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From a couple of hours with an extremitiy tourniquet Tourniquets are used thousands of time in surgery daily without issue. I think you're confusing crush syndrome (which there's debate if that's even a K+ issue or just a loss of hemostasis) with tourniquet use. I work in the CCT environment...

You're welcome in Texas as long as you don't attempt to bring California style laws, taxes and attitudes with you. Otherwise we're full.

#swallowstudy

I think he's talking distal as in lower leg vs thigh, and upper arm vs forearm. Lactic acid buildup also isn't the reason you don't remove an extremitiy tourniquet, it's because hemorrhage requiring a tourniquet usually requires surgical control or take a very long time to achieve hemostasis...

I thought you anesthesia guys had balls.....:D Remi is correct, it is 1mCg/kg

Epi 0.01mg/kg Amiodarone 5mg/kg Adenosine 0.1mg/kg Midazolam 0.02mg/kg Fentanyl 1mg/kg That should cover about 90% of your needs.

Haven't we basically known this since circa 2000? Why did we need ANOTHER study to confirm it. Anti-dysrhythmics are useful in the peri-arrest phase....not so much intra-arrest.

It depends entirely on the injury and the location. It's one of those things that can't be distilled down into a checklist. Generally 2-3" away from the wound, however if it's "exsanguinating in 2 mins" vs "exsanguinating in 20 minutes" it's going high and tight with a second one behind it if...

I'm sorry, nurses have no business doing any of this. It should be educated and experienced medics, not a nurse with a short "MICN" class. Consider if the situations were reversed and medics were giving RNs orders, would you be ok with that situation? Medics are fully capable of performing the...

I can go either way...the "nursing model" is at times overly check box oriented and favors those who follow the flow chart in favor of doing good bedside care. N The same criticism could be leveled at EMS of course, however physicians seem to understand deviation more than nursing management...

EMSA is a cluster...well you get the idea. High call volume, lowish pay, and a management change that no one has anything good to say about.

One of the great myths of medicine is that we "cure" things. Sure, in a few isolated cases we do, but the vast majority of modern medicine is providing symptom relief. I'm curious how where you got the impression we can "cure" depression. That's the kind of myth we fight daily at Code Green.

Ahh yes nursing. Extremely protective of their sandbox while actively trying to piss in everyone else's. I love nurses....not hugely fond of nursing organizations.

"Is your pain bearable right now?" "Would you like something for it" We neither create nor treat dependence issues in EM. Withholding does no one any good.

If every 911 ambulance were to magically disappear people would still manage to get to an ED. If every IFT ambulance were to do the same things would get a lot more interesting.

1. Hypoxia causes tachycardia 2. If they were thin, JVD would be present normally. If not tachycardia can cause JVD due to decreased ventricular filling time. 3. If the heroin was cut with fentanyl or one of it's synthetic analogues you won't see a lot of hemodynamic effect, you get little to...

Treating acute decompensated heart failure aggressively isn't going to lead to cerebrovascular problems. The B/P isn't a compensatory mechanism for perfusing the brain, it's due to the RAA system going wild from decreased CO. The appropriate treatment for this patient is lots of NTG, Bi/CPAP and...

450 is not the "max" dose of amiodarone, the patient will end up getting a gram over 24 hours at various rates. Your local protocol is going to dictate heavily if they get the post-ROSC infusion or not.

Yes there's fraudulent companies out there. Doesn't mean every IFT company is. IFT is probably more essential than 911 in some areas, no matter how bad EMTs seem to hate it.

Since this was seemingly directed at me.... 1. I'm pro-safety to the point of unpopularity. We do A LOT of stupid stuff that's killing us all the time. I work in a subset of EMS that kills people ENTIRELY too often. Lecturing me on safety is like lecturing Jack Stout on posting 2. Have you...