ccmedoc Posted April 11, 2008 Share Posted April 11, 2008 ...I'd hold the bicarb/calcium for the time being. Agreed..If it progresses to ecg changes from suspected hyperkalemia. After looking at the med list, there are some other options for the hyperkalemia....We have glucose, insulin, and albuterol... A couple amps of glucose, around 10 units of regular insulin, and albuterol nebs...5mg/3ml..give or take. This would help with the hyperkalemia and acidosis. We need an I-STAT, or equivalent..without blood gases, its a crapshoot. I would have a hard time giving bicarb without a pH. I'm saying fluids, diuretics, the drugs above..use calcium if cardiac irritability and, if deemed necessary, maybe a bicarb drip...not push. (edited for content and continuity) Link to comment Share on other sites More sharing options...
DwayneEMTP Posted April 11, 2008 Share Posted April 11, 2008 Found what I was looking for. Benzos can be more effective in treating the pain caused by muscle cramping secondary to envenomation, and are preferred over muscle relaxants or opioids. So I'd definitely get some Versed on board. Also, these kind of enevenomations can lead to rhabdomyelosis... which is countered by administration of sodium bicarbonate. So since your transport time is so long... I might be considering that. I knew there was something in there... Wendy CO EMT-B You know, as I don't have anything productive to add to this conversation, and I'm always looking for a way to bloat my post count, I'll just say this... Wendy, I demand that you stop such postings as the one above. You're a basic, which means that in no way should you ever make me feel foolish, as I'm an 'almost' medic...Please remember your place. In the future I would appreciate it if you would include misspelling, poor grammar and some reference to medics wasting time on scene in all future posts. Failure to do so would dictate that we may need to take basics, on a case by case basis, at least somewhat seriously. And that can not be allowed...even by a basic with a BA in biology Thank you for your understanding and in this matter. I'm just sayin'.... Dwayne Link to comment Share on other sites More sharing options...
Eydawn Posted April 11, 2008 Share Posted April 11, 2008 Read that post you quoted closer... I did misspell something. Look hard... you'll find it! Wendy CO EMT-B Link to comment Share on other sites More sharing options...
Mateo_1387 Posted April 11, 2008 Share Posted April 11, 2008 Read that post you quoted closer... I did misspell something. Look hard... you'll find it! Wendy CO EMT-B Rhabdomyolysis Yay, I win...........jk But really, who is looking anyways? :wink: Link to comment Share on other sites More sharing options...
AZCEP Posted April 11, 2008 Share Posted April 11, 2008 Also, these kind of enevenomations can lead to rhabdomyelosis... which is countered by administration of sodium bicarbonate. So since your transport time is so long... I might be considering that. I knew there was something in there... Wendy CO EMT-B Nice try though. I'm willing to bet there are more than one way to spell rhabdomyolysis, and if you change it around a bit it will describe an entirely different problem. Link to comment Share on other sites More sharing options...
Eydawn Posted April 11, 2008 Share Posted April 11, 2008 Yeah, dunno how that "myelosis" ending got in there. Rhabdomyolysis. And I spotted that extra "e" in envenomation just after the friggin' edit button vanished on me. What can ya do? Wendy CO EMT-B Link to comment Share on other sites More sharing options...
BryanDyinToBeAMedic Posted April 11, 2008 Share Posted April 11, 2008 she was grabbing at her crotch did she take a look at it too see if there are any diformities? where did she brush somethign off of her? Link to comment Share on other sites More sharing options...
spenac Posted April 14, 2008 Author Share Posted April 14, 2008 she was grabbing at her crotch did she take a look at it too see if there are any diformities? where did she brush somethign off of her? Thank you for joining in and playing the game. Perhaps will catch you in chat. Well Wendy has even made the hospital look bad. They did what she has found is no longer in favor. Patient that this scenario with many changes to it to protect the innocent also had to have dialysis I found out. In the ambulance we did treat with promethazine, morphine, toradol, oxygen, heat packs as Wendy mentioned taped in place, Calcium gluconate gel form rubbed on to site, cold pack at bite site, and more but do not remember for sure all of it. EKG beyond being Tachy was unimpressive, perhaps some very mildly elevated T waves. Wendy very impressed. Good job. Nice to see a basic reaching for more in depth info. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted April 14, 2008 Share Posted April 14, 2008 So it was a black widow spider bite, come on give credit where credit is due!!!!! You know you want to Spenac. Link to comment Share on other sites More sharing options...
spenac Posted April 14, 2008 Author Share Posted April 14, 2008 So it was a black widow spider bite, come on give credit where credit is due!!!!! You know you want to Spenac. Congrats are due to ......................................... Leener for being the person that suspected spider bite in the outhouse. And congrats to the winner of name that spider go to .......................................Ruff. And honorable mention goes to ...............................Wendy for going way beyond her level, for not being satisfied with the basics. Two very important lessons, maybe more, came from this. 1. No matter our level of certification we should strive to continue our education. 2. Not all doctors stay up to date. So if you require treatment don't just take the docs word for it, do some research. Link to comment Share on other sites More sharing options...
Recommended Posts