DFIB

I might be able to buy that idea if all textbooks contained were a dissertation about how one should blindly trust the machines but since textbooks teach patient assessment beyond what the oxemeter reads then I am calling BS on this statement. Does the fact that he is IDDM mean that he is necessarily in a diabetic coma? Are there any other reasons for acidosis? Can you think of any possible scenario where a patient would be pale, diaphoretic and tachycardic that are not hypovolemia? And even a hypovolemic patient can maintain his BP for some time. This is called compensated shock. A person would have to lose 30% or more of their blood for their systolic pressure to drop below 90 mmHg. A plummeting BP is a late sign. Also I would expect the distance between the systolic pressure and the diastolic pressure to become closer not further apart. This we agree with.

Thanks. Double post.

So does this mean that if I started hanging out with you and your friends I would over time develop a "gay accent"?

For me, any SPO2 reading of 100% will always be suspect of a false reading. You are fortunate to be alive amigo. Another couple of days and you would not be posting on The City. Your medic buddy might do better in another line of work. Maby you should look him up and give him a smack for every neuron you lost. How low was you SPO2 really at that time? Did you ever get an acurate reading?

Here is the enhancement from hades. http://main.aol.com/2011/12/12/botched-penis-injection-_n_1145698.html

Anyone who loves Goodfellas is OK in my book. Welcome to the city.

I have never used the B.E.A.R. but have used a modified spider with positive results. Did you ever see the video? Any idea why it was removed?

The SPO2 reading is just one component of the patient assessment. Only one indicator in a long list of signs and symptoms. If the Oximetry reading agrees with the signs and symptoms all is well. If it disagrees then a differential assessment must be done to determine the reason for inconsistency. As a EMT-B I find Pulse Oximetry to be a very useful tool although it really doesn't influence my treatment that much. At our level we pretty much give everyone a little O2 except when otherwise contraindicated. Running 100 respiratory calls will definitely make you a better clinician considering you do the proper workup and have a good feedback system but saying that the only way to learn to use oximetry is by running calls indicates that you think we all are idiots and incapable of learning through didactical training. Also denying a patient the luxury of available Pulse Oximetry while you are still on your "learning calls" would not be fair to them and would be inconsistent with the best healthcare practices.

L-Arginine is an ineresting aminoacid that has effect on quality and quantity of male erictile function. Very interesting the effects it has on blood flow and the clames of increased GH.

Comment deleted due to redundancy/

I don't see how they cold avoid it. They must have really had it out for you. The dangers of nitro and ED meds are in the modern literature and skill sheets.

tniugs - I know that I ask patients with CHF to weigh daily before breakfast and record the changes as an indication of fluid retention and possible PE. I am truly couriouse if this is not done at the hospital. Humor fail. Ok, so returning to our obese, CHF, medicated, COPD, smurf .... What does he weigh? Is this his normal weight or has there been a sudden increase? I echo the question about urine output. I would recommend a RAST test or serum triptase as well as changing the antibiotic just to observe what happens. You mentioned his airway is patent but did you mention lung sounds? Are his legs swollen? Are his legs bilaterally equal in size and color? Is he taking any medication that could be competing with O2 and binding to hemoglobin? Do we know where his infection is? Lungs, peri cardium, endocardium, etc,,? Is anyone standing on his air hose?

With a history of CHF I would expect the hospital to weigh him every morning before breakfast but not being a floor nurse I could be wrong.. Muffled Heart sounds are in the EMT literature as one component of the cardiac tamponade triad but I was not aware that listening is not a common practice. Note to self, skip listening to heart. I am going to have to wait for the big guns to chime in. I am at a loss as to what the problem is but still lean toward the Keflex having something to do with it.

Simply a wonderful experience and great story! Thank you for sharing. Edited for spelling

Dude, you gotta have faith in the little man. I am gonna go drink some pirex now.

I work out and I find exercise to be beneficial to my EMT activities.

Since I like going out on a limb and pulling ideas out of what Kiwi calls “some orifice” Here goes. This guy could have a bunch of things 1. Could he be having an allergy to the Cephalexin that has been masked in severity by the hydrocortisone. This is only viable if Cephalexin was taken prior to blue tint. Possibly an anaphilactoid reaction. Also if he is having a reaction to the antibiotic and was already becoming cyanotic, could a Cephalexin reaction have potentiated an already blue skin color. How long ago was his first dose of Cephalexin? Is he allergic to Pennicillin? 2. Although his BP seems inconsistent with a tamponade we don’t know what his BP usually is, so. How many mmHg does his Blood Pressure usually run? Does he have Jugular vein distention? This is not likely since he is calmy sitting but I have to ask. Does he have muffled Heart sounds? Has he gained weight while in hospital? 3. Has he been exposed to chemicals such as poisons or silver? Edited to ask: Is he anemic? And Eydawn has a good point. If he has been in the hospital for two days why isn’t he compliant to his meds?

The achievement of EMT-B level of studies is exactly what it says. It is the basis for all of your other EMT knowledge. Every step you take in EMS will build upon what you learned or didn’t learn in your EMT class experience. If you cannot pass your final without cramming I would recommend retaking the class. The people that you will serve deserve a provider that knows his scope of practice and moves well within its protocols. Be excellent and party on dude.

Apples to oranges. You cannot compare people in t- shirts and shorts to people in bow ties. It is a totally different standard.

Very nice, No not exactly but I can see the humor in it. :0

Lamentably generality establishes the rule in most societies. The laws may be flawed and influenced by tho morays of the writers but are still ths measuring stick for lawful public behavior. So what is the solution? A more diverse congress? State legislature? A 'colorblind' society.

Sorry we must have been writing at the same time when I edited my post. What I mean is that patrons have to make a conserted effort to be exposed to Hooter girls. They know where they are gpoing and what htey are going for. It is not like you will turn the corner and run into a bunch of Hooter chicks.

You mean considering the Hooters waitress is walking down the street with a her friends Yelling things like " Hey Hey, Ho Ho, Hooterphobia's Got to go!

I am cautious about posting on this thread because I am not a homophobe but do not necessarily agree with the marketing and propaganda machine that the homosexual movement has used to promote their lifestyle. I simply could not care less how people get their jollies because every individual is responsible for his/her own actions. The simplicity of this is that public behavior is regulated by law. These parades do however cause a huge gray area as to the definition of public obscenity and its relationship with free speech.

You could use a light source and a digital camera to view the eye. I think it would work quite well.