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    Prehospital Lactate Meters

    Is anyone using lactate meters prehospitally? I'm looking for sepsis protocols involving them. Actually, any and all first hand accounts. Pros/ cons etc. Thanks in advance
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    Some Pediatrics

    Good point. I see what you're getting at.
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    Some Pediatrics

    Sorry. No zebras here. What ultimately ended up happening was, we t/p the pt in a position of comfort to the hospital that performed the surgery without any complications. I had never heard of a B.T. Shunt and asked what it was and for. Mom didn't know exactly what it was, but said that it was...
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    Some Pediatrics

    agreed. You assume it's a VP. Shunt and look behind the ears to find nothing. No scars. No bulbs. Nothing. In the back of the ambulance you attmpt and get an IV on the 1st attempt. Your thorough and get a BGL: 97 mg/ dl. You KVO the fluids and begin t/p to the facility where he had the shunt...
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    Some Pediatrics

    Walking up to the child you observe that he is ~ 18-20 kgs and is in no apparent distress. As mentioned before dressed appropriate for his age and the weather. He is clean and is neither under or over weight for his age. He is not tripoding there are no supraclavicular retractions. He speaks w/o...
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    Some Pediatrics

    3 floor apartment building with a separate apartment per floor. First 2 floor hallways could be better, could be worse. The apartment you're in is clean and well kept. It is the grandmother's residence and appears to be a central meeting point for her family. She is "grandma day-care" while mom...
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    Some Pediatrics

    No last night: partially digested vomitus. This afternoon clear fluid. No frank blood. Mother reports last PO was an attempt at water which promptly came back up. Apparently what goes down, comes back up ... No other reported pain/ discomfort, just the (assumed) nausea and PO induced...
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    Some Pediatrics

    First time presenter, long time reader. It won't be the most challenging of scenarios, but will hopefully bring up some interesting learning points. If you're BLS, play BLS. If you're ALS, play ALS. I'm going to attempt to present this much akin to the wise folk over at Flightweb. If you...
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    Dumping syndrome and other gastric bypass maladies

    Absolutely fascinating. Didn't know there was a name for it. Seen it first hand w/ a colleague. He had the surgery 5-10 years ago, had his gall bladder out shortly there after, had problems w/ his inability to eat healthy and has been going up and down w/ his weight ever since. However, once...
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    Will it get better?

    At some point you're going to have to stand up for yourself. What I mean is that you are going to run into a patient care situation where someone wants to do something detrimental to your patient. You, as the patient advocate, are going to have to stand up, grab your coin purse, and put an end...
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    My Patient or A Patient?

    If the person in question actually needs an ambulance and by default an Emergency Room, it's "My patient" even after transfer of care. If said person doesn't need anything, they become the non possesive "the patient".
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    Scenario: The Chronic Cab?

    Great idea. One that's been toyed with and talked about in my (very) busy Dept. There really are no down sides providing, as you stated, the operator of the sub-acute van be an EFR or EMT. The problem initiating this is having a strong medical director who is able to implement it and ward off...
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    76 y/o M - Hypotension

    Do you have any idea what meds he was on? Further, was the ascites new onset or a chronic condition. We had a pt not long ago who was non-compliant w/ his diuretic and the "extra" fluid accumulated into his scrotum. (think basketball) Similar to this pt, he had no complaints (save when he sat on...
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    Spinal Immobilization and Cardiac Arrests

    Confucious say "a dead man complains not, about being paralyzed"
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    Another Firearms Scenario

    Is keep rolling up the window and drive away an option?
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    capnography questions

    http://emscapnography.blogspot.com/ Here's another rescourse for y'all
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    Trainwreck #5

    I'd also consider a neonatal dose of naloxone see if that picks up the respiratory drive.
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    Trainwreck #5

    I don't think it was mentioned, maybe it was assumed, but bulb syringe the little one, also would like a heel CBGL.
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    ECG Strip: Strange QRS Complexes

    undiagnosed atrial septal defect? (crochetage (sp?) sign?)
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    Trainwreck #5

    time to do some prep before t/p begins: find and dust off the OB kit(s) turn the truck on and turn up the pt compartment heat find/ make sure I have blankets/ means to warm/ keep warm a newborn find the mec aspirator and make sure the suction is working start a second peripheral access w/...
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