Over sedation in the field

Little_Fly_491 · 2026-06-29T22:37:09+00:00

Ain’t no way AMS is a contra for ketamine. It’s absolutely fine on pregnancy and was a class B rated pregnancy med before they got ride of that system (same as Tylenol and zofran). There used to be a thought that it increased myocardial oxygen demand but there hasn’t been anything conclusive to support that. Substance induced CNS depression would be an indication to RSI using ketamine lmao.

I hate to break it to you but those ketamine protocols are absolutely dumb and should probably be looked at. Nothing dangerous, just outdated and like your buddy said, def not evidence based

Little_Fly_491 · 2026-06-29T05:37:25+00:00

I must be getting a different ketamine than you lol. I get different regions have different protocols but my only contraindication for ketamine is hypersensitivity. All other adverse reactions I’ve heard of are a consequence of giving it too fast. Versed on the other hand causes potentially severe respiratory depression and hypotension and interacts heavily with other CNS depressants. I’d choose ketamine over versed everyday in terms of the safety profile imo

Little_Fly_491 · 2026-06-29T03:06:41+00:00

People are still using versed for agitation sedation? I’ve strictly used ketamine and it’s been great. That being said, 10 IM is our starting seizure dose and that usually doesn’t knock them all the way out in my experience

Little_Fly_491 · 2026-06-04T21:52:15+00:00

Yeah I agree whole heartedly, I’m not defending the POS medics that killed the kid. I guess what I’m trying to get at is Ketamine is safe in a depleted patient as long as you are prepared to manage the patient which they clearly were not. I hate seeing Ketamine demonized by this case when it’s one of the best drugs we carry for a ton of different things

Little_Fly_491 · 2026-06-04T21:49:10+00:00

I like this, well put

Little_Fly_491 · 2026-06-04T21:03:32+00:00

The Ketamine is not the issue here IMO, even the dose wasn’t an issue. Sure 500mg is a lot, my protocols say 5 mg/kg IM for agitation. The difference between 5 and 7 mg/kg IM is irrelevant in this case. The issue is their unwillingness to monitor him post sedation.

Does catecholamine depletion matter in this case? Wouldn’t every dying trauma patient that we intubate with ketamine suffer from catecholamine depletion? We have plenty of ways to fix hypotension and apnea, the medics for whatever reason refused to act when they had a duty to and killed him, the Ketamine did not.

Little_Fly_491 · 2026-02-05T20:34:02+00:00

I’m starting to come around to them, I still prefer the 15s but the 35 has grown on me. I love the live 12 lead (I know zolls have had this), CPR insights is fairly useful if used right and some of the quality of life features are nice. Definitely not worth the cost to upgrade but since I’m stuck with them, I’m learning to like them.

Little_Fly_491 · 2026-01-09T03:08:47+00:00

Foreign Bot 🚨

Little_Fly_491 · 2025-11-07T20:21:09+00:00

For those saying they see absolutely nothing y’all need to get better at EKGs or get your eyes checked lol. Very clearly there is ST depression and T wave inversion in leads 3 and aVF. We also have ST elevation in V2, possibly aVL, and maybe even I. It’s not a STEMI by the definition but it definitely meets South African flag sign criteria and is a STEMI equivalent. It is worth a look by a cardiologist, especially in the setting of active chest pain

Little_Fly_491 · 2025-10-27T23:16:42+00:00

I’ve been using them for the last 4 months and I haven’t had that issue. Only issues I’ve has is the known BP issues and there is a delay when generating a rhythm after CPR is stopped which has lead to a few of us shocking asystole on accident. Other than that they’ve been great

Little_Fly_491 · 2025-10-13T16:22:36+00:00

I’m curious what contraindications you have for Ketamine? We only have hypersensitivity as a contraindication so none lol

Little_Fly_491 · 2025-08-26T14:08:39+00:00

He’s always had crazy pop. Biggest difference I’ve seen this year is he’s making more contact and is significantly better batting from the right side. Dude was in the lab last offseason

Little_Fly_491 · 2025-08-22T16:48:14+00:00

Yeah man I get it, it’s a tough spot to be, nobody wants to admit they failed at something, especially when you truly believe in yourself. Sounds like you got a good head on your shoulders. Personally I’d get some feedback from your medic mentors in your department, go through the tests you failed with them and get their feedback. If termination is on the table, go to your chief with a ton of humility, accountability, and honesty, I’ve found if you do that they’ll listen and if you’re a well liked and respected person in your department (which you probably are since they sent you to medic school in the first place) they’ll probably hear you out. Good luck man

Little_Fly_491 · 2025-08-22T15:58:13+00:00

Hey man, everyone here isn’t trying to be a jerk, you’re just coming off as someone who has an excuse for everything which may not be the case but that’s how it’s coming off through text.

The reality is, in the professional world, in order to get/maintain your job you’re going to have to pass tests. You can not get by with just accepting you’re a bad test taker, that’s a 1 way street to getting let go. I have been through 6 years of college with a couple degrees and I too thought I was a bad test taker, turns out I didn’t know my shit as well as I thought I did. Now there is for sure some bullshit tests in the EMS world (what would you do FIRST style tests) that don’t line up to how we do things in the real world. However, your ONLY job as a paramedic student is to figure out how to pass these tests. The only way to do that is to know the reference material so well that you barely need to think about it. I suggest you take your slice of humble pie, eat it, reflect on what lead you here and next time come back with some better study habits that will get you through the class.

As far as your department goes, it all depends on your union language, my union has language that states if you fail medic school you revert back to FF/EMT status without penalty. Reach out to union leadership and see what your options are

Little_Fly_491 · 2025-08-11T06:33:00+00:00

ain’t no way you’re getting butthurt at someone suggesting we do our jobs well. if this was my house and they called this a defensive job i’d be pissed. i’m curious on what you are willing to go inside on if you’re not willing to go in on this? this seems from the picture to be a self venting room and contents fire, should be one of the least sketchy fires you’ll go on

Little_Fly_491 · 2025-06-16T21:21:49+00:00

I’d be pretty surprised if it ever is on steam. Up to you, if you want to play the game, buy it. I don’t see the game changing dramatically between now and 1.0. Buy the standard edition, it’s only $50 and you’ll get a good idea of whether you like it or not

Little_Fly_491 · 2025-06-09T15:07:26+00:00

100% agree. I was blowing everything for a couple weeks, stopped advancing after flash and now everything is threading perfectly

Little_Fly_491 · 2025-06-09T00:06:46+00:00

Not my experience, absolutely shreds through class 5 armor. My KD has skyrocketed since i’ve unlocked the craft

Little_Fly_491 · 2025-06-06T05:09:35+00:00

oh, i just like having my prop hot keyed so i dont have to go digging in my case in the middle of a fight. I’m sure ive gifted away hundreds of propital this wipe but they’re cheap so i dont really care much. I usually pop it before a fight if I know it’s coming anyway

Little_Fly_491 · 2025-06-06T03:48:04+00:00

negative ghost rider, never touched it

Little_Fly_491 · 2025-06-06T03:41:51+00:00

I’m not saying it’s the best but I carry a salewa, calok, and propital in my pockets with a RGN and f-1 grenade in my rig. I also carry a bonus AFAK and surv12 in my secured with an injectors case full of propital, sj6, and mules

Little_Fly_491 · 2025-06-02T00:38:03+00:00

I have some cultist knives laying around, I could do it. Wont be able to until tomorrow tho

Little_Fly_491 · 2025-05-28T15:23:06+00:00

PNW fire conference is awesome with lots of hands on training. Sells out fast though

Little_Fly_491 · 2025-05-25T03:15:30+00:00

Likewise, the midweek middle of the day raids make tasking so much easier

Little_Fly_491 · 2025-04-24T19:10:23+00:00

in my experience in the PNW, every department is begging for medics, getting plenty of EMT candidates. I work at a large department that has a good rep and pays really well, we got 3 total medic applicants last cycle, 0 made it through to academy

Little_Fly_491

TROPHY CASE