MIxing Meds

[tniuqs]

Could anyone help me out with finding any indications of mixing nitro, with blood pressure meds and insulin. I have a family member who is diabetic, and such who is popping nitro like candy and refuses to seek medical attention...Also complains of chest pain and has been told of a possible blockage..anyone have any ideas on how to get them to get medical aid..etc...

Thanks

Holy How to get OFF TOPIC, end of life choices, read between the lines and then personal life and family stories btw no mention of any age in the OP, just uncontrolled IDDM, HTN, and NTG requires an internal medical specialty not Paramedics voicing opinions, lets throw a little "depression" into the mix.

I agree with 4C6 call 911 PERIOD !

Although a bit of literary licence, which is his way, I have a difficult time cancelling on any chest pain call, yeah know abandonment of a patient comes to mind. I disagree that a medic in the field should should not give best medical advice as to possible outcome, as we know any delay in chest pain evaluation by an expert is a recipe to be practicing CPR at home.

Be careful to not use coercion and scare tactics. Sick people do not need to be faced with 'you are going to die', especially when you do not know the end point of their demise. I would not want anyone to sell me something by coercion, not my care, and especially not my health care.

Ok so Matt you have never told someone to lie still on the LSB and don't move because you could end up in a wheel chair ?

GVFD2-36The time stamp is Nov 27, I am hoping that you have convinced this individual to seek medical advice (past tense)

cheers

[Mateo_1387]

Holy How to get OFF TOPIC, end of life choices, read between the lines and then personal life and family stories btw no mention of any age in the OP, just uncontrolled IDDM, HTN, and NTG requires an internal medical specialty not Paramedics voicing opinions, lets throw a little "depression" into the mix.

You of all people know that threads take on a life of their own.

Ok so Matt you have never told someone to lie still on the LSB and don't move because you could end up in a wheel chair ?

Nope, cannot recall ever doing it. Why do you ask?

[HERBIE1]

Mateo, we are on the same page here. I do not LIE to patients. I explain to them the possible consequences of their decisions and the limitations of what we can tell them about their conditions and current situation based on our level of training and knowledge. If someone has a laceration they prefer not getting sutured, I do not tell them they will die if they do not allow transport. I DO tell them about time limits on suturing wounds and the potential for infections, but that's the extend of my "coercion" in such cases. On the other hand, if I have a 60 year old who has a sudden syncopal episode who is refusing, I do include the possibility they may have had some unknown cardiac event that caused their problem.

Here's another story.

Had a recent call for an elderly 80 year old gentleman-end stage renal failure, CHF, CAD, diabetic- very weak and frail looking. He just returned from Florida, and was mildly SOB- the reason we were called. We were also informed he was a doctor. Uh oh... We evaluated him- EKG, pulse ox, glucose, etc. He had a sick heart, PVC's, slight basilar rales, pedal edema, glucose and V/S were OK. He said he felt no different than he has for the last several months, and that it was not his idea that we were called. We gave him some O2, and he said he felt better. His family was panicked and wanted him evaluated- at their own hospital 20 miles away, which we could not oblige him with. This gentleman was very nice, quiet, seemingly immune to the frantic family members who surrounded him, and said he simply wanted to go to "his" hospital where he would be most comfortable, and where he was the recently retired chief of the medical staff.

My take- he took his final vacation, said his good byes to his extended family, and simply wanted to go home to die. I felt foolish explaining the consequences of his refusal to him as I explained what may happen, as if he did not know - but he was very understanding and patient. He admitted he knew there was a possibility he may not make it to his own hospital, but that he was OK with that. I asked him about his family and the impact that would have on them- they were scared and worried. He said he understood, he appreciated their concerns and did not want to cause them undue worry but they were also in denial about his condition. He was tired of being sick and tired and had enough of endless tests, procedures, medications, dialysis, hospital stays, and no longer wanted to put up with them. He was ready to go, he had a good life, he wanted to die with dignity and on his terms, and his family needed to accept that fact. He also said he almost wished he had died in Florida and avoided all this hoopla.

We called medical control, and after much discussion, they were finally OK with the refusal. We told the family to call us back if he changed his mind enroute, or if something happened, and even explained to their limo driver where the closest ER's were along their route. The doctor was very thankful, said he appreciated our efforts, and even apologized for "wasting our time." We shook hands and the family pushed him away in a wheelchair.

Did we feel guilty about this- no. I was more concerned about the impact on the family members, but I respected the doctor's wishes and completely understood and agreed with his reasons.

A couple days later, I read a glowing obit about him, praising his long career, his contributions to medicine(he was well published) and that he died in his hospital, surrounded by his family and friends.