Kaisu

somewhere a fortune cookie factory is missing its writers

Just read those sonofaguns sometimes - they'll kill ya

I have learned that the psychos, criminals and depraved will do whatever they want to regardless of the laws. A lot of women die and suffer at the hands of men who cannot be arrested for what they intend to do. We are not talking about psychos, criminals and the depraved. We are talking about parents who without a doubt (for the most part) love their children.

what a great and stimulating topic. Just when I think I know what I think, you guys get me going. Who was it who said that a conclusion is something you come to when you are tired of thinking? I don't believe that God gives simplistic answers to complex issues. This whole issue of what the bible really means is a valid one. Whether it's upbringing, or personal inclination, life experiences, etc. something brings us to our own understanding of the universe and our place in it. Our world view, as well as our practice of the divine is one of the things that makes us uniquely human. We all have some kind of "religion", some encoded in doctrine and organized churches, others not. We are meant to struggle with these issues. We are designed to balance the needs of the child with the needs of the community. I value the strength of commitment that JWs generally display, but I disagree with what I believe is faulty scholarship and indoctrinational isolation. That not withstanding, my place of regular worship has demonstrated errors in doctrine that will be extremely challenging to address. The key is that these doctrinal errors be corrected. The study of the bible without an understanding of languages, cultures, historical development, etc. along with the guidance of the Holy Spirit will produce erroneous conclusions. The bottom line for me is the preservation of life and you bet, I will do everything in my power to convince the parents of a child to allow standard of care - BUT I am not God and if I fail, then it was not my call. Thanks for the great discussion

might be normal for that patient. I would not treat the PVCs either, unless the patient is symptomatic - showing signs of poor perfusion. Ditto for PACs and PJCs as well.

I was overwhelmed with the A & P when I first started it too. I was amazed that there was this whole world out there that I knew nothing about. I couldn't figure out how I had lived as long so ignorant. :oops: I learned that I had to spend the time with the material. I am an impatient person, and prior to this, things had come in easy. The hardest thing I had to learn was to curb my anxiety and just buckle down and spend the time with the stuff. It came - and I am so proud of myself for learning it. You can do it too. Good luck

Man you really paid your dues... I am glad that you are having a decent experience now. It took a lot for you to stick with it after that idiot you had. I hope you can turn it to good and turn the negative to a positive.

You were way provoked man... I wouldn't have even bothered to try... Your patience amazes me...

Did you read the original premise of the scenario? Did you read any of the responses? You missed the whole game bud.....

I love being married.... did it 3 times

I've had several spontaneous pneumos present in the ED.. young (not 45 yr old) males - tall and thin.. BUT - they usually only drop one lung and can tolerate it very well. They relate a history of activity (basketball, one guy was bending over to pick stuff up, etc.) followed by a sharp pain. A bilateral pneumo in a middle aged fellow is pretty much a zebra IMHO. My instructor told me that we were expected to recognize the common stuff.. that there was no way of knowing every wierd thing that was out there... I don't know if I've said it but I sure as heck have thought it - your preceptor is an anal orafice... Don't let her get to you.

Is this the same medic that is making life miserable for you? I don't understand poor compliance with an intubated patient. Do you hear lung sounds when ventilating?

dypsnea progressed to complete lack of air movement... the man gets a tube.............. I worry if its anaphylaxis or asthma, copd or heart AFTER he's being ventilated....

I did it and I am kicking a$$ But... I put everything else in life on hold - I study for 2 hours for every 1 hour of lecture, I make flash cards about everything and essentially work my buns off... I have a very supportive family (in the real way - they take over the chores of living) and the commitment is huge. I think that's true for medic school no matter what. Good luck.

my husband's favorite - and the worst joke I know... what lives in the desert, howls at the moon, has 4 legs and a bag of cement? a coyote - I threw in the cement to make it harder...

You are one eloquent son of a gun Dwayne... you write beautifully. One of the strangest things I've learned about taking a little time to do something for some people - you get back way more than you give... and there is no way of knowing beforehand who that will be... go figure... all the best of the season to you and yours too.... Love Kaisu

congrats.. good work, good result...now go out and do good...

oops.. wrong info... wrong girl.. .please excuse my post

http://yoism.reality-movement.org/images/P...ogButtJesus.gif

I thought it was hilarious... God Bless the red blooded American male... You guys ROCK!

Oh gosh no.. I sure didn't mean to leave the impression that I was inferring that that was what you were implying.. 8) No, I was actually responding to an earlier post where that is exactly what the respondent was stating. That is very interesting about the dobutamine. I think we want the vasoconstriction as well as the beta 1 effects of the dopamine when dealing with the cardiogenic shock patient. I know that dobutamine is one of the drugs of choice for CHF. Not in our protocols tho.. I will check it out with the million people around that know more than me. Thanks

6 burned children under the age of 5, 2 dead and 4 critical because their caretaker left them unsupervised in the van while she went to the store will never be anything but sh***y.

the cardiogenic patient gets the small fluid challenge in case he/she wasn't really cardiogenic - and was really hypovolemic... most of them will NOT respond positively to the fluid... then they start getting a very carefully titered dopamine drip to get a pressure up to about 90 or 100 systolic.. then I can begin CPAP to treat the pulmonary edema... 70% of cardiogenic shock is fatal.. but that's what I would do.. Same with MAOI patient in status asthmaticus.. gotta breathe... A & A, repeat A, 0.3 to 0.5 of epi sub Q - RSI intubation ready in case... and watching the BP and heart rate like a hawk.. ready to run interference on those as the situation unfolds... with 40 minute transports.. no- high flow O2, comfort and transport just doesn't cut it in either situation.

backstabbing and politics.. come to think of it.. I hate that with any job, but it hurts more when it comes from people that you would go through fire for....

Nope - me by my lonesome - but we are on a break for Thanksgiving. Classes resume on Monday with this specific lab on Thursday so we will see what transpires. I trust the instructor. I will leave it with her.