Punisher

I was taught the same thing Andy was when I was trained as a cardiology technician and also when I became an ACLS instructor the materials stated V1/V2 were anterior leads, but there wasa caveat that in some cases there would be individual variability as far as what leads represent anterior vs. septal segments of the myocardium. This is simply due to variations in the anatomy of a person who is tall and thin (the heart tends to lay more midline in these persons) than in someone who is short and fat (where the diaphragm and the abdominal contents tend to lateralize the ventricles somewhat). There is also the issue of patient positioning- the effect of semi-Fowlers vs. supine positioning of a patient will effect to a variable degree how the heart is positioned at the time the EKG is done.

You can sneeze on your antecubital fossa. Most people can't sneeze on the dorsum of the arm that is in question in the "elbow bump". For example can you rotate your arm around far enough to see the protuberance that is the "elbow" proper while still having it up at your mouth and nose to stifle a cough or sneeze? That is not likely. A better example would be to ask if you can lick your own elbow.....

It's only a mistake if you keep doing it over and over and expect different results (which is actually also the definition of the behavior of crazy people ). The not being able to remember what to do happens to everyone- rookie and veteran alike. Just step back, take a deep breath and think for a second. All of us do it; the difference is that we veterans have learned to just not make it obvious. :wink: Good luck and keep your head up.

Eh, republicans......

You're right that it probably is due to hyperkalemia- although it's probably due to a sudden transient release of potassium from damaged muscle cells into the bloodstream as a result of the seizure, rather the absorption of K+ into cells. The other possibility is that the T wave alterations are a sign of myocardial ischemia brought about by hypoxia and/or catecholamine release during the seizure episode. Without lab tests and a 12-lead there really is no way to be certain, but one of the above situations would be my guess.

Two things to keep in mind: 1. If they need oxygen by their clinical presentation- give it to them. There is only a VERY small minority of COPD patients that are relying upon hypoxic drives to breathe, i.e. you won't hurt them by giving them supplemental O2. 2. Most (up to 85% depending on the study you rely upon) of COPD patients have some manner of psychological illness- usually a panic disorder of one form or another. Some researchers theorize that more than a few of the COPD exacerbations we see may actually be misdiagnosed panic attacks. If anyone wishes to see the documentation backing up this, let me know.

It was an honest statement....paramedics aren't technically trained to be in OR's. But at the same time the bagging thing is somewhat degrading, but at the same time....IT IS TELEVISION, and it sucks so much that it is not even bad television at that (it would insulting to such high quality programming as American Idol :roll: to call Grey's Anatomy bad television)

Could be worse, before Rural/Metro left Terre Haute, IN two of their medics were severely reprimanded because of a stuck mic and an "inappropriate" conversation. The topic: The blowjob the one medic had received from the dispatcher the preceding night.

I wonder what the last thing to go through his head....I'm guessing one of his femurs....

I've puked after every field delivery I've done. All three of them.

Nice site, crappy department- I used to be a resident volunteer for them when I worked for University of Missouri. They don't treat their people well at all and their chief ran off some of the best fire officers they had (including one of the finest fire officers I've ever had the pleasure of knowing).

I don't remember precisely (this was several years ago) but I think it was the Anne Arundel. It was the furthest south....the 50/301 bridge. When we found him (most of him) he was several miles south of the bridge and in PG County's jurisdiction.

When I was in Maryland, I helped fish a guy out of the Chesapeake Bay after he jumped from a bridge. The drop to the water was approximately 100'. Put it this way, he was in pieces. I couldn't imagine that type of damage from hitting water.

Personally I think EMT's should be a minimum of 19 (18 + 1 year of school- yes I think EMT-B should be a much longer program than it is now). For medics, it should be a BS program after two years of full time work as an EMT. Mandatory psych evaluation and multiple references from people who know and have worked with the student candidate should be collected and assessed.

I agree....this is the single best response ever..... way to go Dusty.

Couldn't have said it better myself.

As for whether personal faith and medical care are compatible, the answer is yes. That is so long as you don't allow your beliefs to cloud the realization that you must do what is right for the patient, not what is most morally palatable to you. Imagine you were an atheist; would you want a fundamentalist Christian nutcase deciding your care based on his distorted view of a religious text? Probably not.