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I don't think I'd be giving adenosine to someone that I had to electrically cardiovert multiple times.

Some musings in no particular order: In 2010 there were less than 250 paramedics in all of Vermont and there was no paramedic school in the state. This has since changed but the provision of paramedics in the state is pretty new, relatively speaking. EMS is more regional in VT and the state...

This patient is not protecting their airway very well. In my experience attempts at intubating people like this without medication never go well and often results in more airway comprise. If you think this airway needs managing, I would be doing it through RSI and not other means. Also...

just want to restate here—placing an IO to provide adenosine would be silly.

I loosely followed the development of the wilderness paramedic certification and my impression at least is that it’s a solid, modern certification. Is there lots of value to it? I have no idea. I know several physicians who have personal interests in wilderness medicine and have taken...

These are the sickest patients I ever manage. Poor kidney care wrecks everything. Completely lacking any other info here so for sure the potassium could be relatively normal, but hopefully this RSI was done without succinylcholine.

Probably would have been more effective than whatever happened.

Sounds like they didn’t use any “technology” at all. Can’t imagine how this happens when you put the monitor on for more than five seconds to observe asystole. BLS here can and does cancel ALS for obvious death. Eventually the odds are an EMT crew will get this wrong. But medics? Come on...

If it was a decent volume system, I think you would be alright. If it’s slow, probably not. I started as a medic in a relatively slow service. Got a part time job at a busy service where I’d work at least once per week. I still had lots to learn even after a year of doing this, but in general I...

If you did this in Colorado (I understand you were not), your certification would be in investigated and likely suspended in short order. There is a list of meds Colorado paramedics (and a longer one for critical care paramedics) can take on transfers provided your agency has a guideline for...

I’m waiting to hear the backstory here. If it’s helpful then great. But also, if it’s only of marginal benefit, there’s lotssss of stuff we could also be buying.

We have been instructed to start placing 3M Curos Caps on the end of our IV extensions or drip sets. Apparently they are alcohol impregnated and keep the caps clean. https://www.3m.com/3M/en_US/p/d/b00031542/ Anyone else doing this in the field? I’ve never seen these used in the ED and only...

Yup you’re right. Nonetheless, such a pattern would be concerning. But also possibly baseline for the patient right now.

A sending facility cannot provide orders that are outside the paramedic's scope of practice. Obviously scope of practice varies significantly in Texas, but that doesn't mean the sending doc can just ask the paramedics to do whatever he or she wants.

Hopefully they sent an EKG with you so you can compare to see if there are any changes. While I am concerned that there is marked ST depression in I and AVL, I do not see any reciprocal elevation in the inferior leads. She is going to a telemetry floor for a cardiac complaint. I assume there...

Not a single person here nor anyone else I’ve seen throughout social media has done anything but call out EMS for doing the wrong thing. For once our profession shows some ownership of wrongdoing. Truly an awful example of how the police are treated unfairly. not sure why law enforcement even...

lol spare us the blue lives matter histrionics. This crew willfully made a terrible choice. I haven’t seen anyone argue that they didn’t make a colossally poor judgement. And they should be charged criminally, without a doubt. It is your responsibility as a provider to know that this position...

If we have the patient we are just going to leave. No sense waiting for the assailant to come back.

Lol no the place I do healthcare things in does not have roaches.

Why are we giving pressors to chest trauma?