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I considered making a quiet post about natural selection taking it's course here, but instead... please ask them not to do this, although best of luck getting anyone to listen to you that has powdered your rear anytime in the last 50 years. -B

Of course, not really enough to go on. Several psych meds have extrapyramidal side effects, even at normal serum levels. Not that it matters, but did you pursue what the patient meant by 'weakness' and what he meant by 'dizzyness'? Weakness could be fatigue or musculoskeletal weakness...

Absolutely a good point about the Narcan. Meclin, adding etoh to a bzd opens up a whole new area of bad-ness. Take a few and read up on it, tell us if you think it fits your profile. tc -B

I've not endorsed narcan on this patient, I think you are correct about not using it. Treating this patient with diesel would be ideal, especially when you are 4mins from a hospital. Effexor has been shown to cause atrial fib along with other arrhythmias ->...

If it had been pontine hemorrhage, what are the chances he would be down a while at GCS 3, then sit up in the ambulance and pull out the tubes then 10 mins later fall back to GCS 4? If his skin is hot to the touch as mentioned later in the post, I'm still very much leaning toward NMS...

Tricyclic overdose typically results in anticholinergic effects, which would include mydriasis, not miosis. (Of course wouldn't want to diagnose based on that), so i'm leaning away from TCA overdose. Xanax overdose produces CNS depression (miosis & respiratory depression), arrhythmias...

No idea on the first one. The second one, if you assume that the patient has asthma (why are you preparing albuterol?) then when wheezes stop, the patient is in ventilatory failure. I'm not sure I like the question, but I base the answer on this: Michigan EMS Expo 2004 ; Bob Page, AAS...

Please be cautious: Ginko : interacts with anticoagulants (Warfarin/coumadin, ASA, and some herbal anticoagulants) Gensing : interacts with anticoagulants and MAOIs St. John's Wort : Many interactions, including those used to treat HIV. It is an inducer of CYP450 - see the list of drugs ref...

I understand the feeling behind this type of post, but I'm unsure about the appropriateness of making decisions on letting patients die simply because they 'might end up in the trach and peg club'.

Been busy, but relatively happy :)

Thanks for serving. I don't know what access you will have to medicines, but if you think you may have some that are unfamiliar to you, you may want to consider a tarascon pocket pharmacopia as well. It is about half the thickness of a deck of cards but has a tremendous amount of information...

Sorry, wasn't paying enough attention, I was just thinking about localized v/q totally missed that his question was about generalized hypoxic-vasoconstriction.

Currently, there are some theories on why this happens, but the full pathways have not been discovered. I just find it easiest to remember, if a portion of lung won't oxygenate, better that blood be diverted elsewhere so it can pick up some good 'ole O2 stay safe -B

Such a tired old cliche, when will "narrow minded" & "intolerant" end up in the same stack with calling someone a "nazi" and show that you have already lost your argument a la Godwin's Law Just because someone disagrees with you does not necessarily mean they are narrow minded nor intolerant...

Policy will differ between jobs and I'm no expert on policy. Just remember, in an emergency situation: 1. You have a very small amount of time to gain the trust of the people on scene. Beware of anything that might inhibit interactions with others. 2. Any scene can be dangerous, excess...

A big cuff can lead you to a falsely low reading, but I suspect that the number you got was more related to the method used to obtain it. Make sure you get with someone to ensure you are using the steth and cuff properly, especially if you have trouble getting pressures on multiple patients...

By the time AIDS patients need medications, most of them go on disability due to the extreme costs of the medications required to treat their disease, which can easily exceed $1200 per month. So we are actually paying for these people already, just via a different system. I may have...

Have to admit, I've seen this. White picket fence, 1 part through a certain part of the male anatomy and another part through the perineum. Didn't come in for it for several days. (why???!!!) He also was running from someone and should've used the gate.

Gonna have to read up on this! apparently more has been found since I last studied it. Great discussion -B

Good clarification and I like that website. The only thing I would disagree with (and it's a meaningless distinction for those providing emergency care) is about Broca's area. It probably shouldn't be considered a motor disorder as Broca's is responsible for sequencing and syntax, the final...