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It's really the only anti-emetic I use. It's safe, fast, effective, and well-tolerated all around. It is very, very expensive though. Especially the oral dissolving tablet thingys "Zofran ODT." ...and I never give anything to my fans of the Carbon-Carbon bond - except for restraints and a...

Awesome. Strong work, MSDeltaFlt.

I'd treat it like any other traumatic arrest. Bilateral 14's, an ETT, CPR, Epi, Atropine, Calcium. :excl:(For the one medic I'm thinking of that will want evidence -and who is out to get everything I say: there's evidence out there for Calcium in traumatic arrests, I've read it and...

...Would we be looking for a roach-induced ST segment elevation MI:wacko:?! That is overkill. Just go to the hospital. She will be in pain. If you're really pressed to do something, call ALS. Ask them for an amp of lidocaine. Put it in her ear. It will make sure the cockroach is dead (and...

Usually not. I see it less and less. What I see more and more and have some very good results with (and is biochemically fascinating!): http://www.ncbi.nlm.nih.gov/pubmed/3327372

If you weren't breathing, I'd hold the benzos, but, I routinely give ativan (and yes, sometimes versed!) to my friendly drunks. EtOH + Benzos (of course, in moderation) together really aren't that dangerous (yes yes be monitored etc). It's commonly done to chill 'em out. You sounded...

By itself, 25mg propofol isn't *that* much, I give 25mg of milk of amnesia daily and sometimes (for drug naive pts, too...90 y/o church-goin' ladies) it does nothing! However, when combined with wicked benzos, etc., yeah, it'll make you lowpertensive and maybe arrest. Let us also remember that...

The reason we don't try vagal manuvers on pts in VT is ... well, VT is neither a rhythm triggered by vagal stimuli nor helped by the administration of vagolytics (VT is a rhythm of distal origin where SVT is a rhythm of proximal origin). I.e. we don't give atropine for VT (atropine is a...

ecg: sinus bradycardia with markedly good R wave progression (so it's most likely not a pump problem). look at the htn meds. can her meds do this? (yes. i hear that drugs that treat hypertension ACTUALLY lower your blood pressure!) can she be just old? (yes.) my plan: 500mL fluid...

Art lines in the field? oh god no. for what? art lines are meant for longer term mgmt of hypotension with pressors on board, or if things smell like you may need pressors soon. If a pulse is sketchy in the field, fill the tank then give your favorite flavor of pressor (depending on why...

Right, but a high lactate doesn't tank the pH to the point that you arrest THAT quickly (if at all). Hell, usually it doesn't tank your pH for a good while after the initial insult. They'd get dyspneic, altered...and *maybe* arrest a few hours later from a pH less than 7. Seems sketchy.

Lactic Acid? That's a new one for me. Asystole that promptly was probably a vascular catastrophe of some sort. Let us not forget why he crashed the car (a PE? MI? CVA? Lost a bet?) as a source for his demise.

I'd say it's you who is the questionable patient advocate. Check it. Families know when their loved one is really dead (or, they have for the 20 or so pedi codes I've run). You always, always, always, want to show the family that you've done your best, no matter how old the patient is. This...

Completely correct. Use Neo. Works great: (for nosebleeds only; it 'blows' as a pressor). Lido doesn't stop nosebleeds. Except for analgesia, lidocaine really doesn't do anything. Ever. As a rule. It doesn't terminate pVT/VF (except for a really, really, specific case) and doesn't blunt...

Ugh. Really? Procedures are fun. Should be taken seriously, but, hell, our jobs are fun. The most fun I've ever had on a call was doing a crich and then a chest tube...Sorry, I have neither documentation nor studies for procedures being "fun." Just ask old medics who *aren't* jaded. We do...

On a purely sensationalist note...the individual who took that picture...hope he/she get fried. That's so wrong.

1) OMG we're still using that?! I thought the trials where something goofy like 12% of pts had episodes of Torsades de Pointes kinda said "BAD MOTHER EFFING IDEA" [So, no, I dont use it, ever. Neither the the companies, the hospitals, the pharmacies, nor the assasins carry it near me.] 2)...

"defibrillating" A-Fib should be broken down into two categories...stable vs. unstable. (And please, dear baby Jesus, don't say defibrillate, say cardiovert. I know it's a trivial matter of sematics, but, it makes me nervous) -SICK: Cardiovert them. With electricity. Nobody will *ever*...

As per the QT prolongation comment, I have one thing to say: meh. (Now, if we were still using droperidol, then I'd say have 'em on isuprel before you gave it.) If medics had any idea how many drugs prolong the QT, they'd sit there and just give periodic NS boluses (oh, right, and MgSO_4)...

Yeah yeah yeah, lowpertension = hypotension. I'm gonna give an amen to NOT giving naloxone to an intubated patient. They can do it in the ED as a diagnostic if they really want to (when they can *quickly* snow 'em again with the milk of amnesia). I am a fan of my intubated patients not...