chbare Posted September 2, 2008 Author Posted September 2, 2008 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.
Mateo_1387 Posted September 2, 2008 Posted September 2, 2008 Well....Mom is probably going to be getting hungry.....So we have a couple choices, we can eat the placenta.......or we can go to IHOP. I'm thinking IHOP....... But in all seriousness, we probably need to get some nourishment for the mother, to keep the baby nourished. So...Lets start with some food.
Chief1C Posted September 2, 2008 Posted September 2, 2008 Transport to the best facility, and threaten their life, if they refuse, in private of course.. So, that way, you can deny it.
VentMedic Posted September 2, 2008 Posted September 2, 2008 Now, for the twist. All hospitals are on divert and you are forced to care for mom and child over the next few days. Take care, chbare. You should only be stuck with them for 8 hours since that is the length that an OB/Maternity/Peds facility can divert for...unless extreme conditions cause an extension. Initially I thought this thread was a spinoff from some of the political commentaries and blogs that are making headlines today.
chbare Posted September 2, 2008 Author Posted September 2, 2008 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.
craig Posted September 2, 2008 Posted September 2, 2008 Seeing that I come from the REAL land of OZ, this really doesn't happen here therfore i would click the heels of mu ruby red slippers and say 'there's no place like home' three time to get the heck out of there nad bck to reality stay safe Craig
chbare Posted September 2, 2008 Author Posted September 2, 2008 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.
firedoc5 Posted September 2, 2008 Posted September 2, 2008 My sister's two youngest are only 50 weeks apart. Who says you can't have another kid in less than a year? I'm pretty sure, no matter what size city you are in, that I can't see where you can't find somewhere to take them. If need be, take them to the next town. But if you do have a case like this, treat the mother's symptoms as needed and find an OB/GYN. That's what she needs.
p3medic Posted September 2, 2008 Posted September 2, 2008 congenital heart defect would be at the top of my list, tachycardic, dyspneic, cyanotic....Does the kid have a duct dependant lesion, and is now in distress secondary to closure of the DA? Damn...got a call....
chbare Posted September 2, 2008 Author Posted September 2, 2008 congenital heart defect would be at the top of my list, tachycardic, dyspneic, cyanotic....Does the kid have a duct dependant lesion, and is now in distress secondary to closure of the DA? Damn...got a call.... Sounds like a real good start. Going with the congenital defect theory, would you call this a cyanotic lesion or a non cyanotic lesion? Hint, many of one type of lesion require a PDA for the patient to have any chance of survival. What about treatment in the short term? Take care, chbare.
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