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Posted

Staphelo what? Etiology? :roll:

I thought we were talking about not getting into figureing out what it was, now you guys are trying to figure out which nasty little bug it could be. :P

Thanks again for all your time. Now I just hope we have class tongiht. 6inches of snow and its still snowing! YAY!

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Posted

Don't worry about all of the big words. However, after the class and national/state registry, I would strongly urge you to take a college level anatomy & physiology course and a college level microbiology/molecular biology course. You will not get any cool guy skills or patches, but I promise, your understanding of your patient's condition and your overall knowledge as a provider will be greatly enhanced.

Take care,

chbare.

Posted

Ah, I hadnt thought about that. I am going to need something to fill in the time till I can start riding an ambulance. No one hires 19 y/os. :P

Posted
My take on this scenario is: defiantly reeks of CHF. At this point her body is still compensating for the decreased cardiac output. This pt could also have an AMI, and other fairly complicated cardiac complications. What's going to help this pt most is a hospital... I don't really find the glucose to troubling, if your chasing glucose levels as the cause of this pt's troubles you've missed the boat. It's just probably because she didn't eat today and only had liquids. Don't worry about it unless they have altered mental status... FOR YOU MEDICS: just curious - would you treat her pressure with nitro or lasix? Or would you be concerned with disabling her compensatory mechanisms and wait and see about the pressure???

I wouldn't be surprised if this is the guy with 3 previous MIs and a cardiologists number on speed dial. I smell AMI or just an old and busted heart. This is leaning more toward cardiogenic shock i think... check for swelling elsewhere, this guy has either a right sided MI or heart failure... a BP would be nice on this guy lol

You know, the more I look at these two scenarios the more I think they could essesntially be the same thing- MI or CHF, with the added possibility of cardiogenic thrown in for #2. The BP is going to tell the tale on that guy; if your instructor isn't going to provide vitals she needs to stop giving you scenario-based questions.

As for the first patient, she's definitely getting a Nitro, I'll make a decision on Lasix enroute when I have time to re-assess and think about it for a minute. Even still, under my protocol she'd only get 20mg, which is going to do.... jack @#$%. Our starting dose for patients with no script is 40 for cryin out loud.

Posted

Case 1- I would say AMI vs CHF until proven otherwise then I would think about a pulmonary problem.

tx would be IV,O2,Monitor, EKG, as a basic o2 via NRB.

Case 2- I would say either CHF, AMI, or Acute Liver Failure of some sort.

Tx would be IV, Monitor, V/S EKG, as a medic. Basic tc would be o2 via NRB and watch him

Case 3- I would say Croupe vs Epiglottitis hard to tell the difference in a 3 year old. Just try to keep them from crying and high flow o2 via blow by.

Posted

I forgot to get back to yall and tell you what she said.

#1. CHF

#2. MI

#3. Croup or Epilogottis

Thanks for all your help.


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