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  1. MonkeyArrow

    MAP Question

    But what about orders that require you to give a medication if a MAP is below a number. For example: start an epinephrine drip if MAP is below 65.
  2. MonkeyArrow

    the 100% directionless thread

    http://www.medmalreviewer.com/case-13-cervical-fusion/
  3. MonkeyArrow

    Dizziness while driving

    I'm now thinking DKA (probably caused by underlying infection) that is causing hyperkalemia. If calcium and bicarb haven't been given yet, lets do so. Let's give him a lot of insulin and avoid intubating if at all possible. Physiologically a nightmare tube. Probably now has pulmonary edema from...
  4. MonkeyArrow

    Dizziness while driving

    12 lead: tachycardia at ~110, not very convinced this is Afib RVR as rhythm strip appears regular enough, especially in the last 3/4 of the strip. Suspect acute MI due to elevation in v1 and v2, reciprocal depression inferiorly, and hyper acute T waves globally, although TCA overdose and...
  5. MonkeyArrow

    the 100% directionless thread

    Pan searing with a nice butter baste is definitely the only way I cook steak now, as of two or three years ago. Never putting another steak on a grill again. The only thing I haven’t figured out yet is how to scale that up for more than a couple steaks at once.
  6. MonkeyArrow

    the 100% directionless thread

    I'm curious. What were the indications to do a nasal intubation?
  7. MonkeyArrow

    Survival Flight Ohio Fatal HEMS crash

    I'm certainly not an expert on how calls for service get routed in the HEMS world, but why does more than one program even get an opportunity to take the call for an emergent flight? Certainly if you [as a hospital/scene provider/whatever] get turned down once due to weather, you wouldn't...
  8. MonkeyArrow

    Fluid Resusitation?

    RT. I can't count the number of times I heard our ED physicians say yesterday "lets just start the sepsis bundle so we don't get dinged" on people who the sepsis bar fired on, even though they obviously weren't septic. It doesn't help the patient, is not good medicine, and may worsen the...
  9. MonkeyArrow

    What is the best multitool knife to get?

    What model is that? And is your hand that big or the tool that small? I currently have a Leatherman Sidekick and Wave, but have been looking for something smaller/lighter that still has a decent set of pliers to more reliably carry every day.
  10. MonkeyArrow

    HyperK/Ventolin

    NS/fluids would actually help this patient, albeit marginally, but in the absence of calcium, may have been worth a consideration. Fluids would help "dilute" the blood, thus reducing the K concentration and further downstream, help increase urine output and thus K excretion.
  11. MonkeyArrow

    Here it is: PARAMEDIC-2 study paper - Epi vs. placebo

    I would really love to see someone tackle replicating Meantzelopoulos 2013 (https://www.ncbi.nlm.nih.gov/pubmed/23860985) which showed significantly better ROSC and survival with CPC 1/2 after a vasopressin-epinephrine-steroids cocktail over just epi in an in-hospital cohort. It looks so...
  12. MonkeyArrow

    EMT seen on video beating restrained 17-year-old boy

    It'll be interesting to see what happens seeing as Dunwoody is a relatively small city without a fire department. Dekalb County Fire used to do all EMS transports before this AMR contract, but I'm not sure what Dunwoody can do on its own if the whole county doesn't follow suit.
  13. MonkeyArrow

    EMT seen on video beating restrained 17-year-old boy

    This has been a long time coming. Dunwoody is in Dekalb County, which AMR has the primary 911 contract for. AMR has missed contractually obligated response times and has been struggling to get an adequate number of trucks on the road for a while now. Low morale, chronically understaffed...
  14. MonkeyArrow

    the 100% directionless thread

    Coachella?
  15. MonkeyArrow

    the 100% directionless thread

    Your new pitcher/hitter extraordinaire that you poached from the Braves...
  16. MonkeyArrow

    Patient refusal

    The bolded is an important distinction.
  17. MonkeyArrow

    Diversion

    I don’t explicitly know who this is on this forum (although I think I can hazard a pretty good guess), but I wonder if the tone here is different because some of the regulars “knew”/knew him. I’m not necessarily implying anything, but if this same story about Joe Blow was posted on here, I think...
  18. MonkeyArrow

    Prehospital antibiotics

    The ADRENAL trial result was discussed at the Critically Care Reviews conference in Belfast just recently. The gist was no improvement in mortality with steroid therapy, but decrease in surrogate clinical endpoints like ventilator days and I believe vasopressor requirements. There is a lot of...
  19. MonkeyArrow

    Student question about Tidal Volume!

    To accurately determine a person’s tidal volume, one would usually expect the patient to be on a ventilator, or otherwise in an outpatient setting, by a pulmonary function test.
  20. MonkeyArrow

    Another mechanical CPR study abstract

    I'd like to know what specifically this sentence means and whether they adjusted for this in their regression model.
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