NYMedic828
Forum Deputy Chief
- 2,094
- 3
- 36
Had a call this morning in my volly area for a 94 year old female with acute on-set dsypnea at 8am. (im sure most people know what the problem is already)
Medic flycar is there before me, he takes vitals and puts her on O2. Tells me she hasn't been able to urinate x 2 days and has SOB with Rales bi-lat.
BP 164/82
HR 80 Irregular (a-fib)
RR - 18
SPo2 - 96 on room air.
ECG - A-fib stable.
Patient takes a cornucopia of meds but has Hx of CHF, A-fib and HTN.
She said this happens occasionally and she just needs IV lasix, which is available on standing orders here.
I gave her one nitro tablet 0.4mg SL.
After the nitro she said she felt worlds better, I asked her if she felt another would help and she said no she feels ok now. (Rales still present but improved)
Bp dropped to 144/62
Due to the stability of her condition, and being 5 minutes from the ER I opted not to bother starting a line to give Lasix. The Lasix didn't seem necessary pre-hospital. (the ER is just going to rip my line out to do their own anyway, and I didn't want this poor old lady to get poked for no real reason)
So I walk into the ER and this nurse asks what is going on. I told her
"Shortness of breath secondary to APE with bi-basilar rales"
She gives me a completely blank stare has no idea what im talking about. I put it into English for her and just said "Fluid in the lungs."
I then told her I gave 0.4mg of nitro and she still has rales but feels better. She then gave me this attitude over the fact that I felt it was wise to give nitro without starting an IV.
Since people don't take their own nitro without an IV at home all the time or anything... Its not like I gave nitro to a hypotensive she was 160 systolic.
Sorry just had to get all that off my chest. Nothing irks me more than nurses thinking they are better than us just because they have a higher title.
Medic flycar is there before me, he takes vitals and puts her on O2. Tells me she hasn't been able to urinate x 2 days and has SOB with Rales bi-lat.
BP 164/82
HR 80 Irregular (a-fib)
RR - 18
SPo2 - 96 on room air.
ECG - A-fib stable.
Patient takes a cornucopia of meds but has Hx of CHF, A-fib and HTN.
She said this happens occasionally and she just needs IV lasix, which is available on standing orders here.
I gave her one nitro tablet 0.4mg SL.
After the nitro she said she felt worlds better, I asked her if she felt another would help and she said no she feels ok now. (Rales still present but improved)
Bp dropped to 144/62
Due to the stability of her condition, and being 5 minutes from the ER I opted not to bother starting a line to give Lasix. The Lasix didn't seem necessary pre-hospital. (the ER is just going to rip my line out to do their own anyway, and I didn't want this poor old lady to get poked for no real reason)
So I walk into the ER and this nurse asks what is going on. I told her
"Shortness of breath secondary to APE with bi-basilar rales"
She gives me a completely blank stare has no idea what im talking about. I put it into English for her and just said "Fluid in the lungs."
I then told her I gave 0.4mg of nitro and she still has rales but feels better. She then gave me this attitude over the fact that I felt it was wise to give nitro without starting an IV.
Since people don't take their own nitro without an IV at home all the time or anything... Its not like I gave nitro to a hypotensive she was 160 systolic.
Sorry just had to get all that off my chest. Nothing irks me more than nurses thinking they are better than us just because they have a higher title.