Re: Hydrofluoric acid

[Guest guest]

Tom -

Yes, there are. I've personally witnessed them, and had them placed on

patients I worked. I've never placed one and never been trained to place

one myself... but I've known medics that have, have been protocoled to do

so, and have done so.

Mike

>

> Wes,

>

> Are you telling me that there are ground crews in

> Houston area that are doing central lines?

>

> Tom

>

> --- ExLngHrn@... wrote:

>

>

> ---------------------------------

>

> Oh gee, pardon me. I may just be a dumb lawyer and

> ground medic, but could

> someone point me to the DSHS regs where it states that

> only a flight medic or

> RN can install a central line? If so, please let many

> of the Houston area

> providers know so they can cease doing it.

>

> More importantly, can you point me to any scientific

> reason why a central

> line is needed? Which reference recommends the

> installation of a central line?

>

> Regards,

> Wes Ogilvie, MPA, JD, EMT-B

> Attorney at Law/Emergency Medical Technician

> Austin, Texas

>

>

> In a message dated 2/26/2006 9:37:26 PM Central

> Standard Time,

> flymedic1@... writes:

>

> but if you had a FLIGHT CREW a cental line would be

> placed and the patient

> mght survive

> > From: wegandy1938@...

> > Date: 2006/02/25 Sat PM 08:06:23 CST

> > To: AmbuBag@...,

> > Subject: Re: Hydrofluoric acid

> >

> > The information I have, from Goldfrank's

> Toxicological Emergencies, 6th

> > edition, is that the nebulized calcium works very

> quickly. Of course,

> this is

> > given along with IV calcium gluconate and/or

> magnesium.

> >

> > Calcium choride can be given also, but it is very

> irritating to the

> vascular

> > system and is best given through a central line

> which, of course, most of

> us

> > do not do.

> >

> > There are many, many variations on treatment

> modalities, depending on

> which

> > source you read, but all of them involve calcium

> administration, generally

> by

> > multiple routes.

> >

> > Because of your excellent responses, I am granting

> you a reprieve from

> > Ladonia.

> >

> > Gene

> > In a message dated 2/25/06 18:47:41,

> ambubag@... writes:

> >

> >

> > > Gene,

> > >

> > > I wonder how long it will take to reverse the

> effects of HF inhalation

> using

> > > the nebulized calcium gluconate? I am assuming

> that it depends on how

> long

> > > she was exposed and the amount inhaled. Since I

> am not sure I am still

> going

> > > to

> > > have my airway equipment ready.

> > >

> > > Also, thanks for coming back to the list and

> posting scenarios. These are

> > > learning experiences and the spirit of this list

> should be just that.

> > >

> > > What time am I leaving for Ladonia?

> > >

> > >

> > >

> > >

> > > [Non-text portions of this message have been

> removed]

> > >

> > >

> > >

> > >

> > >

[Guest guest]

I heard a few years ago that Cypress Creek and Montgomery County Hospital

District were supposed to be adding central lines to their protocols. I don't

know if they actually did add it.

Re: Hydrofluoric acid

>

> The information I have, from Goldfrank's

Toxicological Emergencies, 6th

> edition, is that the nebulized calcium works very

quickly. Of course,

this is

> given along with IV calcium gluconate and/or

magnesium.

>

> Calcium choride can be given also, but it is very

irritating to the

vascular

> system and is best given through a central line

which, of course, most of

us

> do not do.

>

> There are many, many variations on treatment

modalities, depending on

which

> source you read, but all of them involve calcium

administration, generally

by

> multiple routes.

>

> Because of your excellent responses, I am granting

you a reprieve from

> Ladonia.

>

> Gene

> In a message dated 2/25/06 18:47:41,

ambubag@... writes:

>

>

> > Gene,

> >

> > I wonder how long it will take to reverse the

effects of HF inhalation

using

> > the nebulized calcium gluconate? I am assuming

that it depends on how

long

> > she was exposed and the amount inhaled. Since I

am not sure I am still

going

> > to

> > have my airway equipment ready.

> >

> > Also, thanks for coming back to the list and

posting scenarios. These are

> > learning experiences and the spirit of this list

should be just that.

> >

> > What time am I leaving for Ladonia?

> >

> >

> >

> >

> > [Non-text portions of this message have been

removed]

> >

> >

> >

> >

> > Yahoo! Groups Links

> >

> >

> >

> >

> >

> >

> >

> >

>

>

>

>

>

> E.(Gene) Gandy

> POB 1651

> Albany, TX 76430

> wegandy1938@...

>

>

>

> [Non-text portions of this message have been

removed]

>

>

>

>

>

[Guest guest]

I heard a few years ago that Cypress Creek and Montgomery County Hospital

District were supposed to be adding central lines to their protocols. I don't

know if they actually did add it.

Re: Hydrofluoric acid

>

> The information I have, from Goldfrank's

Toxicological Emergencies, 6th

> edition, is that the nebulized calcium works very

quickly. Of course,

this is

> given along with IV calcium gluconate and/or

magnesium.

>

> Calcium choride can be given also, but it is very

irritating to the

vascular

> system and is best given through a central line

which, of course, most of

us

> do not do.

>

> There are many, many variations on treatment

modalities, depending on

which

> source you read, but all of them involve calcium

administration, generally

by

> multiple routes.

>

> Because of your excellent responses, I am granting

you a reprieve from

> Ladonia.

>

> Gene

> In a message dated 2/25/06 18:47:41,

ambubag@... writes:

>

>

> > Gene,

> >

> > I wonder how long it will take to reverse the

effects of HF inhalation

using

> > the nebulized calcium gluconate? I am assuming

that it depends on how

long

> > she was exposed and the amount inhaled. Since I

am not sure I am still

going

> > to

> > have my airway equipment ready.

> >

> > Also, thanks for coming back to the list and

posting scenarios. These are

> > learning experiences and the spirit of this list

should be just that.

> >

> > What time am I leaving for Ladonia?

> >

> >

> >

> >

> > [Non-text portions of this message have been

removed]

> >

> >

> >

> >

> > Yahoo! Groups Links

> >

> >

> >

> >

> >

> >

> >

> >

>

>

>

>

>

> E.(Gene) Gandy

> POB 1651

> Albany, TX 76430

> wegandy1938@...

>

>

>

> [Non-text portions of this message have been

removed]

>

>

>

>

>

[Guest guest]

I heard a few years ago that Cypress Creek and Montgomery County Hospital

District were supposed to be adding central lines to their protocols. I don't

know if they actually did add it.

Re: Hydrofluoric acid

>

> The information I have, from Goldfrank's

Toxicological Emergencies, 6th

> edition, is that the nebulized calcium works very

quickly. Of course,

this is

> given along with IV calcium gluconate and/or

magnesium.

>

> Calcium choride can be given also, but it is very

irritating to the

vascular

> system and is best given through a central line

which, of course, most of

us

> do not do.

>

> There are many, many variations on treatment

modalities, depending on

which

> source you read, but all of them involve calcium

administration, generally

by

> multiple routes.

>

> Because of your excellent responses, I am granting

you a reprieve from

> Ladonia.

>

> Gene

> In a message dated 2/25/06 18:47:41,

ambubag@... writes:

>

>

> > Gene,

> >

> > I wonder how long it will take to reverse the

effects of HF inhalation

using

> > the nebulized calcium gluconate? I am assuming

that it depends on how

long

> > she was exposed and the amount inhaled. Since I

am not sure I am still

going

> > to

> > have my airway equipment ready.

> >

> > Also, thanks for coming back to the list and

posting scenarios. These are

> > learning experiences and the spirit of this list

should be just that.

> >

> > What time am I leaving for Ladonia?

> >

> >

> >

> >

> > [Non-text portions of this message have been

removed]

> >

> >

> >

> >

> > Yahoo! Groups Links

> >

> >

> >

> >

> >

> >

> >

> >

>

>

>

>

>

> E.(Gene) Gandy

> POB 1651

> Albany, TX 76430

> wegandy1938@...

>

>

>

> [Non-text portions of this message have been

removed]

>

>

>

>

>

[Guest guest]

How is it that we went from a discussion of treating a toxic exposure to yet

another divisive " us " versus " them " kerfuffle?

No wonder EMS can't get ahead.

In the words of Pogo - " We have met the enemy and he is us "

" The true soldier fights not because he hates what is in front of him, but

because he loves what is behind him. " - GK Chesterton

---------------------------------

Yahoo! Mail

Bring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

How is it that we went from a discussion of treating a toxic exposure to yet

another divisive " us " versus " them " kerfuffle?

No wonder EMS can't get ahead.

In the words of Pogo - " We have met the enemy and he is us "

" The true soldier fights not because he hates what is in front of him, but

because he loves what is behind him. " - GK Chesterton

---------------------------------

Yahoo! Mail

Bring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

How is it that we went from a discussion of treating a toxic exposure to yet

another divisive " us " versus " them " kerfuffle?

No wonder EMS can't get ahead.

In the words of Pogo - " We have met the enemy and he is us "

" The true soldier fights not because he hates what is in front of him, but

because he loves what is behind him. " - GK Chesterton

---------------------------------

Yahoo! Mail

Bring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

Larry,

I do not see it as a " us " versus " them " kerfuffle. Some guy tried to hijack the

thread by making a hit and run comment about flight crews and central lines. He

was simply put in his place.

kelly

Re: Hydrofluoric acid

How is it that we went from a discussion of treating a toxic exposure to yet

another divisive " us " versus " them " kerfuffle?

No wonder EMS can't get ahead.

In the words of Pogo - " We have met the enemy and he is us "

" The true soldier fights not because he hates what is in front of him, but

because he loves what is behind him. " - GK Chesterton

---------------------------------

Yahoo! Mail

Bring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

Larry,

I do not see it as a " us " versus " them " kerfuffle. Some guy tried to hijack the

thread by making a hit and run comment about flight crews and central lines. He

was simply put in his place.

kelly

Re: Hydrofluoric acid

How is it that we went from a discussion of treating a toxic exposure to yet

another divisive " us " versus " them " kerfuffle?

No wonder EMS can't get ahead.

In the words of Pogo - " We have met the enemy and he is us "

" The true soldier fights not because he hates what is in front of him, but

because he loves what is behind him. " - GK Chesterton

---------------------------------

Yahoo! Mail

Bring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

League City carries equipment for their supervisors to do central lines,

according to their webpage.

-Wes

Re: Hydrofluoric acid

>

> The information I have, from Goldfrank's

Toxicological Emergencies, 6th

> edition, is that the nebulized calcium works very

quickly. Of course,

this is

> given along with IV calcium gluconate and/or

magnesium.

>

> Calcium choride can be given also, but it is very

irritating to the

vascular

> system and is best given through a central line

which, of course, most of

us

> do not do.

>

> There are many, many variations on treatment

modalities, depending on

which

> source you read, but all of them involve calcium

administration, generally

by

> multiple routes.

>

> Because of your excellent responses, I am granting

you a reprieve from

> Ladonia.

>

> Gene

> In a message dated 2/25/06 18:47:41,

ambubag@... writes:

>

>

> > Gene,

> >

> > I wonder how long it will take to reverse the

effects of HF inhalation

using

> > the nebulized calcium gluconate? I am assuming

that it depends on how

long

> > she was exposed and the amount inhaled. Since I

am not sure I am still

going

> > to

> > have my airway equipment ready.

> >

> > Also, thanks for coming back to the list and

posting scenarios. These are

> > learning experiences and the spirit of this list

should be just that.

> >

> > What time am I leaving for Ladonia?

> >

> >

> >

> >

> > [Non-text portions of this message have been

removed]

> >

> >

> >

> >

> > Yahoo! Groups Links

> >

> >

> >

> >

> >

> >

> >

> >

>

>

>

>

>

> E.(Gene) Gandy

> POB 1651

> Albany, TX 76430

> wegandy1938@...

>

>

>

> [Non-text portions of this message have been

removed]

>

>

>

>

>

[Guest guest]

League City carries equipment for their supervisors to do central lines,

according to their webpage.

-Wes

Re: Hydrofluoric acid

>

> The information I have, from Goldfrank's

Toxicological Emergencies, 6th

> edition, is that the nebulized calcium works very

quickly. Of course,

this is

> given along with IV calcium gluconate and/or

magnesium.

>

> Calcium choride can be given also, but it is very

irritating to the

vascular

> system and is best given through a central line

which, of course, most of

us

> do not do.

>

> There are many, many variations on treatment

modalities, depending on

which

> source you read, but all of them involve calcium

administration, generally

by

> multiple routes.

>

> Because of your excellent responses, I am granting

you a reprieve from

> Ladonia.

>

> Gene

> In a message dated 2/25/06 18:47:41,

ambubag@... writes:

>

>

> > Gene,

> >

> > I wonder how long it will take to reverse the

effects of HF inhalation

using

> > the nebulized calcium gluconate? I am assuming

that it depends on how

long

> > she was exposed and the amount inhaled. Since I

am not sure I am still

going

> > to

> > have my airway equipment ready.

> >

> > Also, thanks for coming back to the list and

posting scenarios. These are

> > learning experiences and the spirit of this list

should be just that.

> >

> > What time am I leaving for Ladonia?

> >

> >

> >

> >

> > [Non-text portions of this message have been

removed]

> >

> >

> >

> >

> > Yahoo! Groups Links

> >

> >

> >

> >

> >

> >

> >

> >

>

>

>

>

>

> E.(Gene) Gandy

> POB 1651

> Albany, TX 76430

> wegandy1938@...

>

>

>

> [Non-text portions of this message have been

removed]

>

>

>

>

>

[Guest guest]

League City carries equipment for their supervisors to do central lines,

according to their webpage.

-Wes

Re: Hydrofluoric acid

>

> The information I have, from Goldfrank's

Toxicological Emergencies, 6th

> edition, is that the nebulized calcium works very

quickly. Of course,

this is

> given along with IV calcium gluconate and/or

magnesium.

>

> Calcium choride can be given also, but it is very

irritating to the

vascular

> system and is best given through a central line

which, of course, most of

us

> do not do.

>

> There are many, many variations on treatment

modalities, depending on

which

> source you read, but all of them involve calcium

administration, generally

by

> multiple routes.

>

> Because of your excellent responses, I am granting

you a reprieve from

> Ladonia.

>

> Gene

> In a message dated 2/25/06 18:47:41,

ambubag@... writes:

>

>

> > Gene,

> >

> > I wonder how long it will take to reverse the

effects of HF inhalation

using

> > the nebulized calcium gluconate? I am assuming

that it depends on how

long

> > she was exposed and the amount inhaled. Since I

am not sure I am still

going

> > to

> > have my airway equipment ready.

> >

> > Also, thanks for coming back to the list and

posting scenarios. These are

> > learning experiences and the spirit of this list

should be just that.

> >

> > What time am I leaving for Ladonia?

> >

> >

> >

> >

> > [Non-text portions of this message have been

removed]

> >

> >

> >

> >

> > Yahoo! Groups Links

> >

> >

> >

> >

> >

> >

> >

> >

>

>

>

>

>

> E.(Gene) Gandy

> POB 1651

> Albany, TX 76430

> wegandy1938@...

>

>

>

> [Non-text portions of this message have been

removed]

>

>

>

>

>

[Guest guest]

Unfortunately, we can't physically put him in his place, which should be outside

of EMS.

-Wes

Re: Hydrofluoric acid

How is it that we went from a discussion of treating a toxic exposure to yet

another divisive " us " versus " them " kerfuffle?

No wonder EMS can't get ahead.

In the words of Pogo - " We have met the enemy and he is us "

" The true soldier fights not because he hates what is in front of him, but

because he loves what is behind him. " - GK Chesterton

---------------------------------

Yahoo! Mail

Bring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

Unfortunately, we can't physically put him in his place, which should be outside

of EMS.

-Wes

Re: Hydrofluoric acid

How is it that we went from a discussion of treating a toxic exposure to yet

another divisive " us " versus " them " kerfuffle?

No wonder EMS can't get ahead.

In the words of Pogo - " We have met the enemy and he is us "

" The true soldier fights not because he hates what is in front of him, but

because he loves what is behind him. " - GK Chesterton

---------------------------------

Yahoo! Mail

Bring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

Unfortunately, we can't physically put him in his place, which should be outside

of EMS.

-Wes

Re: Hydrofluoric acid

How is it that we went from a discussion of treating a toxic exposure to yet

another divisive " us " versus " them " kerfuffle?

No wonder EMS can't get ahead.

In the words of Pogo - " We have met the enemy and he is us "

" The true soldier fights not because he hates what is in front of him, but

because he loves what is behind him. " - GK Chesterton

---------------------------------

Yahoo! Mail

Bring photos to life! New PhotoMail makes sharing a breeze.

[Guest guest]

It sounds like you were on one of the HFD basic boxes. There are several 911

services located in county near Houston that have some top notch

paramedics, excellent medical direction and protocols.

Re: Hydrofluoric acid

Central line in Houston?

May I point out that when I called 911 for an MVA a couple years ago and

reported a patient was unconscious and not breathing, I ended up going in

the box and the provider (EMT?) was not even qualified to start an IV. I

was shocked to be in one of the largest cities in the US, driving

lights/sirens and had to direct the EMS personnel to where the appropriate

supplies were located. Luckily, i had spent many shifts on the box in

Houston in medical school so was able to manage the airway, iv etc... while

EMS watched and we drove to Ben Taub...

Kirk D. Mahon, MD, ABEM

6106 Keller Springs Rd

Dallas, TX 75248

[Guest guest]

It sounds like you were on one of the HFD basic boxes. There are several 911

services located in county near Houston that have some top notch

paramedics, excellent medical direction and protocols.

Re: Hydrofluoric acid

Central line in Houston?

May I point out that when I called 911 for an MVA a couple years ago and

reported a patient was unconscious and not breathing, I ended up going in

the box and the provider (EMT?) was not even qualified to start an IV. I

was shocked to be in one of the largest cities in the US, driving

lights/sirens and had to direct the EMS personnel to where the appropriate

supplies were located. Luckily, i had spent many shifts on the box in

Houston in medical school so was able to manage the airway, iv etc... while

EMS watched and we drove to Ben Taub...

Kirk D. Mahon, MD, ABEM

6106 Keller Springs Rd

Dallas, TX 75248

[Guest guest]

Dr. Mahon -- Several of the Houston area services (not HFD) allow central line

placement and other advanced interventions in their protocols. HFD has

implemented a program where the ambulances inside 610 are staffed by EMTs and

ALS intercept squads may back them up.

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

Re: Hydrofluoric acid

Central line in Houston?

May I point out that when I called 911 for an MVA a couple years ago and

reported a patient was unconscious and not breathing, I ended up going in

the box and the provider (EMT?) was not even qualified to start an IV. I

was shocked to be in one of the largest cities in the US, driving

lights/sirens and had to direct the EMS personnel to where the appropriate

supplies were located. Luckily, i had spent many shifts on the box in

Houston in medical school so was able to manage the airway, iv etc... while

EMS watched and we drove to Ben Taub...

Kirk D. Mahon, MD, ABEM

6106 Keller Springs Rd

Dallas, TX 75248

[Guest guest]

Dr. Mahon -- Several of the Houston area services (not HFD) allow central line

placement and other advanced interventions in their protocols. HFD has

implemented a program where the ambulances inside 610 are staffed by EMTs and

ALS intercept squads may back them up.

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

Re: Hydrofluoric acid

Central line in Houston?

May I point out that when I called 911 for an MVA a couple years ago and

reported a patient was unconscious and not breathing, I ended up going in

the box and the provider (EMT?) was not even qualified to start an IV. I

was shocked to be in one of the largest cities in the US, driving

lights/sirens and had to direct the EMS personnel to where the appropriate

supplies were located. Luckily, i had spent many shifts on the box in

Houston in medical school so was able to manage the airway, iv etc... while

EMS watched and we drove to Ben Taub...

Kirk D. Mahon, MD, ABEM

6106 Keller Springs Rd

Dallas, TX 75248

[Guest guest]

Dr. Mahon -- Several of the Houston area services (not HFD) allow central line

placement and other advanced interventions in their protocols. HFD has

implemented a program where the ambulances inside 610 are staffed by EMTs and

ALS intercept squads may back them up.

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

Re: Hydrofluoric acid

Central line in Houston?

May I point out that when I called 911 for an MVA a couple years ago and

reported a patient was unconscious and not breathing, I ended up going in

the box and the provider (EMT?) was not even qualified to start an IV. I

was shocked to be in one of the largest cities in the US, driving

lights/sirens and had to direct the EMS personnel to where the appropriate

supplies were located. Luckily, i had spent many shifts on the box in

Houston in medical school so was able to manage the airway, iv etc... while

EMS watched and we drove to Ben Taub...

Kirk D. Mahon, MD, ABEM

6106 Keller Springs Rd

Dallas, TX 75248

[Guest guest]

Please correct me if I am wrong, but does Houston FD not run a two tiered

system? Most or all ambulances are staffed BLS with paramedic intercepts?? I

thought that I read that somewhere once.

[Guest guest]

Please correct me if I am wrong, but does Houston FD not run a two tiered

system? Most or all ambulances are staffed BLS with paramedic intercepts?? I

thought that I read that somewhere once.

[Guest guest]

-- I believe that's what was said on here earlier.

-Wes

In a message dated 2/27/2006 7:28:54 PM Central Standard Time,

fremsdallas@... writes:

Please correct me if I am wrong, but does Houston FD not run a two tiered

system? Most or all ambulances are staffed BLS with paramedic intercepts??

I

thought that I read that somewhere once.

[Non-text portions of this message have been removed]

[Guest guest]

-- I believe that's what was said on here earlier.

-Wes

In a message dated 2/27/2006 7:28:54 PM Central Standard Time,

fremsdallas@... writes:

Please correct me if I am wrong, but does Houston FD not run a two tiered

system? Most or all ambulances are staffed BLS with paramedic intercepts??

I

thought that I read that somewhere once.

[Non-text portions of this message have been removed]

[Guest guest]

Thank you.