Arctickat Posted September 14, 2013 Author Share Posted September 14, 2013 Triemal; The ambulances met on the side of the road, no turnout is available. Both ambulances are the same size, just the cot mounts don't match up. Link to comment Share on other sites More sharing options...
paramedicmike Posted September 14, 2013 Share Posted September 14, 2013 PEA at 10? Continue compressions and give another round of EPI. Link to comment Share on other sites More sharing options...
Arctickat Posted September 14, 2013 Author Share Posted September 14, 2013 (edited) Epi is given and a perfusing heart rate of 130 - 140 soon appears with a BP of 128/67, Sp02 is 94 and climbing with BVM and an OPA. Edited September 14, 2013 by Arctickat Link to comment Share on other sites More sharing options...
BushyFromOz Posted September 14, 2013 Share Posted September 14, 2013 ECG / 12ld, GCS, temp + full set of vital signs Get them on my kmonitor Prepare for RSI and cooling Adrenaline infusion drawn up in case she bottoms out again. Link to comment Share on other sites More sharing options...
Arctickat Posted September 14, 2013 Author Share Posted September 14, 2013 (edited) GCS is 3, 12 lead is attached Vitals: BP 132/70 HR 140 RR no respiratory effort, BVM and OPA 12 per minute SpO2 96% Skin, warm, pink, dry Pupils, Right ERL, Left Non reactive. Edited September 14, 2013 by Arctickat Link to comment Share on other sites More sharing options...
J306 Posted September 14, 2013 Share Posted September 14, 2013 Establish a second line, get a glucose reading off of the IV stick, check lung sounds for any signs of aspiration or flash pulmonary edema. With no respiratory effort, intubation could be considered. Link to comment Share on other sites More sharing options...
Arctickat Posted September 14, 2013 Author Share Posted September 14, 2013 Second line is in, BGL is 22.8 mmol/L, Lung sounds are good, Vitals are still good, with the exception of no respiratory effort, Would you like to intubate? Link to comment Share on other sites More sharing options...
J306 Posted September 14, 2013 Share Posted September 14, 2013 Set second line to TKO to be sure not to fluid overload, reassess pupils, Glucose spike could be due to stress response. I would like to have this pt. intubated, however, under the new MFI protocol, I'd like to call med control first for orders to maintain sedation if needed, 25-50 mcg fentanyl PRN, and lets hook the tube up to your portable ventilator that you have in your ALS unit for the trip to the hospital. Link to comment Share on other sites More sharing options...
Arctickat Posted September 14, 2013 Author Share Posted September 14, 2013 (edited) Why would you need to sedate him with a GCS of 3? You don't need medical control to intubate an apneic patient. Edit: Pupils remain the same Edited September 14, 2013 by Arctickat Link to comment Share on other sites More sharing options...
BushyFromOz Posted September 14, 2013 Share Posted September 14, 2013 (edited) Why would you need to sedate him with a GCS of 3? I dont get a choice if inducing hypothermia for ROSC management Whats the patient weight? 100mcg Fentanyl .1 mg/kg midazolam 1.5mk/kg suxemethonium Tube 8mg pancuronium morph/midaz infusion, start off low at 1mg/hr upto 2L ice cold saline, aim for temp of less than 34C Edit. I dont do this stuff yet, just trying to get into the spirit of things =D Edited September 14, 2013 by BushyFromOz Link to comment Share on other sites More sharing options...
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