squad51medic

Hi Brice, I am in S. Florida near Boca Raton. You might want to try AMR in Orlando, Positive Medical Transport in Sebring, or even Lake-Sumter EMS in Lake-Sumter county. Also, Sunstar is popular in the Orlando area as well. Anymore info just PM me on Twitter @Paramedic_FLA. Good luck!! David

Welcome Stacy! Follow me on my twitter page "Paramedic_fla" for news in the world of EMS, Chronicles of EMS, and others involved in EMS. It is also another great place to network with others like yourself. Squad51paramedic

What does the ECG 12-lead show?

Not sure if it was answered, but what was he doing 12-24hrs before this condition began? Does he take any meds regularly? Is there any postition of comfort that helps him breathe easier? Did he have any recent (within 30-60 days) surgery's. I'm gonna rule out scuba diving, he's in Denver. Perhaps, he skies? High elevations?

I just certified with the new ACLS standards. Doesn't seem to different except alot more compressions. I believe the old AHA standards were concerned more about airway management, now it seems that that is taken second to circulation.

I couldn’t agree more with the assessment (AZCEP). I Totally agree with the 6 Hs – 5T’s. I agree with the Pt. Assessment and HX. I believe that it is extremely important in treating the pt. to get good HX. But… Look again at scenario; “Should we be good and bolus him with Lidocaine or say "it probably wasn't an irritable foci that through in into v-fib, so lets not play with his heart rhythm since he's NSR." My thinking was to just leave the NSR alone and monitor for changes during transport. I agree you could treat the ectopic foci or irritable foci and there isn’t anything wrong with that, but suppose there was something else underling that’s causing the dysrhythmia. How would we in the field be able to determine this and when we supply the pt with Lidocaine are we treating for long-term effect? Why not give Amiodarone? Ok, my three cents!

I will do some interjecting here as well; Treating foci in the field seems a little out of the norm for a paramedic, doesn't it? Aren't we treating the patient not the monitor? I mean, recognizing what the ailment is great, but what if you are wrong? Is your medical director going to stand by your decision? Stabilize and transport, don't play doctor. Some of us have limited resources at our disposal, the hospital has more. Don't try to figure out why he went into VFib, just treat the vfib. Perhaps the pt. was taking GHb, or Efedrin(?), you just won't know the answer to that until you do blood tests. Now don't get me wrong, I love to learn more and study emergency medicine to make me better in the field, but sometimes I think we over think a situation. Learning new stuff is scary! Appling it is dangerous. Just my two cents!