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Kn.ght1 last won the day on May 28 2013

Kn.ght1 had the most liked content!

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  1. The settings are very restrictive they go as such: 20RR/0.200 (200 ml) 15 RR/0.400 (400ml) 12RR/0.650 (650ml) 12RR/0.900 (900ml) 12RR/1.10 (1100ml) So the respiratory rate is restricted to a certain tidal volume. If you want to ventilate your patient 20bpm you can only give them 200ml then. PEEP has to be added. If you look up careVent by Otwo they are quite similar. Here's a link to vent world for the careVent it has some information that I believe is similar to the Genesis. The vent itself looks identical to the genesis except for colour. http://www.ventworld.com/equipment/ProdBooth.asp?ProdId=3862
  2. Hello, This is a equipment questions as well as a patient care questions. Currently on my paramedic practicum and they carry a Genesis II ventilator. We had a one day 2hr session on ventilators in class so my knowledge is basic and I only understand basic setup. I want to become comfortable with utilizing the genesis but I'm unable to find any literature even product manuals for this unit. Does anyone have any resources for me? Or know where I can find them? Second questions, based on the 6-8ml/kg ARDS protocol and the ideal body weight formula the 5 setting are restrictive to patient 25kg-35kg, 50kg-65kg, 80kg-105kg and 130kg and up. Is it appropriate for the in between weights to round the tidal volumes up? Or down? If to round down would PEEP need to be increased? Would this change anything from 5-10 mm H2O? I want to do the best to avoid volutrauma and causing atelectasis for my patients. On top of all of that we only carry ETCO2 so the ventilator will be titrated to those values. What would be safer for these patients with in between weights, to BVM them during transport? Thanks
  3. Hi All! I had a interesting discussion with my paramedic partner while on shift. I brought up a study about endotracheal intubation and that our protocols here are be coming more restrictive about when paramedic are allowed to intubate. She mentioned that there is more and more evidence showing that intubation increase mortality by 20% in most patients. She said that studies are showing the King LT are just as effective in maintaining a airway. I've read a couple studies that showed the disadvantages to intubation during a cardiac event and that a King LT was just as effective. Other that not being able to deep suction a patient what does the endotracheal intubation have that King LT don't in the prehospital setting? Especially since there has been questions into the number of attempts it takes some paramedics to acquire a successful tube. Will ET tubes eventually be replaced by King LT's in the prehospital settings? What situations would a ET tube still be the golden standard in the field? kn.ght1
  4. Kn.ght1

    Deep Breath

    Hello! Easy Question! I'm feeling frustrated. Working were I do our service mostly responds to trauma, overdoses and alcohol related incidents. When we respond to medical calls it usually catches me off guard! The other day we responded to a SOB call. On arrival the patient was sitting at the kitchen table with a NRB on with 10LPM running as there was first repsonders on scene. During my first impression I was thinking for sure a NEB, then during my assessment of the patients air entry I didn't find any wheezes. The patient wasn't able to taken deep breaths due to feeling restricted but I was able to hear quiet, clear air entry, or so I thought. We moved the patient into the ambulance and by time we got there (which was only 2min from the house to the ambulance) she had audible wheezes. I'm feeling mildly frustrated about not starting a NEB in the house, I feel like I completely missed the wheezes and patient treatment. How can I improve recognizing different auscultated lung sounds? Would you have started a NEB in the house? I've looked up online a couple of audio clips but going over them with a couple of my paramedic partners they seem to have different diagnoses than what the sites are saying. Any suggestions on good reliable audio clip sites? Also my partner is saying that most people use rhonchi and wheezes interchangeably what do you guys think? Any suggestions would be greatly appreciated. Kn.ght1
  5. Multiple iTclamps would probably be used on a patient with a wound like that. Here is the article about the clamp being used on a scalp wound. If a wound somewhere so vascular could be controlled I don't see why using 2 or more clamps wouldn't be beneficial on a non-linear wound. http://www.edmontonjournal.com/Trauma+clamp+used+first+patient+will+Edmonton+ambulances+within+weeks/8431423/story.html
  6. Thanks Dwayne, There was a article in our city newspaper that has the iTclamp coming onto our ambulances in the next couple months. Apprently one was used by a rural ambulance and they had great success. When I complete the training I will post more about it! Kn.ght1
  7. So about 6months ago I cut out a article out of the newspaper about this cool new piece of equipment coming out called the iTClamp. Its pretty simple with how it works and I can see it being effective in hemorrage control! Anyways I thought i'd share it with you guys. Has anyone seen this on car yet?? I posted the video below. Kn.ght1 http://www.innovativetraumacare.com/
  8. Answered my own question! Obviously I shouldn't be researching at 2am! http://www.ncbi.nlm.nih.gov/pubmed/11869586
  9. What about a pt who has a spinal cord injury that affects the their ability to control body temperature? Also what about a pt with a TBI? There in study showing just as in MI therapeutic hypothermia has its benefits in TBI. Dwayne- Thanks, it's somewhat the best movies out there!
  10. I believe my friend was mistaken as well. I just wanted to see if there anything to it. Also it helped me break the ice and put up a topic thanks everyone! Kn.ght1
  11. Ok here is my first topic go easy I have two questions. The other day a fellow EMT and I were talking about trauma patients. I told him about the trauma triangle of death. Hypothermia, coagulopathy and acidosis. He mention that he read a article about hypothermia being a good thing for trauma patients. Does anyone know more about this? I've done some reading but no articles show hypothermia being good for trauma patients. Any thoughts on keeping our trauma patients warm or not? In the process of looking for hypothermia in trauma I came across hypothermia therapy for MI. I've read a couple articles positive outcomes for randomized patients. Is there anything we can do as ems providers to start the HT process? Or be aware of when dealing with acute MI? Kn.ght1
  12. Kn.ght1

    Hi there!

    Thanks everyone:) Raysofsunshine just be open to learning and to keep your work atmosphere positive! Kn.ght1
  13. Kn.ght1

    Hi there!

    Hello Everyone! I'm a EMT from Alberta. I've just started to take true interest in bettering myself as a EMT. So I thought I'd start here! I've now worked just over a year on a ALS unit in Alberta and am already kneen on going back to school for my paramedics. I've read a few out the topics and am already using the google machine like a madman. I'm excited to fill up my time with EMTcity Chao for now:) Kn.ght1
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