I may look into one when they can be ordered again. I tried to convince work to buy them but no luck there.I got myself an Ops-Core SOTR since i am Gucci. Being able to plug in the microphone to my helmet is actually a huge perk tho. Trying to communicate in a helicopter with N95s is pretty useless.
the 100% directionless thread
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DesertMedic66
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Have you guys really been having issues with comms while wearing N95s? That hasn’t been an issue for us so far.
CALEMT
The Other Guy/ Paramaybe?
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I got myself an Ops-Core SOTR since i am Gucci. Being able to plug in the microphone to my helmet is actually a huge perk tho. Trying to communicate in a helicopter with N95s is pretty useless.
Yeah you would be the guy who owns a FAST helmet...
Then again I own a TW EXFIL (non-ballisitc unfortunately).
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I just bought the facepiece/hood. It's compatible with the PAPR units we have at work. The system we use, not including any headpiece, runs about $1,000 per kit. The kit includes the blower, battery, hose, filter (replaceable/disposable), and charger for a battery. Extra batteries run about $300/each and have about an 8 hour runtime. The helmet is also compatible with supplied air systems IF you have the right adapter kit. This is one of 3M's Versaflo system components.
So, yeah, expensive, but if you're doing woodworking, metal grinding, or really anything with LOTS of dust potential, and you're going to be doing it for hours at a time, these systems are awesome. I got mine because my nose was just getting chewed up by our N95 masks if I had to wear one for more than a couple hours at a time.
In this current time, they say COVID19 appropriate PPE includes a surgical mask UNLESS something occurs that will create aersolized particles, such as intubation, swabbing the oro/nasopharynx, the patient coughs or sneezes, or is getting a neb treatment. I'll wear this when I initially get any suspicious patient as I'll do at least one of those things that will cause aerosols (usually swabs) while doing my initial assessment and such. I want to minimize the number of times I go into those rooms.
DragonClaw
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How often are LP15s wrong? I'm not sure if it's the stress of transport or a regular increase because the machine does it, but I feel like the BP runs a false higher number (not crazy high).
How often is it completely wrong?
Is it true a BP isn't that accurate when taken in a moving vehicle?
Pt has a BP of like 130/80. Took it again about 15 minutes later and it was like 50/33. That can't be right. Wouldn't someone pass out with that BP (or be close to death?). She was on hospice DNR, but *relatively* stable. No apparent change in impression. Took it again a few minutes later and it was fine.
Once could be a fluke, no trend on a sudden drop in BP. But what would cause that?
HR, sats, resps were fine.
How often is it completely wrong?
Is it true a BP isn't that accurate when taken in a moving vehicle?
Pt has a BP of like 130/80. Took it again about 15 minutes later and it was like 50/33. That can't be right. Wouldn't someone pass out with that BP (or be close to death?). She was on hospice DNR, but *relatively* stable. No apparent change in impression. Took it again a few minutes later and it was fine.
Once could be a fluke, no trend on a sudden drop in BP. But what would cause that?
HR, sats, resps were fine.
DragonClaw
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Me for a few solid minutes
Never trust an auto BP. When in doubt get a manual/palp/dopler pressure.
DragonClaw
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DesertMedic66
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They can be accurate at times but they can also be very inaccurate at times, as with any NiBP. A lot of people will say it is good practice to get your first blood pressure manually and then use the NiBP afterwards.
In any case if the NiBP gives you a value that doesn’t seem right for one reason or another it is best to verify it manually.
There are several reasons why it may give you an inaccurate reading including: patient movement, incorrect cuff size, movement of the NiBP tubing, cardiac rhythm, patient condition, and others
The NiBP also does not record a normal BP like we do when we are auscultating one. It is not looking for the SBP and DBP. They use an oscillometric technique.
An accurate reading can be taken while moving but it is definitely more difficult. You will learn to time some of your assessments and treatments on stoplights/stop signs and certain roads.
Using a doppler machine to obtain a blood pressure or more specifically using a Doppler to obtain a MAP. This is very useful for LVAD patients.
DragonClaw
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a *what* technique...
I do that when possible. Some areas the potholes are as big as mosquitos, and as prolific, so it doesn't matter where you go you're doomed to be in a space shuttle on re-entry
I doubt I'm going to see such a machine that I've never heard of before in this operation. I've never even seen an LVAD. I'll look into it just to be more familiar with it though. (I know what an LVAD is. I meant the doppler machine)
Once had a pt with a mechanical mitral valve though. That was cool to ascultate.
DesertMedic66
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LVADs are slowly being seen more and more in the EMS setting. None of our local hospitals are LVAD centers so when they get an LVAD patient in they will contact the facility that placed it and 9/10 times they will request the patient be flown to them. When I was on the ground full time I never had an LVAD patient however I have had over a dozen while flying.
DragonClaw
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The hospital I'm at most is one. Per this LVAD something website about approved Heartmate centers or something from a quick Google. But LVAD probably requires a 12 lead so as a usual double basic I'm probably not going to see it.
DragonClaw
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DesertMedic66
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It all really depends on what the issue is and why the patient is being transferred. My last LVAD patient could have gone by ground. It was a nosebleed. Local ED contacted LVAD center for guidance on what they could do as far as stopping or reversing the patients anticoagulants. LVAD center said “just fly the patient to us and we will take care of it”. Patient was extremely stable with no complaints.
DragonClaw
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But my medical directors be like
"Narcan is an advanced skill."
I doubt they'd let us treat an LVAD pt.
DragonClaw
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This doppler thing looks like it came out of the 60s. 
Is it a gold standard still? Will it be around for awhile, should it be?
It looks like it belongs next to a manual defibrillator (which I'm dying to learn)
With the BP, you use gel for some increased wavelength travel thing I assume? Seems like not a good choice for an ambulance short travel as one would need to be still to not mess up the reading?
Is it a gold standard still? Will it be around for awhile, should it be?
It looks like it belongs next to a manual defibrillator (which I'm dying to learn)
With the BP, you use gel for some increased wavelength travel thing I assume? Seems like not a good choice for an ambulance short travel as one would need to be still to not mess up the reading?
This doppler thing looks like it came out of the 60s.
Is it a gold standard still? Will it be around for awhile, should it be?
It looks like it belongs next to a manual defibrillator (which I'm dying to learn)
With the BP, you use gel for some increased wavelength travel thing I assume? Seems like not a good choice for an ambulance short travel as one would need to be still to not mess up the reading?
While a lot of medicine changes constantly, a good exam doesn’t. Many of the old school clinicians actually perform a much better exam than those fresh out of school.
Did you know that you can identify and isolate fractures with a tuning fork?
Doppler is still used quite a bit across multiple care areas. It can be used to find peripheral pulses in patients with peripheral vascular disease.
Doppler is the cardio portion of cardiotocography, and is how we check for fetal heart rate without ultrasound.
As a bit of ED cowboy medicine we will often hold a doppler over the femoral or carotid artery after ROSC and until we can place an A line so that we can hear if our pulses are deminishing and have a quicker feed back mechanism that we are about to code again.
I doubt most street buses carry one. I can use my phone and butterfly as one so I always have it as a tool at my disposal.
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I'm going to put some responses in line...
I havent worn an N95 yet but my partner wears a mask on everything, even if he is just going to check the aircraft in the morning.
I cant hear anything he says unless he pushes his mic to his face (likely breaking the seal on his N95), but he is also 67 years old and generally sucks with any technology.
NomadicMedic
I know a guy who knows a guy.
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The air fryer is the best thing we ever bought for the kitchen.