defib_wizard Posted August 22, 2008 Share Posted August 22, 2008 I believe this patient has a occluded foley cath which is causing a sympathetic crisis. he needs his foley unclogged. I don't remember the mechanism but his full bladder is causing a release of norepinephrine. The distended bladder also stimulates the vagus nerve causing bradycardia. I would contact medical control to see about flushing the cath or removing it. Then reassess him. Link to comment Share on other sites More sharing options...
p3medic Posted August 22, 2008 Share Posted August 22, 2008 I believe defib wiz is barking up the right tree....autonomic dysreflexia.... Link to comment Share on other sites More sharing options...
zippyRN Posted August 22, 2008 Author Share Posted August 22, 2008 I believe this patient has a occluded foley cath which is causing a sympathetic crisis. he needs his foley unclogged. I don't remember the mechanism but his full bladder is causing a release of norepinephrine. The distended bladder also stimulates the vagus nerve causing bradycardia. I would contact medical control to see about flushing the cath or removing it. Then reassess him. medical control says good call take him to whichever of the closer EDs you think will be easier becasue of the traffic ... do you want the field physician who is in the town becasue of the carnival to see the patient or are you happy to transport him they also ask if he has any nifedipine with him ? and (skill level appropraite) to give standard dose of GTN if not Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted August 23, 2008 Share Posted August 23, 2008 why don't we first advance the catheter in just a little bit to see if the catheter is kinked or not? That woudl be a first step before we consider removing this catheter. Link to comment Share on other sites More sharing options...
firedoc5 Posted August 23, 2008 Share Posted August 23, 2008 Was the catheter a completely new sterile one, or a used one that had been cleaned and sterilized either at home or a doc's office? Had the catheter tube going into the bag been pulled or accidently yanked at anytime? Any bladder or prostate pain? (I might have missed that in the earlier posts). Any flank pain, such as kidney discomfort? Link to comment Share on other sites More sharing options...
Richard B the EMT Posted August 23, 2008 Share Posted August 23, 2008 T4 paraplegic following motorcycle RTC 4 years ago I'm probably going to kick myself, but...what is/are a/an RTC? Link to comment Share on other sites More sharing options...
Eydawn Posted August 24, 2008 Share Posted August 24, 2008 Can you Limeys and Aussies provide translation for the following drugs? I followed some of the gist, but I haven't memorized international pharmacology yet. This poor Yank is in need of edification! Nifedipine = ? Movicol =? and what is one sachet? Lansoprazol =? Thanks kindly... and glad to see that tentatively, it's an easy fix... Richard, I think RTC stands for Routine Traffic Collision... or some other R word and Traffic Collision. It's their equivalent for "MVA/MVI" Wendy CO EMT-B Link to comment Share on other sites More sharing options...
akflightmedic Posted August 24, 2008 Share Posted August 24, 2008 Nifedipine used to be a common drug on the ambulances is also called procardia. Lansoprazol is prevacid. Movicol is a laxative. Sachet are single dose medications individually wrapped. For example, Aussies may sometimes carry Ibuprofen and in their drug box they will have a sachet that has two tablets in it, and they just hand that to the pt instead of digging out of a big bottle. Another example of a sachet that you may be more familiar with is Goodys headache powder. Single dose individually packaged and in powder form. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted August 24, 2008 Share Posted August 24, 2008 Can you Limeys and Aussies provide translation for the following drugs? I followed some of the gist, but I haven't memorized international pharmacology yet. This poor Yank is in need of edification! Nifedipine = ? PROCARDIA or Adalat Movicol =? and what is one sachet? Each sachet of this medicine contains macrogol (polyethlene glycol '3350'), which is a type of medicine known as an osmotic laxative. Each sachet also contains sodium bicarbonate, sodium chloride and potassium chloride. The contents of the sachets are mixed with water to make a drink. Lansoprazol =? PREVACID Thanks kindly... and glad to see that tentatively, it's an easy fix... Richard, I think RTC stands for Routine Traffic Collision... or some other R word and Traffic Collision. It's their equivalent for "MVA/MVI" Wendy CO EMT-B What happens when we advance the catheter? Is the catheter clamped with the white clamp on the catheter? Could it be that simple?????? Link to comment Share on other sites More sharing options...
Eydawn Posted August 24, 2008 Share Posted August 24, 2008 Ah. Sachet = dose pack. Thanks! And movicol... the things they call laxatives... "move yer colon!" ROFL. Wendy CO EMT-B Link to comment Share on other sites More sharing options...
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