defib_wizard

Eww thats bad! ( I like it ) but isn't this a conflict of interest/ :shock:

morphine only for pain here in az.

He forgot the eleventh commandment; Thou shall not get caught!

I don't want too ask so please don't tell!!

crotchitymedic1986 said A junctional rhythm has a narrow QRS. While a ventricular rhythm is wide. Any rhythm that is faster than its " normal" intrinsic rate is considered accelerated. Until the rate is 100 or more then it is considered tachycardia. Junctional rhythm normal rate 40-60, >60 accelerated, >100 junctional tachycardia. Ventricular rhythm normal rate 15-40, >40 accelerated, >100 junctional tachycardia. Hope this helps.

It sounds like she would have been a perfect candidate for a full body vaccuum mattress. You can immobilize the pt in a semi-fowlers position. Then vaccuum all of the air out making it a custom fit to the pt. The only problem with the ked is on some people even with the sides all of the way up into the armpits. The back of the ked will hang down past the pts buttocks. So you are suspending the pt from her armpits unless you pad the void under her butt and the mattress.

In any hanging, the pts c-spine needs to be immobilized. But before you put a collar on the pt check his thyroid cartilage for crepitus. I suggest you have someone hold manual immobilization while you check the oral airway for trauma. If you are going to work him as a viable patient you don't want to be removing equipment that you just put on. ( C-collar ) Cricothyrotomy is a procedure that you will probably be performing on this pt. ( That was a lot of P's in 1 sentence LOL )

Saddest Call Ever is any call after midnight before you get off shift and have to drive more than 3 hours afterward to meet someone the next day.

If you feel like improvising you can do both. All it takes is a NRM and a SVN. 1. Set up your SVN with the saline or meds you want to give. 2.Here comes the creative part- Option A- Cut a slit in the NRM bag put the svn in it ( in such a way it wont spill ) tape the slit closed with the svn O2 line coming out. Hook up your NRM to O2 at 10 lpm and the SVN at 5-8 lpm. Option B-put the NRM on the pt as normal. put the SVN together with the T and extension tubing take the bag the SVN came in and seal the end of the T by putting the plastic bag on the mouthpiece and attach it to the T. Put the spacer tubing under the mask and start the SVN. If you need too, trim a notch in the mask for the tubing. ( This way of blocking off an SVN also works for giving SVN's with blow-by to a pediatric pt.) Hopefully this keeps you from getting called into a MDs office for not following protocol.

I would call it accelerated idioventricular rhythm with periods of sinus rhythm after coughing. How about transcutaneous pacing and some versed. Or at least have the pads on him.

A teacher is explaining biology to her 4th grade students. "Human beings are the only animals that stutter", she says. A little girl raises her hand. "I had a kitty-cat who stuttered", she volunteered. The teacher, knowing how precious some of these stories could become, asked the girl to describe the incident. "Well", she began, "I was in the back yard with my kitty and the rottweiler who lives next door got a running start and before we knew it, he jumped over the fence into our yard! "That must've been scary", said the teacher. "It sure was", said the little girl. "My kitty went 'Fffff, Fffff, Fffff'... and before he could say "F***," the rottweiler ate him!"

I'm in az also so no beta blocker in my drug box. I would like to start giving the pt morphine. I can give up to 14 mg under standing orders. Since this pain is not appearing as cardiac. and absent pedal pulses. I'm leaning towards a TAA. Patching for MD input would be a good idea. I would hold off on the ntg until I talked to a dr. Does morphine help him?

You cant argue with that type of thinking!

arizonaffcep - if I get to go to flying here in town on this call ( again) I'm gonna hurt ya! LOL But seriously; Lets get him out of the restaurant start him on O2, and do a 12 lead ecg. Does he have = radial and pedal pulses? Any pulsating masses? How does he describe the pain? Sharp and/or tearing in his cx and Im thinking PE vs Thoracic Aortic Aneurysm. Heavy and dull possible MI. Now for questions 1 Did the pain change with O2 2 Did the 12 lead show evidence of STEMI? 3.Any other changes with tx and does he have any allergies? As with any call like this an IV is indicated of NaCl 0.9% at TKO.

My advice is simple, when you start in Iowa. Get a copy of your protocols, standing orders, tx guidelines and learn them. If you want place them in sheet protectors and a 3 ring binder and carry them with you. Also get the profiles of the drugs you will be carrying that you are not familiar with. Last but not least get a little composition book that will fit into your pocket. Carry this with you and write door codes, patching channels, hospital phone numbers, etc. Or anything else you need to remember on a daily basis. I know you can do this with a cell phone but batterys die and people change phones. Above all stay calm, and welcome to being a medic.