first call of the day is...

Handsome Robb said:
First call in ten months is a mechanical fall with a fractured hip and refused pain management.
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Now you broke your hip?! You have very bad luck haha
 
First ED walk in while I was on last night was a case of chicken breath secondary to abdominal pain. The good sir was sort of holding his breath because of the pain, family was freaking out (but negative hispanic panic). He was satting about 88%. NC O2 on board, coach breathing, solve that problem. Later Dx is kidney stone.
 
DesertEMT66 said:
Now you broke your hip?! You have very bad luck haha
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Hahaha. I'd go ballistic.

We're posted right now about an hour into a 16. Yesterday was pretty uneventful, we'll see what today brings.
 
Handsome Robb said:
Hahaha. I'd go ballistic.

We're posted right now about an hour into a 16. Yesterday was pretty uneventful, we'll see what today brings.
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Hope you have a nice slow.shift lol
 
Yesterday was an inferior STEMI at an urgent care
 
Femur fracture from fall.
 
Postictal from seizure (GCS 1-1-1) incontinent (of course, fortunately only code yellow, no code brown) laying fetal position on the floor next to his bed at the kind of SNF that makes you want to petition to ban the word "skilled"
 
N/V/D x 1 hour. 12mg Zofran had zero effect
 
You guys carry 12 of zofran? We have 8 and have to call for orders to give more than 4.
 
we have 4mg vials and tabs but the most we can give is 16. our system is a mixture of rural/urban though so our protocols are fairly liberal in a sense.
 
Anjel said:
You guys carry 12 of zofran? We have 8 and have to call for orders to give more than 4.
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We carry a crap more than 12mg. The last time I looked we had 10 ODT and around 8 4mg vials. Our standing orders are for 12mg max total before base contact
 
Dialysis
 
DesertEMT66 said:
We carry a crap more than 12mg. The last time I looked we had 10 ODT and around 8 4mg vials. Our standing orders are for 12mg max total before base contact
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Do y'all not carry phenergan? I've noticed that for patients who are actively puking it works better. Zofran is amazing for nauseous patients though
 
TransportJockey said:
Do y'all not carry phenergan? I've noticed that for patients who are actively puking it works better. Zofran is amazing for nauseous patients though
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Negative. Our only option is zofran.

Remi said:
12 mg? Really?

Zofran doesn't work in those situations.
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I've had mixed results with doses up to 12mg. It either works extremely well or doesn't work at all.
 
DesertEMT66 said:
I've had mixed results with doses up to 12mg. It either works extremely well or doesn't work at all.
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I'm not surprised that has been your experience. Studies (and overwhelming anecdotal evidence) show that repeated doses have very little efficacy.

Because ondansetron has a relatively slow onset (10-30 minutes), I think what people are often seeing when repeat doses appear to work is just the first dose finally taking effect. You see the same thing with morphine when you dose it every 3-5 minutes....people end up getting huge doses of it when the initial dose or two probably would have worked fine, had they just let it take effect before re-dosing.

Ondansetron is a great prophylactic, but not a good rescue drug at all.
 
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