sort of doses are you using in asthmatics?

LOL sometimes it seems that way

Just a comment to help you to think alittle more on CYA narcan. If you have a PT. with either an expected bathsalt OD (or any stimulant overdose for that matter) and that patient is tachy(this has nothing to do with what he is wearing), warm dialated pupils muscle spasms rapid resp rate why...

Do you usually use versed or is there a better choise?

I don't think protocols say anything about using our brains

The most important factors for survival in cardiac arrest are early compressions and early defib during the cardiac arrest all the Epi (adrenaline) in the world will show no differance in outcome. By caring a AED onboard so that you can defib as early as possible and as long as you can maintain...

When you use it for RSI do you use it with sux vec or roc as your paralytic if sux is there a worry about useing the two together and causing increased ICP or is all of that unfounded Thanks this is helpful

I would like to find prehospital providers who use ketamine for pain managment or any other use and what you think of it.

In the USA I don't think that anyone uses acetaminophen IV (at least not prehospital). OFIRMEV which is IV acetaminophen was FDA approved recently. I read a study a while ago and I can't for the life of me remember what it was called I beleve it took place in France in which they compared...

Yeah I found that they use sodium and potasium chloride hydorchloric acid IV (WOW) and dialisis but these treatments are all for severe metabolic alkaliosis which they would want to have labs back before they treated anyway. I think this is a pretty valid question is the hospital staff of the...

Using mag to relax the pt. seems like a poor method. Was the pt. still having a wheeze if so did the hospital start with first line treatments (Nebs ect.). As for the alkaliosis I did a little searching and didnt find mag as a treatment that doesnt mean they were not trying it(Im not being...