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    fish hook back of the neck

    Because in 90% of cases it is either not beneficial, prolongs the problem, or in some cases can be downright harmful (due to the way it is taught mostly). Combined with the fact that even for the 'true emergencies' that are relatively rare, they can't do crap to address the problem in most...
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    fish hook back of the neck

    Lidocaine! Aka: prep site, infiltrate lidocaine (plain is ok), push hook through skin, cut barb, pull hook back through. Make sure tetanus is up do date. Apply some polymixin b ointment and refer for follow up. THIS is why BLS drives me insane. This is about as fricken basic as you can get re...
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    Why can't COPD pts be on a non rebreather mask?

    Agree and very true, as long as SpO2 (or PaO2) are hypoxic. As soon as you get the SpO2 into the target range, then more oxygen will NOT help the PT and WILL cause significant harm. Give the oxygen, but titrate it. DO NOT GIVE NON TITRATED O2 to these patients - it kills them. But if you are...
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    Why can't COPD pts be on a non rebreather mask?

    Shunt is oxygen unresponsive. Oxygenation ≠ ventilation. COPD exacerbation induced resp failure s nearly always a Type II resp failure. Hyperoxia also is extremely relevant, as several studies and trials have demonstrated. Hyperoxia kills people. Period. Use the minimum required FiO2 to...
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    Why can't COPD pts be on a non rebreather mask?

    http://www.bmj.com/content/341/bmj.c5462
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    Wilderness med kit suggestions

    Yes. They are good bags. Approx $70 a unit but well made.
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    Wilderness med kit suggestions

    These work well: http://www.trevorowenltd.com/pharma_kit_bag.htm You can let out a stitch to make the loops bigger for larger stuff if needed.
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    5 Medications

    1. EPInephrine 1 mg/ml (1:1000). This is the first line treatment for anaphylaxis, and asthma refractory to salbutamol when the patient is in respiratory failure. Can also be diluted down to 0.1 mg/mL for arrests (although you don't have a monitor, so this is likely not very useful) or to 0.02...
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    In-Line Nebulizers

    Why? Seems like very few places in the USA do.
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    In-Line Nebulizers

    Why does no one seem to use these: MDI adapter that goes inline with any vent/CPAP/NIPPV/BVM. Plug MDI into the cap part and use like normal. Only 1 O2 source needed, and easy to switch MDI canisters out between atrovent and salbutamol (albuterol).
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    Remote Ischemic Conditioning

    Rationale?
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    Remote Ischemic Conditioning

    https://www.dropbox.com/s/frlgsrm6gnj5rhw/RIPC%20Trial.pdf?dl=0 Trial demonstrating significant reduction in mortality in STEMI pts.
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    Remote Ischemic Conditioning

    Apparently Indionapolis EMS has it in their STEMI protocol. Easy, safe and effective...
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    Statpacks G2 drug module

    Is anyone using the statpacks G2 drug module? If so, how is it? Pics of your setup would be appreciated. We are trying to determine different ways of setting these up.
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    Bags And Kit Pictures

    I'd prefer the type 10 or 11 escharotomy tool myself...
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    EMT with a variance vs AEMT in MN

    So you can start an IV, but can only give po benadryl and epi via epipen? Call me crazy, but IM injections are pretty basic to the point where they're almost BLS. With that scope you should definitely be allowed to give meds IM.
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    Manual traction

    Good idea. This could even be taught to ILS providers who usually cannot give opioids. AFAIK this is a safe procedure with few contraindications. Lidocaine used for LA is very safe as well.
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    BLS with Advanced Skills

    This is what should be happening in every system, and was the point of my post. They are a basic lifesaving intervention that do far more good with less risk of harm than some other interventions that are "BLS"
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    Medic with Motion Sickness

    Either a script for zofran ODT or possibly a transderm scopolamine patch. The transderm scop should be otc as well, just check w the pharmacist to make sure it is safe.
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    BLS with Advanced Skills

    Agreed. Simple and easy. I was referring to the fact that in most places, epi autoinjectors are not even considered BLS and carried. How you get the epi in isn't that important, it just needs to get in asap. Autoinjectors actually improve pt safety in some cases even with ALS providers. I...
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