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What medication was it that she took? I strongly suspect a phenothiazine-induced dystonic reaction, but differentials I would consider would include infection, due to her hx of nausea. Treatment would be diphenhydramine, 25-50mg, IM or IV. Transport, yes.

Training AEDs need to be with training materials. As you said, they should NEVER be placed with the regular AEDs, to stop just such a mistake. Also, why was an airport laborer installing them in the cabinets, rather than an EMS person from the airport?

And if they aren't with you any longer? Say, on their way to the ER via POV? If it is a deep enough lac to need further attention, it gets bandaged. Most of the time, my patients do go via POV for lacs. But you are correct, if they require more interventions, then the lowest priority wound/injury isn't tended to instantly. Doesn't mean it can't be later during transport, though. Now, getting into the microbiological aspects... ALL WOUNDS ARE CONTAMINATED. Whether by whatever flora is on their skin, to the material that caused their injury, to the ground, the air, other surfaces. This is why they irrigate the hell out of wounds in the ER; to cut down on the foreign material in the wound, including those lovely microbes. I say protect it from further contamination, if possible. Do I do this for every abrasion, and small lac? Not all the time. But if I have the time, I certainly will attempt to. Why not? Your patient may be more comfortable for it also. Getting it covered can reduce pain from the air blowing on it. And my previous arguments of microbiological control, along with the possibility of it bleeding later. Why not prevent a little? Just because we are the ones who deal with things as they become issues doesn't mean we shouldn't work to prevent and issue from happening, or becoming worse, IMHO.

Just because it isn't freely bleeding right now, doesn't mean it won't later. Bandage it well to control bleeding. Check CSM distally afterward to verify it isn't too tight, and ship 'em to the ER for closure.

http://www.medscape.org/viewarticle/569161 has some interesting reading on this topic.

This was in Circulation (and is free to read): http://circ.ahajournals.org/cgi/reprint/123/6/691 Hope it helps you!

1. Don't miss a single class. 2. Ask questions. 3. Read AHEAD. Be prepared before class. 4. Ask questions. 5. Practice, practice, practice. If there are extra practice sessions, go to them. 6. Ask questions. 7. Have fun!

Learning A&P is a stepwise process. Nailing down anatomy is a matter of memorization. There are tricks to memorizing, but it still boils down to just KNOWING the bones, the muscles, the nerves, blood vessels, etc. Physiology can also be memorized, partly. Physiology requires understanding the anatomy first, the function(s) second, the process for the function(s) third, and the result of proper and improper function. Physiology starts at the simple and progresses to the difficult. Where are you having problems, specifically?

Have you asked your upcoming instructor or program if they have a requirement? Many want polishable boots that are bloodborne pathogen resistant (You want them that way also!). There are some that are reasonably priced that do this. I wear 5.11 ATAC Storm boots. They run about $100/pair. Are they my boot of choice? No. But they work for me. They are waterproof almost to the top, side-zip, polishable, and decent. My boot of choice is either Redbacks or Magnums, but both are a bit outside my price range right now. Avoid the Walmart boots. They fall apart. You want something you can work in. If your feet are killing you at the end of the day because of a crappy boot, then it isn't worth it.

Hmmm... a couple of possibilities... Pulmonary Embolism is high up on my list of suspicion right now, with his HX of PVD and fem-pop bypass, along with the dyslipidemia. AAA is a possibility, especially with the back pain and difficulty moving his legs, as is an MI, but I'm putting my initial thoughts on a PE. What are his O2 sats? What does an ECG show? What meds is he taking aside from the Z-max? His renal failure also makes me wonder... When did he last dialyze? Is he fluid overloaded? Fluid overload doesn't usually cause the issues with his legs, but certainly can cause the dyspnea (and back pain, BTW).

I love it!

My condolences to their families. May they rest in peace.

Here is mine: (Yep, that's a rubber chicken on a keychain)