chbare Posted October 15, 2007 Author Share Posted October 15, 2007 -Your partner attempts to assist his respiration; however, he becomes agitated and pulls away from attempts at BVM assisted ventilation. He continues to tolerate the NRB however. He currently has a GCS of 15. -Rhythm strip in lead II: Sinus tachycardia without ectopy. Intervals appear within acceptable limits. -No history of CHF or COPD is noted. Take care, chbare. Link to comment Share on other sites More sharing options...
spenac Posted October 15, 2007 Share Posted October 15, 2007 12 lead? Link to comment Share on other sites More sharing options...
akroeze Posted October 15, 2007 Share Posted October 15, 2007 Lung Sounds? Do I have my line? I want a XII lead done. If no RVI (don't suspect it at this point really), he's crackling and I have my line I'm going to go ahead and give him 0.4mg Nitro SL q5min. Also, 160mg ASA PO and rapid transport as close to after the first administration of nitro as I can as I don't have CPAP on my truck. Link to comment Share on other sites More sharing options...
chbare Posted October 15, 2007 Author Share Posted October 15, 2007 -IV life line is established. Lung sounds: crackles throughout all lobes anterior and posterior aspects. Or any other type of nomenclature you use to describe wet lung sounds. Take care, chbare. Link to comment Share on other sites More sharing options...
akroeze Posted October 15, 2007 Share Posted October 15, 2007 Actually, I'm going to go ahead with the nitro regardless of what I hear in his lungs but I'd still like to know what I hear as it may effect other Tx. Link to comment Share on other sites More sharing options...
akroeze Posted October 15, 2007 Share Posted October 15, 2007 -IV life line is established. Lung sounds: crackles throughout all lobes anterior and posterior aspects. Or any other type of nomenclature you use to describe wet lung sounds. Take care, chbare. Perfect. Tx as above: Nitro 0.4mg q5min ASA 160mg Continue high FiO2 Initiate high flow diesel Link to comment Share on other sites More sharing options...
chbare Posted October 15, 2007 Author Share Posted October 15, 2007 -12 lead ECG: Sinus tachycardia without ectopy. LBBB noted with Q waves in V1, V2, V3, and V4 along with poor R wave progression. No ST elevation, depression, or acute T wave changes noted in any leads. -You administer NTG 0.4 mg SL and ASA 160 mg chewed. In between doses of NTG you begin to set up your BIPAP machine. Take care, chbare. Link to comment Share on other sites More sharing options...
ERDoc Posted October 15, 2007 Share Posted October 15, 2007 -12 lead ECG: Sinus tachycardia without ectopy. LBBB noted with Q waves in V1, V2, V3, and V4 along with poor R wave progression. No ST elevation, depression, or acute T wave changes noted in any leads. :shock: :shock: I'm going with testicular torsion vs PID. Link to comment Share on other sites More sharing options...
chbare Posted October 15, 2007 Author Share Posted October 15, 2007 You may be onto something with the torsion. Syphilis, possibly. PID, unlikely in this guy, but not unheard of I suppose. :shock: About 20 minutes into your 45 minute transport you have the following V/S: P-130, R-36, B/P-120/84, Pulse oximetry-86%. He is developing a noticeable amount of lethargy and appear to be very "tired of breathing." Do we continue onto BIPAP therapy at this point? What is going on with this patient? Take care, chbare. Link to comment Share on other sites More sharing options...
spenac Posted October 15, 2007 Share Posted October 15, 2007 FTD Link to comment Share on other sites More sharing options...
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