I love that this is viewed an extremely wasteful use of air transport and a critical care transport team

I feel like a min ventilation of 200 ish mls/kg/ min without to much trouble which usually gets you a paco2 of about 20-25 mmhg
Seems like a reasonable goal

This is really good!
My only question thought is
Should the vasopressor challenge have two versions?
One simply aiming for a DBP > 50 and then another for MAP > 80 ?
It seems like many patients improved CRT with DBP >50 alone

I really like those things, another great option is multi lumen PIVs which I wish were more widely available.

I have seen this happen, and while it wasn’t a huge deal I can imagine patients who could be harmed by it.
Not to say you can’t/shouldn’t run other things with pressors, just that you need to be careful

This actually can be a problem depending on how things are set up and the concentration of norepinephrine used.

For example we tend to use 64 mcg/ml norepinephrine and let’s say the deadspace in the line is 2mls and now you want to start a bolus could possibly give all of that rapidly

For sure, very niche use cases
It makes sense for some small ambulance services or maybe crash carts in the hospital
We’re talking about getting it as a backup to the glide scope at my HEMS job

Glidescope go is fantastic, UE scope and intersurgical Iview are great lower cost alternatives

On the monitors I use you only get it if you get a 12 lead ECG and it seems accurate enough for most clinical use
I assumed the qtc from hospital monitors was similar

You run in to difficulties with the computer QTc ?

But it makes the Etco2 higher! Isn’t that good? Don’t you want the patient to live?

That’s interesting and not my experience(but prehospital may be different from in hospital)
Only the lifepack brand defibs have the ability to increase beyond 200j

My understanding was that there was no convincing evidence that Zoll 200 j was less effective than lifepack 360j. And some poor quality evidence that zoll is better despite less energy
But there may be some evidence I’m not aware of

May bolus as well or just start the drip?