Arctickat

Why do we use a verb for aggressively grabbing something to describe someone who is having a seizure? To Seize is to grab something. To Seizure is an active convulsion due to illness or trauma. I have actually had doctors confused when I stated the patient was seizing because their interpretation of the word was that the patient was grabbing for stuff. Now we use "Seizuring" to avoid further confusion.

The four point box is a fantastic back exercise. I used to always tweak my back until I started doing these. Here is what it looks like: http://jennfit.ca/blog/four-point-box-exercise/ Try to hold the pose for 15 seconds at a time, then switch sides.

I've been a firefighter, and I've been a paramedic, and solely a paramedic for over 30 years now. No complaints here. I seriously can't understand how being moved off an ambulance and onto a fire truck could be considered a promotion.

Only once, and many years ago so I read up on it. There are a lot of research articles on it dating back over 50 years.

Highest BGL I have ever seen occurred last night. 75.8. More than double my previous high.

Around here you can't swing a dead cat without hitting someone who has a Narcan kit. Firefighters, Police, mental health, family members of known addicts, as well as the addicts themselves, are given the kits. Typically for free. Nasal administration and viola, get outta dead free card.

http://www.cbc.ca/news/canada/saskatoon/passersby-save-children-yellow-quill-1.4169445 http://www.cbc.ca/news/canada/saskatoon/boy-who-died-in-rollover-near-yellow-quill-heralded-as-hero-1.4171141 http://www.cbc.ca/news/canada/saskatoon/3-year-old-girl-fishing-lake-first-nation-dies-collision-1.4175949 I put this in LODD because of the second story. He died saving the lives of those he loved. He has the soul of a medic in my books and at his wake I made sure his family knew that.

Chuckle. Welcome Jackie.

Beta Blockers are a NorEpi and Epi antagonist, and typically target Beta-1 receptors, so BBs are actually designed to prevent those two drugs from working. However, with NorEpi, some BBs actually trigger the receptor while blocking the NorEpi. This would result in a possible increase in the heart rate as well and given the situation, a slight increase in the heart rate may be beneficial. Epi has alpha and beta effects, however, the beta blocker prevents vasodilation, also, Epi has to be administered at higher concentrations to have Alpha receptor activation. At these higher doses, without Beta-1 stimulation, the vasoconstriction from the Epi could result in uncontrolled BP increase and worsening pulmonary edema. Both of them have similar Beta-2 effects, which may also improve oxygenation. Although they both have a short half life, NorEpi is about 1/3 shorter and will wear off quicker if it needs to be d/c and is, therefore, more forgiving. Dopamine wasn't given consideration because we don't carry it in the ambulance. Studies have indicated better outcomes with NorEpi.

Why would CPAP be contraindicated? I know it increases intrathoracic pressures and reduced preload, but in this particular case, that could be a good thing. Sounds to me like he's in shock as a result of acute hypoxemia secondary to the CHF. The Digoxin will prevent any compensatory tachycardia. CPAP would have been my goto as I did an IV NS bolus and prepped a Norepi infusion in the event that CPAP was not sufficient in reducing respiratory workload and improving the hypoxia.

Do mine Mike, Do mine!!!!

"Transport to the nearest APPROPRIATE medical facility" If they can be treated at a UC, do they need to go to the ED even if it is nearer? I think our protocol is a cut and paste of almost every other protocol out there. "Transport to the nearest APPROPRIATE medical facility, bearing in mind that the nearest appropriate facility may be more distant than others nearby" People have interpreted that to mean that we are to bypass the local hospital in favour of more advanced care at a cath lab or a trauma centre, however, I look at it both ways. If my patient doesn't need the services of that Level I Trauma centre two blocks away...I'll take him to that UC ten blocks away. I don't think it's a matter of "can we" Mike, but "Why don't we when we already have a protocol in place for it?" Maybe, back in the day, transporting to a lower level of care wasn't the spirit of the protocol when it was first devised, but then, your founding fathers never considered the possibility of easy to conceal automatic weapons when they wrote the Second Amendment either.

Why not? Isn't that what we've been supposed to do for decades? We already treat and release in the home. "Transport to the nearest APPROPRIATE medical facility" Why does that have to be an ER? We transport to nursing stations rather than hospitals on a routine basis. Many communities have a primary health centre rather than a hospital, and often the ambulance transports to the nursing centre.

Want a copy of my profit/loss statement?

If you've been in this job long enough.... We had a 1981 Chevy low roof van, had a main cot, portable cot mounted on the squad bench, and a hanging cot that hung above the squad bench. I'm pretty sure I uploaded a picture of the cot hangars in here some time ago. Ahhh, the good old days.