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Talk about complex medical cases. This is what I refer to when I say oftentimes the "critical trauma" Mongo brags about bringing in ends up way sicker from the physiological cascade of no-goodness that unfolds in-hospital more often than not; it's sad, really.
My fav contraindication.@Summit admittedly I had to google-fu CPM, so thanks for sharing
Also, as far as DI, and SIADH how often are you all ICU's nurses seeing this in-hospital? Are there any major pointers aside from an acute perception of the patients medical history to tip prehospital folks off?
I find endocrine disorders remarkably fascinating and can't help but wonder how often they're missed by us out-of-hospital folks.
And just 'cuz it's fun to say...pheocromocytoma anyone?
No grant money, we are a federal agency so it just comes out of the overall budget for supplies.
We currently are planning on carrying 3% saline, but it may change to Sodium Bicarbonate instead in the protocol. We have a unique demographic for most of our patient population being military and on a training installation. We see some things that most others don't see on a regular basis, but the reverse is true too. Most common complaints like chest pain and true SOB calls are less likely for us. We also do a lot of rectal temp monitoring for our heat patients and have chilled saline and iced sheets to cool patients. Will definitely update once we start the protocol and how the iStat machines handle in the field. Some of the "roads" we go down are nothing more than dirt between trees, so we get rocked around in the ambulances a lot.@luke_31 are you guys going to be carrying HNS at your service as well? That's interesting that it's a priority demographic in your region.
Keep us posted on the results
Maybe, since we are directly attached to the ER at our hospital it would be the same machines and they are used to treating patients that we bring in directly on what information we gather in the field.
Neither do we, but we don't have a say on this
We have one for our MIH program. In order to bring patients directly to psych facilities we have to run a Chem 8 on them. We don't do it while moving, but it's held up pretty well especially since it's in an big pelican case. Also, it does not like cold. At all.
Depends what you mean by that. We don't have a CLIA waiver that would allow us to make destination decisions based on labwork alone. However, we nonetheless developed a checksheet for admission of mental health patients and one of them is "lab values within normal ranges." There is still wiggle room if the provider does not think they lab value is concerning (ie BGL of 180).
Apparently we require something called a moderately complex waiver. That's about the end of my knowledge of it, our community paramedic guy knows these things (or at least I think he does).