akroeze

Ah crap, another place to add to the "Do Not Visit" list

On a side note I wonder what the canine dosing scheme is. If it is the same weight based formula for humans or not

Kudos to them!

They covered themselves even by having the vet consult over the phone.... so now they weren't practicing veterinary medicine without a liscence since it was delegated to them.

Etomidate 0.3 mg/kg IV up to 40mg. Wait 60 seconds, and if insufficient, give the rest of the 40 mg you didn't use with the first dose. Combining agents will get you good results. 0.3 mg/kg of etomidate along with 10 mg of versed or 200 mcg of fentanyl will do quite well. If you don't carry etomidate, 10 mg versed and 200 of fentanyl. If you don't carry fentanyl, versed 10mg and 5mg of morphine. Haldol is another one to consider as an adjunct, particularly if the patient is hypotensive and you don't have a lot to work with for drugs. The above combinations are likely to result in an inability to protect the airway. That's good for tubing, but not good if you can't get the tube.

But I've been able to tube a lot of folks with just 40 mg of Etomidate.

The above does not include adjuncts such as atropine, lidocaine, or LTA lidocaine. And it's assuming you don't have ketamine, propofol, or methohexital. And the doses mentioned are for adults.

'zilla

Thanks for that post Doc! Out of everything you listed my only choice would be Versed/Fentanyl but its good to finally see some clear numbers on recommended dosing.

Wow you must be really enjoying that trust factor in your relationship!!! I often work with the opposite sex overnight and can honestly say my partner has never been in the least bit concerned.. Talk to your wife about having a little trust!

Quoted for truth

As a side note, AHA is scheduled to come out with new guidelines in Dec 2009.

Are there any "leaked previews" of what is to come?

I really wish they would let us carry Mag Sulfate at all...

What, no pool? That's rough man.

I doubt it. From what I understand ALS in BC is nearly non-existent. And I doubt they'd allow out of province ACPs to practice there to fill in the gaps.

So now I shouldn't consider Alberta OR BC? My options keep shrinking!

No AB or BC

NB, the territories and NF (I think) don't have ALS.

Not many options left.

What is it with all these EMS problems happening at the same time?? Is this economy related or just coincidence?

Actually a BIG and replacement needles for the EZ IO are about the same, EZ IO maybe higher, so you will never recoup cost of start up. But you will have less chance of failure so might recoup in not as many failures by improperly used BIGs.

Ok so initial startup cost greater but not for ongoing operation. Except when you consider that EACH BIG is a stand alone device so it is much more versatile in that regard.

What is the cost difference?

I'm thinking start up is going to be more for the EZ as you have to buy a bunch of drills. Assuming the needles are cheaper than a BIG, how many EZ insertions would one have to do in order to have saved money over the BIG?

I know it isn't all about whats cheapest, but lets be honest... it factors in.

I haven't met an ER nurse who would pull an IO. They would always leave that decision up to the doc.

So much for Canadians superior education in medicine... or maybe it is just their pre-hospital educations that are better.

One study in one area != all of Canada

Just saying.

Driver fail

I'll be man enough to admit that I might have treated that patient incorrectly. Obviously I don't know for sure what I would have done but salvos of V-tach was my thought process.

I would consider NB except in reading the ANB website they don't seem to have ACPs in their system.

Ok follow up question. To those who have responded thank you very much for your input, I have several options open to me and right now if I don't get a job I'm looking at: AB, NS, BC as my short list (plus going out of country). What kind of time frame are we looking at? I keep hearing April 1st. Is it a case of "all will be revealed" on that date? Or is that just the first day in a long process of finding out what will really happen?

I'm albeit late replying, but wow, 18 days?? My class was 3 days a week for 4 hours a day, for 3 months, and we all thought that was fast!!!

Which would be 8 hours a day for 18 days straight. Not that hard to do really and same amount of hours.

So what does this all mean for me as a jobless ACP who may be looking at a province such as yours to find one? Is this situation to MY benefit or is this a situation where I should wait for the dust to settle?

Can't view the main article

Where was this study done? That's a great survival to discharge.

which is exactly why I'm considering working as an emt-i for a while before continuing.

Don't do it. Get your Paramedic ASAP. There is no benefit and lots of potential negatives to "getting some experience" first.

Not impressed....

Really: Not impressed.

Far to expensive, doesn't seem like making anything better what I hate about the LP12.

We currently use the LP12 and I hate it.

In my part time job we use an Corpuls 3 (http://www.corpuls.com/en/konzept-concept.html.

I lov this one....Simply gives everything I need and the "divert it to parts with bluetooth" Idea works great.

I love the concept of that!

What is today's date?

Technically the Pi moment is March 14 @ 1:59am and 26 seconds.

That having been said most people think of Pi as 3.14 therefore the entire day is known as Pi day.

I tend to take the view that this further cements the relationship between doctors and EMS which shouldn't have to be there in the first place. This will make it even harder to become an independent profession with our own scope of practice if we have a group who has their own agenda for keeping it under their domain.