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1:1 atrial flutter tops my list, although AVRT is a possibility. The neat bit about 1:1 flutter is it doesn't actually need an accessory pathway to conduct that quickly as certain conditions can "enhance" AV nodal conduction (e.g. high sympathetic tone, hyperthyroid). I've got a nearly...

The term you're missing, which caused your confusion, is Kounis Syndrome. This is a type of myocardial infarction brought on by an allergen. (As you note, you can also have a Type II MI from vasoconstriction related to epinephrine administration.)

...women and men do not really experience ACS thaaat differently, and no study has shown that they have "less chest pain" than men (or at least no rigorous study exists). I know our textbooks love this tidbit, but it is a giant Old Wive's Tale. http://www.ncbi.nlm.nih.gov/pubmed/24275751...

Vastly more predictable than pushing antiarrhythmics in the same patient.

How about sedation/analgesics have a much more predictable effect/side effect profile than our antiarrhythmics (excepting adenosine)? When I push fentanyl/etomidate/etc I generally know what to expect. When I push amiodarone I wonder if it'll work.

Everyone above has given some great suggestions, and if you make it out to the Southeastern Coast let me know and I'll help you navigate our services. Welcome to the land of EMS as a first class citizen.

Electrical cardioversion has far fewer side effects than antiarrhythmics. If I have to choose, for myself, between adenosine/lidocaine/amiodarone/procainamide or cardioversion, I'm taking cardioversion. Stable or unstable. The whole idea that antiarrhythmics are somehow safer than electrical...

Cardioversion of septic patients is a no-no. Far too often we forget compensatory tachycardia itself isn't what you treat. That being said: 1. Sedate. If they can answer your questions they have time for and deserve sedation (unless they refuse). 2. Adenosine can/does work through distal...

A few notes: 1. First 12-Lead shows definite Atrial pacing, with a relatively narrow complex ventricular response. Differentials include: A-V sequential with a programmed AV-delay set at ~240 ms (perhaps found as part of a search algorithm in the pacemaker), A-pacing with a long AV-delay and...

As a dude I wear polos/slacks or button downs/slacks, and if lecturing depending on the audience I may wear a suit. For ladies, I suggest "business casual" and I suggest you avoid asking dudes what that means ;-)

One's a clinical educator for a medical device company and the other is a PA.

(disclaimer: president of non-profit department) We pay better than the minimums and try to be above-average for our area, for all job functions. Why? Two simple reasons: 1. Better employees. 2. Better retention rates. Both decrease the cost of doing business. One area agency led the charge...

One of their Batt Chief's (or similar rank) has been posting on Facebook comment threads clearing up misconceptions. They run nearly everything Lights and Sirens, Code <RANDOM NUMBER FOR YOUR SERVICE AREA HERE>, 10-18, We Do What Doctor's Do But at 8,000 MPH (<MORE> KPH), Delta, Indigo, Status...

Feel free to email us if you need anything related to FD-CPR. We're more than happy to help you get what you need!

My opinion is not that you should not be able to spend time as an EMT before paramedic school. My opinion is that arbitrary entrance requirements are not the right approach. Why aren't paramedic programs enabling students to get their sea legs underneath them? Why aren't they ensuring that...

I've never agreed with their entrance requirements, but I find it hard to believe they do this to supplement their educational program. In fact clearly they do not, considering they use ~3000 hours of schooling (3 times most programs). Why do they require 6 months experience? What could you...

One interesting aside would be that an Urgent Care / Clinic does not fall under EMTALA. We do transports sometimes to these types of locations and if our patient is not "accepted" then we have not transferred care and still have the responsibility to provide care. (Just something to keep in mind)

There are actual two levels of education: 1. First Aid 2. Paramedic Don't make the mistake of conflating the skills aspect with the educational aspect. The education you receive in EMT school is insufficient to be a strong clinician. The educational component of paramedic school is the bare...

I give CaCl without labs. I usually do not give bicarb, but if we are lucky enough (hello horrible vascular access patients) to have a second line I will. I rarely get to Albuterol.

Calcium chloride can be pushed, calcium gluconate needs to be given over a longer period of time. I use the term because an "old" protocol is no excuse for a service to hide behind (not directed at you in any way). Services love to hide behind, "well that is what our protocol is."