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We were called for nursing home to a severe hypotensive patient. Upon arrival, we found a 85 yo female severe pale, conscient but disorientated in space and time. The nurse state that the patient had a vomit episode 2 hours before, and had a severe diarrhea since yestarday. In the last 30...

He was watching tv. The patient did not remember anything else from "waking" laying on the floor.

We receive a call to a 67 yo male with possible seizure and syncope. When we arrive, we found a severe pale male, but with recovered mental status. GCS 15. Pupils equal and sluggish to light. His son, who is a nurse tell that his father had an absence seizure with some myoclonic moviments on...

The best health tips to everyone, is, definelly cut carbs and excess of animal foods. Low carb plant based diet (with some animal protein), is the best diet.

In this specific case, I don't think that a combi of salbutamol and ipratropium bromide is an reasonable option. I would prefer a combi of salbutamol and budesonide, and some IV hydrocortisone. How is his vitals? HR and blood pressure? Despite of that, I will give IV paracetamol/acetaminophen...

In our system, we use (and abuse) in NS and LR, specialy if systolic BP <90 mmHg Plasmalyte its pretty rare in trauma situations.

What kind of crystalloid do you prefer to use in hypovolemic shock in trauma calls, when you are on an unit who have no blood units (ILS)?

@MonkeyArrow In Portugal (Europe), most ER doctors wear lab coat.

A 57 yo f, complaining of chest pain, dyspneia and palpitations. P.S.: I was not on scene, so I did not a lot of details.

At my night shift on a ILS service (me-EMTB and a pre-hospital RN), we received a call at 7 am for a rural area. A 50 year old man with weakness, diaphoresis, and chest pain that radiates to the back and left arm. When we arrived, we found him lying in bed, being assisted by local firefighters...

The video has 18 minutes, but it's worth it. Everyone, especially young and healthy people, should have a chance. http://www.youtube.com/watch?v=vDHUBu_Kl6k

At least I can't see P wave. Is it not a sign of A-fib?

I use to compare the apical pulse, with radial pulse. Just that. Besides, I only listen lungs sounds.

^^ This :) My bad:ph34r:

ASA ciprofloxacin or azithromycin ( I guess azithromycin have less serious secondary effects) epinephrine 1:10000 IV fentanyl promethazine And if its possible, normal saline/IV fluids and oxygen.

Indeed. An SNF nurse is quite diferent trainning and competences than an ICU/ER Nurse or even an CRNA.

I agree that they are different systems. And I agree also that a nurse with no experience in PH has no ability to work in the area, even because work in a hospital, even with critical patients, is totally different than working in PH, but I can not see the problem of RN-Paramedic bridge...