sledogg1

Thats where I did my hospital time when I went though EMT-P school at Davenport University in 95-96........wow.....glad that eneryone is ok.

Easy...........NO

Sounds good but ouch when it to tax time.......3 wks on 3 wks off or go as a casual on a call basis. Why leave the rock, things are inproving slowly. Bunch of us Nova Scotia CCP'S are turning things around. Say hi to Cory Banks from Sledogg next time u see him.

All I have to say is WOW! Now from what i have been thought and follow is treat the pt not the machine. He is having c/p simular to previous M.I's, and has an extensive cardiac hx, for the love of god treat it. As for the absence of elevation in the 12 lead, I would agree with possibility of non-stemi mi. The only reliable way to rule out an MI is through labs. I agree, listen to your pt. He is probably on blood thinners so ASA is not a big deal if not sure give it to him unless other contraindications. Give Nitro, DO A 12 LEAD, has he gone into CHF or cardiogenic shock call ALS so next steps can be done if needed......m/s salbutomol, lasix TNK. Sounds like lazziness

Here in Nova Scotia, we don't have pumps on board but if it goes out on a pump it stays on a pump. its goes to the ALS Crew, PCP'S can manage a NACL on a pump but the rest to ACP'S. We do alot of antibotics, panto etc from rural hospitals,

Bring back the death sentence.

Bring back the death sentence.

Bring back the death sentence.

With her age and mental stability........did overdose come in mind. SynthroidOverdosage & Contraindicationsfont sizeAAAOVERDOSE The signs and symptoms of overdosage are those of hyperthyroidism (see PRECAUTIONS and ADVERSE REACTIONS). In addition, confusion and disorientation may occur. Cerebral embolism, shock, coma, and death have been reported. Seizures have occurred in a child ingesting 18 mg of levothyroxine. Symptoms may not necessarily be evident or may not appear until several days after ingestion of levothyroxine sodium. Treatment of Overdosage Levothyroxine sodium should be reduced in dose or temporarily discontinued if signs or symptoms of overdosage occur. Acute Massive Overdosage – This may be a life-threatening emergency, therefore, symptomatic and supportive therapy should be instituted immediately. If not contraindicated (e.g., by seizures, coma, or loss of the gag reflex), the stomach should be emptied by emesis or gastric lavage to decrease gastrointestinal absorption. Activated charcoal or cholestyramine may also be used to decrease absorption. Central and peripheral increased sympathetic activity may be treated by administering β-receptor antagonists, e.g., propranolol, provided there are no medical contraindications to their use. Provide respiratory support as needed; control congestive heart failure and arrhythmia; control fever, hypoglycemia, and fluid loss as necessary. Large doses of antithyroid drugs (e.g., methimazole or propylthiouracil) followed in one to two hours by large doses of iodine may be given to inhibit synthesis and release of thyroid hormones. Glucocorticoids may be given to inhibit the conversion of T4 to T3. Plasmapheresis, charcoal hemoperfusion and exchange transfusion have been reserved for cases in which continued clinical deterioration occurs despite conventional therapy. Because T4 is highly protein bound, very little drug will be removed by dialysis. CONTRAINDICATIONS Levothyroxine is contraindicated in patients with untreated subclinical (suppressed serum TSH level with normal T3 and T4 levels) or overt thyrotoxicosis of any etiology and in patients with acute myocardial infarction. Levothyroxine is contraindicated in patients with uncorrected adrenal insufficiency since thyroid hormones may precipitate an acute adrenal crisis by increasing the metabolic clearance of glucocorticoids (see PRECAUTIONS). SYNTHROID is contraindicated in patients with hypersensitivity to any of the inactive ingredients in SYNTHROID tablets (See DESCRIPTION, Inactive Ingredients).

What kind of moron puts another country's leader as his avatar? Dust is being mean again............lol $23.85 now step 4 $24.?? step 5 April 08

sledogg1 wrote: Still like the 1 that I stopped at a mvc motorcycle out of province where the medic were ass's (BLS) and pushed me aside and i offered ALS support iv. ett i said tramatic cx trauma I got we got it.......till they lifted back the sheet and this heart lungs were looking back and the cocky medic passed out........so he went in the 2 nd rig and I came the primary medic. So stop and assist but stay in your scope. Again, a tremendous story there. I thought I had read something similar before... http://www.emtcity.com/phpBB2/viewtopic.ph...sc&start=30 sledogg1 wrote: Stopped at a mvc motorcycle saw the pt with two ladies, asked if they needed help, I am a Paramedic ACP they said "no they are RN's " Noticed the pt was on his stomach ,heard snorring respirations!!!!!!!!!!! I Went down and told them they must gain airway control HE'S BREATHING THEY SAID I said thankyou for your help, I now need Your assistance. With all the c spine logged rolled and his helmet was chacked in half beside him ................rn's nicely removed it before I arrived, he had massive head trauma. Had my wife get my medical kit out the back as we where heading back from Sudbury Ont and suctioned him Airway was contolled, did abc's proceeded to remove clothing noticed a Hells Angles tat and patch GREAT he had 2 femur fx, 2 radial/ulner fx and when I opened the shirt 1 Rn passed out there was 2 lungs and a heart doing a bradycardic beat........his ribs were sticking lt/rt. Covered the cx the ambulace arrived I had 2 14g IV's in and they where BLS. THE LOOK OF HORROR ON THERE FACES I had my ACP TAG with me and went with them,intubated and he coded in hospital. Yes it is nerdy to have a kit with you if you use it be prepared to go, have your tag with you, but the hospital was impressed with our scope of practice.....got a thankyou from the Hells Angles and the RN woke up after her friend pulled her out of the bullrushes. Looks like some of the details of the story changed, maybe you just forgot. I'm sure it still happened... You also never answered any of the questions that I posted regarding your ability to practice in Ontario on that call. Maybe you can answer them now in this thread. Back to top Well I wanted it to be a quick version........It was in Northern New Brunswick coming back from Ontario. I am covered by our Medical Director and personal insurance to assist in these situations. I mean't RN not medic typo.........

Good Samaritan does not apply for a trained medic, you can get nailed if found out you did not stop..........and how can you sleep that night if u passed an MVC and did not assist. Do your 1st aider stuff and that is it till you are trained. Keep the glucometer and b/p cuff at home till u get the diploma.........remember radial and carodic pulses tell you alot. Still like the 1 that I stopped at a mvc motorcycle out of province where the medic were ass's (BLS) and pushed me aside and i offered ALS support iv. ett i said tramatic cx trauma I got we got it.......till they lifted back the sheet and this heart lungs were looking back and the cocky medic passed out........so he went in the 2 nd rig and I came the primary medic. So stop and assist but stay in your scope.

You did that rt thing, you did not abandon anyone cause a medic was on scene with same qualifications..........but could you met up with the ALS for a ALS intercept and let the ALS jump into the bls rig and continue on ??? and the bls unit head back to the scene?? Not saying you are wrong but suggesting. Do u have aircare?? How did the pt do at the end?

Hay Dust, long time no chat.....................as Connie mentioned earlier our policy/protocal does not include this, look but don't manual dilate. Trained in class and rotation as the EMT-P, ACP scope but not allowed on the rig like catherazion....... in breech though allowed to if head does not deliver 2-3 min place gloved hand -figers in a v position over baby's face and push vagina away.

In 18 - 19 yrs doing this and delivered 5 , I have never inserted fingers for a dilation check. Believe me you know, if she not a crowing don't go a measuring!!!!!!!!!! With ambulance chasing lawyers out there, you don't have a leg to stand on. Yes, we are trained in school and rotations but really..........do u want to go there.

God i love this site, Shane thanks for the refresher as well ER Doc. Did u do a stroke test on her...........no smart coments :oops: as a pre sycope????? could this be a sign of a possible CVA in the works, smoker???? drink??? meds legal or not birth control etc. Interesting.

History The symptoms of lidocaine toxicity tend to follow a predictable progression. The toxicity begins with numbness of the tongue, lightheadedness, and visual disturbances and progresses to muscle twitching, unconsciousness, and seizures, then coma, respiratory arrest, and cardiovascular depression. CNS toxicity: When the lidocaine dose is increased from 1 mg/kg to 1.5 mg/kg, the risk of CNS toxicity increases from 10% to 80%. Symptoms include the following: Lightheadedness, dizziness Visual disturbance Headache Perioral tingling, numbness or tingling of tongue Sedation Impaired concentration Dysarthria Tinnitus Metallic taste Muscular twitching, tremors With progression of toxicity, the patient may experience tonic-clonic seizures and, eventually, unconsciousness and coma. Seizures generally do not occur with lidocaine levels of less than 10 mcg/mL. Cardiovascular: Excessive lidocaine concentration can cause cardiovascular toxicity, although this is less common than CNS toxicity. Lidocaine is somewhat less cardiotoxic than lipophilic local anesthetics such as bupivacaine. Risk of cardiac toxicity is greatest in those patients with underlying cardiac conduction problems or after myocardial infarction. Potential cardiovascular effects include the following: Negative inotropic effects Effects on vascular tone (with low doses having vasoconstrictive effects and higher doses causing relaxation of vascular smooth muscle) Effects on cardiac conduction (including widened PR interval, widened QRS duration, sinus tachycardia, sinus arrest, and partial or complete atrioventricular dissociation. Cardiac arrest has been reported after intraurethral administration of lidocaine.) Cardiac toxicity is potentiated by acidosis, hypercapnia, and hypoxia, which worsen cardiac suppression and increase the chance of arrhythmia. This is important to consider since seizure makes this metabolic picture more likely. Plasma lidocaine levels of less than 5 mcg/mL are unlikely to have cardiovascular toxicities. Levels of 5-10 mcg/mL can cause hypotension by inducing both cardiac suppression and vascular smooth muscle relaxation. Levels of more than 30 mcg/mL are associated with cardiovascular collapse. Lidocaine should be avoided in persons with Wolff-Parkinson-White syndrome. CNS symptoms may be masked in patients premedicated with anticonvulsants such as benzodiazepines or barbiturates. The first sign of toxicity in these premedicated patients may be cardiovascular system (CVS) depression. When blood levels are high enough to block inhibitory and excitatory pathways, convulsions cease and the patient experiences respiratory depression or arrest and cardiovascular depression. Large bolus injections may increase peak anesthetic levels to the point where the CNS and CVS are simultaneously affected. Causes

Asthma and wide complex tachy are 2 no no's for adenosine...............sytomatic go to repeat cardiversion if not lido is the way to go, but lido is a no no for WPW as well.

rats asssssssssssssssssssssssssssss :oops:

Drug Name Dextrose 50% (D-Glucose) -- Monosaccharide absorbed from intestine and distributed, stored, and used by tissues. Parenterally injected dextrose used in patients unable to obtain adequate oral intake. Direct oral absorption results in rapid increase of blood glucose concentrations. Effective in small doses; no evidence of toxicity. Concentrated dextrose infusions provide higher amounts of glucose and increased caloric intake, with minimal fluid volume. Use 1 ampule of 50 mL of a 50% glucose solution (25 g). Adult Dose 0.5-1 mg/kg IV bolus Pediatric Dose <12 years: Not established >12 years: Administer as in adults Contraindications Do not administer to a patient in diabetic coma if blood sugar levels are extremely high, and avoid in severely dehydrated patients Do not administer concentrated solution if intraspinal or intracranial hemorrhage is present; avoid in dehydrated patients with DT, hepatic coma, or glucose-galactose malabsorption syndrome Interactions Caution when administering parenteral fluids to patients receiving corticosteroids or corticotropin, especially if solution contains sodium ions Pregnancy A - Safe in pregnancy Precautions Extravasation may cause significant tissue necrosis when used IV; Isolated reports of nausea, which may also occur with hypoglycemia, have been recorded; Dextrose solutions administered IV can result in dilution of serum electrolyte concentrations and overhydration when there is fluid overload; caution in congested states or pulmonary edema. Ok.......................if u can find it where u can drink D50 let me know,I can't.

Glucagon u see results 5-7 mins..............they stop snorring seems quick to me :? but last Fri went with D50 IVP < 1 MIN he's up oh gave 100mg thamine for malnurished.......... SO AS AN INSTRUCTOR are u recomending the D50 shooter? I now pushing it is a job itself, can't imagine drinking it :tongue9: All I can say if u use the shooter and the pt's airway somehow becomes compermised get ready because Mr. :ky: is your friend and u won't see :downtown: or :drunken: for awhile.

Why would anyone give D50 orally is my point............. rub monogel buccally and it will absorb time release is slow but safe or if he can shallow which it shows he can let him have the tube and repeat times 3..............................but gluagon is guick and fast.

Happpppppppppppppppppppppppppppppppppppppppppppy EMS Week. Our nurses here are putting up a display here for us,Shocking I know, but very nice of them :headbang:

Mybe with lifeflight.........cabin pressure decresses and dislodges the clot in the rt atrium...............goes the to nogging and now you have a CVA and a cabbage patch...........can you post a 4 lead up here so we can see TU.

If you are giving D50 oral, I would think the pt would not follow commands and that they wouldn't be able to shallow properly. So, you lose there airway cause you have a bit globe of crap in there airway.........you cric them and that fails because you are now covered in dextrose...............you only wish you had given the 1.0 mg glucagon IM. Now u have a date with a lawyer cause of malpractice and causing death....................kiss your licence and the last thing on your mind is rectal D50 :oops: