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Arctickat last won the day on January 11

Arctickat had the most liked content!

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About Arctickat

  • Birthday 07/09/1967

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  • Location
    Kelvington, Sask
  • Interests
    SCUBA, Flying

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35,362 profile views
  1. Paramedic vs. Firefighter/Paramedic

    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.
  2. CHF & Low BP

    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.

    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.
  4. City of Ottawa Firefighter

    Chuckle. Welcome Jackie.
  5. CHF & Low BP

    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.
  6. CHF & Low BP

    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.
  7. Transporting to an urgent care

    "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.
  8. Transporting to an urgent care

    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.
  9. 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.
  10. For child restraint systems we have the pedi-mate from Ferno, but that's only for short distance emerg calls. We keep certified child and infant car seats at the base for IFT.
  11. Or their patients. CPR is much more effective when you aren't bounced around.
  12. Diagnostic Narcan

    We used to call that the "Coma Cocktail"
  13. Jobs as a medic

    Industrial paramedics work at remote industrial sites, often in the oil patch or construction sites.
  14. EMTB