bethea Posted December 17, 2007 Share Posted December 17, 2007 [/font:824a503dd3] It's a 90 y/o female with hx of valve replacement , Iddm, pacemaker and htn. Pt is acting out of sorts for herself. She is "talking out of her head." Even though she has a pacemaker do you run an EKG on her or not ? Link to comment Share on other sites More sharing options...
mobey Posted December 17, 2007 Share Posted December 17, 2007 [/font:ed2c2d0a1b] It's a 90 y/o female with hx of valve replacement , Iddm, pacemaker and htn. Pt is acting out of sorts for herself. She is "talking out of her head." Even though she has a pacemaker do you run an EKG on her or not ? Better than talking out of her a$$ Yes I would still run an EKG, but I would first get a BGL (IDDM + acting inapproprate). Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted December 17, 2007 Share Posted December 17, 2007 blood glucose first before ekg or anything else actually except the other vitals. Just like mobey said. 90 percent chance of blood sugar problem and 10 percent chance of anything else. Let's turn this around. Bethea, what are your thoughts on this? did you actually have this patient? How did you address this patient? What were your treatment/evaluation steps? Link to comment Share on other sites More sharing options...
akroeze Posted December 17, 2007 Share Posted December 17, 2007 In my mind setting up the ECG or the BGL first is not so important in that they are relatively simultaneous and I won't be giving any TX before both are done anyway. Link to comment Share on other sites More sharing options...
bethea Posted December 17, 2007 Author Share Posted December 17, 2007 [/font:79bb091c44] Thank you much for your help, I thought maybe something else should have been done but the medic said being as the pt had a pacemaker it would defeat the purpose of the running the strip, Thank guys for you help :wink: Link to comment Share on other sites More sharing options...
spenac Posted December 17, 2007 Share Posted December 17, 2007 [/font:b6cefd0264] Thank you much for your help, I thought maybe something else should have been done but the medic said being as the pt had a pacemaker it would defeat the purpose of the running the strip, Thank guys for you help :wink: Sounds like a dumb medic. The 12 lead still shows whats happening including whether pacemaker is working properly or not. Link to comment Share on other sites More sharing options...
Dustdevil Posted December 17, 2007 Share Posted December 17, 2007 I thought maybe something else should have been done but the medic said being as the pt had a pacemaker it would defeat the purpose of the running the strip... Not knowing how to read an EKG defeats the purpose too. Sounds like that's what the problem was here. :roll: Link to comment Share on other sites More sharing options...
MSDeltaFlt Posted December 17, 2007 Share Posted December 17, 2007 12-lead? Yes. Along with the usual neuro exam... and sats. If the medic didn't want anything else done, then the best course of treatment is a diesel bolus to prevent any prehospital iatrogenic mortality. My honest opinion. Link to comment Share on other sites More sharing options...
akroeze Posted December 17, 2007 Share Posted December 17, 2007 To me the patient would be a "stay and play" with the idea that if we can't find a correctable cause pretty quickly we need to get going. I wouldn't immediately start moving though. Link to comment Share on other sites More sharing options...
emtannie Posted December 18, 2007 Share Posted December 18, 2007 [/font:3b3a3f5e8c] the medic said being as the pt had a pacemaker it would defeat the purpose of the running the strip I agree with previous posters that the initial vitals and blood glucose would be priority.... but to not consider an EKG as it would "defeat the purpose"..... hmmmmm This would appear to be an excellent opportunity for you to do some research, compile your findings, and then approach this medic with some questions..... particularly, how would it defeat the purpose.... Link to comment Share on other sites More sharing options...
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