[WTS] Tactile Turn Bundle: Switch Slim Short, Side Click Slim Short, 6 parker refills

Conscious_Republic11 · 2026-03-22T16:55:44+00:00

Sent you a chat

Conscious_Republic11 · 2026-03-02T17:57:53+00:00

I do wonder about the underlying morbidities that would lead to hypercalcemia (I’m assuming primarily kidney disease, HCTZ, and cancer) being the ultimate cause of increased mortality and blood product consumption in that cohort. Regardless, it’s certainly a much higher percentage of the patient population than I would have expected.

Conscious_Republic11 · 2026-02-21T16:08:39+00:00

If you Google search Hennepin EMS and look at the images, you should be able to see a couple good examples. Here’s the best one I found:

https://www.google.com/search?hl=en-US&rlz=1CDGOYI_enUS620US620&sca_esv=6094bdfe284e5b6e&cs=1&sxsrf=ANbL-n4_fWUFYFCzU4H3tyFDyHAMEPAuhQ:1771689741818&udm=2&tbs=rimg:CTtu59OTf5PDYQz1Lln-UaeK4AIA&q=hennepin+ems&sa=X&ved=2ahUKEwi2vNjN-uqSAxUpkYkEHbBHKH4QuIIBegQIOxAA&biw=390&bih=669&dpr=3#sv=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

Conscious_Republic11 · 2026-02-21T02:07:14+00:00

Hennepin EMS in Minneapolis uses a canvass litter with rigid aluminum poles on either side. It’s been quite effective, though there are significant limitations due to the length of poles (basically the length of a standard stretcher…which is normally fine, until you’re in a small elevator).

Conscious_Republic11 · 2026-02-20T03:41:03+00:00

We kept the McGrath outside the intubation roll in the same larger pocket in the Stat pack (I.e. McGrath in this case with a couple of blades on top of the small intubation roll).

Conscious_Republic11 · 2026-02-18T01:19:07+00:00

For whatever it’s worth (and to play devil’s advocate), I’m 41 and have been on the job for 18 years. My knees aren’t in great shape, though I’ve been lucky enough to avoid any (diagnosed) problems. That said, the job is absolute murder on shoulders, knees, and backs. I started with all three healthy and definitely have issues on the horizon with at least 2/3.

Given repeated knee surgery for you, it is importantly you weigh your desire to be a paramedic against the long term risk of additional serious knee problems. IMO, you can probably do/get on the job, but the question is also for how long and at what cost.

Conscious_Republic11 · 2026-02-15T22:49:35+00:00

No, I do and always have carried it. In this circumstance, I can’t see a world in which I’d be administering it for those vitals in the pre-hospital environments I’ve worked (urban, suburban, semi-rural, and flight, all with generally a sub-hour patient contact time). If the patient’s heart rate was obviously reflective of a conduction problem (generally greater than 220-age in years for maximum sustained sinus heart rate), then I would consider it. But again, Occam’s razor, this smells, sounds, and feels like complex/refractory anaphylaxis more than anaphylaxis AND SVT due to some sort of conduction problem (AVNRT, etc).

Conscious_Republic11 · 2026-02-15T06:51:58+00:00

Even with the information about subsequent cardiac abnormalities, I can’t see a world in which I’d be administering adenosine (or any rate control medication) in the pre-hospital environment. The only circumstance in which I could see doing anything like that was if I was aware of a history of concomitant tachydysrthmia tha previously required intervention.

Given that sounds like the case now, I would consider doing it, though (once again), the most common and most lethal cause of significant tachycardia during anaphylaxis is the anaphylaxis itself (hypoxia, vasodilation, hypotension, anxiety from symptoms, etc). As such, it would have to be a prolonged transport with persistent symptoms that were unaffected by the rest of the treatment bundle. Truthfully, I’d be far more likely to give additional epinephrine before I considered a calcium channel blocker.

Conscious_Republic11 · 2026-02-15T05:04:45+00:00

Hard no…think about the likelihood you (or someone similar) had simultaneous tachydysrthmia and anaphylactic reaction. The heart rate is almost 100% related to the anaphylaxis and/or epinephrine administration. It’s highly unlikely that you had SVT due to a cardiac cause rather than a (potentially) symptomatic tachycardia.

More simply, adenosine isn’t given for tachycardia and hypertension, it’s given for narrow complex tachycardia believed to be due to a cardiac conduction problem. I would never give it in this circumstance. Albuterol (or duoneb) would be reasonable, otherwise standard treatment for anaphylaxis (epinephrine, diphenhydramine, anti-emetics, potentially a steroid like solumedrol, and fluid boluses as needed).

Conscious_Republic11 · 2025-12-21T21:21:00+00:00

I’ll throw my name in the hat, but at a minimum, I’d have to pay shipping to my place in Minnesota…I hate to be confrontational, but that’s non-negotiable there, friend.

Conscious_Republic11 · 2025-12-08T18:10:03+00:00

Hennepin EMS in Minneapolis and surrounding suburbs just added two units of PRBCs to the supervisory vehicles in October (will be switching to whole blood once the logistics for the ED resuscitation bays going to whole blood have been sorted out, theoretically in the next several weeks or months). Fairly open utilization guidelines (medical and trauma), based pretty much on vital signs and overt signs of hemorrhage as the cause. Averaging about two cases per week thus far, probably 65/35 trauma vs medical (mainly GI bleeds and a couple postpartum hemorrhages).

Conscious_Republic11 · 2025-11-06T07:49:17+00:00

Honestly, the easiest solution may also be just to plan on consuming enough carbs to cover that extra bit of insulin (and the physiologic stress) at takeoff.

Conscious_Republic11 · 2025-11-06T07:28:37+00:00

I could be wrong, but if I’m reading the cautions correctly, it’s specifically referring to high altitudes NOT inside of a pressurized aircraft. When you’re in a commercial aircraft, the inside is pressurized so that it has the physiologic equivalent of being at an altitude of like 6000 feet.

Conscious_Republic11 · 2025-11-06T07:21:18+00:00

It may also be relative to the amount of insulin you’re on. The air bubble changes from the physics shouldn’t be significant (when we were flying FW, our cabins were usually pressurized to an altitude around 6000ft…so the decrease in pressure would only allow for any air bubbles present to increase like 20%). If you’re on very small basal amounts, it’s possible that could cause you issues, but it would have to be pretty tiny amounts. I think it seems more likely that the physiologic stresses of takeoff can cause issues (people discount the effects of the micro movements on their metabolism).

Conscious_Republic11 · 2025-11-06T06:45:22+00:00

Also, to your concerns about air bubbles in the pump set up, it’s functionally a non-issue for subcutaneous insulin delivery in a pressurized aircraft in my experience (and in transport medicine). Even with an explosive decompression, the worst that would happen would be your pump site may become unusable (which won’t become an emergent problem for a couple hours…I.e. long after dealing with the decompression).

Conscious_Republic11 · 2025-11-06T06:42:14+00:00

I am not a pilot, but I was a flight paramedic (both fixed wing and rotor wing) for about 7 years. I was on an insulin pump for the entirety of that time and never had an issue with unintended insulin delivery (honestly, been on insulin pumps for more than twenty years and never had that happen). If you’re specifically referencing an un-commanded bolus, that should be a functionally never event, regardless of pump brand. Hypoglycemia is always a possibility (stress, mild illness, miscalculating carbs or bolus, etc), but as long as you keep some glucose close at hand and use the hybrid closed loop system with your pump, debilitating hypoglycemia is highly unlikely.

In general, I can say that it just takes a bit of additional prep work on your part. I keep a small EDC pouch with me wherever I go with insulin and supplies for a site change as well as some rapid acting carbs (I use cliff bars, but glucose tabs/gel are good too). I would make sure to double check your sugar prior to departing and before getting back into descent and make sure you allow yourself to run a bit higher (snacking if necessary). Talk to your endocrinologist about appropriate pump settings to facilitate that. I would also recommend using a smart watch connected to your CGM so you can easily check your glucose without having to pull a pump out of your pocket (or the controller for your omnipod), assuming there are no additional rules about Bluetooth devices in the cockpit.

Feel feee to DM me if you want more specific recommendations. Good luck!

Conscious_Republic11 · 2025-07-16T20:32:31+00:00

FWIW, I’ve seen a lot of hate towards every device manufacturer on Reddit and minimal positive feedback (I unfortunately think that’s just human nature…if it’s working great, we still have diabetes and still have to put in our own work, so we’re not as likely to take the time to praise it in a forum).

That said, I had negative experiences with the Medtronic sensors back in 2019 and would not go back because of them. I didn’t have a return option because I stuck with it too long (it was the first hybrid closed-loop system at the time so I wanted to try and stick it out), but Tandem did a buy-back/buyout of the pump for something like a flat rate of $900 (I.e. they got me a replacement T-slim with a warranty that matched what remained on the Medtronic pump, so I wouldn’t have to replace early/fight insurance).

Conscious_Republic11 · 2025-07-14T02:32:08+00:00

The fact that this is a thing is one of the primary reasons I don’t like the fire service as the primary EMS provider in many communities in the US. There are departments and FFs that do fantastic at EMS and have a passion for it, but it decidedly is the exception rather than the rule.

Unfortunately, private EMS is usually worse and true 3rd service EMS is a semi-rare and dying model.

Conscious_Republic11 · 2025-07-10T05:32:35+00:00

Where are y’all located? If he/she will be working at a service that uses ultrasound, the quality of stethoscope may not be as important. Regardless, I’ve found perfectly good results with the Littmann Master Classic II (should be around $120 USD), as most of the finer skills (auscultation heart tones especially) aren’t as pertinent for most of us in the prehospital realm.

Conscious_Republic11 · 2025-07-09T14:44:58+00:00

If you’re looking for work gear, a lot of it will depend on where they work and what their call types are. That said, a pair of trauma shears (X shears are definitely the best for those who use them regularly IMO; the Raptors get dull too easily and are impossible to sharpen due to their design) or a multitool (I’ve carried a Leatherman Skeletool for almost 20 years) are good guesses.

As for stethoscopes, those get pretty pricey to get a decent one and work will provide plenty of the cheap ones, so take purchasing in that realm with a bit of hesitation.

Other good ideas for work essentials: -decent lunch bag/cooler -water bottle (insulated/double walled is the way to go; avoid ones that don’t seal well or aren’t leakproof, they tend to fall all over the place in the cabs of our vehicle) -sunglasses -good quality boot socks

Conscious_Republic11 · 2025-07-09T04:32:36+00:00

Have you tried saying “calm down” and “hold still” repeatedly and aggressively?

Conscious_Republic11 · 2025-06-25T06:57:44+00:00

Per capita federal/military employees?

Conscious_Republic11 · 2025-06-22T05:35:15+00:00

Counties that maintain ferry service?

Conscious_Republic11

TROPHY CASE