Guest guest Posted February 9, 2009 Report Share Posted February 9, 2009 jarrodtomassi@... wrote: > First I just wanted to say, " What up to the fellow ISOS members " > > I've read through numerous discusions on this RSI topic. What I > realized, is your all smart and your all right. There are different > standards across the world. So one technique may not make to sense or > be as practical as anothers. Just remember stick to what you know. > Also don't forget you we're taught certain things for a reason. Which > was probably based on the area surrounding your courses. However you > are now remote and the world is allot different from downtown LA or > London. So you must be open to changing your style of paramedicine. > This is why remote medics are few and far between. You can spend all > day trying to convince one another lidocaine with ICP. Or even > treating right sided infarct with fluids only... Hi Jarrod, and welcome to the group from an occasional poster. Normally I would have left it at that, but you hit a bit of a button of mine here. I couldn't agree more that our approach to the practice of medicine will vary, by necessity, based on a lot of logistical and other variables. However, human anatomy and physiology (with very rare exception) remains constant across the human race, as do the body's needs in the face of ilness or injury. Whether you're an Islander from Fiji, a Russian from Siberia, or a gangbanger from Los Angeles, lidocaine's effect on ICP is poorly supported and Starling's Law remains in effect, among many others. Welcome again, and best regards, LT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2009 Report Share Posted February 9, 2009 You must be a Doctor from France or England. I know personally that every trauma center in the So. Cal use Lido for ICP with RSI. You know small facilities like UCLA, USC and UCI. They must have it all wrong. Nice to meet you Doctor Larry. If your not a Doctor don't forget your a paramedic. Because I know for a fact that paramedics don't have 8 years minimum of schooling. Stick to your protocols..before you get your self in trouble. ________________________________ From: Larry Torrey <ltorrey@...> Sent: Tuesday, February 10, 2009 2:07:40 AM Subject: Re: RSI) jarrodtomassi@ ymail.com wrote: > First I just wanted to say, " What up to the fellow ISOS members " > > I've read through numerous discusions on this RSI topic. What I > realized, is your all smart and your all right. There are different > standards across the world. So one technique may not make to sense or > be as practical as anothers. Just remember stick to what you know. > Also don't forget you we're taught certain things for a reason. Which > was probably based on the area surrounding your courses. However you > are now remote and the world is allot different from downtown LA or > London. So you must be open to changing your style of paramedicine. > This is why remote medics are few and far between. You can spend all > day trying to convince one another lidocaine with ICP. Or even > treating right sided infarct with fluids only... Hi Jarrod, and welcome to the group from an occasional poster. Normally I would have left it at that, but you hit a bit of a button of mine here. I couldn't agree more that our approach to the practice of medicine will vary, by necessity, based on a lot of logistical and other variables. However, human anatomy and physiology (with very rare exception) remains constant across the human race, as do the body's needs in the face of ilness or injury. Whether you're an Islander from Fiji, a Russian from Siberia, or a gangbanger from Los Angeles, lidocaine's effect on ICP is poorly supported and Starling's Law remains in effect, among many others. Welcome again, and best regards, LT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2009 Report Share Posted February 10, 2009 WHOA there ! Seems like a lot of wrong buttons being punched here! If we have something to share, just do it, there is no compulsion to follow anybody's viewpoints. There's a lot to learn from everybody's experience, so let us just keep it respectful. Kishore. > First I just wanted to say, " What up to the fellow ISOS members " > > I've read through numerous discusions on this RSI topic. What I > realized, is your all smart and your all right. There are different > standards across the world. So one technique may not make to sense or > be as practical as anothers. Just remember stick to what you know. > Also don't forget you we're taught certain things for a reason. Which > was probably based on the area surrounding your courses. However you > are now remote and the world is allot different from downtown LA or > London. So you must be open to changing your style of paramedicine. > This is why remote medics are few and far between. You can spend all > day trying to convince one another lidocaine with ICP. Or even > treating right sided infarct with fluids only... Hi Jarrod, and welcome to the group from an occasional poster. Normally I would have left it at that, but you hit a bit of a button of mine here. I couldn't agree more that our approach to the practice of medicine will vary, by necessity, based on a lot of logistical and other variables. However, human anatomy and physiology (with very rare exception) remains constant across the human race, as do the body's needs in the face of ilness or injury. Whether you're an Islander from Fiji, a Russian from Siberia, or a gangbanger from Los Angeles, lidocaine's effect on ICP is poorly supported and Starling's Law remains in effect, among many others. Welcome again, and best regards, LT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2009 Report Share Posted February 10, 2009 Sorry I was a little sarcastic. Woops!!! > > First I just wanted to say, " What up to the fellow ISOS members " > > > > I've read through numerous discusions on this RSI topic. What I > > realized, is your all smart and your all right. There are different > > standards across the world. So one technique may not make to sense or > > be as practical as anothers. Just remember stick to what you know. > > Also don't forget you we're taught certain things for a reason. Which > > was probably based on the area surrounding your courses. However you > > are now remote and the world is allot different from downtown LA or > > London. So you must be open to changing your style of paramedicine. > > This is why remote medics are few and far between. You can spend all > > day trying to convince one another lidocaine with ICP. Or even > > treating right sided infarct with fluids only... > > Hi Jarrod, and welcome to the group from an occasional poster. > > Normally I would have left it at that, but you hit a bit of a button of > mine here. > > I couldn't agree more that our approach to the practice of medicine will > vary, by necessity, based on a lot of logistical and other variables. > > However, human anatomy and physiology (with very rare exception) remains > constant across the human race, as do the body's needs in the face of > ilness or injury. Whether you're an Islander from Fiji, a Russian from > Siberia, or a gangbanger from Los Angeles, lidocaine's effect on ICP is > poorly supported and Starling's Law remains in effect, among many others. > > Welcome again, and best regards, > LT > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2009 Report Share Posted February 10, 2009 On Tuesday, February 10, 2009 01:03, " Jarrod Tomassi " <jarrodtomassi@...> said: > You must be a Doctor from France or England. I know personally that every > trauma center in the So. Cal use Lido for ICP with RSI. You know small > facilities like UCLA, USC and UCI. They must have it all wrong. Nice to meet you > Doctor Larry. If your not a Doctor don't forget your a paramedic. Because I know > for a fact that paramedics don't have 8 years minimum of schooling. Stick to your > protocols..before you get your self in trouble. Jarrod, I realise that the firemonkeys in So Cal are all about their " protocols " , and doing things the way everyone else around them is doing it. And when the typical medical education is ten weeks, as it is in the LA area, strict adherence to the cook book is probably a good thing. But welcome to the real world. The world of remote practice is not about cookbooks. It is about intelligent medical practice. It is about using a solid educational foundation (which is rare in So Cal EMS) to diagnose a problem, and formulate a competent approach to addressing it. Not only does that take a good educational preparation, but it also takes the professional commitment to staying current with the literature. And by literature, I don't mean your LA county protocol book. Larry is -- as usual -- correct. Different situations call for different approaches. Your protocol book does not fit all sizes. Stick blindly to your protocols, without using the brain that God gave you to think critically, and you will indeed get yourself into trouble. Regards, Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2009 Report Share Posted February 10, 2009 Mr. Tomassi, Just because a procedure is practiced, does not make it necessarily correct. There is controversy in this area and Mr. Torrey has good reason for his views. The most recent study finding any efficacy in lidocaine use for RSI is dated 1993. I would suggest a little reading, as there is a recent literature that does not show such favorable results. For instance: 1. et al. 2001 Emerg Med J 18:343 2. et al. 2001 Emerg Med J 18:453 3. Reynolds et al. April 2005 Chest J 127(4): 1397 - 1412 4. Neilipovitz et al. September 2007 Can J Anesth 54(9): 748 - 764. I would also suggest you attempt to be a little more polite in your responses. Regards, Donn ________________________________ From: [mailto: ] On Behalf Of Jarrod Tomassi Sent: Tuesday, February 10, 2009 1:03 AM Subject: Re: RSI) You must be a Doctor from France or England. I know personally that every trauma center in the So. Cal use Lido for ICP with RSI. You know small facilities like UCLA, USC and UCI. They must have it all wrong. Nice to meet you Doctor Larry. If your not a Doctor don't forget your a paramedic. Because I know for a fact that paramedics don't have 8 years minimum of schooling. Stick to your protocols..before you get your self in trouble. ________________________________ From: Larry Torrey <ltorrey@... <mailto:ltorrey%40maine.rr.com> > <mailto:%40> Sent: Tuesday, February 10, 2009 2:07:40 AM Subject: Re: RSI) jarrodtomassi@ ymail.com wrote: > First I just wanted to say, " What up to the fellow ISOS members " > > I've read through numerous discusions on this RSI topic. What I > realized, is your all smart and your all right. There are different > standards across the world. So one technique may not make to sense or > be as practical as anothers. Just remember stick to what you know. > Also don't forget you we're taught certain things for a reason. Which > was probably based on the area surrounding your courses. However you > are now remote and the world is allot different from downtown LA or > London. So you must be open to changing your style of paramedicine. > This is why remote medics are few and far between. You can spend all > day trying to convince one another lidocaine with ICP. Or even > treating right sided infarct with fluids only... Hi Jarrod, and welcome to the group from an occasional poster. Normally I would have left it at that, but you hit a bit of a button of mine here. I couldn't agree more that our approach to the practice of medicine will vary, by necessity, based on a lot of logistical and other variables. However, human anatomy and physiology (with very rare exception) remains constant across the human race, as do the body's needs in the face of ilness or injury. Whether you're an Islander from Fiji, a Russian from Siberia, or a gangbanger from Los Angeles, lidocaine's effect on ICP is poorly supported and Starling's Law remains in effect, among many others. Welcome again, and best regards, LT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2009 Report Share Posted February 10, 2009 Mr Tomassi, Hi and welcome to the site guy! Boy, you sure have put your foot in your butt haven't you? You will notice that although you have come back and said whoops about your comments, you will probably continue to receive some " negative feed back " . There are 2 reasons for this. First is some guys will NOT let something die a natural death with out beating the dead horse to dust....Especially if you keep adding fuel to the fire. Second and more likely, is that due to the way the Internet works and peoples location the world, it takes a good day or more sometimes for people to read your stuff....get pissed / or agree....and put in their own comments. Like me. So, read on as they come in and take your licks because what was been said so far is true. SoCal and it's various EMS programs and med schools are not the center of the medical (or any other) universe. A note to Rob placed here because I'm too lazy to start a new mail OK?? ////////File under " for what it's worth from a fellow ranter//// What is it with the " firemonkey " , and I think I once saw, " hosemonkey or hosedragger " ? For a guy that rants about the need for better education of paramedics and taking the higher ground professionally, you seem to be stuck in a grade school name calling thing. I am not a fire man, never was, don't want to be....yes, I have friends that are....who cares. Point is, and speaking for myself alone, I think your name calling and equally venomous and dare I say...obsessive...rants about " patch factory " paramedics is worn out. We all got the message about how you feel and for the most part it's quite true. Better education in ones field is never wasted and in some places in the US...and around the world...it's sorely needed.....agreed! But when you sink to the cheap " nanny nanny boo " name calling and trashing of people wholesale than all your good points and arguments take second place and are cheapened. Well, I've had my say. I hope I didn't offend you too deeply. I enjoy your posts and in general agree with lots of what you say.....I simply have been slightly offended by your style is all. Believe me, I'll survive and so will you. Just give it a rest. Good day (or night) to all Mike S. Wm. M. (Mike) Spurgeon, NREMT-P DynCorp Medical Gardez, Afghanistan From: jarrodtomassi@... <jarrodtomassi@...> Subject: Re: RSI) Date: Tuesday, February 10, 2009, 3:41 AM Sorry I was a little sarcastic. Woops!!! > > First I just wanted to say, " What up to the fellow ISOS members " > > > > I've read through numerous discusions on this RSI topic. What I > > realized, is your all smart and your all right. There are different > > standards across the world. So one technique may not make to sense or > > be as practical as anothers. Just remember stick to what you know. > > Also don't forget you we're taught certain things for a reason. Which > > was probably based on the area surrounding your courses. However you > > are now remote and the world is allot different from downtown LA or > > London. So you must be open to changing your style of paramedicine. > > This is why remote medics are few and far between. You can spend all > > day trying to convince one another lidocaine with ICP. Or even > > treating right sided infarct with fluids only... > > Hi Jarrod, and welcome to the group from an occasional poster. > > Normally I would have left it at that, but you hit a bit of a button of > mine here. > > I couldn't agree more that our approach to the practice of medicine will > vary, by necessity, based on a lot of logistical and other variables. > > However, human anatomy and physiology (with very rare exception) remains > constant across the human race, as do the body's needs in the face of > ilness or injury. Whether you're an Islander from Fiji, a Russian from > Siberia, or a gangbanger from Los Angeles, lidocaine's effect on ICP is > poorly supported and Starling's Law remains in effect, among many others. > > Welcome again, and best regards, > LT > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2009 Report Share Posted February 10, 2009 Maybe he was drunk? > First I just wanted to say, " What up to the fellow ISOS members " > > I've read through numerous discusions on this RSI topic. What I > realized, is your all smart and your all right. There are different > standards across the world. So one technique may not make to sense or > be as practical as anothers. Just remember stick to what you know. > Also don't forget you we're taught certain things for a reason. Which > was probably based on the area surrounding your courses. However you > are now remote and the world is allot different from downtown LA or > London. So you must be open to changing your style of paramedicine. > This is why remote medics are few and far between. You can spend all > day trying to convince one another lidocaine with ICP. Or even > treating right sided infarct with fluids only... Hi Jarrod, and welcome to the group from an occasional poster. Normally I would have left it at that, but you hit a bit of a button of mine here. I couldn't agree more that our approach to the practice of medicine will vary, by necessity, based on a lot of logistical and other variables. However, human anatomy and physiology (with very rare exception) remains constant across the human race, as do the body's needs in the face of ilness or injury. Whether you're an Islander from Fiji, a Russian from Siberia, or a gangbanger from Los Angeles, lidocaine's effect on ICP is poorly supported and Starling's Law remains in effect, among many others. Welcome again, and best regards, LT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2009 Report Share Posted February 10, 2009 Welcome to this group, Jarrod. I think it will be educational for you. LT Jarrod Tomassi wrote: > You must be a Doctor from France or England. I know personally that > every trauma center in the So. Cal use Lido for ICP with RSI. You > know small facilities like UCLA, USC and UCI. They must have it all > wrong. Nice to meet you Doctor Larry. If your not a Doctor don't > forget your a paramedic. Because I know for a fact that paramedics > don't have 8 years minimum of schooling. Stick to your > protocols..before you get your self in trouble. > > > > > ________________________________ From: Larry Torrey > <ltorrey@...> Sent: > Tuesday, February 10, 2009 2:07:40 AM Subject: Re: > RSI) > > > jarrodtomassi@ ymail.com wrote: >> First I just wanted to say, " What up to the fellow ISOS members " >> >> I've read through numerous discusions on this RSI topic. What I >> realized, is your all smart and your all right. There are different >> standards across the world. So one technique may not make to sense >> or be as practical as anothers. Just remember stick to what you >> know. Also don't forget you we're taught certain things for a >> reason. Which was probably based on the area surrounding your >> courses. However you are now remote and the world is allot >> different from downtown LA or London. So you must be open to >> changing your style of paramedicine. This is why remote medics are >> few and far between. You can spend all day trying to convince one >> another lidocaine with ICP. Or even treating right sided infarct >> with fluids only... > > Hi Jarrod, and welcome to the group from an occasional poster. > > Normally I would have left it at that, but you hit a bit of a button > of mine here. > > I couldn't agree more that our approach to the practice of medicine > will vary, by necessity, based on a lot of logistical and other > variables. > > However, human anatomy and physiology (with very rare exception) > remains constant across the human race, as do the body's needs in the > face of ilness or injury. Whether you're an Islander from Fiji, a > Russian from Siberia, or a gangbanger from Los Angeles, lidocaine's > effect on ICP is poorly supported and Starling's Law remains in > effect, among many others. > > Welcome again, and best regards, LT > > > > > > > Quote Link to comment Share on other sites More sharing options...
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