Solu Medrol - What are its uses? How to use?

[chbare]

Or, what about steroids and septic shock patients? Why even consider doing this?

Take care,

chbare.

[spenac]

Or, what about steroids and septic shock patients? Why even consider doing this?

Take care,

chbare.

Actually you do not use with patients in sepsis any longer. It has been found to actually increase mortality rates. It actually masks some infections as well as makes one more likely to catch other infections.

[chbare]

Actually you do not use with patients in sepsis any longer. It has been found to actually increase mortality rates. It actually masks some infections as well as makes one more likely to catch other infections.

Yes indeed. In fact, recent article reviews does indicate outcomes are not improved with steroid use. So, now I wonder how this will all relate to the etomidate, adrenal suppression, "stress dose" with steroid arguments with RSI and septic shock patients? Still up in the air for now.

Take care,

chbare.

[spenac]

Yes indeed. In fact, recent article reviews does indicate outcomes are not improved with steroid use. So, now I wonder how this will all relate to the etomidate, adrenal suppression, "stress dose" with steroid arguments with RSI and septic shock patients? Still up in the air for now.

Take care,

chbare.

Thats a lot to digest. I love learning. Can't wait to see what research will find.

[steve_emt_68]

I have personally been involved in giving Solu Medrol for suspected spinal cord injury. I was called for a diving accident where the party was still in the pool and completely flacid. Pt. was removed from the pool and flew him to regional trauma center. When we made contact with the Trauma center, we were given orders to administer 2 grams of Solu Medrol. We only had access to 750mg to administer but flight crew administered what they had and the patient got the balance at the trauma center. Turns out patient had C3 and C4 fracture with pressure on spinal cord. 2 days later patient was walking and today has made a complete recovery.

Our service now carries 2+ grams of Solu Medrol on all trucks. This incident made a firm believer out of me for use on spinal injuries in the field.

[chbare]

I have personally been involved in giving Solu Medrol for suspected spinal cord injury. I was called for a diving accident where the party was still in the pool and completely flacid. Pt. was removed from the pool and flew him to regional trauma center. When we made contact with the Trauma center, we were given orders to administer 2 grams of Solu Medrol. We only had access to 750mg to administer but flight crew administered what they had and the patient got the balance at the trauma center. Turns out patient had C3 and C4 fracture with pressure on spinal cord. 2 days later patient was walking and today has made a complete recovery.

Our service now carries 2+ grams of Solu Medrol on all trucks. This incident made a firm believer out of me for use on spinal injuries in the field.

One incident of anecdotal evidence made you a firm believer? One must consider the numerous complications associated with using steroids for SCI and the fact that there is limited definitive evidence proving that steroids cause measurable functional improvement.

I am not saying do not use steroids; however, try to look at the big picture rather than isolated anecdotal cases where the treatment may or may not have been an actual factor leading to a positive outcome.

Take care,

chbare.

[akroeze]

I have personally been involved in giving Solu Medrol for suspected spinal cord injury. I was called for a diving accident where the party was still in the pool and completely flacid. Pt. was removed from the pool and flew him to regional trauma center. When we made contact with the Trauma center, we were given orders to administer 2 grams of Solu Medrol. We only had access to 750mg to administer but flight crew administered what they had and the patient got the balance at the trauma center. Turns out patient had C3 and C4 fracture with pressure on spinal cord. 2 days later patient was walking and today has made a complete recovery.

Our service now carries 2+ grams of Solu Medrol on all trucks. This incident made a firm believer out of me for use on spinal injuries in the field.

One time I punched my patient in the face and they didn't end up dieing from their asthma attack. Obviously all asthma patients should be punched in the face for their own good!

[Ridryder 911]

Why? Why not?

Does anyone use a nebulizer with it?

I never have used Solu-Medrol nebulized but I have used Decadron as per nebulizer. An old ICU trick to help reduce laryngeotracheal swelling, especially for new trachs. I remember using in a patient that had an idiopathic reaction to Bumex. He was already trached but the reaction caused severe swelling I nebulized the Decadron (along with the usual tx regime) and appeared to work.

In regards to Diabetics I do make note of it. They may have to receive additional Insulin or be placed on supplement therapy. As well, I am sure to observe for previous oral therapy such as Prednisone and I may withold administration of additonal steroids. Again, a case by case matter.

[steve_emt_68]

In my case, the fact that the regional trauma center wanted to give steroids and the patient had a good outcome would lead a reasonable person to believe that the use of steroids was a beneficial treatment.

I believe the initial question asked if anyone had any experience with Solu Medrol and what were they. I gave my opinion and then kicked in the nuts for expressing my opinion. I am to the point of giving up on this site as there seem to be a group who only want to blast anyone who doesn't share their burnt out attitude.

Unfortunately those who want to use this site to grow as providers end up getting shot down. Why don't those of you with your bad attitudes go start a new site like crappy EMS providers.com and blast each other!!!

[mobey]

This incident made a firm believer out of me for use on spinal injuries in the field.

The replies were based on this statement.

Although not all replies are sugar coated or diplomatic they are usually valid. Try to look beyond the aggression and understand the underlying concept.

On my practicum I had a shock patient that we put the MAST pants on. Although we barely made it to the city with 2 lines wide open the patient did survive.

Based on your statement above.... Should we put MAST pants on all shock patients?

You need to ask yourself "Did the Solu Medrol have any effect on that patient? Would he have walked out without it?

The evidence says ".....Maybe".

EMS must be science based not anecdotel.

Now I will talk out the other side of my mouth:

One time I punched my patient in the face and they didn't end up dieing from their asthma attack. Obviously all asthma patients should be punched in the face for their own good!

The above statement lacks professionalism and constructiveness. I am quite sure we can hit some Dr forums and not see crap like this spewed at one another. I completely agree with the theory/message behind it, but we MUST resist our urges to sling mud at eachother and use sarcasm as a method of helping our brothers and sisters grow as practitioners.

At the Paramedic (ACP) level we should be beyond this.