firedoc5

Outstanding on the pacer pads. Personally, I'd rather see what his BP would do if you raised the heart rate first. If you bring up the heart rate but is still border line hypo-tensive, then try the fluid challenge. Then go from there. I guess that's what I was trying to say in the first place. Just couldn't get it out. I'm just really leary of over loading him with fluids, especially too rapidly.

I resemble that remark. Duct Tape can be so useful.

One thing I forgot to mention in my earlier post is that when AED's first came out, and were actually still in a trial stage. There was an argument of that even if a dysrhythmia was successfully converted and no ALS or that ALS had a long response time, without Lidocaine, Bretylium, Procainamide, or other anti-dysrhythmic drug(s) they could revert back into full arrest more readily. Then you had to def-fib more. So, is it better to just do CPR until ALS get's there, or defib up to three times and have them convert only to go back to the original dysrhythmia needing to be shocked again? We had some think that with the additional shocks, it may have caused more damage to the cardiac muscle than the trauma of CPR alone. You have to remember this was many years ago. I'm only posting this as food for thought and to let some of the younger medics what kinds of arguments there were when these kind of new things were being implemented. As far as trusting computers to identify a rhythm, I've seen where artifact was picked up as coarse V-fib and verbally stating that it was a shockable rhythm. I'm not sure of the circumstances but I heard of when a patient was in a 3rd degree block the computer picked it up as low voltage sinus brady or something like that. It was over in another county closer to St. Louis and there was a write up about it in a newspaper. Along with a story of how a medic was shocked through the paddle buttons while testing a monitor. I'm sure the computers of today have much improved. But just things like that sticks in the back of my mind. I must truly be old school.

"The Night They Drove Ole Dixie Down" - Allman Bros./ Dickey Betts

I just keep my MySpace pretty much plain. No cutesy wall paper that makes text hard to read. No funky cursor. Who needs all that clutter? The only thing I play around with is my PlayList.

I'm in the same boat. My migraines are now pretty much under control, but they used me for all sorts of trials with meds and treatments when I was getting them very frequently. At one time I was getting three every two weeks on average. I found out real quick I couldn't have Torodol (also for kidney stones). Immitrex worked great, thought it was a miracle drug and that I had it made. But the third time I had it I had crushing chest pain, went into a PSVT and my blood pressure rocketed. They said no more for you. I have about nine allergies. Some are really adverse reactions other than true allergies, but when they ask for allergies you have to tell them all. I like to describe what happens when I have them.

With the description of pain (10/10, distress) and knowing that he had to be feeling ill, possibly with N & V causing even more straining, all of which can cause more vagal stimuli. Dehydration is an issue, but not to the point he needs rapid fluid replacement. One IV WO should be sufficient. Non-trauma fluid replacement should be in slower and in moderation than trauma/ hypovolemic. One fluid to consider is D5 NS + KCL. I believe hypotension is due to bradycardia, not fluid depletion. Dehydration is more gradual. This gentleman stated it was sudden onset. Also, it seems like I remember something about if A-fib is not already chronic, bringing up HR may correct A-fib. Also take into consideration his age, 70. May have other underlying conditions not yet diagnosed. I'm posting this quickly sitting next to my wife in the hosp. I'll explain more under "Personal" schtuff.

I follow what you are saying, but......... If you suspect something causes the arrest and can be easily fixed (hypoglycemia, narcotic OD, tension pneumo) why push the drug/intervention to fix the problem down the line when they have a good chance to wake up in the next few minutes? I am just thinking that if I suspect they will wake up, I would not want to "come to" with a tube sticking down my throat.

Hope you get feeling better real soon. I saw what my brother-in-law went through with gall bladder trouble. But I did ask him if he wanted to trade me with my kidney stones. He declined. Take it easy, rest, have people wait on you hand and foot. But do keep moving around. I'm sure Roy is going to take good care of you.

By no means a high jack, CC. Did the girl present with Toxic Shock Syndrome? That was a problem in the early-mid 80's with women. Does anyone remember that? I guess mom didn't explain things too well to her. I can see someone puke due to something like that, but not a doc. But I guess somethings just bother some people more than others. :puke:

Sounds heat related. Still a possible MI, just not being detected by ECG yet. I wouldn't have started two IV's. Hypotension probably due to cardiogenic situation, not hypovolemia. You don't want to overload him. Since bradycardic, 0.5mg. Atropine. O2 15L/NRM if tolerated. If heart rate and BP comes up, adm. MS for chest pain. I can't believe you had to wait that long for a bed with a patient in that situation. Either they had a whole lot of critical patients already or you were just being ignored. Personally, I would have kept requesting a bed ASAP to whoever. Don't be embarrassed for not having 12 lead yet. We did III lead for years before 12 lead was available in the field with no major repercusions that I know of.

Multiple news outlets are reporting that a wildfire chopper crash in California late last night has claimed the lives of as many as nine firefighters, in what would be one of the largest losses of firefighters in recent memory. The helicopter was carrying 11 firefighters and two crew members when it went down Tuesday night in the Shasta-Trinity National Forest, according to the Federal Aviation Administration and the National Transportation Safety Board, the Associated Press reported. Four people including a pilot were taken to hospitals with severe burns, including two in critical condition, according to the U.S. Forest Service. The chopper was shuttling firefighters into remote areas of the blaze. The Oregonian reported that the firefighters may have worked for Grayback Forestry, a private firefighting contractor based in Merlin, Ore. Grayback issued a statement late this afternoon confirming that at least three of its personnel had been injured, but did not advise on fatalities. The injured team members were listed as Michael Brown, 20, and Jonathan Frohreich, 18, who were transported to the University of California Davis Medical Center in Sacramento. Rick Schoeder, 42, was admitted to Mercy Medical Center in Redding, Calif. The condition and extent of their injuries is unknown at this time. The Oregonian also reported that this would be the second large scale tragedy for the company. On June 21, 2002, a van carrying 11 Grayback workers rolled over in eastern Oregon while on the way to a Colorado fire. Four people were killed outright and a fifth died later. The NTSB issued the following statement: The National Transportation Safety Board has dispatched a Go Team to investigate a helicopter crash in a remote wooded area about 35 miles northwest of Redding, California. The Sikorsky S-61N (N612AZ) operated by the U.S. Department of Forestry, crashed at about 7:30 p.m. PDT last night during takeoff. A post-crash fire ensued. Of the 13 people reported to be on-board, four suffered serious injuries; nine are unaccounted for and are presumed to be fatally injured. Nine Charleston, S.C. firefighters were killed last year battling a furniture blaze, the largest loss of firefighters in a single incident since the terrorist attacks of 9/11 which claimed 343 firefighters.

"Never Been to Spain" - Three Dog Night

I don't see why an EMT-I/99 just doesn't take the additional training and become a full Paramedic if they can already do almost the same things. It wouldn't take all that much, would it?

Maybe it was a rivalry. One trying to make the other one look bad to make himself look better. In any case, both were stupid.

Sounds like a wild ride.

I have heard about it, but never seen it myself. But never heard of it in ACLS guidelines.

I can't remember but in a thread a long time ago, Spenac, that you and/or your agency can declare death? Are you also a Deputy Coroner or equivalent? I'm by no means calling you out, I just recall something like that. I really wish we could have. No matter when or where, if we had a very obvious death at the scene we still had to wait for the Coroner's office to arrive. Or at least have one person wait. It was a real drag sometimes. By law, even if they are decapitated we have to wait for them to be declared by either a doctor or Coroner.

Torn uterus. Luckily OB/GYN doc already in-house. Was in OR within 20 mins. Doc did not think it was actually the broom handle. Thought it had to have been something more sharp than blunt. Have no idea what they were thinking. What all was used? What kind of game(s)? Chalk one more up for the "If I ever write a book..." category.

OK, I will. Messing around consisted of the use of several things, including a broom handle... We did not know about this until after the doc had examined her. I'm sure almost everyone here can come up with what was causing the bleeding. It through us off due to her denying any recent intercourse. Evidently she did not consider foreign body insertion as intercourse.

My great-grandparents and aunt & uncle are buried almost right next to Johnny in Bosier City, LA. I wonder, how many girls wouldn't put out during the War of 1812? :-k

I'd rather have the pt. tubed, even if they do come out of the full arrest and then have to pull it. Airway #1. You need that tube in during the entire code, and if you are going to give the Narcan and/ or D50, that's way down the line of what you are going to do first. I doubt if anyone is going to come into a full arrest with the intention of giving those two drugs first no matter what the suspicions.

Nope, definate vaginal bleeding.

My late Capt. was outstanding. But he never really wanted to be Chief. An some people couldn't see him as a Chief. They said he was too nice. He was nice, but he made sure you did things right and in a timely manor. But you sure didn't want to p!ss him off.

Pt. is about 5'6". Blood red, and dripping when we do get her to stand up. Did not pass any clots. Was feeling normal prior to start of bleeding. Very small apartment bathroom. No previous pregnancies. Two IV's established, one NS, one LR. (This was ordered by medical control by phone) O2 6L per nasal canula. No N & V. Cramping pain did increase on deep inhalation. At the apartment at the time were her roommate and two male friends. The three witnesses stated they were only "messing around" when she got up to use the rest room. No ETOH or drugs obvious. Pt. had no medical history or meds. When asked how they were "messing around", they all four were vague. Pt. placed on cot with pads and drop cloths. By the time we got down from the third story floor, she saturated three pads. Still, no clots or tissue present. Pt. did complain of more generalized weakness. BP: 90/60, P: 120, Resp: 24. While en-route, total number of pads used were six. We ran out when arrived at ER.