chbare

However, it is less about how long we keep the patient and more about learning. Time may play an important role in the development of this problem. This scenario is no different than scenarios where you have a progressive EMS system with CT scanners, X-ays, and the such. The emphasis is on learning and understanding. Sometimes we can learn much when we take ourselves out side of our little box. Take care, chbare.

Sorry, in the Land Of Oz we will have to take care of these patients. You are able to get mom to a facility, but the bouncing baby boy is still your problem. A little bit of an unrealistic scenario to aid with the learning process. Baby continues to do well for the next several hours. After about 20 hours, the patient begins to develop tachycardia, progressive dyspnea, and central cyanosis. First: What do you think is going on? Does not have to be a specific problem at this point; however, think of broad categories that may fit. Second: Why do you suspect this problem? Third: Are we dealing with one problem, or could other problems be present? Fourth: Could any of these additional problems actually help in the short term? Take care, chbare.

You see what appears to be a health, full term, male patient. En route, both baby and mom do well. The placenta is delivered without incident and mom has very little bleeding. You dry, keep warm, cut the cord, the usual stuff. Now, for the twist. All hospitals are on divert and you are forced to care for mom and child over the next few days. Sorry, being in the Land of Oz and all, this stuff happens all of the time. Take care, chbare.

I did not know we had finished the call? Take care, chbare.

Baby and mom appear to be doing fine. Baby is active and moving about with vigor. Baby is currently pink and mom has calmed down a bit and now appears in shock over realizing she was pregnant. Take care, chbare.

Yeah, you see a little guy getting ready to fast rope into the toilette. So, to make up for the loss of style points from earlier you gracefully slide in and catch the kid. Now what? In addition, what were some of the indicators that the patient was getting ready to deliver? Take care, chbare.

Not a scream of pain. More like "oh no I knew she had something going on but did not push to check and now something not so good is going to happen" kind of scream. Take care, chbare.

You start hearing her scream shortly after she enters the bathroom. Take care, chbare.

All of her pregnancies were uneventful. Each successive labor and delivery was "faster and easier." Hard to tell if she looks pregnant, she is a large framed person. No real complaints of any ongoing problems. She tells you she "would rather talk after using the bathroom" and continues walking past you. Take care, chbare.

Scene appears safe. You enter to find the patient on her way to use the bathroom. She says, "I feel like I have to go." She is a G5P5A0. She states while walking past you, "I can't be pregnant I just had a baby less than a year ago." Reports severe pain that comes and goes. 10/10. Take care, chbare.

You are kicked out on a call for a 28 year old female with abdominal pain. Take care, chbare.

When I took a job as a CNA and realized I was making much more money than I could ever hope as an EMT-B. Off to nursing school with me. Take care, chbare.

How about we wait for the formal repots to be released? Take care, chbare.

How can your contact know such information? It can take a year or more for the root cause analysis to be reported. My flight company had a crash over a year ago and still no official word on the investigation. He said she said anecdotes are not helpful. Wait for the official investigation and conclusions before throwing out opinions. Thoughts and prayers go out to friends and families. Take care, chbare.

Thank you, that helps clear up one of my major questions. I must apologize; however, I had a difficult time understanding the post. Take care, chbare.

I do not understand the dynamics of your situation: You are an adult, yet your family will not allow you to use flash cards? Your sister who is in nursing school is using EMT-Basic flash cards to study? You are currently in school working on a degree in english, yet your articulation, spelling, and basic grammar is a bit on the rough side? You are unable to look into a job with another service or at a health care facility? Take care, chbare.

Consistency is also very important. This is especially true when performing serial XII leads. It is not helpful when you have people placing leads differently on the same patient. We want consistent placement in order to identify actual changes. Take care, chbare.

"but in the real world, when you go to calls, you have 15 people standing around you, moms screaming to save thier kid, a wife begging you to save her husband, people getting in your face because you took to long to get thier in thier opinion," A bit overdone on the drama eh? Most of my real world EMS calls were how to deal with BS at 3 am. A properly educated paramedic will have an extensive amount of clinical experience where they should be placed in a leadership role. Take care, chbare.

Yeah, need to consider beta blocker use. In addition, SC epi may not reach the central circulation in a patient who does not have peripheral perfusion. Epi gtt is a good idea. We could also consider H2 blockers. I know of a couple of cases where preservatives in 1:1,000 epi can cause a reaction, so try 0.1-0.3 mg of cardiac (1:10,000) epinephrine slow IV. Once stable, we can give a steriod such as solumedrol. Take care, chbare.

IV access, a little O2 for good looks and style points, try 0.4mg of NTG SL, and a dose of fentanyl for the pain. Hold on beta blockade at this point. Anterior leads would be: V3 & V4. Any depression in any other leads, axis deviation, BBB, or PRI changes? Pulses in all extremities strong and equal, JVD, blood pressure difference between arms, hoarse voice? Can we get: Port CXR, CBC, CMP, Cardiac isoenymes, coagulation panels, urine tox screen, ethanol, and TSH to start? Take care, chbare.

Any drugs on board. Cocaine up the hooha for example? Any past history, medications, or allergies? Vital signs and XII lead? IV access, blood sugar, and a little O2 if it makes him feel better. Take care, chbare.

Even better working with South African and Afghan medications and supplies. IV Tramadol, Duragesic is a muscle relaxer and not a fentanyl patch, and Creps is equivalent to curlex among many other things. Let's not even talk about labs in SI units. Hell, the treadmills even read in kilometers. You know, the US has been over here for 7 years, you think a few things would rub off on these people. Take care, chbare.

Yeah, many threads on combitubes and King airways. Do a quick forum search and you will find a multitude of information about these devices and other supraglottic airways. Take care, chbare.

Good luck. Many programs exist. Some good, others not so good. Research the program in question and talk with the instructors. Try to get a feel for how the program is set up and how well the didactic and clinical experiences are structured. Make sure the program has NLN credentials and be suspicious of programs who spout off about their NCLEX pass rates. Good job recognizing the fact that online programs are not for you. I have seen many a paramedic fall into the pass nursing school fast and easy mentality, only to waste their time and money. Take care, chbare.

She had rheumatic fever? Not a very common illness in the US these days. Typically, strep throat is painful and people want to be treated for the disorder. Then, not every case of strep will develop rheumatic fever. In addition, the presentation of an involved left arm is not typical of GBS. A pattern of signs and symptoms usually follow the progression if GBS in many cases. Take care, chbare.