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How would you guys treat a renal failure pt with sepsis and or hyperglycemia? The same as any other septic or hyperglycemic patient, however, fluid administration is slightly different. Non-renal failure patients usually receive 30ml/kg LR or NS. Fluid sensitive patients recieve fluid over a...

Hilarious, would be nice to skip a 3 year CRNA DNP program along with the 100Ks of tuition.

Very interesting, 12 lead doesnt look like a STEMI, they probably correllated it with " high" troponim levels that were mentioned. Trop was probably elevated due to demand ischemia from tachycardia. With the abdominal pain and gallstones, sounds like he was in septic shock. Levophed is the go...

X shears cut through anything like butter.

Sounds like PE, given the recent pelvic injury and ORIF. Who knows how long we was immobile, if at all. He'll get CT Angiogram to rule out PE in the ED. Pulmonary embolism can present different especially when they get into the submissive, massive size.

Grind it out man, you really want that house, you want out of that neighborhood, suck it up! Were pretty privileged over here complaining of moods, whats for lunch, mental health, etc. Meanwhile, there's people that would die for our wages and hours. Just ranting, our family used to pick fruits...

Tina and Laurie were some badass nurses, used to work with them in the ED before they went CCT/ Flight. They will be missed.

Oh I believe you. Way cheaper than leaches, especially if you have that 14g or cordis. Always make sure you titrate to a MAP>65 or SBP >90. 😆 🤣

Palomar college in San Marcos, CA has an RN to Medic courses, they may be able to assist with clinical placement. Very reputable P and Fire Programs. I've looked into this program along with Creighton University. I'm an RN with SICU/ED/EMT- B background. I love the schedule and pay of my...

No, sounds like a straight forward immunocomprimised PNA patient. BP is high but, not urgent unless the patient is showing signs of end organ failure along with the HTN. What is ALS generally doing nowadays for HTN emergencies/urgent hydralazine, labetolol IVP? Cardene drip 🤔

Wow, there are definitely specific policies in place that prohibit visitors from entering healthcare facilities. We don't allow anyone in our ICU/ED unless it's end of life. The Quality of care that some of these Fire Based agencies in San Bernardino is second class. Used to run calls with...

Yes they do, especially those ED nurses. Large majority have no clue what type of training goes into EMS providers. However there a nurses,MDs, and PA's that were prior EMT/P. We appreciate you guys.

Sounds like your in a pickle, I would opt for the jab brother, sound like a pain in the *** to deal with testing and so forth. We just admitted a few patients for ECMO due to unvaccinated COVID. Would hate to see you with rectal tube, foley, dobhoff FT, OG, Cordis, Central lines, PRONED...

Lead III, AfV elevation with reciprocal in AVL, Inferior MI irritated the **** out of the ventricle resulting in VTACH. In my experience Most inferior MI involves the right ventricle. This is one of the main reasons nitro shouldn't be given to Inferior MI, You will drop your pressure...

I've seen the "pt circuit" alarm due to flow sensor problems, due to the pts neuro status,, maybe APV/CMV mode would have been more appropriate than AC mode?

Prior to switching careers I had the same doubts. I suffered with severe social anxiety, alcoholism(not out of the woods yet), and depression. I remember having severe panic attacks prior to going to EMT class, self medicating etc. It was bad, I almost tapped out, but as time went on and the...

Accurate BPs are difficult to obtain in the obese patient. I had an obese septic,.intubated patient once, BP cuff could not get a pressure and was very labile 60s to 140s,.wtf. How can I titrate pressors and sedation with an inaccurate pressure!? Pain in the ***. I told MD to put in an A-line...

That's non-sense. Is "compounding" specifically for syringes? In the ICU we often y-site many sedatives/opioids together and pressors as well, we verify compatibility, and our database states Y-SITE or SYRINGE. Whether it be on peripherals or CVCs. How else would we give the B-52 shot? , 3...

Border town , California

What part of this was tool-like or disrespectful? Our patient population is 90% hispanic and we call mostly all the elderly female patients " mamita". Its a term of endearment/ respect. Most of our staff are Filipino or Hispanic , myself included.