2nd year Rt student, a few of us were chosen to deliver a mini vent class and lecture. What things do you wish you understood better with regards to ventilation and oxygenation, as well as all things regarding ventilators and their modes? I'm just trying to gather thoughts and narrow my scope before working on slide shows and my lecture.

I had some various questions lined up but I decided to narrow this to individual issues where each person might be able share their own areas of struggles. It would also be helpful if you do have a good understanding, to share things you see new grads struggle with.

Edit: Our RT instructors will be present and presenting alongside us. All content must be preapproved, and we are required to present our material to our instructors before presenting it to the students. We are also selected based on our GPA, and each student must receive three votes from our program professors to participate. These requirements are in place to ensure that we stay within our scope of knowledge and expertise.

My agency is finally getting with the times and adding norepi to the arsenal. I’ve only ever used norepi on a pump at a different agency and that was great.

The proposed plan by them is to run norepi without a pump with 60 gtts tubing that has a more precise way to manually adjust flow.

How do you all feel about this? US by the way.

Hi, everyone. We are getting ready to roll out our new protocols here in Delaware on November 1st. Here's probably the biggest "hot button" protocol for this year's update. I just wanted to get some opinions on this one, and I was wondering if anyone has anything similar.

Please excuse the formatting as I copied and pasted it from a PDF.

COMFORT CARE/END OF LIFE CARE

INDICATIONS: An adult patient has a life limiting/terminal illness, prefers focus of treatment to be comfort and has a valid DMOST form specifying “Treatment of Symptoms Only/Comfort Measures,” or the patient is confirmed to be enrolled in hospice care.

Exclusion: patients who are FULL CODE.

Patients or family may choose to exit this protocol at any time.

The goal of comfort care is to reduce patient’s symptoms and distress and maintain patient dignity by aligning their care with their stated end-of-life preferences. All interventions should be minimally invasive with the goal of keeping the patient comfortable and reducing pain. If the patient is enrolled in hospice care, contact the hospice care agency.

Discuss with the patient and/or caregiver the reason for calling 911 and their goals of care. Review home management versus transport options and engage in shared decision-making. If clinically appropriate, consider treatment on scene. If the patient cannot be safely or comfortably managed at home, arrange transport to the hospital.

If there are any unresolvable issues regarding an appropriate treatment plan, contact medical control.

Do not administer Naloxone.

Ensure patient is warm, clean, dry, and comfortable. Use supplemental oxygen as needed for patient comfort. Suction the airway as needed for patient comfort.

Administer Ondansetron (Zofran) 8mg ODT, IM or IV for any nausea. For refractory nausea/vomiting, after 10 minutes, administer 1.25 mg Droperidol IM or slow IV push.

Treat for pain based on patient’s subjectively reported symptoms. Acetaminophen, Ketorolac, and Fentanyl may be given concurrently. Hypotension is not a contraindication for Fentanyl during Comfort Care.

Acetaminophen (Tylenol): Give 975-1000 mg of Tylenol PO if patient can tolerate PO.

Ketorolac (Toradol): Give 15 mg IM or IV.

Fentanyl: Give 100 mcg of Fentanyl IM or IV. Can be re-dosed after 5 minutes for persistent pain. Maximum total of 400mcg permitted. Contact medical control for additional doses.

Contact Medical Control for consideration of Ketamine to treat refractory pain.

Treat anxiety based on patient’s subjectively reported symptoms. During Comfort Care it is acceptable to administer Fentanyl and Midazolam concurrently. Hypotension is not a contraindication for Midazolam during Comfort Care.

Midazolam (Versed): Give 2mg IV or 5mg IM. Contact medical control for additional doses.

For hypersecretion, administer 0.5mg Ipratropium Bromide (Atrovent) by nebulizer.

May assist family with utilization of hospice provided comfort pack.

Patient disposition may include:

• Transfer of care to hospice.

• Transport if necessary.

• Refusal of transport. o To include release of care to family. Contact medical control if interventions have been performed for refusal.

• Telemetric pronouncement of death.

I saw this in my phone's settings as a suggestion to set up. It seems like a useful tool, but I'm curious if anyone would actually receive the information this way anyway.

Miniature model from Hamilton, Ontario, Canada! Approximately 2.4%/1:42 scale. Took about 14hrs in total.

I have this wierd thing where whenever i even hear someone talk about a massive hermmorage, amputation or whatever my body goes cold and i collapse- let alone seeing it. Is it possible to overcome this? i’m in the military and i wish to become more involved with trauma care but this is preventing me

Hey y'all.

So I had a thought today, and I'm curious how the rest of you view this.

I'm not sure about the rest of the world, but in my area, paramedics don't have a lot of room for advancement. We can make field supervisor....maybe. Go to flight or critical care, but again, in my area they generally don't make any more money, just work a different schedule. So then I thought about it. Paramedicine is the equivalent to fry cook at McDonald's. It's an entry level position. We have the ability, by being in the right place at the right time, to keep people alive that would otherwise die without our intervention, but we are the lowest paid degree in the medical field, with some of the highest burnout rates, and highest suicide rates.

So I'm curious, as a profession, how are we going to fix this? Can it be fixed? Is the system too broken?

Over half of my company currently is bridging to nursing or in PA school, which leaves us with a handful of the old, grumpy medics like myself, or the brand new 20 year old medics, without much in the middle. There has to be a better way. What are your companies doing to increase retention? Combat burnout? I'm not asking what you do in your spare time, everyone's coping skills will be completely different. Im asking what your organization is doing for its medics to end this vicious cycle, or what pathway you are all taking to exit it on your own. (I'm back In school actively pursuing a way out as we speak)

Hi all, looking at OCEMT for paramedic school, it says it’s a 6 month program, is that everything? Intern, clinical, didactic? How’s the entrance exam? How’s the interview? What questions would be asked? Anyone go through the program and what was it like? Thanks for all the insight