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@gonefishing I dont believe diluted protocols have anything to do with it. Its how you apply the protocols that makes the difference. sorry this thread is going faster than i can keep up lol.

@FireWA1 "In 2001, using stopwatches, city officials found that Washington firefighters don’t respond as quickly to medical calls as they should. Their finding prompted the city to buy global positioning equipment so officials could track the movement of rescue vehicles. USA TODAY reviewed...

@Qulevrius couldve fooled me i figured you were in intensive care somewhere. @FiremanMike @VentMonkey I wouldnt advocate for a crash airway or a "modified RSI" for this patient, nothing tells me he will crash in the next 5 minutes so i would pull out all the stops. Premedicate if you are...

@VentMonkey i do not have any hands on experience with PRVC in the transport setting. But thats great if you got it. @Brandon O i know your settimg is more icu but, would you salt bomb this patient without a foley or labs ?

@Brandon O sorry bout that. I would preffer to use a pressure mode over a volume mode to better controll the mean airway pressure (MAP) as on most transport vents focusing on map gives you better control/understanding of how your ventilation is efficting hemodynamic status and cerebral drainage...

@VentMonkey i think its less to do about elevation and more to do about stimulation (extreme noise, vibration etc.) Also, i would go pressure control with this guy so i can control his mean airway pressure more accurately. But thats personal preference. @Qulevrius some of my rationel, is that...

Airway management is just one part of a treatment you should be able to see the forrest just fine. He requires an OPA to make his airway somewhat patent and the man still has occasional snoring. Everything you describe could happen either way. Hes not going to neuro icu, the OR or getting an...

Most airway experts suggest removing the collar and holding manual during the attempt. There has also been extremely very few instances of an intubation attempt further injuring a spinal patient. If he is going to herniate then he will do it with or without an ET/LMA in his mouth, that makes no...

If you wait until the patient gets hypoxic to do something then youve already lost the battle

As per your exam my primary concern is airway and less any catastrophic hemmorage. Im gonna choose to perform RSI while im still and not moving for transport that way i have all hands on to assist. Place NC+NRB at flush rate to begin preoxygenation for atleast 2minutes while i prepare fully...

Youre either a half *** firefighter or a half *** paramedic the way i see it.

@VentMonkey ive seen protocols say 12yrs and ive seen 10yrs. I recently listened to a smacc podcasts where a pedi ENT doc said he would go much younger for the cric as you can just cut through the cartilidge to make the whole bigger. And i beleive the little information that is availavle for...

Because its a low exposure and high risk skill that when done correctly has plenty of benefits, but there are also plenty of lower risk work arounds or temporizing measures. I also dont think every ER doctor should be able to RSI a pediatric unlesd they have annual to bi-annual training for...

While i am all in favor for prehospital intubation, pedi ET less than 8yrs old is a rarely performed skill. And even if youre highly proficient the complications of tube extubation, right mainstem, and lung injury from high tidal volumes in the prehospital setting remain a high possibility. I...

Well just examine where the JET or CAT would restrict flow and the artery you figured the bleeding was coming from.

Good story, good question. I never would have thought of placing nor would i think it would work enough to matter.

As in published research or internal ? Does the info get forwarded to either of the trauma centers in H-town ? Not to seem like a prick, but alot of places claim research when in reality they look at their own numbers for self-falacio rather than reporting to an entity to make it public and...

Well in speakong with field RSI (which i am a fan of) alot of patients need to be rescusitated first. Say for instance the trauma patient with a shock index of 0.9 or greater. Sure they may need an airway but what is worse for THIS particular patient. The questionable airway or post intubation...

Yes pretty good, i dont go hungry. But there are plenty of FD's in my area with starting pay similiar if not more. Which can be disheartening to see people with far less experience, certifications, and volume of work make more. But hey i dont do it for the money

No particular drug or procedure.