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I have typically used Zofran and had good success. We do carry Reglan as a backup as well. In the ER setting, I've had great success with Phenergan.

Cardiology of a Rhythm, huh? Sounds like the class I took at OCEMS with a certain older medic? He liked my paper on Ashmann's Phenomenon, quite interesting too. If you need any help, let me know

Good Morning, All While I only bounce on and off these boards occasionally on my free time, I have something that might be of interest to you all. I run an online newspaper covering the State of Michigan, all with citizen contributed news and columns. I had a random nurse from the Detroit Area begin writing a column. I had never met this person, but as a Paramedic, I was quickly impressed by their thoughts on the most everyday situations. So impressed, in fact, that I figured I would share it with you. The entry I'm posting the link to is entitled "Live and Let Die (or I'll haunt you" and it deals with the reality of end-of-life decisions, something we can all appreciate. Feel free to ignore, but this was too good not to share with the EMS community. Live and Let Die EDIT: I may have accidentally placed this in the wrong category. If so, feel free to move as needed. My apologies

Hi Tiffany, and welcome to the City! My name is Chris, I'm from Mount Pleasant (about three hours away) and I work as a Paramedic. I am also majoring in Psychology, and have a black belt in Kuk Sool-Hap Ki Do. If there is any way I can help you, or you just want to say hi, I'm around Good luck in your EMT course!

I've heard this both ways and was wondering if anyone could help me.. Would there be a difference in the sugar of a blood sample from the capillaries (finger stick) or from a vein (flash chamber)? If the blood had already been through the body and back, would the sugar not be depleted?

I graduated from my Paramedic program a week before my 20th birthday, receiving my license at 20. The new employee process for my company was exactly the same for me as it would have been for a 30 year old new medic, with the same goal of being placed in charge of an ALS unit.

Do I feel I have anywhere near the experience needed to act in a role of a supervisor? no... of course not... But I don't think that is because of my age, I think that is because I have only been in EMS for two years. If someone got into EMS at age 40, I don't think they're going to be ready for a supervisor role by the time they hit 42...

After completing the standard FTO Time, I am paired with an EMT-Basic, and we run calls as a two-person team. My age has made no difference in how I have been treated within our company.

I am 20 years old, and working as a Paramedic in a busy ALS service.

I'll be there both days! Looking forward to it

Ruff, Is there a name for this type of seizure? I wouldn't fall under grand or petit mal, so how would they be classified?

No evidence of drugs anywhere nearby... slept last night, didn't go anywhere the day before... awakens as if being startled... reminded me of a tired driver... starts to slip, then quickly comes back when they realize they're falling asleep

B/P 114/78, RR 16 N/L, BLG 119 mg/dl, Sinus Tach at 106, eyes look slightly glazed over, coherent and able to answer questions but literally falling asleep while she is talking... No medical history, other than being a "borderline diabetic." NKA, no medications

Dispatched to a 17 y/o female, unresponsive. Arrive on scene about 4 minutes later to find patient seated in a chair. Per patient and family, patient was doing her makeup in the bathroom and passed out. Patient is sitting in a chair now, conscious, but nodding off repeatedly, even in the middle of speaking. What do you want to know/what do you want to do?

A question for those of you working on ground-based ALS services out there. Do any of you carry Cardizem? Is the type you carry powdered, pre-mixed, etc? Does it need to be refrigerated? Do you have a protocol for a maintenance drip? Thanks!

What books are you using? If you're using the Principles and Practice 5 Volume Set, I'd be willing to part with them for far cheaper than you'd pay for a new set...

My response is a bit late, but thank you all... your responses were extremely helpful

I was reading in a book that it is not recommended to use adenosine to treat re-entry tachycardias such as WPW or LGL syndromes. Could someone please help clarify why it is not recommended, and what the recommended treatment is (Cardiovert, CCB, etc.) Thanks in advance for your help

Thanks for that, Doczilla... Somehow my mind overlooked that, not sure what I was thinking..

My suggestion is to use NEXUS criteria in clearing ANY trauma patient from SMR. You can find more information here: http://www.fieldmedics.com/articles/the_nexus_study.htm

Thank you all for your help

Hey Everyone I was reading on some arrhythmias, and couldn't find the answer to this online or in any books... How do you differentiate between SVT, Atrial Tachycardia, and MAT? I'm confused by this, and having trouble understanding. Thanks, Chris

Has anyone ever headed up/participated in any EMS-based field research? I see so much research in medicine from the AMA, AOA, etc. and I see none from EMS, and I would like to change that... Any ideas for topics, methods, etc? If any of you have any, please either reply or PM me.

Well, here's the way I do it. Dispatched by (Phone, pager, 911, etc) to _____. Arrived on scene to find patient ____. Patient has history of____. Assessment findings as follows: (of if there is a separate assessment section of the report, I use "Assessment findings as shown above") HEENT - (with this list, include things that are present, as well as relevant things not present (example: in a trauma, there might not be tenderness, so don't leave it blank, put "no tenderness on palpation". This indicates that yes, you did check, and found nothing.) Neck - Chest - Abd/Pelvis - Extremities - Neuro - Psych - ROS normal unless otherwise specirfied. On scene, _____. Moved to ambulance (how) Transport (what happened? Hospital contacted? orders?) Care transferred to ______ in room _____ of _____ hospital. Example: Dispatched by 911 to an 86 year old male fall victim. Arrived on scene met by **** First Responders. Per First Responders, patient was found supine on floor and backboarded. Per wife, patient has history of falls in the past, as well as CHF and dementia. Patient states that he tripped, fell and struck his head, denies any other pain. Assessment reveals: HEENT - Pupils equal, round and reactive. Skin pink, warm, and dry. Tenderness noted on occipital portion of cranium, skin intact with mild contusion noted. Neck - No tenderness on palpation. Patient denies pain. No JVD or TD noted. Range of movement exam deferred due to immobilization. Chest/Back - Patient denies any tenderness in chest or back on palpation or difficulty breathing. Chest wall shows to be intact. Lungs clear and equal bilaterally. Heart tones present grade 3 murmur over aortic valve. Extremities - Good, strong distal pulses in all Extremities. No deformity or pain noted. No pedal edema found. Abd/Pelvis - Abdomen shows to be soft with no masses, tenderness, or bruising. Pelvis stable and nontender. Psych - Patient alert, oriented to person, place, and event. Confused as to time. Wife states that this is normal for his condition. Neuro - Patient denies any numbness or tingling. Good sensation throughout body and Extremities. Good deep tendon reflexes, full neuro exam reports no deficit. ROS Normal unless otherwise specified. Patient secured to backboard by spider straps by First Responders. Patient lifted onto cot and secured by straps, moved to ambulance. **** Hospital contacted en route, spoke to *** RN, no orders received. Transported priority 3. Oxygen applied en route at 2 LPM via nasal cannula per protocol. Transport uneventful. Patient care transferred to *** RN in *** Hospital, Room 3. This is all assuming that there is a separate section for vitals as well. Hope this helps.

Touch of Life - Robert Fulford