akflightmedic Posted August 26, 2007 Share Posted August 26, 2007 Aortic tear with sub arachnoid bleed...see it all the time Cease all efforts, he is going to die. Get a sheet ready. Link to comment Share on other sites More sharing options...
ninjaemtff Posted August 26, 2007 Share Posted August 26, 2007 Can basics in NJ place 3 leads? If so, a simple EKG strip would be nice to see. Just a question...where in the US, can basics doe 3 leads or EKG's? Link to comment Share on other sites More sharing options...
JakeEMTP Posted August 26, 2007 Share Posted August 26, 2007 Just a question...where in the US, can basics doe 3 leads or EKG's? I thought it was a EMT-B skill to obtain a 12 lead, or 3 lead in this case, but they cannot interpret it as they haven't the proper education as yet? Link to comment Share on other sites More sharing options...
Eydawn Posted August 26, 2007 Share Posted August 26, 2007 In the state of Colorado (where I am) you can get your EKG cert. This means you can place a three lead on a patient and take a look at the strip, but not make any sort of differential diagnosis or treatment based on it. Basically you can get a rhythm strip for ALS going with this cert, and some of the really obvious stuff jumps out even at basics, like asystole or V fib, etc. Now, I don't *think* they've changed that since the last time I looked. I remember a few community colleges offering the EKG class last semester, but hey, they just issued new protocols for all of us so I may be wrong. Wendy CO EMT-B Link to comment Share on other sites More sharing options...
Eydawn Posted August 27, 2007 Share Posted August 27, 2007 With our patient, I'd call him a stay and play with ALS so close by and do supportive care, reassurance, re-monitor vitals, etc. It's not going to really adversely affect your transport time, and while it looks like a simple concussion, something in the subject line makes me suspect something else like a CVA of some sort, or perhaps a medication or low blood sugar induced altered mental status. Since a paramedic can do a glucose stick and I can't in NJ, and the patient doesn't seem to be in critical condition, I think it's a valid call for stay and play while waiting for intercept. Ok, now what did I miss? Wendy CO EMT-B Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted August 27, 2007 Share Posted August 27, 2007 I was talking to a trauma surgeon the other day as well as another physician(both teach ATLS) and they cited research that fully 50% of all crossover accidents are medically caused. Meaning, the person suffered some sort of medical problem(ie MI, syncope, diabetes etc etc) which caused them to cross the center median. The other 50% is caused either by stupidity or alcohol of which stupidity would qualify for the entire 2nd 50%. Maybe 5% is caused by mechanical failure. Link to comment Share on other sites More sharing options...
dahlio Posted August 27, 2007 Author Share Posted August 27, 2007 That's actually quite interesting. Considering you don't smell alcohol, it's looking like a medical problem. ALS is here, what do you want to know now? Link to comment Share on other sites More sharing options...
zzyzx Posted August 29, 2007 Share Posted August 29, 2007 Ask him if he has a history of seizures. And, obviously, check his blood sugar now that ALS is here. Link to comment Share on other sites More sharing options...
Freaknuggetz_chick Posted October 22, 2007 Share Posted October 22, 2007 ok, so buddy is confused. post MVC. minimal damage. considering confusion, difficult to rule out c-spine, so: approach, c-spine, standing take down. all-the-while talking, gathering history (what we can) etc. Hx: LOC? what happened? medications? allergies? PMHx? primary survey, secure patient. primary should include stroke assessment ALS so close, package and get prepped for ALS. Reasess, VS (including BGL in canada). high flow O2, IV (rate dependant on BP, or saline lock), minimum 3 lead ECG, 12 lead in back of ALS unit. Link to comment Share on other sites More sharing options...
dahlio Posted October 22, 2007 Author Share Posted October 22, 2007 He can't remember anything, and he keeps asking you what is going on. No meds/allergies from what you get from him. ALS gets a BGL of 104, nothing on 3 or 12 lead. There was damage in the car, yet most of which occurred on the front passenger side. You play doctor, what could this be? Link to comment Share on other sites More sharing options...
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