Eydawn Posted February 27, 2012 Posted February 27, 2012 I love this new instructor. ST elevation in all leads... global MI? Nah... just pericarditis... (you really have to be here, but I never knew that before and I could totally see freaking out seeing ST elevation all over the place if I didn't realize it was pericarditis!) Wendy CO EMT-B
Kiwiology Posted February 27, 2012 Posted February 27, 2012 Thats funny I'm not too up on the non-MI causes of ST elevation but I know pericarditis is one of them. ST elevation in non-specific leads or not in a pattern typical of an MI (e.g. II, III and aVF) or without reciprocal changes is not an MI or so I am told
Eydawn Posted February 27, 2012 Author Posted February 27, 2012 Oh, I got more. Talking about carotid massage and baroreceptors... my instructor is a code blue nurse at her facility, so she was saying "Yeah... if you stimulate baroreceptors, you're activating parasympathetic, and just making them more dead. Oops! So check pulse at the femoral. I put on gloves and go right for that groin." Best lecture I've had in a while... Wendy CO EMT-B
Kiwiology Posted February 27, 2012 Posted February 27, 2012 Hmm, I didn't think we checked a pulse any more unless the rhythm looks capable of producing output; I think I read that somewhere Glad you are enjoying school there Wendy
HERBIE1 Posted February 28, 2012 Posted February 28, 2012 Funny stuff, Wendy. I know we have a long standing division between nurses and medics, but some of these old school nurses are incredible sources of knowledge and practical experience. In most of the hospitals I have worked, some of the nurses do as much instructing of med students and residents as the doctors do.
Eydawn Posted February 28, 2012 Author Posted February 28, 2012 Yeah... I'm lucky enough in my program to have a paramedic turned nurse turned law student... he's a wicked resource. This particular instructor that I'm referencing above is an ICU nurse, and she's just absolutely fantastic. Loving it for a change! I got to ask a question today about the ACLS algorithms (referencing changing from lido to amio) and nobody bit my head off- refreshing to say the least! Wendy CO EMT-B
chbare Posted February 28, 2012 Posted February 28, 2012 Pericarditis is not exactly a benign condition however.
Eydawn Posted February 28, 2012 Author Posted February 28, 2012 Ah, true that, especially if you start to build up fluid in there... however, what she was trying to illustrate was that knowledge is power, and not knowing that something other than an MI could cause ST elevation (early early on in her career...) caused a really funny phone call to the cardiologist on call. However, she emphasized that the cardiologist recognized what was happening, prescribed the right course of treatment, and then came by later to run through the strip with her and teach her what she didn't know. Half of what was interesting was her delivery. She wanted us to realize that we won't know it all, not even close, when we get out of school and that learning is a continuing process; you can either be ashamed of what you don't know, or eager to learn and ready to acknowledge that you didn't know something before. This person is so smart she scares me... and she's energetic... I love it. It's nice to see someone who's excited about teaching and not afraid to be asked questions. Chbare, since we didn't really get into it, what's your primary concern when you see pericarditis? Tamponade? Wendy CO EMT-B
chbare Posted February 28, 2012 Posted February 28, 2012 Tamponade is a concern; however, the etiology, it's consequences and treatment are my primary concerns. Also, I do not want to insinuate that I have any negative thoughts regarding your instructor.
Eydawn Posted February 28, 2012 Author Posted February 28, 2012 Ooh, didn't read anything casting aspersions on her at all... no worries. Just wanted to go into why she was using that particular example. She was a young nurse when it happened... so she was reaching out to connect to where we're sitting right now. Thanks, Chbare! Wendy CO EMT-B
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