AT-Medic

I love the Q brake, sounds like something from an old movie. Kinda funny when used at just the right time. Federal Q sure got it right.

Not really my style of music, but I did like it. Thanks for posting it!

Very good advice, and an excellent post. Way to stand your ground and do the right thing for the ICU pt, inspite of being pushed by the resident MD and the nurse!

So far I've got a, "Why did you bring him here for that?", from a knocked up nurse who didn't want to be at work today. I begged her forgiveness and stated that I was not allowed to refuse a requested transport. She replied with a roll of the eyes, and stated, "well what am I suppose to do for him?". I had a whole host of replies run through my head, but I smiled wishing her a nice day and returned to my short bus with flashy lights. One of the local ER's put out some stuff, but I didn't make it there yet. I'm sure it was picked over very well by now, lol! Hope everyone has a safe EMS week, well a safe week every week for that matter.

Excellent post. You are working the same approach as I think I would be. Treat for seizures due to possible OD, rule out CVA, work with the good airway we have, and secure it via ET time permitting. Depending on what station I’m working at, I could be just a block from the hospital, or be 45 plus minutes away. So it changes how you do things completely.

I agree with kiwimedic on this one. Take time to go to the next level, and don't fall victim to an endless liability issue.

Wow, name calling. After a slight review of my post, I find that in no way was anyone being slammed, so get over it, and go un-Ruff yourself...LMFAO!

Wow, that whole below 8 - must intubate mind set. Hence the reason for all the studies out there wanting to take intubation away from us. Its not your first tool in this case, or in about 99% of all cases. In reviewing my post, I could have added to my Local tx statment, the fact that I would have used an NPA, and placed the pt on 02 at 15-lpm. This pt automatically buys a 12 lead, which was something else I left out. I would also monitor his EtCO2, which would have some bearing on intubation. Unless there was a staus change with the airway, bagging would have been the most I would have done. The ED would most likely place this person on Bi-Pap, not intubate, but then again, you sometimes can't guess what the Doc is going to do.

I don't want to go into treatment as that can be as different as night and day depending on location. So I'll take a shoot as to what I think might be the problem. Effexor is a very popular drug for depressive disorders in general. Effexor also comes with a nearly never ending list of side effects. I would highly suspect a toxic response to the Effexor as a result of OD or hypersensitivity. The pill bottle will yeld information as to when this Rx or refill was started, dose, and by counting - the number of pills left, assuming that there are no pills in a plastic pill box at home. So based on the current vitals, I woulld guess that the pt is in a postictal state from a seizure caused by the Effexor, as well as the fact that the pt is hypertensive and tachycardic which are both side effects of Effexor. Whats burning in the back of my mind? Is this an intentional or unintentional OD? Although decreased in this pt's age group, the risk of suicidality is high on Effexor. Local tx for this pt would be; support ABC's as needed, monitor for change in status, moniotr heart rhythm, IV-kvo or saline loc, transport to hosp. I would like to address the HTN, but there is no HTN tx in Maryland.