hammerpcp

I'm too dumb to do anything else.

:shock: The fact that you even have to say most of these things astounds me. I am also very worried about the state of EMS where ever you are from.

I'm with you buddy. It is clearly (to me anyway) a parody.

So, Lidocaine is a sodium channel blocker and an antiarrhythmic, right? And we give sodium bicarbonate to tricyclic antidepressant overdose to unblock the sodium channels, are you still with me? So TCA is a sodium channel blocker, yet it causes lethal arrhythmias and that is why it is so dangerous if an OD is taken. So like WTF? What am I missing here? Why does one Na+ channel blocker prevent dysrrhythmia (usually) and the other causes them?

So like, four minutes have passed and where's the fire department?

Did you read those articles?

That is the funniest hting I have ever heard! LMAO! Ten points for Bushy.

Ha ha! You are so full of sh it.

:love4: :love5: :love7: :love1: You all laugh, but I have picked up a pigeon and a seagull in the ambulance. Little did the pt who we subsequently picked up know that there was a bird in the garbage can all bundled up in sheets. Also, I have been called to a "pedestrian struck" and it turned out to be a four legged pedestrian who had been struck. We were cancelled prior to pt contact. I agree that it would be silly to have EMS look after peoples pets. It just wouldn't work. However, don't be mistaken, this is not because human life is more valuable then non-human. Dog CPR: Femoral pulse check-no pulse-compressions on left side of chest. Ratio of 15:2, compressions:ventilations. I think the new guidelines are coming out soon though..."Push harder Push faster"

Can we talk about this a bit? By what mechanism does atropine potentially worsen the myocardial infarction? I found this so far. EDIT: And this. EDIT 2: And this....... EDIT 3: This is a good article. It recommends anteroposterior placement for TCP and it suggests that if capture is not obtained pads should be moved (page 4). If that doesn't work they should be replaced. Did you try any of that? Also, the second column on page two near the top addresses the atropine issue again. Did you have a twelve lead on this pt?

Yep.

He wasn't talking to you Nsmedic393. So like, why not Atropine?

Good point. Very good point. That phrase means to me that my partner should have O2 on a pt he is treating with Nitro and has on the monitor and has an IV initiated on. It's just a reminder not to forget the basics. O2 is still the standard of care even if it doesn't actually do anything.

Atrial fibrillation isn't always irregular. A rate of over 150 for V-tach is usually the number the monitors use to defibrillate. They will not shock at a rate under that, however it is possible that the pt still has a pulse above that. Thats why we check for a pulse (do we still do that?). Maybe that is why they've gotten you all so hung up on that number. :dontknow: It sure does look like V-tach to me.

It's starting to make a little more sense to me now. Thanks Azcep. I will continue to read up on it though, because even all this does not satisfy me as far as why it is contraindicated for peds in our protocols. Perhaps they think we are too dumb to try other options first? I don't know.

Wimp.

What does that mean?

You are crazy! and cute!

God damn that common sense...... Article in the Globe and Mail Hard at work in Nova Scotia? Let's do lunch Government encourages its public servants to go out for a full hour, hoping to feed productivity, SHAWNA RICHER writes SHAWNA RICHER HALIFAX -- Getting in touch with employees of the Nova Scotia government might be difficult these days if you're trying to catch them over the lunch hour. There's an excellent chance they won't be at their desks. Unlike most North Americans -- a recent U.S. study suggests 75 per cent of workers eat at their desks at least three times a week -- public servants are trying to take an hour lunch break out of the office most days. It sounds rebellious in this workaholic age, but they are just following orders. And employers in other provinces and outside Canada are taking notice. Borrowing from a similar project started at the University of Toronto several years ago, the N.S. government wants its 10,000 employees to leave their desks at lunch -- to eat, exercise, run errands, even power nap -- in hopes of making people more productive in the afternoons. To drive the point home, the N.S. Public Service Commission sent out postcards proclaiming, "Take back the lunch break" with orders to "relax, refocus, refresh, re-energize." The project, which cost about $5,000, is part of a healthy-workplace campaign based not on scientific data but rather employee surveys and a good amount of common sense. "We all know from our private lives that when you have a chance to take a regular break while you're working it helps make you more alert and productive," said Human Resources Minister Ernie Fage. "We've taken a pro-active approach to promote not just good nutrition but being more active. It's important to take that time, get that break and clear your head. Everyone benefits." Lunch as a meal has long been fodder for big thoughts. "Ask not what you can do for your country. Ask what's for lunch," said the husky Hollywood icon Orson Welles. "Lunch is for wimps," Michael Douglas as Gordon Gekko barked in the 1987 film Wall Street. And former U.S. president Ronald Reagan quipped, "I never drink coffee at lunch. I find it keeps me awake for the afternoon." The "three-martini lunch" gained popularity in the seventies as a way of gentlemen doing business. The concept was famously condemned by Jimmy Carter during the 1976 U.S. presidential campaign on the basis that inequitable tax laws allowed boozy lunches to be written off as a business expense. In response, his opponent Gerald Ford called the practice "the epitome of American efficiency." Only the relaxation part of such a lunch-hour activity was what Myra Lefkowitz had in mind several years ago when she thought to reclaim the lunch break at the University of Toronto. "Even though the Employment Standards Act provides everyone with the right to take lunch nobody really does it," said the university's manager of health and well-being services. "We wanted [the campaign] to speak to the institution, management and employees. It wasn't something over which individuals would have to fight or feel guilty or deal with the critical gaze of their colleagues as they went and did something we used to all do. "We know that in the long run, if people don't pace themselves they run into things like burnout and stress leave -- the results of people not paying attention to themselves and their needs during the day." Michelle Lucas has worked in communications for the N.S. government since 2001, currently for the Department of Human Resources. Like many of her colleagues, she habitually worked through lunch, grabbing something at her desk, hoping for a tasty sandwich tray at meetings or forgetting to eat at all. "I rarely took a lunch break," she said. "I can think of days where I was driving home and I realized I hadn't eaten and I was just famished. "So many people go steady through the day and don't take breaks for themselves. We see it all the time. It's just what you do. But it's not good. A nutrition or activity break or even running errands makes you feel less stressed in the afternoon." Several studies have suggested that a simple 10-minute walk at lunch can provide a two-hour burst of energy through the afternoon. Nova Scotia has already heard from other provinces interested in adopting the quirky campaign. Officials in Texas and London, England, have also made inquiries. Since the program was quietly announced in the spring, Mr. Fage, never "a lunch guy," makes an effort to stop for a healthy meal or a brisk walk in downtown Halifax. He hopes to see the idea catch on with private companies. Leslie Beck, Globe columnist and nutritionist, said lunch is as important to health as breakfast. She lamented a corporate culture that has ruined workers' sense of entitlement to a midday respite. "People feel guilty for taking lunch," she said. "I talk to so many people for whom it's not part of their office culture. If their boss doesn't do it, they won't either. There's a real guilt thing going on. "But it's been four hours or maybe five since breakfast. Your blood sugar is low. People who don't eat lunch get far too hungry and eat more later." Nova Scotia isn't measuring the results of the program. There is no lunch-break attendance taken, though Ms. Lucas chuckled that at the beginning, some employees e-mailed Human Resources to inform they had indeed gone for lunch. "We're not being prescriptive," she said. "No one is telling anyone else what to do. It's an awareness campaign. But it brings something out in the open that we all used to do and have gotten away from. Hopefully it will go a long way to bringing back healthy habits."

PFFFTTTTT. Azcep, Thanks teach. So, more questions.....if the parasympathetic NS is poorly developed (namely the vagus nerve) why would there be a sudden increase in vagal tone during intubation? I wouldn't expect a poorly developed system to not have much effect under any circumstances. Also i wonder why they often give atropine to peds in hospital but it is contraindicated prehospital (as Lithium mentioned)? Any ideas? Another question (I'll allow that this may be a dumb one), but stay with me here. So Atropine is a parasympatholytic, meaning it blocks the parasympathetic nervous system (effects on the heart at least), which means that the sympathetic nervous system can then exert its effect uninhibited or unchallenged. This leads to an increase in heart rate (hopefully). So a pediatric pt experiencing bradycardia- that can not be corrected with proper or improved oxygenation- who has a poorly developed PNS in the first place should be more effected by a blocking of the PNS. No? Is any one else confused? 8-[

Why?

Does Lithium know he is toxic? Maybe someone should warn him.

Dopamine? What would we do without ERDoc to cut and paste for us?

You aren't wrong. By default you must be right! As far as sedation goes, I don't believe we carry anything that would be appropriate for this pt given her vital signs, namely midazolam, morphine, or valium. What do you think? Also since she already has a decreased LOC sedation is not of paramount importance. Why not try some atropine first?

That's not very nice.