I gotcha bud.

If anyone has any medical questions feel free to ask.

Join your local volunteer fire department, most will send you through basic first responder, as well as give you a jump bag. 🙂

That’s true.

I got all kinds of goodies.

If you have access and the funds, try to get an EMT-B class under your belt.

@[LA] Zoomer Medi/k/ definitely in the works hopefully this year.

I haven’t taken any classes if I’m honest. I just screw around with the paramedics I know and learn everything from them.

I learn from them and combat medics.

Certain things you learn in EMT and Paramedic are not applicable to combat medicine, however. Such as push dose pressors.

Yeah I’m a career fire fighter, as well as volunteer, I live in a small rural part of Georgia so I work closely with our medics and I’ve learned more on scene from them than any class.

@[LA] Zoomer Medi/k/ exactly.

I talk with the medics around me pretty often.

Because I’m bored, let’s go over with push dose pressors aren’t applicable for combat medicine.

The main reason is they bust clots.

They may increase heart rate and pulse strength, but in the process, they will break blood clots and make hemorrhage worse.

And unlike typical EMS, combat doesn’t usually have blood on hand.

Which means that any blood lost is irreplaceable.

You’re damned if you do, and damned if you don’t.

And because blood is the life force of the casualty, breaking clots and causing hemorrhage is a no-go.

IV/IO are amazing if you can do it.

The order of effectiveness for IV stuff is this:

Well if they have a pulse you just have to be careful it’ll definitely be worse.

Fresh whole blood, blood products, colloids, crystalloids.

That’s the order that you will want.

epinephrine wise anyway

Hetastarch and Hextend are nice. TXA as well.

Hetastarch definitely

> epinephrine wise anyway
@ToɳTo Tuck

By all means. Works well to increase blood pressure but breaks clots.

TXA is very effective for internal bleeding, other than the ~45 minute wait for it to kick in.

I’ve never been around any TXA

Not familiar at all with it

Transexamic Acid

Lysine

I think I know what it is

But haven’t seen it used

Definitely gonna research

Thanks 🙂

Pretty sure it’s a colloid

I haven’t went on any calls so I haven’t either. *But* talking to both combat medics and paramedics, it’s wonderful stuff.

Also, DSI > RSI

Yeah I’m trying to think if it’s named something else?

I’m not sure.

Another thing: KETAMINE IS AMAZING

TXA is awesome, Ketamine is more betterer. I don’t give a fuck what anyone says, it causes respiratory depression 😂 great for keeping BP from shitting and if given with Benzos helps the emergency phenomenon.

I can see how it would cause respiratory depression

Used Ket <20 times. Worked like a champ though

Especially when you’re putting someone in a whole different world

Had a medic tell me about one time having to use ketamine because of behavior

Guy was threatening the medic

Yeah i gave it to one guy with a GSW to the shoulder, he was screaming about pain and once he was secure he went deep in the K hole.

He put some Ket in that guys system IM, and in like 1 minute he was in a whole different world

I’m so fucking glad there are guys here to talk medical with

None of my other servers have guys interested

Snapped out of it as we were pulling i to the ER, looked at me and said ‘God??’ I said no man other end. He said ‘Jesus christ’ and just starred at the roof of the ambulance, after that everyone who got Special K, got 2 of versed. My old service had protocols for ketamine for excited delirium.

Yeah its hard to find folks who give half a fuck about basic care let alone combat care/advanced shit.

I gave a guy 500mg IM one night. Head on MVA. Ejections, fatalities in the vehicle. It was really cold, and i guess it sat in the muscle until he warmed up a little. He was quiet in the ER for several hours lol he had multiple lower extremity fractures so he was in deep space with the mormons for the poking and prodding and xrays

Holy hell

Yeah got stories for days about weird shit lol

The guy I was just referring to said “IM GONNA FIGHT IT OFF, THE MEDICINE ISNT GONNA HURT ME” and then immediately went into that different place

He came back to Earth and the medic said “I thought you were gonna fight it off?”

I’ve heard about some fucked up shit.

Lol

Yeah i usually have people count back from 10, he said 10 and then stopped breathing

I don’t actually do EMS, I just know quite a bit. Combat medicine is more my stuff. I do know what MVAs and everything are though. Volunteer firefighter.

I remember being put under once and they did that.

Yeah. I enjoy combat medicine. Id take that over some idiot with a BGl of 800 because those donuts are just so tasty

I feel dizzy, yeah because you weigh 400lbs and are going blind

Sorry, burned out lol

On god

EMS can see fucked shit tho

Medic I know

Responded to a real bad one

Guy was an alcoholic, had esophageal “varrasies?” I don’t know how to spell it anymore damnit.

Essentially, he wasn’t doing so hot one night but his friend just thought he was drunk. Woke up the next morning, called, no answer. Sent police on a wellness check.

Medic got called in

He knew it was bad the second he saw the firefighters face.

A “holy fuck what do we do” kinda face

He walks in and follows a gargling sound to the guy in the bedroom

So turns out

Guy had a stroke, the esophageal shit busted, got into his stomach, and made him throw up, and he was drowning in his own blood and vomit

* After having a stroke

Medic just cleared what he could

esophageal varices... fucking sends shivers down my spine lol

Was gonna intubate but didn’t wanna make the esophageal varices worse.

Varicose veins in your esophagus basically, get fat and full of blood then they explode. Ive had pts with them, my go to is RSI and TXA and haul ass

So he bagged that bitch up till oximetry was above 90 and just went enroute to hospital.

Keep systolic at or around 90 and you’re gtg

Yeah I know what it is

Fucking oof

You a paramedic?

Yes Sir

Unfortunately lol

I don’t have any certs at all

I just know stuff

🤷🏻‍♂️ive seen folks with all the certs in the world be absolute shit providers. Mindset is everythinng

True

Was with that paramedic and he was quizzing an EMT because he was about to get on with Acadian

I knew everything that EMT did and knew it faster

Quick convo with you and a look through the shit you’ve been posting, you’re already more competent than most medic students I’ve precepted lol