Medic192575

In reading the posts I'm hearing a lot about treating the underlying cause, which makes sense since that has been drilled into out heads with ACLS. So, let me make an analogy to ACLS. You have a pt in a PEA which could be caused by a number of underlying conditions {PATCH(4)MD}. You eventually want to treat those underlying conditions so that the PEA doesn't continue or come back, however, you still have a pt who has no airway, no pulse and no breathing. Before you can treat any underlying cause (unless it's hypoxia) you have to get your ABC's out of the way. As it is with an active seizure, you don't have a secure airway. The best way to get one would be to stop the seizure (versed intranasally would be very nice as it is fast acting and has a relatively short half-life). You now have a nice shot at an IV and assuming that your seizure was caused by the hypoglycemia you can go ahead with D50. Glucagon IM takes awhile and I would not want to be sitting around on scene waiting while my pt continues to thrash around without an airway.

We've got Solu-medrol if we have a pt whose SOB seems to be more congested than bronchospasm. It takes awhile but it does work. Most of us also give the albuterol along with the solu-medrol

How about toxicology, burn injuries, environmental emergencies, difficult airway lectures, advanced 12-lead EKG. Just some of the lectures we have done and/or plan to do. Hope this helps!