RocketMedic
Californian, Lost in Texas
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I had my first one *ever* today, pretty psyched, but I made a few mistakes.
1. I tunnel-visioned. My FTO said he needed to see me tube, which I then missed. Not good. (As an aside, I'm having a tough time finding initial anatomy/landmarks, and I'm having an even harder time aligning axis. Any tips?
2. As a direct result of tunnel vision, my scene control sucked sort of- fire did a great job on compressions, but I should have asked my partner to get either the tube or the IO instead of me trying both.
3. Patient kept converting from perfusing rhythms to VF/VT and back with defibrillation, and thus my medication times are odd. I'm sure eyebrows will be raised.
4. Defibrillations were good and aggressive, with 8 defibrillations in all, with 210mg amiodarone total and only 1 epi. I'm fairly certain that the epi didn't mean a thing, but the amiodarone *may* have helped.
Sustains: IO access, great compressions by fire, good ventilations, and aggressive electrical therapy.
Improves: Better intubation technique- be more aggressive with moving the patient's head/body to align axis.
2. Delegation.
I'm sure there's an argument for timely medication in there, but I don't think that medication influenced this one way or another as-is, and I don't know if we would have had similar results with epi. With our patient's constant changes in perfusion and rearrests, I was reluctant to start with the epi cascade.
All in all, I think the credit should go to the BLS fire guys. Great compressions and Edison did the miracle-working on this one.
Now I just have to hope I pass my internship...patient is apparently still alive and talking as of EoS.
1. I tunnel-visioned. My FTO said he needed to see me tube, which I then missed. Not good. (As an aside, I'm having a tough time finding initial anatomy/landmarks, and I'm having an even harder time aligning axis. Any tips?
2. As a direct result of tunnel vision, my scene control sucked sort of- fire did a great job on compressions, but I should have asked my partner to get either the tube or the IO instead of me trying both.
3. Patient kept converting from perfusing rhythms to VF/VT and back with defibrillation, and thus my medication times are odd. I'm sure eyebrows will be raised.
4. Defibrillations were good and aggressive, with 8 defibrillations in all, with 210mg amiodarone total and only 1 epi. I'm fairly certain that the epi didn't mean a thing, but the amiodarone *may* have helped.
Sustains: IO access, great compressions by fire, good ventilations, and aggressive electrical therapy.
Improves: Better intubation technique- be more aggressive with moving the patient's head/body to align axis.
2. Delegation.
I'm sure there's an argument for timely medication in there, but I don't think that medication influenced this one way or another as-is, and I don't know if we would have had similar results with epi. With our patient's constant changes in perfusion and rearrests, I was reluctant to start with the epi cascade.
All in all, I think the credit should go to the BLS fire guys. Great compressions and Edison did the miracle-working on this one.
Now I just have to hope I pass my internship...patient is apparently still alive and talking as of EoS.
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