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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 Introducing Myself From Canada (:   

    Those are not the conversations that will benefit you the most in your chosen career. Knowledge, leadership, procedural competence and professionalism will forever be the cornerstones of sound practice at any level. The conversations that enrich any or all of those factors will be of the greatest benefit throughout your career. 
    Arctickat said it well. Eventually those one-up-manship stories will be your nightmares. Not because they grossed you out, but because as you age you realize there are human lives attached to said stories.
    Oh and welcome to the city. Hopefully our crusty selves haven't deflated your enthusiasm. Most of us really do still love our jobs.
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  2. rock_shoes added a post in a topic Bad Lungs Bad Transfer   

    Seems everyone is in agreement. We want more information so that we can proceed.
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  3. rock_shoes added a post in a topic Bad Lungs Bad Transfer   

    Let's bump up the FiO2 to 1.0 if it isn't already. Paralyze. Nebulize Ventolin/Atrovent into the vent circuit. Dial her rate back to 12. Looks like she's probably hyper-inflated. Continue with some fluids at this point. Titrate in norepinephrine to a MAP of 70 if necessary. Methylprednisolone 125mg IV.
    What does her EtCO2 waveform look like? Surely they've done some labs on this girl. The chest tubes are in position but are they kinked or otherwise blocked off preventing relief of a pneumo?
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  4. rock_shoes added a post in a topic Bad Lungs Bad Transfer   

    Has the tube buggered up? Are the chest tubes bubbling away like they should or have they gone awry and she's tensioning out? What are the vent settings?
    Short term a fluid challenge and a push pressor while we start getting things sorted would seem reasonable. The only infusing medications you've mentioned are the Fentanyl/Versed. What are they set at?
    Allergies? Meds? PMHx.? History of the precipitating event? Any recent lab values available?
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  5. rock_shoes added a post in a topic Labor Day - what are you doing?   

    Putting the "Labour" in Labour day weekend. Day shift Saturday/Sunday, nights Monday/Tuesday.
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  6. rock_shoes added a post in a topic So I had this weird patient...   

    Was the patient taking his insulin correctly? I know of several IDDM patients who would use the wrong length needle and end up depositing insulin between layers instead of into the subcutaneous layer. As a result the insulin would sit in pockets instead of being properly absorbed at the time of injection. The patient would take increasing amounts of insulin to control their BGL not realizing what was happening. Seemingly at random these "pockets" of insulin would absorb and the patient would end up having profound and sudden drops in BGL.
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  7. 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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  8. 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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  9. 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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  10. 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.
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  11. 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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  12. 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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  13. 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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  14. 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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  15. 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).


    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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