celticcare

We use Fentynal here in the CCU if the serum creatinine is unstable for Morphine as the Morphine will damage the kidneys, so I would take that into account before I gave pain relief. I know there isnt a mobile lab out there in the field yet, but check into your patients history whether there is renal impairment before pushing morphine if you have fentynal as a substitute. Just my two cents and just thought I would add it. Scotty

CCU RN here and yeah, we treat like the site says, assess the heamodynamics, if conscious and tolerating then go down the chemical lines, if unconscious and able to sync, then sync, if unconscious and pulseless then get the lunchbox of life and zap the crap out of them. Polymorphic *TDP* is Magnesiums best buddy and those two will get along swimmingly , go down that path before electrical therapy. But yes Anthony you are correct, it is a play on words as such. Sedate and defibrillate. Hey that rhymes. But only if the chemical cardioversion hasnt worked or other measures. Scotty

Waaaaa my big little brother forgot about me :'(

I am not endorsed by Laerdal, I am saying this of my own free will, the MRX will not only shock, pace, sync, 12 lead, sp02 and bp your patient, if you order now, you will get the deluxe model, that will think for you, act for you and even tell you where to have lunch. THanks Laerdal, you saved my ass Laerdal MRX, because more cables = more fun for you as a crew. Scotty

"Puts on my best Dustdevil face and puffs my chest" *GRUNT* OOOOO YEAH BRING IT ON Seriously, I'd do it just to give it a go. you'll all fix me? Right? Right? Guys?

GO LAERDAL MRX Hehehehehehehe

Crap well anyone that knows me will know that Pink Floyd is the band that speaks all about me, but which album to pick????? Ok three albums that defined my life - Dark Side of the Moon - The pinicles of life and death, wealth, insanity and fitting in with society as a whole, emcompassed my entry into Health Care. War of the Worlds - Jeff Wayne - Galiant struggle, the chances of anything coming from mars are a million to one he said, and hey imagine responding to the track of "The eve of the war" playing hehehe. Queens Greatest hits Volume One - From Bohemian Rhapsody to Flash through to we will rock you and of course, fat bottomed girls, every song can represent an element of either an emotion I have gone through, a liking of mine or even a disliking of mine. Good music from an ultimate great band. Lol old school I know, but hey, those would be three I would love to have as part of defining my life and me Scotty

Back to original topic before we got sidetracked with wild and kinky forms of anal pleasures and stimulations, IM Glucagon is a basic skill here (national cert in ambulance) and these providers are not IV providers so if the patient is Diabetic, displays a diabetic coma, hypoglycemic, then you grab that needle and shove it in their muscle. Plain and simple. Hopefully an Intermediate care officer *paramedic* is on their way or an advanced paramedic is on their way to start an IV to give back up dextrose if needed, but I've seen it give fast results and then you replenish the supplies with a carb and some more sugar and transport for evaluation. Its not a case of money, a medical transfer to a facility here is roughly 75 dollars and as long as you are a resident at least, then the health care is free, so there isnt a case of making money its a basic fact of treatment. But lets get off the topic of stroking egos, lubing et tubes to become AP tubes *anal path tubes* and focus on the topic, is giving dextrose without an IV in situ a good idea or not? Scotty

If it delivers the electrical therapy, then that is all that is needed

In general essesnce, and yes I know there are exceptions to every rule when it comes to the services here in New Zealand, the minimum to ride a truck solo is often national certificate of ambulance, which includes basic ECG interpretation. All the emergency trucks have either a lifepak manual defib or moving more now to the MRX units. The Patient transport service have Heartstart AEDS in their trucks. Many fire appliances now have AEDS on them with a major amount being Lifepak units with a few now changing to the Laerdal Heartstart units. I cant imagine a truck without an AED at least its like sending a fire truck with no hose. You don't have it, murpheys law you will need it. Scotty

I am sitting here, in bed at 0330, just finished playing sober driver for everyone, dealt with enough drunks and vomiting twits to last the rest of the season, just wanted to wish everyone a Happy New Year from the first Country to see the sun on the new year in 2 hours. I intend to actually be sleeping at this time. hehehe. Lets all make 2009 a year of surprises, learning, support and advancement of our field, our teams and ourselves, show pride, show love and show compassion, we can all do it, lets make 2009 a year to remember. Til the setting of the first sun, shall forth come, the dawning of a new tide. Love and best wishes to my EMS family. Scotty

*Somone has to say it* Sure its from the flashlight Richard B

*steps out of the shower* BUSTED :oops: :oops: :oops: :oops: :oops: :oops: :oops:

We covered the use of the bougie in my ACLS course in September for work *CCU RN*. We carry one on each resus trolley in CCU and when practicing on the manikins *and yes before you old farts in here who have to have your two cents worth, I know a manikin is different from a patient blah bloody blah* the bougie made intubation ten times easier than the laryngascope and tube on its own. I have to go with P3 though, if you can see the cords, why double handle, shove the tube in, inflate and away you go. if its going to be a difficult one, then get the bougie but if you can see it, then shove it in. To quote the great Uncy Lone "Any holes a goal". Scotty

Hey there gang, I subscribe to the online e-letter of the heart.org and saw this article, thought you might like a read. Scotty [web:f98444d79f]http://www.theheart.org/viewArticle.do?primaryKey=916147[/web:f98444d79f]

Terri, just come out and admit it...... WE'RE HAVING TWINS!!!!!

*Rubs his tummy and starts crying* IM PREGNANT!!!!!!! Medic Texas seduced me with his cute eyes and southern charm, telling me that he would be the one to check my pulse all over, then gave me some jesus juice and asked me to be his womb. :'( How am I going to survive as a solo father? :'(

Guess it also leaves it open for the bad guys to resort to oral or anal rape then if they know they are gonna get spiked on the johnson for going in the front entrance :S

*shudders* I am making sure the women that I work with don't read this thread, there are enough man haters out there. And there was a comment in the original article - this isnt applicable in a gang rape situation. That is true the prospect can take one for the team while the senior gang members get their jollies. And yes majority of sexual assaults and rapes occur in a persons own home, and imagine it as a mood killer when a girl pulls a guy she likes in a club, "oh sorry hunny I have to pull the rape device out of my v jay/...... hunny hunny where are you going?"

Hehehehe Dust would probably say "With his boot" Sums it up hehehe

I have used the Laerdal unit and like it for predominatly most laerdal systems are interchangeable with their line of resusci manikins. So it can function as a stand alone simulator or be incorporated with a manikin for full ACLS training options. If purchasing a laerdal product, you can also ascess a variety of online resources to update and upgrade your unit constantly. I have heard of the symbio corp unit but not had the chance to use it yet. Would be keen to hear more though Scotty

Whilst sitting at work at 0130 hrs, I am reading this and thinking yes it is a tough one to toss up, whether do a 12 lead or not. Couple things do spring to mind - Has the service just received 12 lead capability and has to justify having 12 lead monitors to the bosses or are the bosses being anal about wanting to show off new toys? With more and more refered pain and patients placing their bodies under strain due to secondary sources such as drugs, stress, alcohol etc, perhaps routine 12 lead is going to be the plan of attack for patients. Remember roughly 80 % of women dont show or exhibit signs of chest pain during MI or other cardiac events so I always ear on the side of caution with gastro and back complaints. I do see routine 12 leads being done in the near future almost as common as 3 leads. Kinda watch this space eh.

With the Heartstart FR2+ there is the 3 lead attachment module that slips into where the pads would go, yes I know this is for a public access aed setup, but imagine having the capability if somone of higher medical training saw something on scene, ie an MI or anything and if there was an AED, with the ability for 3 lead if possible, would be better than nothing. Its just a thought, please don't go hating lol. Scotty

There is a service set up with St John here that is the caring caller service and from what I have heard *unofficially* that patients who are the ones that need babysitting etc *I love the term duke hehe* are referred to it and a person rings each day to see how they are and have those chats, that way they are still having contact with an emergency service aspect of care but then they are hearing that friendly voice of someone that wants to chat and help solve the worlds problems. This will be interesting in years to come with paramedic practitioners making their mark and impression in society. Scotty : )