Paramagic14

For me, I have found that having a patient supine, if possible, works the best.

Hey everyone, if you havent already participated in the poll for this topic can you please do so. Thanks!!!!! -paramagic14

This is great, this is why this forum is so amazing. Something so "basic" if you will causes so much debate. I know one person was less than thrilled about the OP being so open ended BUT I did that on purpose to see where things would go. Another person wanted to know where this came from and it simply just came from a discussion I had with a fellow paramedic. We each had opposing sides to the matter. My stance on this issue is I personally wait until the 12 lead is finished with a clean baseline as long as the pt is NOT in any respiratory distress. My opinion, like some others, is that you want to get the earliest possible picture of the heart prior to any interventions/meds and oxygen is technically a med. Then if you do any subsequent 12 leads OS or En Route you can observe ANY changes that occured... BUT like I said I would NOT withold ANY Tx from a pt that is needed. If the Pt is not in any respiratory distress than in my humble opinion I believe you cant wait the extra 25 seconds to get a 12 lead... ANd yes, that is what you have your partners OS for. They could be setting everything up while the 12 lead is being completed that way it is ready to go. Also, no 15lpm via NRB was not specified, I was actually meaning any sort of oxygen at all. I also beleive this is where not being a cookbook medic and thinking "outside the box" comes into play. Now, if any of you would like I could post a couple different Chest Pain scenarios with their OPQRST SAMPLE, pertinant neg's and etc and we could all post our opinions or we could continue this great open ended debate. Respectfully, Paramagic14.

Question for all of you. ..... You have a pt c/o chest pain. pt denies sob and there is no evidence of an increased work of breathing. pt speaks in full sentences. My question is: if the pt is not in any obvious respiratory distress, do you wait to put the pt on oxygen until the 12 lead is finished. Why or why not? Thanks.

-early hypoxia would be one of my diff Dx based on his new found combativnes. but if he has a hx of bipolar and normally gets aggressive this could be normal if he hasnt taken his meds. -Blood sugar????????????????? -updated vitals? -any trauma noted? -Carbon monoxide will give you false highs on your spo2 so i wouldnt exact rule anything out based on his 100% spo2 - I wouldnt narcan him...no reason..even if his pupils are pinpoint. his airway is patent and he is breathing effectivly. - i would chemically restrain him with versed if no other cause was found.

i second that.....

has this ever happened to her before and if so was she treated and what was the outcome. has she had any hx of recent chest trauma/rib fractures,something of that nature...maybe the sneeze caused more musculoskeletal pain or maybe the sneeze just happened to come on the same time as a cardiac event.

How is touching with your elbow any different than touching with your fingers? you are still touhing it.

is it safe to say that having the CBT shut off after a very low number of questions means you passed?

what about textbook hyperventilation syndrome. Carpo-pedal spasms,numbness in fingertips and lips,provoked by an argument. i just ask beacause i put high flow oxygen on a patient and my paramedic preceptor told me that was the wrong thing to do.

Good job putting the Patient on high flow oxygen. I am gonna get a little off track, its sill the whole "do i put the patient on high flow oxgen or not"....what is your opinion about putting high flow oxygen on hyperventilating patients?

....Gotta love that EJ!

question for all you......do you leave you line running wide open during D50 administration to dilute the D50 to make it easier to push?

In my paramedic class ...which i just finished 4 months ago we were taught (or reminded rather) to Aspirate prior to administration and after every 10-15ml to ensure IV patency since the medication will cause necrosis and to cannulate the largest vein possible and run the IV wide open prior to and after administration to check for patency. They also told us to hand the bag low and look for blood return to make sure its patent. This is actually in our pharmacology manual for D50.

what is the OPQRRST SAMPLE Hx and vitals signs along with Sp02, blood glucose,monitor,12 lead,pain scale(?/10)

sepsis?

what about HIV. the purpulish skin rash could be kaposi's sarcoma. as it progresses it involves the central nervous system, which in turn lead to peripherial neuro disorders such as the siezures.

what about herpes simplex virus type 1. Which can lead to aseptic menningitis in adults.

is the rash more petechiae or purpura

Sorry if this isnt the right forum......... how long did it take you to start your field internship from the day you finished your clinicals?

just curious for all of you in paramedic school or those of you that just finished.....From the day you finish your clincials how long did it take you before you started your field internship?

give a second fluid challenge if lungs are still clear.....consider dopamine...reasses pts mental status......perfusion status

02 15Lpm via NRB, POC high fowlers,continous cardiac monitoring,12 lead with a repeat after a few minutes, check blood glucose---> if low give D50/no iv access?----> glucagon IM, IV 18gauge,fluid challenge 250mL NS--->checking lung sounds before and after,reasses,consider second 250mL fluid challenge, quick neuro exam,seizure hx?,consider atropine if no change consider second dose or pacing,possibly dopamine, rapid transport code 3

if anyone said this i missed it......but why not also take full spinal immobilization precautions since it was an unwitnessed fall,there is blood on the cold tile,lac on his head,AMS,and unknown period of down time. i know the answer is hypothermia....but what caused him to be on the floor....CVA caused the fall....trip and fall?...

Hello, I am a Paramedic that works for a EMS private 911 ambulance agency in the western United states. I am very interested in pursuing a tactical EMS career and i was wondering how to go about that. i have done some research and found some training programs i am interested but still have some questions. Are there any programs that you know of in California or Nevada that i am able to attend. i have NO previous tactical,Police, Law,military expierence, nor do i have any tactical gear....currently. Any info will be greatly appreciated!! Thanks in advance. -Paramagic14