Mark the O

I am a little embarrassed to post this but I need some help. I was sitting at the station practicing drug calculations and drip rates. I could not get this right for the life of me. I have the formula for infusion rates but I keep getting stuck. Dopamine drip for a 100kg pt at 10mcg/kg/min. Epi drip for a 20kg pt at 1mcg/kg/min. I keep getting enormous drop/min, like 3000gtts/min. What the heck am I doing wrong.

Thanks for that. The "tale" was pretty funny. I did that once.....ok no I dindnt.

So in the interest of keeping the conversation going....with the pt's Hx, age, and cardiac findings (occasional PVC's to increasing PVC's to trigeminy) is not chest pain/discomfort, and sudden SOB not a significant finding that could be either a result of the pain and SOB or a cause? And maybe im mistaken but isnt the progression of the ventricular ectopy a change on the EKG including the 12 lead? In general, I was not very worried about the pt. She was in some amount of distress but I (eventually) did not feel that she needed immediate treatment. With that said, I like the way someone else put it....Could I have prevented something that potentially happened or could have happened an hour after I dropped her off? PS. ... Im begining to detect some tension in this post.....CHILLLLLLL, maybe we should get a 12 year old to post and solve this issue.

Wow, my mind is full of thing to write. I wish I had time to write it all. I will later hopefully. I have not leared much of EMS outside of the US. Is it really that different? Gotta say im impressed. I wanna hear more.

So this particular pt had vitals all within normal ranges. I did mean 12 lead by the way. Got several of them on the way (while stopped). there was no other abnormal findings on that. Her history was somewhat troubling. she had an aortic anyerism (spelling?) that was being monitored, 3 MI's and a long list of other things. after debating wether or not to treat, I decided to be more conservative due to there being no other changes in her status (monitor changed...pt did not change). The thing that kept ringing in my head was the list of things that make PVC's dangerous....the list i learned in school 5 years ago. Multifocal PVC's, more than 6 a minute, R on T, runs of V-Tach...she was sure having more than 6 a minute. Oh and FYI, she was being treated for CP and SOB with O2, IV, ASA, Nitro and of course the EKG. other comments....................I have had several pt's like this and Im still trying to form a general idea of wether to be more aggressive or not.

We use valium for Sz's and versed for sedation and RSI. have not had much in the way of using versed over valium though we do use it as a back up for the valium. seems after reading some of these posts that only having the one would make more sense.

60 year old female calls for SOB. She says she ate some candy then became SOB (did not choke). shortly after that, she develops CP. vitals are all stable...no significant increase in work of breathing, lungs clear......EKG has a sinus rhythm with occassional unifocal PVC's. begin treating the pt for CP and dyspnea. on the way to the hospital the 12 lead EKG is being monitored. you see that the pt is now having some multifocal PVC's though rare. now 10 minutes prior to reaching the er the pt is now showing periods of trigeminy PVC's on the monitor. there is no change in the pt's presentation or complaints. What next............

Galveston EMS has been using it since 2005 at least.

Seems to me that EMS is painfully but rapidly growing as a profession. (been a paramedic for five + years). I look at the two professions that we are most related to and I see that we seem to be growing at a faster pace than they did. One: The fire department is more structured and looked at as more of a profession than EMS, but fire has had more than a hundred years to establish itself as a field and to become what it is today. EMS has been "organized" in the USA as far as I know only since the 70's. Two: Nursing has been around even longer and has established itself as a strong well paid profession. Nursing has evolved a lot in the hundreds of years it has been needed. Key point.......lots of time.... My point: EMS is still so young as a proffesion and just like fire and nursing when they were young, EMS has to establish itself in the minds of the public as a needed, profesional, organized feild. I think that we have come a long way in the mere 30-40 years that the feild has been around. We have gone from driving as fast as we can to the funeral home to treating anything from medical to trauma with hopes of actually improving the person. Im looking forward to seeing what EMS will become in the next 30-40 years. As someone else mentioned in a previous post, we (the people in the feild now) will decide where this feild goes as a profesion. OK OK the rambling is done.