scubanurse

Any idea if he was a type 1 or type 2 diabetic?

I was going to say DKA, Sepsis r/t possibly osteomyelitis with the hx of DM.

I'd like to see an ABG?

The argument could be made that if you used alcohol to prep the IV site that could cause falsely high readings as well, but like the doc said...who the f cares when it's such a small difference and your clinical pathways won't change much at all.

Everyone else in CO ok? We have flooding in our neighborhood and basement. Could be worse. How are you doing up north Wendy?

I'd be pissed and write a letter to whoever ran the program about how disrespectful that was.

Yeah I've just seen her and my other half works at DH...small world!

Hell there's a Denver Paramedic with an above the elbow amputation I think. I saw her once in an ER and she seemed to be a damn fine medic. Correction: Denver EMT and she's an ER tech now... So I'm pretty sure a nysgamus won't be a big deal.

If your state law states that you need to have both lights and sirens on to be running emergency, it won't matter much if you live in a small town.

I can't stand when units use just lights and no siren. My local FD does this all the time and I can't think of anything more dangerous. They won't even turn the siren on at intersections. I have seen cars pull out in front of them several times, yet they rarely use the siren. Where I learned to drive ambulances and fire trucks, you are not going emergency unless you have BOTH on. If you just have one, you can not run a red light and you can not speed. They are designed to be used together to help the other drivers on the road acknowledge the emergency vehicle's presence. There are laws about this as well so I encourage all to seek them out in their area and abide accordingly. It's one of my biggest pet peeve's. The ONLY time I could see it being ok to not have the siren on but just the lights is once you are in the neighborhood if it's residential and close to the address. But never going through intersections or down main roads.

At burning man?? Noooo....never any drugs at all!

Yeah ... that movie is pretty depressing...

Just a random thought I figured I'd throw out here... with that angiogram you posted, how would the hematoma formation affect limb perfusion? I understand it's use, especially in this case, is life over limb, but just thinking long-term....again probably a stupid thought but figured what have I got to loose.

Glad I could be of some help to the site.

Part of the reason we work through scenarios like this one is to think outside where you normally are. In the original post, the OP gives you what hospitals you have available to you for this scenario. The hard part for you is making the clinical judgement based on the condition of the patient in the scenario and you available resources.

296md/dL you mean mg/dL??? I'm not aware of the unit md/dL. If it is mg/dL than that is high (normal 70-100 mg/dL or 3.8-5.5mmol/L)

No I was agreeing with you. I was just saying that just because you go L&S to something doesn't mean it's balls to the wall... I was actually agreeing with you, and just reinforcing the idea that we both share. Did you misread something???

This, and unknown med history makes getting there to assess a priority. That doesn't mean balls to the wall flooring it, but have some urgency. If this patient was on blood thinners, very likely in that setting, had facial fractures that could compromise airway, and several other possible circumstances, why wouldn't you have some sense of urgency? L&S doesn't mean flooring it and swerving in and out of traffic. Especially at rush hour, it just helps you not waste time sitting in traffic.

A good lawyer could argue the release isn't legit. Signed under emotional duress and all of that...just a thought. If that policy is still in place, you could get yourself into trouble by not getting a release signed.

I don't think I ever got a code back with a viable rhythm or pulse for >5 sec in my career in EMS. In the hospital is a different story though. People in my first due response area were stupid though and would wait too long to call 911 and/or not start CPR.

I've only really seen those inside the secondary line set. Like this http://www.ecomm.baxter.com/ecatalog/browseCatalog.do?lid=10001&hid=10001&cid=10016&key=99b7d9accf51b054b7ca43d7edbe018&pid=458467

Usually it's the regulars butting heads.

congrats

I might actually have a job...