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@NPO given low doses of ketamine for anxiety isnt really the best thing to do. Giving ketamine to a cardiac patient with pulmonary edema really isnt the best thing to do. Ketamine has been shown to reduce LV function and increase PA pressure. I would just focus more on making the BiPap work and...

Ive read and heard of several places doing this. At my current service they seem to prefer the IABP instead of the impella to prevent LV stunning. But then again this is what ive observed on the aircraft, im just a medic and am not in the CVICU

@PotatoMedic transport provider advanced trauma course ? TPATC?

Ive done both. I personally like PHTLS better but i also think its up to the instructors.

I can see why people are debating over the ECG. If it was just the ECG alone i would probably lean towards not calling it (although it would be close). But given the rest of the patients presentation, CP + hypotension + Tachycardia/Tachypnea, i would definitely call it and would just base it on...

Wheres this at if you dont mind me askin ?

http://rebelem.com/sodium-bicarbonate-in-cardiac-arrest-management/ sodium bicarb administration without proper ventilation to off-load the increase in CO2 just generates more acidosis, or atleast doesnt raise the PH as much as thought. Then there is the fact you're bolusing hypertonic saline...

Or maybe while we are all pointing fingers at epi, excessive administration of sodium bicarb is hurting our patients.

The lucas in a 145 is OK but usually ill go with manual compression's unless its a long flight. TCA's from penetrating injury (not counting ones to the head) have a far better outcome then blunt.

Fly patients in active TCA. Intubation, Any trauma to torso region gets bilateral darts, and blood broducts x2. Tourniquets if needed. Ive gotten several back usually after intubation and blood products.

This makes alot of sense, thank you for clerifying this. I was told that they place the IABP in ECMO to reduce the instance of cardiac stunning. And i always wondered why they went with a balloon instead of an impella, but now i know.

@CWATT I think you are reading more into this than what i mean. Im just advocating for good habits and preparedness. Once you start going down hill on the dissociation curve its hard to climb up it.

@CWATT a properly placed NPA will terminate a where the oropharynx begins to turn into the laryngopharynx, usually right before. This helps facilitate ventilation past the tongue mainly. People often forget that OPAs in its self is obstructing some ventilation (still use OPA's when indicated)...

@E tank, While yes i do agree with you that it can create bleeding for patients on blood thinners, and in your anatomically simple airway patient, may be overkill. I actually am an advocate for this and am pleased to hear other people do this as well. This is great preparation on patients that...

Fully agree

Because of bougie use or VL use?

There is a youtube video entitled intubating the Williamson county way or something like that. Its pretty good, you should watch it. Im a big believer in standardizing airway protocols and procedures. When i was a wee little medic i remember the all the veterans had their own way of doing...

No offense to you sir, but this does not sound like very appropriate preoxygenation procedures. For someone with any kind of respiratory drive NRB+NC for 2-3 minutes is the standard. CPAP for patients with shunt physiology. Or NC +BVM with PEEP valve set at 10-15. If you are consistently bagging...

VL and bougie mandatory with our VL being mcgrath. Im fine with it being mandatory as i use the mcgrath DL anyways and just use the video for a reference if i need to. Our FPS is about 95%+ which is good i think considering we get all the hard airways because if they were perceived to be easy...