Kaisu

Good job Nifty.. I understand that Florida is almost as good as Wisconsin... Seriously - congrats..

I'm hoping for the very best for you firedoc... let us know

Gosh I hate to be a nit picker firedoc but I can't help it - full gestation is 38 - 40 weeks... doesn't change the fact that the kid was early .

did ya notice that they named the kid a combination of their two names.... that always bugs me.. for this guy, it's all about him.. His head is up his a** and there is no room in there for thoughts of others - even his wife and child.

I'm probably exposing my ignorance again, but isn't asthma characterized by expiratory wheezes indicatingbronchiole constriction? This upper airway stridor is generally inspiratory. I have seen sudden onset angioedema only once, and it was due to an allergic reaction. (the patient had eaten shellfish). If it was my patient, they would be getting epi. I'm goiing with anaphylaxis.

That's what he told me

Hey - I'm a paragoddess if you don't mind. 8)

another old fart joins the ranks of paramedics - :wink: congrats on a job well done.

I stand corrected - and once again, I have learned something. It's a good day.

Well done doc, and thank you for your presence on this board. I am sure that you will be a gift to your patients and your co-workers. You certainly are for all of us here.

I was thrown off by the description of the pain as "cramping" quality. I always thought that ectopic pregnancies were asymptomatic until they ruptured, then producing sharp pain with abdominal distension and rigidity. I was under the impression that cramping type pains were associated with uterine issues (premature contractions, menstrual cramping, etc.) Thanks for the scenario.

Rhabdomyolysis is the physiological process that results from damaged muscle tissue. The cause of the muscle damage can be localized or systematic. Some of the causes of rhabdomyolysis include crush injury and compartment syndrome. Hope this helps.

I didn't know you were having difficulties. I'm sorry to hear it. It's pretty common to have these problems. I wish you all the best.

electrifying video

Congrats to NYPAEMT. Good job.

I don't understand how someone can use any of those things either - it's pretty ridiculous.

Do you know more about it? What was the guy doing? It looked like an employee at a plant of some time and I think he was turning something. I would really like to know more details if you have them.

My opinion for treatment of crush injury: - Airway and ventilatory support - High flow O2 - Aggressive hydration to maintain urinary output (dilution). Note that although crush injury treatment is still controversial, most physicians agree on dilution - Maintenance of body temperature - Certainly pain control - Tourniquet Most agree on this too – arterial flow and venous return must be prevented Controversial Treatment Surgical amputation on site if the individual cannot be freed by removing the compressing force Sodium bicarbonate to treat hyperkalemia and acidosis Calcium chloride to treat hypocalcaemia and hyperkalemia Mannitol and Lasix to maintain urine output and prevent myoglobin (released from damaged muscle) from plugging up the kidneys I agree that the tourniquet, high flow O2, fluids, pain medications, sodium bicarb and calcium chloride are appropriate pre-hospital treatments, but think that the Mannitol and Lasix can wait for the hospital.

ROTFLMAO

OK - now I'm really intrigued - who, what, where, when? details man - details. (please)

Once again I misread.. I read compartment didn't see crush - I agree with tourniquet for crush injuries AKA the "grateful dead syndrome".

????? Why would you apply a tourniquet? Compartment syndrome causes loss of distal circulation and risk of loss of limb. How would a tourniquet be beneficial? Wouldn't it just compound the problem?

For the past eight years or so, I have been driving up from Wisconsin and along the north shore of Lake Superior into Canada once a month. (My brother calls WI the state of the exploding deer). As an insomniac, I often drive in the wee hours in the dark. I cannot count the number of deer, wolves, eagles, bears, etc. that I have encountered along the way. Wildlife has jumped in front of my vehicle innumerable times. I have had many close calls but have made contact only once. I slowed down enough that I "bumped" the deer into the ditch. Always be alert to the possibility of wildlife crossing. If you are familiar with the area, you will know where deer cross. When approaching areas I know are popular with deer, I will honk my horn although that may be whistling past the graveyard. A buck in rut will not be thinking much beyond does. Does will be warned off. If an animal appears on the road in front of you, never, ever swerve. Apply brakes only as safe to do so. Hit the horn. Does often travel together - if you see one, there is a good chance others are behind it. Generally, the white tail deer is relatively small and if you do hit one in a reasonable sized vehicle, the deer will be toast but you will be fine. The mule deer are bigger and more dangerous. In Canada, what I fear are the moose (or swamp donkeys as they are referred to up there). Those suckers are tall, and when you hit them in the legs, they do come into the car with you. In short, keep your eyes open and drive smart.

I got on google earth and checked out Bagram - wow - it may not be the a**hole of the universe but I think you can see it from there - that's just my impression though. From what I understand, that's just your starting point. Keep us posted - and stay safe!

I was very surprised too Spenac. I thought "How could I misjudge someone so much - what is going on with the universe today?" Thanks for clearing it up. :wink: