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Things we teach in EMS that are wrong


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Three of the non paralytic (I've never done a paralyzed intubation) intubations that I've done were on exhausted geriatrics.

The person that taught me to nasally intubate explained about nasally intubating exhausted elderly where transport times were longer and assisted vents wasn't likely to be the best option that, "Often you'll get the tube and they'll fall asleep as soon as they feel you breathing for them."

And it happened exactly that way. Some panic at the time of intubation, a shocked/relieved look when they could feel me breathing for them, then almost immediately they'd fall asleep.

Maybe I did them just because I could, but it certainly appeared that it was a very kind thing to do as well as a verifiably supportive measure physiologically.

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Hyperoxygenation of head injury patients is beneficial

Doing fracture management without analgesia is appropriate

OPAs and King tubes can be inserted on responsive patients without pharmacological intervention

An NPA inserted on a head injured patient creates a high risk of the NPA entering the brain

You can 'tell' by looking who is having a heart attack and who isn't

Response times are the gold standard marker for a system's performance

People who are unconscious yet maintaining an airway need to have advance airways placed

EMTs save paramedics

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  • 1 year later...

That oxygen is harmless and is a cure-all That pulse oximetry is evil and should not be used when giving oxygen because you just throw on an NRB@15. That BLS providers cannot give medication, but can only "assist" That you do ABC instead on CAB for your primary in an unresponsive pt. That a 1 day HCP cpr class means everyone is a BVM jedi that will never fail or have a difficult bag mask ventilation pt. And due to this failure of ventilation never occuring, that BLS providers can't safely drop in a king-LT in an apenic GCS 3 pt. And that king-LT's should only be used in a code. That training BLS providers on what vital signs ACTUALLY tell them is taboo and evil... Physiology and pathophysiology education is evil... Oh wait, sadly these are still issues w bls in Ontario.

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That oxygen is harmless and is a cure-all

That pulse oximetry is evil and should not be used when giving oxygen because you just throw on an NRB@15.

That BLS providers cannot give medication, but can only "assist"

That you do ABC instead on CAB for your primary in an unresponsive pt.

That a 1 day HCP cpr class means everyone is a BVM jedi that will never fail or have a difficult bag mask ventilation pt.

And due to this failure of ventilation never occuring, that BLS providers can't safely drop in a king-LT in an apenic GCS 3 pt.

And that king-LT's should only be used in a code.

That training BLS providers on what vital signs ACTUALLY tell them is taboo and evil...

Physiology and pathophysiology education is evil...

Oh wait, sadly these are still issues w bls in Ontario.

I was going to say, I wasn't taught any of this.
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-Some patients are too critical for pain management.

-The time saved by emergency traffic is clinically beneficial.

I don't know about these Bieber? I might have missed some past conversations on this, but what pain management procedures are good for patients in a state of shock?

I also don't know how we'd survive without lights/sirens in Los Angeles. For my local fire station it takes about 15+ minutes to cross some 2-block stretches... lights/sirens can cut down a transport time from 45+ minutes to under 10 minutes in a number of areas (more in some specific areas)....no speeding involved either..

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