Old is new again

[usalsfyre]

Lidocaine-Out

Intubating cardiac arrest early-Out

Defib Paddles-Out

Jelcos-Out

Separate pulseoximeters-Out

Nasotracheal intubation-Out, then back In

Diazepam-mostly Out

Smaller ambulances-Out, now back In

Decent sized, capable HEMS aircraft-mostly Out

That's all I can think of for now, and I've only been around 10 years.

[croaker260]

Lidocaine-Out

Intubating cardiac arrest early-Out

Defib Paddles-Out

Jelcos-Out

Separate pulseoximeters-Out

Nasotracheal intubation-Out, then back In

Diazepam-mostly Out

Smaller ambulances-Out, now back In

Decent sized, capable HEMS aircraft-mostly Out

That's all I can think of for now, and I've only been around 10 years.

Lidocaine-Out NOPE, Lidocaine still OK

Intubating cardiac arrest early-Out NOPE, interrupting CPR for ETT out, Intubating during CPR OK and encouraged in the 2010 guidelines.

Defib Paddles-Out NOPE, Not OUT, just pads are preferred.

Jelcos-Out Still use them for EJs, Needle Crics, Decompression, and up to a year ago, we still used them for central lines.

Separate pulseoximeters-Out Uhm, still see separate pulse oxes, and SPO2/SPCO2 (wich is really just advanced SPO2 when you look at the technology and development history)

Nasotracheal intubation-Out, then back In NEVER was out for us.

Diazepam-mostly Out NOPE, not at all. There are still things we have preference for Valium over versed.

Smaller ambulances-Out, now back In Region specific.

Decent sized, capable HEMS aircraft-mostly Out Depends on your region, though I will agree we are starting to see reconsideration of how HEMS is used and trauma levinling in general.

[BAYAMedic]

lets not forget some of the meds gone by the wayside.

Thiamine

Phenergan(promethizine)

Vasopressin

Vecuronium in lieu of Rocuronium

Morphine for fentenyl then back and now have both.

Demerol (Meperidine)

Tnkase

and those are just what i remember from when I started as a basic back in 03 to becoing a medic now.

[usalsfyre]

Thiamine, vec, morphine and vasopressin are all still commonly on EMS units.

[roninwarrior]

Hopefully not too off topic

Anybody use "the thumper"? (Lucas device) I remember back in the day my department had one of these devices but only a few people ever took the time to use it. Never forget my first code as a basic hearing that thing for a good 10 mins to the ER. Sound still sticks in my head.

[croaker260]

Technically the Lucas (or to be more specific the LUCAS II as it had to be redisigned for us american fat bodies) and the Thumper are two different devices. The AHA has put them (and similar devices...I was surprised to learnthat there are quite a few knock offs outside the US) as "Mechanical Piston CPR" devices, as opposed to the Zoll Auto Pulse wich is a "load distributing band CPR" device (AKA Geezer Squeezer).

The AHA discussion on various types of CPR is here: http://circ.ahajournals.org/content/112/24_suppl/IV-47.full

A good overview of these is here: http://www.signavitae.com/articles/review-articles/135-mechanical-cpr-devices

[Just Plain Ruff]

Hopefully not too off topic

Anybody use "the thumper"? (Lucas device) I remember back in the day my department had one of these devices but only a few people ever took the time to use it. Never forget my first code as a basic hearing that thing for a good 10 mins to the ER. Sound still sticks in my head.

Putting the thumper on seemed like such a horribly long process expecially if you have a couple of free fire fighters to do the work.

But without the fire fighters or extra help the thumper was quite useful.

[croaker260]

Putting the thumper on seemed like such a horribly long process expecially if you have a couple of free fire fighters to do the work.

But without the fire fighters or extra help the thumper was quite useful.

The assumption is that the two are equal in quality of CPR, both in the intial 5 minutes and for longer arrrests. Results of research are mixed, and I am not saying that one is absolutely better than another.

I am saying that it stresses the importance of consitant (not just transient) high quality CPR and a team leader who is willing to ensure that.

[roninwarrior]

Technically the Lucas (or to be more specific the LUCAS II as it had to be redisigned for us american fat bodies) and the Thumper are two different devices. The AHA has put them (and similar devices...I was surprised to learnthat there are quite a few knock offs outside the US) as "Mechanical Piston CPR" devices, as opposed to the Zoll Auto Pulse wich is a "load distributing band CPR" device (AKA Geezer Squeezer).

The AHA discussion on various types of CPR is here: http://circ.ahajourn...uppl/IV-47.full

A good overview of these is here: http://www.signavita...cal-cpr-devices

Nice, thanks for the links!