SHARK1

lETAS LOOK AT THE PATHOPHSIOLOGY OF A CVA. YOU HAVE A THROMBUS, EMBOLUS, LUCANA, ANYERUSIM,PONTINE HEMMEROGAE IN ANY CASE THEY ARE ALL CLOSED HEAD INTERVENTIONS. I HAVE NEVER SEEN A PERSON WITH HPOTENSION GET A STROKE , MAYBE HYPOTHERMIA WITH A RECIRCULATION DISPBRITUTION BUT FOR ALL INTENTS AND IMPRESSIONS HER BP WNL WHICH BASICALLY RULES OUT LUCANA AND WITH HER EYES PERRLE R/O PONTINE AND DID YOU SEEK ANY ADDITIONAL HISTORY PERTINENT LIKE EAR INFECTIONS SINUS INFECTIONS OR ANY OTHER TYPE OF BRAIN DISORDER LOU GERIG, MYASTHINIA GRAVIS ETC. THIS WILL HELP YOU IN YOUR QUEST HER ECG WAS NSR AND NO POSSIBILITY OF STOKES ADAM. IT SEEMS LIKE A STOKES ADAM WITH A UNDERLYING POSS MI DIN'T SAY ANYTHING ABOUT DIABETES. GERIATRIC MEDICINCE IS A BRANCH ALL IN ITS OWN AND REPEAT EXPOSURE AND GOING OVER YOUR ALS REPORT WITH YOUR MD WILL HELP IN HONING YOUR SKILLS. a FLUID CHALLENGE TO R/O SOMETHING IS NOT PRUDENT IN THIS SITUATION. CAPT MITCHELL STERN, AS, MPH, EMT-4, NCEMT-4 (RET)

tHE CHALLENGE IN ANY SEDATION PROCEDURE IS MAINTAINING A AIRWAY AND EXCELLENT PERFUSION. BACK WHEN I WAS A MEDIC FROM 1977-1996 (PROMOTION) WE ALWAYS SEDATED BAD PULMONARY EDEMA PATIENTS . DUE TO THE HYPOXIC INDEX, REMEMBER IT ONLY TAKES 5% DE SATURATED BLOOD TO CAUSE ISCHEMEA AND CYANOSIS. YOU CAN HANDLE A PATIENT WITH LESS AGITITAION BUT THE RAMIFICATIONS ARE THESE.NO1. MANY ELDERLY PATIENTS ARE NOT WEENED OFF THE RESPIRATORS SOON ENOUGH AND USALLY DIE FROM SOME PNUEMOCOCCI VIOLATION. NO 2, WHEN INTUBATING A PATIENT THAT IS HYPOXIC FROM HEROIN OVERDOSE I HAVE SEEN SOME OF THESE PATIENTS LIERALLY PULL OUT A VOCAL CORD FROM NOT RELIEVING THE 10CC IN THE CUFF. BESIDES WE HAD ONLY MORPHINE WHICH CREATES VENOUS POOLING WHICH HELPS WITH REDUCING PRELOAD AND REDUCES THE HIGH PULMONARY PRESSURES; THE CONVERSE SIDE IS THE RESPIRATORY COMPONENT WHICH CAUSES HYPOVENTILATION WHICH NEEDS TO MAINATINED WITH A PULSE OXIMODOR. MIDAZOLAM IS A BY PRODUCT OF DIAZAPAM A BENZODIAZEPINE WHICH ACTS ON THE BRAIN FOR ANIETY AND MANY PEOPLE SEEM TO HAVE A ALLERGENIC RESPONSE TO IT. OF COURSE THERE IS NO REASON WHATSOEVER TO SEDATE A TRAUMA PATIENT AND MASK THE % OF BLOOD LOSS. WHAT MAKES A GOOD PARAMEDIC IS THE ABILITY TO BE INTIMATLY FAMILIAR WITH THE MEDS AND THEIR EFFECTIVENESS AND A MASTER DIAGNOSTICIAN.