I've been on both sides of the fence on this one. I started my career in a fairly big city that had an EMS system that was separate from fire. The firefighters were great at fighting fire and the paramedics were, for the most part, great EMS providers (ALS only 911 trucks). The issue was that...
Before medic school, I went over all of my BLS skills and knowledge, especially things we don't do a lot of: OB/pediatrics, anatomy, basic pharmacology, and medical terminology. Having a good foundational knowledge of these subjects helped me immensely. After the BLS refresher, I read a book on...
I would have to agree that there are too many variables and possible reasons for the IO vs IV in each specific case to come to a definitive conclusion. Extended down time, obese patients, patients with medical problems causing poor vasculature, who knows. There is a strong possibility that if a...
Yes, 2 to 4 mg. Technically, fentanyl dose is 1 to 3 mcg/kg of fentanyl, but we get a lot of flack if we go over 200 per dose. I was mistaken before as well, we have 400 mcg in the box. Either way though, in doses I've given in the 1 to 2 mcg/kg range, I haven't seen much decrease in pain in...
In the rural areas it's about conservation. For most adults a loading dose of 100 to 150 mcg of fentanyl is best for me, but we only have 200 mcg in the box. If you're an hour out, increments of 50 mcg. If it's needed, we also have ketamine in the RSI box, but we have to call for orders.
We stopped carrying morphine in the box a few years ago, now we have both fentanyl and Toradol. In my personal experience, fentanyl has not had the same level of analgesia that morphine did. I've found that a higher loading dosevof fentanyl is usually required as well as more frequent redoing...