Ace844

OK, the short quick immediate answers are as follows...2+ large bore IV's, labs, 325 ASA PO {Barring contraindications} Low flow o2, as already started, a follow up 12-lead in a few minutes, and BENZO'S until anxiolysis-symptomtology reduction is achieved..extriacte to the ambulance and transport, as care is supportive mostly in this case.

Reciprocal changes occur on a 12-lead in 'opposite' leads. So if there is elevation in a few leads, there will be depression in the 'opposite' leads. As far as the scene, i thought soemone had asked that, but in case not, add that to the list, and as well whatever other bystander, partmner, PD, etc.. info you can get or see.

ok, when you isolate the kid from the parent, any further tox related information coem out? Is the pt a smoker? supplement user? Any signs of Drug abuse-use?What activities was she partaking in prior to coming home, running exertional, etc...? Next, since you didnt mention it, Breath sounds, what are the other B/P's, etc...? Any murmurs?

How about the rest of the H&P-P/E? Is the depression reciprocial, any axis deviation, any question of recnt tox or substance ingestion?

PMHX, Meds, ALL, V/S's,complete head to toe assessment, and Events preceeding, v/s's including bilat B/P's pulse ox, 12-lead, and pert + and - cardio-respritory exam findings. Thanks, ACE844

"GA," It's called ADVOCACY...Contact PRPG and or CAPEM; and they can put your preaching to work...where you will be doing more than just taking up space on a forum.. ACE

Kindly refer yourself to my previous posts..... ACE844

AGAIN, KINDLY DO A SEARCH, THOSE DISCUSSIONS HAVE OCCURED, AND THE INFORMATION IS AVAILABLE!! If you'd like to post those seperately in the applicable threads, thats one thing...this is preaching from a pulpit.. ACE844

I think he was trying to talk at us again with no room for discourse, and or made a vague personal attack as he posted right below me...either way, this poster needs to stow the pulpit.. ACE

"GAMedic," The evidence and information as "JPINFV," has taken the time to point out to you is ALREADY HERE. My suggestion is to do a search and leave the preaching for whatever religeous or public platform you prefer. There are many posts here to which are still awaiting your reply with evidence and actual factual information. Until then, good luck and have a nice day, ACE844

"GAMEDIC," I am going to say this once, and politely. Kindly don't tell me what I do and don't understand because as you can see I was the one who posted the majority of the information here about this. Also, based on your posts it appears to be YOU who needs to evaluate what is and isn't understood in your world. There are a number of threads initiated on this board which are awaiting your replies to overwhelming evidence which contradict the things you have posted and reported as fact. So in closing, until you post facts, and answer the other posts with verifiable and 'reputable' information, don't come here and preach to me about what I do and don't understand..Here's your: OUT HERE, ACE844

Yeah..what he said....above....and yes god and I have a very special relationship... :shock: 8) [stream:375f0dc0ad]http://www.moviesoundscentral.com/sounds/full_metal_jacket/god.wav[/stream:375f0dc0ad] Out Here,

I think until we see some solid clinical and safety profile data it's abit pre-mature to get hopeful about this...Think the smallpox vaccine... Out Here, ACE844

Yeah, forget any care at all....SHTUFF....My AVATAR SAYS IT ALL "GOT SHOES LADY!!"

Hello Everyone, At various times on this board we have had proposals to chnage the state of EMS and an oft asked question is how. While doing some reading I stumbled upon this article which we ALL should read and I think it could give us each a basic idea and frame work for which to perform some organized EMS lobbying from, then begin to effect soem much needed changes. Hope this Helps, ACE844

Here's one for ya nate:: http://www.heroinhelper.com

I bet there is...just their spelling and vocabulary....well..nevermind...

Some how I suspect that when 'systemlord,' figured out we weren't a bunch of wanna be push over whackers who would be echoing his cries of 'YEAH... NURSES SUCK DUDE!!' He has gone away never to be heard from again..!!! ACE

What kind of capital are we talking about "Ruff," ballpark?

For those who are interested here's alittle more information on 'Dopamine'

Above here, by doing a search at EMTCITY for international ems, and at www.international-ems.com.... OUt Here, ACE844

LighteningFastACE search.com Actually you just happened to catch me studying using "Zipes: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed., Copyright © 2005" ACE844

Here's your 12-lead you requested http://www.ecglibrary.com/wpwaf.html http://www.ecglibrary.com/wpwaf2.html http://en.wikipedia.org/wiki/Wolff-Parkinson-White_syndrome http://www.clevelandclinic.org/heartcenter...mp;thirdCat=259 ( Goldberger: Clinical Electrocardiography: A Simplified Approach @ 6th ed.,) Wolff-Parkinson-White Pattern The WPW syndrome is an unusual and distinctive ECG abnormality caused by preexcitation of the ventricles. Normally the electrical stimulus passes to the ventricles from the atria via the AV junction. The physiologic lag of conduction through the AV junction results in the normal PR interval of 0.12 to 0.2 second. Imagine the consequences of having an extra pathway between the atria and ventricles that would bypass the AV junction and preexcite the ventricles. This is exactly what occurs with the WPW syndrome: an atrioventricular bypass tract * connects the atria and ventricles, circumventing the AV junction (Fig. 10.18) . Preexcitation of the ventricles with the WPW syndrome produces the following three characteristic changes on the ECG (Figs. 10-19 and 10-20) : The QRS is widened, giving the superficial appearance of a bundle branch block pattern. However, the wide QRS is caused not by a -------------------------------------------------------------------------------- * Formerly called the bundle of Kent. -------------------------------------------------------------------------------- delay in ventricular depolarization but by early stimulation of the ventricles. (The QRS is widened to the degree that the PR is shortened.) The PR is shortened (often but not always to less than 0.12 second) because of ventricular preexcitation. The upstroke of the QRS complex is slurred or notched. This is called a delta wave. Figs. 10.19 and 10.20 show the WPW pattern, with its classic triad of a widened QRS, a short PR interval, and a delta wave. Notice that the pattern superficially resembles a bundle branch block pattern because of the widened QRS complexes. Depending on which area of the ventricles is preexcited first, the ECG may show a pattern simulating that of either RBBB with tall R waves in the right chest leads or LBBB with a predominantly negative QS in lead V1 . The significance of WPW preexcitation is twofold: Patients with this pattern are prone to arrhythmias, especially paroxysmal supraventricular tachycardia (PSVT) (Fig. 10.21) . The ECG of these patients is often mistaken as indicating a bundle branch block or MI (see Fig. 10.20) . The WPW syndrome predisposes patients to develop paroxysmal supraventricular tachycardia (PSVT) because of the presence of an extra conduction pathway. For example, a premature impulse traveling down the AV junction may recycle up the accessory pathway and then back down the AV junction, and so on. * This type of recirculating impulse is an example of reentry. Another type of preexcitation variant, the Lown-Ganong-Levine (LGL) syndrome, is caused by a bypass tract that connects the atria and AV junction. Bypassing the AV node results in a short PR interval (less than 0.12 second). However, the QRS width is not prolonged, because ventricular activation occurs normally. Therefore the LGL pattern consists of a normal-width QRS complex with a short PR interval and no delta wave; the WPW consists of a wide QRS complex with a short PR interval and a delta wave (see Fig. 10.19) . Patients with the LGL pattern may also have reentrant-type PSVT or paroxysmal atrial fibrillation or flutter. * And Here's 2 more images for ya.