Vorenus

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Vorenus last won the day on November 28 2011

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About Vorenus

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  • Gender
    Male
  • Location
    In the middle of Germany
  • Interests
    Swimming, Reading, Travelling

Previous Fields

  • Occupation
    Rettungsassistent
  1. Respirations

    The question posed at the beginning of the threat was dedicated to repiratory rates, though, and that`s what krumel meant, I think. And the respiratory rate alone, I gotta agree there with krumel, doesn`t poses such an impressive or precise marker (which is what krumel meant I guess). Fair enough, very low and very high most likely indicate a problem in a patient - but it`s not "accurate" as let`s say SpO2 or RR, which pose a variety of interpretations. I`m only talking `bout respiratory rate as the quantitative date in itself here, not about possible lung sounds, position of the conscious patient while breathing, possible pathologic patterns, etc. Apart from that, although skin-colour, temperature and moisture might be connected to your discovery of a pahologic pulse, they may be totally unrelated to that particular vital measurement and attached to an underlying or secondary problem.
  2. About the best damn used car ad I've ever seen

    Lol! Now I wanna buy that car, damn. And what is On Star, btw?
  3. IO access

    Same here: we have the BIG plus Cook needles.
  4. IO access

    Far as I know, the only one`s still using sternal access are military medics in the field (apart from the obvious, that you`d need different IO needles for sternal access).
  5. Intubation in 2012

    For cases like yours, we use Propofol - short sedation, never experienced problems with this med in "easy" (I`m sure it was a most "un"-easy sensation for yourself ) cases like this.
  6. Intubation in 2012

    Exactly my point. Especially since I seem to remember that continued/general use of paralytics seems to complicate/prolong the process of getting someone off the vent/weaning in the end.
  7. Intubation in 2012

    There is no valid reason for keeping a patient on paralytics after an ET tube is in place, apart from insufficient possibilities to sedate/keep up sedation.
  8. Ketamine... PCA?

    Never used it in that way (Propofol or Midaz) - wouldn`t an already agitated patient be more open for the psychotropic aspects of the drug, I wonder? Any experience or studies in comparison to other sedatives?
  9. Ketamine... PCA?

    First to say that I`m not familiar with PCA systems at all, since never having worked in a clinical setting aside from my apprenticeships. Ketamine wouldn`t strike me as the drug of choice for a PCA, though, considering its rather heavvy psychotropic and hallucinatory side-effects. Former named characteristics are the reason why ketamine should be administered in a combination with benzos - I can`t really see how this could effectively be acchieved with a PCA, considering the corresponding imbalance between ketamine and the benzos. As said, just my personal thoughts without being familiar with the PCA administration of ketamine. As an analgesic? This would imply that you haven`t had enough in your guidelines before, or that you´re analgesic dosages tend to be more sedative now...
  10. Midazolam vs Diazepam

    That might have been the case, because 5mg is a pretty low start dosis for someone who ways more than 15 kg.
  11. Drugs for agitated patients?

    Yeah, Propofol can be useful in chemical restraint. It acts pretty fast and you can control it pretty good since the effect wears off pretty fast too (this also means you`ve gotta stock up your propofol reserve if you`ve got a long drive) and most contraindications aren`t found in your usual psych patient, so yeah, it`s pretty handy. Course you`ve gotta take a close look at their saturation, same as Ketamine.
  12. Zombie apocalypse protocols.

    Would be kinda risky, though, seeing that you`d might get burned too, if you were standing all too close to a zombie...
  13. Zombie apocalypse protocols.

    Don`t forget the double tap! Safety first!
  14. Adenosine given to Sinus Tach?

    What ERDoc said. Especially seeing that he was jogging - which suggests that he`s trained (or not, but at least he`s trying to start training ). A little bit OT: Most UK Ambulance Services demand a fitness test prior to employing. If I remember correctly, there you`d have to be back under a 100 HR after 2 minutes post-exercise (varying) to be deemed fit for service.
  15. Adenosine given to Sinus Tach?

    Just to wait a few minutes would have been my route of treatment, too. Assess, vitals, line, then start transport. Depending on how long a drive you expect to have to the ER, there might have been a call for medication or not, but Adenosine with a HR of 170 instantly after post-exercise wouldn`t have been my first thought.