Static Cardiology

[MedicAsh]

Ok, so we attempted to do this in class and it was a disaster. Everyone tried to do it like dynamic cardiology but just verbalizing everything. So What ia a good way to prepare for the static portion??? It seems to be the one part that EVERYONE in class is really getting caught up in.

[medicKristina]

This is VERY different than what you do with the hands on portion. In our class, we wrote out our algorithm and became comfortable running through it from arrival to transport. Our scenarios always stated that the scene was safe, but don't forget that if needed!!

An Example for a patient with Stable SVT (based on scenario and strip):

Scene Safe

Vitals

Vagal Manuevers such as bearing down

6mg Adenosine IVP followed by 10ml saline flush

If no response, 12mg Adenosine IVP followed by 10ml flush

If no response, 12mg Adenosine IVP followed by 10ml flush

Prepare pt and begin transport

If no response, sedate patient with 5mg Versed IVP

Cardiovert patient (use the amount you are told to with biphasic v monophasic)

At that point our preceptors would simply change cards during NREMT exams or we would state "Transfer care to hospital and I'm done".

We were told to ALWAYS verbalize transport as part of the static

It's all about repetition and breaking it down to the basics.

Good luck!!

[P_Instructor]

Ok, so we attempted to do this in class and it was a disaster. Everyone tried to do it like dynamic cardiology but just verbalizing everything. So What ia a good way to prepare for the static portion??? It seems to be the one part that EVERYONE in class is really getting caught up in.

Relatively simple.....what do you have, and how would you treat it. Example: (caption) You have been dispatched to the residence of a 50 year old male. Your patient complains of severe chest pain rated as a 9 on 1-10 scale. He is very diaphoretic, cool, and ashen. Vitals are B/P 190/130, Resp 28 and shallow, Pulse 125. The patient states the pain started about 40 minutes ago and became worse. The patient has NKA and does not take any medications. The patient was working in his garden when pain first occurred. Provide oral treatment. (Strip) Sinus Tachycardia, no ectopics.

The rhythm appears to be a Sinus Tachycardia.

BSI, oxygen @ 15l/NRB, monitor, establish IV, 324mg ASA, NTG 0.4mg SL and reassess. No changes and B/P supportive, then 2nd NTG 0.4mg SL and reassess. If no changes and B/P supportive, 3rd NTG 0.4mg SL and reassess. If patient still having pain and vitals supportive, consider analgesic such as MS 2-4mg IV. Continue monitoring and transport.

Keep it simple but complete. This example would be a MONA type of situation. Of course, this is my interpretation and opinion, and there could always be variations on how others would respond to your inquiry. Good luck.

Edited June 10, 2010 by P_Instructor

[tskstorm]

Ok, so we attempted to do this in class and it was a disaster. Everyone tried to do it like dynamic cardiology but just verbalizing everything. So What ia a good way to prepare for the static portion??? It seems to be the one part that EVERYONE in class is really getting caught up in.

When we went over static cardiology, all the instructors wanted was the treatments that could be rendered. They didn't mess with us or give us too much into the scenario. Just "treat the patient" Just know the treatments for every strip, and remember the treatment for a pt in normal sinus rhythm(or other 'stable' rhythms there are no algorithms for is oxygen, and txp)

[MedicAsh]

Thanks everyone. That really does help. I was just confused at what they exactly wanted to hear. It all makes sense now. Thanks again!

[tskstorm]

Thanks everyone. That really does help. I was just confused at what they exactly wanted to hear. It all makes sense now. Thanks again!

You're welcome Good luck.

[speedygodzilla]

I just recently went through all my testing and static cardiology really didn't have much a scenario. Basically a small paragraph with the patient's presentation and vital signs. I ask the proctor at the start if I needed to include scene size up and he said no this is just skills portion. Still a good idea to ask to make sure every one is on the same page.

Always treat completely and assume that the rhythm and patient presentation does not change no matter what treatment is rendered.

A helpful acronym we were taught was every patient (in NREMT Skills) gets VOMIT

V-Vitals

O-Oxygen

M-Monitor (EKG)

I-IV

T-Transport

So at the very end I would just repeat the basics again making sure I fully covered VOMIT.

Good luck.

[Kiwiology]

Remember, while your test might still be stuck in the seventies actual praxis is not and has evolved beyond such a primitive approach to medicine, but ssssh do not tell the Houston Fire Department or other such reputable agencies.

Not every cardiac patient requires oxygen or cannulation, or amiodarone, cardioverison or adenosine ... treat the patient not the rhythm.

[tskstorm]

Remember, while your test might still be stuck in the seventies actual praxis is not and has evolved beyond such a primitive approach to medicine, but ssssh do not tell the Houston Fire Department or other such reputable agencies.

Not every cardiac patient requires oxygen or cannulation, or amiodarone, cardioverison or adenosine ... treat the patient not the rhythm.

EVERY PT requires o2 according to my protocols lol, I can't think of any protocol where we don't give o2 lol.