Niftymedi911 Posted November 13, 2008 Posted November 13, 2008 Dammit I was gonna say hyperkalemic too!!!
DwayneEMTP Posted November 13, 2008 Posted November 13, 2008 oh Matt - you sooooooo smart - and handsome toooooo Heh, sure, you say that now, but wait until you see him peeing out of a car window at 60mph! :shock: Dwayne
Mateo_1387 Posted November 14, 2008 Posted November 14, 2008 Heh, sure, you say that now, but wait until you see him peeing out of a car window at 60mph! :shock: Dwayne Wait a sec Dwayne........did you consider she may be talking about the Admi ? oh Matt - you sooooooo smart - and handsome toooooo :love10:
medic112 Posted December 13, 2008 Posted December 13, 2008 how would you be able to tell this out in the field without getting blood samples? you dont often see hypo K.
tniuqs Posted December 13, 2008 Posted December 13, 2008 how would you be able to tell this out in the field without getting blood samples? you dont often see hypo K. Can't Dx this in the field bang on, a VERY good point medic112. I have observed this wide tachy complex looking situation but was later diagnosed by Cardiology as old BBB, got a pat on the back for NOT complicating the patients situation and loading with any drug, just in passing. To the OP ... what were YOUR actions. And can you actually deliver KCL ? and whats a little ? crotchitymedic1986 : if you do not include ALL the PMHX then these senarios just become a guessing contest. you are looking at Vtach in lead II (this was before twelve leads and pulse oxs). You check his b/p --still 130/80, A&OX3, no pain. You check lead 1, still Vtach -- you check lead III, which shows SVT - but the other two leads are still textbook Vtach <Edit> Is this Monomorphic or Polymorphic ... wide or narrow complex if its was Vtach ? sure would like to see that 12 lead ... 2 Rythums on the same pt. .... very curious indeed. cheers
medic112 Posted December 13, 2008 Posted December 13, 2008 So how did you know to treat this pt with K ? Did you call command? take a wild guess? why would you not treat the fact that the pt is in what you described as a wide complex tachycardia?
crotchitymedic1986 Posted December 13, 2008 Author Posted December 13, 2008 As far as the comment about not providing a history, I answered the questions asked. I did not treat the patient with K. This call occured in 1987, and was my first "treat the patient, not the monitor" call. There was no 12Lead back then. The rhythm was textbook VTach in 2 leads, and SVT in the other. The patient was A&O with stable V/S. I called the ER Doc (I could tell he didnt believe me, or thought I was stupid), I asked to just start an IV and transport (which he quickly concurred with) -- yes we had to call for IV orders. This call was in the wee hours of the morning, upon leaving the ER, no one had any clue what was wrong with him. We came back to the ER with another patient about 3 hours later, and found out the diagnosis and treatment. Today, a 12-Lead could help you come to that diagnosis.
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