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MIG Labs
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Добавлен 10 май 2016
Our goal is simple: to improve the education of EMS providers. There are a lot of reasons why we believe in that one goal - it's better for ourselves, our careers, and our industry's reputation. Above all else, it's better for our patients. Join us at MIG Labs - learn something, teach us something, and let's make prehospital medicine better!
The "X-waiver" — prescribing buprenorphine
Download the lesson PDF here:
www.miglabs.com/x-waiver
Get the free training from the PCSS:
pcssnow.org/medication-assisted-treatment/
Apply for an X-waiver:
www.samhsa.gov/medication-assisted-treatment/training-materials-resources/apply-for-practitioner-waiver
The "X-waiver" (technically the DATA 2000 waiver) is a process that allows certain medical providers to prescribe buprenorphine for treatment of opioid use disorder (OUD). The use of buprenorphine (and Suboxone, a combination of buprenorphine and naloxone) is a cornerstone of medication assisted treatment (MAT). While there is a lot of stigma and confusion surrounding the X-waiver (and even more surrounding MAT in general), the process i...
www.miglabs.com/x-waiver
Get the free training from the PCSS:
pcssnow.org/medication-assisted-treatment/
Apply for an X-waiver:
www.samhsa.gov/medication-assisted-treatment/training-materials-resources/apply-for-practitioner-waiver
The "X-waiver" (technically the DATA 2000 waiver) is a process that allows certain medical providers to prescribe buprenorphine for treatment of opioid use disorder (OUD). The use of buprenorphine (and Suboxone, a combination of buprenorphine and naloxone) is a cornerstone of medication assisted treatment (MAT). While there is a lot of stigma and confusion surrounding the X-waiver (and even more surrounding MAT in general), the process i...
Просмотров: 2 812
Видео
Compartment Syndrome
Просмотров 1,9 тыс.4 года назад
Download the lesson PDF here: www.miglabs.com/compartment-syndrome *The links aren't working right now! RUclips has changed their requirements for embedding links, and I don't currently have enough subscribers to embed links in new videos. I apologize for the confusion! The link above has the lesson outline PDF, and you can always get more information at the website: www.MIGLabs.com Compartment...
Diabetic Ketoacidosis (DKA)
Просмотров 8 тыс.7 лет назад
Did you know that in a span of just 21 years, hospital admissions for diabetic ketoacidosis (DKA) in the United States nearly doubled? As prehospital providers there's a very good chance that we're going to have patients who are suffering from DKA. DKA is one of those unique diseases that can be deadly if untreated, but if the patient receives proper care, mortality is less than 1%. Join us in ...
Hyperthermia & Heat-Related Illness
Просмотров 21 тыс.8 лет назад
Get the lesson outline here: www.miglabs.com/hyperthermia Summer is upon us and prehospital providers are likely to see more patients suffering from heat-related illness. The most serious heat-related illness - heat stroke - has a mortality rate of up to 30%, so it's important that we're prepared to treat hyperthermic patients. This lesson will discuss heat stroke - the different types, how to ...
Trauma Triad of Death
Просмотров 33 тыс.8 лет назад
Get the lesson outline here: www.miglabs.com/trauma-triad The trauma triad of death: hypothermia, acidosis, and coagulopathy. Mortality rates for trauma patients in the triad of death range from 50% to 90% - not good. However, there are a handful of relatively simply interventions that we can do to prevent our patients from entering the trauma triad of death. Music: That Sunny Day by Kronicle -...
Welcome to MIG Labs!
Просмотров 4748 лет назад
Get the lesson outline here: www.miglabs.com/intro Welcome to MIG Labs! This video describes what we're all about. In this lesson we talk about some of the problems facing the EMS industry today. Not too long ago, nurses were in a similar spot - they were unhappy with their pay, their working conditions, their career options, and the respect they received from other healthcare providers. We'll ...
Treatment of Opioid Overdose - Pt. 1
Просмотров 15 тыс.8 лет назад
Get the lesson outline here: www.miglabs.com/opioids Part 1 of this lesson covers opioids. Many prehospital providers have the same burning questions - What exactly is an opioid? Which drugs are and aren't opioids, again? Can it be bad to give naloxone to a patient who isn't on opioids? Can you give too much naloxone? Treating an opioid overdose can actually be very simple once you understand w...
Treatment of Opioid Overdose - Pt. 2
Просмотров 6 тыс.8 лет назад
Get the lesson outline here: www.miglabs.com/opioids Part 2 of this lesson covers the treatment of opioid overdoses. Many prehospital providers have the same burning questions - What exactly is an opioid? Which drugs are and aren't opioids, again? Can it be bad to give naloxone to a patient who isn't on opioids? Can you give too much naloxone? Treating an opioid overdose can actually be very si...
This is wrong information you posting and that a problem. YOU DO NOT GET ANY FEELING OF BEING HIGH. IT blocks and opiates from getting to the receptors that get you high. I take this and there is no feeling at all.
Thanks. Helpful! Sidenote: it's pronounced "co-ag-u-LOP-a-thy."
X-Waiver no longer required
Am 56, good shape, moved to Tuscon in April. Being very physical, I continued as usual until I was feeling cold in 95 degree temp. Thought it was strange, but nothing more. While washing car I got weak, then a headache behind eyes. Went inside at around 4pm, ended up staying in bed until around 3pm the next day. Headache cleared, was able to drink and eat again. Was this heat related? Or simply age? I did feel cool and didn't sweat, but was full of liquid and urinating well. Do I need to reduce activity? Yes, it's kind of obvious, but really! I wasn't running or doing much, just was 95 out in dry Tuscon climate.. thanks... Also during down time in bed, I was shifting from cold to warm by the minute. Was putting covers over body, then opened widow for air. Indoors was 75 degrees. Thanks
What about Butrans patch for pain. PvP has had me on Butrans patch for 10yrs now she said she has to do 8 hrs of training I think she is not right . now with the Biden thing I called the FDA and u don't even have to get the training for OUD. ????
PCP
To the point! Excellent presentation! Thank you for sharing!
What a quack racket the medical profession has turned into! Any nurse takes a year of classes and she's an NP. Then she can write suboxone under an x? Give me a break! I've never seen so many incompetent nurses writing under other people. Please give me a former junkie who went to college like me. The one thing I see is no real understanding or compassion. As long as the insurance pays for it it's on. Where are all the real MD's?
very helpful vid. Thank you!
Regarding medications: Central nervous system dysfunction is a hallmark of heat stroke. Lack of neurological improvement with good basic medical management suggests the need to consider both brain injury and the deleterious effects of agitation and muscular activity such as tremulousness and shivering. Heat stroke patients can seize due to brain injury, electrolyte imbalance, or a combination of the two. Benzodiazepines are the drug of choice in this situation because they have a beneficial effect on the agitation and may lower the risk of a seizure. So remember- immediate administration of benzodiazepines is indicated in patients with agitation and shivering, to stop excessive production of heat. (This was a Board exam question for Pediatric Emergency Medicine)
Tooo good 👍.. liked and subscribed 👍
Get herpes curative herbs to treat herpes virus totally, text/call Dr Oluta on RUclips.
Heat exhaustion is more common than heat stroke.
Some of the the link for those studies , I am doing study in on lethal triad of trauma
I feel like this is a money grab at this point. So,... if you search online, there are doctors in Texas who will prescribe it with NO drug testing and virtual dr meetings for $200/visit (monthly) plus the cost of paying cash for this drug is as much as buying illegal drugs unfortunately now. IDK how they doing it without getting a drug screen from patients. In CA, my suboxone dr has a very tough time prescribing this. In 2022. There should be NO BARRIERS at all to prescribe this life saving drug. IDK why every time I try to fill this prescription, (after a full drug screen BTW,) a lot of pharmacies won't fill it or dont carry it. WTF are the barriers!!????? Literally I've been on this drug on and off since 2009 and it's either been outrageously expensive or actually harder to obtain than regular pain killers. what is the hold up? And you have to be a "opiate dependent" so my doc has trouble cause I have chronic pain in neck and knee, well documented and used to get methadone for it up till 2009, (BTW that wonderful compassionate doctor I had lost his license for prescribing opiates to people with broken backs so he's gone.) And since I haven't used illegal opiates or any opiates besides suboxone in like 9 yrs, i really only qualify as being dependent on suboxone@! And the AOD services (low cost clinics) are trying to taper folks off of it and making sure you're attending NA. I don't want NA. Drug dealers hang out there and I've been CLEAN on suboxone of 9 years. Man. this country needs to figure out if they want folks to have easy access or continue to allow prohibition of all opiates lead to millions of deaths by fentanyl. I live in a city where ppl are dying on the streets in their wheelchairs from overdosing because they can't obtain pain meds that were less harmful than street drugs. It is easier to get fentanyl laced poison than filling this Suboxone Rx which 3 pharmacies don't have the generic 2mg tablet anymore then my dr has to prescribe the film which costs EVEN MORE!!!!! wtf. this is a money grab. if you don't have mediCal or mediCaid, expect to pay hundreds for the generic version. Some places like Kaiser won't prescribe it or even see you if you smoke weed. Even in CA where marijuana is recreationally legal. Another barrier. Might as well send addicts into the street to buy illegal drugs. We're so busy witch hunting doctors who prescribed Vicodin that there are no pain docs left and I fear for my old age in some years that there will be no pain relief available in the USA and I'll have to go to Mexico to get any relief from chronic pain I can control now but in 10 yrs who knows? and what if you're dying? nothing? they gave my dog suboxone and he was still in pain while he was dying. he was my best friend and 6lbs and they wouldn't give him morphine or anything real because they afraid i will take it? how much of my 6lb dogs meds would i have to take and let him die in pain to get high. I will never forgive myself for him not having real pain meds while he was dying. He turned into a zombie when he was on it and stared into space. He didn't go to sleep or rest like you would on morphine or something for the DYING in pain. Disgraceful. That is not DO NO HARM. The whole system is broken now. And I know that morphine would have been best for him because I've tried both and suboxone really only controls cravings it is not a pain med to me. But I'm still addicted to it, aren't I?
I'm a pharmacist and everything you say is true. It is much more difficult to get a Rx for Suboxone than oxycodone. Providers have to jump through ridiculous hoops to get a special "x" DEA certification to even be able to prescribe the meds to treat opioid addiction. A nurse practitioner fresh out of school can prescribe 40mg of oxycodone daily to an otherwise healthy 25 year old with 'back pain' but cannot do anything to help treat the inevitable addiction that will result. Many insurances do not cover MAT or have absurd requirements for doing so. They'll pay for oxys and hydros all day long but treatment? Nope. We are the only pharmacy in my rural area that will sell a quantity less than 30 and for a fair price. I have people who come to the pharmacy every other day to buy 5 strips with their every cent of spare change. The truth is that 'they' do not want to solve the opioid epidemic. There are many reasons for this but it isn't coincidental that this started in rural areas and old factory towns
18 YEARs CLEAN 0ff HER0iN, NOOOO LONGER iS WORTh it! BETTER TO BANG HEROiN ThAN TRY ANd GO ANY LEGAL ROUTE ThRU DRs & PAiN MANAGEMENT.
You can take a real low dose of methadone for 3 days or a week and kick buprenorphine. You got to just make up your mind to get off it. If you can't kick one bag of smack then you're lost.
When I first started the program 5 years ago they put me on Suboxone it made me very dizzy it made me sick so I had to go to an allergy specialist they said I was allergic to narcan they put me on buprenorphine it has worked great my life is amazing 4 years now I've been on it now the pharmacy tells me I have to get another allergy test which I will do no problem if not I have to find another pharmacy it's just like why do they mess with people when they're doing so good I don't understand it
Clean 2years now.I was addicted to morphine IV to a maximum of 80mg in 24hours then I was started on suboxone which I managed to taper to 1mg daily by assumption since I used to split the 2mg tab.Then there's this doctor in a clinic in Kenya who gave me some powder to boil and drink when I was feeling withdrawal from suboxone .....I drunk that herb once and from that day I never felt any withdrawal or any craving for any opiate.Almost now 3years clean.
What was this herb that they gave you? I need whatever that was badly
good for you man! what herb? is it like kratom?
Did u experience percipated withdrawal?
It work for my server chronic back pain n diabetes nerve pain this sht works better than the prescription opioid to me I be without pain for 2 days I got a condition call disc generation disc disease it those taste like methadone a little bit I tried that too for the pain cuz I lost my pain management doctors cuz of the epidemic opioid after they had me on prescription opioid I had no doctor for about 5 month I was going crazy I got this server chronic pain but then I tried buorinorphine naloxone that sht work for me waoo a miracle medication I call this a miracle med I wish I did not have to use no type of med but I'm very sick n disable this days with crazy back n neck n diabetes nerve pain is no joke I can't sleep for days I didn't when through withdrawal I was surprised not taking opioid pill for 5 month it was weird but I never abuse the pill either only when the pain come to attack me but then it stop working for me cuz my level of pain change got worse thanks to those doctor that left me out with no pain medication for 5 month
the best part is: no constipation compared to methadone! beware the sneaky nodding you may have 6 hours after taking it sublingually. i think it's sort of more dangerous because i only take .5mg now in the morning and sometimes at 5pm driving home I get the nods from it. So, it's not like fast acting where you know you can't drive after you take it. it's sneaky. otherwise it's great and lifesaving.
thank you so much!! Very well explained!
What about dextrose for maintaining sugar between 200-300??
Could you please provide a link to those study conducted?
Tq
thank youuuu, exellente
I can’t thank you enough for this videos. I’m a combat medic and I enjoyed and learned a lot from them.
wellbingz.com/14-hypothermia-symptoms-and-causes-you-should-know/
And it’s withdrawal is worse than heroin
Crap. I was probably on the verge of heatstroke yesterday. The thing that scared me was that I had problems recalling my students' names and ages and the words to the birthday song- all things I know on any other given day. Also, I was so very red and sweating so much my eyelids were wet. I never sweat like that at work.
This was so eye-opening! I'm teaching a trauma class to a group of soldiers next month and this will help them understand why we are doing certain interventions. Can you tell me what study was done by the Army?
Adam Garceau here's the studying he's referring to: Nessen SC, Lounsbury DE, Hetz SP. War Surgery in Afghanistan and Iraq: A Series of Cases, 2003-2007. Office of The Surgeon General, Department of the Army, United States of America; 2008.
Good to see you back.
So people need a stethescope to check on folks and to check for small pupils. If they see small pupils and do not hear bowel sounds as well as do not detect breathing, then they should administer narcan.
If the patient has pinpoint pupils (miosis) and they aren't breathing, that is an immediately life-threatening condition and those two findings alone warrant Narcan administration. If the patient is still breathing and the provider is unsure of the diagnosis, bowel sounds can be a tool to help determine if there is an opioid overdose.
I don't know if it's a myth... But I can say first hand that I was not sweating like my body normally should have been. I felt it. So even if it is a myth. It sounds like a very "plausible" myth. I suffered this Heat Stroke just today
thankyou so much for this resource
Thnx ❣️
Happy to help!
The "5 P's" do not relate to compartment syndrome. They relate to acute vascular occlusion. If paresthesia is present with a compartment syndrome, the potential for full functional recovery is only 10%.The 1st symptom is pain out of proportion. The 1st sign is loss of function within the compartment. The 2nd sign is pain with passive stetch.
Thanks for the comment! I always appreciate discussion. I respectfully disagree with your assertion that the 5 P's are not related to compartment syndrome. To separate "acute compartment syndrome" and "acute vascular occlusion" is splitting hairs, as they go hand-in-hand. This is not my own opinion, but is the consensus of a large body of peer-reviewed evidence. Here are just a few supporting examples: Donaldson J, Haddad B, Khan WS. The pathophysiology, diagnosis and current management of acute compartment syndrome. Open Orthop J. 2014;8:185-193. Bowyer MW. Compartment Syndrome. In: Gahtan V, Costanza MJ, editors. Essentials of Vascular Surgery for the General Surgeon. Springer; New York: 2014. pp. 55-69. Mauser N, Gissel H, Henderson C, Hao J, Hak D, Mauffrey C. Acute lower-leg compartment syndrome. Orthopedics. 2013;36:619-624. Konstantakos EK, Dalstrom DJ, Nelles ME, Laughlin RT, Prayson MJ. Diagnosis and management of extremity compartment syndromes: an orthopaedic perspective. Am Surg. 2007;73:1199-1209. Raza H, Mahapatra A. Acute compartment syndrome in orthopedics: causes, diagnosis, and management. Adv Orthop. 2015;2015:543412.
This is the most in-depth video I've seen so far on naloxone and opioid overdoses. Thanks for sharing this buddy! It's honestly helping me with my research project.
Thanks! Glad that you liked it and found it helpful.
@@Miglabs Can you send me your resources/studies that you used for this video? I'm required to show both the positive and negative effects of naloxone and your sources would greatly benefit my research. Thanks again!
@@diegogarcia-yr6oz You can get a complete lesson outline, including references, on the MIG Labs website: miglabs.com/opioids/ Good luck with your project!
Thank you so much this was so helpful
At 9:09 I accidentally wrote "10x as many women" but I meant "10x as many men." Oops! Such are the struggles of trying to speak and write at the same time...
The 5 P's describe acute vascular occlusion alone. I agree with you on that point.
You forgot to mention the other Poly of which , there are 3- Polyphaser = hunger. What about Potasium via IV drip (comes in tablet form too) as a course of treatment. Awesome video all the same👍
All of the colors except red are ok to use.
Keep writing in the white
Thank you for all the information, I live in the middle east where it's very very hot and we r not very much educated on what's happening to our bodies during the summer. Thank and God bless you.
Thank you
Excelent!.
Very important information i will adopt this all while giving resusitation to patient. Thsnks a lot.
Thank you soooooo much!!!!!
I have almost died twice due to negligence from hospital staff. Hypothemia is serious..... The second time it happened the last thing I remember is the fricking nurses talking about their weekend in next room....terrible PEOPLE LIKE ME....PLEASE GET MEDICAL ALERT BRACLET
I'm sorry to hear this. It may help though, if you let us know what your underlying medical problem is? How/why did you initially become hypothermic?
Great video! You explained it very clearly! I just started my own medical youtube channel, and I also made a video on Morphine. However I still find it hard to find the balance between informational content and a fun way to explain it. You do this in a very natural way, which inspired me to make my videos more visual. Keep it up!
Your pdf link is broken :(
Great Video Man
Good work and clear informative demonstration...Thanks a lot
Great video. And the intro music was AMAZING. ok, serious about the great video, kidding about the music. : )