the 100% directionless thread

RocketMedic

Californian, Lost in Texas
4,914
1,381
113
Those suck. I had a DOA a few years ago that was essentially the perfect sleeping storm. Parents were idiots.
 

NysEms2117

ex-Parole officer/EMT
1,946
908
113
Well if anybody is interested the FDNY chief position is open for the first time in a good long while! My uncle officially retired after 40+ years of being a firefighter! Never seen so many politically influential people in one spot(retirement party).
 

Old Tracker

Forum Captain
493
251
63
Even if I were qualified for the position, there isn't enough money in Besos portfolio for me to even consider moving east of the Mississippi River, let alone NY. But, thanks for the vacancy announcement anyway.
 

NomadicMedic

Pot or Kettle? Unsure.
11,898
6,602
113
I love when people who have NO IDEA what they're talking about expound on how to fix EMS and deliver patient care. I mean... people are f'in clueless. There are several threads here that serve as prime examples.
 

NysEms2117

ex-Parole officer/EMT
1,946
908
113
Even if I were qualified for the position, there isn't enough money in Besos portfolio for me to even consider moving east of the Mississippi River, let alone NY. But, thanks for the vacancy announcement anyway.
it's so political now it doesn't even matter idt. but np :D lol.
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,439
3,142
113
Even if I were qualified for the position, there isn't enough money in Besos portfolio for me to even consider moving east of the Mississippi River, let alone NY. But, thanks for the vacancy announcement anyway.
Meh, I agree there are lots of places out west that are pretty much impossible to beat, but there are also plenty of places in the east that don't suck. There's a lot more here than NYC and Boston and DC.
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,439
3,142
113
https://www.ncbi.nlm.nih.gov/pubmed/28202295

Anyone ever set up intubation like this article was studying? Messed with it in school, never have actually done it. Might be something to revisit one of these days when I have a little down time.
In the OR, I don't always do this (I probably should) but if I have any suspicion that the airway might be at all challenging (i.e. the 120kg+ patient with OSA and COPD and MP4), I will tilt the bed into a little reverse t-burg and also raise the head up a little and then adjust the height to where I want it. This generally results in a pretty optimal position. I know, I know, this ability to make things "easy" is exactly why prehospital and ED folks don't like taking advice from us anesthesia folks, because "we don't know how it is" outside the OR (even thought I've been a paramedic for almost 20 years and spent a majority of that time in HEMS). But I digress....

Anyway, you can do close to the same thing on your ambulance stretcher and pillows. If you are on a living room floor or the side of the road or somewhere even more challenging, just do the best you can to align the axes and set up positioning to work in your favor.

"Optimization" is relative. In airway management, positioning and pre-oxygenation are easily the two most important things.
 

GMCmedic

Forum Deputy Chief
1,640
1,055
113
https://www.ncbi.nlm.nih.gov/pubmed/28202295

Anyone ever set up intubation like this article was studying? Messed with it in school, never have actually done it. Might be something to revisit one of these days when I have a little down time.
My medical director participated in a study at IU health with 1st and 2nd year residents intubating like that. I have the paper here at home. It was like 85% first time pass rate at 40 degree angle versus 65% supine. I dont remember the exact numbers. She told us to try it.

Sent from my SAMSUNG-SM-G920A using Tapatalk
 

StCEMT

Forum Deputy Chief
3,028
1,692
113
@Remi, the only time I griped about that was when I was told stylet/bougies were a crutch and I had precious few opportunities to practice as I work. That being said, I would absolutely love a chance to just learn the finer points of airway positioning techniques and medication administration.

Do you find that manipulating everything is easier with the head elevated?

@GMCmedic, those numbers are the same as the above article I believe.
 

GMCmedic

Forum Deputy Chief
1,640
1,055
113
@Remi, the only time I griped about that was when I was told stylet/bougies were a crutch and I had precious few opportunities to practice as I work. That being said, I would absolutely love a chance to just learn the finer points of airway positioning techniques and medication administration.

Do you find that manipulating everything is easier with the head elevated?

@GMCmedic, those numbers are the same as the above article I believe.
I just looked and the study you linked is the same one she gave us a copy of a few weeks ago.

Sent from my SAMSUNG-SM-G920A using Tapatalk
 

Old Tracker

Forum Captain
493
251
63
Meh, I agree there are lots of places out west that are pretty much impossible to beat, but there are also plenty of places in the east that don't suck. There's a lot more here than NYC and Boston and DC.

I was on a submarine out of Charleston, S.C. and that wasn't too bad, except for the humidity. We also spent almost a year in the shipyard at Portsmouth, N.H. okay, but dang it got cold in the winter. That being said, I really don't have a desire to even go visit those places. Lived in the DC area for two long, grey, damp, miserable years too. Never again!
 

CALEMT

The Other Guy/ Paramaybe?
4,463
3,312
113
Nothing like the sound of lead vs steel at 100 yards on a Sunday morning to make you feel American.
 

NysEms2117

ex-Parole officer/EMT
1,946
908
113

NysEms2117

ex-Parole officer/EMT
1,946
908
113
Took forever to zero my rifle... I'm better at sighting in my bow and arrow then I am guns.
how'd you like the good ol' LWRC?
 

CALEMT

The Other Guy/ Paramaybe?
4,463
3,312
113
how'd you like the good ol' LWRC?

I shoots straight. Have 300 rounds through it now. I can already tell I want to change out the trigger, but I'll roll with what I've got for the time being.
 
Top