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Oh this could be fun. I'm not currently working in the EMS field but will be soon (hopefully), provided I pass my NRP practical. With that being said, I'm pretty familiar with the MA state protocols, and these are the things I'd change: -Implementation of a hospice/comfort care protocol, with...

In fairness, if he was able to get a crying, vomiting 2 year old to hold still for an accurate 12-lead, he is probably a better provider than 90% of us on this forum.

If you have a patient who is hypokalemic and needs fluids, the fluid of choice would be something containing potassium. Fluids without potassium could lead to a further decrease in potassium levels through dilution or other electrolyte shifts. You also mentioned concerns over making the...

ABGs.

http://www.medscape.com/viewarticle/543590_2 Perhaps this will help? Seems to be called "orthostatic hypertension."

Sounds like a seizure and/or stroke.

It can't be stressed enough that this was the right thing to do. If you're not sure if there's a pulse, it's much better to do CPR. It's better to do CPR on someone who did, in fact, have a pulse that wasn't detected than it is to "assume" you had a pulse (even if you weren't sure) and to...

You made the right call! And very well may have saved this person's life. Nicely done. In the situation you described, CPR was absolutely the right call. It's impossible to know whether the patient was truly in cardiac arrest, but since you were not able to detect a pulse in a completely...

Welcome to the forum! Let me take a few minutes to give you some hints to make your stay more education and enjoyable: 1) Congrats on your accomplishments and furthering your education. Seriously. With that being said, if this is the attitude you have as a student, you're going to be in for...

It's those damn potlucks

I own firearms. I may or may not carry on personal time, but that's not something that I will discuss on a public forum beyond that. I would never, EVER carry while working as a medical provider. I'm not going to carry while working as a nurse in a hospital, I'm not going to carry while...

Probably not a good idea to start giving insulin without a full electrolyte panel. The treatment for a "hi" BGL isn't necessarily just insulin. It's slightly more complicated than that.

Let's get the family and medcon (and/or the patient's healthcare provider) involved before we rush to transport this patient. A 90 year old DNR/DNI in cardiogenic shock with a pressure of 65/42 isn't necessarily someone we want to be super aggressive with. In all seriousness, letting the...

What's the surgical site look like? Bruised? Hot? Tender/swollen? I'm a bit concerned about re-bleeding and don't necessarily want to just give this guy ASA until we dive further into this, even with the chest pain. Left-sided EKG?

I'll be 100% honest, vent management is a weak point of mine and I'm currently studying up on it to improve my knowledge regarding them (at my current job, we only mess with FiO2 in emergencies and the alarm silence button, the most important button there is). With that being said, I do know...

I definitely agree that with prehospital therapies it wouldn't matter (unless we had more info, like labs and ABGs). The RR is borderline, so I don't think there's anyway to tell without lab work like you said. I was just curious if I had missed something that you had picked up on!

What's your thinking on HHNK as complared to DKA Vent? If you're thinking that he's in metabolic acidosis, I'd lean more towards DKA than HHNK. Any idea what the EtCO2 was? And do we have access to an iStat by any chance? :cool:

Another way to practice is to take a radial pulse, pump the cuff up until it disappears, then start decreasing the pressure until you can feel the radial pulse again. At that point, you should be able to hear what you're looking for at the brachial artery. As far as the thumb thing goes, it...

This. I'm jealous of services that have the iStat, and I personally think it would be awesome to have the EC8+ cartridge. Basic electrolytes and VBG/ABGs (though not complete), along with H+H.

What does your system consider a CCT? I agree, the simple "IV, O2, monitor would get pretty boring pretty quickly, but I personally also wouldn't consider that a true CCT.