emti2008

I have been taught to get the pt. into a cool environment first. If the pt. is a&o x4 then they can sit up and sip up to a liter of water if nausea does not develope, other wise lay them supine, if nausea is present they can lay in recovery position. If decreased LOC then lay them back, do not give water try to get a line if it's in your protocols and transport.

I hope that helps some, I had heat exaustion a month and a half ago. I can tell you that they used ice to cool me down which was not a good idea. It threw me into convulsions, i had been unconcious and they were trying to talk to me but I couldn't respond, even though I could hear some of what they were saying, I was considered a load and go, and they stuck me 5 times to get an IV in me, so I say this to say that if anyone has said use ice it's really not that good, it can cool the body down too rapidly during heat exaustion. You should also look for signs that they may be going into heat stroke because it's a different protocol where I'm at... Hope it helps some.

I just put one up and there's more to come.

Thank You.

Does anyone have a scenario for EMT's. I would like to stretch by brain. Please post one if you have one.

I think your nurse friend is mistaken. I don't recall hypokalemia as a side effect of CCBs, and I couldn't find any reference that mentioned it. Did you find any reference material that said so?

'zilla

No that's why I was confused about it. She said that Verapamil has a Diuretic in it, but I think she is mistaken as well because I looked it up on multiple wedsites and can not find where it says that it has one in it. The side effects do say that it can cause dizziness, lightheadedness, headache, fatigue, nausea, and of course a decrease in BP. The signs of OD is also dizziness, LOC, irregular HR, and syncope. It also says if one has SOB or peripheral edema to contact Dr. ASAP because it can cause CHF, it also says it can cause liver and kidney damage. I would rather deal with a little HTN than CHF, but both can kill you so.....anyway I researched the medicine and did not see anything about a diuretic.

Something that is completely misunderstood, and often neglected is mental health.

Sure, you will get the 16 year old who scratches his/her wrists for attention when they don't get their way.

But how about some of the other people out there?

The ones that have undergone severe emotional trauma, and tried to bury it, and move past it?

Everyone deals with trauma, be it mental or physical, in different ways.

There is a stigma attached to depression, anxiety, bipolar, manic depressives and the like.

Often times, those suffering do so in silence. What we see is a cry for help.

DON'T FUCKING WRITE THEM OFF BECAUSE YOU DON'T UNDERSTAND

Be an advocate for them. Ensure that the ER does not throw them in triage. Talk to them. Let them know that they have someone to talk to, and not be judged.

If you couldn't tell, this is a subject that I am painfully familiar with

I a very familiar with this topic as well...There are those of us (survivors of such addictions as cutting, true cutting not just for attention) who get "caught" just as we are slipping away. If you can talk to them and let them know that they are free to talk it really helps. And you should also know that if caught AND properly treated they can live a normal healthy life. They are human beings with feelings just like anyone else, so please don't judge them, it will only make it worse.

Thanks, We didn't learn about the MAP, but it's something that is good to know.

No. You're thinking of diuretics.

I do treat the Pt. for the Pt. and not the #'s, I just wanted to know what the standard #'s were. Thanks to all.

Is that the patients normal BP while on her medications or is that her un-medicated BP? It's possible that her BP was reduced too quickly by her medications thus the symptoms. Anti-hypertensives are normally titrated to desired effect to avoid these kind of circumstances. If the patient is alert and oriented with adequate perfusion, BP over 90 systolic, in NSR, there really isn't anything to be done pre-hospitally for her. She does need to be transported to a hospital where they can review her medication situation and adjust dosages however.

Pt. states that that is the BP while not on the Medication; and can't some calcium channel blockers lower the potassium level?

An other option is the MAP. Most NIBP cuffs will calculate this for you. In general a MAP should be 60 or greater.

I'm sorry but what is a MAP. I don't remember learning that one.

For an even deeper understanding of hypotension/shock, I’ve attached the following link.

www.ems1.com/medical-clinical/articles/479223-Blood-Pressure-Assessment-in-the-Hypovolemic-Shock-Patient

thank you I'm about to look at it now.

Tnak you all for your information, it really helps, I'm still new at this.

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

Yes I can read it, and I'm glad I don't have to worry about my spelling, I suck at it anyway.... Oh and can I watch too, sounds fun!

Oh and I now I'm strange.

We got a call for an MVC.

An older guy smoked an 8 ball, and tried to commit suicide by ramming an oncoming SUV in his little car, No Seatbelt, No airbags (Yes it was highway speeds)

My heart was just a pounding, and adrenaline Flowing and i thouhgt "Ohhh man this is gonna be one of those Holy Sh** Calls"

BUT......

we got there and Both drivers had NO INJURIES!!!

Figure that out.....

Ok if the Pt. in the 'little car' just smoked an 8ball, they were more than likely relaxed when they hit the 'suv' which causes less damage than when someone tenses up before an impact. I guess the 'suv' Pt. was protected because the other vehicle was small and their vehicle was larger, also did they have seatbelt and airbags, that would make a difference, and were they able to slow down before impact. Just my thoughts....

"Flu-like symptoms" & "Not feeling Well" (most of these come from the 2 NHs in town)

I live in a faily small county, we get a lot of 'code 30 from a fall/mvi' which is possible injury, and 'code55 (sick person)' CP, and SOB mostly, ocaisional unresponsive.

Those are pretty normal BP readings for a 23 y/o female. Maybe slightly on the hypotensive side but not really. What range does this patients BP normally reside in? It's all relative. If your BP is usually 150/100 you will most likely feel light headed if your BP dips to 110/65. That's a pretty rough history for a 23 y/o. Congenital I'm guessing?

Umm, the normal BP is high (160/100-140/92), which is the first reason Pt. was put on medication, but medication is also used in treatment of Hx of Angina and Palpitations. and only 5 years of Hx, no problems before.

How low would the #'s need to be to be concerned that it is a problem that needs to be fixed.

Why is the patient on calcium channel blockers?

Hx of Angina, HTN, and Palpitations

Ok so I have my EMT-I, and I have a question about hypotension.

First, when is a BP reading in a normal, healthy adult considered to be hypotensive. I've looked back in my book and it says that a normal systolic BP is 90-140 systolic, but it does not say what the normal Diastolic BP is.

Second, if you have a 23 y/o female Pt. taking a Ca channel blocker, c/o dizzyness and is slightly lathargic and the BP reading is consistently 99/58 to 99/68 (taken q5min), is it considered hypotension, and what would be the definitive treatment.

Please help me with this, and if you have any questions or need me to explain it better let me know.

GA Law

FR = VS, O2, CPR, Basic First Aid

EMT-B= SpO2, Traction Splint, EpiPen, NTG, Charcoal, Oral Glucose

EMT-I= IV, D50, Narcan (is some areas of the state), CombiTube

EMT-CT= ACLS Drugs, 3-Lead ECG, ET on apnic/ pulesless PT, Defib

Medic = Full ALS

Thanks, you know now they consider EMT-I's medics, but I know your talking of Paramedics here. One question, what's a EMT-CT? They can do some of the cardiac support that Paramedics do, like ACLS. Here in Savannah we are not allowed to give Narcan, but most of our vans have either an EMT-I and a Paramedic or two Paramedics so someone is on scene who can administer it. Around here we need a steady supply of it, especially on the weekends (payday).

Oh yeah, I forgot to mention I'm halfway through Fire Fighter One classes, taking my midterm Monday! I'll be a "Blue Helmet" soon. We actually will be allowed to carry out own First Responder Bags, which as a first responder you can do just basic stuff. VS, O2, and CPR in my county, I think it is a GA law. N E way see ya later...

I'm currently in the EMT-B/EMT-I program at Savannah Tech.

I was an EMT-B in MI for 12 years.

After I go through this portion of the course, I'm looking at doing My A.A.S. for Paremedic Technology at Savannah Tech as well.

Hi, How long is the EMT-B/I class? How is the classes out there at Sav. Tech? I got my EMT-I at Rescue Training Inc. in Savannah. It only took a few months. By the way if you have any concerns about the National Registry PM me. The Practicals are not as bad as some think if you know your stuff. Good Luck.

And hello to everyone else also. Yes Valdosta counts, I love Wild Adventures, although I havent been back since I broke my ancle on the Cheeta, you know the wooden one. Anyway it's good to be in the City.

Last year during my clinical rotation we picked up a woman on the side of the road, her husband had died and she had taken 2 packages of cold medicine and a thing of store brand Accetominophen (sp?) She was only responsive to pain and had extremely high BP. I don't know if she made it, I don't think they found her quick enough, the meds had already been released into her bloodstream. The same week we had a 15 year old put a shotgun in his mouth, because of a gf breakup. It's so sad that ppl think they will make things all better, No girl or guy is worth me taking my own life.

ugly,

and

Just stopping in to say Hello, I'm from Savannah, GA and I'm new to this site. I got my EMT-I at the end of last year. I plan on going back to get my Paramedic as soon as I can save up enough money to do a one time payment it's a lot cheaper that way. I'm excited to find this site where I can talk to people who know the field.