Arctickat

Thanks for the update!!!

So, what I did was hand off the patient to one of my other medics who did the transfer...I wasn't on duty. The Hyponatremia was judiciously treated with a NS infusion at 120 ml/hr for the 2 hour transport time and the hypoglycemia controlled with D50. Since we don't have the ability to continue monitoring labs enroute we couldn't really start treatment, it was more or less a case of "let's do what we can to mitigate the damage, but control the sodium uptake so we don't kill him." Fortunately he wasn't in a severe state.

What big game is on today?

I disagree, and so does our College. Medics have been disciplined for not providing adequate care within their scope. Deferring care to the client until hospital arrival is an unreasonable delay in patient care. I will not allow my patient to suffer their condition one minute longer than he or she must and to use the excuse that "I'm only 2 minutes away from the hospital so I'll let them do it." is simply nonfeasance. I've been trained to do a job and I will do it.

I'm hoping just shaken a little the epicentre was pretty deep. http://www.foxnews.com/world/2013/03/10/strong-quake-strikes-papua-new-guinea-no-reports-damage-and-no-tsunami-alert/

I'll let you know what I did after some answers come in.

Sounds about right Kiwi, but given the normal urine production levels of 1 - 2 litres per day, and even the ability to produce up to 1 litre per hour; even this attempt to normalise the imbalance would prove difficult given the vast volume of water involved. Especially given the other medical conditions involved.

Cross Country running and rifle.

Sorry Doc, you are of course and always, correct. My concern wasn't with the amount of dextrose my patient was given. It was with the vast quantities of water he'd received. About 3 litres in I probably would have switched to a D10NS or a D10/0.45%S

So, here's the scenario.... Client is brought to local hospital with Hypoglycemia, 2 amps of D50, 50 grams total bring his sugars up, but he had taken his insulin the night before a cultural fasting (religion). For the next 12 hours our hospital tries to manage the hypoglycemia with a couple of amps of D50, 6 litres of D10W and 3 litres of D5W. Then they do some lab work and freak out because the client also has hyponatremia. They then decide to send the client to a larger centre because they cannot manage the care for the client here. My first question to them was "What were the Na levels prior to all the dextrose you gave him?" "We don't know, we didn't check it." "Hmm, d'ya think it might have something to do with his hyponatremia now?" Sigh. The concept of D5S hasn't filtered down this far yet.

http://www.collegeofparamedics.sk.ca/conduct/Discipline/Greg%20Sim%20final%20decision%202010-03-25_Redacted.pdf http://www.collegeofparamedics.sk.ca/conduct/Discipline/2011_C007ED%20Signed%20CCRA_Redacted.pdf http://www.collegeofparamedics.sk.ca/conduct/Discipline/2011_C015%20CCRA%20Signed_Redacted.pdf I know that at least one of these individuals has overcome the addiction and has returned to work for the previous employer.

We've got several medics who have undergone rehab and returned to the system. I honestly believe that a permanent ban from practise is a heavy handed and unreasonable response.

Yeah, all kidding aside, I've learned long ago that the best way to de-escalate a situation is to let the crazy one think he has all the control and take the dominant role. Once the Alpha Dog has his bone he's much more docile.

I actually received an application from her, first thing I do when I am considering application seriously is google the name and that's what I found. I'll never mention my findings to her...unless she reads this forum she'll never know, and it's not relevant to her potential employment one way or the other. however, i know I wouldn't want videos of me belly dancing out in the interwebs.

errr, Tami?

Uber Cool

I I is the first person singular subject pronoun, which means that it refers to the person performing the action of a verb. I want to go. This is the one I like. You and I need to get ready. Tom and I are going to the movies. Me Me is an object pronoun, which means that it refers to the person that the action of a verb is being done to, or to which a preposition refers. David told me to leave. He gave me ten dollars. Between you and me, this is a bad idea. She needs to talk to Joe or me. Since it was you who performed the action of posting the comment, the proper word would be "I". http://www.elearnenglishlanguage.com/difficulties/ime.html

How about Belly Dancing?

I did that at our hospital a few weeks back. We hadn't moved in almost a week and as I was sitting in the nursing station they asked how things were. I told them it was quiet. Quiet, oh so quiet, QUIIIIEEEEEEEEETTTTTT, and just kept saying it over and over on my way out the door. 20 minutes later they called me to take a cardiac to the city.

Hmm,,,what is the student doing? Shouldn't he have been sent in there first to evaluate scene safety? Reading this scenario makes me think that maybe I should get our emerg buttons reconnected. I had them d/c because they're right beside the volume knob and kept getting hit. They're the Keylock button now. Scary thoughts Ruff, but an excellent and thought provoking scenario. One I could easily see myself getting into.

Fixed that for ya.

My guess is that the first time Momma B was admitted to said health facility she had your sister as the contact person and that has just never been updated in the past 40 years.

Partner goes high, I go low, 50% odds of survival.

Thanks Tami, as you just saw on Facebook, we came close to losing another one today.

Sob...snurffle