Guest Posted April 18, 2006 Share Posted April 18, 2006 Tamponade from shearing Nice try, Arrest from Hypoxia! Horses not Zebras! How bout a little electricty? What do you think? Protect an AIRWAY YET? tick tick tick! :roll: Link to comment Share on other sites More sharing options...
Callthemedic Posted April 18, 2006 Share Posted April 18, 2006 Looks around for medic :shock: Of course but the underlying problem is still there and isn't going away. I can buy him more time with acls but can't get the fluid off. I could have treated the fulmination with an aerosol and got some gas exchange, but that is probably not on the truck. So, knowing I can do something tube, and ventillate with 100% , start cpr, epi down tube,check pulse and shock. I don't know what good it would do. Until the fluid comes off he's a dead man. Link to comment Share on other sites More sharing options...
Guest Posted April 18, 2006 Share Posted April 18, 2006 Looks around for medic :shock: Tube, and ventilate with 100% , start cpr, epi down tube,check pulse and shock. Great! Perfect! Epi in V Tach? :roll: Lets try a shock? Shock? Yes! OK, cardioverted @ 200 j's....Aysyole! Damn, witnessed Asystole......TCP @ 80.....guess what, a Pulse, radially, good capture. OMG! Yes u can......! PEEP try 5 cm h20 ......SOB ODS? thread? Overcome osmotic pressures with positive pressure ventilation's? V/S: LOC: Starting to fight the Tube. B/P: 90/50. SaO2 92% on BVM @ 12 BPM 5 to 7 kg per breath, with 5 of PEEP. Rid will like this, EtCO@ now at 42 slowly going down to 38 mm hg. OK, 20 minutes out now. Information Patch! ??????? Link to comment Share on other sites More sharing options...
Guest Posted April 18, 2006 Share Posted April 18, 2006 Ok now in ER. You suddenly become a MD its magic! Where do we go from Here? :twisted: The EMT gives a great history, Paramedics drinking Tim/s and hitting on the RNs! Lasix? Dopamine drip? CCU consult? Link to comment Share on other sites More sharing options...
ERDoc Posted April 19, 2006 Share Posted April 19, 2006 Guess the doc isn't going to be able to get too much more info from the pt. I would first reasses ABCs, confirm tube placement, manual BP by my well seasoned RN. Completely expose if not done already. We need a full trauma workup including xrays (chest, pelvis, femur, hip, knee), CTs (pan scan at this point), labs (basics trauma labs plus cadiac enzymes (will be positive at this point), BNP, Dig level, ABG with K), blood and call trauma team, if we have one (no medical team would touch this pt due to the fall, his life depends on the surgeons (hope he's made his peace with whatever god he beleives in)). Need to drop in a cordis in the IJ for TVP and a femoral cordis for blood/pressors/etc. 12 lead would be nice. Would also be thinking about dropping in some digibind. Let's start there and see where it gets us. Link to comment Share on other sites More sharing options...
Callthemedic Posted April 19, 2006 Share Posted April 19, 2006 I had a ventillator on my BLS rig? I have a......job? I see that epi is secondary survey by opening the book I use as a coffee coaster. Now that i'm a doc, I just want credit for everything..........or operate on his brain. I don't think there's anything wrong with his brain, I just think it would be cool to crack his nut. Then I would flirt with the nurses. digoxin level Toxicology abg's (vent settings) chem panel (electrolytes) urine cath (hopefully we will need it) lasix (to make pee pee) CXR EKG What is the vent setting? SIMV/IMV/Control (probably old terminology) Were there other EMT-Bs on the run? I don't want to hog all the limelight. Link to comment Share on other sites More sharing options...
Callthemedic Posted April 19, 2006 Share Posted April 19, 2006 VS De De Deeee Link to comment Share on other sites More sharing options...
EMT City Administrator Posted April 19, 2006 Share Posted April 19, 2006 Hello, There were some posts that were removed as this tread went off topic. The post that sent it off topic was removed, making the posts that followed confusing and off topic. If anyone has concerns about this, please PM me. Thanks Admin Link to comment Share on other sites More sharing options...
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