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PART 1 You're a CCT flight crew dispatched to a sending facility ER for a transfer to a pediatric ICU. Radio report details 2yr old pediatric with sepsis & pneumonia. Intubated, GCS of 3. You arrive to find patient under sterile drapes with a ER physician placing a left IJ central line. You...

I dont beleive a stroke assessment can be accurate if the bgl is that low. Give the D50 amd reassess. Yall are over thinking things.

@needsleep i do beleive CHF and asthma realted emergencies is where medics can seperate themselves and really make a difference. I know some of these guys throw out somethings that may or may not apply to your practice but the more you understand the physiology of both the better you can help...

@Summit great article

Intubating a CHF patient is difficult due to anatomjc issues but mainly physiological issues as pre-ox and FRC are barely existant. On top of that extubating them is also fairly complicated. Pressure is what they need and it is easy to give it to them with NIPV (in most cases, not all) CHF...

Sometimes CPAP needs more time to work. On SCAPE patients its really gonna push your comfort zone for how long to try cpap and how much nitro to push. But youll learn to be more patient the more experience you get. On some cpap msaks youncan attach the inline etco2 between the mask and the...

In airway & respirstory emergencies there is NO end all be all. What did your breath sounds reveal ? Do you think it was bronchoconstriction or pulmonary edema? Or did you go to a treatment without a field diagnosis? There is other pathologies ie PE that will play out like this. If he wasnt...

@Fiafyter i guess ok. 9/10 in the aircraft im putting it in the shoulder. And it just never seem to carry enough power to really put it in there. We only trialed them for 2-3 weeks.

We trialed them. Positives: cheaper than the EZ IO, all in one. Negaitives: learning curve, consistant problem with needle not making it to the proper depth in muscular or obese patients. We decided against them. Mainly because of the needle not reaching the right depth in above average...

No medication is good or bad, sucks or rocks. But it is how the clinician chooses to use them for the patient at hand, that makes the difference. @Peak without data, you're just a fool with an opinion.

I can tell you in texas, most of the ground providers THINK theyre just as good at airway management as air medical providers. And they think that even as we rescue airway after airway from them.

I just wanted to echo this statement.

Ive been in situations in houses of patients, wrecks on roadways, and going interior in structure fires where i have felt we took full safety precautions and suddenly the dynamics change and suddenly i am no longer safe. And while yes HEMS gets alot of publicity for crashes, ive accepted that no...

My 2cents. I think for 90% of patients its fine. If im intubating in the hospital and have some time then maybe i can come up with a more comprehemsive RSI induction/sedation but in reality i dont worry too much about it. What my concern is, and im still sifting through studies, isnt the...

Yes, youre correct the exhalation of CO2 in all the pathologies i mentioned is low and therefore real. I use the term false low as the patients PaCO2 is significantly high while the etco2 is low and people mistakenly think that in these pathologies they correlate giving a false impression. And...

I fully agree with this. One thing ive come across is people become so engrossed with etco2 they neglect their other tools for assessment, and in some cases end up blaming the use of etco2 for "false numbers". Etco2 is just another tool in the box.

ETCO2 will never be higher than the PaCO2 but will give "false lows". In my experiance, a patients who is clearly having an asthma/copd attack will have a pretty high ETCO2 and then it will drop to the singles or teens (due to insuffeciant air movement) just prior to them going into respiratory...

Just because the patient had a SBP does not mean they had good right-left cardiac blood flow. Also possible PE.

I worked with someone who did that part time, made good money especially if you do traveling

How well does PRVC work with a patkent with lung etiology. Asthma/COPD or pulmonary contusion ?