celticcare

Interesting patient indeed Rat, few differntial diagnosis points there. Plus a few off topic posts in this thread *but hey that is normal here right * cold and not well perfusing peripheries will hampen acquiring a decent blood sugar reading. Whilst I know it would have been difficult in the case of this patient, if I have a patient with shut down peripheries, I take my BSL reading from the ear as the head will still have a good supply of blood. This is pointing probably more to a cerebral call, be it CVA or dementia (probably a combo effect). If you are able to acquire any of the lab values, can you post for me a CK and Trop level please. In regards to the symptoms posted by NYCEMS, I have seen presentations like the one he described and also similar to those posted in following posts whilst I was doing my Psych rotations (8 weeks worth). The hightened responses however, seemed to come from patients who either had their first insidence of the episode or had underlying pathological issues also. This coupled up to make the effect more pronounced as the body was fighting within itself secondary to an adjustment to new medications. They sound similar though, to tardive dyskenisia. I am fighting very hard to not go off topic in regards to mobeys comments and also a few others by people. This thread is not to be a bls vs als thing *as the undertone was starting to arise in there*, it is a question of what else could have been done and were the actions so far proper. It might also be Rat's locale policy to acquire a 3 lead strip for the doctors, different areas different protocols. *to echo the great Richard B, Follow your local protocols*. Volunteer services are common place here in New Zealand for same reasons that Rat mentioned. Some volunteer areas offer ILS care also and it is a love to do the work and stay in your local community. Alot of the volunteers I know, would love to do the job full time, however, they either have family commitments and cannot relocate, or are in steady income as it is and cannot leave due to that. At the end of the day, voly or paid, it is the service to mankind that counts. Pro utilitate hominum. Scotty

Its on the page that describes the product, there is a flash presentation with examples of the devices sounds and operatiing features.

THe device makes a verbal warning that it will shock, it will be the same as if we took to the patient with our external defibrillators, if they are on metal, they will put the shock into that same as we defibbed them manually externally. It is something that public will need to be made aware of and stand clear themselves if a shock is going to be delivered.

My reply can go either 2 ways 1) Lone you have to face 50 lashes for always picking on us for grammer and spelling when it proves spelling is not important. 2) Lone you have to face 50 lashes for reaffirming what the rest of the world thought of American literacy Either way, I get a free show lol

I just wish to add.... that it was cold that day and the jacket did not give adequate warmth or maintanence of circulation of my neithers. She was also ugly and it would be insulting to have more than a stub for this woman. Thank you for letting me clarify that fact.

Oh live the american dream, captain Jack Sparrow did and he was a pirate Now if the Pirates looked like this...... would we shoot them? Lol

Congrats Anthony, You have lost your pvc virginity and succeeded. Proud of ya mate, may many more tubes come your way with ease and care and the aid of lubricant. but good on you mate Scotty

I hope I can personalise mine..... Yes I want the heart that is robust, can pump for hours and hours and never needs a break and looks good in red. Actually I want the heart of a porno star Bow Chica chica wow wow

It starts with one viewing of this video....... and your life is never the same...... A ONE TWO THREE FOUR ..... http://www.youtube.com/watch?v=GOxR7rTYuSI

I managed to open it right clicking it and open in new window

Agree on the final line ruff Anyone keen on an update of the article?

Cannot grant...... male brain cannot compute....... trying to understand woman..... DANGER WILL ROBINSON DANGER WILL ROBINSON I wish Terri and I starred in movies together

I've only worked christmas as an RN and that is hard seeing people brought in with conditions that they cant spend the holidays with their family or one gentleman I had nursed for a while *as an in and out patient, kindly lovely man* dying like 4 days before christmas. Looking into the cubicle he had been in whilst waiting for a heart transplant, just saddened me working that shift. Christmas in general is a bit of a downer as my ex (whom I was going to move to aussie with) left me the week before christmas for another guy and left me heartbroken, lost and alone at christmas. Saddest call ever, whilst I wont go into detail, as basically I saw a lady take her last breathe on me as a young EMT (I was only 20) and holding this womans head on my lap as we ceased CPR and after seeing her husband snapped in two in the drivers seat, hearing the families scream "She's lost her pulse" when I was the first on scene and highest ranking officer until ALS arrived. (and before any of you lecture me on traumatic cardiac arrest, we shocked her 9 times as she was still in coarse V-Fib). I don't want to go into the debate of CISD, personally I requested to see someone, to this day (five years later) I'm still waiting.

I was watching that on the news tonight Krumel, and it disgusted me, is it when you become a politician, you forgo human rights, morals and dignity and gain a labotomy??????? Where some of the logic is with these people defys me, small attention span too.... "And we will punish the people of this heinous.... Oh look at the Kitty" Scotty

As the original post was as my old identity on here *no I don't have multiple personalities..... shhhhhhh I'm typing here* I was smoke free for 5 months, then I moved up north away from my home and support networks and started again the day I moved up. I am angry at myself for it, but nearly a year later (May 15th will be the exact date) I am still smoking. Though cut down considerably, I am still smoking. Time to go with the patch therapy, I am feeling breathless alot more now and want the money from smokes to go to a gym membership so I can be that buff Scotty that the women oh so love lol. I feel saddened going through the old posts and finding that post from over a year ago and to see myself now, its made me determined now. I can't let myself get like this ever again. Scotty

It is also down to personal interpretation and being aware that as human beings we do step on other peoples toes as part of reality and all it could have taken is a conversation with a fellow student that has gone wrong and boom, an allegation laid or anything and thats your career down the toilet. There is however, a time and a place and whilst I am human and have disagreements with fellow co-workers, the system in general and even treatement by patients to health care professionals, those even in the context of a personal blog are not for internet. Plain and simple, you are no longer an individual on the net, once its out there it's out there, plain as the day we were born. Thanks CH for the post. Scotty

My best wishes to you on surviving your better halfs Ca Tx. Here in NZ, we have a national take back policy on medications with local pharmacies and with controlled drugs especially, though funnily enough, we still say flush the pills away if you're not going to use them OR take them to the pharmacy. Patients who are on controlled medications including narcotics, are monitored when they recieve a script of narcotic etc in the essence the medication balances out and they shouldnt have used soo much too fast etc. Again, my best wishes to you and your family. Scotty

Good Scenario indeed, we dont have the native type of mushroom you described growing here, but we have enough deadly native flora and fauna to cause issues. The ones who aren't so bad now, arent necessarily going to remain not so bad soon, if thse young ones got to the extent of unresponsive, im sure the adults would be heading that way, i guess transport the ones that arent actively vomiting yet by the bus and the ones that are vomiting, either by helicoptor if they can be taken, or via the next ambulances coming. Just a question though, are the ones "not so bad" parents of these kids, because there would be issues revolving around them wanting to go with their kids, could kill two birds with one stone *and sorry bad analogy I know but couldn't think of anything else*. Again great scenario, I need to get my thinking cap on for one of my own to write. Scotty

Did my e-mail make sense at all or cover what is meant to be covered? Look forward to hearing back from you and the team of future EMT's.

Ahhhhh so this will explain the bleeding as what is part of rat poison.... warfarin lol.

Check your email

I guess just monitor, continue to administer care to alleviate symptoms, save a sample of the vomitus for the medical staff and continue supportive cares and remain non judgemental. Just a question, is the fishy smelling vomitus actually fish from dinner? I can't think of any other meds or anything other than omega three or fish oil capsules that would make it smell like fish....

We have had a few patients with this in the CCU this year with the condition being linked to Apical Ballooning syndrome. I was looking after a patient who had had bad news from her son, she got chest pain that night, st segment changed, Trop I went to 2.97. She had what we thought was a NSTEMI however her angio gram showed normal coronary arteries and the TTE showed cardiomyopathy. With medication and rest, her heart had begun the healing process. I was in a teaching session yesterday and broken heart syndrome came up, shows how often I don't scroll through the old threads as I had been treating these patients and didn't even click to that it was called this syndrome. Differential Diagnosis, but then that is said as I work in a hospital with access to lab tests and TTE and other procedures, not quite out in the prehospital arena yet lol . Scotty

You got me there Terri, ummm I guess metoclopromide to qaulm the vomiting and monitor more, see what the vitals are like, is the husband in the ambulance with you or following in a private vehicle?

Do we just await an e-mail from you and the kids asking questions or do you want a statement prepared for the kids explaining our roles, what our services are like, photos of trucks and equipment etc?