Amazing Call I Just Heard Dispatched

[Dustdevil]

In some regions, physicians have observed thiamin deficiency brought about by severe malnutrition, particularly in diets consisting mainly of polished rice, which is thiamine deficient.

I suppose that would explain why all Asians are crazy.

[tniuqs]

I totally agree on the thiamine. You're right. All too often NH pts. are under-nourished.

Firedoc: love you man but the assumption that most are dehydrated and malnourished is well just that, we must look to evidence based medicine to guide us in treatment guidelines not wrote protocol, and statistics. The geriatric patient is often far more complex than "well, their just old" they must be this or that.

Then the patient is evaluated in ER with all the blood workup, that evaluation of that now may falsely lead the ER MD or bloodwork results fowarded to the GP and could falsely indicate that that individual is NOT suffering from malnutrition hence no action taken and a negative feedback loop is generated ... the revolving door senario and now Paramedics have caused this Iatrogenic disorder .... following ?

cheers

[tniuqs]

I suppose that would explain why all Asians are crazy.

ONLY the rich ones, and mostly politicians .... the common asian women gets the unpolished rice and rich in B1 and then there is all that roughage.

Thats why there so hot!

lol

[Mateo_1387]

The fact that you would even have that image on your computer is disturbing. :shock:

Interpol tracks that kind of stuff. The US is the only country where it is still legal. I'd scrub my hard drive if I were you.

With the exposure of Dust, I had to take a picture and post for all to see !

(I used Jake's computer to upload the picture, I did not want to be tracked with that stuff.......BTW, he wants the name of your outside designer, should I tell him to call the local Squad?)

[firedoc5]

Firedoc: love you man but the assumption that most are dehydrated and malnourished is well just that, we must look to evidence based medicine to guide us in treatment guidelines not wrote protocol, and statistics. The geriatric patient is often far more complex than "well, their just old" they must be this or that.

Then the patient is evaluated in ER with all the blood workup, that evaluation of that now may falsely lead the ER MD or bloodwork results fowarded to the GP and could falsely indicate that that individual is NOT suffering from malnutrition hence no action taken and a negative feedback loop is generated ... the revolving door senario and now Paramedics have caused this Iatrogenic disorder .... following ?

cheers

I guess I should have elaborated some. I was meaning that if a NH patient appears to be under-nourished (not malnourished) and you have a somewhat long ETA, it wouldn't hurt to call medical control for permission for Thiamine. Hopefully the NH Nurse will give you a report of how their appetite has been. I only had to do it a few times and each time permission was granted. And as far as I know, no more than we give can do no harm. (I might get swamped for that statement). But how many times have you brought a NH pt. in and before you are done with your paperwork they are giving Thiamine?

[EMS49393]

First of why are you defending someone else ? I have been in many nursing homes that to an Awesome job of caring for the elderly, the assumption that all should be lumped into one catagory is not only folly but disrespectful. How in hell are we going to as a proffession recieve recognition if we slam and lump all into the same group, I just wonder what the LPNs and Caregivers say when the gods gift to paramedicine arses leave the building .... plant seeds, not burn crops if you see where I am going with this, don't forget you are judged too.

Interesting but the issue of pushing thiamine for nutritional issues is a bit beyond most Paramedic concerns, can one from a clinical observation diagnose malnourishment ... the primary reason for giving this medication is Wernicke-Korsakoff. As stated prior its not a bad thing to do but if you were going to go this step, why not give Mag Sulfate as well ? Most chronic malnourished suffer from hypomagnesemia, its the protocol monkey attitude that annoys myself to no end.

cheers

First of all, take a Valium, and get off of you high-horse. Spellchecker broken? Where'd you get that nice blurb on Wernicke-Korsakoff Syndrome? They might like some credit. I'm far from a protocol monkey. I know what I what I know thanks to several years in college. I know that hard to believe, but some American paramedics actually went to college, not a parapup mill. Lest ye be judged? Take a look at yourself with your condesending statement directed at me.

Second of all, I'm not defending any postition but my own. I have yet, in nearly 15 years, seen a "good" nursing home. Take into consideration I have worked in the inner city slums nearly my entire career. Maybe surburbia is different. Maybe Canada is different. I wouldn't know, I live and work in the US. If you have never experienced any US nursing homes from a paramedic standpoint, you have no idea what I'm talking about, so before you make yourself look like a total ass, you should probably retreat.

Lumping everyone in the same group? You bet. Everyone is an idiot until they prove to me otherwise. Good job.