spenac Posted January 27, 2008 Share Posted January 27, 2008 What's heel strike? Is that a joke? Are you joking? You have never performed heel strike or heel tap or markle sign , just some of the names for this test? This is an old pretty reliable exam to help determine if it is appendicitis. http://or-live.mediwire.com/main/Default.a...rticleID=118602 http://books.google.com/books?id=fs6sQlM0z...BbptM#PPA176,M1 http://answers.yahoo.com/question/index?qi...22174621AAtOZU2 Link to comment Share on other sites More sharing options...
ERDoc Posted January 27, 2008 Share Posted January 27, 2008 While assessing vision and cranial nerve function, one of the tests would be to hold a pen or finger about 12" from the tip of the nose and have the patient focus on this point. Both eyes should converge equally and pupils should constrict slightly. After a few seconds, have the patient focus on a point on a distant wall..10 feet or so away...like a picture or prepositioned tape line. The pupils should dilate back to normal and the eyes return to midline..equally. This is known as accommodation and I have seen the test in either order..far to near or near to far. Often, it is easier to have the patient focus on a far object first an then focus on a penlight of pen... The absence of constriction, convergence, dilation, or an asymmetric response should be noted and reevaluated. :cheers: Link to comment Share on other sites More sharing options...
hammerpcp Posted January 27, 2008 Author Share Posted January 27, 2008 Are you joking? You have never performed heel strike or heel tap or markle sign , just some of the names for this test? This is an old pretty reliable exam to help determine if it is appendicitis. http://or-live.mediwire.com/main/Default.a...rticleID=118602 http://books.google.com/books?id=fs6sQlM0z...BbptM#PPA176,M1 http://answers.yahoo.com/question/index?qi...22174621AAtOZU2 I have never heard of this test before....and before you get all self righteous and condescending let me remind you that I am in pre-hospital emergency care and this test is obviously not something one would generally do in the field. Upon investigation this test isn't even conclusive. Also, a bump in the road may prove just as useful as taping the heels in locating the pain. Link to comment Share on other sites More sharing options...
spenac Posted January 27, 2008 Share Posted January 27, 2008 I have never heard of this test before....and before you get all self righteous and condescending let me remind you that I am in pre-hospital emergency care and this test is obviously not something one would generally do in the field. Upon investigation this test isn't even conclusive. Also, a bump in the road may prove just as useful as taping the heels in locating the pain. Actually this is done in the field all the time. It is another part of the puzzle that you can relay to the hospital. I did not intend to sound all self righteous and condescending. I was taught this as an ECA ( first responder ) and so was very surprised that you were not familiar with it, plus you asked if I was joking for mentioning it. It is a very good predictor of what is going on especially in adults. Like most other prehospital exams it is not all conclusive. It will require confirmation before they start surgery. Another good test is the pinch an inch test. Really maybe I am in the minority because I believe the more info the better I can treat and the better patient advocate I can be. ( see do you look and touch discussion as well as nut is swollen and hurt thread ) Link to comment Share on other sites More sharing options...
firedoc5 Posted January 27, 2008 Share Posted January 27, 2008 Really maybe I am in the minority because I believe the more info the better I can treat and the better patient advocate I can be. ( see do you look and touch discussion as well as nut is swollen and hurt thread ) Then we are in the same club, dude. :occasion5: Link to comment Share on other sites More sharing options...
hammerpcp Posted February 15, 2008 Author Share Posted February 15, 2008 Actually this is done in the field all the time. It is another part of the puzzle that you can relay to the hospital. I did not intend to sound all self righteous and condescending. I was taught this as an ECA ( first responder ) and so was very surprised that you were not familiar with it, plus you asked if I was joking for mentioning it. It is a very good predictor of what is going on especially in adults. Like most other prehospital exams it is not all conclusive. It will require confirmation before they start surgery. Another good test is the pinch an inch test. Really maybe I am in the minority because I believe the more info the better I can treat and the better patient advocate I can be. ( see do you look and touch discussion as well as nut is swollen and hurt thread ) You are contradicting yourself. On one hand you agree that it is an inconclusive test and then in the next sentence you say how useful it is. There are all kinds of stupid useless tests you can do in the field under the guise of obtaining more pt information, as if MORE information equates to BETTER information, which of course it doesn’t. I take issue with your implication that those that don’t conduct these admittedly inconclusive and therefore useless and time wasting tests, which are therefore more likely NOT in the pts best interest, are somehow less adept health care providers. This is what I meant when I noted your air of condescension. Good pt care occurs when practitioners use clinical judgment to direct them in what tests need to be done and what tests don’t need to be done. Let me make my position dead simple: More information does not equal better information, does not equal better pt care, does not equal better diagnoses, dose not equal faster or more effective treatment. Link to comment Share on other sites More sharing options...
CBEMT Posted February 16, 2008 Share Posted February 16, 2008 I don't see the point of this statement.....? The point is, are you saying that you routinely give D50 to pregnant women? Link to comment Share on other sites More sharing options...
NREMT-Basic Posted February 16, 2008 Share Posted February 16, 2008 What is PEARL?? :?: To convert mmol/L to mg/dl....multiply mmol/L times 18..FYI for the Americans:lol: If you look at most EMT Patient report notebooks (the little 3x5 jobbies likes I carry in my top pocket) it is usually spelled PERRL as in Pupils Equal Round (and)Reactive to Light. A sidenote: if you keep your notes in these, dont let the ER staff take that notebook from you. It will disappear into the bowels of medical record hell. Offer to make a copy. I need mine for my PCR. Link to comment Share on other sites More sharing options...
hammerpcp Posted February 16, 2008 Author Share Posted February 16, 2008 The point is, are you saying that you routinely give D50 to pregnant women? If they are hypoglycemic and symptomatic, yes. Why not? Link to comment Share on other sites More sharing options...
CBEMT Posted February 18, 2008 Share Posted February 18, 2008 We were taught that it should not be administered to pregnant women. Link to comment Share on other sites More sharing options...
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