Recent content by Merck

Feel free to PM me if you're coming to Canada (British Columbia). I can probably point you in the right direction. Have fun!

Well I guess I'll respectfully disagree. I think that, given you inability to begin an EMT program before next fall, that an EMR course is a reasonable step. Learning a basic patient assessment model and a systematic approach to patients at a basic level is a good beginning. The 'why' of much...

This is a nice little video. http://intensivecarenetwork.com/ketamine-how-to-use-it-fearlessly-for-all-its-indications-by-strayer/?utm_source=The+ICN+Newsletter&utm_campaign=88c27fc407-RSS_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_0f92106109-88c27fc407-22644025

+1 for the vent. You can mitigate the need for drugs with a little bit of care for your strategy.

Hiya, I only question the effectiveness of propofol because my admittedly brief research shows the claims are made primarily using animal (murine) models. Not great evidence. My other concern there is that, well, you know how it goes, all of a sudden - "have to use propofol, it's...

Do you guys have AIME education in the states? Might just be Canadian: http://aimeairway.ca/ Anyway, all of our practitioners go through it, one for ALS and one for BLS. Teaches principles, not protocols generally. I'm not associated with them in any way, and have my own critiques of the...

Well, my opinion (to keep Remi happy, apparently) is that a twin-engine machine is safer. Granted I can't quote great stats and that's for a couple of reasons. The first is that I don't care enough to look - I'm happy to rely on the opinions of people I trust and know are more well-versed in...

We use roc so don't have much issue. It was more of an info point on some of the other non-depolarizers. I have no idea what other services use. I'm sure the point is minor.

Granted the HD instability is rare, but NMBAs can cause hypotension through histamine release. As well, if a patient has some inherent pull on the vent (i.e. PSV) then paralyzing them could affect their HD status as you transition them to full vent support. (both admittedly minor issues and...

Propofol works very well in transport. Perhaps it is a question of experience and training. The notion of not being able to titrate is crazy. As for the idea of paralyzing anyone for transport - no dice. Perhaps I'm not getting the context of the transports as I work in a different system...

There's no issue with it. And 5 mcg/min is only a sniff anyway. The problem with the ER is that they look at the patient as they present and don't appreciate how they were. Guarantee you that if the pt had been pushed in wheelchair into the ER as they presented to you they would have started...

Dopamine can work, it is just not usually the best choice. You get, as mentioned, some inotropic and chronotropic effects, but also some squeeze as the dosage increases. However, in general most patients in septic shock are already tachycardic. Given that levo has much less chronotropic...

I suppose, knowing little of the EMT-B scope, that from a license/job perspective perhaps you overstepped. I guess it seems a bit odd to me since there is no way a decision like that would even register here. From a patient care/medical perspective, it made zero difference.

That would be an unfortunate protocol. I only say this because I'm generally against any protocol that requires a strict approach to a dynamic situation. VL is great in patients for whom VL is great. But don't underestimate good ole fashioned DL. Visualization is easier with VL in general...

I carry a little something I call, "Not being a d-bag at work". 100% effective so far....