the 100% directionless thread

fm_emt

Useless without caffeine
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Wisdom teeth out Tuesday. And I guess they'll give Norco. I've never had anything stronger than Tylenol or ibuprofen before and I'm kinda scared of meds tbh. But I'm scared of the dentist and getting teeth yanked, too.

It's so much easier to deal with stuff when you're not the pt.

Non medical Advice for dealing with this? Suggestions for how to chill out?
cannabis. :D

ok, there's a few good things about California.
 

fm_emt

Useless without caffeine
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I thought the chat room was for day to day conversations?
it can be for that too! if your heart desires. :D but I found that if I don't check it for a day, stuff scrolls off and it's lost forever.
 

Fezman92

NJ and PA EMT
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100
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Had my first hot transport on my last shift. Male 49 years old. Went in earlier in the day for a 10/10 headache. He was completely fine, walking around and talking when out of the blue he crashed. Completely aphasia. They call us for a critical care transport to the local stroke center. We get there and met up with our CC medic. PT had a subarachnoid hemorrhage. He’s most likely going to be a vegetative state for the rest of his life because for some reason they waited a few hours. No idea why they didn’t fly him out of call someone else.

Also “+++”? What’s that?
 

Akulahawk

EMT-P/ED RN
Community Leader
4,924
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Also “+++”? What’s that?
Value is too high for the machine to display. Kind of like when the glucometers simply read "High" or ">550" instead of giving you a number.
 

Fezman92

NJ and PA EMT
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100
28
Yikes
 

Fezman92

NJ and PA EMT
497
100
28
I’m on my way to transport a CC PT, going from one hospital to another for a blood transfusion. I won’t be able to be in the back because it’s going to be CCRN and two medics plus the PT, so I’ll be riding shotgun. Should be interesting.
 

Peak

ED/Prehospital Registered Nurse
1,023
604
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...the dentist told me he'd just given me fentanyl. They also gave me or would give me Versed, Dexamethasone, Propofol, and NS.

Once whatever it was hit, I got this weird buzz and a few seconds later I woke up in my car out of it, boyfriend says I was in a WC all limp with my head straight down. They tried to get to to get into the car by an assisted walk, but I was just too flaccid and out of it so he says he just picked me up and put me into the car. I don't remember this part.

@Carlos Danger How do you feel about that PACU discharge?
 

Akulahawk

EMT-P/ED RN
Community Leader
4,924
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Back from the oral surgeon. I was going to ask about keeping my extracted teeth when the dentist told me he'd just given me fentanyl. They also gave me or would give me Versed, Dexamethasone, Propofol, and NS.

Once whatever it was hit, I got this weird buzz and a few seconds later I woke up in my car out of it, boyfriend says I was in a WC all limp with my head straight down. They tried to get to to get into the car by an assisted walk, but I was just too flaccid and out of it so he says he just picked me up and put me into the car. I don't remember this part.

How do you feel about that PACU discharge?
Having recently gone through my hospital's procedural sedation (monitoring) training program, all I can say is: :eek::mad:
 

Fezman92

NJ and PA EMT
497
100
28
So that run was cool, just seeing it, the PT hooked up to the blood bags (right term)? Super odd case. PT came in with right shoulder pain. History of cardiac issues, vitals were fine, they did blood work and her levels were good. They did a CT scan. Turns out she had extensive lacerations of the liver. No visible signs, no bruising or swelling. PT denied any injury, no car accidents, no falls, nothing. Due to the spleen damage they had to do the transfusions. I’ve done two critical care calls (ok I did the driving for one and rode shotgun for the other) and both have been super bizarre ones. So happy I was able to get put on the ALS rig. Looking forward to working on the CHOP truck. I’d be driving an 11ft box truck with a mini ER in it. Driver, nurse, medic, and a respiratory therapist.
 

Akulahawk

EMT-P/ED RN
Community Leader
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Turns out she had extensive lacerations of the liver. No visible signs, no bruising or swelling. PT denied any injury, no car accidents, no falls, nothing. Due to the spleen damage they had to do the transfusions.
Spontaneous liver lacerations and spleen injury just doesn't happen. Absent something really odd/weird, I would highly suspect traumatic injury that she's not admitting to because she's protecting someone. It could be her, or someone else... but I think someone did something stupid (possibly while drunk or high) and she got seriously injured.
 

Fezman92

NJ and PA EMT
497
100
28
The thing is that there were no signs of any trauma. Her labs were perfect. Talking to the medics after they said that the hospital could have missed an aneurism that ruptured.
 
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Peak

ED/Prehospital Registered Nurse
1,023
604
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The thing is that there were no signs of any trauma. Her labs were perfect. Talking to the medics after they said that the hospital could have missed an aneurism that ruptured.

A normal H&H is common in early early trauma, as well as normal ranges for many other labs. Also if the patient is very early in trauma they may not have extensive external signs of trauma. Bruising takes time to manifest (and resolve) and cannot be used as a reliable timeframe indicator in trauma.

A ruptured AAA looked very different than liver lacs on a non-con, and you would have to be blind to confuse the two on a CTA.

Depending on mechanism I’ve seen plenty of non-criminal mechanisms of liver and splenic lacerations. I’ve seen plenty from people falling 20ish feet off a ladder who landed just right and didn’t have any other major injuries. We also see quite a few from skiing and snowboarding accidents that feel well for a surprisingly long amount of time before they come in. I’ve had quite a few grade III liver and spleen lacs who come in 24 plus hours in with a complaint of only abdominal pain.
 

Fezman92

NJ and PA EMT
497
100
28
Interesting. It was still very interesting to see.
 

DragonClaw

Emergency Medical Texan
2,116
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They mean you shouldn't have been sent home in that condition.

They usually have people chill out until they're walking and alert, but with COVID, I think they wanted to get people out of the door.

I dunno.

1-2 discomfort. I took 2 Norco yesterday 6 hours apart, but I couldn't tell if that made me a little wonky or not or if that was still the anesthesia.

My face is pretty much back to normal though. Swelling really went down. Only minor pain where the impacted tooth was.

Maybe they gave me too much sedative.

Afterall, I was asking about what meds they were giving me. After he told he he'd already administered the Fent, there was a small discussion on me size. Height and weight. He was surprised when I told him I was about 5'4.5" and 100 lbs. He didn't think I was that small under the blanket they'd given me to help me keep warm

So maybe they just gave me too much of everything. I dunno.
 
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