AZCEP

Very capable in their area of expertise perhaps, but that is poorly translated to the civilian world.

Are you saying that the chief doesn't REALLY deserve it?

Thank goodness for union protected jobs. :shock:

You asked for someone to put it in writing. You did not specify who needed to do this so that you would be better able to do your job. I never said, nor implied, that they did. I'm willing to bet, however, that most of your current protocols are based on the recommendations from American Heart, right? The fact that you are not allowed to terminate resuscitation based on this recommendation and a medical control consultation seems rather piece-mealed together. Perhaps the providers in your area should consider bringing this up, rather than just accepting it at face value. Your safety, if nothing else, should push you to ask why you can't terminate resucitative efforts instead of transporting the obviously dead.

I hope your pleased spenac.

American Heart already did. The recommendation is to perform 20 minutes of adequate resuscitation, to include vascular access and airway management with appropriate drug administration. IF there is no response the suggestion to terminate efforts is made.

http://www.medscape.com/viewarticle/555229...&uac=4700ER Stimulant Abuse May Increase Stroke Among Young Adults There you go Dust. That should appease you for now.

I'd like to see DOT/NHTSA/DHS/DHHS or whomever is holding the leash at the federal level this week to mandate a change in how resources are allocated. It makes no sense to have urban centers with short transport times oversaturated with ALS providers that don't get enough exposure to calls when the rural areas try to make due with a BLS crew. Move some of the urban providers into the rural setting where they will actually make a difference. Probably a discussion for another thread, but it just came to mind again. :roll:

Hey, what do you know? I didn't think I'd live to see the day that the FDA put out something that acutally made sense. Way to go Feds! :roll:

What happens when these "fast-tracked" providers decide they don't want to work in a rural environment? There isn't a shortage of urban medics, and there isn't enough pay to keep experienced providers out of the cities. It is a good thought, but it sounds like it wasn't quite thought all the way through. :roll:

At an MCI, you could still park them side by side. You'd just have to make sure that everyone had their doors open. Move the patient through however many ambulances until they get to the one on the end with their door closed. Sounds sort of Wile E. Coyote, but it could be done.

This is an extremely insightful statement spenac. Thank you for that. Does the phrase "No student left behind" ring a bell for anyone? Students don't have to work to achieve anything all through their elementary/secondary education then enter the professional world only to find that they won't be "given" the same breaks. This leads rapidly to students complaining to administrators, which in turn leads to problems for the instructors that expect more from their students. It is pandemic in the entire educational system.

They are, at their base, giving you the same information. If you've taken PHTLS, you might consider giving the ITLS version a try. There are some differences, but mostly from a presentation stand point. ITLS comes from ACEP, or emergency physicians. PHTLS comes from ACS, or surgeons. This is the only real difference between them. The instructors will make more of a difference than the information.

Why would I take offense from an RN/EMT-I. Honestly, this is one of the reasons I don't participate in education nearly as much as I would like to anymore. The students come in thinking they will leave with a course completion card without proving they understand the material. Between the LCD regulation and the inability of students to want to work, "no student left behind" has created an untenable situation trying to educate these people.

Reread the answers you got if this is what you really think. Each and every one of them stipulated that the memory aid is garbage without knowing the anatomy and physiology of what you are looking at. Move past wanting a memory aid that will not help you understand what is going on. Just because your service doesn't use 12 leads doesn't mean that you should not learn how to read them. After all, you may decide to go somewhere that exects more from their providers.

This isn't really new, just since the 2005 guidelines were published before this could be included. Two minutes of uninterrupted compressions prior to ventilation for unwitnessed arrest, or if there is any delay applying the defibrillator. ACLS recommends performing compressions while doing other interventions whenever possible. IVs, medication administration, intubation-if possible, while compressions are underway. Two minutes of compressions, then rhythm check, decision making, and continue.

This acronym is garbage. It doesn't relate the information to what you are trying to remember at all. Think of the individual electrodes as cameras, and decide which portion is being viewed by the direction the camera is looking. My god, is it really this difficult to understand where the anatomy and physiology come into play? :shock:

Ah, hell.

Excellent point. Not to go all spelling Nazi on you, but it is AMIODARONE, not amNiodarone. Procainamide is still the drug of choice for stable VT. It doesn't get much press because, like lidocaine, it has been around a long time and most people don't even consider it anymore.

This is because there is actually very little education time spent teaching doctors or nurses how to perform this task. Paramedics and EMTs are exposed to cardiac emergencies almost daily from the beginning of their training. Could the foul ups come from having so many people available to help that everyone loses track of their assigned tasks? Just a thought.

DM is not an opiate in the true sense of the term. It does not come from, nor bear the same chemical makeup of true opiates. It will bind to narcotic receptor sites, but it is poorly antagonized by naloxone/nalmefene/naltrexone. It is reasonable to try some of your available antagonist, just don't expect it to work very well.

More reading needs to be done on the few studies that claimed that amiodarone was more effective. 1. Because they were driven by the manufacturer, the articles that got amiodarone placed in the 2000 guidelines were at best suspect in accuracy. 2. Amiodarone has been shown to have more patients survive to hospital admission, but no more survive to hospital discharge. The parameters for this are suspect as well, as the definitions are poorly adhered to, or non-existant. 3. Long term survival for both agents is identical. Amiodarone has more deleterious side effects, and lidocaine is more commonly mis-dosed. At one years time, no patients survived no matter which antidysrythmic was used. 4. The use of research to guide practice is evidence based practice. Your description of the use of lidocaine seems to suggest that you are discussing anectdotal evidence, not true evidence based recommendations.

Which is easier, to open a vial and withdraw the medication or screw together a prefilled syringe? How exactly is it "bull"? I disagree with following protocols by rote, but faster is faster regardless of which drug you are using. You need to take your own advice on this one. In the doses used for cardiac arrest the alpha effects predominate. Beta effects are more useful for someone needing smooth muscle relaxation, not cardiac stimulation. Here again, take your own advice. Vasopressin has no alpha effects. That is a sympathetic nervous system receptor site that will not respond to an anterior pituitary hormone. Vasopressin has it's own receptors which chbare already discussed. Every dose of epinephrine and vasopressin are used as pressors. You will get the same response from the two drugs no matter how many times you give them.

Upton, you have restored a bit of my faith. Thank you for that. I would suggest that you take it easy on the use of the tired cliche, but on the whole a quality post. Take a nap and clear some of the cobwebs.

Looks like an engineering design study rather than anything that could actually be used. Very rare are the occasions when you can manage an airway from the side of the patient. I suppose it would be an impetus to purchase more high dollar equipment, but why would someone do that? It is a neat idea, just not very practical.