taidan

i stand corrected. I heard this from some paramedics at my department with shiny new B.Ss. thank you for the info

CUrrent paramedics are not required that is true, but any new students taking emt-p under the new DOT curriculam must have an AA degree. EMt-p was moved up and the new emt-i is occupying the space P '85 had.

I just want all the nurses to realise what we are not all as abrasive and arrogant as medic 173. There are people like him in all health care fields. I agree with some of the other posters. In md paramedics get a licsense and are now required to get an AA. THe training involved in both is vastly different and as said before hard to compare.

actually from what i understand the new DOT curricula requires a paramedic to have atleast an AA degree. Regarding licenses, a nurse has their own license because they require doctors order to push drugs. If they had standing orders (like paramedics do) to push drugs, intubate etc. they would require a license under a physician. You are comparing apples and oranges.

I have never seen or heard of that procedure before. Transcutaneus pacing usually works well enough untill we get to the hospital.

Another treatment for hyper K Is, wide tented T's Thiazide Diuretics Depresed st and prolonged qt Bicarb, albuterol and glucose insulin then lasix prolonged QRS/ sine waves Calcium chloride, then bicarb, then lasix. THe calcium as mentioned before antagonises the myocardial affects of Hyper K, the neb and bicarb produce a temporary intra cellular shift of K and the lasix removes k into urine. Also two questions what heart sound is associated with endocarditis (sp?) and what specifc ECG wave is seen in hypothermia?

With the new DOT Guidelines ALL Paramedic Classes have to be at min. AAS. And there are many great B.S. In paramedicine programs out there.

to think you cant can jump right on a unit and run calls shows your lack of understanding of what really goes on. Besides the additional medical and clinical skills you have to be able to controll and manage a scene with possibly dozens of lower providers, family members , firefighters, patients, cars, police, all att 3am on the side of the road at 5 degrees below while treating patients. You wouldent like it if I came into and ER or MED-SURG floor and start working as a nurse would u?

First stop the RN- Medic- LPN pissing contest. All three have their own place in a healthcare team. There are competant and incompetant Medics EMTs Nurses etc There Are even some MDs I would not want getting within ten feet of my parents. Second, Cardiac Care like most of medicine is an art. Yes ACLS recommends certain energy settings but depending on the experience of the provider these may be changed. There are plenty of ACLS recommendations that I have modified to treat patients. For example 100J monophasic Sync. is the recommended starting energy for Stable v-tach. I have started at settings of 50 or even 25 and have been successful. Another good one I always like to bring up is that ACLS says a levophed(norepi) drip should be started on a CHFer with a SBP under 70. A CHFer already as a high SVR and therefore becayse norepi has relatively low Beta stimulation Relative to its Alpha effects it might bring BP up but there would be no significant forward flow/cardiac output third, unfortunately Sudden V-tach in young otherwise healthy individuals does happen all too often. It usually stems from some kind of conduction abnormality such as a prolonged QT interval. This coupled with vigorous physical activity may cause bouts of V-tach or Torsades. Rant Off

Yup. esp. for us Medics :) , Before My service got Fentynal I would give morphine then the docs would complain that they cant do a motor sens. exam. Now with fentynal the anelgesia is more potent and shorter acting. Also has less adverse hemodynamic effects.

lol I just meant normal Ringers With nothing added

I agree the intravascular fluid shift may be fairly temporary but, especially pre hospitaly when Blood products and rapid transfusers aren't always available the extra fluid can usually keep a patient alive untill defintive care, oftentimes from my exp. not possible with vanilla LR or NS

in the EMS service i work with we have a choice of either versed/fentynal or etomidate then succs. We use lido for ^ICP and atropine to blunt brady in peds.

Because NaCl Is a hypertonic solution giving only a 250 ml bolus can actually increase blood volume by 500 ml or more. It also helps improve renal function something usually lacking in severly hypotensive patients

Hey, I have been reading the forums for a couple of months now and I would like to thank allnurses.com and all its members! I have gained much knowledge and pearls of wisdom simply by hanging around I am a paramedic student in MD and I have this nagging problem with starting IVs. I either underestimate the resistance of the vein and end up causing a nasty lac or I push too hard, infiltrate and leave a nasty hematoma. I cant seem to find the right amount of force and I don't want to go around hurting more people lol. I have tried slow insertions and quick jabs but nothing seems to help. Any suggestions?