chbare Posted August 4, 2006 Author Posted August 4, 2006 MedicRN, you nailed it. He has a ruptured septum. This was a complication of his MI. Here are some links for additional information on this problem. Managing his hemodynamic status will be a nightmare until we can repair the defect. http://cardiacsurgery.ctsnetbooks.org/cgi/.../681?ck=nck#R31 http://www.emedicine.com/med/topic3574.htm Take care, chbare.
AZCEP Posted August 4, 2006 Posted August 4, 2006 One cardio-thoracic surgery team for table 2! Order up!!! Was there any cyanosis? Can't really say when it actually ruptured, but with the right to left shunt, wouldn't you expect some pumping of deoxygenated blood?
chbare Posted August 4, 2006 Author Posted August 4, 2006 AZCEP, I would think cyanosis could be present. I guess that this patient was compensating well given the serious nature of his condition. Edit: Rocket, you are welcome. Take care, chbare.
hammerpcp Posted August 4, 2006 Posted August 4, 2006 Geez, I go to bed for six hours and I miss everything! But wait! There is still an opportunity to educate me. Hooding? <---------What is that? Is it really relevant if he is circumcised or not?
AZCEP Posted August 4, 2006 Posted August 4, 2006 No, no, no, silly hammer :roll: Hooding is the slang term that we use for the line of demarcation that goes along with pulmonary emboli. When working a code, or really sick patient, the "hood" goes from about the level of the pulmonary vein/artery over the face. Nice purple/flushed red color. You really can't miss it. I'm sure there is a more technical/professional sounding medical term for the same thing, but this is what we use.
medic429 Posted August 4, 2006 Posted August 4, 2006 Geez, I go to bed for six hours and I miss everything! I missed it too hammer, I was at work though. Thanks chbare-good scenario!
chbare Posted August 5, 2006 Author Posted August 5, 2006 I am glad everybody liked this scenario. I hope people have noticed a trend in my last few scenarios. I am trying to get people to use good assessment and history taking skills/techniques. This scenario could be solved using only BLS skills with good assessment techniques. I want to help people see that the power of knowledge and an appreciation for pathophyisology is just as important if not more than all of the cool guy ALS skills. As an EMT-B you may not be able to put in an IV or perform intubation. Your care is limited to BLS, however, your knowledge of patient assessment and pathology can be limitless. Take care, chbare.
hammerpcp Posted August 5, 2006 Posted August 5, 2006 No, no, no, silly hammer :roll: Hooding is the slang term that we use for the line of demarcation that goes along with pulmonary emboli. When working a code, or really sick patient, the "hood" goes from about the level of the pulmonary vein/artery over the face. Nice purple/flushed red color. You really can't miss it. I'm sure there is a more technical/professional sounding medical term for the same thing, but this is what we use. Ahh yes. Also seen in cardiac tamponad. I have never heard that term before, and come to think of it I'm not sure there actually is a technical term for it other then a description of the sign, namely mottling of upper chest and face. Chbare, can you do the chbare countdown? 5..4..3...2...1..Stare!? How's life in Care-alot? which one are you? Chbare lmao. I kill me. I can't get this image of a fuzzy little guy with a cute little picture on his tummy taking care of pt's and sharing his "special feelings'. :love5:
Scaramedic Posted August 5, 2006 Posted August 5, 2006 ChBare (Champ Bear) ready for duty. Ahhh Cute factor of 10!!!! Peace, Marty :joker: P.S. Great scenario by the way.
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