Recent content by Smellypaddler

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    Decorticate type posturing with normal GCS

    Good pick up, my bad. I should have written something along the lines of he remained cognitively unimpaired. I actually scored him a 13 as he was able to localize to central painful stumuli using his upper arm motor control although his wrists remained heavily flexed and he had no grip...
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    Decorticate type posturing with normal GCS

    Wondering if anyone can explain the patho related to a pt I transported today who had decorticate type posturing with a high GCS. Pt was a 70yoM transfer out of a regional hospital who initially presented with sudden onset neck pain and bilateral arm pain. On arrival of the pt was agitated due...
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    Modified Valsalva

    Our agency uses this exclusively before all other measures. If BP >100 then 3 x modified Valsalva manoeuvre before moving to Adenosine OR if rapid deterioration then immediate electronic cardioversion. I have sued it a number of times with great success.
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    ECG of a case today

    @TomB I'm going to do a bit more digging on this one and see if I can get hold of a copy of her hospital ECG. The computerised statement from the Zoll monitor simply said "Abnormal finding for female >40" & "moderate ST depression". On a subsequent ECG it also said "probable lateral Ischemia"...
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    ECG of a case today

    Thanks for the feedback. Initially this lady was a bit strange and with the descriprion of her pain I wasn't going to treat as cardiac. We have only just had the Zoll introduced into our service and have been told the auto-generated diagnosis is greater than 95% accurate and to bekieve what it...
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    ECG of a case today

    70yoF who presented with 9/10 central chest pain, associated diaphoresis and vomiting. Pain described as stabbing in nature, worse on inspiration and palpation. The Zoll auto-diagnosis only states "moderate ST depression" no finding of infarction. I'm just wondering what others would think of...
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    Which services have tactical paramedics?

    Thanks guys, it looks like Canada has a strong history with tactical Paramedics. I also looked up the Colorado Springs info. Many thanks for your help, I've traveled through the posts on this board and it looks like there are lots of EMT-T or TP-C people on here so if you could please keep...
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    Which services have tactical paramedics?

    Hi, A few random questions that I am hoping some of you guys can help with in order to help me with a potential research proposal. Which services do you know of that have tactical paramedics or a tactical unit? In particular I am looking for units that have civilian paramedics who work day to...
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    Paramedic student pain management question

    Victoria, Australia Adult Non-IV options: >60Kg and <60Yrs: Fentanyl 200mcg IN repeat up to 50mcg IN @ 5/60 titrated to pain or side effects (MAX 400mcg) <60Kg and/or >60Kg (or frail) Fentanyl 100mcg IN repeat up to 50mcg IN @ 5/60 titrated to pain or side effects (MAX 200mcg) Methoxyflurane...
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    non-synced cardioversion during pulseless VT arrest

    My bad, you are right re: delivering the synced shock on the R wave. Not sure why I wrote Q.
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    non-synced cardioversion during pulseless VT arrest

    I wasn't aware of that FB page so thank you for linking it. Is there any evidence or even literature out there to support the FB post? Not because I don't believe it, it does make sense. More because I'd like to be able to refer others to a more reputable source than a random FB page...
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    non-synced cardioversion during pulseless VT arrest

    A question came up today that I didn't really know the answer to and thought some of the greater minds on here might be able to point me in the right direction. During an unstable conscious VT rhythm we cardiovert with the monitor in "sync" mode (post sedation) so that the DCCS is delivered...
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    Mythbusting

    Thanks Halothane, 1 & 2 I did search google scholar and the databases I have access to but only turned up opinion pieces on the COPD/02 debate and an article from 2000 on pulse correlation with BP. Other than that I think I'm either looking in the wrong area or typing in the wrong key...
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    Mythbusting

    Maybe I should have been clearer with myth number 1. The notion being taught is that if you don't have a BP cuff but can palpate a radial pulse then the pt has a systolic BP >80mmHg. I agree with your treatment of hypoxic pt's but specifically want some evidence to say that high flow 02...
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    Mythbusting

    OK, it's mythbusting time. I heard these three today and went looking for evidence to prove or disprove them. I'm not looking for "In theory it is this but in practice it is different" answers. I am looking for reputable evidence to inform my practice. I can't base my practice upon...
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