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Labetalol? Doesn't that last for up to 12h? Metoprolol and esmolol FTW.

EMCrit has some good stuff on this. Delirium Tremens is perhaps best treated with repeated boluses of Valium, at 10 mg each dose (IVP). Striking, huh? In my short career I've seen Fentanyl tank a pressure a few times, but every time the pt had something very clearly wrong with them that...

I could be totally misinformed, but isn't the I99 course around 800 hours? Why not just take a medic course?

68, passed. I think it took about half an hour.

Can someone please fix the grammar on this thread's title? It's driving me nuts.

Take note that a CNA isn't a nurse, but a "certified nurse's aid." It's fairly analogous to an EMT-B tech working in an ER. Out east we had CNAs, out west we have EMT-B techs. I feel like the "tech" title commands more respect.

It's these damn rural ER docs. Half of 'em are family practitioners playing around. Going to med school does not an ER physician make. You were 100% right. Just wait 5-10 years, when reasons NOT to backboard are taken more seriously than reasons to throw a pt on a piece of plastic with few...

I've been thinking about what I'd like to have around. Going to the doctor is a pain, esp. when you wait around for 2 hours just to walk in and ask for Keflex. BP Cuff Stethoscope Glucometer ENT Kit Gloves Gauze 4x4's 20ish Abd Pads 10 Kerlix 20ish Coban...

I wouldn't see a need for a 12-lead with those vitals and generally sick appearance in a 20 something y/o M, but agree with you that he should get one given his syncope Hx. Pity he didn't get a halter monitor earlier. Gastroenteritis FTW. You vomit, get hypotensive, maybe pass out, and make a...

Wow, this is terrible advice. Most EMTs and even medics suck at neuro exams. When you suck at something, you should get better at it, no matter your cert level. Every full neuro exam should include the following: GCS (includes A&Ox whatever) CSM x 4 Cranial nerves (this is where it gets...

Headscratcher. But what do you guys think the underlying pathology is? I'd like more info, obviously - did the pt ever have any complaints other than AMS/lethargy? CVA doesn't make sense based on progression. I'm thinking possibly UTI to start, perhaps with rhabdomyolysis around when the husband...

Would you mind giving us some more examples? It's going to be very difficult to convince your supervisors that this medic is dangerous without concrete examples, especially since you're a new EMT. I don't doubt you're right - there are plenty of awful medics out there and many of them work for...

Clinic referrals and antibiotics would make my day. Cut transports in half. I note you have "MD" in your training. I plan to go down the same road in a few years. Ultimately, I think paramedicine needs to progress to the level of nursing so that we're respected as healthcare providers.

Nitro doesn't normally drop BP that much, but if the patient is having a RVI or is in pre-cardiogenic shock, it will tank it. IMHO, it should not be given without a 12-lead (15-lead, really), by a medic, ever. Most physicians who prescribe NTG to their patients will only do so after EKG and...

Nitro hasn't been shown to significantly decrease morbidity or mortality. Aspirin has, and that's what EMTs should be giving. If there's CP over 4/10, EMTs should be able to give IN fentanyl.

For noobs and nerds. ACLS algorithms are easy to learn, and there's no excuse for delaying treatment, especially while consulting some card that just tells you all the stuff you should already know. Calipers may be useful in some cases, but I can't really image a case where you would need to...

Medic: "I'm calling for a field pronunciation." MD Med Control: "FIELD." (Hangs up)

I read somewhere semi-legitimate that coke is the best hangover cure. My protocol: 1. Finish drinking 2. Drink a liter of water 3. At least one hour between last drink and bed 4. Liter of water upon waking 5. Coke if hungover But let's face it, hydroponics are the best prophylaxis (not...

For the most part, this is why we have medics. That said, I'm all for EMT-Bs doing more for their pts. First off, they need better assessment skills. As a medic now, I can't believe the crap I didn't know as a basic. I thought I did then, but boy, was I wrong. Better pharm, esp., to include...

I agree with what others have said - it's a dynamic process. MOST IMPORTANT: a good knowledge of pathophysiology guides your history. If you know how the body works, you'll know what you want to ask. Here's an example of questions I'll ask in different settings, by no means all-inclusive: All...