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I agree taught properly it is one of the better courses out there. The book is pretty good reading as well.

sorry, let me clarify, I mean the NTG and CPAP work best. Lasix is an important part of the treatment and overall management of the patient, however it does not have the immediate effects on the patient's condition that the NTG and CPAP have. Oxygenating the patient and decreasing preload...

Most of the evidence supports that CPAP and NTG works the best with Lasix. The histamine release caused by Morphine may be more harmful than any benefits gained. If the patient is agitated a small amount of Benzos may be better, some studies are saying Fentanyl may work as well. I have had the...

A good rule of thumb is if you have impending airway compromise they need to be intubated. This is a call only the medic on scene can make. A good physical exam like Flight-LP listed will get you pointed in the right direction. You also may want to consider if there were other drugs involved...

I think 70mg/kg is the peds dose, I'm not sure if it is FDA approved for kids. You could always call Poison Control on a nonemergency line they can probably tell you.

I recently participated in an AHLS class. There was some time spent on this topic. One important point is that most Cyanide kits use Sodium Nitrate to create Methemoglobin to bind to the Cyanide. It is very dangerous to create large amounts Methemoglobin in a patient who already has a high...

With our transport times, the second dose of Etomidate works fine. We normally induce while in route. If the 2nd dose is required it normally gets us to the hospital (lasts 8-12mins). We have Ativan further down the protocol if we need, we also carry Fenanyl. As far as the adrenal...

My current service uses a second dose of Etomidate. Previously I have used Ativan. I thought our Medical Director was crazy but the second dose of Etomidate actually works very well. You have to be careful of Adrenal insufficiency but other than that there is very few side effects. It also...

I found AMLS to be one of the better classes I have taken. PEPP is a total waste of time. PHTLS and ITLS are about the same the curriculum is a little different.

Unionize, which you can do in WV, however keep in mind the funding is probably not there to do too much more, leave the state, or leave EMS. The latter two are what the majority of the providers in WV end up doing. It is unfortunate WV has a strong EMS education program and is a beautiful...

Telling dispatch to go ahead and take them is fine and probably what I would have done, but once you as a medic are on scene with the patient, it is your patient, especially if your standing orders list hypertension as an ALS ride. If he had told dispatch to have the BLS crew transport before...

You did the right thing, treating a patient on scene is generally acceptable if you can provide definitive care, i.e. anaphylaxis. This is not the case here, keep in mind you stated they had already been given a Calcium Channel Blocker with no change. As far as not letting the BLS crew take...

Makes sense to me. Another good immediate indicator is their skin. Underlying CHF patient's in Crises are almost always cool and soaked with sweat. If the underlying issue is COPD they are usually warm and dry.

You have to treat the COPD/Asthma if there is wheezing or diminished lung sounds. This the more immediate problem to be corrected. It can make the CHF/PE worse by increasing HR, O2 demand, etc. Do a good assessment. If it is obstructive pulmonary in nature about 90% of the time you will find...

Regardless of what your personal beliefs are, part of what we do is comfort patients and families. In some cases it is the most important thing we do. Would I delay treatment to pray with someone, no, but if we have done all we can medically then we are there to take care of the family. So...

I think what can and should be done is very dependent on the situation. For example a patient with Abd trauma should be obviously transported as rapidly as possible to the nearest Trauma Center, but lets consider a patient having an anaphylactic reaction. A paramedic in most locations can...

keep in mind if they did use succs it was not given cleanly IV. It was at best given IM by someone who was fighting. The absorption times and rates would be very different than what we are used to seeing.

The Navy and Marines currently use civilian GS employees, however they are combination Fire/EMS. It is next to impossible to be hired as a EMT unless you are a vet and have all your training on both sides. A medic is another story. There are not many Vet qualified FF/Medics out there so that...

We've been using it for a while. It is not sedating like Promethazine, so it is possible to use it on drunks without as many concerns, but keep in mind if you can remove some of the Alcohol through vomit that may not be bad. I personally like Promethazine better if the patient is already...

Here is a copy of the letter.