hammerpcp

Magnesium for asthma exacerbation? Has anyone ever heard of and/or witnesses this treatment? I hear it's damn near miraculous in its effectiveness. So my question is why isn’t this standard treatment? If you know anything about this please share.

Actually that wasn't directed at you, it was meant for Akroez. But with a mug like yours I'd say you're pretty damn close to perfection yourself.

Shut up, you're perfect.

Hammerpcp to the rescue! The Fick principle: Air goes in and out, blood goes round and round. Voila, no thanks needed... =D> Is that what you were thinking Michael? :wink:

Also, no one has ever consumed more then two beers. Regardless of how intoxicated they appear.

I had a very similar situation recently. We were called to the residence of an elderly couple for the husband (81 y/o male) who had collapsed after returning from the bathroom. He is on home O2 and has quite severe COPD for 20+ years. Essentially his quality of life is non-existent. He is attached by a ten foot leash to his O2 compressor. So we arrive scene and the pt is quite hypotensive and is feeling dizzy, weak and SOB. He is sitting on the floor being supported by a fire fighter, otherwise he could probably not sit up on his own. My partner and I began treatment on this pt and were getting ready to transport him, when he told us that he did not want to go to the hospital. His wife was also there and she was in agreement. We of course inquired why, if he did not want treatment or transport, did he phone us? Apparently all he wanted was to be assisted back to bed. I told him that he could and probalby would die without treatment. He said that he wanted to die at home. The wife was in agreement. We assisted this pt back into bed after repeating the risks to him and ensuring that he understood and that she understood. We then contacted our supervisor and our base hospital doctor and both concurred that this pt was of decision making capacity and that he had every right to refuse. The couple had a living will in place but there was no DNR order. I advised the wife that she must contact the family physician and arrange a DNR order, and that of course if he changed his mind about treatment that they should call us back (911), but otherwise, if and when he does die they should not call 911 because we are obligated to start resuscitation. They both assured me that they understood the role of EMS and our legal obligations, etc. The following night when I reported to work to relieve the day crew, they informed me that approx 5 hours after we had been there, they had returned to the same address for the same man who was now vital signs absent. They were obligated (as EMS is here) to start resuscitation -although we can begin BLS resuscitation only- while they contacted the base hospital doctor for a field pronouncement. This situation seems to arise far too frequently. The big issue here is that family physicians rarely, if ever, will make a house call for any reason, even to pronounce death. A person is almost obligated to die in hospital, even if it is an expected and inevitable death, if only to save their family the hassle of dealing with the body, etc. Of course a funeral home will not take a body that death has not been pronounced upon by a physician or delegate. Anyway, I am glad that your system allows for you to make a call to your doc without having to take the unnecessary step of attempting resuscitation. Good work.

You think that's a cracker? Check this out. :scratch: Ouch my brain hurts...

Hey John, Just curious as to what your source for this info is.

THAT was wickedly hilarious.

I find a straw is much more cost efficient. :wink:

It's like American health care!

Are classmates or fiends/siblings experiencing similar symptoms? Is he on a special or restrictive diet of some sort?

YES YES! At least 2 Euros.

Yes!

I can picture it now......all the nurses and health care aids standing around the desk in the lobby laughing at the stupid paramedic who needs to ask if a pt is awake or not, when he is lying there on the floor hollering.

Hammerpcp is drafting a formal letter of complaint to add to melangels alreaady thick file..... :wink: P.S. It's supposed to be a story about something stupid YOU did, but as long as we are telling NH stories......I picked up an elderly gentleman for a fall the other day, he was wailing away and apparently had a history of alzheimers. I asked the RN on scene what his normal level of consciousness is, (in order to assess if there was any changes in his mentation post fall), she replies :"Oh, he is normally conscious". I was glad when this one disappeared from the room.

In all fairness, it is a hell of a lot cheaper to live anywhere in NS then it is in southern Ontario. Although your milk is a little over priced for some reason. Cow shortage?

Lithium, that question was clearly directed to the smart kids only. What about the inherent attributes of cardiac cells, automaticity, irritability, synchronicity?

You guys are pretty good. This seems to have indeed been a medication interaction between the Levodopa and the alcohol, and since the pt is on beta blockers as well his HR could not compensate when his pressure dropped out. On scene the pt's orthostatic VS where the same: HR just below 50 and no BP. So now a question for the smart kids. If Atropine is administered to a pt on beta blockers does the HR increase? What happens when you block parasympathetic and sympathetic impulses simultaneously?

So you've been with this pt for about twenty minutes and 400cc's of NS have infused. The pts BP is 136/54, HR is still just below 50 BPM, and the Pt is responding normally and looks quite a bit better. What do you think is going on with this pt? And why or why not did you decide to treat aggressively?

Is that guy like the male Martha Stewart?

I thought it was pretty funny.

The pt survived so therefore they were doing something right.

Too long? You suck at IV's so it took you awhile to get the fluid in with a 22 gauge. Oh and you only put the Pt supine on the stretcher because you recently read somewhere that trandelenburg doesnt work. :wink: Mentation is improved, pt is responding a little quicker then he was. Pt still appears pale cool and diaphoretic. Denies any pain of any kind. HR remains unchanged.

Alrighty, the general concensus seems to be to try a fluid bolus prior to addressing the rate. So we administer 250cc over 5-10 min or so. Pt's BP is 78 systolic. Now what?