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  1. #121
    Forum Member IronsMan53's Avatar
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    Quote Originally Posted by croaker260
    And yes, you are correct, it is Glen Cooks work that my screen name comes from...probably one of the most underrated "old school writers" in the genre.....Have you read it or just searched and came up with it?...long story how I got stuck with it, but it is the proximal cause. Where do I send the beer money?
    I tried reading it but just never got into it. I had a friend that was a fanatical Glen Cooks reader and I didn't hear the end of it until I tried the book. I will admit I couldn't remember the name so I did have to google that. Keep the $ I have plenty of beer on hand.

    As far as the rest of your post... I think you are really paranoid about this. Your views are the same ones of gloom and doom that many medics had here before the merger. They were exaggerated and unfounded.

    A few accounts that you have heard on the internet does not apply to a whole system.

    BTW, it was the public safety director and county administrator's idea to merge our departments. (neither of whom were ever firefighters) It seems that they were wanting to become more efficient and to ensure that everybody was operating on the same page at incidents.
    I can't believe they actually pay me to do this!!!

    One friend noted yesterday that a fire officer only carries a flashlight, sometimes prompting grumbling from firefighters who have to lug tools and hoses.
    "The old saying is you never know how heavy that flashlight can become," the friend said.
    -from a tragic story posted on firefighterclosecalls.com


  2. #122
    Forum Member IronsMan53's Avatar
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    Quote Originally Posted by firefight99
    I've been off for a while because of no power, phone due to Hurricane Wilma...
    I'm guessing Croaker is either TrojanHorse, or a close relative.
    Yeah... He's the same, only different.
    I can't believe they actually pay me to do this!!!

    One friend noted yesterday that a fire officer only carries a flashlight, sometimes prompting grumbling from firefighters who have to lug tools and hoses.
    "The old saying is you never know how heavy that flashlight can become," the friend said.
    -from a tragic story posted on firefighterclosecalls.com

  3. #123
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    Quote Originally Posted by medicmaster
    Actually...I have used amiodarone three times in the last month...just used procainamide a few weeks ago.

    I use a number of medications that fire based EMS systems don't regularly use because I work out of a hospital...I use alot more of my skills in the ER and inpatient units than I do on the rig...which is exactly why I don't think ALS belongs in the fire service.
    Well of course you will, and you should be allowed to.


    Croaker, I suggest a minamilst approach on EMS why...because when it comes to aggressive street medicine, in all reality, you don't need 1000 drugs to do your job. In my area we preach aggressivness as we have a largely rural environment. Our arrest survival rates are just as good as anywhere else in the nation, except for Oregon/Washington, they probably have a better rate..but that's only numbers. If I can work a code with only a few select drugs that I know can have a profound effect, why should I have more to select from, just makes my job harder. Obviously I threw out Procainamide, and Amiodarone only because they are two prevalent cardiac drugs within most paramedic services. Take a look at what else you use on a routine basis..then throw out what you either never have used, or ones with the chance to use is so low, it doesn't bother to carry them. It would be amazing to see what you get rid of.
    FF/NREMT-B

    FTM-PTB!!

    Brass does not equal brains.

    Courage is not the absence of fear, but rather the ability to control it.

  4. #124
    Forum Member medicmaster's Avatar
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    Quote Originally Posted by pfd4life
    Well of course you will, and you should be allowed to.


    Croaker, I suggest a minamilst approach on EMS why...because when it comes to aggressive street medicine, in all reality, you don't need 1000 drugs to do your job. In my area we preach aggressivness as we have a largely rural environment. Our arrest survival rates are just as good as anywhere else in the nation, except for Oregon/Washington, they probably have a better rate..but that's only numbers. If I can work a code with only a few select drugs that I know can have a profound effect, why should I have more to select from, just makes my job harder. Obviously I threw out Procainamide, and Amiodarone only because they are two prevalent cardiac drugs within most paramedic services. Take a look at what else you use on a routine basis..then throw out what you either never have used, or ones with the chance to use is so low, it doesn't bother to carry them. It would be amazing to see what you get rid of.
    Since this statement is coming from an EMT-Basic that doesn't use drugs, let me enlighten you....

    Drugs I carry in the rig, their purpose and average usage-

    Epinephrine- Cardiac Arrest, Asthma, Anaphylaxis (Frequent)

    Atropine- Cardiac Arrest, Bradycardia (Frequent)

    Lidocaine- Ventricular Arrythmias (Moderate)

    Lidocaine Drip- Post Arrest and Ventricular Arrythmias (Moderate)

    Adenosine- SVT and other Narrow Complex Tachycardias

    Verapamil- Atrial Arrythmias, Refractory SVT (Frequent)

    Dopamine- Decreased Cardiac Output (Moderate)

    Retavase- Thrombolytic for AMI (Moderate)

    Heparin- Required for Retavase administration (Moderate)

    Nitroglycerine- Chest Pain, CHF (Frequent)

    Nitroglycerine Drip- Chest Pain refractory to SL Nitro, CHF, Hypertensive
    Crisis (Frequent)

    Cardizem- Atrial Arrythmias (Moderate)

    Sodium Bicarbonate- Cardiac Arrest (long downtime), Crush Injury, Tricyclic Anti-Depressant OD (Moderate)

    Valium- Seizures, Sedation (Frequent)

    Versed- Sedation (Frequent)

    Morphine- Chest Pain, CHF, Pain (Frequent)

    Fentanyl- Pain Assocaiated with Ortho Injury or Abdominal Pain (Frequent)

    Phenargan- Anti-Emetic, usually given in combination with Morphine, or for IFT when pt. c/o Motion Sickness (Frequent)

    Dextrose 50%- Hypoglycemia (Frequent)

    Aspirin- Chest Pain (Frequent)

    Calcium Chloride- Hypokalemia (Rare)

    Magnesium Sulfate- Asthma, Cardiac Arrest, Premature Labor (Moderate)

    Oxytocin- Post Child-Birth (Rare)

    Narcan- Opioid OD (Moderate)

    Romazicon- Benzodiazepine OD (Moderate)

    Benadryl- Allergic Reaction, Pediatric Sedation, Anaphylaxis, Asthma (Moderate)

    Albuterol- Asthma, Allergic Reaction, Anaphylaxis (Frequent)

    Lasix- CHF (Frequent)

    Critical Care Transport Drug Kit-

    Succinylcholine- RSI (Frequent)

    Etomidate- RSI (Frequent)

    Versed- Sedation,RSI (Frequent)

    Norcuron- RSI (Frequent)

    Propofol- Sedation, RSI (Frequent)

    Nimbex- RSI (Moderate)

    Mannitol- Spinal Cord, Brain Injury (Moderate)

    Hespan- Volume Expander (Moderate)

    Oh, and of course...Oxygen (Very Frequent)

    Out of all these drugs....Looks like I could only do away with 2 of them! I'm not very amazed with what I would get rid of....Oxytocin and Calcium Chloride....
    Last edited by medicmaster; 11-07-2005 at 03:01 AM. Reason: Got called away for a call.

  5. #125
    Forum Member gunnyv's Avatar
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    As I mentioned, not every med control MD is enlightened enough to let us use all that. Even some of the drugs we do carry, we are limited in their use to post-radio for some of the conditions you mentioned. Our protocols are vary narrow. Out of all that you carry, here's what we carry:


    YES-Epinephrine- Cardiac Arrest, Asthma, Anaphylaxis)

    YES-Atropine- Cardiac Arrest, Bradycardia

    YES-Lidocaine- Ventricular Arrythmias

    YES-Lidocaine Drip- Post Arrest and Ventricular Arrythmias

    YES-Adenosine- SVT and other Narrow Complex Tachycardias

    NO, RECENTLY REMOVED-Verapamil- Atrial Arrythmias, Refractory SVT

    YES-Dopamine- Decreased Cardiac Output

    NO-Retavase- Thrombolytic for AMI

    NO-Heparin- Required for Retavase administration

    YES-Nitroglycerine- Chest Pain, CHF

    NO-Nitroglycerine Drip- Chest Pain refractory to SL Nitro, CHF, Hypertensive
    Crisis

    NO-Cardizem- Atrial Arrythmias

    YES-Sodium Bicarbonate- Cardiac Arrest (long downtime), Crush Injury, Tricyclic Anti-Depressant OD (Moderate)

    YES-Valium- Seizures, Sedation

    NO-Versed- Sedation

    YES-Morphine- Chest Pain, CHF, Pain

    NO-Fentanyl- Pain Assocaiated with Ortho Injury or Abdominal Pain

    NO-Phenargan- Anti-Emetic, usually given in combination with Morphine, or for IFT when pt. c/o Motion Sickness

    YES-Dextrose 50%- Hypoglycemia

    YES-Aspirin- Chest Pain

    YES-Calcium Chloride- Hypokalemia

    YES-Magnesium Sulfate- Asthma, Cardiac Arrest, Premature Labor

    NO-Oxytocin- Post Child-Birth

    YES-Narcan- Opioid OD

    NO-Romazicon- Benzodiazepine OD

    YES-Benadryl- Allergic Reaction, Pediatric Sedation, Anaphylaxis, Asthma

    YES-Albuterol- Asthma, Allergic Reaction, Anaphylaxis

    YES-Lasix- CHF

    NO-Succinylcholine- RSI

    NO-Etomidate- RSI

    NO-Versed- Sedation,RSI

    NO-Norcuron- RSI

    NO-Propofol- Sedation, RSI

    NO-Nimbex- RSI

    NO-Mannitol- Spinal Cord, Brain Injury

    NO-Hespan- Volume Expander

    YES-Oxygen

    And we just got Amiodarone and Childrens Tylenol-you don't have that? How backwards your service must be!

  6. #126
    Forum Member IronsMan53's Avatar
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    gunny, we run exactly the same meds in our system. EMS didn't even have that many when we merged with them. We are slowly getting more meds out of Medical Control though.
    I can't believe they actually pay me to do this!!!

    One friend noted yesterday that a fire officer only carries a flashlight, sometimes prompting grumbling from firefighters who have to lug tools and hoses.
    "The old saying is you never know how heavy that flashlight can become," the friend said.
    -from a tragic story posted on firefighterclosecalls.com

  7. #127
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    Medicmaster..just because I'm a basic on the street, does not mean I don't have a higher level of training for use elsewhere... The drugs you listed are just about everything our paramedic rigs do, but there are a few I'm aware of that carry twice, if not three times that.
    FF/NREMT-B

    FTM-PTB!!

    Brass does not equal brains.

    Courage is not the absence of fear, but rather the ability to control it.

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