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I make my decision on a case by case basis, but with that being said I do right sided ecg's a lot. I do do posterior leads, but less often.

I like http://www.ems12lead.com and hqmeded-ecg.blogspot.com for ECG's.

And I would also echo TransportJockey, Will Wingfield's ACE SAT video review is very good.

For anyone looking for online education that is accepted by NREMT, look into http://www.distanceCME.com (link is work/family safe). It is completely online however it is lead by a live instructor and prescheduled. Because the instruction is given live, it is accepted by NREMT as live in person...

No, I live in Saudi Arabia right now. That kind of desert. No place for Aikido as far as I've been able to find. We have an indoor rock wall on my compound that's not bad, but it's run by the school and they're not keen on us using it. My motorcycle is at my parents house in Massachusetts...

Riding and maintaining my old motorcycle ('75 BMW), rock climbing, Aikido, hiking, and brewing beer. All except rock climbing are on hold until I finish up here in the desert. I can't wait to be able to get back to them.

You will run into this kind of person everywhere you go in EMS. Both kinds actually, the ones who complain about other employees behind their backs and the ones who lose their cool when the poop hits the air mover. Best thing I think is to keep your mouth shut unless you actually witness them...

I run CCT and emergency service out of a vanbulance now until I finish with this remote rotation. I normally don't find it that bad, except that the backboards supplied by this company are too large to fit in the space provided so that have to permanently reside on the bench seat until it's...

I'm wondering about hyperkalemia. Absent p waves, widened qrs, with tall sharp looking t waves. Check the potassium. That's just my two cents though.

These are really good points. In general, I would say the majority of my RSI's are elective and are done in the ED before admission or in a remote clinic before a medevac flight due to combativeness or because I question my ability to manage their airway in the confines of the aircraft. In...

That makes sense. I think you could make good arguments either way.

Or norepinephrine. I was just reading about this last night. Apparently there's less mortality with norepinephrine in cardiogenic shock. I'd definitely say this is the way to go.

Although, I do understand that a lot of protocols only allow sux as the first paralytic unless it's a dialysis patient or something like that. With my current protocols it would be etomidate and roc for the initial intubation then fentanyl and midazolam for continued sedation.

I like your ideas of fentanyl and ketamine. I would probably use roc instead of sux so long as there's no predictors of a difficult airway. When given at the higher end of the dose range (1.2 mg/kg) it tends to have an onset similar to sux, but doesn't come with the risk of hyperkalemia. If...

Given what little info we have at the moment, it's a good place to start.

I would want to get a good quality 12 lead ECG with a quickness, especially before resorting to dopamine or another vasoactive medication. We also need more history. Was she recently sick? Any recent infections, cough, cold, etc? My thoughts on treatment based on the given information are...

It does actually appear that there are some subtle changes from the first ECG to the one with V4R. V4R is slightly elevated, indicating to me probable RV involvement, and also it would appear to me that V2 and V3 show more ST depression, indicating more posterior involvement as well. Just my...

Where I'm at we do a lot of the intubations (RSI and otherwise) in the emergency department. We are authorized to RSI in the field. It isn't exactly a once in a career procedure, but it doesn't happen very often at all. I would imagine there are other places (Sussex, DE for example) where it...