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Your ignorance is astounding and only works to fuel your arrogance. I hope you enjoyed your short tenure on this site.

I'll add in here that the colonic prep for the procedure may cause significant fluid shifts, which may not be well tolerated in the elderly with fragile cardiovascular status. Patient may become fluid overloaded or dehydrated. Various preps include: Golytely or colyte, which is a gallon of fluid with electrolytes and polyethylene glycol. This should be the safest with regards to fluid shift, but it can still happen. Mix a bottle of Miralax (polyethylene glycol) with a bottle of Gatorade Fleets phosphosoda Castor oil Usually a laxative such as bisacodyl (dulcolax) is included in the above regimens, and they're usually followed with enemas. 'zilla

Hello, Like noted above there was talk of transfer the patient to a CVICU/CCU. As luck would have it, he started to come around and was transfer to the ward. Currently, he is doing very well and has return to his normal level of activity. The one new medication that was added was an ACE inhibitor (Ramipril I think). As it turns out he was on an ACE but he stopped taking it because of a dry cough (common side effect). No new treatments. However, improved patient teaching. As the years go on I see this as a critical part of an patient care plan (for EMS and hospital). A part that is often neglected. CHF and DCM was explained to the patient. The importance of daily weights. Simple stuff like that may prevent future episodes of failure. Cheers

As I recall it, NREMT-P exam was the easiest I've ever taken and passed. The hardest exam I've ever taken was administered by North Shore LIJ hospital for their job interview. Cheer up, it will get a lot harder and humbling down the road, so pick yourself up now and try again.

You should be buried alive if you administer Atropine for 3rd degree block. There are cases of Atropine induced VF in 3rd degree block, and if you think about it, Atropine will increase the atrial contraction rate, thus decreasing pO2 in RCA and decreasing available oxygen for the ventricles. If you administer Atropine for 3rd degree block you are in essence malpracticing medicine, as it offers no benefit whatsoever, and causes side effects associated with Atropine, and further endangers the health of the patient.

Atropine is a recognized treatment for bradycardia, even that caused by heart block. ACLS teaches this nation-wide. It is part of prehospital protocols in many jurisdictions. It would not be difficult to defend in court at all. This statement is closed-minded, dogmatic, intentionally inflammatory, and wrong. It is not malpractice, and I don't know who convinced you of that. As illustrated in previous posts, there are clinical indications for atropine in heart block. Intentionally causing pain to elicit a physiological response is a draconian way of practicing medicine. If you want to increase sympathetic tone, you can administer a sympathomimetic agent, like dopamine or dobutamine or norepinephrine or epinephrine, which I see as far better than torturing the patient. Increasing sympathetic tone, by drugs or by causing pain, carries the same risks that you ascribe to atropine of increasing myocardial oxygen demand. And so will TCP. I've given quite a bit of atropine, and I do not see it as "dangerous" in the proper clinical setting, and is very well tolerated overall. TCP carries issues as well, if the patient is in such severe pain that they are trying to rip the pacer pads off their chest, then it's not "more efficient" than atropine. Then why do any treatment at all? Just load them in the truck and take them to the hospital if that is the way you want to go. Your differential diagnosis must guide therapy. You have to think critically about what is causing the patient's condition and act accordingly. 'zilla

What does that even mean? I could walk before you were even a sperm in your drunk daddy's balls. Are you being intentionally dense? First of all you keep talking about Atropine like it is used for any heartblock. I don't know what they teach you in the Caribbeans, but here in the states we prefer evidence-based medicine. Atropine in 3rd degree blocks is well documented to cause a cardiac arrest.