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Arctickat

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Everything posted by Arctickat

  1. The Saskatchewan College of Paramedics has made it very clear to the practitioners in the province that an education seminar must be submitted to and approved by the education committee before each of these new protocol upgrades can be implemented. The College is extremely focused on all practitioners acquiring the proper education prior to engaging in new treatments and procedures. Siffaliss States "One should not be able to give nitro without the ability to first, initiate and monitor/maintain an IV line" The Saskatchewan BLS protocol still requires the provider to call for medical control to provide Nitro to a patient who does not have a prescription. If the patient has a prescription for Nitro, the BLS provider may administer the medication without medical control. Vital signs must be checked after every dose. The reasoning is twofold, if the patient has a prescription for Nitro, he is told to take it when he has chest pain. The patient can not check his BP, nor can he initiate his own IV therapy; therefore, the inability of the BLS provider to initiate an IV is not so relevant. Secondly, the patient is supposed to be in a sitting position when given Nitro, this provides the BLS provider the opportunity to place the patient supine if a drastic drop in blood pressure occurs and the patient loses consciousness. To date, there has been no complication of that severity. That said, I'd like to see IV initiation become part of the PCP scope and I expect it will become fact within the next 2 years.
  2. Trauma lovers and Haters might find this of interest. Trauma News 1 Trauma News 2 Trauma News 3 To save you all time...Trauma sounds like it'll be gone after episode 13.
  3. I have no idea, but I think there should be a $50.00 surcharge for each identical post placed in multiple forums. Edit See what time I placed my original post? See what time I added this edit? That's how long it took for me to google your answer. http://www.yelp.com/biz/kang-david-oan-md-san-jose
  4. Our sensors are 6 inches off the ground but there are also sensors inside the bottom of the door that cause it to open back up if the door comes down onto something that is not tripping the beam. Example, ambulance is parked half out of the garage the bean is intact and the door can close, but will only come down far enough to hit the top of the ambulance and then open again.
  5. The article states that the blue shirts are still available, but are not issued and must be purchased. Why not just buy the blue shirt if one doesn't like the yellow?
  6. I remember about 20 years ago I was driving down the road at about 4:00 am when I saw a 30 foot tall "Tony the Tiger" only pink where he should be orange. He was wearing a top hat and spats whilst carrying a cane and tap dancing across the highway. The sound of gravel hitting the fenders woke me up and I eased my way back onto the road, I woke my partner and made him drive the rest of the way home. As for seeing faces, lights and shadows can make people see many things, all that's needed is the power of suggestion. Remember the "Face rock" on Mars that people claimed as proof that there was once life there? Here's what it really looks like with newer technology and without the shadows. http://apod.nasa.gov/apod/ap060925.html
  7. Nothing drives me battier than to be called to our local hospital to transport a 200 pound 55 year old male who is having an active MI and 9/10 chest pain to the cath lab only to discover that the "pain management" consisted of 2 or 3mg of morphine. First thing I do for the poor guy once he is settled into the ambulance is do drop in 5mg and usually another 5mg 10 minutes later...then another 5mg until that pain is under control. I really don't understand what the issue is that some people have with pain control for the patient. Oh, and we don't need pee tests any more...they have saliva tests for that now.
  8. Deja Vu? Or has this just taken you 4 years to come to grips with? In this case however, the couple was estranged, thus it shouldn't have been a surprise.
  9. I don't know about Swine flu, but the H1N1 Flu Virus can live outside the body on hard surfaces, such as stainless steel and plastic, for up to 48 hours and on soft surfaces, such as cloth, paper, and tissues for less than 8-12 hours; however, it can only infect a person for up to 2-8 hours after being deposited on hard surfaces, and for up to a few minutes after being deposited on soft surfaces. http://www.phac-aspc.gc.ca/alert-alerte/h1n1/faq_rg_h1n1-eng.php
  10. We've been doing Prehospital 12 leads for 8 years, we transmitted them for the first 3 years but after that the docs were comfortable with paramedic interpretation. About 2 years ago we started doing point of care blood tests like these to identify elevated cardiac markers in the prehospital setting and also forwarding those results to the hospital prior to our arrival. Currently we are conducting a pilot study comparing the advantages of tenecteplase in the field to immediate transport to a cardiologist.
  11. I've had good luck with it in all aspects of care, it has a -5cm/H2O demand valve trigger for the spontaneously breathing patient, a nice variety of settings for the ventilator. and as a test I set the CPAP to the highest setting and it uses about 700 litres/hour. I'd have preferred one with separate respiratory rate and tidal volume controls, but there was a cost vs benefit issue in there. I'd have also preferred something a little lower than the 60cm/H2O pressure limit, but it's also not adjustable. 50 would have been my choice.
  12. Man, I wish I would have thought of that. So can I consider that as an endorsement that the ALS is a good machine?
  13. I'm not being facetious, I'm just wondering, was it a ventilator with CPAP capabilities? In my service we use the Carevent ALS+/CPAP http://www.otwo.com/prod_atv.htm Since it is all I've ever used I'd be interested in getting input from others who have an informed opinion.....Vent?
  14. It says in the heading that "We lost one of our own" but the story mentions nothing about a fatality.
  15. That's what I am trying to express though. If etCO2 were mandatory on all intubated patients it would go a long way to confirming and more importantly, monitoring tube placement. I suspect that many cases of those esophageal intubations are actually properly placed tubes which became dislodged following movement.
  16. IMHO the intubation skill is not something that is broken beyond repair. Until something better comes along, endotracheal intubation is still the definitive airway treatment. Perhaps rather than consider abandoning it altogether one should consider adding more opportunities for confirmation of proper placement, etc. For example, all of our LP12s include capnography. It is placed on every one of our intubated patients to continuously monitor respiratory status. As with a suddenly abnormal ECG, first thing you do is check the leads, if a suddenly abnormal etCO2 develops, we check the tube placement. Additional practice on mannequins may not be ideal and access to operating theaters to conduct intubations on real people may be unrealistic in some instances, but I haven't seen anyone yet suggest cadaver training as an option. Many years ago I even had one doctor approach the family immediately following a code to inform them of his death and request permission from them to allow us to practice intubations on their loved one. I was surprised when they didn't rip off his head, but rather, allowed us to each take turns dropping a couple of tubes. Many people dedicate their bodies to science or education, these are who should be sought out. In short, practice makes perfect. Higher success rates are a result of experience and tools are available to maintain confidence following tube placement. Use of these tools and opportunities for practice should be considered.
  17. I know, I'm resurrecting a semi-dead thread, but that's what we do, right? Just wondering, has anyone seen or used the Res-Q-Scope? I'm considering adding this to my airway kits and some experienced input would be nice.
  18. I've put them into my transfer units, the 911 response units still have the old MX-Pro because they are 80 pounds lighter to go up and down stairs with. Given time my staff may decide the convenience is worth the added weight. Recently Saskatchewan EMS services got a grant for "recruitment and retention" Applications could go as high as $70,000.00 Most services applied for and received a grant for the power cots. One health region bought 28 of them.
  19. Arctickat

    Angry

    Okay, I really don't know if people are not bothering to read my entire post or being deliberately obtuse and antagonistic. I thought it was pretty clear. I don't give credence to anonymous complaints in that I will not accept them as true and discipline an employee based on them alone. I thought that was pretty clear in my second paragraph. I look into them, I'll review the applicable video if it exists. (my units have patient and dash cams) I ask about them, and if the employee fesses up, then I act on it. But I will not ever put a black mark on an employee`s record simply because some ex girlfriend is trying to start some trouble to make his life difficult.
  20. Arctickat

    Angry

    Where is the attack in that? I see what I stated to be no worse that Herbie's comment. Regardless, I've given all the advice I can to this thread. Nothing left to add. I'll be sure not to defend myself to further attacks to avoid sullying your thread.
  21. Arctickat

    Angry

    I'm sorry that you are unable to understand a post which includes a qualifier. I will try to dumb it down for you in the future.
  22. oooo, thanks, I've been watching for more Wii Fit compatible games and could only find the Jillian Michaels one, and it's only compatible with the board and not the software which keeps track of time and such. Does EA sports intergrate with the Wii fit software?
  23. Arctickat

    Angry

    Anonymous complaints are worthless. As a high level manager I see them often, and I will not give them credence. If the complainant is too much of a coward to take responsibility for his accusations then I will not do anything to followup on the incident. I've even told this to people who have phoned me up to complain. The very first question I ask is their name. If they do not provide it I tell them that they are unlikely to see any satisfaction from their complaint because anyone can make false anonymous accusations without fear of repercussion. If they are willing to give their name so I am able to follow up with them, it's a different story and I take it very seriously. Either way, I do follow up on all complaints. If anonymous I tell the target of the complaint about it and ask if there is anything to it. Sometimes they admit that something may have happened, other times they deny it. I do not put anonymous complaints on the record. The only time I might ever consider an anonymous complaint to be valid is when I get inundated with them regarding the same incident. So, in your case, if you're going to make an anonymous complaint, make several. Make them via different media as well, phone call, letters, etc. That might get some attention.
  24. Shrug, I just do the Wii fit workouts. I complete the entire Yoga and the entire strength training in about 90 minutes. Once in a while I'll do the aerobic workout too. Call me a geek, but I have been getting more toned and lost weight. I think it's because I can't eat junk food while i work out for 90 minutes a day.
  25. Nope, never. Although there have been a couple of times I've had to break up a fight after our arrival at the hospital. Also, the police here, although slow to arrive at times, are always willing to help.
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