Just Plain Ruff Posted January 1, 2009 Share Posted January 1, 2009 I have no problem using my field guide for this problem nor do I have a problem using a drip chart that helps me out. I have no problem admitting that I use a cheat sheet every time I start a dopamine, nitroprusside, dobutamine or epi drip. As long as the drip rate chart is correct I have no problem using it. This does not make anyone a lesser medic. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted January 1, 2009 Share Posted January 1, 2009 Ok, since nobody else is chiming in here is one off the top of my head. Woman in active labor, child is stuck in the birth canal due to shoulder distocia, (I think I have that right). What is your treatment. Link to comment Share on other sites More sharing options...
tniuqs Posted January 1, 2009 Share Posted January 1, 2009 I have no problem using my field guide for this problem nor do I have a problem using a drip chart that helps me out. I have no problem admitting that I use a cheat sheet every time I start a dopamine, nitroprusside, dobutamine or epi drip. As long as the drip rate chart is correct I have no problem using it. This does not make anyone a lesser medic. Nope in fact a smarter medic, PEPID has proved with out shadow of a doubt that peds and neonatals benifit with the use of PDA .... re: underdosage and over dosage .... want the link to the studies ? Thing is if the plastic brain fails ... get the pencil out, got you still gotta know the basic math. cheers but really how often does this occur ... like really? Link to comment Share on other sites More sharing options...
mobey Posted January 1, 2009 Share Posted January 1, 2009 I am sooo glad the discussion went this way. Of course being a student I have to do all the math on paper, and lots in my head right now, but when I hit the street I do plan on using the aids. I am glad that does not make me lesser of a medic! Link to comment Share on other sites More sharing options...
tniuqs Posted January 1, 2009 Share Posted January 1, 2009 Ok, since nobody else is chiming in here is one off the top of my head. Woman in active labor, child is stuck in the birth canal due to shoulder distocia, (I think I have that right). What is your treatment. Firstly yes you do. How long ? Whats the time frame, any fetal heart beat rate ? any decels ? Cephalic presentation ? Footling presentation ? Any CPD ie Cephalo-pelvic disproportion ? Prima gravida ? go LOL. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted January 1, 2009 Share Posted January 1, 2009 Yeah, It's been a long time since I've had to figure up the formula for dopamine. I've always had the cheat sheet resource or the fiield guide. But yes I can still do it on paper if needed. Link to comment Share on other sites More sharing options...
tniuqs Posted January 1, 2009 Share Posted January 1, 2009 Yeah, It's been a long time since I've had to figure up the formula for dopamine. I've always had the cheat sheet resource or the fiield guide. But yes I can still do it on paper if needed. Why go Dopamine in the first place ... I would go Epi. Link to comment Share on other sites More sharing options...
Eydawn Posted January 1, 2009 Share Posted January 1, 2009 Sidetrack... can someone explain the benefits/risks of using dopamine vs using epi? I only recently realized what dopamine is and why we use it... Just curious. Wendy CO EMT-B Link to comment Share on other sites More sharing options...
tniuqs Posted January 1, 2009 Share Posted January 1, 2009 Good query, dopamine is a precurser and dependant on dosage has numerous effects, around 5 is renal and mesentaric artery effects ... is this needed in the neonatal? then positive chronotropic over 10 mcs/kg /min.. yes neonatals respond with increased rates to compensate, unlike adults witch is positive inotrophy ... ie starlings laws so alpha and vaso constriction becomes quite a factor. Vent will most likely deal with sepsis as neonates respond with odd coagualopathys quite typical in sepsis and epi will increase PVR and your ahead of the issues, BUT when your kid is not responding to fliuids you have major concerns like death. cheers looking forward to ventmedics comments. Link to comment Share on other sites More sharing options...
spenac Posted January 1, 2009 Share Posted January 1, 2009 Firstly yes you do. How long ? Whats the time frame, any fetal heart beat rate ? any decels ? Cephalic presentation ? Footling presentation ? Any CPD ie Cephalo-pelvic disproportion ? Prima gravida ? go LOL. Rapid transport. May have to place fingers into vagina and form an airway, if able suction mouth then nose. May even need to provide supplemental oxygen. If way out at the end of nowhere this will be your longest ride ever. If head has protruded from vagina makes your job much easier. You also have to encourage mother not to push, which all the women says is tough. Link to comment Share on other sites More sharing options...
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