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rock_shoes

Elite Members
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About rock_shoes

  • Rank
    Alta. EMT-P/BC ACP
  • Birthday 04/27/1984

Previous Fields

  • Occupation Alta. EMT-P/BC ACP

Contact Methods

  • Website URL http://
  • ICQ 0

Profile Information

  • Gender Male
  • Location British Columbia
  • Interests Paramedicine, Climbing (rock,ice,alpine), Mountain Biking, Photography, Music

rock_shoes's Activity

  1. rock_shoes added a post in a topic Narcan at the EMT level.   


    Anecdotally I can say I've only ever had to sedate one overdose patient after administering naloxone in the last 7 1/2 years. As we later discovered this particular patient had a long standing history of violent/aggressive behaviour directed toward LEOs and Paramedics.
    In my own experience the key to preventing violence and aggression with these patients is to correct hypoxia prior to bringing them up. This however does beg the question as to whether or not a lay person should be administering naloxone. Lay people won't be providing ventilation or oxygen prior to administration.
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  2. rock_shoes added a post in a topic WANT TO START A AMBULANCE COMPANY IN NYC   

    Why are you yelling at everyone? All caps is the forum equivalent of yelling.
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  3. rock_shoes added a post in a topic What is the dumbest question anyone has asked you?   

    Oh we all know the dumbest question people ask.  "What's the worst thing you've ever seen/had to deal with?"
    My usual response is that they don't want to know.
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  4. rock_shoes added a post in a topic Passing of Island EMT - Member   

    We lose too many too early. If it isn't shift work related or worsened illness it's PTSD. You will be missed Island. I knew you only through your contributions here, but based on what I've read over the years I'm certain your passing has left a giant hole in the hearts of your loved ones.
    Your shift has ended. Just leave us the keys mate. We'll take it from here.
    Ed
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  5. rock_shoes added a post in a topic Safe vehicle operation...   

    Since when is it acceptable to just rip through an intersection on a red light without clearing it first? Either the ambulance in question had a brake failure or the driver was an idiot.
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  6. rock_shoes added a post in a topic Mobile Stroke Ambulance   

    I expect the Edmonton unit may have more of a positive effect than some of the other similar units because of the deployment plan. AHS plans to send this unit to intercept potential hot strokes coming in from rural areas which could make the difference for a number of patients (two units travelling toward each other at 100km/hr would equate to one unit running toward the stroke centre at 200km/hr).
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  7. rock_shoes added a post in a topic Aviation Practicum   

    I can't speak for other programs but CAMATA was included in my ACP program at SAIT. I suspect the best thing would be to approach the local schools directly and offer the ride along/practicum space for students on final practicum. Perhaps it could be an additional two tours/blocks at the end of a successful students practicum?
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  8. rock_shoes added a post in a topic EPI in Cardiac Arrest - study   

    Intuitively the reported results make sense. In my own experience with enough epi and bicarb you can get ROSC out of a rock. That doesn't mean the person will have survival to discharge.

    At this point it appears that epi is more beneficial than harmful in cardiac arrest. I would expect the next logical step regarding epi will be dosage determination. Is 1mg IV q 3-5 minutes the ideal dose? Should it be more? Less? An infusion instead of bolus dosing?
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  9. rock_shoes added a post in a topic Aviation Practicum   

    If you're starting entirely from scratch I would suggest finding a CAMATA course to put your people through. The course is fairly old and certainly due for an update but it's the best primer I know of without putting them through a full Critical Care Paramedic program (The 1-2 year Canadian version of the CCP I mean).

    http://www.camata.ca/educationoverview.htm

    A lot of it will come down to the basics. Teach Loading/unloading using whatever system the aircraft is equipped with; flight physiology and how you can expect it to affect you and your patients. Racking equipment for the flight environment; Modified patient assessment for the flight environment. It doesn't sound like you'll be flying any vented patients so that should make things a little easier. If you're flying psych patients BC actually has a fair amount of experience with this and a well developed sedation policy. It's a policy that has come under some heat over the years but is strongly backed by a record of zero patient harm incidents.
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  10. rock_shoes added a post in a topic Thoughts on this? Uber style Narcan delivery!   

    Island I am sorry for your loss. Preventing the drugs from ever landing on home soil is certainly a valid avenue to try and prevent addiction all together. I was speaking in reference to treatment cost reduction for those who are already addicted. Sent from my SM-G900W8 using Tapatalk
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  11. rock_shoes added a post in a topic Thoughts on this? Uber style Narcan delivery!   



    "Supervised shooting galleries" as you refer to them do not really assist anyone in getting off drugs. What safe injection sites do is reduce the amount these people drain out of the public system (remember Canada, and in fact most of the developed world, has some form of publicly funded health care). Safe injection sites reduce 911 responses for overdose, they reduce infection due to the sharing of dirty needles, and for a very small number they provide access to rehab facilities.

    From a study in Quebec looking at the cost of caring for septic patients (a frequently occurring malady amongst the IVDU population). "The mean cost for all patients abstracted was $11,474 per episode of care ($1,064/day). The survivors had a mean cost for their treatment of $16,228 per episode of care ($877/day). The total cost per episode was $7,584 per nonsurvivor ($1,724/day). An average cost of $27,481 for survivors after day 28 through 1 year was calculated. The burden of severe sepsis was estimated to be $36.4 to $72.9 million per year, but higher if costs beyond day 28 are included."

    http://www.ncbi.nlm.nih.gov/pubmed/12040548

    From the CDC regarding the cost of HIV treatment "The most recent published estimate of lifetime HIV treatment costs was $367,134 (in 2009 dollars; $379,668 in 2010 dollars)."

    http://www.cdc.gov/hiv/prevention/ongoing/costeffectiveness/

    In a country with a publicly funded hospital system the tax paying public is on the hook for Sepsis and HIV treatment cost. In the end I don't support safe injection sites because I think they help people get off the drugs. I support safe injection sites because I'm a responsible tax payer who likes seeing the impact of junkies on the public purse reduced as much as ethically possible.
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  12. rock_shoes added a post in a topic I think I'm a........gasp......whacker!   

    I salute your inner whacker!

    You however are a very rare form of whacker. You are the nearly extinct productive whacker who uses his powers of whackerism for the betterment of human kind.
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  13. rock_shoes added a post in a topic Handheld Ultrasound   


    Assuming of course your Paramedic crew has sufficient A&P knowledge and the willingness to learn the FAST system.
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  14. rock_shoes added a post in a topic job offer need some advice   


    That would be my question.
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  15. rock_shoes added a post in a topic resQCPR FDA Approval   


    Bingo. I participated in this study. The ITD was of no benefit and actually had slightly worse ROSC rates in absolute numbers (not statistically significant).
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