captainstandup Posted October 15, 2007 Share Posted October 15, 2007 I have this one or mine may be an updated version of this one as it has two CD's instead of the audio cassette. In any event I would suggest searching for the most up to date version of this text. Heart Sounds and Murmurs: A Practical Guide Barbara Erickson (Author) Paperback: 129 pages Publisher: Mosby-Year Book; 3 Pap/Cas/ edition (January 15, 1997) Language: English ISBN-10: 0815131461 ISBN-13: 978-0815131465 Product Dimensions: 9.5 x 7.4 x 1.3 inches Shipping Weight: 1.3 pounds Link to comment Share on other sites More sharing options...
EMS_Cadet Posted October 15, 2007 Share Posted October 15, 2007 Hmmm...Very interesting scenario! I'm very tempted to think that this is acute pulmonary edema. I am, however, reminded that no patient is "normal" or "textbook". As an EMT (and EKG guru) waiting to state test, this is my line of thinking: More than likely, this patient has suffered a previous anteroseptal MI, causing acute heart failure. The presence of the Q waves in the septal and anteroseptal leads leads me to believe there was an old infarction. Also, since the bundle branches are contained in the septal area, an old infarction could possibly damage the LBBB. The septal damage is probably causing LV dysfunction, resulting in acute pulmonary edema. As for the presentation, it sounds like a classic CHF case with the exception of the BP. However, this patient could be one of those "odd" people that has a fairly normal BP even during a major cardiac event. Also, does the patient have any edema, JVD, or abnormal cardiac tones? I also would LOVE to get a BGL on this man. I don't think anyone has asked for one, despite his NIDDM. I said it a while ago...Honestly, I wasn't thinking a valvular issue, but it did cross my mind. Link to comment Share on other sites More sharing options...
chbare Posted October 16, 2007 Author Share Posted October 16, 2007 Oops, so you did. My mistake. Take care, chbare. Link to comment Share on other sites More sharing options...
captainstandup Posted October 16, 2007 Share Posted October 16, 2007 What a great learning opportunity, thanks again. Unfortunately the Critical Care Service I work for now is hospital based and all they care about is JACO accreditation bullshit. Our training program is virtually non existent therefore we have to find creative ways of training. We have universities and Community Colleges that provide a great deal of training and education thankfully. Most of the CCEMTP's work really hard to remain current and I myself get roughly 250 hours per year but it takes effort to say the least! I must tell you this is outstanding and fun. I have already told over half of my colleagues to visit EMT City. Link to comment Share on other sites More sharing options...
katbemeEMT-B Posted October 16, 2007 Share Posted October 16, 2007 Great scenario and an awesome learning experience for me. Thanks for sharing chbare. Link to comment Share on other sites More sharing options...
DwayneEMTP Posted October 16, 2007 Share Posted October 16, 2007 Chbare and the two Docs make incredible scenarios, always difficult, but relevant but it's often for nothing as very few participate...Pretty cool chbare got so many people!!! Any chance to get you guys to post regular if we promise to come and play? I think this thread made me review about 6 months of A&P and 4 months of medic school in two days...Pretty cool... Link to comment Share on other sites More sharing options...
MeekoBB Posted October 16, 2007 Share Posted October 16, 2007 You know, I was just reading through this scenario and there were areas that kept nagging that voice in my head that I've read this somewhere....then the word regurgitation popped in my head just before I scrolled down to find the dx of AMR. Another interesting part in my head at least, when I read about MR in my patho book, not even an hour later I had transported a patient with the dx of MR to go to another facility for cardiac catherization. I saw the mitral regurgitation on the paper and was like "Oh!!! I know what that is!!" I think I freaked the unit nurse out :roll: Link to comment Share on other sites More sharing options...
CBEMT Posted October 16, 2007 Share Posted October 16, 2007 With no RSI option here, I predict a very long 20 minute transport ahead of me.... Link to comment Share on other sites More sharing options...
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