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    OR resus/ed bypass

    One of the best trauma surgeons I have ever heard lecture.
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    OR resus/ed bypass

    There are hospitals in the US that already bypass trauma bay and go dirtectly to the OR. I recently attended a lecture by Dr. Kenneth Mattox of Baylor University School of Medicine in Texas where he lectured about his trauma service. When a pt is brought in via EMS, the attending trauma surgeon...
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    Chest pain

    Can't tell you how many providers (medics, nurses, even ED docs) have been burned tossing things up to anxiety without in-depth and proper assessments. Yea, I used do it all the time, triage something back to BLS knowing its a BS chest pain, but one days that BS chest pain, is actually going...
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    Large bore IV's

    Both projects I work for use the Easy IO. IF a pt requires fluid resucitation and two peripheral IV attempts are unsuccessful, IO line must be initiated or if pt presents initially with poor peripheral access, IO is first line. Rapid fluids can be administered via an IO line wioth ease if a...
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    Post not showing up

    I am newly registered and have replied to a few posts, however my reply is not showing up in the thread...anybody know why?
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    Chest pain

    So apparently a 17yo can not have any legitimate acute medical problem. Have you considered pneumomediastinum? Drugs? Cocaine? Did anybody ask if the pt used any illegal drugs? Yes, she has no cardiac hx but how many young kids can have prolonged QT syndrome? More common thinsg could be URI...
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    New Paramedic

    They shouldn't be "hard" on you. I am a preceptor in my project (very busy city in New Jersey) and I am never "hard" on my new medics. I do expect the best out of them and expect them to be on top of thier game, however by being rough or hard on them, all this does is discourage them. We were...
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    Morphine for facial/airway burns.

    Coming from a major east coast burn center...Morphine, Morphine, Morphine. And i laugh at anyone who says anything less than 15mg doses. If the pt is not intubated yet, high dose fentanyl should be used. Anywhere form 7.0-8.0 mcg/kg of fentanyl should be considered. If the pt has facial...
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    Large bore IV's

    16s and 14s are really becoming a thing of the past. 20s are pretty standard as are 18s. There is a lot of recent material suggesting that rapid fluid resuscitation in trauma pt's is actually more detrimental then beneficial. Research shows pt's have a better outcome when fluid resuscitation is...
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