Search results

  1. C

    Bells vs stroke

    No mention of arm drift but Cincinnati Stroke Scale says 1 of 3 findings = 72% change of stroke and 3 of 3 is 85% of stroke, it’s reasonable to estimate 2 of 3 is ~80% likelihood of stroke. This is enough for me to think about heading toward a stroke centre but taking the patient presentation...
  2. C

    Flight suit winter survival gear

    ‘Survival’ in the flight world might not always take place after an accident or emergency. I’ve heard of a few stories of medics being left at scene due to an unknown multi-casualty situation. One guy spent the night in the woods when the more emergent of the two casualties was evac’d first...
  3. C

    Vertical light bars

    One night I was driving past Boston on the 95 when they were doing roadworks. They had a cruiser stopped every 100-meters. I have no idea what the speed limit was because I was probably only doing 20mph. The lights were so blinding and distracting it took every bit of concentration I had to...
  4. C

    Atypical STEMT Treatment

    How are we defining outcomes? Mortality? Cardiac wall function post MI?
  5. C

    First Tactical EMS Bags?

    I can see the similarities between both packs, however $430?!?! True, however it’s two sets of zippers and two sets of velcro, and I can’t imagine anyone removing it for the few minutes they intubate someone and then go through the process of reinstalling it again.
  6. C

    First Tactical EMS Bags?

    Does anyone have experience with the First Tactical ’large’ Jump Bag? It seems to have a few nice features — ‘infection control’ exterior, module-based interior organization, and no exterior pockets of zippers to get caught on doors (I’ll admit, this has happened to me a few times). Do other...
  7. C

    Refusal after Narcan administration

    There are two separate entities here — the professional regulator (the College of Paramedics) who set-forth the expectations of members (described in my first post), and your employer who establish the operational standards (protocols) as per the regional legislature. The employer ‘refusal of...
  8. C

    Refusal after Narcan administration

    Katzung, Basic & Clinical Pharmacology 14 ed., p.571: ”It is very important that the relatively short duration of action of naloxone be borne in mind, because a severely depressed patient may recover after a single dose of naloxone and appear normal, only to relapse into a coma after 1-2hrs.”...
  9. C

    Non-Transport EMS

    This is exactly the set-up the volunteer fire department a different friend is involved with elsewhere in the country. They respond to 911 medical calls when the local service does not have any available units, although I’m told this is rare. Correct — I was asking more about first response...
  10. C

    Non-Transport EMS

    A friend of mine works for a volunteer fire service which also does medical response. They have an ambulance and sprint truck (Chevy Tahoe) in their fleet and operate as ‘medical first response’ (stop-the-clock). Since they not a licensed ambulance service, they do not transport patients. I’m...
  11. C

    Elevated CK as Contraindication for Succs?

    From Katzung — Basic and Clinical Pharmacology Section V — Ch. 27: Skeletal Muscle Relaxants (p. 475) “At least two additional types of acetylcholine receptors are found within the neuromuscular apparatus. One type is located on the presynaptic motor axon terminus... The second type of...
  12. C

    Elevated CK as Contraindication for Succs?

    The protocol for Succs. lists the following Contraindications: - Hypersensivity - Family Hx Manignant Hyperthermia - Known or Suspected Hyperkalemia - Myopathies assoc. with Elevated CK The first three make sense and are discussed in various airway, pharm., and anaesthesia texts I have...
  13. C

    GTN for hypertension/Stroke???

    @PNWmedic767 — Do you have the opportunity to sit-down with the medics on this call? If so, I would ask them what their goal of therapy was and why. This ‘scenario’ fringes on the cleché ‘treat the patient not the monitor’. They obviously recognized the hypertension and came to the conclusion...
  14. C

    GTN for hypertension/Stroke???

    I searched for a dose-response graphic for Nitro but couldn’t find one. The following article (https://link.springer.com/article/10.1007/BF00874655) suggests a 1.6mg SL dose (2-4x typical EMS protocol) primarily produce venodilation with ‘peripheral arterial resistance’ (aka Afterload)...
  15. C

    Narrative vs entire PCR

    This. Someone once told me ‘you should be able to hand your PCR over so someone and have them arrive at the same conclusion you did’. To achieve this, the narrative is essential. I found the SOAP mnemonic obstructed my ability to ‘tell the story’ clearly. SOAP requires the author to separate...
  16. C

    Has anyone here performed and in field eschorotomy??

    Just out of curiosity, what make/model aircraft are dispatched in your area? Do you know their wind protocols?
  17. C

    Is the Fentanyl Problem Overstated?

    I entirely agree. I was thinking about seizures when I wrote that post (classic Ferudian slip), but due to the unique way this forum is run I wasn’t able to correct my post to read ‘pro-emetic effects’. I thought about making a follow-up post to identify the error but it was an irrelivant...
  18. C

    EMTs and Paramedics in the Hospitals

    @TransportJockey — in your experience and opinion, what are the primary benefits to Paramedics in the hospitals? What settings do you think would most greatly benefit from Paramedics? What settings do you think Paramedics would not provide any benefit? I need to issue a correction so I...
  19. C

    Is the Fentanyl Problem Overstated?

    Have any other providers experienced push-back from their patients not wanting to receive Fentanyl? I have and it’s a adifficult situation when you’re providing aeromedical transport and want to avoid Morphine due to its pro-convulsant effects. I struggle with the ethics of this one as I’ve...
  20. C

    EMTs and Paramedics in the Hospitals

    Here in Canada, EMTs and Paramedics are starting to appear in Emergency Departments (EDs) in a few provinces — Nova Scotia, Saskatchewan, and British Columbia. No surprise, these are the provinces with the lowest paid medics and also have very rural areas and low populations. I can’t speak for...
Top