I'm calling for a field pronouncement here Doc. I'm in the back yard of a residence with a mid-30s female patient who was found floating face down in the pool, unknown how long she was there. On arrival of the PCP crew the patient was VSA. They performed upfront CPR and then upon analyze discovered Asystole. We arrived as ACP backup just as they were doing their 3rd analyze and patient was still asystole. After one round of epi patient had fine v-fib which was shocked into a bradycardic PEA. Atropine and a 250cc bolus were given and patient was found to be back into v-fib. She has had 2 more epi and 2 lidocaine since then and remains in fine v-fib unresponsive to shocks. Patient is intubated with good air entry however ETCO2 is reading in the middle range on the disposable detector. At this point I'd like to cease resuscitation Doc unless you feel that a trial of bicarb is warranted.
Hi Doc this is Alex Kroeze, ACP, OASIS #15411
I'm 20 minutes from the closest ER. I'm calling for orders for a lidocaine bolus for ventricular bigeminy/trigeminy. Patient is a 75 y/o male with a history of COPD, Angina and Hypertension and is on salbutamol puffers, flovent puffers, nitro patch and metoprolol. Patient this evening while sitting watching TV had a sudden onset of inability to catch his breath as he describes it that doesn't feel like his usual respiratory difficulty. Patient took his own puffers with no relief and when it didn't go away within a few hours he called us. On arrival patient was ambulatory to meet us at the truck. On assessment he is in moderate respiratory distress and pale in colour. BP 102/68, P 68 and weak, R 20, SPO2 98% on NRB. He is in a sinus rhythm with periods of ventricular bigeminy that alternates with ventricular trigeminy. 12 Lead is non-diagnostic. Patient has no allergies. I'd like to give this patient a 1.5mg/kg bolus followed up by 0.75mg/kg q5min prn x2
I need some radio reports!
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Wow tha'ts cool