Gag Reflex testing

[Flynnstone26]

The other day in class I brought up the question of WHY there is a correlation between eye movement and gag reflex and my instructor didn't even know. We brought the question up to one of the neurologist and his broken down answer is that since the two nerves are so close in proximity that once one is out it's extremely likely that the other is out.

 

[Muppet]

Glad to see you sticking with the basics; they save lives.

Refresh my memory Brother, as I am certain we have discussed this in the past, do you guys RSI by protocol? If so is lidocaine indicated in your protocol for increased ICP prior to Etomidate? Secondarily, there is a good bit of literature suggestive of a decrease in ICP of patients who receive single dose Etomidate.

As for advanced procedures, paramedic students, eager to complete their skills check-offs, and paramedics stuck on single paramedic trucks, fresh out of paramedic school, want to go straight to [more] advanced procedures instead of progressing step-by-step as necessitated by the patients needs.

Flynn26: Paramedic school is your time to question everything. This includes the basis for every skill, evaluation procedure, and treatment you are being taught. Knowing why is every bit as important as knowing what.

In P.A. bro, there is not ground 911 R.S.I. We have M.E.I. (Etomidate) but it is not a true R.S.I. Only the Etomidate w/o Lido, Atropine is used and that is under dosed. I have seen personally, Etomidate used on massive head trauma with sub par results including multiple tube attempts, bradycardia, vomiting.... Our medical director (since we have state protocols but the M.E.I. SOP is agency used) says that this was poorly written protocol and he would rather have true R.S.I. Our oversight on the Q.A. aspect is progressive and tight but again, the way it was written. We used to use Versed for M.E.I. until Etomidate was rolled out in "13". I have had 3, yes, 3 events where I needed R.S.I. and again, I fell back to B.L.S. ventilations, all were satisfactory used with Etco2 attached to B.V.M. Hope that answers that brother. Miss ya!

M.

 

[surgicalcric]

In P.A. bro, there is not ground 911 R.S.I. We have M.E.I. (Etomidate) but it is not a true R.S.I. Only the Etomidate w/o Lido, Atropine is used and that is under dosed. I have seen personally, Etomidate used on massive head trauma with sub par results including multiple tube attempts, bradycardia, vomiting.... Our medical director (since we have state protocols but the M.E.I. SOP is agency used) says that this was poorly written protocol and he would rather have true R.S.I. Our oversight on the Q.A. aspect is progressive and tight but again, the way it was written. We used to use Versed for M.E.I. until Etomidate was rolled out in "13". I have had 3, yes, 3 events where I needed R.S.I. and again, I fell back to B.L.S. ventilations, all were satisfactory used with Etco2 attached to B.V.M. Hope that answers that brother. Miss ya!

M.

That sucks ass... Now that you typed it out, I remember the MEI crap.

Looks like I will be back at WRNMMC in a few weeks. We should get together.

 

[surgicalcric]

The other day in class I brought up the question of WHY there is a correlation between eye movement and gag reflex and my instructor didn't even know. We brought the question up to one of the neurologist and his broken down answer is that since the two nerves are so close in proximity that once one is out it's extremely likely that the other is out.

Glad to see you followed up on your question. It is unfortunate that a paramedic instructor is passing on institutional medicine without understanding it. What BS.

 

[Muppet]

That sucks ass... Now that you typed it out, I remember the MEI crap.

Looks like I will be back at WRNMMC in a few weeks. We should get together.

Let me know bro. Maria and I will be there...

M.