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I have seen wpw from 150-300 that wasnt seen until it was slowed down. remember rate alone does not justify the rhythm. I also disagree with "Leaving it Alone" as I have treated many patients that were pretty symptomatic due to the rate, due to preload, who discontinued all of the s/s post...

Cardizem is an awesome medication that works well with afib with rvr, the major effect is hypotension which responds well to bolus. Truth of it is that if you have an afib with rvr at a high rate you cant really tell if its wpw untik you get good reduction in the rate

wow, you sill carry calan on the truck? procanamide is the best choice currently, however we actually cangive diltiazem for it based on our medical director.

We use Ketamine in the prehospital setting and I can tell you that it is a great and fairly safe medication when given appropriately.

We have the option of versed or ketamine:rolleyes:great option

Lol the only way a NM 911 service could obtaion those medications would be for that service to do a special skill application through the state and thats ALOT of work. I have done that for AMR in Dona Ana county for cardizem.

Paintball, I no longer work in NM, Im in TX but thanks for noticing. I just havent changed my profile thingy. :blink:

RSI absolutely :P

We have Ketamine, Fentanyl, Nitrous Oxide all great choices foer different situations Versed and Valium but would like to Ativan

The Bicarb is mainly given because of the Sodium in the medication because as the post earlier its the sodium channels being blocked prolongs the QRS interval it also secondarily helps with the acidosis. So after giving it the channels are flushed and reopen allowing the sodium the go in and...

Absolutely, apparently your Instructors havent seen it before but that doesnt mean it cant happen so they are wrong. I have had this happen a handful of times.

That is correct, first line no excluding arrest and near arrest. The problems that I see is that the new or green medics use it as a crutch at times because its new and cool. I think the good ol IV attempt or even the easy with a fairly high successful EJ is going to the wayside for some...

I said perhaps a DD but not me personally. Anything is possable as is my big toe hurts and I fell and hit my head. Not all AAA will have a difference in BP and not all different BP in arms indicates AAA clearly however its one of many assessment tools you have that could help in your DD. No...

Perhaps a little initially but not so much for me personally. The decomp shock presentation is clearly representative of more than just kidney stones. Also typically kidney stones by itself usually wouldnt cause someone to fall without defending it or bracing it. Remember that typically an...

Flying him for the presentation that you gave i wouldnt have and it really doesnt match a kidney stone at all. Did you ever get BP on both the arms?

Yes it could be a junctional strip with the p wave falling after the qrs or perhaps atrial enlargement with prolonged q-t interval. Hard to guess without the strip.

Ya that sucks and you can give zofran to peds typically its weight based until you reach 4mg the adult dose. We also carry zofran ODT and we give 8mg for adult because typically the range is 4-8mg. Typically for peds its 8-30kg you can give up to 4mg.

Fox800 I agree with all your reasoning of why to give it and how often. We can give zofran or phenergan its the medics preference. ME personally if you havent yacked but fell like it Ill probably give zofran but if you are currently yacking Ill probably give you phenergan.

I would look at the weight of the patient more than the size. Typically ped pads are for 10kg and less and alot of services only have adult and ped pads so there could be some of a gray area so to speak. So Adult pads A/P is what I would do for the instance.

AMR has alot of upper managment and HR issues.