Vorenus

Same here!

Aaaaaahhhhh... cute kitty

Funny. So, if you`re wisdom is that widespread - why do you keep going with the statements that are obviously wrong? Ah... sry, I get you now - all you say is wisdom and everything else is bullshit. Yep, that`s gonna be it...

Sure enough, only the comments that agree with you are rationale... You`re just pathetic. Not sure if you even realize that you make yourself ridiculous? And no, of course I didn`t expect an answer to my latest post, seeing that you would need to make a precise answer and of course that`s beyond your capabilities.

You said: Implies to me, that you`d expect to see a positive result of the given ASA. Since ASA is not thrombolytic, what other result may that be? I answered you: Which led you to answer me: {quote]And to be Repedantic, ASA could improve if it is a musculoskeletal issue. And Aspirin reduces blood clotting, which can help blood flow through a narrowed artery that's caused a heart attack, which is probably what is causing the cardiac type chest pain -- but thanks for trying, and no, there is no doubt that I am right on this one.{/quote] Seems to me like you try to justify your opinion that ASA will give your pt. pain relieve - why you`d want to do this if you never ment to state that the given ASA might have this effect, I don`t know. ERDOC, squint and me then told you that ASA`s not thrombolytic, but that it only hinders further blood to clot. Your answer: That surely a very competent way to lead a discussion... BTW: What do you mean with "fecicious"? Spelling mistake? Looked it up, couldn`t find something?

@squint: Here, we give 500mg of Aspirin i.v. in MI, so the pain issue could be possible with the musculoskeltal component, seeing that in the literature, the first single analgetic dosis is often described as 600mg. On the other side, I`ve seen references as to dosages of 20mg per kg of body weight to obtain an analgetic effect...

In the case you described, I wouldn`t give ASA as an analgetic, but as an antiplatelet drug (looked that up, don`t know if that`s the common term, sry if not). With a musculoskeltel issue the pain may improve. Regarding to your second point. The reduced blood clotting is an important factor for the overall chances of reconvalescence, but it won`t give an immediate pain relief. ASA will only hinder the existing clot getting bigger, but it`s not a thrombolytic drug.

You might just wanna calm down and think about the (true, unrealistic) possibility, that only because you think somethink is right, doesn`t mean it actually is. Regarding to your Chest-Pain-Scenario: I`d go for Nitro and ASA after making sure there are no contraindications, seeing that NSTEMIs aren`t that uncommon. Just to be pedantic: ASA is not going to visibly improve your pt. as you have stated above.

Just looked it up, it may be that those words you pointed out are the most commonly used, but "miserere" seems to be also fitting. http://en.wikipedia.org/wiki/Vomiting -> look at the "Contents" abstract. I fully agree on your second point!

As is releasing all of the depth on the thorax before doing another compression.

First, of course, the whole round of vitals. Patient history? Illnesses? Similiar episode in the past? Did he have any other symptoms in the past few days/weeks aside from that days? Any regular meds or did he take any in the imminent past? Any drugs, alcohol? How long was he unconscious? Was the passout observed? Convulsion? How much can he remember of the episode? When did he passout? Was he standing, sitting, lying? Any injuries from a possible fall? Pupils?

The fecal vomiting is called miserere. Saw that one too, kinda disgusting. Funny thing - in german, a plight or a misery is called Misere. So, if you have Miserere you are in a Misere. Sorry for the cynic humour, but we found that kind of hilarious (and fitting) back in school. Had a very, very inflamed and secreting leg with maggot infestation last week - also not really a treat for your nose.

Hm... never considered that, sounds kinda logical on the one side, though kinda overprotective on the other side. I can`t imagine that the bit of added fluid would make such a difference in the risk of a clot getting loose... Any literature on that one? Couldn`t find one in a quick search. I started lines in the foot veins too, though only if I couldn`t find any usable material at the upper extremities. Sorry for the screwed up post, can`t really edit posts with the old computer at work.

I had/have issues with sleeping sometimes, too. Take a look at autogenous training, it helped me. It`s a great thing, not only for sleeping disorders, but a bunch of other issues. `Course you gotta do it on a regular, if not daily basis, for it to be effective. @DFIB: Hilarious story...

Saw it in school, but never used it there and neither in the field. Around here, I don`t know of any service using it, we still do it the oldschool way... Therefore, can`t make any claims about it. Though I`d be interested to hear from someone who used it on an actual patient. Have you (couldn`t make that out from your post). What about the stability on the thorax? Could imagine it slipping out of position...? BTW: Are you from Israel?

That makes it a bit clearer, thanks. So what is the regular pay for a hour?

Sounds like a hell of a system...

Femoral pulses or distal pulses at the lower extremity may occur when an AAA rupturs, or, when unruptured, due to arteriosclerotic processes below the aneurysma (read that somewhere).

True, but they still teach the 100 compressions as a number in the algorithm - that`s why I pointed out that faster is better than slower. Even though the trend may point towards a faster rate in the next guidelines, they haven`t really changed the number of 100 in a definite way (while they changed the depth from 4-5cm to 5-6 cm).

Seeing the thread that Bushy is referring too - I wouldn`t say unprovoked... though true, cursing should may be reduced to a minimal level.

The best would be to hit the advised 100 compressions per minute. To get statistics about individual outcomes with varying rates you have to look up some studies (search for it in the internet). You want to get a continuous flow to supply the inner organs with enough oxygen (above all the brain), in a CPR situation studies have shown that 100 compressions is your best way to reach that goal. To increase or decrease the number will have a worse influence on the outcome, out of obvious reasons -> less compressions means less flow, more compressions means less stroke volume. But I can remember a lecture from a Doc who, I think, said that a slightly higher rate would be better than a slower one (leaving aside, that, as I said, in most cases you will automoatically be higher).

With the dummy in school, me and my pratice partner tried out a various number of songs, just for fun. When the algorithm was 120 compressions per minute, Highway the hell fitted perfectly - a little macaber...

With the number of deaths you may be right - but you can`t only speak of the major terrorist attacks that find there way into the media. In almost every country there are terrorist groups operating on a daily basis, founding there violence on hate and racism. Look up the Southern Poverty Law Center,only to stay inside the US.

Best to do more then less. But the past has shown, that most likely you`re gonna be too fast than too slow -> adrenaline excitement, etc. Look up the AHA page or the ERCs site for detailed abstracts on that topic. What can be helpful - remember a song where the beat is exactly 100 beats/compressions per minute. If I think I`m off the rythm, I just hum that song out of a beer commercial in my mind. You just gotta be careful not to hum or sing it too loudly - that can give you strange looks in that sort of situation...