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Sequel

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    Paramedic

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  1. I recently placed my first EJ on an 11 month old patient who had no other good sites for placement. I wish I could give you some advice about how to find one, but with mine it was very visible (although bouncing quite a bit due to an increased work of breathing). Don't know that I would place one without it being quite palpable or visible though. When in doubt, remember that there's always IO!
  2. The service I just completed my internship at had glucometers that tap out around 600 before reading only, "HI," however I treated a late 20s male pt with such a reading who was complaining of nausea/vomiting with pretty substantial abdominal pain, to the point we had to pick him up and move him and he fiercely guarded his abdomen after initial palpation. He had about 4-6 episodes of emesis just in the time I saw him and had been like that for a few days so I loaded him up with fluid. Good call, had never seen a really symptomatic DKAer before that.
  3. Sounds like some cardizem could've fixed the problem and gotten rid of the associated chest pain. >.>
  4. I've used Haldol once. It's a real pain to draw it up from the vials though, so I've never been able to administer a full dose (if anyone has any tips for drawing up from those vials I'm all ears). I administered it about 10-15 minutes prior to arrival at the hospital and as I understand the time of onset for Haldol is typically 30 minutes so I didn't notice much of a change in my patient except that she was less excited and didn't speak as much (or quite as crazy).
  5. My concern with administering nitroglycerin to a patient on CPAP would be less about having to remove the mask (because once they have that mask on, they likely won't let you take it off them) so much as lowering their BP too much. In the few times I've used CPAP on a patient they had very drastic drops in their blood pressures. My last patient went from 199 systolic to 116 in 5 minutes. Not that I've ever seen nitro drop BP that much, but with those kinds of rapid changes I'd be cautious about controlling that blood pressure.
  6. I have used the EZ-IO twice in so far in my internship and I enjoyed it as a mainline form of IV access. Site was the tibial plateau both times. Not 100% on whether or not humeral access is permitted but even if I had the option I'm pretty sure I'd still prefer the tibia as my site since it is larger and the plateau serves as a stable base for access.
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