AmboGuy

As I read these wonderful answers, I worked in Queensland as a paramedic, where if it gets below 10 deg C, (50F) the poor blighters have to put on a jumper (pullover) Now, right now, working as a rig medic (and bored shirtless) the first thing I thought about, what keeps the back of the MTC (industrial first aid unit) warm (well not frozen) so as freezables (remember guys and girls, defib pads and burn gels freeze too) don't have to be thrown away, 110v little fan heaters. If your in this situation, you should have fire on site, what does every fireie have, a generator, great, heat source, and electricity (when I get my own ambulance, I will get maybe one of those quiet Honda genny's to save a bunch of money idling all day. Anyway, back to topic, someone else said you wouldn't want them in some situations (overturned etc) We are medics, why are we medics, we can think outside the box (unless your agency/service don't trust you and make you consult for a sneeze), we are thinkers. We have different backgrounds or day jobs, so before you fall asleep, what about..... You all (assume) have seen the flexible foil lined hoses that vent your clothes dryer or bathroom (dunny) exhaust.... See where I am going!! Cover the heater if outside on ground in frigid conditions (to help that air heat up) using your hose that you have modified to fit snugly over your heater, say 3m or ten odd feet, you now have a flexible heat source to leave near pt's feet, or near exposed body parts, just my trivial thought. Guy Oh, Queensland is in Australia, right now, northern Alberta, if you guys down south don't know where it is, go to the USA border, if you see Mexican flags, turn around

Content. As long as BP remained above 100, you could give 1 tablet or spray q5 on scene, to a max of three on scene doses, then 1 spray/ tablet q10 en route, indefinitely as Long as not contra indicated (BP below 100), but if the BP dropped, well it was oxygen only, though the ami guideline didn't say you couldn't use Entonox, you are caught because they must receive high flow oxygen, making it's use a problem, though Entonox benefits are many. Cautions Qld; reduced LOC, alcohol intixification, pts unable to understand/comprehend instructions, aero medical Evac. British Columbia; depressant drugs, maxillo-facial injuries, COPD (COAD in oz, nz) distended abdomen, shock. Contra indications Qld; chest injury/pneumothorax, air embolism/the bends, scuba dive last 24 hours, bowel obstruction. BC; inability to ventilate an enclosed treatment area*, inability to comply with instructions, suspected inhalation injury, suspected air embolism/pneumothorax, pt has taken nitro in last 5 mins, decompression sickness. *north American ambulances have a pt care compartment vent system so paramedics Including those driving, don't get stoned, those of you in aust/nz that have input to ambulance design please note this and implement changes!!! Guy Entonox

As an advanced care paramedic from Queensland, and previously qualified as a PCP in British Columbia, I can relate to both Penthrane and Entonox, as I have used both. Penthrane is for those who don't know, an inhaled analgesic, but highly addictive, in Australia, there are limits to it's use on patients - contra "hx liver kidney or liver disease, known severe reaction, more than one previous dose in the past four weeks for the same condition", you can fit two doses and the "whistle" in a shirt pocket, ideal for remote access, not having to carry a cylinder in with you!!, in saying this, and people seeing the Australian "surviver" episode where a member suffered burns, and was treated with methoxyflurane (Penthrane), but wiki Penthrane and you will soon see that it may never be used in North America, regardless of it's proven use pre hospital. Entonox in Australia is used in all states and territories from volunteer (I was a volunteer in South Australia (St John Ambulance Service (not brigade, we were the ambulance service)), and Tasmanian Ambulance Service, right through to ALS (yes ALS still have a use for it) I have used it extensively for abdo pain (with bowel sounds) fractures, excellent on little old ladies with #nof, in B.C (and probably other areas of Canada) it is included in the chest pain protocol to continue analgesia (not to mention calming) of the chest pain patient until nitro can be resumed. In Queensland this was not practiced but I think it maybe should be!!, but as long as the BP was