Forgot oxygen

[Handsome Robb]

That's what my I instructor I've had for the past year has drilled into my classss head treat the patient not the devices. This was especially true during cardiology class.

Clinical correlation. They don't give us all these tools for no reason. We use clinical findings along with quantitative and qualitative measurements to treat our patients.

Example: patient is aysmptomatic with minor complaints yet in VT on the monitor, what do you do?

 

[Aidey]

I'd be much more concerned about the first patient than the second.

HOWEVER...

The sentiments about NOT treating the monitor/number are correct. You have to take all the clinical informatin you have and put it altogether. If you simply treat a number or an EKG trace, all by itself, with no other data to correlate it with, then you're foolish.

Arguably taking into account the pts age, past history (diabetes) and gender are clinical information you can use to interpret the test results you get.

 

[usalsfyre]

I'd be much more concerned about the first patient than the second.

HOWEVER...

The sentiments about NOT treating the monitor/number are correct. You have to take all the clinical informatin you have and put it altogether. If you simply treat a number or an EKG trace, all by itself, with no other data to correlate it with, then you're foolish.

The key word you said is correlate. Treating a single assessment tool is indeed foolish.

However, what I've seen far too often in "I treat the patient" medics is a tendency to simply ignore electronic assessment aids that don't "fit" their impression of the patient rather than go back and reevaluate if their impression is flawed.

 

[JPINFV]

I'd be much more concerned about the first patient than the second.

HOWEVER...

The sentiments about NOT treating the monitor/number are correct. You have to take all the clinical informatin you have and put it altogether. If you simply treat a number or an EKG trace, all by itself, with no other data to correlate it with, then you're foolish.

You're equally foolish if you just disregard what your assessment tools tells you just because they're run by a battery.

 

[JPINFV]

Clinical correlation. They don't give us all these tools for no reason. We use clinical findings along with quantitative and qualitative measurements to treat our patients.

Example: patient is aysmptomatic with minor complaints yet in VT on the monitor, what do you do?

According to the TV show Trauma, you check to make sure they aren't shaking a lead.

 

[ZootownMedic]

Clinical correlation. They don't give us all these tools for no reason. We use clinical findings along with quantitative and qualitative measurements to treat our patients.

Example: patient is aysmptomatic with minor complaints yet in VT on the monitor, what do you do?

WELD EM BRO! MAX joules!

I actually had a fire medic the other day who thought a pt was in V-fib. When we explained that the pt had palpable carotids and BY GOD radials TOO!....he still didn't care because he was seeing 'V-Fib' on the monitor. Thank god we were there for THAT pt.......

 

[OzAmbo]

I'd be much more concerned about the first patient than the second.

HOWEVER...

The sentiments about NOT treating the monitor/number are correct. You have to take all the clinical informatin you have and put it altogether. If you simply treat a number or an EKG trace, all by itself, with no other data to correlate it with, then you're foolish.

Are you advocating ignoring a half of your assessent to concentrate on the other half of your assessment?

Either way its a half arsed assessent :blush:

No one its saying ignore you assessment tools, everyone is saying perform a thorough assessment using all the tools available and then make a clinical decision. No one here, ( and ive seen qiute a few of the people in this thread over in EMT city fighting the good fight for a few years now) is saying treat a single monitor

I have to ask though, if that single ECG trace did not fit the rest of the clinical picture, would you reject it?

 

[KellyBracket]

I guess I'll treat the dead horse.

Had a medic bring in an intubated patient. His monitor had inline ETCO2, so rather than confirm lung sounds myself, I just asked him for the numbers and waveform.

He replied "You know, I think it's not working right. Couldn't get anything above 5, but the tube is in the right place, I could tell."

The ETCO2, it turns out, was working just fine.

We have monitors, tests, and imaging precisely because our clinical skills have limits. Yeah, sometime I have to treat the monitor, because it's better than me.

 

[EMTNJA]

Have to agree with others.

Any sort of Cardio/Respiratory complaints. HTN, CVA, CP, DB, SOB, all need immediate application of supplemental O2. Stable usually 2-4 lpm NC, unstable 15 lpm NRB. Vitamin O is a great drug, as well as making most pt's feel like we're doing tangible things for them. Calms them down immensely.

 

[STXmedic]

 

[NYMedic828]

Any sort of Cardio/Respiratory complaints. HTN, CVA, CP, DB, SOB, all need immediate application of supplemental O2. Stable usually 2-4 lpm NC, unstable 15 lpm NRB. Vitamin O is a great drug, as well as making most pt's feel like we're doing tangible things for them. Calms them down immensely.

This is not the way to do things. What are you achieving by giving oxygen to someone with hypertension?

The only people I usually put on a cannula are those on one already home...

 

[Medic Tim]

Any sort of Cardio/Respiratory complaints. HTN, CVA, CP, DB, SOB, all need immediate application of supplemental O2. Stable usually 2-4 lpm NC, unstable 15 lpm NRB. Vitamin O is a great drug, as well as making most pt's feel like we're doing tangible things for them. Calms them down immensely.

facepalm
I hope you aren't serious

 

[EMTNJA]

My bad HA/DZ, not HTN. Also many providers fail to use O2 on N/V pt's. works well in most cases prior to any emesis.

 

[usalsfyre]

My bad HA/DZ, not HTN. Also many providers fail to use O2 on N/V pt's. works well in most cases prior to any emesis.

I'm going to take a stab and say you haven't done much education outside your EMT class...

 

[NYMedic828]

My bad HA/DZ, not HTN. Also many providers fail to use O2 on N/V pt's. works well in most cases prior to any emesis.

Your methods are still facepalm worthy and completely in the wrong.

I have no idea what HA/DZ is an abbreviation for.

In my experience, nauseous patients get worse when put on an O2 mask and then when they need to vomit, they have a mask on their face.

If they are vomiting odds are their problem is not the result of inadequate oxygenation or ventilation. If they were that hypoxic they probably need more than a NRB anyway.



On the other hand, learning is what we are here for so I think it's time you read through the rest of the thread.

 

[Tigger]

Your methods are still facepalm worthy and completely in the wrong.

I have no idea what HA/DZ is an abbreviation for.

In my experience, nauseous patients get worse when put on an O2 mask and then when they need to vomit, they have a mask on their face.

If they are vomiting odds are their problem is not the result of inadequate oxygenation or ventilation. If they were that hypoxic they probably need more than a NRB anyway.



On the other hand, learning is what we are here for so I think it's time you read through the rest of the thread.

Well this pretty much sums up what I was going to say. The next time you've got some nausea try putting a tight fitting mask over your face with very dry air coming out and tell me if that makes you feel better?

 

[NYMedic828]

Well this pretty much sums up what I was going to say. The next time you've got some nausea try putting a tight fitting mask over your face with very dry air coming out and tell me if that makes you feel better?

I put all of my patients on humidified O2. (not serious)

 

[medichopeful]

I have no idea what HA/DZ is an abbreviation for.

Wikipedia (so take that for what it's worth! :rofl seems to suggest "HA" is "headache." "DZ" from the same place is "disease," though I'm guessing here it means "dizziness" :wacko:

 

[NomadicMedic]

I put all of my patients on humidified O2. (not serious)

I use ginger flavored O2. It helps prevent nausea. Kids get bubblegum flavored O2.

Also not serious.





...but, think of how cool it would be.

 

[Anjel]

I use ginger flavored O2. It helps prevent nausea. Kids get bubblegum flavored O2.

Also not serious.





...but, think of how cool it would be.

One of the medics I worked with told a pt the o2 was infused with a pain reliever.

Wrong on all levels. But made her feel better. I giggled.