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2mg IN rarely needs to be titrated, I'm not 100% sure what the fear is? IV naloxone is far more unforgiving. Perhaps I've just seen too much ham handed BVM use.

The number one reason is (possibly) misplaced accountability fears. A very, very close number two is the FDA's stance on "adulterated gasses" makes the blenders a serious pain in the *** to obtain and carry around. Worked one place that had it, and it was great. Maybe one day we can get it...

I cringe when I read this...unskilled BVM use has killed a lot of people.

I've seen them carried, but most blood banks are pretty insistent their tubing be used, even in traumas. So it's pretty pointless honestly.

I'm gonna take a guess that VinBin has never worked more than 30 minutes from a tertiary center.

So you would say there's no utility in using it to determine the correct destination?

I'm fairly certain you would need to consult a lawyer and get an official accounting of what happened. This sounds way too much like legal fishing.

It's funny how the world is small enough you know what programs everyone works for.

Fixed wing Paramedic/Paramedic crew in a King Air C90.

Last time I checked, my ambulances/aircraft weren't really any dirtier than an ED room. I've worked in both. Preventing contamination is more of a training issue than anything.

Strive to learn medicine and common doses for common conditions. Protocols, ect, really aren't the important thing to learn.

Those both clock in pretty damn high on the list....

Ok, I'll admit I'm grumpy and I apologize for that. That said, there's a number of ways to obtain the info you're looking for. Maybe not with a neat little clean number (that really means very little without a baseline ABG, but that's another story), but honestly good assessment skills won't...

6 times in a day, we knew her well. MedStar MH in Fort Worth stopped billing one guy at four million dollars outstanding debt.

Yes, and medicine is the real job of EMS providers. Not public safety, not firefighting...delivering medicine in out-of-hospital, transport and austere environments.

By the way it's end TIDAL carbon dioxide. You know...like TIDAL volume. Perhaps learn the name of the tool before you lecture on its use.

Yeah...no. You don't have a farking clue what you're talking about. If that's the case then why isn't every little old lady in a SNF wearing ETCO2? Or even every patient in an ICU? Get your head out of Backboard Action Monthly and into a physician level text if you want to learn medicine.

A lot of EMS providers like ETCO2 because it gives a nice, neat number that doesn't appear to give false positives nearly as much as SpO2. However many times they don't really understand what they're looking at and how different is actually is from PaCO2, and that hypercapneia almost never kills...

But you can't tell me anything about the quickest killer of your patient with ETCO2 Nate :D

Hyperkalemia if you can't deliver calcium chloride. I'm unsure of your level and location.