mobey

Jessi, are we still missing something. It is a big MI, we have started MONA and are enroute to a cath lab. Is there more?

Hmmm, this may not fit the mold but it may be worth mentioning, I had a 52 y/o female that was following commands such as "squeeze my fingers" and "wiggle your toes", but she would not open her eyes or speak. She had deep non-laboured resps, and was slightly hypertensive, and drooling like crazy. I thought for sure she was being stubborn - looking for attention. But as the call went on she never moved her face at all. I was finally convinced when her head flipped forward and she began snoring and waving her arms frantically. Yup her face and neck muscles were paralized. I really became a believer when the Doc told me of the big CVA on the CT. I really did not think this was possible. There was no droop or unilateral paralisis or weakness!!

I just wish they would have showed medics spinaling the patient instead of the cops and FF. Another great advertisement showing how heroic FF are, at least there was an ambulance on the scene!

Last bowel movement? Last meal? Urine output? Does she feel like she has to have a BM? How bad is the dementia? Can I trust her answers about her current condition? Is she always a little jaundice or is that new? Oh ya, how long has she been in the hospital?

I have no idea then. Pretty hard to come up with a decent differential diagnosis off 3-4 symptoms, with no history, med list, or even complete vitals :roll: I say Hypoglycemic, asthmatic, having a major coronary event.

pulse rate? Any history?

, Soo... responsive to pain only, Then CPAP, then unresponcive, then skin dries up and responsive again? UnCx due to hypoxia, CPAP assisted with ventilation then patient became resonsive again. Could be COPD exacurbation.

Alright I give, please enlighten me! What the heck does a hoarse voice have to do with aneurism or MI??

I usually use triangulars to fasten the hands to the siderails, then straps across the thighs and chest, that usually does the trick. Luckily I don't have to deal with this scenario much.

Woulden't the epy take care of that?

Ok I am pulling this out my a$$. What about exercise induced bronchospasm, whether it is related to asthma or not. (kid was not diagnosed w/asthma anyway). As he works to breathe through the constiricted bronchioles he further triggers the bronchoconstriction?? If we can get him back, stick him on a ventolator for a while and keep on stickin him with epy, and bronchodilators. I am really just shootin from the hip here though. great scenario, I love it when I have no idea what to do, keeps the gears turnin!!

Is this limited to the US?

phsyc calls, we are not trained to handle them.

If we are thinking along the lines of tamponade, watch for a narrowing pulse pressure trend, you can also assess for JVD, and listen to heart sounds to see if they are "Distant". All of these signs are pretty late signs (not as late as PEA).

C'mon spenac, I need to know the source if I am to believe that! I still think it is AK. Unless you had a reliable source.

I have used a BVM many times for P. edema. Sometimes I will even offer it to the patient to assist themselves, you may be surprised how many times they take me up on my offer. This is something I learned off this forum and it works great!!

Sounds like a union negotiation to me!! That's what we do as union members, if we don't get what we want we walk out. Other side of the coin though.... Our neighboring town back home hated thier manager, they decided to walk out unless she was fired. They walked out, and 2 weeks later the health region shut down the service, and we got more coverage area.

That's pretty cheap learnin' My medic course is just over $14000, with books and A&P pre-requisite included.

Hmmm... If you are going to a hospital where you know there is a panicky air-head doctor on shift, I wonder if you still have to deem it the "Closest appropriate facility"

WOW, that is the dumbest $hit I have ever seen. Anyhoo.. because the lung sounds are clear for now, I would fill a nebulizer with saline and set it at 6lpm. Make sure the ventolin is handy, I am not sure how the cinnamon is going to act once I pour the fluid at it. I would also encourage coughing and spitting, and make sure there is no more cinnamon left in her mouth.

Ya I am always very careful when removing lungs in the field! *Jokes* Seriously though, it is sad that in this day and age mistakes like this still happen. This is why the surgeons usually sign the skin over the area the operation is taking place!

Is that policy or opinion? Do you feel this way of doing refusals results in you being liable? Welcome to the city!!

I may be corrected here but I believe in Canada once you start assessing a possible patient you have "Made a relationship" with them. At that time they are considered a patient and you are required to properly assess and write a care report even if they refuse. I sometimeswrite a "Generic" PCR and have multiple patients sign it. Something like "The following patients were involved in a 2 vehicle T-Bone at approx 30km/hr, bla bla bla....... All patients presented with no pain, no visible trauma, bla bla bla,.... then get all who want to refuse care to sign the bottom.

Well then the CPR was not being done right Jokes, jokes As a side note, I had a nurse hit the NIBP while I was doing CPR once and it read something like 210/30. kind of interesting I thought.

Ya, thanks for comin out :roll: I cover a town with a pop of about 4000, plus the farms in our area, 1500, and in summer we have many a tourist. Probably 7000-7500 daily. Not that many in comparison, but we only staff 2 units full time.