Self Aid

[iStater]

Yea IStater, I work on a project where one of our key measures is making sure that the ED clinicians have all the tools that they need in the medical records system (EPIC) that I give them, to be able to do just what you say on the medical history and medications. For those who do not know the terms it's called medication reconciliation.

Wish everyone had EPIC. The medical world would be so much easier. It is nice to know what happens on each office and clinic visit as well as the hospital. Kaiser does do that well when they made this system popular. CERNER and Paragon are also out there with mixed reviews. The medication reconciliation can still be done and a medical record list obtained. The med list is one thing which should be made available without a hassle by a MR policy.

A good EMR system also helps track all those boo-boos even if treated at different physicians or clinics if they are on the same system.

Edited October 25, 2013 by iStater

[ERDoc]

When pts are discharged from the hospital they are given a med list (part of the reconciliation process) which lists old meds and new meds. This is the easiest way to get an up to date list. This isn't always done from the ER. What's nice is that we are starting to be able to pull up the prescription history from the pharmacies (we use Cerner). So, no Mr. Jones, you will not be getting 180 Norco today since I see you just got 240 yesterday. Most of the time it is updated in real time. The govt mandates, while being onerous, do help sometimes.

[Caduceus]

@Capt You could put in apple sauce, dried fruit of any sort, jerkey would also work well because it has sugar and a ton of protein too. Certain lunch meats are high in sugar and have other things to keep your levels even, but it doesn't keep that well. Can't remember if you said you had a drink in your kit. You can put in a bottle of orange juice or a sports drink. . .

As for the med sheets, my grandfather was on Reglin for a really long time. This gave him really bad side affect; hallucinations, tremors. He has also had is esophagus removed and his stomach is now in his chest. Are these details EMS should know, say, should he have a heart attack? Or are they redundant?

Pretty cool the hospital updates things like that so easily, I knew that at some point but not working in the medical field yet I had forgotten.

[ERDoc]

You could also just store a big bag of sugar, just make sure you have something more complex to follow it.

@Cad, it's good for EMS to know all information. Just to use your example, if he is having chest pain, it could be from a multitude of other things besides a heart attack. Even if EMS doesn't think it is important, the ER will need the info. The best thing you can do is to keep the following info and keep it up to date (doesn't need to be in this order):

Past medical history (medical problems)

Previous Surgeries

Medications

Allergies

Any physicians involved in care (PMD, oncologists, surgeons, etc)

[Caduceus]

Okay, got it. Next time I see him I'll ask to see his records/have him add any misc. stuff that for some ungodly reason isn't on them. Everything should be there, but he's seventy two. Who knows?

By the way, I've been wondering; if someone is having a heart attack but is still conscious/can swallow and maintain an airway, but are allergic to aspirin, will non-aspirin work? Or is there a suitable sub that will work in place of it? Other than calling an ambulance.

[ERDoc]

What do you mean by non-aspirin? If you are asking if tylenol or motrin can be substituted, the answer is no. The aspirin is not being used to treat pain. I'll let you google why aspirin is given so that you are more likely to remember it.

[Caduceus]

Ugh hey look I'm sorry. That was a stupid question; I'd just gotten off work and dealing with stupid people when I asked that. Thanks for putting up with my stupidity! I'll google it.

So, my grandpa just got diagnosed with multiple myeloma. The cancer is already in his blood stream; he is undergoing blood transfusions regularly. If he had an open fracture, should I treat it like normal? His bones are very brittle because of it and it might be easy (if the bone punctured the skin) to break it more. . .

Add one more thing to my self air list: I was working at the library and I dropped a book on my face. Right in the eye! Some water and a cold paper towel anyone?

Edited October 26, 2013 by Caduceus

[MariB]

I have never done self aid on myself, but with a chronically I'll daughter I have :

Recognized strider and went through the debate in my head if calling 911, I then chose to get her in the car and drive her to the hospital as I could get her there in 3 minutes or less. I also called ahead.

I have recognized wheezes, crackles , rales and a plural rub . Once while she coughed blood out. Again, I just loaded and went.

I looked at her and immediately knew what they meant by "circling the drain " and she was then sent by ALS to a larger hospital after being stabilized. She had gone into shock.

[Caduceus]

Wow Mari. That's really scary. Good thinking on your part though to just get her to the hospital ASAP. I commend you!

Those are all pretty scary situations; knowing and recognizing something is key to treatment and reaction. Good job!

In my area, we are twenty miles away from ANY hospital, so I would have to call 911 if someone was as close as that. Worst case scenario, my brother or I gets hurt and my folks are in town; if I didn' t call for EMS then it'd be 1+ hours before we could get medical help. It's scary being so far out sometimes. Thank god for volunteer EMTs~

[ERDoc]

Ugh hey look I'm sorry. That was a stupid question; I'd just gotten off work and dealing with stupid people when I asked that. Thanks for putting up with my stupidity! I'll google it.

So, my grandpa just got diagnosed with multiple myeloma. The cancer is already in his blood stream; he is undergoing blood transfusions regularly. If he had an open fracture, should I treat it like normal? His bones are very brittle because of it and it might be easy (if the bone punctured the skin) to break it more. . .

Add one more thing to my self air list: I was working at the library and I dropped a book on my face. Right in the eye! Some water and a cold paper towel anyone?

No need to apologize, that is how we encourage learning around here. As for open fxs, they are all treated the same in the field. Immobilize as found.