Arctickat

Or a RIG, or a TRUCK, or a ....

Whoops, you are correct. I misstated the thread title. It should say Full Term rather than Preterm.

this "No IV in 90 seconds = Go IO" concerns me. At what point is the timing supposed to start? From the time you decide to start the IV and begin prep, or the time the IV cath pierces the epidermis? I can see a significant increase in IO if it's the former, but I gotta admit, I've gone EJ before going IO.

On Tuesday, the Journal of Obstetrics and Gynecology released new definitions for Early term, Full Term, Late term, and Post term pregnancies.

http://www.ctvnews.ca/health/nearing-your-due-date-full-term-pregnancy-gets-new-narrower-definition-1.1509645

Saw in a movie, FDNY EMT taking a dead woman from a scene. Like, totally dead.

Is that realistic ?

Only if someone slammed their hand on the back doors after they were closed to signal the ambulance driver that he was good to go, then they drove away with lights and sirens.

Spent today bumming around in a diesel and going from dead stop to 55 just takes way too long.

It's not a dragster, it's an ambulance. Fast acceleration is not a priority, smooth acceleration is. Your partner and your patient will appreciate it far more.

Yeah, most of us have actually switched to the 5.11 but we have to add the stripe to them after we get them.

http://www.advancedresponsevehicles.com/catalogue.php?cat_id=334&item_id=2956

Mike, I'm thinking an open air fire pit in the back.

Yeah, I know Mobes...

Diesel, in our environment we typically had to replace a gas engine at least once, and the cylinder heads 3 - 4 times during the life of an ambulance,,,and they were usually rotated out of service at 300k. Worst engine ever was the Chevy 400 small block. There wasn't enough space in the water jacket between the two inboard cylinders for proper cooling and the cylinder walls would melt. We bored one out to 0.060 over before the wall was smooth again, but by then it was too thin.

I had the pleasure of getting to know Mike when he was speaking up here at a conference. A great speaker and a great man.

I'll never go back to gas, but I sure miss the 7.3 engine. I've got one with the 6.0, fortunately after all the computer problems were rectified. I've driven Dodge, Chev, and Ford, gas and diesel. For reliability reasons, I'll stick with the Diesel engines, however, most of our driving is highway rather than tooling around the city. In the low speed start stop start environment, gas is a better option.

When I do my remounts...I'm seriously looking at a Hino.

I've seen holier

My thinking is that the saying "You get what you pay for." doesn't really apply here, because it'll be your patient who pays the true price.

Thanks...the driver is my son.

Last Spring we shot a PSA for distracted driving. Here are the completed works. Please share and distribute the links to any you might think would find this of value.

The PSA

Behind the scenes

I've been a DAN member since I started diving. Calling DAN for a diving emergency should be as common sense as calling the Poison Control Centre for a poisoning or Medic Alert for someone with an ID bracelet. They are invaluable tools.

nice work Ug.

What really bothered me about this call is that the EMT on the call didn't even think to defib the guy or put on the AED, oh, and after we got to the hospital the Doc gave him Adenosine..twice because of the heart rate at 126 bpm. Fortunately the patient survived despite everyone's efforts to kill him.

I am awaiting an authorisation to access the medical records from the family for the other hospital he was transferred to. However the cardio docs agreed.

The old term for his condition is HONK. Hyperosmolar nonketotic state. Now known as Diabetic Hyperglycemic Hyperosmolar Syndrome.

http://www.nlm.nih.gov/medlineplus/ency/article/000304.htm

Not sure where you're seeing AF Dave, however, I'll throw the last of the info that I am able to provide at this time. These are all we have available for labs, but were sufficient to make the diagnosis. We can't do Tox or ABGs.

The PDF files of the lab reports can be downloaded from the downloads section here:

http://www.emtcity.com/files/download/28-scenario/

File Name: Scenario

File Submitter: Arctickat

File Submitted: 16 Sep 2013

File Category: Misc Files

Files associated with a scenario presented in the forums

Click here to download this file

I'd like to see an ABG?

Not available at my facility.

Whats the EKG showing

How long does the seizure last

Less than 2 min

Do we have a Istat to check lactate as PM requested

No, Unfortunately

what is the BGL in mg/dl

Do the math yourself

Did the EKG change after the seizure

No change

Would versed be a choice to control the seizures

5mg Versed administered,

You've arrived at the hospital. Any thoughts to the underlying cause before I post the labwork?

BP 127/83

HR 136

RR 14 spontaneous resps

SpO₂98% on 100% O₂ through the ventilator

etCO₂ 36mm/hg

Summary:

Cardiac History AMI x 4

Diabetic History (Non Insulin Dependent)

Prosthetic Eye

Current untreated significant Infection

Post Cardiac arrest ROSC after 15 min CPR and 1 defib

1mg Epi for Bradycardia PEA

Intubated

ECG Sinus Tach

5 mg Versed for Seizure

Bilat IVs running TVO

The only real problem is that the glucometer we use is calibrated for capillary blood rather than venous. However, as mentioned, the variance is so slight as to be insignificant to our treatment process. I will guarantee you that if you take your glucometer and poke your index finger on one side and then on the other you will get 2 readings that are 5% apart 9 times out of 10.