the 100% directionless thread

[Chris07]

Well...the puppy chewed the only other MacBook charger in the house. Roommate still hasn't replaced the one she chewed that was mine. Tried to blame me for the second one, "you left it on the ground!"

"Maybe you shoulda listened to what the other three roommates in the house said and not let her roam free at 14 weeks..."

"We'll now neither of us can use our laptops!"

"Looks like you're making a trip to the Apple Store to buy me that charger that you owe me then."

He didn't like that one much.

This pup is so damn cute but that's 200$ in computer chargers that she's destroyed...On top of the cash he already owes me for rent and the deposit I'm starting to lose my patience.

Time to start covering everything you own in Nuclear strength hot sauce.

 

[Handsome Robb]

+10000000000000.

The screws and bolts are the easy parts. Those dang plastic clips are a complete PITA. They are molded into the plastic trim so if you break the clip you can't buy a new clip.

x3

The plastic screw-pop-rivet type things are a close second in the PITA race.

Also, if you really feel like busting up some knuckles change the clutch in an EVO. Not fun. Books in AllData for like 14 hours or something ridiculous like that.

 

[Handsome Robb]

Time to start covering everything you own in Nuclear strength hot sauce.

Hahaha.

I just really hope she doesn't decide to chew on one that lights her up. "Paramedic Robb what do we do!?!?!?"

"What do I look like? A vet!?"

I would like to learn more about veterinary emergency medicine.

 

[NomadicMedic]

Hahaha.

I just really hope she doesn't decide to chew on one that lights her up. "Paramedic Robb what do we do!?!?!?"

"What do I look like? A vet!?"

I would like to learn more about veterinary emergency medicine.

No thanks. The stuff my wife does to dogs makes me cringe. I can do awful stuff to humans... But puppies? No way.

 

[Hunter]

That really sucks. I just ran on a 62yo that was beaten by her 7yo great grandson with a picture frame and a curtain rod. She had about a 10cm lac on her head and some bruising. Kid also broke the window out in their living room.

Dang...

No these are never fun, but feels good when you can leave your patient's laughing and feeling better about themselves even though they're in a :censored::censored::censored::censored:ty situation.

 

[Anjel]

Time to deliver some babies and start some IVs.

Labor and delivery then ER clinicals.

I am really starting to have. Love hate relationship with medic.

Only 350 more clinical hours to go!

 

[DrankTheKoolaid]

2 weeks of orientation done. Starting my 5 call this morning at AMR San Mateo. I have not been nervous like this since my first day of paramedic field internship 5 years ago!

 

[JPINFV]

So my child on pediatrics has rotavirus. Well, I guess that gives the RSV on me someone new to play with. :-/

 

[Aprz]

What do you mean? How would you note that electrical activity on the ecg? Do you mean the occasional blip or complex?

I was asking that question since we're assuming p-wave fibrillation can be so fine that it was indistinguishable from a flat isoeletric line.

Either way, wouldn't be distinguishable in the field and neither would really alter my course of treatment.

Although it probably wouldn't change our treatment prehospitally, it's an interesting discussion, and it would be nice if an admin can separate this if you, Clare, and Chase don't mind.

What I meant was constant electrical activity with low amplitudes. I believe that ventricular fibrillation can become so fine that people may call it asystole, but with treatment, changed monitor settings, or a 12-lead, you may see fibrillation waves.

This made me think about ACLS, and I kinda want to read the experience provider book to see if the answer is in there. It's obvious why we don't defibrillate asystole, but what if the fibrillation waves in fine ventricular fibrillation are so small that we call it asystole, or it's indistinguishable? If that's the case, the patient has probably been down for a long time. I imagine that it would be unlikely that they would respond to defibrillation for many reasons like hypoxia and the right ventricle being fluid overloaded, but would respond to chest compressions and epinephrine. Isn't asystole usually associated with somebody dead dead? I don't think epinephrine would create electricity for it to become a shockable rhythm. I just thought this was pretty interesting to think about since the AHA does pull stunts like this and try to consider provider errors in their algorithms.

Atrial fibrillation can be tricky sometimes. It can have fibrillation waves so small that it does look like a flat isoelectric line. It can look regularly regular if the patient is taking digoxin, or the fibrillation waves can be so course that it looks like atrial flutter (with a variable block).

When I interpret rhythms or 12-leads, I am not always 100% sure what it is, but I'll say what I think is most likely. I would be more comfortable if we had a longer rhythm strip and/or a 12-lead, but since we don't have that, based on the strip we do have, I think atrial fibrillation is most likely.

First, atrial fibrillation is the second most common supraventricular tachycardia. Probability is already on our side!

It's irregularly irregular without discernible p-waves, which fits atrial fibrillation best.

It's also fast which I think favors atrial fibrillation.

I am assuming that people are calling the fourth and seventh complex a premature contraction, which is something I considered though. It's late though... It would really be an escape beat instead. It also does not have a compensatory pause which makes it being a premature contraction less likely.

 

[Aprz]

Intentionally double posted in case our ECG discussion gets separated. I probably should've just started a new thread and quoted everybody. <_<

Good luck Corky! By the way, you are working fricken close to me... I live across the bay in Alameda County, and I regularly go to San Mateo County. I love Redwood City. I like to go to Johnny Rockets and Stacks (By the way, Stacks is my landmark where I turn to go to Sequoia Hospital, lol). Those are probably my most favorite AMR rigs.

 

[NomadicMedic]

Here's one for you.

37-year-old female, normally healthy and fit. Experiencing transient nausea and vomiting. This morning found tachycardic, experiencing sudden onset nausea, "can't keep anything down." No significant medical history, no meds, no allergies.


I know what you're thinking…

I thought the same thing.

And it turned out, I was right! My wife is pregnant, due in September.

And Zofran is her new best friend.

 

[chaz90]

Congratulations n7!

 

[NomadicMedic]

thanks Chaz.

By the way, what shift are you going to?

 

[DesertMedic66]

Here's one for you.

37-year-old female, normally healthy and fit. Experiencing transient nausea and vomiting. This morning found tachycardic, experiencing sudden onset nausea, "can't keep anything down." No significant medical history, no meds, no allergies.


I know what you're thinking…

I thought the same thing.

And it turned out, I was right! My wife is pregnant, due in September.

And Zofran is her new best friend.

Congrats!

 

[DesertMedic66]

2 weeks of orientation done. Starting my 5 call this morning at AMR San Mateo. I have not been nervous like this since my first day of paramedic field internship 5 years ago!

One of the medics I got deployed with to Hurricane Sandy was from AMR San Mateo. The way he talked about how they operate made me extremely jealous. Even their special operations uniforms looked pretty amazing.

If I ever decided to move up north that is probably where I would try to work at.

 

[Anjel]

Here's one for you.

37-year-old female, normally healthy and fit. Experiencing transient nausea and vomiting. This morning found tachycardic, experiencing sudden onset nausea, "can't keep anything down." No significant medical history, no meds, no allergies.


I know what you're thinking…

I thought the same thing.

And it turned out, I was right! My wife is pregnant, due in September.

And Zofran is her new best friend.

OMG!!!! Congrats!!!!!

 

[chaz90]

thanks Chaz.

By the way, what shift are you going to?

Great question, don't know for sure quite yet. I'm starting on A-shift for my evaluation period tonight, so I don't know if that means anything shift wise.

 

[NomadicMedic]

Great question, don't know for sure quite yet. I'm starting on A-shift for my evaluation period tonight, so I don't know if that means anything shift wise.

Nope. It doesn't mean anything. :/ I didn't know if they said anything...

 

[Epi-do]

Here's one for you.

37-year-old female, normally healthy and fit. Experiencing transient nausea and vomiting. This morning found tachycardic, experiencing sudden onset nausea, "can't keep anything down." No significant medical history, no meds, no allergies.


I know what you're thinking…

I thought the same thing.

And it turned out, I was right! My wife is pregnant, due in September.

And Zofran is her new best friend.

Congrats!!

 

[PotatoMedic]

So you going to name the baby zofran? Congrats!