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If you are asking if she has the right to refuse, the answer is yes, because she is alert and oriented. Not knowing the exact date is ok. The fact that she does not remember the event is significant, but it does not mean that she isn't now alert and oriented. You also need to ask yourself if she...

It's not offensive to wear a mask, but why not just breathe through your mouth? You can't smell anything if you breathe through your mouth and not your nose.

This is actually a situation where an EMT can make a big difference in a patient's life. EMT's (and nurses) freak out when they see a very high BP. The important thing to understand is that this is not an emergency and no, you don't need to talk them into going to the ER because that will be a...

I'm researching pre-hospital care in Australia for a school project. Is there anyone here who works in Australia?

LOL. You mean like hyperkalemia?

Brain swelling and herniation will kill the patient without treatment. I understand what you are saying, but with one or two 100 ml boluses of hypertonic saline, or the equivalent in sodium bicarb, is not going to cause osmotic demyelination, especially not in an acute hyponatremia. You are only...

Why not just give it based on the history alone? Say there's a marathon going on and you had a healthy young runner with no history of seizures come into the ER actively seizing. If he is refractory to all the treatments done on the ambulance and in the ER, are you going to watch him seize for...

Yes, give it over 5 to 10 minutes like hypertonic saline

I'm surprised no one got this. There is something most paramedics carry that would work for hyponatremic seizures. It's also in every crash cart.;)

ER Doc, what would you do if your nurses told you they needed to wait for the pharmacy to bring down the 3% saline? A lot if ERs dont have it stocked.

You dont have any hypertonic saline on your ambulance. The seizures are refractory to your benzos. You are 45 minutes from an ER. What can you do?

A supervisor comes in and tells you that she was supposed to be on fluid restrictions. He states that the patient on a previous stay had to be taken to the ER and was hyponatremic." Now that you can be fairly certain that the patient is hyponatremic due, what would you like to do? she is still...

The tech says, "Yeah she was always at the drinking fountain. So weird!"

No vitals available since she is seizing. Blood glucose: WNL A mental health worker tells you that just yesterday she began getting an increased dose of Risperdal. She has been there a week and no meds were stopped. She is a paranoid schizophrenic and has not been eating much because she...

You are called to a psyche facility for a patient who has had multiple seizures. The patient is a 50 y/o female on a 14-day hold and has a history of paranoid schizophrenia. As you walk in, the patient is actively seizing. Staff is available for any questions you may have.

"There were medics who came forward in Canada and had their licenses pulled." Huh, what? This idea that seeking treatment for depression or anxiety related to your EMS job will get you fired is nonsense. Your employer does not have a right to monitor your medical records. Nor would an employer...

It is important to keep setting future goals for yourself. Right now you are focused on medic school, but in the future you may try to advance your education or achieve some other goal. It is also important to understand that EMS is a job, and that you aren't supposed to love every minute of it.

Actually, I think what this guy really needs is a transvenous pacer. His circulation has clamped down to compensate for his severely compromised heart rate, and now his tired old heart is having to pump against a massive systemic vascular resistance, the SVR being the only thing in the equation...

I saw the same thing once on a patient who was asystole and never got ROSC. Maybe someone has an explanation for this?

Is he stable? He's good a cardiac history, having excruciating chest pain, and is really hypertensive.