akroeze
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Everything posted by akroeze
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Where is this? I think I've asked you this before but can't remember. I just want to confirm I have this right. You have bases throughout the region designed for 8:59 response that are staffed by 24hr trucks. If one of those trucks get a call then there are 12 hour trucks that slide over to that station to provide coverage? So in other words the 12 hour trucks could be jumping from station to station all shift?
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Do you have equal criticism for those who claim DL to be the holy grail when it fails and an alternative is successful? If not, why not?
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We only carried 30mg Morphine and 300mcg Fentanyl
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I don't believe Paracetamol (Acetaminophen) is available in North America in intravenous form.
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Out of curiosity do you still have physicians delegating tasks to you? In other words, are you allowed to give all treatments and medications under your license or do you need a doc to have signed a piece of paper somewhere for you to do it?
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You carry 100mg of Morphine? :shock:
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Out of curiosity is intubation a skill that all physicians, regardless of specialty, should be competent in? In other words, should it be one of those things that are minimum standard? Sort of like BP, lung auscultation, that kind of thing you should expect that any doctor regardless of their specialty would be able to do.
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Same here too
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Only every used the MAD. Incidentally, all seizure patients I've ever managed at the ALS level have always been treated IN. I'm not going in on a seizing patient with a sharp and risking a needle stick when I have a safe route that is effective.
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Are your protocols online somewhere?
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Holy crap, that's a lot of Fentanyl. Any 'up to' on it?
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Just doing some reading and it seems that 5mg Versed would be a reasonable amount for an adult to sedate to intubate. Does 10mg Valium translate well as they are roughly equivalent?
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Ok on the topic of Drug Assisted Intubation without paralytics.... I have Valium and Versed, Morphine and Fentanyl. What kind of doses/combinations do people use? I have seen a wide range of dosing schemes. I only wonder because although I don't have a standing order for DAI, I could probably get permission from a doc to do it if needed via patch and I would kinda like to know what kind of doses to be asking for.
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Do you guys have that much Benzo in your protocol or is that something you have to call for? Also, what is your protocol for mixing valium and midaz? I usually see it as an either or thing, not both.
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You ask many questions comrade.... many questions indeed.
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This is interesting to hear a different view on this. I have ALWAYS been taught to get a glucose reading before you initiate seizure management. In fact in my protocols it is mandatory and if they are hypoglycemic I have to treat that BEFORE I consider benzos.
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Personally I would always always check blood sugar before treating a seizure. Other than that it seems reasonable. Have the NPA ready though as this patient is going to be very out of it after 5mg Versed.
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So the last ACLS guidelines came out 5 years after the ones before them. Are we in store for new guidelines yet again next year? Anyone in the know on what kind of time line we're looking at?
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I appreciate your response Doc and tend to agree with what you have said. May I ask a follow up question of you then? Where do you weigh in in the "house next door to the ER" scenario? Should these people be transported too? I guess what I'm trying to get at is where do people draw the line on what is acceptable to run into the ER and what is acceptable to work in the field?
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What happened to the concept that it is more appropriate for us to work a patient on scene?
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Did anyone here get training in what to do for a situation like this? I honestly can't remember it if I did...
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So where do you draw the line? If you are at a residence right next door to the ER do you work it on scene and call it or do you load and go? How far away do you have to be? I'm not questioning if you work it or not, I'm questioning HOW you would work it.
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To clarify people this isn't a scenario, this is an open ended question. If there are various answers, give me examples of when you would treat in the truck and examples of when you would book it into the resus room.
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EMS should NOT be based on economic gains! We are an essential service and emergencies happen 24/7 therefore crews should be ready to respond 24/7.
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Sorry irritated myocardium, you CAN'T arrest because I SAY SO. :roll: