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I second 04_edge's post. In the first set of strips, the patient had no native atrial activity, and was being paced at a rate of 80. In the second set, the patient's atria started doing their job (at a rate of 96), and just the ventricles were now being paced. I could be totally wrong...

Gee whiz. I'm sure glad Dr. Antevy came along and edu-mah-cated me on pediatric dosing. I might have given some poor schmuck of a kid 10 times the appropriate dose of epinephrine because the Broselow tape doesn't make it perfectly clear which dose is for the tube. ... and if you believe that...

If you suspect the cardiac arrest was caused by hyperkalemia, why would you wait upwards of 4 to 6 minutes to administer calcium?

Yep, I know the part. The guy previously in charge never included it in the equipment on the rigs or in the master list of what our department can order through central supply. My question was whether or not its worth the month (and I kid you not, it WILL take a month) of me playing e-mail and...

Does anyone have any thoughts (or better yet, know of any peer-reviewed studies) re: in-line nebulizers being used with a BVM? Long story short, a previous lead within the agency I work for thought that by simply throwing the t-shaped piece on the rigs would allow for in-line nebulizers with...

Vehicle Service Techs. I so wish that was an option.

The short question: Does anyone have any experience with staff at their agency re-arranging the ambulances how they feel they should be set up, despite how management has dictated they be stocked and arranged? Background: I recently took a lead medic position with a service that up until the...

Its a Hennepin County ordinance that all ambulances operating a PSA in the county be staffed by two paramedics. (http://www.hennepin.us/your-government/ordinances/ordinance-9#SECTIONV) Even the "big wig" services that otherwise run medic/EMT are required to staff dual medic trucks when...

Out of curiosity, has anyone seen research similar to the French study looking at Ketamine in addition to morphine/fentanyl/pick-your-favorite-narc?

At one point during his laryngosocopy attempts I did suggest ketamine, to which he replied that he didn't believe they have it. I offered ketamine out of my narc pouch and he refused, stating the etomidate was enough. As far as positioning goes, while he was off dealing with another patient I...

Halothane, quick question about using fiberoptics - The only times I've seen it performed have been in very busy, metro ED's and it was the EM residents performing it, rather than anesthesia. I myself don't know very much about it. Is this a procedure I can expect a rural ER physician to be...

The capabilities of the hospital are minimal. He was the only physician there at the time. They do not have any RTs on staff, and I believe their anesthesiologist is shared between a few of the area hospitals - I did ask the nurse if anyone knew how to page/get ahold of him, and no one knew...

Given the experiences I've had with this particular ER and their airway management capabilities in the past, I'd seriously doubt they would even have the necessary equipment (granted, like I said, I'm not super familiar with the procedure and I don't know what it requires) or even the know-how...

I don't know a whole lot about retrograde intubation but my best guess is it wouldn't have been an option here because of the total lack of neck on this patient (think Jabba the Hutt).

Bloody saliva.

When I got there she was maintaining around 92% SpO2 and 50 mmHg ETCO2. After the attempted intubations, she was no longer able to maintain oxygenation (left to her own devices she was sitting around 70%). With a nasal trumpet and a BVM we were able to maintain her between 85% and 90%, with a...

Not entirely sure. She was brought in by another crew. No family, she'd just moved to the area. Only history they could get from a friend was she had a history of alcoholism and cirrhosis. Sugar was good. Tox screen negative. She had a high ammonia level so the ER doc thought it might be hepatic...

Medic Tim, you're not dense, I just could have been clearer. After the initial dose of etomidate, the ER doc dinked around for a couple minutes before taking his first look via direct laryngoscopy. He spent about 15 minutes attempting (in between periods of bagging her) via DL, and then spent...

Short question: Has anyone ever had any difficulty seating a (obviously properly sized) King airway in a very obese patient? Longer context: got called to transfer of an unconscious patient pushing about 230 kilos. When I walked into the ER they had the patients torso raised about 45 degrees...