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Before I get off my own behind and look for myself, I thought I would ask... Does anyone have, or know of, any data or research into ambulance crashes. I'm particularly interested in the relative risk of driving lights and sirens compared to normal day to day stuff. Anything on fatigue would...

What's the rush?

Thanks, that sounds ideal if they make specific "Tall" sizing which typically increases length rather than just girth. I'll have a look at those.

Roomy isn't the main issue, everyone makes jumbo jackets. It's the arm length I need to cover my hairy, scarred knuckles.

Ok, I don't usually post here, but I have a question a little out of left field. I am a big unit: 6'2", 255lbs. I am broad across the shoulders and back, and unfortunately have a very long reach: i.e. I have monkey arms that are longer than they need to be. I therefore have trouble...

Damn right. The single biggest failure in the treatment of anaphylaxis is not giving epi. Irrational fear of epi must surely contribute.

Give it. Pt is smaller? Give it.

It's actually a really good example of evidence based medicine in action. Prior to the TTM and Seattle trials, the best evidence we had was that TH was good for patients. However the studies weren't really all that good (lots of animal studies) and the prehospital ones (Bernard et al in...

I'm waiting for a good study of tPA for acute stroke

There are solid studies in the prehospital realm, none of which have ever showed any benefit to starting cooling early. The first decent, intention to treat, randomized trial into prehospital TH was Stephen Bernard's RICH trial, which in itself actually showed no benefit to prehospital cooling...

Seems odd to be getting serious about prehospital therapeutic hypothermia when it has pretty conclusively been shown not to help.

Fortunately EMS is nowhere near where this is at in my shop. We RSI frequently and well, in the last quarter performing over 200 drug facilitated intubations with 100% success. We also do not allow patients to become hypoxia, hypocapnic, hypercapnic or hypotensive while we are doing it. Our...

What medicsb said. This is yet another "study" that purports to show that prehospital intubation is the root of all evil. It's utter rubbish. Prehospital intubation isn't bad, it's prehospital intubation done badly that is bad.

So in the severely broncho-constricted patient who cannot speak, is gas-trapping with minimal tidal volume and has poor perfusion from increased intra-thoracic pressure, you would give several doses of inhaled albuterol prior to giving epi?

Always the thing to keep in mind. Keep it simple and all that Yes. Probably because we forget, or never realized, that pressure is not flow. Flow is what is important and pressure is only one part of achieving flow.

Simple heroin overdoses have been a catch and release call for well over a decade in Melbourne, Australia. It is safe, effective and sensible. Treating heroin overdose like in the video posted is none of those things.

You sir, are awarded eleventy billion internets for the use of proper drug names. God bless you.

I think the piece from Hauswald is essentially an op-ed. However he does usually bring an interesting slant to the conversation. From what I can read from the literature, combined with my experience, spinal immobilisation by EMS is pretty much an intervention in search of an indication. I...

If anyone has read the above article by Hauswald in the latest edition of EMJ I would love to hear from you via PM. Many thanks Smash

Three words: Soy. Chai. Latte.