Airmedic999

I diagree...there are examples worlwide of paramedics who perform intercostal drainage. Here,. in UK there is a new critical care paramedic course and the general feel is thatthey may be trained in drain insertion.

I think we have all been driven crazy by the diaphoretic patient who cannot hold onto his ECG electrodes for long enough to get a trace - makes me scream sometimes. Alcohol swabs are useful,however, at the end of the day if they dont want to stay on...they just wont :roll: :wink:

We have always given it IM, however, we also give it IV from time to time incrementally ...

I tend to look at conscious level, neurological signs, BP, HR and rhythym(AF in particular),heart murmurs, peripheral pulses and signs of infection.Taking into consideration that 85% of CVA comes from ischaemia..i.e embolic event or artherothrombotic occlusion...MI and failure etc

I have done PEPP and APLS ...... there seemed to be a greater emphasis on skill tuition and examination in APLS, however, that said, PEPP made me think a bit more about the whole picture that wass occurring......

I think bougies are underused the world over in pre - hospital care. We should all bougie on down as it is certainly a technique that can get you out of serious trouble now and again.

Dunno if it is or was ever AF...far too regular. starts off by the looks of it over 150 with narrow complex tacy i.e SVT and then progresses to multiple ectopy in bigeminal rhythym. QRS complexes are regular in amongst the bigemini are they not?

I have all but stopped using Lidocaine now and use Amiodarone for refractory VF/VT and narrow and wide complex symptomatic tacycardias. Seem to have somewhat better results mananging the symptomatic arrythmias with Amiodarone than with Lidocaine...

Anybody who thinks tramadol isn't an effective analgesic simply isn't taking enough of it! :twisted:

I use Tramadol sometimes. Does not seem like a bad drug on the whole. The main probs are the fact that in the UK it's not licenced for paeds and needs good anti - emetic cover

I gave her 7.5mg IM protocol is 5-15mg (could not get a line) I did not want to totally snow her. It worked well. we also carry demeroll, fentanyl

but protocol is longer than 20 min transport time go with morph.

Interesting that you use Fentanyl in over there. Nice drug with few side effects. I presume you give the fentanyl for anything less than 20 minutes journey to emergency department...i.e. they will be needing more analgesia when they arrive or shortly thereafter. What is your max amount - presumably up to about 100mcg is it?